Significant snow in New England every winter is about as certain as sun in Florida every summer. When I moved to the USA from the south of (old) England to do my medical residency in Maryland, my first few years living in the United States were relatively snow-free. But when I started my first job as an attending physician in central Massachusetts, I was in for a big shock. I had ...

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The nationwide shortage of physicians is a very real crisis across all 50 states, causing a huge strain at all levels of health care. Hospitals and clinics are struggling to hire, current physicians are overworked, and ultimately patients have to wait longer. There are a number of reasons why this has happened, but one thing’s for sure: With the aging population, the problem is only going to get worse. One estimate from ...

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shutterstock_136759886 As part of the increasing push for health care quality improvement, a lot of energy is being focused on improving our communication with patients and making sure that patient-centered care is more than just a buzz phrase. Gone are the days when the doctor-patient interaction was a wholly paternalistic one, where the doctor’s word was taken as final and absolute, and patients weren’t encouraged ...

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The world of health care has made tremendous progress in the last several years in raising the quality and safety of clinical medicine. Despite this, the discharge process (when patients are discharged from hospital) is still fraught with potential pitfalls and opportunities for things to "slip through the net." If you ask most patients who are discharged -- particularly the elderly with multiple medical problems -- they will tell you that ...

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Happy 2015! Health care in the United States continues to change faster than any of us can keep pace with and this shows no signs of slowing down. Having written a lot in 2014 on a variety of different topics, I wanted to focus on my own 5 wishes for hospital care this New Year. A lot of you may think that what you’re about to read sounds like wishful ...

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The enormous push continues to reduce readmissions, due in no small part to stiff financial penalties from CMS for the worst performing hospitals. The most commonly cited statistic is that about 1 in 5, or 20 percent, of Medicare patients are readmitted within 30 days. A staggeringly high number when you think about it. Having discharged thousands of patients and seen the characteristics of those patients that are frequently readmitted ...

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Improving patient engagement is a subject that’s being talked about in hospital boardrooms across the country. It’s become the in-fashion political buzz phrase. Certainly sounds very well and good, but what exactly does it mean? Likely different things to different people depending on what angle they approach it -- all the way from a care assistant up to the hospital CEO. In a nutshell, it’s all about allowing the patient to ...

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shutterstock_221545084 There’s been a lot of talk recently about low morale and disgruntlement among doctors. A recent article on focused on a list of reasons when doctors know it’s time to quit. I found the article a bit sad and unfortunate, but I’m sure the feelings behind it were sincere. Another excellent article in the Wall Street Journal last week extensively discussed the factors behind ...

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There are certain universal laws that appear to govern the broader workings of the world around us. For those of you unfamiliar with Pareto’s principle, it’s a concept that was first applied in economics and then found to be a governing rule in a whole host of different arenas. It’s no understatement to say that understanding and acting upon this concept can be transformative, not just in your work but ...

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shutterstock_169875926 The job of a nurse has changed dramatically over the last couple of decades. I’ve witnessed these changes at close quarters and heard feedback from nurses in several different hospitals. The biggest change undoubtedly is the interaction with information technology and the move away from paper charting. The theory behind this push, which is part of the federal government’s meaningful use policy, ...

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