Many healthcare organizations are contemplating making dramatic changes in the way they do business and treat patients.  Some of these are driven by the recently passed Accountable Care Act and the Tarp Bill.  They are planning on adopting electronic medical records, becoming Accountable Care Organizations or becoming Patient-Centered Medical homes. Unfortunately, like many businesses, they will undergo a lot of stress and loss of resources in time and money in making ...

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In 1905 William Osler gave his farewell address as he prepared to leave Johns Hopkins for Oxford and England. After speaking to the assembled medical students about the tragic side of medicine he said:

The comedy, too, of life will be spread before you, and nobody laughs more often than the doctor at the pranks Puck plays upon the Titanias and the Bottoms among his patients. The humorous side is really ...

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A response to my recent post, The malpractice system doesn’t improve patient safety. by Brian Nash In his blog, Dr. Kevin acknowledges that in the "world of medical error, truth is often clouded in secrecy." He then points out that "... taking the bold step of publicly describing your mistake is a brave one. Some would say it’s long overdue." Well so far, Dr. K, we’re on ...

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Medical errors have been in the news lately.  An Ontario provincial review probing unnecessary surgeries at a Windsor hospital found significant concerns with the work of a pathologist involved in a mistaken mastectomy case. In the US, avoidable medical errors added $19.5 billion to the nation's healthcare bill in 2008, according to a claims-based study conducted for the Society of Actuaries (SOA). The report lists the 10 most expensive errors in healthcare settings. Here ...

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I told a friend what I did recently to get in to see a dermatologist and she was shocked. “You wrote a letter asking her to take you as patient?” “Wow!” “Yes,” I admitted. “I’d called her office for an appointment; she wasn’t taking new patients; I needed to resort to an over-the-top approach.” You see, I’d researched her (ok, I Googled her) and after reading her background, schooling, and patient reviews, ...

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"Instead of focusing on treating him, an employee said, St. Mary nurses and other hospital staff did the unthinkable: They snapped photos of the dying man and posted them on Facebook." What can you say about an article like this? I bet there is not a single physician or nurse who are not reasonably conversant about the basic tenets of the health care privacy laws under which they practice. Stupid is as ...

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Year: 1993 Setting: Mendi Hospital, Southern Highlands province, Papua New Guinea Position: Chief medical officer for Chevron Chevron is contributing to the budget of Mendi Hospital in the capital city of the Southern Highlands province. Each year, the hospital director sends a financial request to the company’s medical department, and this is my first time to review and approve it. Curious about how the money will be used, I phone the director to ...

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Do nurses want to be doctors? Of course many do. And I say, if you want to be a doctor, go to medical school. I say that as a red-blooded, licensed, board-certified, AMA card carrying, guild mentality, protectionist physician. But I am also a citizen, a patient, a taxpayer, a public health professional, and a member of the Institute of Medicine (IOM) of the National Academy of Sciences. The IOM has recently issued ...

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Have you ever discharged a patient from the hospital and had a gnawing feeling that maybe you could have done more to educate the patient about their disease, medications, and plan of care? Probably so.  A recent survey published in the Archives of Internal Medicine tells us that this feeling is based in reality (I'm guessing that you already knew this) and that you are not alone. The ...

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Doctor, did you eat your fruits and veggies today? Two servings of fruit and three servings of vegetables each and every day? If you did not, how can you expect your patients, for whom you are supposed to set an example, to do so? The Healthy People 2010 program of the Department of Health and Human Services set as a goal that 75% of Americans would consume two or more servings a day ...

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