A new paper says "metastasis of email at an academic medical center" may cost millions of dollars. A pediatrician from the Penn State College of Medicine kept track of all of his emails for an academic year and found that 2035 mass distribution emails were received. They originated from the medical center in 1501, the department in 450, and the university in 84. The emails were about information technology, academic and professional ...

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Our 13-year-old woke up feeling lousy two days ago. He had a sore throat and sinus pressure, and felt really tired and generally icky. He didn’t look toxic -- just a little tired. I gave him a zinc lozenge and told him to get ready for school -- a method that generally can tease out exactly how bad one of my kids feels. He just sat at the table. We generally ...

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We hold these truths to be self-evident:

A hospital administrator with a clipboard is in search of a physician who isn’t following “evidence-based guidelines.” There are fads in medicine just as there are in fashion -- today’s ”evidence-based guidelines” may be tomorrow’s malpractice.
Did your hospital, like so many, abruptly switch from povidone-iodine antiseptic solution to ChloraPrep® for cleaning a patient’s skin before surgery?  If so, I’m sure the staff was told that ChloraPrep would ...

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On December 23, 1971, President Richard M. Nixon signed the National Cancer Act of 1971, and declared the "war on cancer."  The allusion to combat appealed to the soul of the American people not long after their success in World War II and the humiliation of Vietnam; they intuitively understood the sacrifice, teamwork and massive effort, which is implied in the concept of War and they were ready for another victory.  Committing dollars, ...

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Here’s a question I’m almost afraid to ask: when you go to a doctor (not one you see all the time), does the doctor usually introduce himself (or herself) and explain what they are there to do? And, do they sit down? I really hope that you are answering yes ... but I know that the answer is often no. In a study recently published in the Journal of Hospital Medicine, researchers observed 29 ...

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The term “open access” in the context of primary care means that patients are able to get an appointment whenever they wish. The ultimate in open access is 24/7 availability. No, I don’t offer this, although I come pretty close. I’m available by cell phone virtually 24/7 and I’m also almost always willing to come in and see someone if they really need to be seen. This seldom happens. Most of ...

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Ms. Smith (name changed) is 82-years-old, but currently looks about a hundred. I met her, intubated, in the ICU two weeks ago. She lived alone, hadn't told family she wasn't feeling well, but had called 911. In the emergency department, she was struggling to breath, and was intubated, having gone into respiratory failure. She was found to have a severe pneumonia affecting the majority of both her lungs. She also went ...

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Patient satisfaction and improving the hospital experience is being discussed in hospital boardrooms across the country. Now that financial reimbursements are directly tied to HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey scores, there is a significant incentive to do so. A multitude of ideas are being put forward into how this can be achieved, and hospitals are investing heavily to get tangible results. Many involve complicated and ...

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acp-logoA guest column by the American College of Physicians, exclusive to KevinMD.com. A couple of weeks ago, a television commercial caught my attention. It was an official-sounding announcement, a “national healthcare alert” that if you have Medicare, you might qualify for a knee brace “at little or no cost to you.” I found it interesting because a week earlier, a durable ...

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Doctors are tough critics -- as well they should be. The news that CVS Caremark pharmacies will no longer sell tobacco brought about quite a bit of rapid online dialogue. Even President Obama chimed-in with praise, a response that some in the business world say is worth billions for CVS. Having a good reputation, particularly when you’re in the business of delivering health care and lending health advice, seems essential. In my ...

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