Ten years after the release of the IOM report To Err is Human, which documented the toll taken by medical errors in this country, the question remains: What can be done to reverse the trend of ever-increasing morbidity and mortality due to medical errors?
Last December, a look back over the decade since the release of To Err is Human — and a steady medical error death rate of about …
Overuse of the emergency department is commonly discussed during the health care conversation. Especially with the lack of primary care access shunting patients with seemingly routine symptoms to the ER.
But is this a myth?
That’s what two emergency physicians contend in a piece from Slate.
The emergency department is functioning just fine, they say: “Just 12 percent of ER visits are not urgent. People also tend to think ER visits …
Thanks to AOL News for publishing my latest opinion piece, Reform’s Great, But We Need More Doctors.
I discuss how health reform’s ultimate success or failure is largely dependent on whether our primary care system can accommodate the millions of newly insured patients:
… having health insurance doesn’t necessarily mean it will be easy to find a doctor. Even before reform, …
Medicare’s sustainable growth rate, or SGR, has been the bane of doctors for years now.
To encapsulate, this is the reason for Medicare’s annual threat to cut doctors’ fees by 20% or more, only to be staved off at the last minute.
Emergency physician Shadowfax has a nice take on it, explaining why it has devastated primary care:
Primary care has many fixed expenses in addition to those we bear: they pay …
One of my interns was “running the list” with me last week (giving me a thumbnail update on the plans for each of our inpatients). It was standard stuff until he got to Ms. X, a 80ish-year-old woman admitted with urosepsis who was now ready for discharge. “I stopped her antibiotics, advanced her diet, called her daughter, and YoJo’ed her.”
Say whaa?
I’m pretty sure that the most valuable thing I’ve done …
In America, too many people die in the hospital.
I don’t mean that they die due to medical error or incompetence, though that’s always a hot topic of discussion amongst doctors, researchers, administrators, and regulators.
What I mean is that if you ask most people, they say they’d rather die at home, surrounded by their loved ones, drifting off to sleep painlessly after having had last rites administered (feel free to plug …
An excellent article appeared recently in the Washington Post, entitled, “Having health insurance doesn’t ensure it will be easy to find a doctor,” where a young, otherwise healthy and insured woman discusses her extreme difficulty in finding a doctor in Washington, DC who will see her.
“I was just 23, basically healthy and, most important, insured. So I pulled out my computer, looked up the UnitedHealthcare list of pre-approved doctors …
Doctors don’t garner much sympathy when they rail against the perpetual threat of Medicare reimbursement cuts.
In a story from CNNMoney.com, a primary care physician provides some stark reality.
In an independent solo primary care practice, employing an office staff and two nurse practitioners for instance, fixed costs add up to $60,000 per month. A 21% cut in Medicare reimbursement, assuming an average sized Medicare panel, can take away …
When nurses sign out during the end of shift, it’s done so in a quiet setting.
Contrast that to medical residents — at least when I was a resident 8 years ago — where pager interruptions during sign out were the norm.
PookieMD compares the situation to the “sterile cockpit” that airline pilots enjoy: “Pilots have the sterile cockpit–a situation in which, if the plane is below 10,000 feet, only conversation …
Originally published in MedPage Today
by Joyce Frieden, MedPage Today News Editor
Patients with erectile dysfunction (ED) who were treated with telmisartan, ramipril, or both were at greater risk for cardiovascular events than other patients on the same medications, researchers found.
In men who reported ED at baseline, all-cause mortality during a median follow-up of four years was double that seen …
by Patrice Villars
The best learning experiences for me have been times when I come away questioning core assumptions about the work I/we do. As palliative care folks, we try to help people understand where they are in relation to their disease and what their hopes and goals are for care. We offer treatments and resources to match those needs through, in part, supportive communication.
What if, in our kind, well-meaning …
I haven’t ever saved a life. No doctor has. We may prolong the inevitable, but we don’t save anyone. We aren’t immortal, and weren’t meant to be. We die. All things do. Plants, animals, even stars. Death is as much a part of life as birth. And yet, at times people chase medical science as if we have immortality in all our gadgets and pills.
Why am I writing this?
A few …
As correctional health care professionals, there may be times when we are tempted to conduct ourselves in a less than professional manner simply because we can.
We may be able to get away with speaking to our patients rudely, using profanity profusely, or wearing inappropriate clothing. After all, we work in jails and prisons. This culture is far from prim and proper. And, our patients are inmates. Many may tolerate misbehavior …
Ten years ago, I was an Emergency Medicine Resident and wanted to die. Today, I’m a general practitioner in part-time practice and am in love with life. What made the difference? I signed up for a dance class.
Reports on physician burnout list the personality traits that set us up for trouble: we’re excessively conscientious, feel overly responsible, want to please everyone, and function on an extremely high level – even …
If the lack of time is the chief barrier to poor physician-patient communications, it logically follows that longer patient appointments are the solution. Ok, let’s say that I could wave a magic wand and add 5 or even 10 more minutes to the average primary care office visit. Would more time really make a difference?
Probably not.
A quick examination of just some of the key drivers of physician-patient …
I received several requests asking me to comment on this CNN story, “Some nurses paid more than family doctors.”
This isn’t really news, as CNRA salaries have been on a trajectory surpassing primary care physicians’ for a few years now. In fact, I wrote about it back in June of 2008.
According to the latest numbers, “Primary care doctors were offered an average base salary of $173,000 in …
Here’s a novel, and incredible, use of social media in health care.
A 40-year old man was admitted several days ago with a fever of unknown origin. His significant other, Laura, is live blogging his hospital stay — hoping to solicit other medical opinions on the case, as there is no clear reason on what is causing his symptoms.
Blogging at The Z Update, here’s an excerpt of how he …
With health reform possibly passing within the next few months, attention now turns to the primary care doctor shortage.
Regular readers of this blog know that there are not enough primary care doctors currently; it’s frightening to think what would happen if an additional 40+ million newly insured patients start looking for care.
A recent piece from Newsweek nicely encapsulates the problem. It’s a good piece, elucidating the myriad of …
I went to my physical therapist yesterday for knee treatment and we talked about the fact that Blue Cross is cutting their reimbursement to the point that the cost of providing care will not even be covered. All I could do was lament with him and listen.
One insurer even told him (the owner of the business) to just “make the sessions shorter and don’t give as much care.”
Clearly the insurance …
One of the joys of practicing at an academic center is that I get to do many different things in my job.
The foundation of my work is seeing my own patients in a large group (more than thirty doctors!) primary care practice.
Two months a year, I take my turn rotating on the hospital inpatient services, supervising teams of residents and students who are the primary caregivers for patients with illnesses …
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