After six weeks in the accelerated bachelor of science in nursing program at the University of Rochester, I was already on clinical rotations in the hospital. I was learning clinical functions that my second-year medical school friends had no idea how to perform: catheterizations, wound dressing changes, how to calculate and administer medications.  There’s just not enough time in the first two years. On the other hand, in the nursing program, ...

Read more...

Choosing a new doctor is never easy. You need to know about convenience factors, such as office location, available appointment times, and accepted insurance plans. You will probably also consider background information, such as education, board certifications, and licenses. But the most important question you likely have involves results: Is this doctor any good? Unfortunately, there just isn’t a single, perfect way to measure the quality of individual doctors. ...

Read more...

In addition to the possible legal pitfalls of advertising on Groupon-type websites, there are also ethical and practice management concerns to be weighed by healthcare practitioners before agreeing to such arrangements. Even with the recent announcement that companies such as Groupon and LivingSocial may be offering contracts to healthcare providers that take into consideration the prohibition against fee splitting, practitioners should nonetheless proceed with caution. The concerns about social coupons in the healthcare context extend ...

Read more...

One of the more contentious topics on my site is the scope of practice for non-physician providers, such as nurse practitioners.  This echos the debate on the national stage where leaders of physician organizations, who want to protect their scope of practice, conflict with those of nurse practitioners’, who want to perform the tasks that physicians traditionally have. Simply Google “nurse practitioner” on this site, for instance, and you’ll see ...

Read more...

The Oregon Medicaid study: What does it tell us? Recently, an article by Kate Baicker and colleagues came out in the New England Journal of Medicine. Almost immediately, the article received widespread attention in the media where headlines claimed that giving people Medicaid coverage doesn’t improve their health. This is not exactly what the article said, but most journalists aren’t scientists, so we should cut them a bit of ...

Read more...

I used to be a stickler for time. One of my first blog posts was about how it felt to go to work without my wristwatch. I also used to be very particular about knowing the purpose of each visit, partly to help me manage my time, and partly to help me feel prepared and in control of the visit. I often questioned why my colleagues’ patients would sometimes end up in ...

Read more...

American health care: The problem of always wanting more I remember going to see the movie “Oliver” in the theater when I was a kid.  Since this was my first movie in a theater, my mom made me a treat: a bag full of raisins and chocolate chips (Raisinets for Dutch people) and sent me there with my sister.  It was a fine film, with Oliver getting kicked out of the ...

Read more...

In the wake of the Newtown shootings, as a country we are all taking a step back, looking at our laws and our policies and thinking about what we can do to prevent unspeakable tragedies like the deaths of those children from happening again. I am not a gun owner and never will be, but I am not advocating getting rid of all the guns. I totally get that there are ...

Read more...

I recently blogged about the question of what the difference is between a doctor and a nurse, now that advanced practice nurses can do so many of the same things physicians do.  As both a nurse and a doctor I thought maybe I could wade into that quagmire.  In that post I suggested that the real difference is one of ultimate responsibility.  A reader pointed out that this ...

Read more...

How to effectively keep tabs on a patient’s multiple medical problems? And how to do so without losing sight of the whole person? The first question is the one I wrote about in a recent blog post. The second was the theme of many of the responses and also LinkedIn. I love this second question; it’s an issue that’s always been of interest to me. Plus it’s especially ...

Read more...

Trending