Burnout and dealing with its symptoms has become a hot topic in the last decade. It’s a problem that has multiple contributing factors. Some of those factors are thrust upon us and are beyond our control, such as government regulations. Other factors are self-imposed, and thus under our control, such as volunteering for extra call shifts. One self-imposed factor is a little thing we use to improve our lives, our …
We all have that one patient. That one patient who can always find a way to turn a good day bad, who just knows how to push your buttons in all the wrong ways.
Who’s that patient for me? Let’s just call him Elton Reed.
Oh, Mr. Reed … where to begin with him?
When we first met, I remember being so excited and energized by him. He just had this fresh feeling …
Attend any biotech or health informatics conference and one thing becomes clear: the scarcity of physicians. Entrepreneurs, businessmen, angel investors, and software engineers swarm these conferences — and their encompassing companies — all the while the imperative persona in this realm remains tied up behind a dysfunctional EHR or in an overbooked operating room. Why?
Certainly, inculcating these dynamic players in the health care space is integral to the successful evolvement …
“There’s an app for that.”
The phrase became so popular with the advent of smartphones that Apple even trademarked it. There are currently 3.8 million apps available on Android devices and over 2 million available to Apple iPhone users.
Does that mean that we’ve reached a limit on new and useful apps that can be created? Absolutely not. Especially in the medical world, it seems as if there’s so much room to …
It is all too common for a section in a progress note to look something like this:
# Aspiration pneumonia:
- Continue vancomycin 1 g bid
- Continue Zosyn 3.325 g q6h
- Follow-up blood cultures
- Follow-up sputum cultures
- MRSA nares screen negative
- Blood cultures negative
- Discontinue vancomycin
Yesterday, a version of this note (lines 1 to 5 to be precise) had my name on it. Today, it is signed by someone else. Read it …
The third year of medical school is when a student experiences the frustrations of medicine firsthand. Once, my team admitted a transfer patient from another hospital to treat a condition that was ravaging the patient’s lungs. But before we could act, we needed to rule out a dormant infection; if our patient was unknowingly infected with tuberculosis (TB), giving our first-line therapies could lead to a disseminated infection — even …
In about 1990 we got our first computer. I say “we” because my husband and I shared a desktop which I used infrequently. I mostly used it for word processing, and the Internet was very young. At the turn of the millennium, my children were using computers, and they were limited to 1 hour of computer time a day, which was on a shared desktop. By 2001, I was communicating …
I have wanted to be a pediatrician since I was eight years old. Growing up, my favorite book was the large medical encyclopedia that sat on the bookshelf in our den. My life has been planned around that singular goal, each step predetermined and in a very specific order. I have thoroughly enjoyed practicing medicine over the last 17 years — first as a primary care pediatrician, then for the …
A patient comes into the ER complaining about throbbing migraines after falling off her bicycle; thus, the physician quickly orders an X-ray, complete blood count, and asks the nurse to schedule the patient for an MRI of the head and neck in case both those tests come back inconclusive. As an ER scribe, I saw many conditions where the physician would quickly do a physical exam, and then use a …
During residency, one of my patients brought a tape recorder to his appointment. It was a big bulky old tape recorder, that was antique technology ten years ago. He was older and wanted to record his appointment so he could remember every detail. His children often called him and wanted an in-depth report of all of his medical visits. He decided he would audio-record his appointments and send the tape …
The business value of medication adherence tools is coming into focus. For years, I remarked that, while we could create a case for why adherence was the right thing to do, we had great difficulty creating the right financial incentives to move these programs from curiosity to scale. That is changing now with the collision in the marketplace of new payment models and exorbitantly priced pharmaceutical products.
The poster child for …
Virtual visits are increasingly the rage amongst forward-thinking healthcare providers that want to jump on the telehealth band wagon. Extending the office visit across distance, using the same technology we use to keep in touch with loved ones (videoconferencing such as Skype and FaceTime), is a safe and logical way for providers to venture into a new tech-enabled world that may still be scary for some.
One way to think of …
I order pregnancy tests on men. In fact, I do it pretty frequently.
Now before you go and question my professional competency, let me assure you that I went to a good medical school. I also completed a four-year residency in emergency medicine at a top-notch residency program. I was board-certified less than one year after finishing and have maintained that status ever since.
Despite this, I still order pregnancy tests on men.
Perhaps …
Last week I was playing golf with some friends. The Boston area has been having a bit of an Indian summer, and we are lucky to still be getting out there (long may it last). The conversation during one of the holes turned to health care information technology, when my friend, who is also a physician, told me about his experiences with a (certain famous) new electronic medical record that’s just been installed in their …
I have a love-hate relationship with the electronic health record (EHR).
To be precise, it’s 90 percent hate, 6 percent love. The missing 4 percent? That would be the percentage of time spent on the phone with tech support trying to figure out which order set I have to use to input percentages.
I’ve been in practice long enough to straddle the transition from paper … to even more paper (thanks EHR, you’re the …
I peeked. Several months ago, I met a 60-year-old woman with shortness of breath. Her hospital stay was a whirlwind. She had lost weight, and a test detected her stool had blood in it. This was an ominous sign. Within a few hours, she underwent a colonoscopy that revealed she had colon cancer. The colorectal surgery team whisked her away from my general medicine team. I soon left that hospital for …
I recently read an article in Politico entitled “Doctors barred from discussing safety glitches in U.S.-funded software.” The article states that, despite massive public funding of electronic health records (EHR), the EHR corporations (including Epic Systems, Cerner, Siemens, Allscripts, eClinicalWorks and Meditech) routinely attach gag clauses to contracts with the hospitals and medical groups who purchase their systems. We are talking about gag clauses that prevent criticism by …
The health information technology (HIT) world has been hit by a watershed event like no other. The Department of Defense (DoD), widely respected for its indiscriminate generosity to contractors, has awarded the most coveted prize in recent HIT memory: the Defense Healthcare Management Systems Modernization (DHMSM) contract. And the winner is … Leidos, the contractor formerly known as SAIC. A couple of years ago, when the race for …
So, there I was yesterday, working frantically to keep myself above the water level of the rapidly rising swamp of patients. Navigating, haltingly, the onerous and demonic EMR. So I thought I ordered three nebulizers, but it was only one. The respiratory tech approached me and informed me that she would put them in, but only this time. That I’d have to …
The U.S. health care system is headed toward a profoundly digital future. Provider organizations around the country are adopting and updating their health information technology (HIT) infrastructures. Many have begun requiring that clinicians gain proficiency in electronic health records (EHRs) in order to provide clinical care. A proliferation of start-ups and HIT companies in health care is poised to disrupt (innovatively or …
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