If you’re a health care professional, chances are you know a bit about social media, possibly feel compelled to use it sometimes and you might actually be participating in the Facebook/Twitter/LinkedIn/blog revolution.But there can be real problems in using social media in the health care context. Whether you are in private practice or work for a group of large hospital network, social media mistakes can be costly in terms of ...
October 2010
All Stories
Why doctors have poor customer service
One of my docs was telling us about a patient’s experience at another practice. Apparently, the parent was at her wits end with her crying baby. She called the on call doctor to ask for advice and the doctor told the patient, “your baby has colic’s; turn on the vacuum and stop calling.”It turned out the baby had some gastric condition (not colic) and needed treatment. The patient ended up ...
8 ways to elude a malpractice lawsuit
So you want not to be decimated by a malpractice lawsuit? I understand that, and I agree. Here are eight ways to elude that destiny.Way number 1. Don't do malpractice.Way number 2. Care deeply about your patients; and let them know by your actions that you really do care.Way number 3. Communicate diligently with your patients so that you and they are on the same page and understand together what ...
Early diagnosis of panic disorder can improve quality of care
by Stephen R. Blumberg, PhDAs a panic disorder specialist, I take an active responsibility in helping my patients feel confident that their physical complaints have no organic etiology. My day is filled with my patient’s reporting symptoms of heart palpitations, shortness of breath, chest pressure, rubbery legs, lightheaded feelings, inner trembling, numbness and tingling in the extremities, lump in the throat, knot in the stomach and head pressure, to name ...
Should humanities be the focus of prospective medical students?
There's been considerable buzz on the web recently - on the New York Times website, on Facebook, and on a physicians' forum called Sermo, at least - over a New York Times article recently entitled, "Getting Into Med School Without Hard Sciences."The article describes the Humanities and Medicine Program at Mount Sinai Medical School, a program which each year admits into the medical school 35 undergraduates who major ...
Why specialists don’t do more curbside consults
One of the simultaneously most enjoyable and exasperating aspects of being an infectious disease specialist is the large volume of “curbside” consultations we get from colleagues.For example, here’s this week’s tally — and it’s only Tuesday — done from memory and without systematically keeping track of emails, pages, phone calls, etc.:
- Duration of antibiotics after urosepsis, organism resistant to TMP/SMX and quinolones
- Need for repeat immunizations in splenectomized adults (got that one ...
10 good things that can happen from cancer
The following list is from a cancer survivor, Judy Engibous, posted on Hester Hill Schnipper’s blog Living with Breast Cancer.We first published it back in March of 2009 but are “reloading” it in recognition of Showtimes' The Big C starring Laura Linney. We were wondering if the story could be considered an example of “Participatory Medicine” with Linney’s character being an “e-patient.”10. Being able to shamelessly make fun ...
Patients and physicians should screen for cancer, but cautiously
To screen or not to screen? That is not the question.The question is not whether to screen, it is why, what, where, when, how, and how much, how often, and at what cost for what benefit.Patients and physicians must and do screen. The issue is cautious appropriateness. Self-screening by patients is easy, free, and fundamentally harmless. Look at your skin for potential melanomas, be alert to warning symptoms of a ...
Catherine Zeta-Jones blames doctors for Michael Douglas’ throat cancer
Why is Catherine Zeta-Jones so mad?It’s a facetious question. Her husband, Michael Douglas, was recently diagnosed with throat cancer he described at “stage 4.”She was quoted by People magazine as saying, “It makes me furious they didn’t detect it earlier.” They have young children, and anyone who hasn’t personally been faced with this threat can only imagine her fear and anxiety. I suspect no number of large houses, expensive cars, ...
Should CRNAs practice anesthesiology without physician supervision?
Interesting article recently from Health Affairs about the clinical equivalence between the care provided by anesthesiologists and CRNAs. The article concludes by advocating that CRNAs be given permission to practice anesthesiology without physician supervision. It's more cost effective. And there is no compromise to the quality of care delivered to patients.
We recommend CMS return to its original intention of allowing nurse anesthetists to work independently of surgeon or ...
Pfizer spending money to train journalists in how to cover cancer
The National Press Foundation is sponsoring a four-day, all expenses paid trip to Washington for 15 reporters to learn how to improve their coverage of cancer issues. Pfizer is funding the seminar.Former University of Minnesota journalism professor Gary Schwitzer writes:
Even if National Press Foundation staff choose the speakers and set the agenda, even if the Pfizer "guy never even showed up" last year, even if one reporter doesn't ...
We’re not ready for do it yourself genetic analysis
You may be wondering why Stanford Medical School’s new genetic interpretation class – the one that offers medical students the opportunity to study their own genes – has made the news. After all, what better genes are there to study than your own? And if you were a medical student, wouldn’t you want to have your medical school subsidize 80% of an $800 test as part of your curriculum – ...
Doctors should work weekends, and how reformers alienate physicians
Peter Orszag wants doctors to work weekends.The former director of the White House Office of Management and Budget wrote as much in this past weekend's New York Times:
Doctors, like most people, don’t love to work weekends, and they probably don’t enjoy being evaluated against their peers. But their industry can no longer afford to protect them from the inevitable. Imagine a drugstore open only five days a week, or ...
6 points every physician should consider about Medicare ACOs
by Asa Lockhart, MDDoctors, that age-old business advice still applies: Take your time and read carefully, and evaluate what it might mean to your patients and your practice, before you sign a contract.Specifically, the Patient Protection and Affordable Care Act (PPACA) paves the way for Medicare shared savings accountable care organizations (ACOs).Conceptually, this type of ACO is a collaboration of physicians and health care providers ...
Benefits of EMR outweigh the cost and learning curve
It’s hard to teach an old dog new tricks, but we can try.To write or to type, that is the question. To boldly go (according to the latest statistics) where only a small few are going; that is the challenge. Actually, for everyone in the medical profession, the reality of the paper chart is slowly coming to a close.The digital age is moving forward at lightning ...
Our love affair with technology holds primary care back
My wife and I were invited to dinner at the home of one of my daughter’s friends. My daughter is a graduate of the International Baccalaureate program of Murphy High and her friends tend to be interesting.This particular friend is majoring in pre-med and has parents who immigrated from Vietnam following the fall of Saigon. As is usual when one has a physician dinner guest (and perhaps when one doesn’t) ...
Cake with a terminal cancer patient
by Krupali Tejura, MDA fellow physician called me with a consult this afternoon.He described the case as a 60 year old who had stridor (difficulty breathing) for the past week and was admitted to the hospital recently. A CT scan showed lymph nodes in his neck which was compressing the trachea, and other scans didn't show much better. A biopsy was done but the final results were ...
How academic physicians turn into drug company shills
An excerpt from White Coat, Black Hat.by Carl ElliottThese days many thought leaders find themselves on shaky ground. The past few years have not been good for business. Some of the most prominent thought leaders have been exposed and censured by Grassley. Others have seen public opinion turning against them and gone underground. As more states institute Sunshine laws, anyone considering an industry ...
POLST and the next generation of the “Do Not Resuscitate” order
POLST stands for "Physician Orders for Life-Sustaining Treatment". It is a next generation replacement for an Advanced Directive and DNR ("Do Not Resuscitate") order. Advanced planning documents turn out to be less than useful, especially in urgent care settings, and many patients receive more aggressive care than they might want because universal, transferable physician orders are unavailable or, simply, not applicable because a patient is in a different care setting.The ...
The day that medicine broke her and destroyed her innocence
I was a third-year medical student in the first week of my obstetrics rotation. The obstetrics program was known to be high-pressure, its residents among the best. Mostly women, they were a hard-core group--smart, efficient, motivated--and they scared the heck out of us medical students.I remember the day clearly: Not only was I on call, but I was assigned to the chief resident's team. I felt petrified.We'd started morning rounds ...
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....
