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
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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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Mobile health apps don’t always follow conventional wisdom
Propaganda and non-truths abound all around the Internet saying that mobile health apps are everything from a threat to Big Pharma to...
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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...
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...
