Jeffrey H. Millstein is an internal medicine physician.

New primary care decision support tools make offloading below-license tasks from the EHR more important than ever

Tech
November 29, 2023

Clinical decision support tools in the EHR are gaining momentum. These exciting and meaningful innovations are challenging us to make room for them to flourish.

New technology is often disruptive before it finds its way to being helpful. In the late 1800s, the telephone created unexpected challenges in medical practice at its inception; it brought a need for new team members to answer calls and required doctors and patients to develop …

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New primary care decision support tools make offloading below-license tasks from the EHR more important than ever

Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

Physician
March 15, 2023

For some, it may seem strange to think of the doctor-patient interaction as a relationship. In the most basic sense, a relationship is a connection; it is how two or more people or groups regard and behave toward each other. Relationships are not static – they are influenced by an ever-changing social, cultural, and political environment. They must try to adapt or risk tension and strife; the doctor-patient relationship is …

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Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

Thorough documentation can be weak representation of patients

Physician
October 20, 2018

I am recalling a workshop on unconscious bias from last year, the moderator hands outpatient prototype profiles to each table of participants. Ours is a glossy paper with a color photo of our patient, Jane, and a clear outline of her type of employment, hobbies, interests, family members, religious beliefs, and how she prefers to receive information. This strikes me as very clear and succinct, calling attention to many of …

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Thorough documentation can be weak representation of patients

What parenting has taught me about doctoring

Physician
August 10, 2018

Last year, my high school aged son took an interest in healthy eating. He began examining nutrition labels and scrutinizing the foods that we routinely keep around the house and came up with a list of criticisms and suggestions — some well-founded, and others a bit extreme. At first, my wife and I were quick to debate him on certain choices like eliminating any breakfast cereal that has enough sugar …

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What parenting has taught me about doctoring

It is time to reframe patients’ medical history?

Physician
June 2, 2018

It wasn’t long into my clinical training when I realized that most patients do not convey information the way templates are designed to record it.

Instead, they tell stories — which may weave from topic to topic, progress forward or backward in time or in patterns that may not be familiar or clear.

But they are told as the patient sees fit to convey them. David, a forty-year-old man who recently presented …

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It is time to reframe patients’ medical history?