Bullying is a problem within health care. Stung by a physician's rebuke, Theresa Brown, an oncology nurse, takes to the op-ed pages of the New York Times to address the issue. In it, she cites several vignettes that paint doctors poorly:

But while most doctors clearly respect their colleagues on the nursing staff, every nurse knows at least one, if ...

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A version of this op-ed was published on April 12, 2011 in USA Today. “Would you like to discuss your end-of-life plans today?” It’s a question that I ask my patients, although not as often as I would like.  Talking about death may be uncomfortable, but it’s a conversation that needs to happen more often. We can never ...

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Whenever I speak about social media to doctors across the country, I often get asked, "How do I deal with a negative online review?" Here's one way not to handle it: sue the patient writing the review. There's a well publicized case in Minnesota, where a resident posted a ...

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Medicare is thinking of using patient satisfaction scores in part to determine bonuses to hospitals. According to Kaiser Health News,

... patient gripes soon will affect how much hospitals get paid by Medicare. The Centers for Medicare & Medicaid Services is finalizing details for the new reimbursement method, required by last year’s health care law. Consumer advocates say tying ...

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Kimberly Hiatt was a pediatric critical care nurse who accidentally gave an infant a fatal overdose of calcium chloride last year. By accounts, it was a calculation error. A human mistake. After the incident, the hospital fired her. This past April, she took her own life. Although it cannot be concluded that the tragedy was directly responsible for her suicide, ...

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Whenever I get asked about how the Affordable Care Act will impact health care, I always say, "look at Massachusetts first." That's because Massachusetts serves as a model for what's coming ahead for the rest of the country. As I wrote in 2009, Massachusetts did not provide the primary care infrastructure for near-universal care, which I predicted would drive up emergency ...

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I was quoted recently in the New York Times' Well blog, in a Danielle Ofri piece on Facebook and doctors. There's no question that Facebook has been a minefield of sorts for the medical professions, with infractions ranging from unprofessional conduct by medical students to patient privacy violations by attending physicians. One solution would be for doctors to simply ...

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It's commonly thought that rising emergency department expenditures could be curtailed if we could eliminate non-urgent visits. In Washington state, for instance, lawmakers are proposing limits to the number of times Medicaid recipients can go to the ER. But what, exactly, is a "non-urgent" visit?  And how ...

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The Affordable Care Act does very little to reform the medical malpractice system. It only allocates $50 million to various pilot projects around the country. A recent piece in the New England Journal of Medicine provides more detail.  It appears that, instead of capping non-economic damages, many of the projects have a
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Much has been written on the death of private practice. A lion's share of the reason is economic.  It's becoming financially unfeasible to run a private practice and practice medicine at the same time.  The increasing bureaucracy and regulations will only get worse. And many doctors are responding by becoming employed by hospitals or by large, integrated health practices, and giving up some independence. Some will continue to resist this trend.  But ...

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