Dear ACO General Hospital: Thanks for contacting me about my most recent blog post.  I'm sorry to scare your administration about HIPAA information, but I am equally concerned about that and will always do my best to respect the privacy of my patients.  At your request I hid even more of that information. I know it's kind of embarrassing to have that kind of thing made public, and I am overall ...

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The observation status problem has continued to grow both larger and worse. My hospitalist colleagues and I are caring for patients in hospital beds in the exact same way as other patients in the hospital, but we are told that we must give them the designation called observation status.  CMS recognizes observation status as outpatient care, like seeing a patient in a walk-in clinic. We don’t decide to make a patient observation ...

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Among reams of coverage on the Ebola outbreak, Politico just published a characteristic story with the headline, “In the world of Ebola, no room for error.” The only problem is that is as soon as you introduce a human element to any system, there will be error. That’s the reality that health care leaders across the United States are grappling with now in a simultaneous effort both to tighten the health ...

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Patient satisfaction: Should that be the real mission of health care? As the patient satisfaction movement races full steam ahead, the time is perfect to regroup and define what this whole thing is really all about. Anyone involved in health care, and particularly hospital care, knows that the term “patient satisfaction” has become a buzz phrase recently. Sadly too it’s also evolved into a bit of a bumper sticker in hospital administration circles ...

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Health reform: Great for patients, but this doctor lost his job As an employed physician specialist working in an underserved community, I am thrilled with the Affordable Care Act (ACA). I was initially a skeptic of the program because of the cost to taxpayers, but I have since witnessed first hand the tremendous benefits. People with limited resources and real problems can now get help without suffering financial harm. Those with chronic ...

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Too many cooks in the kitchen can spoil medical care There are times when a common cliché may be the best way to describe academic medicine in today’s medical centers.  In fact, I have heard patients and their families complain about this, way too often.  Simply put, there are many occasions when it seems that there are too many cooks in the kitchen. When someone gets admitted to the hospital, chronic problems ...

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A physician undergoes hip surgery: 10 observations from bedside It finally happened. After years of sitting at John’s bedside through multiple serious bike crashes, I had one of my own. I’ve had plenty of time to build up a ridiculous amount of smugness about why he crashes and I don’t. “John is reckless; Staci is cautious. John rides like an airplane engine on a shopping cart; Staci uses her head.” I ...

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What can be said about the Generation Y physician? Tech-savvy.  Attention-craving.  Lazy, good-for-nothings. These are a few of the many traits that have been commonly bestowed upon those born around the last two decades of the 20th century.  Commonly known as Generation Y, this demographical cohort of 20- to 30-somethings has certainly sparked mixed reviews from its Gen X and Baby Boomer elders. But what defines the particular subgroup of young ...

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 Patient perceptions of the hospital experience Patient perceptions of the hospital experience An excerpt from Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way. Patients’ definition of their own experience is quite divergent. We ask patients for feedback, and the results are fascinating. We’ve found that patients often use the word experience in their comments: “I can’t believe how ...

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Recently, Apple introduced its newest product, the Apple Watch. According to Businessweek, Apple spent years researching watches before deciding to build one. The company flew watch historians to California and they worked to understand how wristwatches have traditionally been used, and how a new “wrist computer” might work. They have hired leaders from diverse backgrounds -- none of them techies -- to lead these efforts. It struck me that health care could learn ...

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