Geriatrics

Ethnogeriatrics

Microlectures

Microlecture 018: Should We Sugarcoat Bad News?

There is a lot of debate about how to give bad news to a patient in a culturally respectful manner. Some cultures value direct communication without any frills. Other cultures prefer to be more subtle. In certain cultures, the family will not want the patient to ever know the bad news about their condition.

What are the pros and cons of giving bad news in a subtle and oblique manner? Is there a benefit to shielding the patient from their diagnosis and prognosis?

VJ Periyakoil, MD, Stanford University School of Medicine.

Tweet to us: @palliator

Microlecture 017: The Role Of Therapeutic Touch

My colleague, Prof. Abraham Verghese,  (a big proponent of the physical exam) jokingly told me once that the modern-day doctor needs an X-ray to diagnose an amputation!

What is the need to do a physical exam in a clinical encounter? After all,  we get so much information about the patient from lab work, imaging studies, and other tests and reports that one can argue that the physical exam may not be required or at best it plays a minor part in the clinical encounter.

I firmly believe that the physical exam forms the bedrock of the doctor-patient relationship. Firstly, if we did a focused physical exam, we might not need to subject the patient to so many lab tests and procedures. Secondly, beyond the obvious diagnostic value of the physical exam, it has a more subtle and deeper therapeutic significance. A careful physical examination, done respectfully, strengthens the doctor-patient bond and improves patient engagement with their own wellness and health.

VJ Periyakoil, MD, Stanford University School of Medicine.

Tweet to us: @palliator

Microlecture 004: Talk Directly To The Patient

This micro-lecture addresses patient rights. When the patient has Limited English Proficiency, how can we ensure their right to access all the information about their healthcare? Don’t they still have the right to take advantage of the therapeutic bond that should exist between every doctor and the patient? How can we decrease the psychological distance between the clinician and the patient? What are some simple steps we can take?
VJ Periyakoil, MD, Stanford University School of Medicine. Tweet to us: @palliator

Microlecture 016: How To Make The Medical Interpreter Feel Respected and Engaged

How can we make the MI feel more included in the clinical encounter?

Lot of times, the medical interpreter is walking into a sensitive situation and they can be caught off guard and feel disconnected from the encounter.

How can we ensure that the Medical Interpreter (MI) feels more included in the clinical encounter? Often, the MI enters sensitive situations and may feel caught off guard, leading to a sense of disconnection from the encounter.

So, how should we provide them with context to better prepare for these situations? Moreover, are there specific challenges where the MI can be of assistance?

For instance, imagine a scenario involving a loving yet opinionated family member who prevents the patient from having a voice in their care?”

VJ Periyakoil, MD, Stanford University School of Medicine.

Tweet to us: @palliator

Microlecture 015: What are the 2 Things a Medical Interpreter Needs to Know Before the Clinical Encounter

In any clinical encounter involving a patient with Limited English Proficiency, both the clinician and the medical interpreter need to prepare for the encounter.

The MI needs to know two things:

a. Standard logistics issue: which venue, which patient and what is the subspecialty so they can come prepared to interpret the medical terms.
b. Context of the encounter, the goals, and the agenda.

The question is this: whose job is it to give all this information to the MI? Are there some aspects they can glean before the clinician arrives for the encounter or is it the job of the clinician to tell them everything? Watch the video to learn more.

VJ Periyakoil, MD, Stanford University School of Medicine.

Tweet to us: @palliator

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