How to effectively keep tabs on a patient’s multiple medical problems? And how to do so without losing sight of the whole person?
The first question is the one I wrote about in a recent blog post. The second was the theme of many of the responses and also LinkedIn.
I love this second question; it’s an issue that’s always been of interest to me. Plus it’s especially ...
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If I were asked “Why should a clinician prescribe an app?” I would answer as follows: Because it’s likely to help the patient reach his or her most important health goals, and is a good fit within an over-arching medical management plan. In other words, if the goal is to provide sensible medical assistance to patients and families, the use of an app should be likely to:
What does the 21st century physician look like?
I’ll admit that the question on the face of it struck me as a bit absurd, especially when juxtaposed with the term “tomorrow’s doctor.”
Tomorrow’s doctor needs to be doing a much better job of dealing with today’s medical challenges, because they will all be still here tomorrow. (Duh!) And the day after tomorrow.
(As for the 21st century in general, given the speed at ...
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A little over a year ago, I found myself burning out and realized that my worklife was unsustainable.
I’d been working at an FQHC clinic, and had become the site’s medical director a few months before. I was practicing as a primary care doc, trying to improve our clinical workflows, problem-solving around the new e-prescribing system, helping plan the agency’s transition from paper charts to electronic charts, and working on our ...
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It all started with my sending a tweet.
Actually, that's not quite true. The way it really started was with my frail elderly patient calling me in mid-January, to tell me he thought he had a UTI. But that part of the story is not new and novel; I've often had patients contact me with similar concerns.
I did what I usually do: ordered a urinalysis (UA) and urine culture (UCx). (I ...
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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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"Hey doctor, what do you think about this product/solution/service?"
These days, I look at a lot of websites describing some kind of product or solution related to the healthcare of older adults. Sometimes it's because I have a clinical problem I'm trying to solve. (Can any of these sleep gadgets provide data -- sleep latency, nighttime awakenings, total sleep time -- on my elderly patient's sleep complaints?)
In other cases, it's because ...
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Do they need a PET scan to confirm the presence or absence of amyloid plaque?
More importantly, would doing such PET scans make meaningful impacts on patients’ health?
Those are the questions that a Medicare expert panel recently considered, and their impression, after carefully reviewing lots of high-quality research, is that we don’t yet have evidence supporting the benefit of using the PET scans. Unsurprisingly, some experts disagree, including a working group ...
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A few months ago I wrote a post about the 159 page digital fax that I received, containing records for a patient's recent lengthy hospitalization.
I've now discovered something even more time-consuming and annoying: a 202 page paper record mailed to me by a major medical system. (I won't name names right now; suffice to say this system uses
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I found out this past weekend that the VA will be making clinician progress notes available for patients to view on the MyHealtheVet portal. In other words, the VA is going OpenNotes. (Note: I was a primary care provider in geriatrics clinic at the San Francisco VA from 2006-2010.)
My first reaction was to be impressed by this bold progressive move.
My next reaction was to feel mildly ...
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"A comprehensive and extremely useful roadmap for doctors."
-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
Dear lawmakers: This is what it’s like to be a doctor today
Matthew Moeller, MD | PhysicianA gun owner responds to Sandy Hook
Edwin Leap, MD | PhysicianIs Chris Christie too obese to run for president?
Jeffrey Parks, MD | PhysicianIf I’m wrong about guns, can you please explain why?
Claire McCarthy, MD | PhysicianPrimary care doctors may no longer be needed
Doug Olson, MD | PhysicianWalgreens moves into primary care, and it’s our own damn fault
Kevin Pho, MD | Kevin's Take