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
At 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 problems make health insurance unaffordable. For those with ...
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 Priscilla Chan may become the country’s most influential doctor
Who has the potential to be the most influential physician of our generation? It's Priscilla Chan, who not only recently graduated from...
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Confused about prostate cancer screening? Make a shared decision
In a widely anticipated move, the USPSTF officially recommended against prostate cancer screening in healthy men. Case closed, right? Hardly. The prostate...
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When it comes to doctors and social media, hospitals fail miserably
When it comes to medicine and social media, much of the attention is negative. Doctors losing their hospital privileges because of Facebook....
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Warren Buffett’s prostate cancer choices aren’t right for every man
A version of this column was published on April 24, 2012 in USA Today. There has been a recent uptick of elderly men...
Physician
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Why test recalls should not be considered cheating
I was appalled recently by the coverage of radiology “test recalls” by CNN, amplified by Dr. Gary Becker of the American Board...
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Why physicians are susceptible to hardball tactics
I was invited to a medical staff leadership conference sponsored by our hospital. A company specializing in training physician leaders ran the...
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How we deliver bad news is critical to how families deal with grief
As a cardiac electrophysiologist, I have had to discuss bad news with patients and families more times than I would like during...
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His father’s suffering had already been too great
He looked dead. The paramedics brought him down the hall toward one of my critical care beds, and for a moment I...
Patient
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How death can be a beautiful experience
I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law...
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What meaningful encouragement can be given to someone who is dying?
Theirs is a lonely journey; to be moving towards the separation and end of all things known and loved. Being with a...
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Health care journalists have tendencies similar to those of doctors
As a patient who was asked to speak at the Association of Health Care Journalists 2012 conference, I felt a bit covert....
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Adaptation can be painful, but it can also be a gift
Nothing will force you to live life on your own terms faster than almost losing it. In 2008, I was on fire....
Policy
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What should America’s health care vision be?
America has this paradox of excellent biomedical science, innovative drug manufacturers and entrepreneurial device developers along with outstanding providers but at the...
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Hospitals around the world aim to remain relevant to patients
"It was the best of times, it was the worst of times ..." So begins a story called A Tale of Two...
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Repairing the tear in health care’s safety net with social media
The nation’s “safety net” hospitals are designed to ensure that uninsured, lower income and indigent populations receive adequate medical care – a...
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Look to technology to reduce health costs
Technology to lower costs rather than accelerate them. Smart phones to increase physician and other providers’ productivity. Fewer primary care physicians but...
Tech
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When patient care becomes secondary to filling out the medical record
The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above...
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Doctors, use Google to get more patients in less than 7 minutes
Every month, hundreds of thousands of people look for a doctor on Google. As an amazing practitioner, your site deserves to be...
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The user interface for EHRs should be uniform
The first thing I noticed when I walked into the physician’s office were the tall cabinets filled with manila folders, tabbed with...
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EMR liability needs to go further than just the physician
This example of a disaster waiting to happen, in the form of an error-promoting CPOE, is a poster example of why the...
Social Media
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We need to see the potential harm of social media
Prior to 1794, farms across the world could only pick cotton as fast as humanly possible. In the late 18th century, Eli Whitney...
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Why social media may not be worth it for doctors
Social media in healthcare is all the rage these days. You can’t visit even one physician-oriented website without someone breathlessly advising you...
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Transparency defines social media success for doctors
Want to understand social media? Physicians wanting to learn about social media must learn transparency. We must learn transparency on a personal...
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How Twitter was used in a potential mass casualty scenario
It was my first ER shift in charge of the resuscitation area. Needless to say, my adrenaline and nerves were firing like...
