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Lotteries in life may have to do with suffering, disability and death

Patient

January 8, 2011

Winning the lottery — yes, I’ve heard the horror stories of how people’s lives have taken a turn for the worse after it’s happened. But, like many others, I still wonder what it would be like. I’d be willing to take my chances with the win!

But this post is not about money. Not at all. Actually it’s about gratitude.

It’s about the many ‘lotteries’ in life that have nothing to do …

Employing a virtual assistant in your medical practice

Daniel McKennitt, MD

Physician

January 8, 2011

The many benefits of utilizing virtual assistant in the physician’s office have become clear to many. Physicians report greater job satisfaction, patient retention and cost-efficiency as some of the most obvious areas impacted by the use of virtual assistants in their practices.

Physicians preparing to shift some of their staffing needs to a virtual assistant or virtual assistance company have many questions and concerns that will be addressed by the person …

A modest proposal for a truly useful EMR

Lucy Hornstein, MD

Health Technology

January 7, 2011

I love computers. Really, I do. Despite my oft-repeated claims about the shortcomings of electronic medical records in their current form, I do believe that information technology has the potential to be of great help to me and other physicians in providing quality care to Americans.

Stop laughing. I really mean it.

I do not believe, however, that IT best serves the medical needs of our patients when …

Explore information technology and safely digitize medicine

Aaron J. Stupple, MD

Health Technology

January 7, 2011

We have an intuitive sense of what is meant by those urging medicine to “go digital.” It seems to refer to modernizing, becoming more flexible, and basically following the path of modern computing and information technology.

Is it useful to think more rigorously than this hazy conception, without necessarily reading a special report from The Economist?

Digital information is special because it can be transmitted to and instantiated within any number of …

Common things are common, except when the diagnosis is rare

Michael Aaronson, MD

Conditions and Diseases

January 7, 2011

During my training at Hennepin County Medical Center (HCMC) in Minneapolis, MN, my mentor would use the following teaching pearl during rounds: “When you hear hoofbeats, think of horses not zebras!” He would also frequently use: “If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck.” What did my mentor, the Sage of HCMC, mean by this?

From Wikipedia: “Zebra …

Little Patient Big Doctor: One Mother’s Journey, an excerpt

Kevin

Patient

January 7, 2011

An excerpt from Little Patient Big Doctor: One Mother’s Journey.

by Haleh Rabizadeh Resnick

Dear Doctor,

I want to share with you my experiences with two of my children . . . . I share the hecticness our lives with you for a reason. We are all the same. We are all busy. We all face adversity. And while we want most to trust the opinions of professionals, …

Your 10 minute office visit needs 8 people and 45 minutes of work

Mary Pat Whaley

Physician

January 7, 2011

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I sat at the checkout desk in my practice last week for the first time and as always, it was a revelation. If you haven’t worked your check-in and check-out desks recently, I highly recommend it.

An insured patient that I checked out was shocked when I said the charge for her visit was $100. She said, “But he was only in …

Why your health insurance medical appeal was rejected

Nicholas Fogelson, MD

Patient

January 6, 2011

One thing that many residents do not know is that there are more benefits to becoming a board certified physician than just that plaque on the wall. One of these benefits is that ability to pick up a few extra hours of work here and there doing consulting for the multitude of companies that would like the opinion or expertise of a physician.

In some cases this consulting can be about …

Will health care melt down, like the mortgage industry?

Dan McCoy, MD

Health Policy

January 6, 2011

Clearly, one issue dominated the election this past fall: the economy, and more specifically the lack of jobs.

So I would like to pose a few questions and ideas on just how government actually performs in creating economic growth and in kick starting job growth. I don’t necessarily have the answers, but I’m real good at asking questions.

Did government assisted mortgages help the economy? …

Secrets of good health website design

Lisa Gualtieri, PhD

Patient

January 6, 2011

I interviewed Tania Schlatter, one of the best designers I know and a guest-lecturer for Web Strategies for Health Communication, about color, imagery, and other aspects of health website design.

Lisa: How is the design of health websites different than for other types of sites?

Tania: The design of any site goes back to the goals of an organization and what people coming to a site need. Healthcare consumers can …

Read more…

Secrets of good health website design

MKSAP: 74-year-old man with gradually progressive dyspnea

mksap

Conditions and Diseases

January 6, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 74-year-old man is evaluated for a 5-year history of gradually progressive dyspnea and dry cough without wheezing or hemoptysis. For the past 2 years he has had pain and occasional swelling in both knees. He has not had fever or lost weight. He smoked one pack …

Doctors can reduce malpractice by being better people

Aaron E. Carroll, MD

Physician

January 5, 2011

My father, although retired, is a general and thoracic surgeon, triple boarded in critical care, who ran a trauma unit. My brother is a pretty successful lawyer. Whenever I visit them, inevitably at least one night ends with the three of us around a table, and the two of them going at it about who is to blame for the malpractice system.

My father, of course, blames the lawyers; my brother …

Measuring health outcomes is important but needs caution

Vipan Nikore, MD

Physician

January 5, 2011

I sat at home with a sense of relief. I had just finished my first month of residency – a grueling inpatient hospital month where I was pushed to new limits.

I now finally had my first “golden weekend” (meaning I had both Saturday and Sunday off). More importantly, I had survived my first month without any patient deaths on my service. Given how sick people are when they come to …

An ACO primer and get started on forming an Accountable Care Organization

Donald Tex Bryant

Health Policy

January 5, 2011

In early 2011 Department of Health and Human Services will be issuing guidelines for the formation of Accountable Care Organizations (ACO’s) for CMS (Medicaid and Medicare).

I know of several organizations looking into this type of organization as they anticipate the new guidelines. There seems to be great anticipation of the guidelines in various health care publications that I have recently read. On December 18, 2010 on the Health Affairs website …

How you can reduce preventable mistakes in your medical care

Neil Baum, MD

Patient

January 5, 2011

There are nearly 1.5 million Americans who suffer each year from preventable mistakes. A report by the Institute of Medicine estimates that as many as 98,000 people die in U.S. hospitals each year as the result of medical errors.

Most of these errors are related to drug mistakes. That’s the bad news. The good news is that your doctors and hospitals are trying to reduce these errors by using by using …

Government and health insurance intrusion penalizes efficient doctors

Jordan Grumet, MD

Health Policy

January 4, 2011

I wish I knew how to express myself. I wish I knew how to put this into words. How the direction of things has just become depressing. How each day makes me wonder how we got to where we are today. And I think back. Back to the beginning.

I think back to my childhood. And how I looked up to my father … the physician. How he died when I …

Start thinking about health literacy in a broader framework

Hilary Seligman, MD

Patient

January 4, 2011

I have a patient who I will call Antonia.

Antonia is in her early 70’s. She came to the United States from Guatemala many years ago, but never learned to speak much English. This doesn’t cause her much of a problem; her community is small and tightly-knit, so she doesn’t have much need to speak English in her home or her neighborhood. And she has a large family—children and grandchildren and …

Patients will choose their medicine, based on their doctor’s advice

Dave deBronkart

Patient

January 4, 2011

TEDMED is a truly extraordinary conference in San Diego, a fall sibling of TED talks focused on medicine. TED talks are just 18 minutes long, chosen and designed to blow your mind. They don’t all hit that level, but many do.

True to form, the opening session was a mind-blower. 26 year old Charity Tillemann-Dick stepped out on stage and belted out a soprano aria. I thought that was it – an opening …

Pain contracts threaten the doctor-patient relationship

Kevin Pho, MD

KevinMD

January 4, 2011

Doctors today are wary about treating chronic pain.

One of the main worries is precipitating fatal opioid overdoses. Indeed, according to the CDC, and reported by American Medical News, “fatal opioid overdoses tripled to nearly 14,000 from 1999 to 2006 … [and] emergency department visits involving opioids more than doubled to nearly 306,000 between 2004 and 2008.”

Requiring chronic pain patients to sign pain contracts is a way to mitigate this risk.

But …