From the sublime to the ridiculous. That's sort of how my day went yesterday. It started out with an early morning meeting with a colleague who has been implementing a telehealth program at one of our institution's practices, learning about how they have been using this technology, some of the bumps in the road they'd hit, and how they'd been able to ...

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Yesterday, I went into an exam room to print out some orders for a patient who needed to get his labs done at an outside facility. Due to his insurance, he cannot get his labs drawn in our office during a scheduled appointment, but must do it at one of the laboratories that his insurer has contracted with. Not a terribly big ...

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Several weeks ago, as I was walking through the halls of our hospital, out from an intersecting hallway drove a robotic delivery cart. Unmanned and adorned with sensors so it could tell where it was in the world, it motored along on its way, heading somewhere with a bunch of flashing lights and audible warning signals. I was told this was part ...

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Recently, I was called to task -- and probably rightly so -- for signing something I know I didn't read. This was several months ago, when one of my partners was out on family medical leave, and we divided up all of the coverage of her patients while she was away, making sure that forms for home health aides were signed so ...

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One little thing. Somehow, with the changeover to the latest release of our electronic medical record, something happened to some of the demographic information on our patients. Suddenly, an enormous number of patients were now labeled as choosing not to disclose their gender. When I first noticed this, it was flagged in bright yellow on the banner in a patient's chart when I ...

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Who works for who? How did we allow ourselves to let a system get built up around us that makes it so hard for us to take care of our patients? Our job is to advocate for our patients, to help guide them towards their best health, to help them understand the difficult choices and to live healthy lifestyles, to give them ...

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Just the other day, while I was in the middle of seeing a morning schedule full of patients, I opened one patient's chart and was thrilled to see a whole bunch of new icons in Chart Review in the electronic health record that I had never seen before. These apparently indicate office visits and other health care encounters with outside providers. Sometime during ...

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I think the time has come for us all to do a little more than put our 2 cents in. Our health care system is a mess, and while many of us fighting in the trenches and taking care of patients are working to make things better (despite the best efforts of much of the rest of the system), the challenges and ...

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Every day, as we care for our patients, we are placed in a unique position, where we are armed with the world of literature, randomized controlled trials, society recommendations, national screening and practice guidelines, and more, working to prompt us to try and do what's best for each patient in a vast array of clinical situations. And patients come to us armed ...

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Apocryphal story from residency: On morning rounds in the critical care unit, the post-call resident starts to present a complicated patient admitted overnight with chest pain, and after the first bits of the history have been presented, the wise old cardiology attending turns to the gathered medical students who are just starting their first clinical rotation and asks them what they ...

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