Fred N. Pelzman, MD

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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Once again, we find ourselves stuck between a rock and a hard place. Increasingly, providers are being pressured to improve access for our patients, which we certainly think is a good thing. We want our patients to come in, whether it's for their annual physicals, for ongoing routine management of their chronic health conditions, or for acute issues best handled in the ...

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To do the math right, you have to get your numerator and denominator correct, or else things just don't work. Recently, in the midst of a large patient safety and quality improvement project trying to bridge gaps in breast cancer screening among our patients, we discovered that one of the large databases of patients who were attributed to us contained innumerable ...

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Several patients seen in our practice recently were significantly and dramatically transformed by the electronic health record (EHR). And not in a good way. Take, for instance, the patient whose outside chart was reviewed when she showed up in our office for a follow-up appointment after an emergency department visit. The notes from the emergency department providers, including a scribe and the ...

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86 minutes. That's what I found when I added up how late patients were through a single practice session earlier in the week. Some patients arrived on time, and some a few minutes early, but the average was about 8 minutes late, ranging up to one patient who showed up an hour and 12 minutes after their scheduled appointment time. The reason I ...

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How do we change the way we think about taking care of patients, particularly when it comes to not the individual patient sitting in front of us, but a whole population of patients just like them (or somewhat like them)? In our practice, we have been struggling with how to best do population health, trying to find the best ways to ...

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5,177. That's the current number of "cc'ed charts" as of this morning in my electronic health record in-basket. While it might sound like a lot, this is not at all an unusual accumulation, partly due to the fact that I receive a notation every time a patient at our practice gets a flu shot, and also every time one of my patients or ...

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