There is a growing group of articulate and engaged patients committed to getting access to all their medical information in order to be better positioned to work collaboratively with their clinical teams. Published studies like the OpenNotes project have consistently shown significant benefits and a lack of serious problems. Health care systems are slow to change and just beginning to understand both the need and value to this ...

Read more...

I get it. It is a little strange. In fact, some people even think I’m crazy. Why? I’m a physician, but in my free time, I love helping my colleagues improve their patient satisfaction. Lately, I’ve spent a lot of time discussing a patient satisfaction survey known as CG-CAHPS (Clinician and Group Consumer Assessment of Healthcare Providers and Systems). I’m sure it doesn’t surprise you to learn that CG-CAHPS is ...

Read more...

I’ve always been good at pattern recognition and my visual-spatial orientation is excellent. Photography is my hobby, so it was only natural that as a medical student and internal medicine resident, I loved my dermatology electives.  Each day yielded up a new parade of interesting skin lesions and rashes, and by the end of my rotations I was confident in my diagnoses and recommendations. Contact dermatitis? Steroids!  Eczema? Steroids!  Psoriasis? ...

Read more...

Ask almost any physician why they chose medicine, and they'll answer, "I wanted to make a difference in the lives of patients." But in today's high-pressure healthcare environment, it's easy to get caught up in performance metrics and obsessed with efficiency. We tell ourselves, "It's OK, as long as we're delivering great clinical care, we're delivering great care. After all, the massive heart attack was averted. The wound was stitched. What ...

Read more...

When things go wrong in medicine, as they invariably do, we try to figure out what went wrong, and why.  We try to learn if there’s anything we could have done better and what we should do next time. It used to be, in the days of the giants, that the physician responsible for the patient with the bad outcome presented the case during a morbidity and mortality (M&M) conference.  It was ...

Read more...

dr-oz-profile Recently, Dr. Oz has come under scrutiny for his information on a number supplements that he alleges help with weight loss. Over the past 2 years, he has presented information about 3 diet supplements: green coffee extract, raspberry ketones and garcinia cambogia. After reviewing the available information, I can not agree that there is compelling scientific information to recommend ...

Read more...

Knowing what to do when faced with a sick patient is relatively straightforward. We learned a lot of it in medical school, picked more up by experience, and usually have the opportunity to look things up quickly on the Internet. Even when faced with a brand new situation, we can usually fall back on our general knowledge of science and medicine. But in today’s practice of medicine, that’s not enough. Physicians, ...

Read more...

This past April, just after the Centers for Medicare & Medicaid Services (CMS) released the highly-anticipated 2012 Medicare provider charge data, the New York Times published an article,"Sliver of Medicare Doctors Get Big Share of Payout." Almost everyone agrees that transparency in the Medicare payment system will likely lead to more efficient health care delivery with less waste and less fraud. However, thoughtful analysis must be performed so that undue stigmatization ...

Read more...

The old adage “time is money” holds true, especially in health care. Apparently the medicine time crunch spans two midnights. In October 2013, Medicare enacted a provision that changed coverage for hospitalized patients. The “two-midnight rule” states that a patient will not be covered as an inpatient unless their hospital stay is expected to cross two midnights. The end result is that many seniors are placed under observation, even if they stay ...

Read more...

I almost died today. I was driving from one clinic to another, on a busy highway in the rain, when my car hit a standing body of water and hydroplaned. I lost control of the car, spun counterclockwise across three or more lanes, and slammed into the dividing median. I remember screaming “NO!” internally right before impact. I couldn’t believe what was happening as it happened.
Read more...

Most Popular