Recently I wrote about the problems with maintenance of certification requirements.  One of the phrases I repeatedly read when I was researching the piece was “the patient as customer.”  Here’s a quote from the online journal produced by Accenture, the management consulting company:

Patients are less forgiving of poor service than they once were, and the bar keeps being raised higher because of the continually improving service quality offered by other ...

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medpagetodayFrom MedPage Today:

  1. Mom's, Kid's Fructose Intake Linked to Asthma. A child's risk of asthma increased significantly with maternal fructose intake during pregnancy.
  2. Mixed Outcomes in Pregnancy After Weight-Loss Surgery. Women with a history of bariatric surgery who later gave birth faced both benefits and risks including a lower risk for gestational ...

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Assigning patients to doctors. Who still does this? We don’t assign hungry people to restaurants, hairy people to barbers, or passengers to airlines. Even State Farm allows me to choose between Maaco or my local chop shop every time I crash my car. We do assign kids to teachers, but still, I don’t need too many analogies to tell me that assigning patients to doctors is a bad idea! The average U.S. ...

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Recently, Ohio became the 20th state to pass a law mandating that hospitals and clinics performing mammography screening to notify a patient in writing if results suggest something known as "dense breast tissue."   Standard mammography creates a 2-D image of breast tissue.  In general, this is sufficient for screening purposes.  However, especially in younger patients, the presence of dense breast parenchyma can lead to higher false negative readings and ...

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The high cost of health care in the United States in part relates to how clinicians are paid. Performing expensive and often risky procedures simply pays better than engaging patients in a shared decision-making conversation. Shared decision-making (SDM) is a process where clinicians and patients educate each other about treatment options, risks and benefits, and preferences, and then they decide on the best approach together. Patient decision aids can assist ...

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Maintenance is the process of maintaining or preserving someone or something, or the state of being maintained. Our certification documents that we have trained (in my case in internal medicine) and that we can pass a test on the breadth of internal medicine knowledge. We accept that the ABIM has developed a test the evaluates our entire exposure to the many diseases and treatments that reflect our patients. The idea of maintenance of ...

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As medical librarians, we’re certainly the first to say that PubMed is a superb database, elegantly crafted at the National Library of Medicine to do fast and efficient searches for almost all medical and health subjects. Much of the power of PubMed is that it makes it possible to search broad subjects easily. When the user searches “cancer,” for example, PubMed quickly finds thousands of citations on all types of ...

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I sometimes think doctors forget what it’s like to be patients. But I’ve been there, and I know how frustrating and scary it can be. I remember one night, I was lying in a hospital bed, resting peacefully. I heard a noise and opened my eyes to a room full of chaos. Nurses everywhere. A crash cart. Someone holding paddles. I tried to speak, but couldn’t. And then I got it out: “Please don’t.” Here’s my story: Before ...

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medpagetodayFrom MedPage Today:

  1. Studies Cement Value of HIV Prophylaxis. re-exposure prophylaxis (PrEP) with a single pill prevented HIV infection among more than 85% of two groups of men who have sex with men.
  2. NSAIDs: A Risky Addition to Post-MI Antithrombotics. Adding a non-steroidal anti-inflammatory drug (NSAID) to antithrombotic therapy after a heart ...

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Help, I need somebody! Help, not just anybody! Help, you know I need someone, help! - The Beatles We are all here on earth to help each other; what on earth the others are here for I don’t know.  - W. H. Auden “Help the doctor!” I’m sure most surgeons have heard this exasperated statement at some point in the operating room. It is said with that special mix of frustration, irritation, and sarcasm, usually when things aren’t going ...

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