Erin S. DeMartino, M.D.

This study aims to assess the experiences of lesbian, gay, bisexual, transgender, and/or queer (LGBTQ) patients who have been admitted to the intensive care unit and to identify any unique stressors or heteronormative biases that are faced by LGBTQ patients in the course of an admission to the ICU. Most patients who are admitted to the ICU require a surrogate decision maker to communicate on their behalf at some point in their stay. However there is wide variety in legal standards for who has the authority to act as a surrogate decision maker if the patient has not designated one already. Fifteen to 25 patients and their families will be interviewed about their experiences in the ICU, with special attention to their communication with their care teams and to the use of surrogate decision makers during their hospitalization.

As medical care in the United States becomes increasingly expensive, cost stewardship is a necessary component of delivering high value care. Cancer patients require additional protection from unmanageable costs, as the average out of pocket (OOP) cost during the first month of diagnosis is as high as $2900. Financial toxicity (FT) describes the adverse impact that the cost of treatment imposes upon our patients. Over the last five years, FT has become a well-recognized adverse impact of a cancer diagnosis. FT not only decreases the patient's quality of life, but also  patients who file bankruptcy during cancer treatment are 80% more likely to die of their disease.

Through the use of semi-structured interviews with patients, the primary aim of this study is to describe in the patient’s own language the symptoms of financial toxicity (FT) suffered amongst participants of phase I clinical trials.

Rates of advance directive completion among Americans, even those suffering from serious chronic illness, are notoriously poor. Moreover, the contents of completed advance directives are often difficult to interpret in the face of a medical crisis. This study aims to determine patient, surrogate and physician perceptions of a standard advance directive as contrasted with a novel, electronic and interactive directive. Renal dialysis patients have been selected as a patient population with limited life expectancy, frequent hospitalizations, and low rates of advance directive completion.