Johns Hopkins ophthalmologist Oliver Schein has found a simple way to save a half a billion dollars a year from our country's health care bill, with no negative effect on patient health. The only thing standing in the way is a stubborn government requirement. Seventeen years ago, Dr. Schein and colleagues published a study finding that cataract surgery patients who underwent routine preoperative testing -- such as ...

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The moment that an accreditation team shows up unannounced can spike the pulse of even the most seasoned hospital executive. The next several days will amount to one big exam for the safety and quality of care, as surveyors meet with executives, managers and care teams, and watch first-hand as care is delivered. Make the wrong move or give a wrong answer, have them see rust on a ceiling sprinkler, ...

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If you understand statistics and possess the intestinal fortitude to examine a ranking methodology, you will recognize that it involves ingredients that have to be recombined, repackaged and renamed. It's messy, like sausage-making. This is not to say that the end product — hospital rankings — are distasteful. Patients deserve valid, transparent and timely information about quality of care so they can make informed decisions about whether and where to receive ...

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Her voice cracked with strain. I could imagine the woman at the other end of the line shaking, overcome with remorse about the hospital where her husband had had esophageal surgery. Might he still be alive, she asked me, if they had chosen a different hospital? The couple had initially planned to have the procedure done at a well-known medical center, but when she went online to do her homework, she ...

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If we want to rein in the costs of the U.S. health care system -- now equal to nearly 18 percent of the nation's gross domestic product -- we cannot ignore the fragmented technologies used to help heal and save lives. At first glance, the devices, monitors, electronic health records and machines found in today's hospitals might inspire awe. Look beyond the slick displays with blinking lights, however, and the picture ...

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In the technology-thick landscape of modern health care, the physical exam remains in a backwoods. Sure, there have been advances — blood-pressure cuffs, for example, now inflate themselves — but on the whole, the exam has barely changed in the past century. Patients still open up and say "ah," take deep breaths and gaze at a tiny light peering into the back of their eyes. A well-done exam can still determine whether ...

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How would you react if you sent your sputtering car to the auto mechanic, and they stopped trying to diagnose the problem after 15 minutes? You would probably revolt if they told you that your time was up and gave back the keys. Yet in medicine, it's common for practices to schedule patient visits in 15-minute increments -- often for established patients with less complex needs. Physicians face pressure to mind ...

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Talking to health care professionals about the importance of loving your patients and colleagues -- as I often do -- might raise eyebrows. How can we be expected to love our patients during a 15-minute clinic visit? How can love form among hospital teams coming together for a surgical procedure but then moving on to other work? Perhaps most importantly, how will this love make any difference in our patients' lives ...

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Selecting the right hospital to receive care can save your life, lower your risks of getting a complication, or even reduce your financial hardship. The problem is that it's extremely hard for patients to make that judgment. Sometimes, the data they need to select the best hospital for their care doesn't exist. In other cases, it's hard or impossible for the public to find. For instance, if you're getting an esophagus resection ...

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As standardized exam scores increasingly define success for students, teachers and schools, parents worry about the dangers of “teaching to the test” -- and of their children being judged by tests with low or unknown validity. We want our children to perform well on tests, of course, yet only if they measure something that students, patients, and teachers believe really matter. We also want the education system to inspire students ...

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