How can we possibly get to standardization in medicine? And is that a good thing? Standardized checklists save lives; rigid procedures for sterilization of equipment saves lives; universal compliance with recommended beneficial treatments saves lives. And while it's sometimes a wonderful thing to let a surgeon solve a problem creatively or to allow a patient visit to go overtime in order ...

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At a certain point, we've all got to go home. Whether it's the end of the shift when the factory whistle blows and the assembly line stops rolling for a brief period while new people take our place, or late in the day after the last patient has been seen and our notes are all written and our portal messages have ...

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Returning from my week of vacation, I was greeted by the usual stack of mail, faxes, forms to be signed, throwaway journals, and a fully loaded group of in-basket messages that had piled up in the electronic medical record that needed attending to. One of the pieces of mail was an unsolicited package with a bright red label on it, along with ...

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As many of you know, if you've read my columns regularly, once a year the whole family escapes from the city, and we travel up to New Hampshire to stay at the lake house that's been in my wife's family for over 100 years. A modest wooden house perched out over the water, situated just right for sunset viewing, for a few ...

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During one long ago very hot Washington, DC summer, at the suggestion of my parents, I enrolled in a typing course that was given at our elementary school. This was the summer between sixth and seventh grades, and there were lots of things I would've preferred to have been doing, but my dad, who started out in advertising, felt that touch-typing ...

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About once or twice a day, everyone on our hospital's computer network gets an emergency message that scrolls across the bottom of our screens, highlighted in the colors of danger and warning. They include things like a notification that a particular data system is down and that a backup on paper will have to be used for documentation, or the hospital ...

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Collaboration is the key. When I think about how hard it is to take care of our patients, and how many different people are involved in their care, it's a wonder that anything ever gets done. We need to simplify systems, and harness the power of the information systems available to us, as well as the promise of the electronic medical record, ...

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As we've seen, the lives of those working in the health care system has become overwhelmingly challenging, burdened by all of the excess nonmedical stuff that has been added into our lives as we try to take care of patients. From prior authorizations, to clicking in the electronic medical record, to endless streams of regulatory requirements, to the continuous onslaught created by ...

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It's always kind of a surprise when you read a patient's chart, and you see an examination of a body part they just don't have. Just the other day, I was reading a consult note on a patient of mine who had been seen by a subspecialist for evaluation of a serious issue, and I received back a long detailed office ...

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I just did my first telemedicine video visit. The concept seems so strange, the idea of carrying out an "office visit" without the patient actually being in the office. Right now we have it structured so that when a patient calls up requesting to see me on a day when I am already fully booked (or, as is usually the case, overbooked), ...

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