Second Life - Will it become a reality for Doctor/Patient Interactions?

A recent assignment for my UC Davis Internet and the Future of Patient Care class was to sign up for Second Life.    Second Life is a virtual reality site that allows you to set up an avatar and start exploring many different virtual worlds.   It allows you to chat and speak with other avatars that you meet and actually provides the ability to “teleport” to new locations.   The first time I tried the teleport feature I experienced a flashback to the days of the Star Trek era and hoped my new avatar arrived all in one piece.    But how could this be a tool to help doctor- patient relationships?    I started doing some research on this and actually came across some great examples of how others have used this tool. 

One example I found was a training tool to help medical students practice their bedside manner.   I would love to be an avatar patient volunteer for this project!    I think it would be interesting to engage in some “chats” with physicians in training and feel free to ask questions that out of deference to physician’s time and status I am sometimes reluctant to ask.    For example, it would be interesting to chat – “Hey Doc, could you tell me in English what you just said?”   The gesture feature of Second Life would also come in handy – a patient may gesture a begging notion and speak the words – would it be possible for you to look at me rather than my chart, Doc?    I think using Second Life in this fashion might be fun and less threatening to a new med student to understand the importance of connecting with a patient.

A more academic use of Second Life was a site I found HealthInfo Island.   Apparently it allows you to do searches of PubMed which is a reputable site for medical information.   This would be helpful for doctors to refer patients to for further research on their medical conditions.  As I explored the site I found various signs with tips on different topics.   The “rooms” within the island appeared to be arranged by specific body parts.  I was in the “eye” room which advised that one cause of dry eye was prolonged computer use, so I decided to teleport on to my next location. 

A final example of how Second Life could be used to help doctor patient relationships might be as a pain management tool.   Some studies have found that the use of the video game Wii has helped some patients, particularly children to manage pain symptoms or to distract them during painful medical procedures.   I think Second Life could serve the same purpose.  (See Dr Gold’s article at http://vgalt.com/2010/05/13/video-games-and-virtual-reality-experiences-prove-helpful-as-pain-relievers-in-children-and-adults/  to learn more about this study of virtual reality and pain management).  

I’m not sure Second Life is for me as a patient, as a novice I find it difficult to navigate, but perhaps with more experience, it will be a less “painful” experience.

Palliative Care - - Why not provide control to a patient?

As the adage goes –“nothing is certain except death and taxes”.    While taxes do seem to beyond an individual’s ability to control beyond casting one’s vote for the latest candidate professing to lower them, death has been something that many fear because of the uncertainty and inability to control one’s final hour.     Even many physicians that routinely have to care for patients with terminal diseases are not always comfortable with discussing death with their patients.    The book Final Exam by Pauline Chen explored this topic and cited many examples of physicians that held out hope to patients even though their condition was terminal.    The topic of Palliative Care has received a lot of attention recently due to the healthcare reform act.    Opponents of healthcare reform protested that palliative care was a mechanism to save costs at the expense of hastening the death of patients.    This outcry was surprising to me since I don’t recall hearing similar attacks against hospice care that has been in existence for some time.    So what is palliative care and what are some of the components of this?    My understanding is that the goal of palliative care is to give patients with terminal illnesses some control over the quality of life that they will experience in their final days.    It includes giving the patient control of the level of pain management and medication that they desire.    This type of care also involves better coordination of care by the patient’s medical team (something that is sorely needed by all patients).    Not only would this include the physicians and nurses caring for the patient, but also behavioral health providers and possibly spiritual supporters that can help both the patient and the patient’s family deal with the inevitable.     Palliative care should only be offered to patients where the evidence is clear that cure is no longer possible.    Many cancer patients are routinely given very expensive chemotherapy drugs in the final stages of their disease that have no verified data supporting curative value.     There was a study cited in the New England Journal of Medicine (August 19, 2010) done by Dr Jennifer Temel and others that found that patients with terminal lung cancer that received palliative care actually had less aggressive care and lived LONGER than the patients in the study that received traditional care.   Granted, this was one study, but it seems to refute those that oppose palliative care as a way to cut costs at the expense of patient’s lives.    If you were faced with a terminal illness, would you opt for palliative care?

Mac's Musing about Healthcare: Intro- First time blogger

Mac's Musing about Healthcare: Intro- First time blogger: "Okay, figured out how to set up my blog. First step, now will I have something substantial to blog about?"



Is there a certain irony about McDonald's talking about dropping their healthcare coverage for their workers - - while at the same time they profit from selling probably the most unhealthy food that people consume.