At what point, we have to ask ourselves, does a medical error that we do over and over again cease to be an error, and simply become business as usual? At one of the patient safety conferences this week, where we reviewed sentinel events that occurred in the hospital and in the outpatient setting, one of the cases was about a patient who developed an abnormal cardiac rhythm as a result ...

Read more...

Sixty is the number of patients left on our schedules at the end of the day on Monday this week, people who never showed up, what we call no-show appointments. This number does not include those patients who did reach our practice to reschedule (these are counted separately), but simply those who never made it in for their scheduled appointments. While we are a very busy practice, and this is not ...

Read more...

I recently took a three hour online course on something I learned to do when I was a medical student. And I thought it was something I had been doing fairly well for the past 20 years.

New regulations have come down requiring all practitioners to take a CME-certified course on safe and effective management of opiates for acute and chronic pain. This has clearly ...

Read more...

Down in Baltimore for a meeting, long days full of plenary sessions and workshops, awards ceremonies and poster sessions. Recycled hotel air, bad coffee, great camaraderie. Lots of new ideas, lots of new ways of looking at things, lots of reinventing the wheel, lots of hope for change. Lots of sessions about how to improve the environment for learners, how to engage medical students, how to build a curriculum, how to ...

Read more...

The phones, the phones, the phones. Every time we look, everywhere we look, getting the phone answered seems to be a problem we just can't lick, a continual thorn in the side of our practice, something that's hindering all the other efforts we try to make things better, to get ourselves to the best care environment for our patients, our staff, and our providers.

Without ...

Read more...

Long ago, before our hospital changed over to a nearly complete hospitalist model, the faculty at our internal medicine practice served as the attending of record for all of our own patients, as well as the patients of the residents we supervised, when those patients were admitted to the inpatient services across the street. When we would arrive in the morning, we would look at the admission list, note that one ...

Read more...

"I can do that?" During a recent morning practice session, a resident was presenting a patient who had had several episodes of syncope which culminated in a trip to the emergency room. She had a brief stay there, and on the discharge plan was written "follow-up with PCP and with cardiology."

We went through her history and physical examination, we talked about how to further ...

Read more...

As part of trying to figure out where telehealth and video visits fit into the primary care setting, this week I got an amazing tour from the director of our emergency department, during which he showed me the program they've developed over the past year. An incredible system, they take patients from triage who report to the emergency department with nonemergent issues, and move them to a consultation room off to ...

Read more...

In these strange days of unsure future health care policies, shrinking budgets, and significant belt-tightening, as we look for ways to improve access for our patients, we need to reevaluate how we to get them into care, making sure we see them in a timely and efficient manner. We have always said that in this topsy-turvy time, in the crazy state of health care, what we really need is more primary ...

Read more...

shutterstock_177270461 The insurance companies have discovered a new way to give me a headache. About a month ago, a number of providers in our practice received an email with instructions about a new task to which we had been assigned. Apparently, we were supposed to log on to some website, create an account, and fill out a SOAP note on about a dozen of ...

Read more...

5 Pages

Most Popular