The Disease Management Care Blog received this posting from an experienced nurse with a background in clinical and administrative medicine.We’ve all seen them. Those vacuous workplace posters exhorting teamwork, creativity and other forms of inspiration and accomplishment. A version has begun to creep into our nation’s health care facilities. reminding everyone of the need for privacy, how infections can be spread and the importance of patient service. And if my ...
November 2010
All Stories
Routine use of sleep medication for children
A recent study published in the journal Sleep Medicine revealed that most child psychiatrists prescribe medication for sleep at least once a month, despite the fact that no sleep medications are approved for use in children. The study was funded by Sanofi-Aventis, makers of Ambien.Managing sleep is one of the greatest challenges of being a parent. It represents the first major separation and can be fraught with complex ...
Health blog posts of the week, ending November 19, 2010
Here are the top posts from this past week, based on the number of times they were viewed.1. First aid rules that everyone needs to know. First aid is defined as the immediate care given to an acutely injured or ill person. It can literally be life-saving so it behooves all of us to know some basic principles.2. Taking a multivitamin, vitamin D and fish oil ...
Cardiothoracic surgery has a shortage of surgeons
by Shawn VuongSome time in the years 2002-2005, cardiothoracic surgery hit the wall.The specialty's big time claim to fame, the CABG (coronary artery bypass graft), surgery was on a huge decline. The field of cardiothoracic surgery became super saturated with over trained surgeons who were no longer in demand. The interventional cardiologist had come along and started stenting coronary arteries, saving patients from the chest opening ...
Quinine, artemisinin and our debt to traditional medical healers
An excerpt from Sustaining Life: How Human Health Depends on Biodiversity. by Eric Chivian, MD and Aaron Bernstein, MDEthnobotany, that is, the scientific study of the use of plants by native cultures, including their use as medicines, can be said to have begun with Carl Linnaeus, who in the 1730s published Flora Lapponica, his detailed account of plant use by the Lappish, or Sami, people, ...
Frog dissection with Lego
Squeamish about dissecting a frog?From MOCpages.com comes an ingenious Lego creation.
(via Street Anatomy)
When does the duty to provide emergency medical care end?
by Lyle DennistonHospitals know that medical care decisions often have legal consequences, which makes it all the more important to know what the law requires. But when judges can't agree, and there also is some ambiguity in the way government officials see a legal issue affecting care decisions, hospitals may need to go to the ultimate authority – the U.S. Supreme Court – for an ...
Taxing soft drinks to combat obesity
One commonly heard propositions to combat the obesity epidemic is to tax soft drinks. No doubt, sugary soft drinks are a common and important source of “empty” calories, but will taxing soft drinks really reduce obesity rates?This assumption was now examined by Yale University’s Jason Fletcher and colleagues, in a paper just published in Contemporary Economic Policy. The researchers collected information on taxation of soft drinks with respect to specific excise ...
Caregiving requires that caregivers need practical and emotional support
Mr. B, the patient who first stirred my interest in family medicine, was a spry former World War Two fighter pilot who came to the ER complaining of an irregular heart beat. I remember him regaling me with stories about the Battle of Britain while his wife dutifully stood by his side in the chaos of the crowded emergency room at a private hospital affiliated with my medical school.It was ...
Never hesitate to seek a second medical opinion
To celebrate your 50th birthday you head to your doctor’s office to get your yearly exam. He rewards you for your diligence by poking and prodding you, sticking you with needles, and arranging for a colonoscopy (happy birthday!). He also sends you for a stress test out of concern about your strong family history of premature heart disease.A slightly abnormal treadmill test leads to ...
Healthcare murders as a patient safety issue
How many murders did you have in your hospital last year? Did they involve sporadic or serial killers?What? You don't know? You really haven't thought that much about it?I'm not surprised.Chances are you might have had some murders but they were not discovered. I'm not only talking about the angry patient or family member who brings a gun to the ER or a patient room to seek revenge for a ...
Social media AMA physician professionalism policy
AMA Policy – Professionalism in the Use of Social Media.This was posted recently and it is a good piece of work that will promote physician (and patient) discussion about the professional role and use of social media.I applaud the American Medical Association (of which I am not currently a member, but I am a member of Medical Society of District of Columbia) for recognizing that physicians are engaging ...
Teaching Dr. Oz about nosebleeds
A reader informed me that Dr. Oz did a TV show recently on nosebleeds.I took a look at the video clip and it is my opinion that some information Dr. Oz conveyed is not entirely correct. Again, I should stress that this is just my opinion and I'm sure there will be many who may feel differently.Error #1: Contrary to what was said on the show, ice packs do ...
Why EHRs aren’t meaningful to doctors and hospitals
Electronic health record (EHR) advocates in Washington don’t seem to get it. They don’t seem to understand that hospitals and doctors aren’t rushing to install EHRs because many EHRs, despite the constant talk that EHRs are a prerequisite for good care. Caregivers are not walking the talk, because in their view, EHRs,
- aren’t ready for prime time
- slow productivity
- decrease revenues,
- show scant returns on investment
- don’t talk to one ...
Healthcare costs cannot be controlled by only banning fee for service
by James Baker, MDOnce the recession is over (maybe that should be "if the recession is ever over"), it’ll be time to do something about the deficit.The way to do that is to get healthcare costs under control.But I don't see how containing fee-for-service medical practice does the trick because, outside of family practice, I cannot see how to get away from fee-for-service, for the most part.I think ...
A National Quality Strategy can create improve patient safety
Among the many provisions in the Patient Protection and Affordable Care Act are elements intended to assure that every American has access to healthcare that is patient-centered, affordable, and of the highest clinical quality.In my mind, one of the act's most essential goals is to establish a National Health Care Quality Strategy -- one that integrates disparate federal and private sector initiatives, building on and expanding current quality assessment and ...
Our malpractice system needs to focus on patient safety
A malpractice lawsuit claims that a doctor treated a patient negligently and that this treatment caused harm, and it seeks monetary compensation. Negligence means that a physician failed to provide the standard of care expected by the prevailing medical custom. Juries decide cases that are tried, but most cases are settled or dropped. Lawyers get paid (typically 35 percent) only when they win or settle a case.A successful malpractice system ...
EMR is here to stay, which will be good for doctors and patients
The electronic medical record, the EMR, is upon us.For those of us who learned medicine entirely with paper charts, some have enthusiastically embraced the EMR and some have refused, to the extent they can, to deal with it at all. But most of us have plowed ahead into learning how to use it as best we can. It seems to me that the degree of enthusiasm physicians show for the ...
How the health care industry competes for patients
On my drive in to work this past week I came across this:
A bus-side advertisement for a local hospital (sadly, not mine) claiming that it was “home to the city’s best transplant outcomes.” Normally I drive right by these moving billboards without paying much attention. But this time I immediately got excited, whipped out my cell phone and snapped ...
Addressing the physician shortage in Texas
by Tayson DeLengocky, DOThe physician shortage in Texas has commanded an unusual amount of public interest in recent weeks.The Houston Chronicle (Oct. 17), Star Telegram (Oct. 19) and Fort Worth Business Press (Oct. 27) all devoted space to the growing shortage of physicians in Texas and the steps necessary to correct the problem. The three articles recognized that the availability of residency slots is 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....
