by Steve P. Sanders, DO, MBAAre hospitals coming clean? An article recently published in Health Affairs reveals details of a government–required survey conducted in 2008 and 2009.The Hospital Consumer Assessment of Healthcare Providers and Systems survey or CAHPS is required of all hospitals receiving and hoping to continue to receive federal funding. Analysts compared CAHPS responses between 2008 and 2009 and gleaned what they believed ...
November 2010
All Stories
Taking a multivitamin, vitamin D and fish oil every day
There is very little doubt that if we eat the diet we were designed to eat and spend adequate time in the sun that we will get most if not all the nutrients we need.That’s the ideal, but not the reality for a lot of us. I was recently advised by a group of physicians who are experts in the area that it is reasonable, and probably preferable, for adults ...
Medical jargon leads to poor communication between physicians and patients
An article in the Wall Street Journal, Taking Medical Jargon Out of Doctor Visits, emphasizes that the use of medical jargon leads to poor communication between physicians and patients, and consequently leads to ineffective medical care. Federal and state officials are now pushing healthcare professionals to use simpler language to communicate medical advice to patients.I could not agree more with this mission. The gap ...
What does the NYC Marathon have to do with health reform?
Legend tells of an Athenian named Pheidippides who, in 490 B.C., ran from the battlefield at Marathon to Athens, telling of the victory over the Persians. Proclaiming the news that Athens would be spared pillage and fire, the Athenian dropped dead. The story is a myth.But the marathon, like most things worth doing, does offer both risks and rewards. Because it gives a chance to go beyond usual boundaries, with ...
Design solutions by truly understanding how humans use tools
The Futurama exhibit from the 1939 World’s Fair, although pretty in exhibition form, looks like a terrible place to live. It’s a world of machines, concrete, and efficiency. How boring! Futurists have always imagined the “what can we do?” scenarios. They’ve never really asked the questions:
- What should we do?
- What do people want that would make them feel more alive and more happily human?
Balancing infection control with the patient experience
Hospitals have recently been stepping up their infection control procedures, in the wake of news about iatrogenic infections afflicting patients when they are admitted.Doctors are increasingly wearing a variety of protective garb -- gowns, gloves and masks -- while seeing patients.In an interesting New York Times column, Pauline Chen wonders how this affects the doctor-patient relationship.She cites a study from the Annals of Family Medicine, which concluded that,
fear of ...
How to create your medical family tree
by Karen Lu, MDThe holidays are a great opportunity to ask family members about their health history.Learning about your family’s health history can help you answer your doctor’s medical history questions. It can even help your doctor determine if you may be at risk for an inherited cancer like breast, colorectal, ovarian, prostate or endometrial cancer, which sometimes run in the family.Keep in mind that ...
Why medical students are burning out and lacking altruism
by mdstudent31Recently, AAFP News Now released an article titled, Unprofessional Conduct Among U.S. Medical Students Linked to Burnout.It focused on an article recently released in JAMA entitled, Relationship Between Burnout and Professional Conduct and Attitudes Among US Medical Students.I had the opportunity to be interviewed for this article and was featured on an inset within the article that shared a minority of my interview. ...
EMTALA threatens the safety net of community care
President Bush once said something along the lines of, "We do have universal health care in this country — just go to the emergency room."EMTALA. The law requiring emergency rooms to treat everyone’s emergent conditions, a well meaning act that has had disastrous consequences for hospitals’ bottom lines. A disgustingly flawed law on many levels.How do you prove it is not an emergency condition? You work it up. ...
Neoplastic epidural spinal cord compression is an oncologic emergency
There are very few oncologic emergencies. Neoplastic epidural spinal cord compression is one of them. The delay in diagnosis and treatment is often explained by the non-specific nature of the presenting signs and symptoms.The patient developed urinary retention a couple of weeks prior to presentation. On the morning of admission he was fully functional. Later he sat down to have a cup of coffee and boom – he couldn’t feel ...
Doctors who order tests for their own financial gain
“What a shame,” said my eighty eight year old Armenian grandmother, shaking her head with sorrow, and I had to agree. “US officials charge 73 people, mostly Armenians, over a massive fraud against the country’s medical insurance system,” read the BBC headline.A (mostly) Armenian crime syndicate set up 115 sham clinics in the United States, using real doctors’ names and real patient information, stolen from different systems, to generate false ...
Physicians the government wants to see
I was talking with a pre-med student recently. He had completed his very first medical school interview and was, understandably, excited. But he told me the interviewer had asked him what he thought would be the outcome of the current health-care reform measures.I laughed to myself. After 17 years in practice, even I don't know the outcome, though I have my suspicions. It seemed a loaded, almost unfair question. After ...
Dying is final, but passing on lives forever
It is hard to believe that those we love will die.We can't bear it. It's too harsh, too complicated, too fraught with emotional baggage and unfinished business and things never said. It's too final. Dead is dead, after all. From the moment of our birth, we are dying. Death can be painful, tragic, too soon, too quick, too slow, too easy, or too hard.So we soften it up a bit.She ...
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.What follows are some rules that cover common conditions and general practices:
- Don’t panic. Panic clouds thinking and causes mistakes. When I was an intern and learning what to do when confronted with an unresponsive patient, a wise resident advised ...
Medical students taking a mandatory rotation in geriatrics
by Eric Widera, MDWhat happens when you randomly assign medical students to either a mandatory two week rotation in specialized geriatric training or to a traditional non-geriatric clerkship that sees a lot of old people?Will there be any difference in the knowledge of geriatric conditions, the attitudes toward older adults, or geriatric clinical skills between the two groups? Or does mere exposure to an aging ...
Side effects of medication sometimes confuse patients
Side effects. Every medication has them. Some are mild, some are annoying, and some are downright dangerous.When doctors write a prescription, they mention that some people experience side effects, and if certain bizarre things happen, the patient should phone the doctor.How do we keep track?If you get one antibiotic to take for two weeks, it isn’t so hard. First, because it’s for a short time period, and also because it’s ...
10 top medical blog posts, October 2010
Here are the top posts from this past month, based on the number of times they were viewed.1. Catherine Zeta-Jones blames doctors for Michael Douglas’ throat cancer. Why is Catherine Zeta-Jones so mad?2. The day that medicine broke her and destroyed her innocence. Not only was I on call, but I was assigned to the chief resident’s team. I felt petrified.3. 7 social media mistakes made in ...
How dietary guidelines can help prevent disease
Most of the illnesses that occur today are chronic like diabetes, heart disease, cancer or kidney disease.These stay with us for the rest of our lives, are debilitating, and are expensive to treat. But in many cases they are not all that difficult to prevent. Unfortunately, our dietary guidelines are of little or no help in this regard but could be.In 1941, following studies that demonstrated ...
Making the decision to go to medical school
First, this piece is not a how-to guide for getting into medical school.But I use this ploy for good, and not for evil. Through conversations with a number of non-medical colleagues, I’ve been forced to think a bit more about premedical and medical education. A letter from a reader (which is presented in a highly altered version below) made me decide to more thoroughly and ...
Get a straight answer from your doctor
How can patients get a straight answer from a doctor?The answer is really very simple: Don’t accept a non-answer answer from a doctor on a question that really matters to you!If you get a dodgy, vague, or useless answer don’t take it lying down. Politely insist that the doctor elaborate and clarify until you get a reply that you understand.We doctors are totally scary, but if you have to have ...
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....
