Why do doctors still use pagers? I was on call last night. Don't get me wrong, this is not as bad as it sounds. With over 20 partners sharing evening call, and residents getting the calls first, we do not have it bad at all. And certainly nothing like my obstetrician friends, who seem to go in every time they are on call for labor and delivery and then ...

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One hundred forty-nine messages. This is what I return to on my first day back from vacation. Many of them were marked with a little red arrow, indicating a high-priority phone message. Recharging with a little time off is a darn good thing, something we all need, and something which has been shown to help all of us be better at what we do. All of us, no matter what our jobs are. ...

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Just the other day I received a somewhat anxious-sounding phone message from a patient of mine, approximately 72 hours after her office visit with me, and about 24 hours after I had already gone over all of her lab results from the visit with her. She sounded quite distressed, and said she'd received a message from someone, but could not really understand what they were saying. She said she was finally ...

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The state stopped by to see us the other day. Wow, that sounds ominous. No, really, I mean it felt like the entire Empire State: multiple people from multiple offices of New York state government, department of health, office of compliance this, oversight that, all with a vested interest in how things have been going (i.e., how we have been spending their money) in our patient-centered medical home resident pilot program. A few ...

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Actionable items. Today I decided to take a look at one of the dashboards that the information technology (IT) department built for our electronic health record, to help us a look at our patients enrolled in the multiple registries of diseases and conditions we are following for the patient-centered medical home. I booted up the program, and with just a couple of clicks of the mouse the program began running, checking with ...

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My morning practice session started out with a few patients arriving early, so I was able to get a jump on the day, and it looked like I was going to actually be running on time. As I was walking from one exam room to the other, my administrator came down the hallway, grabbed my arm and said, "Can I have you for a minute?" It seems that a group of systems ...

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During her annual physical exam, one of my patients recently asked me, "Are urgent care centers any good, Dr. P?" She recounted an incident a few months earlier where she awoke with an acute illness and was sick enough that she felt she needed to receive care -- at least some medical attention -- more imminently than she could get from waiting to speak to my office in the morning. She ...

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Opening my mail today, there are multiple letters from multiple insurance companies, reportedly communicating valuable information to me about my panel of patients that they cover. One of the envelopes holds two single sheets of paper, one of which contains a listing of my panel of patients and the providers they have been referred to over the past quarter. The second sheet, mysteriously, contains only a single line: This page intentionally left ...

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It's a cold and rainy morning, and we've traveled to the middle of Central Pennsylvania to see a presentation at a conference about a patient-centered medical home product produced by one of the largest health care systems and insurers of the region. There are clinicians and administrators from all over the eastern half of the U.S. (plus one from California), and also a large contingent visiting from the U.K., on a ...

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I'm feeling meaningfully used today. Once again, we are faced with another set of administrative hurdles, boxes that need to be clicked, tasks that need to be completed, all in the name of demonstrating that we are meaningfully using the electronic health record in which our practice and the federal government have so heavily invested. An "eligible professional summary" arrives in my email, with lots of bars with lines, and green checks ...

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