The current American climate seems to champion those outside the establishment and eschew the experience of career professionals. Medicine, like politics, has not been immune to the rise of populism. There exists a growing distrust of traditional medical institutions and a movement to concede medical expertise to the public, particularly evidenced by the development of platforms that crowdsource diagnosis. While online medical crowdsourcing is trendy and has received nearly universal ...

Read more...

A few weeks ago, I found myself in the midst of car trouble. A low tire pressure light illuminated my dashboard, and despite my best effort to replenish the air, I had to concede that my front tire was punctured and that I needed to make an emergency visit to an auto shop. As it always seems to go with any car check-up, the mechanics discovered multiple co-morbidities; a nail ...

Read more...

The SOAP note isn’t what it used to be. And what it has become needs to be scrapped, because it has made the office practice of medicine cumbersome and unsafe. In simpler times, when medical records were written by and for doctors, the SOAP note represented a significant leap forward in expanding and organizing office notes and also notes from emergency rooms and walk-in clinics. Before that notes sometimes only documented ...

Read more...

A computer algorithm learning how to play StarCraft like a champ may raise some eyebrows, but when algorithms start to give the skills of a trained physician a run, job security becomes a futile construct. An algorithm now diagnoses melanoma as well as a dermatologist: A consolation for the dermatologists, though: Folks across the hallway -- the radiologists and the pathologists -- are feeling the heat as well. ...

Read more...

One of the topics I write most about and have also done a considerable amount of consulting work on is improving and optimizing health care information technology. I hate to say it, but after a few years of doing this, I’m starting to despair a little from what I’m seeing. It’s a question I never thought I’d ask: But will health care IT ever really get to where it should ...

Read more...

In 1949, my maternal grandparents left everything and everyone they knew -- a happy family, a comfortable home, a thriving medical practice -- to travel further across the Earth than any of their family ever had before, to come through Ellis Island, and to trek to the Mayo Clinic so my grandfather could become a pioneering anesthesiologist. Twenty-one of my aunts, uncles, and cousins have since followed in their footsteps and ...

Read more...

Compare the following two versions of the same medical history: Version 1 CC: chest pain Mr. Smith is a 57-year-old white man who comes into the office today for the first time with a complaint of chest pain. He states he has been in generally good health in the past, though he has smoked about 40 pack-years and admits to not exercising much, other than occasional games of golf. He has trouble keeping ...

Read more...

As I've listened to the confirmation hearings for cabinet nominees, I’ve realized that no one with health care IT expertise has been identified by the transition team. I continue to ask all my colleagues about any contact they’ve had with anyone advising the new administration. So far, no one has been asked anything by anyone related to health care IT. At this early time in the administration, it’s important to offer ...

Read more...

Another year passed by, and I was going to write about my wishes for the New Year as a hospital doctor. But then, remembered that I did something very similar a couple of years ago. I went back and read over my wishes and found that they are identical to my wishes now! That’s not to say we haven’t made some great progress but — as anyone in health care ...

Read more...

The Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program -- also known as meaningful use (MU) -- initially provided incentives to accelerate the adoption of electronic health records (EHRs) to meet certified program requirements.  Many physicians were mandated to change over to electronic records at the cost of tens of thousands of dollars.  Electronic records have never been shown to improve patient care or outcomes with statistical significance, ...

Read more...

Most Popular