In our clinical years, our medical school has instituted a program in which we do learning modules along with our in hospital experience and didactics.I was happy to see a module on empathy for my second month of surgery. The last question to be answered in this module was: "Although the studies on empathy are very consistent other authors have indicated that medical students are really not losing cognitive empathy, ...
October 2010
All Stories
Doctors should embrace feedback and learn from it
In Quality Measures and the Individual Physician, Danielle Ofri, MD, PhD questions the usefulness of feedback report cards for individual providers. She states, “Only 33% of my patients with diabetes have glycated hemoglobin levels that are at goal. Only 44% have cholesterol levels at goal. A measly 26% have blood pressure at goal. All my grades are well below my institution’s targets.”It would be better for Dr. Ofri’s patients if ...
Providing Medicare to everybody increases continuity of coverage
by Aldebra Schroll, MDAt a recent staff meeting, a colleague mentioned her client was at an "awkward age".I thought she was referring to a teenager, but she quickly clarified herself. She was referring to the age before someone is old enough for Medicare at sixty five, an awkward time indeed. Many people between the ages of fifty to sixty four find that relatively minor health ...
Medical blog posts of the week, ending October 29, 2010
Here are the top posts from this past week, based on the number of times they were viewed.1. EMTALA and why this emergency physician is against it. American medicine will die or be reborn in the next ten years.2. Specialist and primary care pay per hour. Authors of a recent study from the Archives of Internal Medicine are unlikely to endear themselves to specialists.3. A cartoon ...
Social media is as important as the web itself
February 2010 was a fortuitous month for me. My website went live, and I met Ed Bennett.Ed is director of web strategy at the University of Maryland Medical System (UMMS). Lucky for UMMS. In his more than 15 years working on the internet, Ed’s been programmer, designer, consultant, information architect, start-up participant. Since 1999, Ed has led the UMMS web strategy building out large (50,000 page) content-rich websites ...
Blockbuster drugs are an addiction for Big Pharma
Blockbuster drugs. They are, to this day, an addiction for big pharma. A blockbuster can produce a huge ROI and fund the development of new drugs and new marketing programs but today the deck is stacked against blockbuster drugs.The healthcare environment today is one in which cost containment is a key element. In the next few years a lot of blockbuster drugs are going to come off patent including Lipitor, ...
How health care could benefit if a company followed Apple
Health care workers throughout the country daily face the growing pains of the transition from paper charts to electronic medical systems. Not only are there frustrations within each system, every hospital seems to have selected a different EMR. When I was a medical student at UCSD, I was exposed to 4 separate EMR’s (Epic, PCIS, CPRS, Centricity, etc) during my rotations at various San Diego hospitals.In this Wild West era ...
If there’s a doctor on board, please ring your call button!
Well, it happened again. Recently, I was somewhere over Saskatchewan, returning from a lovely Mediterranean cruise, in that uncomfortable semi-conscious state that passes for sleep when you’re flying coach, when the airplane’s PA system rang out:“If there’s a doctor on board, please ring your call button!”If you’re old enough to remember the show “To Tell the Truth,” you know what happened next. In the show, four B-list celebrity ...
10 things you need to know before surgery and during the hospital stay
by Winston F. MitchellI'm a 53 year-old male with no history of hypertension, no cholesterol problems and glucose count normal.I was overweight but still in great physical shape. But over a period of weeks, walking to work, I started experiencing a shortness of breath. Finally I went to my doctor, he informed me he was going to admit me to the hospital immediately because a ...
Deceptive marketing is widespread in health care
Recently, reports about deceptive marketing and other questionable practices used by the growing for-profit higher education industry in the US appeared in the news. For example, per Bloomberg:
Recruiters at U.S. for-profit colleges lied to entice students and encouraged them to commit fraud to qualify for aid, a report by the Government Accountability Office found.Recruiters at all 15 colleges studied by the GAO, Congress’s investigational arm, misled potential students ...
Physician email implementation inertia
by Jon MeyerLooking at the industry response to the recent study released by the Center for Studying Health System Change, Physicians Slow to E-mail Routinely with Patients - Issue Brief No. 134, it appears that a piece of the puzzle is missing. Both the study, and the analysis, put the physician at the center of the email debate. In reality, about 30% of a medical practice’s communication is ...
Why physicians should care about online reputation management
I am going to explain a bit about why physicians should care about online reputation management (ORM).As the online world becomes more pervasive, reputations are increasingly built and managed on the Internet. Online Reputation Management is the process of monitoring, addressing or mitigating SERPs (search engine result pages) or mentions in online and social media.Physicians are as visible as anyone on the Internet and the visibility is only going to ...
US News hospital rankings too subjective and encourage self-promotion
by Danielle Ofri, MD, PhDEvery year US News & World Report publishes its rankings of the nation’s top 50 hospitals. Hospital administrators await this top 50 report with a tension and fervor that rivals the NFL first-draft pick.As soon as the report is released, snippets rocket their way into donor appeals, local hospital signage, and highway billboards. “Ranked X by US News & World ...
Comparative effectiveness research needs to be taught to doctors and patients
Oncology is the area where the health care cost conundrum is coming into sharpest focus. Theoretically, who wouldn’t spend whatever it takes to cure a life-threatening disease? And yet practically the costs of new treatments are so high, and the improvements usually modest enough, that when it comes right down to it costs are becoming a real issue for patients and doctors.An interesting article in the Journal of Clinical Oncology ...
Sick doctors who work are doing more harm to their patients than good
Doctors: if you're sick, don't go to work.The stereotype of doctors is that they go to work, despite whatever symptoms ail them. Calling in sick places strain on colleagues. Especially in residency, where team members are expected to pick up the slack.In a recent column, the New York Times' Pauline Chen discusses the image of self-sacrifice that a sick doctor going to work portrays:
Hacking, febrile or racked with the ...
How healthcare marketers can connect with patients
by Daphne SwancuttCall it a silly, useless curse. I get sucked in to trying to find patterns and connections anywhere I can. Most of them are silly and useless. Occasionally I find ones that actually make some sense, if only to me.As a healthcare marketer who also geeks out on reform, genetics and the e-patient movement, I can’t help but try to wrap healthcare up into ...
The doctor patient relationship in team-based patient care
Is the doctor-patient relationship really more sacrosanct than the nurse-patient relationship?That's the provocative question asked by Theresa Brown in a recent column from Well, the New York Times' health blog.She discusses an instance when she had a disagreement with a physician over a patient care issue.
I couldn’t believe that this doctor, who had always worked well with the nurses on my floor, had just suggested, at least in my ...
Why doctors should care about the professional behavior of physicians
Doctor, why did you behave the way you behaved last night?Frankly, I don't really care how you behaved last night as a person, although you should. I do realize that the Christian religion states that "I am my brother's keeper." I do care about your welfare, but I am not that strong a believer as to make your personal life my personal business.But, if it were your professional behavior, I ...
Social medicine and global health should be pre-med requirement
We’ve started taking a course called the “Introduction to Social Medicine and Global Health” headed up by Paul Farmer and David Jones. This is a course that exposes us to a variety of issues related to the social determinants of illness and health with a different lecturer each week. Recently, we had Nicholas Christakis, this week we have Allan Brandt, and for the next few weeks we’ll have Michael Porter, ...
How an antidepressant can hurt your patient
Patients want a quick fix. Society wants patients to have a quick fix, so that they can quickly return to their usual performance at work and home.Patients still have shame about seeking help from a psychiatrist or other mental health professional. So they ask help for their depression from their primary care physician. The PCP feels an emotional pressure to provide the quick fix in that 15-minute appointment - the ...
Kevin Pho, MD
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Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
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Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
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Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
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Doctors: Don’t be ashamed about going bankrupt
Are doctors really going broke? According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising...
Physician
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Patients will understand an honest mistake if the doctor tells the truth
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned...
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Diagnosing an illness is an art
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. ...
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Physicians have a natural role as advocates
As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to....
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Our society expends huge sums on futile care
Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for "feeling good", but...
Patient
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How will the Baby Boomers age and die?
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in...
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Patient engagement is the holy grail of health care
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a...
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Why do doctors delay hospice referrals?
This is a response to Deb Discenza's article requesting a one page informational sheet informing a patient about hospice or palliative care. This would...
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How touch can calm patients
So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: "Question is: are...
Policy
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Improve patient safety to improve healthcare quality
It has taken 13 years for us to revisit the issues in To Err Is Human, the 1999 landmark government report that...
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A lack of incentive for medical schools to train primary care doctors
A social media movement is happening before our eyes with action starting to take shape. The #occupyhealthcare movement has begun within to...
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What should be the stated aim of health care in America?
The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering...
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How Moneyball applies to healthcare
The storyline is familiar. An organization is challenged to achieve better results without spending more money. An executive is committed to obtaining...
Tech
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New classes of devices to diet and exercise
For many celebrities, their livelihoods depend on their physical appearance and they rely on armies of personal assistants, schedulers, stylists, trainers and...
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Repetition is the curse of the doctor-patient engagement
How many times as a doctor do you ask the same questions over and over again as part of the routine process...
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Why the prognosis of patients is difficult
Many clinical decisions in older persons are dependent on life expectancy. For example, as life expectancy declines, cancer screening is likely to...
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Innovative technologies can markedly enhance safety
“To Err Is Human” is the title of the now famous book from the Institute of Medicine on patient safety published about...
Social Media
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The Internet is where patients go for pre-visit consultations
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
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5 ways doctors can benefit from professional connections
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
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Twitter Is my third office location
The physician’s decision to first dive into social media can be stress-inducing. Issues of time management, maintaining professionalism, and determining a return...
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The impact of social media on a physician assistant
The impact of social media on medicine could arguably be compared to the impact of the industrial revolution on the human condition....
