Medical importance of taking an extensive “Patient History”

While this video was created from a recent interview with a top gastroenterologist to shed light of the Diagnosing Difficulties involved with Inflammatory Bowel Diseases (IBD) such as Crohn’s and Ulcerative Colitis, it is directly relevant to the current Ebola Outbreak because it reveals the diagnostic importance of taking a simple, but extensive, “Patient History.”

In a technological time of seemingly pin-point medical diagnostic testing, I found this doctor’s candid revelation and productive “Patient History” technique to be comforting since I will never forget the almost 2-year “diagnosis journey” I embarked on to finally be diagnosed with Crohn’s Disease in 1984 at the age of 21.  Most times during that ordeal I found myself “defending” my seemingly unrelated symptoms to smug, smart doctors who only felt comfortable correctly diagnosing me if my symptoms perfectly aligned with a medical textbook definition of a disease which provided them ample legal “cover.”  Luckily, I met this doctor at the end of that journey but had we encountered each other sooner, his very simple, but smart, “Patient History” approach would have revealed I had a severe case of a very serious autoimmune disease which has ultimately disabled me at the young age of 51.  I only hope new doctors embrace this more humane approach because I fear fancy technological diagnostic tests may not always be the best or most extensive approach – especially when tracing “Contacts” in an Ebola Virus situation.

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This is Video 5 of 8 from my September 15, 2014 interview w/ Dr. Mark L. Chapman of Mount Sinai Hospital in New York City and focuses on the too-often long, arduous and stressful “diagnosis journeys” patients must take before they are properly diagnosed and treated for Inflammatory Bowel Diseases (IBD) like Crohn’s or Ulcerative Colitis.  Dr. Chapman explains how he combats this decreasing occurrence by taking a compassionate and extensive Patient History, conducting a Physical Exam and carefully combing through all that was done previously in a patient’s case.  While technological diagnostic testing for IBD is now state-of-the-art, the most accurate diagnosis still may depend on a simple, but thorough, Patient History.  In that regard, Dr. Chapman shares his incredibly effective techniques for taking Patient Histories.  (Prior videos from that Interview, are also on this Professional Patient Perspective Blog.)

 For more Information:

Dr. Mark L. Chapman
Susan and Leonard Feinstein
Inflammatory Bowel Disease Clinical Center
Mt. Sinai Hospital
1 Gustave L. Levy Place, New York, NY 10029
(212) 861-2000
 
Michael A. Weiss
Founder, Crohn’s Disease Warrior Patrol
www.TheCDWP.org
@HospitalPatient
@CrohnsIBDPatrol

“Top-down” v “Bottom-up” Inflammatory Bowel Disease Treatments

This is Video 4 of 8 from my September 15, 2014 interview w/ Dr. Mark L. Chapman and focuses on the current contrasting styles of treating Inflammatory Bowel Diseases, i.e., “Top-down” v. “Bottom-up.”  Dr. Chapman also explains how he most effectively interacts with Crohn’s Disease and Ulcerative Colitis patients.

© 2014 CDWP  /  Copyright 2014  /  CDWP  All Rights Reserved

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The CCFA’s “Escape the Stall” IBD Campaign is INSULTING

CCFA escapethestall Oct 17 2014

Typical Crohn’s Disease Flare-up w/ PAINFUL Sacroiliitis & Mouth and Eye Sores

I couldn’t sleep last night because my body is still coming down from the massive amounts of steroids it took last week to quiet my recent bout with Crohn’s Disease, an incurable, chronic,  autoimmune Inflammatory Bowel Disease, which simultaneously triggered, what for me, is a typical non-bowel related effect of my 30 years of Crohn’s Disease flare-ups, namely, incredibly painful episodes of Sacroiliitis during which the uncontrollable inflammation infiltrates my Sacroiliac Joint in my lower back and any bodily movement causes me such severe pain that I yearn for Michael Jackson’s personal physician to prescribe his special sleeping medication so I could rest without constantly moaning and groaning.

For those of you unfamiliar with the sensation of a severe Crohn’s Disease flare-up which does not involve an intestinal obstruction, which, incidentally is probably the most pain a human being can tolerate without passing out from an inability to ride the tides of the increasingly intense cramping cycles which threaten to perforate your intestine, I can only describe it as feeling like sharp razor blades embedded in your small bowel which make you feel their every movement they’re cutting into the sides of your bowel each time you merely “digest” some sustainable liquid like Gatorade.  It’s startling when it first happens because you logically deduce that some major bodily organ is terribly failing you but you know as soon as you get to an Emergency Room, all will be fine.  That is, until you arrive and quickly learn that IBD is just as much a nightmare for doctors and nurses as it is for patients.  Even when the most compassionate and well-intentioned doctors and nurses try to proactively treat your IBD to avoid such severe and unpredictable episodes, the side effects from those long-range medications can actually cause MORE physical, emotional and financial devastation THAN THE Crohn’s Disease or Ulcerative Colitis itself.  Throw in the accompanying unpredictable autoimmune-induced Sacroiliitis and the nasty and painful mouth sores which can also sometimes occur in your eyes, and the journey in and out of a bathroom stall is the least of your worries.

But here comes the Crohn’s & Colitis Foundation of America (CCFA) to the rescue with an “Escape the Stall” TV Campaign with the lovely and talented Amy Brenneman

Yet tonight I saw a mainstream television commercial made by the usually WONDERFUL Crohn’s & Colitis Foundation of America (CCFA) about how Inflammatory Bowel Disease can happen to anyone “you know” so you should “Please help them ‘Escape the Stall.’”  I imagine some would say any attempt at raising awareness of the deleterious effects of IBD, Crohn’s Disease and Ulcerative Colitis is a positive step in the right direction toward being recognized as a major problem for many people which warrants support.  This is especially apparent when the commercial ends with the brave Ulcerative Colitis patent, survivor, actress, writer and producer, Amy Brenneman, lending her immense credibility to the cause.  But Ms. Brenneman’s classy contributions aside, that’s like saying “any promotion on national television is good promotion” and when competing against so many other worthy healthcare causes such short-sighted thinking defeats the underlying well-intended purpose of the “Escape the Stall” campaign.

“Escape the Stall” is an INSULT to those w/ Severe Crohn’s & Colitis & could set back our legitimacy as a worthy Cause for YEARS

I fear associating a credo like, “Escape the Stall” with Inflammatory Bowel Diseases such as Crohn’s Disease and Ulcerative Colitis simply plays to the lowest common denominator of people who unfairly stigmatize these often incredibly painful, debilitating, disabling, expensive, incurable and autoimmune diseases as nothing more than inconvenient and unpredictable bowel disorders whose primary effect is unwanted time spent in public bathrooms.  Accordingly, how are we to compete for Supportive and Research Donations with worthy causes for so many other Rare Diseases and the different Cancers when arguably the most important organization in the history of Inflammatory Bowel Disease seemingly trivializes the often horrifically devastating effects of Crohn’s and Ulcerative Colitis?

The often Harsh Realities of Inflammatory Bowel Disease

Most people around the world do not have ANY IDEA about the lonely and painful plight of the IBD patient who routinely gets denied Social Security Disability Benefits in the US despite being deemed systemically ravaged and disabled by the most qualified of doctors after years of battling IBD or those suffering from incurable side effects of the Biologics they had to take just to stop the bowel surgeries and repeated hospitalizations or those who must see Pain Management Physicians month-in, month-out, just to “survive” while even some of their own family members start doubting the disabling effects of the “Invisible Illness” they fight because their spirit gets broken from having to cope with a disease the severity of which, so few truly understand.  With all that on the line, how the CCFA could chose an Awareness Television Campaign with a GREAT spokesperson like Amy Brenneman based on such superficial aspects of the disease is counter-intuitive and an INSULT to the patients with Severe Crohn’s Disease and Ulcerative Colitis who need the support and research advancements NOW.

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Treating Pediatric Crohn’s & Ulcerative Colitis Patients

This is Video 3 of 8 from my September 15, 2014 interview w/ Dr. Mark L. Chapman and focuses on the definition of Diverticulosis and how if differs from Inflammatory Bowel Disease (IBD) and then Dr. Chapman explains the nuances involved with treating Pediatric Crohn’s Disease & Ulcerative Colitis. Coming soon: Video 4 of 8 in which Dr. Chapman explains the different IBD treatment theories of “Bottom-up” v. “Top-down.” 

By way of brief background, I recently had the opportunity to interview a legitimate world-class physician, Dr. Mark L. Chapman of Mt. Sinai Hospital in New York City, about the chronic, incurable, autoimmune disease from which I have severely suffered for over thirty (30) years. But Inflammatory Bowel Disease (“IBD”) affects MILLIONS around the world, of all ages and ethnicities, and tends to “personalize,” or customize, its symptoms and severity leaving some with “just” an expensive chronic disease and others with a living nightmare in which the treatments are as pervasively devastating as the disease.

In association with a charitable organization I founded, namely, the “Crohn’s Disease Warrior Patrol” ["CDWP"], I’ve created eight (8) short videos from my ninety (90) minute September 15, 2014 interview with Dr. Chapman to help raise global awareness about the potential severe, disabling and devastating physical, emotional, psychological, professional, social, financial and familial effects Inflammatory Bowel Disease can wreak on one’s life.

Please SIGN-UP to be a Crohn’s Disease Warrior HERE at the website – it’s free.  To ensure seeing the continuation of such useful video information about Inflammatory Bowel Diseases such as Crohn’s Disease and Ulcerative Colitis, PLEASE DONATE to the CDWP HERE at the website.  Thank you.

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Copyright 2014 CDWP – All Rights Reserved

CDC’s ignorance of VITAL Role of Nurses & Ebola Dallas Debacle

 #Nurses r heart of #Healthcare

No mention of “Nurses” turned Ebola “worries” to Ebola “concerns” to Ebola FEAR

After each Ebola and Texas Health Presbyterian Hospital (“Dallas Hospital”)-related Press Conference held last week, I began to worry about the subtle, but vitally important, omission of the term “nurse” or “nursing” whenever authoritative proclamations were made by the Centers for Disease Control (“CDC”), various Texas and Dallas politicians or by President Barack Obama’s staff about the United States’ readiness and ability to effectively treat, isolate and contain the Ebola virus disease.  My worries were transformed into “concerns” when various BRAVE nurses and representatives of nursing organizations admitted they lacked, and respectfully yearned for, the necessary training and protocols to properly and safely confront all possible Ebola situations.  My concerns were further heightened later last week when Ebola patient Thomas Eric Duncan succumbed to the often fatal virus while in isolation at the Dallas Hospital.  My heightened concerns have now been transformed into REAL FEAR since it was most recently reported that TWO (2) nurses who treated Mr. Duncan at the Dallas Hospital tested positive for having the Ebola virus despite taking the basic safety precautions; all of which must have been at least seemingly adequate since no one commented UNTIL YESTERDAY MORNING about a potential “breach in protocol.”

Two (2) Nurses may pay the ultimate price for a MASSIVE Bureaucratic & Institutional  FAILURE

The Director of the CDC, Dr. Thomas Frieden, initially and despicably reacted to the first nurse contracting Ebola as the result of her apparent “breach in protocol” thus blaming her for contracting Ebola.  He should be FIRED simply for making such a foolish, inaccurate, self-serving and insensitive comment at a time when people around the world are watching and relying upon his every word to quell their fears about contracting Ebola. He quickly corrected himself and issued some vague comment conveying appreciation for this nurse’s brave commitment to her patient and insinuated that any “breach in protocol” was a combination of errors committed by the institutional participants such as the Dallas Hospital and the CDC.  But casually referring to possible CDC errors with respect to a life and death matter such as Ebola safeguards is condescending at best and completely incompetent at worst.  Dr. Frieden should be fired for making this ridiculous comment.  Then, today, we learned that another nurse who treated Mr. Duncan has also contracted Ebola and it turns out the aforementioned CDC and/or Dallas Hospital “protocols” were either incorrect, confusing, inconsistent, ignored by the Dallas Hospital or non-existent and these HEROIC NURSES nevertheless decided to utilize their expertise to help another human being suffering a horrific medical fate.  Dr. Frieden should also be fired for failing to devise and communicate clear and consistent Ebola treatment and containment protocols.

Shockingly, the unpreparedness of the Dallas Hospital to treat and contain an Ebola patient put its own workers and patients at risk for contracting Ebola

Considering all these authoritative press conferences which NEVER ONCE MENTIONED the VITAL ROLE OF NURSES in treating patients with ANY INFECTIOUS DISEASE, it was the Nurses who proved to be the most knowledgeable and forthcoming authority on Ebola treatment and containment when their representatives admitted they were unsure of which protocol to follow.  Yet their pleas for help and guidance were IGNORED until one of them contracted Ebola. Moreover, these HEROIC NURSES didn’t wait for the Bureaucrats to devise a universally safe Ebola protocol; they just “ran to the fire” to help Mr. Duncan and now two (2) nurses may pay the ultimate price for a MASSIVE BUREAUCRATIC FAILURE. But MOST STARTLING is how unprepared the Dallas Hospital was to admit an Ebola patient and effectively treat him or her while also protecting its healthcare professionals and patients.  If the Dallas Hospital only followed the candid, transparent and forthcoming lead of organized nursing groups and admitted they needed guidance about the proper protocols, Mr. Duncan would have been transferred to a different facility better trained to handle an Ebola patient without compromising the health of its workers or patients.

Crucial Role of Nurses should have been acknowledged by the CDC

The CRUCIAL role of nurses in treating patients in a hospital setting should have been duly acknowledged the minute the CDC and/or state and federal health officials devised training programs and protocols for healthcare professionals treating Ebola patients and NOT after a heroic nurse tests positive for the Ebola virus.  I find it reprehensible for the Director of the CDC to react to such devastating news by immediately seeking to apparently blame the nurse for this Ebola occurrence by stating, “a breach in protocol for treating a patient happened,” especially when that nurse had little guidance as to ANY Ebola treatment or containment protocols yet she never wavered in her professional resolve and tried to help a fellow human being who was medically suffering inside a hospital.  That’s a HERO who should be singled out for responding to an unprecedented medical emergency by offering all the knowledge, training and experience she has accrued to try and save a stranger’s life regardless of the consequences.  The “protocol” to question is the one devised by the CDC and/or by federal/state health officials who completely dropped the ball in failing to recognize “the nurse” as the “heart” of any public healthcare system such that Ebola or other potentially fatal infectious disease training protocols, for example, should be communicated to nurses as soon as they  are developed.

Nurses stand with Patients on the Front-lines

Doctors may give “orders” but nurses “execute” them.  This places nurses in direct contact with patients for the longest periods of time making it logical for nurses to perhaps be trained with a greater sense of urgency than that utilized with most any other healthcare professionals with the possible exception of hospital administrators and “First Responders,” a catch-all term referring to the first medically trained responders to arrive on the “scene,” which leaves them extremely vulnerable to every conceivable infectious disease. First Responders typically include the police, fire department and emergency medical technicians (EMTs) such as paramedics, ambulance drivers and various emergency room personnel.

With all due respect to the bright, compassionate and dedicated doctors, I’m tired of watching various Bureaucrats opine on television about the current Ebola situation and how “we” have the “best Doctors ….”  We do; but it is the Nurse who stands in the front-lines of any battle vs. potentially fatal infectious diseases and it’s therefore appalling they are not mentioned FIRST in any discussion regarding reasonable concerns about Ebola & the readiness to contain it from spreading when they are the BRAVE Healthcare Professionals MOST AT RISK because of their unflinching dedication to HELPING OTHERS.  After all, in a typical day at a hospital, the patient sees the doctor for four (4) – eight (8) MINUTES but it is the nurse who’s treating the patient during the “remaining” twenty-three (23) HOURS and fifty-five (55) minutes.

The Ebola Candor & Transparency demonstrated by Nurses MUST transform the CDC

I think we will all learn a great deal from the current Ebola tragedies but people will die needlessly if CANDOR and TRANSPARENCY is not practiced going forward.  To that end, the CDC and state/federal health officials should follow the lead of Nurses and admit they are not NOW fully prepared to address these potential global disasters BUT they are prioritizing their training efforts and anticipate being ready soon.  After all, the first step in fixing a problem is admitting you have one.  In that regard, the CDC not recognizing Nurses as the heart of healthcare reveals something’s seriously wrong at the CDC because their Ebola treatment/containment protocols and training should be initially focused on nurses and first responders.

This is another reason Dr. Thomas Frieden should be fired so that a NEW climate can be established at the CDC which duly recognizes Nursing as perhaps the most at-risk of healthcare professionals when it comes to treating and containing infectious diseases.  Clearly, CDC Director Dr. Frieden either does not believe this to be true or he is incapable of incorporating Nurses into a CDC infectious disease training protocol in a manner commensurate with their high degree of exposure to contracting any such infectious diseases from the patients they treat.  However, I trust the current Ebola debacle at the Dallas Hospital will be carefully studied and the CDC will then quickly rectify this so that nurses around the world will be properly trained to treat and contain any type of Ebola case at their respective hospital.

But what do I know?

I share this information not to boast but to legitimize my opinion in what I believe is a global emergency which presently is “only” a health threat but if it is not properly contained it can quickly morph into a global economic threat and it can affect the surety with which a chronic patient relies on a hospital and a healthcare system. To that end, I’ve been hospitalized over TWO HUNDRED (200) times and endured over TWENTY-FIVE (25) surgeries due to my thirty (30) year battle with the chronic, incurable, autoimmune illness, Crohn’s Disease.  I also wrote a critically-acclaimed book on this subject matter, namely, “Confessions of a Professional Hospital Patient,” which continues to sell as both a paperback and eBook at major retailers and etailers such as Amazon.com and Barnes and Noble.comTherefore, please trust me; nurses are the heart of healthcare.  I also wish God’s speed to the two (2) nurses currently battling the Ebola virus and I pray no other healthcare professional or patient from that Dallas Hospital suffers a similar fate.   

How the CDC's ignorance of the Critical Role of Nurses in Patient Care helped worsen the Ebola Dallas Debacle

How the CDC’s ignorance of the Critical Role of Nurses in Patient Care helped worsen the Ebola Dallas Debacle

Crohn’s Disease, Ulcerative Colitis & Indeterminate Colitis – Video 2 of 8

October 2, 2014

Below is Video 2 of 8 from my 90-minute interview with Dr. Mark L. Chapman of Mt. Sinai Hospital of New York City.  In this 11-minute video, Dr. Chapman explains Inflammatory Bowel Disease and then  the differences between Crohn’s Disease, Ulcerative Colitis and Indeterminate Colitis.

Video 3 of 8 will be released in 2 weeks and in it Dr. Chapman explains Diverticulosis and then he details the issues which make pediatric IBD and IBS cases unique.

 

This is Video 2 of 8 from my recent 90-minute interview of Dr. Mark L. Chapman of Mt. Sinai Hospital re: Inflammatory Bowel Diseases.

This is Video 2 of 8 from my recent 90-minute interview of Dr. Mark L. Chapman of Mt. Sinai Hospital re: Inflammatory Bowel Diseases.

Crohn’s, Colitis & Irritable Bowel Syndrome w/ Dr. Mark L. Chapman

Sometimes, a picture says a thousand words.  Rarely, however, a video interview conveys useful insights into heretofore misunderstood theories about a devastating, chronic, incurable and autoimmune disease.  This is that such video and is the 1st of 8 such short video snippets from my recent 90-minute interview with world-class gastroenterologist Mark L. Chapman of Mt. Sinai Hospital in New York City, a “disease-destination” hospital if there ever was one.  I should know; been operated on and hospitalized there for Crohn’s Disease MANY times.

Video snippets 2 through 8 of my September 15, 2014 interview with Dr. Chapman over the next few weeks.  Thanks for checking it out.

 

Video 1 of 8 of 9/15/14 interview with Dr. Mark L. Chapman

Video 1 of 8 of 9/15/14 interview with Dr. Mark L. Chapman

Crohn’s & Ulcerative Colitis w/ Dr. Mark L. Chapman in 2014

2-hour Interview with Dr. Mark L. Chapman by Michael A. Weiss

2-Hour Interview with Dr. Mark L. Chapman, IBD Center at Mt. Sinai Hospital by Michael A. Weiss of “Crohn’s Disease Warrior Patrol”

My Aim is True  Raising Global Awareness of Inflammatory Bowel Disease (IBD)

It’s no surprise to the kind people who read this Blog, follow me on Twitter @hospitalpatient or who support the charity I founded, “Crohn’s Disease Warrior Patrol” [the “CDWP”], I have battled the Inflammatory Bowel Disease (IBD), namely, Severe Crohn’s Disease, since 1984, with the physical, emotional, psychological, professional, financial, familial and social scars to prove it.  I trust these same people also understand my dedication to raising global awareness about the potentially disabling, excruciatingly painful, pervasive, expensive, and systemic proclivities of IBDs such as Crohn’s and Ulcerative Colitis.

In that regard, I will turn to whatever means necessary to ensure the newly diagnosed, and IBD patients in crisis, do not have to go through the often demeaning and arduous “diagnosis journeys” which I, and many others much worse off than me, experienced in the 1980s with Crohn’s and Ulcerative Colitis. For that, I recently turned to Dr. Mark L. Chapman of Mt. Sinai Hospital and asked him if I could extensively interview him for the purposes of documenting the extraordinary IBD knowledge and experience in his brain and put it on video to share with Crohn’s and Ulcerative Colitis patients worldwide.  That almost 2-hour interview took place on September 15, 2014.

Social Media is revealing continued unnecessary struggles of Crohn’s & Ulcerative Colitis Patients despite technological advancements since 1984

I approached Dr. Chapman because I didn’t like what I was reading on Social Media night-after-night about 1984-ish IBD problems occurring in 2014. While the Web is filled with attention-seeking patients who may exaggerate their situations or vent frustration from managing extremely difficult cases of Crohn’s Disease or Ulcerative Colitis by mis-categorizing their interactions with healthcare professionals, I diversify my social media participation specifically to weed out those types of manipulators, chronic complainers & whiners.  It’s always okay to vent on social media but Health Care Social Media only works if the participants contribute as much as they “take.”

But in 2014, 30 years after I was diagnosed with Crohn’s Disease, on any evening you can randomly visit the preferred social media platforms where IBDers feel comfortable honestly conversing, such as in certain Facebook Groups, on Tumblr Blogs, via Twitter hashtag streams and in LinkedIn Groups, and you’ll come across WAY TOO MANY CREDIBLE folks who understand the “give” and “take” necessary for social media to help IBD patients yet they must communicate because in real life they can’t find reasonably adequate professional assistance with their Crohn’s or Ulcerative Colitis. Whether it be for proper and timely diagnosis, understanding its potential systemic effects; managing pain; having a medication and/or surgical plan laid out for best and worst case scenarios and/or learning how to most effectively interact with their various physicians and navigate the health care system or any applicable government benefits programs, someone must clarify the current protocols and opine on the progress and efficacy of various research efforts so that IBD patients could develop a “measuring stick” of sorts to know whether or not they are seeing the right doctor and taking the safest/most effective medications.

What to do? Find the BEST IBD Doctor to EXPLAIN IT ALL

Finding “the best” at anything is a tall task, indeed, but when you happen to know IBD and IBS Specialist, Dr. Mark L. Chapman, all it entails is correctly focusing the video camera and asking him the most thought-provoking questions to acquire what’s in his brain, and get it on video, to share with the world.  That is exactly what I did, courtesy of my charity, the “Crohn’s Disease Warrior Patrol,” and over the next few weeks the CDWP will be releasing several Crohn’s Disease & Ulcerative Colitis topic-related videos, approximately 6-8 minutes in length, from my recent almost 2-hour conversation with Dr. Chapman. (We also anticipate using some of Dr. Chapman’s comments in a patient-driven Documentary we are producing on IBD.)  As you will see below, Dr. Chapman is not only a world-class distinguished IBD physician but he is also an extraordinary man for sharing so much of his time and knowledge with me, to help so many others.

Michael A. Weiss & Dr. Mark L. Chapman

Why Dr. Mark L. Chapman?

When I met Dr. Chapman for the first time in 1984, what stuck out in my mind was that he listened to me with as much passion as when he talked with me.  I also had never come across ANY doctor who possessed Dr. Chapman’s unique pairing of skills, knowledge, experience, confidence and compassionate style.  It’s been 30 years since then and while I haven’t always taken his advice due to youthful transgressions, I can honestly say he’s NEVER been wrong about my Crohn’s Disease and just like my father, he seems to get smarter as I get older!  In 2001, when I wrote the funny and informative book, “Confessions of a Professional Hospital Patient,” and MSNBC did a “feature” on me as a “professional patient,” they asked me to pick one of my physicians from anywhere in the US for them to obtain complimentary background footage on me.  I chose Dr. Mark L. Chapman and he was fantastic.  Ever since then, he’s been more than a doctor to me especially a few years later when my Crohn’s Disease got much worse and Dr. Chapman played the major role in keeping me healthy enough to pursue my professional dreams, no matter where I lived or what I did.

Dr. Mark L. Chapman – Professional Credentials

Due to my longstanding patent relationship with Dr. Chapman, please don’t take my word for Dr. Chapman being “the best.”  To that end, I’m sure he has colleagues all over the world of close or similar professional stature but when you learn about his “pedigree” at Mt. Sinai Hospital, you will quickly understand why I chose to seek his knowledge and experience to share with Crohn’s and Ulcerative Colitis patients all over  the world.  He graduated medical school in 1961.  He then performed his Internship at Mt. Sinai Hospital; 1 year of Medical Residency at Mt. Sinai Hospital; 1 year of Medical Residency at Montefiore Hospital in New York; a 2-year Fellowship in Gastroenterology at Mt. Sinai Hospital (along with co-fellow, and now retired, Dr. Daniel Present); and then in 1966 in the Army he was Chief of Gastroenterology at Martin Army Hospital at Fort Benning where he treated Officers, from Second Lieutenants to Generals. Knowing Dr. Chapman, I’m sure his own thoughts on war strategy were welcomed by the Generals as the man has a way of showing you how smart he is, as opposed to telling you.  He also speaks to his patients with the same respect for what they go through with Crohn’s or Ulcerative Colitis as he does for the Generals who are saddled with the most seriousness of responsibilities.

Upon being honorably discharged from the Army, Dr. Mark L. Chapman went into Private Practice in New York City practicing Gastroenterology.  What this short but impressive Bio doesn’t mention is that working in the Gastroenterology Department at Mt. Sinai Hospital in the early-to-mid 1960s was like playing for the New York Yankees in the 1950s when they won the Major League Baseball World Series nearly every year.  There were superstars all around Dr. Chapman who were doctors of great intellect and innovation and he was a sponge for everything they were kind enough to teach him.  Besides, back then Mt. Sinai Hospital in New York City was a “disease destination” hospital and thanks to the “players,” that disease was Inflammatory Bowel Disease.  Thanks to Drs. Chapman, Present, Korelitz and many that followed, and to the residents and fellows they trained, Mt. Sinai Hospital remains an international “disease destination” facility to this day.

Mt. Rushmore of Gastroenterologists were Dr. Chapman’s Teachers and Colleagues at Mt. Sinai Hospital

Mt SInai Hospital

During the early-to-mid 1960s, Dr. Chapman worked alongside the “Mt. Rushmore” of Crohn’s Disease and Ulcerative Colitis doctors. Since these much sought-after physicians all worked at Mt. Sinai Hospital, Dr. Chapman also participated in treating an unusually high number of IBD cases, as well as the most complex IBD cases, because they found their way to Mt. Sinai Hospital through international word-of-mouth.  As a result, Dr. Chapman learned from the very best and gained invaluable experience in all things regarding IBD, Crohn’s Disease and Ulcerative Colitis. Who were these “Mt. Rushmore” gastroenterologists of Mt. Sinai Hospital?  They included Drs. Burrill B. Crohn, Leon Ginzburg, Gordon D. Oppenhemier, Henry D. Janowitz and Burton I. Korelitz.

By way of brief background on these extraordinary Mt. Sinai Hospital IBD physicians, in 1932, Drs. Burrill B. Crohn, Leon Ginzburg and Gordon D. Oppenhemier, then, three (3) Mt. Sinai Hospital gastroenterologists,  published a landmark scientific article in the Journal of the American Medical Association (JAMA) on “terminal ileitis” [i.e., an inflammation of the intestinal tract] and in doing so identified the disease which would ultimately bear Dr. Crohn’s name. Dr. Crohn had joined Mount Sinai Hospital as an intern in 1907 and in 1920 was named its first Head of the Department of Gastroenterology.  He remained affiliated with Mt. Sinai Hospital nearly up until his passing in 1983 at the age of ninety-nine (99) years old.  Dr. Henry D. Janowitz served as Chief of Gastroenterology at Mount Sinai Hospital from 1958-1983.

Dr. Mark L. Chapman –  NEW “IBD Center at Mt. Sinai Hospital”

Along with Dr. Daniel Present, who would go on to becoming Dr. Chapman’s longtime partner in a New York City gastroenterology practice which was globally respected and sought out by countless patients around the world for consultation and treatment which would change their lives for the better, each of these aforementioned world-class accomplished men were teachers and colleagues of Dr. Chapman’s.  Accordingly, I trust you understand how he acquired such a unique pairing of skills, knowledge, experience, confidence and compassion, which he applies to every IBD patient he treats.  That’s why I chose Dr. Mark L. Chapman to share his insights about IBD in an attempt to hopefully help many patients around the world who have nothing but the Web and their fellow patients to rely upon.

[Note:  In a few months toward the end of 2014, Dr. Mark L. Chapman will be moving his private practice to help run the NEW IBD Center at Mt. Sinai Hospital in New York City.  I’m sure Drs. Burrill B. Crohn, Leon Ginzburg, Gordon D. Oppenhemier, Henry D. Janowitz, Daniel Present and Burton I. Korelitz would most certainly approve.]

Please be patient with the release of the aforementioned videos as they take a great deal of time to edit and I still suffer from Severe Crohn’s Disease such that there are days when I cannot be productive.  But I will do my best and I assure you that the the Interview was exhaustive so that the topics discussed will be quite informative.  Thank you for your patience.

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From Managed Care to ObamaCare to “Smartphone Medicine”

Healthcare Hashtags & Social Media Analytics

Healthcare Hashtags & Social Media Analytics

After suffering through Managed Care and now living through remedial intended ObamaCare, the United States has entered the first truly exciting times of global healthcare.  The innovative spirit prevalent in the United States is due to the convergence of eHealth and mobile health, the emergence of healthcare entrepreneurs combined with the proliferation of global health care social media platforms such that technology has democratized the practice of medicine for healthcare professionals, patients, institutions, pharmaceutical companies and health insurers.  Given the role of the Smartphone in this transformation, I think it is apropos to refer to this pioneering period of healthcare as “Smartphone Medicine.”    

Managed Care

Pardon my candor but Managed Care sucked.  It sucked for patients, doctors and hospitals.  Other than that, it worked just fine.  More seriously, if you did not obtain the appropriate “referral” prior to seeing a specialist (even in an emergency), the cost of seeing that specialist was either not covered by the health insurer or it was reimbursed at a significant lower amount than the actual charges you had to pay.  There were also pre-defined “in-network” physicians and a formulary of drugs, and with few exceptions, your medical universe was defined by various managed care contracts, the negotiation of each you did not participate in.   If you had surgery, it was common for your managed care insurer to have “in-network” contracts with some, but not all, of the anesthesiologists working at that hospital.  However, you had no control over which anesthesiologist treated you. Therefore, the actual cost of your surgery wasn’t determined until the medical bills started piling up in your mailbox. If you tried to politely request a specific anesthesiologist within your managed care health insurance network to somewhat control the cost of your surgery, you were taken as seriously as Kim Kardashian showcasing her acting chops on “The Kardashians” as her audition tape for a new Martin Scorsese Oscar buzz-worthy movie.

If you had a long-standing relationship with your primary care provider, there was no guarantee you’d be able to continue that relationship.  It all depended upon whether or not he or she “participated” in your insurance plan and was considered an “in-network” physician.  Some devious physician staffers would address such telephone queries with the vague declaration that their physician “participated” in your plan but they passively omitted the detail that he or she participated in your plan as an “out-of-network” physician!

Then there were similar passive “omission deceptions” on your health insurer’s website such that you’d be confident the post-operative occupational therapist you chose from your insurer’s website was “in-network” only to find out later her contract had expired and your insurer had not yet updated its website when you made your selection.  Despite this material error by your health insurer, you were nevertheless liable for the total cost of the occupational therapy, as if you purposely chosen someone “out-of-network” due to their unique high level of expertise, and were willing to pay extra for that added benefit.

The physician “con job” referred to above stung me only once when I had a very expensive Crohn’s Disease surgery based on that deceptive representation.  It wasn’t until I formally alleged “Criminal Fraud” in one of the MANY appeals I had to pursue seeking 100% reimbursement of the cost of the surgery (i.e., as if the doctor was, in fact, “in-network” with my health insurer) when I finally prevailed and exposed this misleading representation.  But many smart patients were directly or indirectly taken advantage of by money-hungry or irresponsible doctor offices and health insurers who banked on the arduous hassles of the appeals process being too steep a barrier for the patient to initiate, and keep pursuing, a meaningful appeal seeking reimbursement based on fraudulent representations.

There were also financial limits on how sick you could be, as if knowing these actuarial generated projected financials would impact your decision to, for example, undergo chemotherapy, when it was recommended by your doctors as the only way to save your life, and by doing so you would surpass your lifetime allocation of financial health benefits and be liable for the balance.  Finally, if you had a chronic illness prior to obtaining your managed care health insurance plan, it was probable that any charges accrued in treating that “pre-existing condition” would be excluded from your health insurance coverage.  Since the increasing costs of managing that pre-existing condition was likely the primary reason you sought health insurance, the fine print of many managed care health insurance plans made as much sense as selling Sexual Harassment Insurance to radio personality Howard Stern’s female sidekick, Robin Quivers.

ObamaCare

ObamaCare, a/k/a, The Affordable Care Act (the “Act”), identified the aforementioned Managed Care issues and sought to improve upon them so that more people could obtain more reasonable health insurance coverage at a more affordable price.  ObamaCare also sought to correct the gross inefficiencies present in American healthcare as a result of a Managed Care system which was largely unaccountable to any laws or governmental agency.  The Act utilizes market forces to stabilize the cost of health insurance policies and mandates that all health insurance plans include reasonable wellness provisions.  Finally, as a self-policing measure, ObamaCare created “Accountable Care Organizations” (“ACOs”) to ensure that larger medical practices and institutions routinely examined their costs and expenditures in a practical attempt to eventually reduce the aforementioned gross inefficiencies prevalent throughout the American healthcare system.

The Act seems to be making a substantial improvement in restructuring and regulating what was one of America’s fastest growing but difficult industries in terms of tracking and appeasing its diverse stakeholders.  However, there are political influences which prevent ObamaCare from being universally implemented and that likely affects its projected initial performance.  This largely remedial Initiative was also hampered by a slow and glitch-filled roll-out which has affected its acceptance by Americans as “the law of the land” and, instead, in some parts of the United States it is viewed by many as a law in effect because of the current political party running the country.  That said, even the most skeptical of patients and doctors would have to agree that ObamaCare is better than Managed Care and it has at least identified American Healthcare as a viable and potentially profitable industry.

Practical changes, as opposed to political “considerations,” must be made to the Act, however, to refine it, just like with any other remedial official government measure.  But at least ObamaCare is a start in the right direction and it also has the good fortune of being implemented at the same time technology and electronic medical records have improved convenience and enhanced quality of healthcare experiences and opportunities.  These experiences and opportunities have attracted healthcare and technology entrepreneurs who have combined their efforts to, in essence, create “American Healthcare 2.0” which includes innovative electronic (“eHealth”) and mobile health (“mHealth”) products and services.

Smartphone Medicine

The aforementioned eHealth and mHealth opportunities seem to be driven by the technology enhanced Smartphone because it has become the tool which has democratized the practice of medicine to the point where the doctor-patient relationship is now one of collaboration and mutual respect.  The proliferation of different global health care social media platforms has created empowered patients who conceivable use their Smartphones more to engage in healthcare Tweetchats than in telephone conversations.  Furthermore, there has been an explosion in the number of useful and generally accepted “Medical Apps” available on the different Smartphone operating systems like the Hospital Patient Picture-Sharing Medical “App,” “HospitalPIX,” which was developed by Dr. Jacques Durand (pictured below) [you can click thru the picture and watch my interview with Dr. Durand from this year's "Doctors 2.0 & You" in Paris, France].

HospitalPIX Medical Smartphone App

Additionally, bold and innovative initiatives like “The Healthcare Hashtag Project,” by the company Symplur  [you can click thru the picture above, before the first paragraph and watch my interview with Thomas Lee of Symplur from this year's "Doctors 2.0 & You" in Paris, France], have transformed the Twitter experience when it is used for healthcare purposes so that it’s more accessible and more time efficient for healthcare providers and for the healthcare community as a whole.  Since people tend to use their Smartphone to tweet and use Twitter, this is another example of Smartphone Medicine.

Smartphone Medicine enhances the Lifestyle of the Chronically Ill

For a chronic patient like me with the autoimmune illness Crohn’s Disease, using my Smartphone in conjunction with hashtags creates a global support team to whom I can turn with questions about new treatments for Inflammatory Bowel Disease (“IBD”), side effects of new drugs, recommended doctors for a specific procedure, a list of hospitals with IBD Centers and recommended IBD specialists in an area of the world where I might be vacationing, etc.  Moreover, I can load my Smartphone with all of my electronic medical records along with years of blood test results, Operative Reports from my 25+ surgeries and a list of the drugs I am currently taking.  I can also always use my Smartphone to contact my doctors whose information is always only a few strokes away.

The Power of the Hashtag in Smartphone Medicine

In terms of the use of hashtags on Twitter, according to Symplur: “By lowering the learning curve of Twitter with a database of relevant [healthcare] hashtags to follow, we hope to help new and existing users alike to find the [medical] conversations that are of interest and importance.”  Accordingly, whether directly or indirectly as a result of Symplur’s extraordinary success simplifying Smartphone Medicine through the use of hashtags, the hashtag is now routinely used in powerful global social media platforms such as Facebook, Google+, Twitter and Instagram.

Conclusion:

Because of Smartphone Medicine, the Prognosis for Global Healthcare has never been more Promising

The bottom line is that the convenience of Smartphone Medicine is liberating for patients who suffer from chronic, serious or autoimmune conditions which would otherwise require substantial record-keeping in different locations. Thanks to the efforts of companies like Symplur, the hashtag simultaneously encourages the use of global connections and conversations while also arranging them so they are directly on-point and easy to access.  Smartphone Medicine appeals to healthcare professionals because it is innovative, efficient and makes for better educated professionals who then can service their patients to the best of their abilities.  It has certainly been a long, strange trip from Managed Care to ObamaCare to Smartphone Medicine, but isn’t it always about the journey and not the destination?  In that regard, we don’t know what will come next but at least we do know that the prognosis for global healthcare has never been more promising.

Smartphone Medicine

Smartphone Medicine

Patient’s Most Valuable Tool is still The Question

The Question is the patient's most valuable tool

The health CARE Burden has now shifted from Doctor to Patient

Patient Questions

Doctor, can you please spell the name of that disease?  Is it chronic?  What are my treatment options?  Should I be seeing a specialist or are you the doctor to treat me?  Should I seek a second-opinion?  Are there additional diagnostic tests I could undergo?  Can it lead to additional medical problems? What medications must I take?  Are there generic versions of those drugs?  What is an autoimmune disease?  How did I get it?  Will my children develop it?  Should I have children with this chronic, autoimmune disease? What’s the future prognosis?  Are genetic treatments being developed?  What about stem cell treatments?  What about experimental medicine?  Can I get into a medicine trial?  Are my options greater if I go to Europe?  My insurance requires “Prior Authorizations” for those tests, can your office help me with them?  Am I disabled?  How do I apply for federal disability?  Do I have to pay for the medical qualifying letters you must write on my behalf?

How invasive is the surgery?  What about the anesthesia?  How much pain will I be in after the surgery?  Should I consult with a Pain Management Doctor? How long will I be in the hospital?  What determines how long I stay in the hospital?  After discharge, what are the danger signs I should look for?  What are my physical restrictions? I have a problem with that medication, what substitute can you give me?  Do I now have a higher probability of getting cancer because of this diagnosis?  What can I do to lessen those chances?  Should I change my diet?  Should I hire a nutritionist?  Why was I treated in the hospital by a “hospitalist” instead of you?  Can I just stop taking that medication or must I wean off if it?  If the side effects are so horrific, why must I take that medication?  You are offering me very difficult treatment choices, how do I choose one?  Will you choose one for me?  What has worked best with other patients facing the same medical problem?  May I use medicinal marijuana to treat the nausea?  How do I get the disease?  Should I see a psychologist or a psychiatrist?  What is the difference between the two?

Professional Patient Comment

I want to try the medication I saw advertised on TV; may I?  Why not, it seems to be a panacea?  This is what I’ve learned in the Internet, what do you think?  What are the best Internet sources for my disease?  Why can’t you recommend one?  What does patient-centric mean? Why can’t I take pictures inside the hospital? Why must I follow you out of my hospital room to finish asking you questions? Why are the agreed upon medical orders not carried out after you leave my hospital room?  What’s the best Smartphone App for my disease?  Why can’t you recommend one?  Who can?  May I text you with simple questions?  May I get a copy of my blood work?  Can’t it just be automatically sent to me, as it is my blood after all?  My child feels as if there is no “plan” in the manner in which his autoimmune disease is being treated in the hospital; what is the plan?  The pain medication helps, and I appreciate it, but what is treating the underlying illness?  Is there a national organization for my disease?  What type of patient support programs are available for me?  Can you recommend me to another one of your patients who’s willing to speak with me before you operate?

What about alternative medicine like acupuncture? What about over-the-counter supplements? Why don’t you believe in them when I read so many positive patient stories on the Internet?  Why must I make an appointment when all I have are a few questions?  Why don’t you have a website? What is a Nurse Practitioner?   What is a Physician Assistant?  What is the difference and why am I seeing them and not you? Is it time for me to change doctors?  Would you tell me when it is time to change? How many complex cases like mine have you treated?  Which doctors cover for you when you are not working like on certain nights and holidays?  May I meet them?  Are my electronic medical records safe?  If something happens to me on vacation in California how long would it take to get them my electronic medical records?  Should I be keeping a food diary to try and help you figure out what’s causing my problem?  How do I handle the depression from the medication?

Conclusion

I could go on and on as a 30-year Crohn’s Disease patient who’s undergone 25+ surgeries, 200 hospitalizations and countless “state of the art” treatments.  I’ve been hospitalized in local hospitals, disease destination hospitals and world renowned facilities and the patient’s right to ask questions is, by far, the most powerful tool in medicine, even in this age of ePatients, brilliant mobile health initiatives and the seemingly endless stream of technological advances.  However, maximizing the strength of this patient tool is 100% dependent on maintaining a respectful relationship with your healthcare provider.  This means you must always be considerate of his or her time.  I’ve been able to do this by writing out my questions beforehand and having someone else at my side when the answers are given to me.  It also helps to organize EVERYTHING from simple blood tests to operative reports.  Purchasing a Scanner will enable you to do this efficiently.

The health CARE burden has now shifted from the doctor to the patient.  Physicians are still certainly responsible for treating medical problems but patients are responsible for their well-being, to the extent that is humanely possible.  Asking well thought-out questions and organizing the information obtained is essential.  To that end, a command of the latest technology advancements is important as different devices such as a Smartphone, Scanner and Medical App will make the patient’s new burden easier to bare.