Given current healthcare pressures to do "more with less," It's easy to rush to simple explanations of and limited interventions with complex medical problems Viewing TBI through the bio-psycho-social perspective can help expand our view.

​Dan Gardner, MD talks about how to understand the way you feel after a Traumatic Brain Injury. Using the Biological-Psychological-Social perspective to thoroughly evaluate problems resulting from TBI. How to find the New Me. 

(Edited version of presentation to San Diego Brain Injury Foundation on 2/20/21) 

​Please take the brain injury recovery community survey here. 
Thanks in advance for your input. 
See results (ongoing) here. 

By Dave Muoio October 23, 2019

A recent literature review of 80 app safety studies details a laundry list of shortcomings.

Consumer-facing health apps are increasingly prevalent, but they’re anything but infallible. According to a recent literature review of published app safety investigations, these offerings have been shown to include issues ranging from poor content or information to faulty functionality.
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Source: New York Times, July 27, 2019 
By Kelli María Korducki
 "The primacy of the chemical imbalance theory of mental and neurological disorders may be at the root of the problem. It is an oversimplification at best. "

The antidepressant Prozac came on the market in 1986; coincidentally, it was the year I was born. By the time I saw my first psychiatrist, as an early-2000s teenager, another half-dozenantidepressants belonging to the same class of drugs, selective serotonin reuptake inhibitors, or S.S.R.I.s, had joined it on the market — and in the public consciousness.
The despondent cartoon blob from a memorable series of TV ads for the S.S.R.I. drug Zoloft became a near-instant piece of pop culture iconography after its May 2001 debut. It was commonplace through much of my childhood to find ads for other S.S.R.I.s tucked into the pages of the women’s magazines I’d leaf through at the salon where my mother had her hair cut, outlining criteria for determining whether Paxil “may be right for you.” In my depressed, anxious, eating disordered adolescence, I knew by name the pills that promised to help me.
The mainstreaming of S.S.R.I.s and other psychopharmaceuticals didn’t eradicate stigmas against mental illness, but it certainly normalized a sense of their prevalence. (A 2003 study concluded that child and adolescent psychotropic prescription rates alone had nearly tripled since the late 1980s.) It also shaped the tone of conversation.
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​What if you come away from an important discussion with your doctor without a clear understanding of why a specific diagnosis was made or why a certain treatment plan was recommended?
 
What if you forget the details of your doctor’s recommendations?  “What other treatment options did she discuss? How many times a day do I take that medication? What potential side effects should I watch for? What further tests did he recommend?”
 
Could an incomplete understanding and/ or forgetfulness cause increased worry,  interfere with effective collaboration with your doctor, and lead to a worse outcome?
 
Throughout my career,  I’ve worked with many seniors and others of all ages to help them deal psychologically with their acute and chronic physical conditions.  A big part of that work involves looking at how patients and doctors interact with one another.  
 
Patients are frequently upset by having to deal with distressing symptoms and functional impairments.  And some conditions affect memory, concentration, and ability to comprehend. The emotional distress and / or cognitive impairment often interferes with focusing, remembering, and clearly understanding important details of discussions with their doctors.
 
Think of a doctor telling a patient about her newly-diagnosed cancer, then going on to list potential benefits and risks of various treatment options.  Do you think the patient is paying full attention to the discussion, or is she thinking about how this condition may shorten her life and affect her spouse and children? Think of the parent dealing with his child’s chronic disability. Or the brain injured person contending with forgetfulness.  
 
Many doctors give their patients a written summary of the visit with treatment recommendations. While helpful, a summary does not include the important details of how the patient and doctor together arrived at the current diagnosis and treatment plan. What other diagnoses were considered? What treatment options did the doctor recommend? What reactions did the patient have to each? And why was the specific treatment chosen over the other options?
 
So, what if you could easily make audio recordings of important discussions and have the recordings automatically transcribed and shared with selected family, friends, and treaters?  Would having a recording and transcription stored on your mobile phone reduce confusion, anxiety, and need for additional doctor visits?  
 
In response to involvement in the healthcare treatment of his family members with serious illness, a highly-qualified tech expert developed Medcorder,  a free and easy-to-use mobile phone app that patients can use to audio record, transcribe, and share their doctor visits.

​Check out the info about this app to see if you think that making audio recordings of doctor visits could lead to improvements in understanding, doctor-patient collaboration, and outcomes.

Note: I have no financial interest in this app.

​You can learn more about Medcorder here: www.medcorder.com. 

Wish you well.
 
​Dan Gardner, MD
www.dangardnermd.com 
 
PS. Please share this with family,  friends, and colleagues who might be interested. 
​
PPS. What methods do you use ensure effective doctor-patient communication? Leave a comment. 

​What is your advice for recovering from a serious challenge? Leave a comment. 

New York Times, 7/1/19
by Gina Kolata
​
You might assume that standard medical advice was supported by mounds of scientific research. But researchers recently discovered that nearly 400 routine practices were flatly contradicted by studies published in leading journals.  Read more.