Readmissions to hospital, especially within 30 days of discharge, are on the radar of all health care organizations in the United States. This is due in no small part to stiff financial penalties that are now imposed on the worst performers by the federal government. On the surface, it may seem like a reasonable thing to penalize hospitals that don’t successfully “get their patients better enough” to avoid readmission. However, the ...

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I was talking with a colleague in another section today, and she was noting the difference between our hospitalist group and her section.  She has somewhat intimate knowledge of our section because she did a year with us before moving on to her specialty fellowship.  She is a bit frustrated with her new home and its team members because she feels like there are a lot of “B's.”  You know ...

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As a fourth-year medical student in a sub-internship in internal medicine, I have something that no doctor in America has. I have as much time as I want to spend with my patients. Don’t get me wrong, I am still a student. I’m still paying hospitals to let me be there, and I only have a maximum of four patients per day, but I inevitably end up spending more time ...

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ZDoggMD's latest! Feel free to share what would make your day, "a good call day."

Recently, I have discussed networks (Internet and electricity), but I would be remiss if I didn’t spend a few moments on the networks that are most likely to rob us of personal choice and increase costs: Health care networks. Wait, didn’t President Obama promise us that the new health care law would preserve choice for us? Didn’t he promise us lower costs?  Well, in spite of much good ...

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Recently, one of my best friends from medical school, Dr. Shoa Clarke published an op-ed in the New York Times titled, “How Hospitals Coddle the Rich.” In the article he describes how many hospitals throughout the country offer VIP services to the wealthy and how that may be detrimental to other patients not offered the same courtesy but also the VIP patients themselves. It’s a thought-provoking article that makes ...

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Statistics suggest that physicians are now spending a minimal amount of time in direct patient care, shockingly as little as 10 percent of their day. This proportion of time that physicians (and nurses) actually spend interacting with patients has been shrinking year by year. There’s the need to communicate with other members of the expanding health care team, increased bureaucratic requirements, and over the last several years -- the need to ...

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“It’s going to be ugly today” was my colleague’s assessment at 6:30 a.m. Wednesday morning, when the electronic medical record failed to launch, the Internet could not be accessed, pagers and phones could not connect, and a recording on the helpdesk line noted, “Systems are down, and there is currently no estimated time of resolution.” So we waded into fourteen hours of practicing medicine without computers. This was not good. Patients’ ...

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The use of information technology in health care holds so much promise, and potential yet to be realized. Ask any front line physician and they will list electronic medical records (EMRs) as one of their biggest daily frustrations. A brilliant video by Zubin Damania, also known as ZDoggMD, recently parodied the current situation and the pain felt by doctors on a daily basis. But it really isn’t all about ...

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Last year, I retired from full-time practice and moved to a new area. At about the same time, my wife was diagnosed with breast cancer, and because she was in good health prior, she had relatively little contact with the health care system as a patient. Before our move she worked as a part-time school nurse, so we were able to share provider horror stories from different perspectives. Since we moved ...

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