Why do we physicians chart the way we do? Hopefully, you do it perfectly well and have no concerns at all. But where I practice emergency medicine, we are approaching maximum inefficiency in charting.
It all became much clearer when we started using our new EMR system. Let me make it clear, I’m not against EMR. In fact, typing and templates work better for me than dictating. My dictations were usually …
If you’ve ever been on a diet, you know that it really helps to keep a food log. Seeing your consumption chronicled in one place is illuminating – and often explains why those love handles aren’t melting away despite two hours on the treadmill each week.
In a recent issue of the New England Journal of Medicine, internist Rich Baron Rich Baron chronicles the work of his 5-person Philadelphia office practice …
A primary care resident wrote in one of the journals recently about making the limited time she has with each patient matter the most.
How refreshing, I thought when she concluded that time ultimately is an absolute and finite resource. We often feel as if we are battling time as much as we are battling disease, and we sometimes have trouble admitting when we are losing either one of those battles. …
by Diana E. Lee
One member of my health care team is a migraine specialist in another state. Since we don’t have many opportunities to work together in person, we generally try to pack a lot into my periodic two-day visits.
Last time I was there I had an experience that has left me feeling guilty all these months later.
My doctor, who I respect and admire greatly, asked if I was interested …
by John Gever
Emergency department patients with chest pain may safely be evaluated in the waiting room when necessary, researchers said.
Among 303 patients triaged to waiting-room evaluation in a prospective study, no acute coronary syndromes were missed and adverse event rates overall were lower than among 804 patients who were assessed in conventional monitored beds, reported Frank Scheuermeyer, MD, of St. Paul’s Hospital in Vancouver, British Columbia, and colleagues online in …
by Chris Emery
Single and childless surgical residents in the U.S. are more likely to pursue specialized surgical fellowships, and a majority of surgical residents believe a successful career depends upon specialty surgical training, a new survey found.
Of residents who responded to the survey, 28.7% believed general surgery is becoming an obsolete career path (30.1% of men and 25.9% of women, P=0.004), and 55.1% believed specialty training is necessary for career …
There’s little question that the workplace environment for doctors is deteriorating.
Especially in primary care, where physicians are arguably needed the most.
That’s why is so disheartening to read this Newsweek essay from pediatrician Karen Li, explaining why she left the field.
Much of her piece can be attributed to the bad old days of managed care, where doctors were frustrated by the bureaucratic impediments placed before them:
Why would a businessman or, worse …
I recently read about a case involving the next step down the slippery slope of criminal prosecution of physicians.
First Michael Jackson’s physician gets prosecuted when his physician gives him an unintentional overdose of an anesthetic medication when trying to help him sleep. According to a previous discussion on this topic, most people seemed to think that prosecutors were justified in those charges.
Now, Dr. Mathew Wallack is being criminally investigated for …
by Nancy Walsh
Busy clinicians in the emergency department reduce the time they spend on clinical tasks when interrupted, working faster and possibly cutting corners, a prospective observational study found.
Overall, clinicians were interrupted 6.6 times per hour, and 11% of all tasks were interrupted, according to Johanna I. Westbrook, PhD, of the University of Sydney, in Australia, and colleagues.
The mean “time on task” for uninterrupted tasks was 1 minute and 26 …
Expanding never events to include conditions that may not be totally preventable is bound to invite controversy.
I wrote about the issue previously in USA Today, saying, “despite impeccable care, some hospital complications cannot be prevented.” I cited the facts that no studies exist that show how infections can be cut to zero, and even the government acknowledges that there are few effective guidelines to reliably halt the onset of …
Time to turn our attention to an unpleasant topic: Lawsuits.
Who files them?
Why? And what actually happens?
There have been oceans of ink spilled about medical malpractice. An oversimplification of the various positions on malpractice and malpractice reform goes something like this:
by Tim Harwood
Hundreds of thousands of people each year are taking the plunge and choosing to have the life changing procedure that is laser eye surgery.
It is currently the most popular elective surgery in the world and the number of people having it done is likely to increase as the procedure becomes safer and more accurate. If you yourself are considering having laser eye surgery, then you will almost …
A video excerpt from The Vanishing Oath, a film directed by Ryan Flesher, MD.
Medical malpractice is a major issue that divides doctors and lawyers — with patients often left in the middle. I wrote last year in USA Today that reform is sorely needed, mainly to help injured patients be compensated more quickly and fairly than they currently are:
Researchers from the New England Journal of Medicine found that …
by Emily P. Walker
Physicians should record body mass index (BMI) of their pediatric patients during routine offices visits, according to a sweeping new plan laid out by a White House task force on ways to shrink childhood obesity rates over the next 20 years.
The inter-agency President’s Task Force on Childhood Obesity was formed three months ago as part of the Let’s Move! initiative and was given 90 days to draft …
Do doctors take care of themselves?
Sometimes, patients may better follow the advice of physicians that are not obese and don’t smoke. That was a question asked in a post last year, entitled, When fat doctors talk to obese patients.
According to studies, as reported in the Wall Street Journal, it’s a mixed bag:
Physicians as a group are leaner, fitter and live longer than average Americans. Male physicians keep …
by Todd Neale
British civil servants working three to four hours longer than usual per day appear to have an increased risk of having a coronary heart disease event, a prospective cohort study showed.
After accounting for traditional cardiovascular risk factors and other variables, those working 11 to 12 hours per day had a 56 percent greater risk of coronary death, nonfatal myocardial infarction, or angina than those who worked normal hours, …
How much is a primary care appointment worth?
Not much, it appears.
Physicians in California decided to embark on an innovative idea, asking patients to simply pay them what they thought the visit was worth.
Here’s how it worked:
On the day of the events, no insurance was accepted. Care was provided only to the uninsured, who were asked to pay what they could afford. Laboratory tests were provided at cost, and patients who …
by Todd Neale
Eating nuts improves blood lipid levels, which may help stave off heart disease, researchers found.
In a pooled analysis of 25 intervention trials, eating an average of 67 grams of nuts a day (2.4 ounces) reduced total cholesterol by 5.9% and LDL cholesterol by 7.4% (P<0.001 for both), according to Joan Sabaté, MD, DrPH, of Loma Linda University in California, and colleagues.
The ratios of total to HDL cholesterol and …
Spring cleaning is a tradition in many homes. The occupants open up the home to the spring air, thoroughly clean the home, and sort through the accumulated goods, getting rid of things not used for a long time and which no one wants anymore. It gives one a sense of accomplishment, makes for a more pleasant surrounding and frees up space.
Is this something that you do at your healthcare site …
I believe in the peak oil theory.
Think about it, in a closed system nothing is infinite. Since oil is a product of millions of years of decay, unless we use it at the same rate that is it produced, we will run out. I do not have a crystal ball any more than anyone else I know, so I will not hang my hat on when, but will commit to …
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