by RH+, MD More than anything in life I wanted to be a family practitioner (FP). Going into medical school there was little doubt in my mind that this was my chosen path. I chose a school that had a significant focus on primary care and was president of the Family Practice Club my second year. I had shadowed several FPs and truly enjoyed the continuity of care that went into FP. When ...

Read more...

Why do we physicians chart the way we do? Hopefully, you do it perfectly well and have no concerns at all. But where I practice emergency medicine, we are approaching maximum inefficiency in charting. It all became much clearer when we started using our new EMR system. Let me make it clear, I'm not against EMR. In fact, typing and templates work better for me than dictating. My dictations were usually ...

Read more...

If you’ve ever been on a diet, you know that it really helps to keep a food log. Seeing your consumption chronicled in one place is illuminating – and often explains why those love handles aren’t melting away despite two hours on the treadmill each week. In a recent issue of the New England Journal of Medicine, internist Rich Baron Rich Baron chronicles the work of his 5-person Philadelphia office practice ...

Read more...

A primary care resident wrote in one of the journals recently about making the limited time she has with each patient matter the most. How refreshing, I thought when she concluded that time ultimately is an absolute and finite resource. We often feel as if we are battling time as much as we are battling disease, and we sometimes have trouble admitting when we are losing either one of those battles. ...

Read more...

by Diana E. Lee One member of my health care team is a migraine specialist in another state. Since we don't have many opportunities to work together in person, we generally try to pack a lot into my periodic two-day visits. Last time I was there I had an experience that has left me feeling guilty all these months later. My doctor, who I respect and admire greatly, asked if I was interested ...

Read more...

by John Gever Emergency department patients with chest pain may safely be evaluated in the waiting room when necessary, researchers said. Among 303 patients triaged to waiting-room evaluation in a prospective study, no acute coronary syndromes were missed and adverse event rates overall were lower than among 804 patients who were assessed in conventional monitored beds, reported Frank Scheuermeyer, MD, of St. Paul's Hospital in Vancouver, British Columbia, and colleagues online in ...

Read more...

by Chris Emery Single and childless surgical residents in the U.S. are more likely to pursue specialized surgical fellowships, and a majority of surgical residents believe a successful career depends upon specialty surgical training, a new survey found. Of residents who responded to the survey, 28.7% believed general surgery is becoming an obsolete career path (30.1% of men and 25.9% of women, P=0.004), and 55.1% believed specialty training is necessary for career ...

Read more...

There's little question that the workplace environment for doctors is deteriorating. Especially in primary care, where physicians are arguably needed the most. That's why is so disheartening to read this Newsweek essay from pediatrician Karen Li, explaining why she left the field. Much of her piece can be attributed to the bad old days of managed care, where doctors were frustrated by the bureaucratic impediments placed before them:

Why would a businessman or, ...

Read more...

I recently read about a case involving the next step down the slippery slope of criminal prosecution of physicians. First Michael Jackson’s physician gets prosecuted when his physician gives him an unintentional overdose of an anesthetic medication when trying to help him sleep. According to a previous discussion on this topic, most people seemed to think that prosecutors were justified in those charges. Now, Dr. Mathew Wallack is being criminally investigated ...

Read more...

by Nancy Walsh Busy clinicians in the emergency department reduce the time they spend on clinical tasks when interrupted, working faster and possibly cutting corners, a prospective observational study found. Overall, clinicians were interrupted 6.6 times per hour, and 11% of all tasks were interrupted, according to Johanna I. Westbrook, PhD, of the University of Sydney, in Australia, and colleagues. The mean "time on task" for uninterrupted tasks was 1 minute and 26 ...

Read more...

Trending