Iinspired by the VA's big bold step of going OpenNotes, I wrote a blog post titled OpenNotes in geriatics: 6 awkward concerns. It was written in the spirit of just about everything I write: to share the nitty-gritty complexities of what I find myself navigating in geriatrics, to bring attention to medical issues that older adults and PCPs struggle with, and to try to bridge the rhetoric-reality ...

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Hospitals are very focused on avoiding harming patients lately. They have been moving in that direction for a long time, but with health care reform legislation, payments are on the line, which makes something that was a very good idea into an imperative. In the year 2000, the Institute of Medicine, a non-profit organization that monitors various aspects of medical care, reported that 44,000-98,000 people died each year due to medical ...

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The Oxford English Dictionary (OED) identifies the first use of the term “doctour”, as the year 1303 AD, shortened to “doctor” in the 1557 addition of the Geneva Bible.  The OED first defines doctor not as a caregiver or healer, not as a science researcher or expert and not even as one with an advanced educational degree.  The OED, the world’s foremost English language dictionary, defines “doctor,” 700 years ago ...

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A reader sent me this question: "Yesterday, after my MCAT class, two biomedical engineering students and I talked about this article and the future of medicine. We debated whether such robots could reduce the need for doctors by 80%." When I read such predictions I chuckle at the naivety of those who make such pronouncements. The computer advocates do not really understand medical care and diagnosis. What do we do that computers/robots ...

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Patricia Wen's front page story, "Children's Access to Mental Health Care is Growing," in which she describes the "co-location" of mental health care services in pediatric practices, brought me back to the summer of 2011 when I attended a meeting of a working group of the Massachusetts Chapter of the American Academy of 
Pediatrics (MCAAP.) The task of this working group, a subgroup of the MCAAP task force on mental ...

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Why do you need a population health management (PHM) IT system? In our last column we discussed the fact that reimbursement tied to outcomes will demand a greater level of patient management. Greater, perhaps, than your EHR can deliver. The early focus of new pay-for-performance and bundled payment systems is on preventive care for top chronic illnesses. The 15 most expensive health conditions account for 44% of total ...

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An apology can be a powerful statement that influences how another responds to a perceived wrong. This can be especially true within the context of a doctor-patient relationship. Yet, most physicians have been conditioned to employ a “deny-and-defend” approach to adverse medical outcomes, avoiding apologies because they believe it could imply an admission of guilt or ultimately initiate a lawsuit. Apology in medicine is neither new or a fringe concept (currently ...

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shutterstock_74641645 Just as Sherry Gorman describes in her compelling post, being sued for malpractice can launch a complicated mix of often overwhelming emotions so debilitating that personal and professional lives are never the same. Since so many physicians are sued at some point during their career—some estimates say as many as 9 out of 10 —becoming educated about the malpractice process may ...

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Politicians, financial experts, pundits and main street America would love to predict what’s going to happen to America in the next five years. But we don’t have to dust off the Dow Jones or the S&P, or even wonder what the Feds are going to do about Medicare, taxes, the debt ceiling or Afghanistan. All we have to is understand the five stages of grief first developed by Dr. Elizabeth Kubler-Ross. Elizabeth ...

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I inherited motion sickness from my father's side of the family.  I can't sit in the back seat of a car for more than 10 minutes without becoming sick.  I take meclizine before every plane flight. I inherited asthma from my mother's side of the family.  Exposure to perfume, 90+ degree temps with 90+% humidity, or even a good laugh will all prompt me to cough. These two maladies of mine have ...

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