An innovative study in JAMA Internal Medicine on surrogate decision making has profound implications for how we take care of older hospitalized patients.  The study, by Lexy Torke and colleagues at Indiana University, systematically described the involvement of surrogates in decision making for hospitalized patients. Surrogate decision making refers to the phenomenon in which someone other than the patient is making or helping to make the key medical decisions.  In older ...

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There was a brief scare in our neighborhood this past weekend. Our phone rang. Our friend, who lives nearby, asked if her 12-year-old son was at our house. He wasn’t. The child had been gone for about 15 minutes. Their family had just returned from a shopping trip with a family friend, and that family friend had forgotten one of his items at our neighbors’ house. The child said, “I’ll run ...

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I wrote a column recently about the role computers play in the doctor patient relationship, and my concern that screens shift physicians' focus away from their patients. This column is part of a large conversation going on nationally and beyond about what I'd call "distracted doctoring." A Wall Street Journal opinion piece by my colleague Dr. Victoria McEvoy addresses the issue of whether all the digital box checking now required of doctors as ...

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"AAP Criticizes Retail-Based Clinics -- Again." I noticed the headlines rolling in about the AAP updated policy statement regarding retail based clinics.  The one above particularly caught my eye.  Something about the tacking on of “again” caught my attention.  It came across to me like we (pediatricians) were perceived to be saying something that was unnecessary, maybe even that we were just complaining. Throughout the day, I monitored my Twitter ...

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It has been freezing cold in much of the country for the last two months, but things have been heating up in the controversy over the implementation of ICD-10. First, a quick primer for those of you who have not been following this. The “ICD” in ICD-10 stands for International Classification of Diseases. The “10” refers to the version of the taxonomy, which is maintained and revised periodically by the World Health ...

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I’ve been working with the latest electronic medical record (EMR) for almost a year now. You know the one. There are many positive changes, to be sure. It has helped me more than a few times with calculating doses for kids’ medications. I can now easily check in on my patients’ progress when they are admitted to the hospital. And, of course, the notes are far more legible. But what do ...

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shutterstock_153353723 As a medical scribe working with a large, well-known scribe company, unnamed to protect my job, it makes me proud reading all the articles published about how much having a scribe benefits a physician, especially in the emergency department. I enjoy my job immensely and I am grateful for the opportunity to learn and engage in patient care. However, as a ...

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How does a working mom and physician keep practicing medicine when her husband’s career brings her halfway around the globe? For me, it was an adventure. While it can be challenging, I encourage other physicians to experience the world with their families while still practicing medicine. As a 14 year family practitioner from Ohio, I suddenly found myself in Qatar with two young children because of my husband’s job. Qatar is ...

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A few years ago when I went skydiving for the first time, I learned about the backup parachute. This is a second chute, just in case the first one failed. While no one wants to think about the primary parachute failing, it was comforting to know we were prepared ... just in case. That’s kind of how I see end of life care planning, while we don’t want to think ...

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The tests came fast and furious.  The diagnosis didn’t. One doctor was certain it was psychosomatic.  My twin younger brothers had been born a few months earlier, and I, seeking attention, was refusing to walk.  My mother kept looking. Another doctor couldn’t figure it out but gave a piece of advice.  “You have other children, right?  Be grateful. Take this one home, keep him comfortable, and when he is gone take comfort ...

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