Here are five things that you should have on your 2011 To-Do list. 1. Start electronic prescribing. What have you been waiting for? The EMR/EHR? (See number 4 below.) Electronic prescribing can work in a stand-alone (no EMR/EHR) environment. Work flow can be modified, and you will benefit tremendously with additional nurse time available to you after the nurses realize how much phone time they save each day. Ask your current practice ...

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Oh, those Millennials. Also called "Generation Y," this is the American demographic group born during and after the '70s, that was vicariously raised by "learning is fun" Sesame Street and became accustomed to getting awarded for any effort. They don't know about bomb shelters, walking to school, tape decks or having to get up to change a TV channel. Well, they're now entering the workplace and their informality, disregard for rank, ...

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Can you succinctly state what your company does, where it’s headed and how you plan for it to get there? In the April 2008 edition of Harvard Business Review, Collis and Rukstad ask an important question: "Can you say what your strategy is?" Of course, they ask this because their research found that many firms’ CEOs cannot succinctly summarize their organization’s strategy. And if the CEO cannot do this, then it’s a ...

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by mdstudent31 One of the hot topics occurring in the health care debate deals with figuring out appropriate leaders of the Patient Centered Medical Home (PCMH). With the recent report by the IOM advocating for independent practice by nurse practitioners, many physician groups, including the AAFP and AMA, have come forth with strong statements advocating against the IOM report and independent practice by CRNPs. A recent editorial ...

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Have you ever been frustrated by an unproductive or inopportune visit with your doctor that wasted your time and money? Here are a few tips to keep that from happening again. The problem Many visits with healthcare providers are poorly timed and less productive than they could be.  Why?  Because nobody is looking out for you between visits. It’s not that your doctor doesn’t care.  He or she is simply too busy with ...

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by Louise Marie Roth, PhD About one third of all births in the contemporary United States occur via c-section.  Physicians and the public at large often attribute this to a "malpractice crisis," whereby obstetricians perform c-sections routinely to avoid malpractice litigation.  Over the last couple of years, I have been conducting research on obstetric practices and malpractice. One of the things that I have learned ...

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I was sitting on one of the hospital's nursing units having a difficult telephone conversation.  Anyone working nearby could have easily discerned the situation from my end of the call. Patient's family member wants to keep aggressive care going for a comatose, terminally ill family member against the best advice of the medical team. Having never had to make such a decision in my own life, I am left to imagine how ...

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Does patient satisfaction matter? The answer is a resounding "yes." In fact, as the director of an emergency department, feedback from dissatisfied patients has provided both me and our group with an early warning about several physicians who were not performing up to our standards. Studies show a clear correlation between decreased patient satisfaction and increased medical malpractice risk, so meeting our patients’ needs is not only in their best interests, ...

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When I was an intern in internal medicine, I admitted a patient to my service with pancreatic cancer. Pancreatic cancer is a bad one; back then, only ten percent of patients with it would be alive within five years after being diagnosed.  My patient was a farmer in the full bloom of late middle-age health when he began rapidly losing weight. An abdominal CT scan ordered by his primary care physician ...

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An interesting article in JAMA by Drs. Jain and Cassel referred to the British economist Julian Le Grand who suggested that public policy “is grounded in a conception of humans as knights, knaves or pawns.” Basically, are we motivated by virtue, by self interest or are we just passive victims? The authors suggest that this is a good question not only for physicians to contemplate but ...

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