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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One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I think I know why. Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency ...

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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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Some seriously cool silent videos showing what surgery was like in the 1930's. Removal of a tuberculoma from the brain: width="425" height="344"> Caesarean birth, in the pre-WWII era: width="425" height="344"> (via Wired and MedGadget)

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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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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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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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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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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I am on record saying that some elements of tort reform will be passed by Congress. The most likely reform will be safe harbor immunity for following physician-developed practice guidelines. We believe this is a start. A more robust approach would include qualified immunity for those who consciously deviate from such guidelines because in a specific clinical circumstance, it makes good clinical sense for patients. This balance would keep doctors from ...

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