Physician

Reducing the paperwork burden on primary care

Of the many obstacles facing primary care, the sheer amount of paper stands out as one of the most burdensome.

There are studies that show that every hour of clinical care generates an additional hour of paperwork. In fact, as Better Health’s Val Jones recently notes, one-third of a primary care doctor’s income is spent on paperwork.

It’s no wonder that the PCP burnout rate is so high, and why …

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Should doctors be paid to e-mail their patients?

by Michael Kirsch, MD

This is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.

* Decompress phone lines, which are suffocating nearly every medical practice in America.

* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.

* Allow office staff …

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Doctor makes more money on eBay than practicing medicine

It’s no secret that more primary care doctors are looking for careers outside of medicine.

And no wonder, considering that burnout rates are at all-time highs, compounded by soul-crushing bureaucratic responsibilities.

This profiled physician on CNN.com, who works at a community health center, sells clothes on eBay – which is not uncommon on the online auction site. What’s impressive, or disturbing, depending on your point of view, is that …

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What was surgery like in the 1930s?

Some seriously cool silent videos showing what surgery was like in the 1930’s.

Removal of a tuberculoma from the brain:

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Caesarean birth, in the pre-WWII era:

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(via Wired and MedGadget)

How to reduce primary care physician burnout

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Primary care physicians who took part in a continuing medical education program emphasizing reflection about their clinical experiences reported improvements in burnout and mood, researchers found.

medpage-today The participants also indicated positive changes in empathy and psychosocial beliefs, suggesting a more patient-centered approach to care, according to Michael Krasner, MD, …

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How much unnecessary testing goes on in the ER?

Plenty, if you ask the people most familiar with the situation, the emergency physicians themselves.

According to a survey from Emergency Physicians Monthly , many tests performed in the ER are deemed unnecessary to good patient care. Here’s how doctors responded to the following question: “Given that in a typical shift of eight hours you see an average of two patients per hour (16 patients/shift), could you have eliminated …

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How to provide safe, quality hospital care by increasing transparency

Paul Levy is the CEO of Boston’s Beth-Israel Deaconess hospital, and one of the nation’s foremost patient safety advocates.

He blogs at Running a hospital, where he openly talks about the various issues facing a major academic institution. Increasing transparency, such as shining a light on medical errors and hospital infection rates for instance, can provide an effective way to confront each of these issues, so patients can benefit.

Better …

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Reasons why doctors practice defensive medicine

Here’s a simple chart that sums it all up. Apologies for the small type.

defensive medicine

As The Happy Hospitalist writes, “Some doctors and patients may be willing to experience some anxiety for the unknown. But most won’t, especially since neither party is directly paying for the testing. This selfish interest is rooted in moral hazard, at the expense of …

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Does the bulk of excessive medical care happen in the ER?

by Michael Kirsch, MD

The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons well. Physicians who sent their patients for various diagnostic tests or specialty consultations were regarded as conscientious and thorough. Patients approved of doctors who prescribed antibiotics regularly for colds and other …

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How hospitals should deal with disruptive physician behavior

by Mark N. Simon, MD

What can hospital medical staff leaders learn from University of Oregon football coach Chip Kelly? In the morning of September 4th, Kelly had an opportunity to review video tape from the conclusion of his team’s game with Boise State University the night before. What he saw was his senior running back LeGarrette Blount punch an opponent and then lose his cool with the fans …

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Medical malpractice reform by President Obama and the White House

by Emily P. Walker, Washington Correspondent, MedPage Today

The White House today announced details of a $25 million grant program to test alternatives to the tort system for medical liability cases.

medpage-today In his Sept. 9 speech before Congress, the president announced he would direct Kathleen Sebelius, Health and Human Services secretary, to launch pilot programs meant to cut down on physicians …

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Do physician apologies make it less likely for patients to sue for medical malpractice?

Not necessarily.

That’s the finding from a recent study in the Journal of General Internal Medicine.

What the researchers did was simulate three scenarios of medical mistakes, “a year-long delay in noticing a malignant-looking lesion on a mammogram, a chemotherapy overdose 10 times the intended amount and a slow response to pages by a pediatric surgeon for a patient who eventually codes and is rushed to emergency surgery.”

Varying degrees of physician …

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Does preventive medicine save money or cost more in the long run?

It depends if you see the glass half empty or full.

I’ve written on several occasions that there is little evidence that preventive medicine saves money, despite what some politicians say or believe. A recent study from Health Affairs provides more clarity, as it related to the long-term implications of diabetes.

There are two decidedly different takes on the article. First, according to The New York Times’ Prescriptions, it …

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Violence in the emergency department and how to promote ER safety

by Patricia B. Allen, MBA, RN

What would you differently tomorrow if you had a violent episode in your emergency department today?

Violence in the ED is a growing and alarming phenomenon. A recent survey conducted by the Emergency Nurses Association (ENA) revealed that 25 percent of the RN respondents report experiencing physical violence more than 20 times in the past three years and 20 percent of the respondents revealed encountering …

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A patient dies after doctors fail to communicate in the operating room

by Jerry I. Meyers, Esq.

Communication is essential between health care providers but sometimes communication fails because of the arrogance or carelessness of the persons involved in the needed medical communication.

Several years ago, a female client about to enjoy an important anniversary was admitted to a University affiliated hospital for the purpose of having a colostomy wound debrided.

This was to be a one-day inpatient hospital procedure and was associated with little …

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Should patient satisfaction influence physician compensation?

One bane of emergency physicians are patient satisfaction scores, which some hospitals use in part to determine physician salaries.

Often times, if patients are denied, say, opioid medications, they’re more likely to give low scores, which the hospital administration can then use to penalize doctors. Of course, this creates an incentive to give patients everything they want, sometimes to the detriment of good medicine.

But Shadowfax, an emergency physician-administrator, delves …

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Should elderly patients always be admitted to the hospital?

95-year old patients who go to the emergency department, more likely than not, will get admitted to the hospital.

But is that always what’s best for the patient? Emergency physician Graham Walker suggests not. He notes, correctly, that, “the group with the highest odds of having something seriously wrong with them are probably also the most likely to have something go wrong with them while they’re in the hospital.”

Indeed, …

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Does being on the America’s Best Hospitals list affect patient outcomes?

by Charles Bankhead, Staff Writer, MedPage Today

A news magazine’s rankings of top-rated hospitals for heart failure care did not include many hospitals that performed at least as well as the ranked centers, according to a comparison of the magazine’s list and government data.

medpage-today Hospitals that made the U.S. News & World Report list had a better 30-day mortality than …

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