Technology adoption is iterative. Here are some suggestions that can help you adopt and morph EHR techniques and processes to fit into your own practice's workflow.When it comes right down to it, some are basic learning techniques that can apply to any new situation in the office.And remember, everyone has something to learn.Don't get stuck in your own routine, if a physician finds a work-around that improves a system function ...
November 2011
All Stories
The benefits of academia-industry relationships
Harvard University’s Edmond J. Safra Foundation Center for Ethics has conducted a lecture series focused on Institutional Corruption. In December, Marcia Angell-Relman, M.D., the first woman to serve as acting editor-in-chief of the New England Journal of Medicine (NEJM), gave an hour lecture which focused on conflicts of interest (COI) in academic medical centers (AMCs), and continuing medical education (CME). After the lecture, ...
Why patients get unnecessary referrals to consultants
Recently, a physician colleague asked me a question about a patient. The patient, who had already been seen by another allergist, was referred to another physician ("the consultant") for evaluation. The consultant was in the same healthcare system as my colleague, but the allergist was not. In evaluating the patient, a specific allergy question came up.The consultant asks my colleague about this question. What was interesting was that the consultant ...
Why I advocate every day for children to be vaccinated
The vaccination debate has been raging over the last several years. As I write this, it is important to know I do not write this blog to creat debate or ill feelings from either side. I wish only to provide one health care provider’s view of the issues surrounding vaccinations. From a mother standpoint, I have friends who choose to vaccinate their children, and those who do not. Our friendships do not ...
Why you should cancel your doctor’s appointment
You heard me correctly. Do not go to your next doctor’s appointment. I repeat, do not go. Do not pass go or collect money.Now that I have your attention, you may be thinking what is this crazy doctor saying? If I had a dollar every time a patient came in and asked for my advice but didn’t follow it, I would have been retired long ago.Why is this?Change takes time. ...
The media’s role in educating patients about MRI overuse
Thankfully, there have been more news stories recently illustrating the overuse of tests.Specifically with cancer screening, the PSA test and mammograms have come under increasing scrutiny.I think this type of media attention is long overdue, as the public needs to be aware of the potential downsides of diagnostic tests.Now comes the MRI.A recent piece in the
Why your website is important to recruit physicians
Just as posited in a prior article featured on KevinMD.com, where it was suggested that implementing an EMR/EHR has significant attraction to prospective physician candidates, I would like to also recommend that a similar stance can be adopted with respect your practice's your web presence.In other words, is your website putting your best foot forward for not only prospective patients, but also to prospective physicians and others who ...
What happened to the art of medicine?
During our medical training we are taught to use evidence based medicine. This means using the most up to date scientific research data that has been analyzed and accepted as fact. But does this mean every patient we see fits into the evidence based medicine algorithm that we have been taught to use?I hope not. For this would mean we would only be following half of medicine. The art of ...
Quality of life issues in caring for cancer patients
Not many years ago it was assumed that most cancers were not caused by viruses. Today it is clear that many are and the list is growing. Head and neck cancers are either caused by the environment (especially tobacco) or by the human papilloma virus, the same virus that causes cervical cancer and some genital warts.The incidence of HPV-related head and neck cancer has been rising rapidly in the past ...
Doctors are reluctant to have end of life conversations
My 64-year-old patient with terminal cancer and less than six months to live wanted to go to Oregon. He was contemplating assisted suicide, which is legal there. “My life has been long and good,” he said. “I believe it is my right. I want the ability to say it’s too much, I can’t do it anymore. A person should have a dignified quality of life.”Another one of my patients, an ...
A nationwide system to collect adverse events from anesthesia
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.Anesthesiologists have been at the forefront of the patient safety movement. Over the past 25 years, anesthesia-related deaths have declined from two deaths per 10,000 anesthetics administered to one death per 200,000 to 300,000 anesthetics administered, due to improvements in patient safety and innovative research ...
3 reasons why doctors will miss Steve Jobs
Doctors love their Apple Products. Just walk into any hospital ward, and see the types of mobile devices we are using. At weekly Grand Rounds conferences, you see plenty of iPads in use. At physician meetings, the laptop of choice is often the Macbook Pro. The data backs these anecdotal examples as well.Doctors love their Apple Products – and Steve Jobs was obviously an extension of these ...
How to control health care costs in the USA
We are finally in the midst of American football season again, after so many dull months. Are you ready for: "We're Number 1; we're Number 1"?School pride; conference pride; regional pride; confirmation of identity; proof of manhood.Think Summer Olympics in London, 2012. As the Gold Medals add up, the chants will ring out ... U.S.A, U.S.A.Goose bumps; spine tingles; national pride.Years back, when John McKay coached the USC Trojans, he ...
What doctors can learn from the orthodontist’s office
I took my daughter to the orthodontist last week to get braces.There's a lot about the process that seems better than when I was a kid. Mostly, it's that instead of having to slide brackets around each of your teeth (yishk!) the orthodontist just paints a special glue on the enamel and places the brace on the front of each tooth. Kids get to pick the color of their braces ...
Patients and physicians in the digital age
The digital age has had a deep and likely permanent effect on the patient-physician relationship. I can’t tell you how many times I’ve had physicians beg me to provide them with a way to stop their patients from Googling their symptoms and diagnosing themselves before their first office visit and much to their chagrin, my answer is always the same, "You can’t stop them. Get over it."The Internet acts ...
Kevin Pho, MD
-
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...
-
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....
-
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...
-
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
-
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....
-
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...
-
I learned the value of listening to the patient
William Osler famously said (among other things): “Listen to the patient. He is telling you the diagnosis.” I was doing my obstetrical...
-
Repeated experiences of shaming are not good for a young child
The little boy, who looked to be about two, darted away in a fit of giggles. His young mother, who seemed thoroughly...
Patient
-
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...
-
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...
-
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...
-
How I became a hospice volunteer
People often ask me how I became a hospice volunteer. For the record, nobody is more surprised than I am. You know...
Policy
-
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...
-
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...
-
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...
-
The problem of insurance gaps in cancer patients
Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella? “Join my Medicare Advantage plan and...
Tech
-
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...
-
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...
-
Google knows more about certain diseases than physicians ever will
Professor Gunter Dueck, is a calm and eloquent german mathematician who’s also the CTO of IBM Germany. He studied mathematics and philosophy...
-
Robotics can revolutionize the delivery of medical care
Robotics has the potential to revolutionize the delivery of healthcare. It can help extend the delivery of information, expertise and clinical care...
Social Media
-
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...
-
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...
-
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...
-
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....
