Customer service needs to be a priority in health care

Patient
July 1, 2010

What do Enterprise Rent-a-Car, KeyBank, and the Cleveland Clinic have in common?

They all make customer (patient) satisfaction a top priority.

They accomplish this in industry-specific ways, but together their emphasis on service as a passion shares common themes:

1. Buy-in for a service culture comes straight from the top, and permeates the entire organization.
2. Copious resources are delegated to building a service culture, starting with hiring.
3. Employees are “hired for fit.” If …

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Customer service needs to be a priority in health care

Children of lesbian mothers have healthy psychological growth

Conditions and Diseases
July 1, 2010

by Kristina Fiore

Children born to lesbian mothers appear to have healthy, if not better, psychological development when compared with average American children, researchers have found.

In the first prospective cohort study of its kind, these children were found to have better social, academic, and overall competence and significantly fewer social problems than typical American children, according to Nanette Gartrell, MD, of the University of California, San Francisco, and Henry Bos, PhD, …

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Children of lesbian mothers have healthy psychological growth

Why patients don’t value primary care doctors

Physician
June 30, 2010

“Hey doc, all I need is this referral.”

I’ve been encountering more of this lately. A patient who has not been seen in the office for months to years (well beyond when they were supposed to come back for a follow up visit) walks in and requests a “referral” for a specialist visit but they can’t be bothered with actually being seen and evaluated in the office or to be compliant …

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Why patients don’t value primary care doctors

Surgeons need to reconnect with patients after an operation

Physician
June 30, 2010

It’s worth your while to browse through Sid Schwab’s sampler one rainy Saturday afternoon when you get a chance.

The old man can write. I was reading through a couple of his old posts the other day when I stumbled upon this one. It’s a shorter post (for him) but very powerful and moving.

He describes what it’s like to enter an abdominal cavity of a patient, with all its …

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Surgeons need to reconnect with patients after an operation

Medication errors spike when new residents start in July

Medical Education
June 30, 2010

by Kristina Fiore

Deaths from medication mistakes appear to spike in July, when medical residencies begin, researchers say.

Over nearly a 30-year period, fatal medication errors appear to jump 10% solely in that summer month in U.S. counties with teaching hospitals, David P. Phillips, PhD, of the University of California San Diego and Gwendolyn E.C. Barker, BA, of the University of California Los Angeles, reported online in the Journal of General Internal …

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Medication errors spike when new residents start in July

Vitamin D myths and advice for patients

Conditions and Diseases
June 29, 2010

As the mountain of vitamin D research showing its importance grows to Everest heights, you may be wondering about some statements that are thrown around as “truth.”

Here are some fun vitamin D myths to pass along to friends, family and loved ones, because, when it comes to vitamin D, you want to get your dose (even of information) just right.

1. Just go out in the sun, already. That will fix …

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Vitamin D myths and advice for patients

Why the medical home may not save primary care money

Health Policy
June 29, 2010

When the Disease Management Care Blog saw the flurry of news reports about the Patient Centered Medical Home (PCMH) “saving money,” it couldn’t wait for the full print version of Health Affairs to arrive at the DMCB World Headquarters.

The DMCB had previously reviewed Group Health’s negative “no statistically significant…. cost differences” one year study and was looking forward to seeing researchers Robert Reid et al’s reportedly positive two …

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Why the medical home may not save primary care money

Abuse of prescription drugs starts in high school

Medications
June 29, 2010

by Todd Neale

One high school student in five has taken a prescription drug without a doctor’s order, according to a nationwide survey.

Abuse of a prescription drug was most common among white students (23%), followed by Hispanics (17.2%) and blacks (11.8%), according to Danice Eaton, PhD, of the CDC’s Division of Adolescent and School Health in Atlanta, and colleagues.

Improper use increased steadily from ninth grade (15.1%) to 12th grade (25.8%). Girls …

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Abuse of prescription drugs starts in high school

How EMR and EHR systems can kill patients

Health Technology
June 29, 2010

Back in the times when EHRs were just EMRs, they had a very simple and humble mission.

The software was supposed to help providers of health care services better manage their business. EMRs were supposed to help physicians adhere to CMS documentation rules, automate patient flow management and get rid of all the mountains of paper floating around a typical medical office or hospital. It was assumed that EMR software will …

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How EMR and EHR systems can kill patients

Prevent bullying by accepting healthy aggression

Conditions and Diseases
June 28, 2010

“Momma, have you ever felt like there’s a puzzle and there’s a piece missing and you find the piece and it fits? When I’m with the Maasai all the pieces fit.”

This is a quote from my friend Roland, a seven year old boy, on a trip to Tanzania with his mother. He was on a safari and, using a stick, he was learning how the Maasai use spears to protect …

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Prevent bullying by accepting healthy aggression

When patients don’t take their prescription drugs

Medications
June 28, 2010

One of my favorite patients in residency was a lady in her seventies who had longstanding high blood pressure, high cholesterol, and diabetes.

Each time she visited the office, I would recommend that we start multiple medications to control these conditions, and every time she would politely decline. Her previous physicians had left frustrated notes in her chart littered with terms such as “non-compliant,” “against medical advice” and expressing wonderment why …

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When patients don’t take their prescription drugs

The public wants resident physicians to work less

Medical Education
June 28, 2010

by Emily P. Walker

A majority of the American public doesn’t approve of doctors working 24 hours straight and supports tougher work hour regulation for resident physicians, according to a new public opinion survey.

The survey, published in the online journal BMC Medicine, is the first to assess the public’s perceptions about the controversial issue of medical residents’ work hours.

The survey found that 90% of Americans believe the maximum shift duration should …

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The public wants resident physicians to work less

A cardiologist discusses screening for vascular disease

Conditions and Diseases
June 28, 2010

Just last week I saw a full-page ad in the newspaper for a series of medical screening tests — EKG, echocardiogram, aortic ultrasound, and the like (all interpreted by “certified doctors”) — that a person could arrange for oneself or a loved one.

We newspaper readers were told we could arrange to have these tests performed without a doctor’s order as …

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A cardiologist discusses screening for vascular disease

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Why Obamacare scares this cardiologist

Health Policy
June 27, 2010

I recently visited my cardiologist. It was a routine follow up after a heart attack a year ago. I enjoy our relationship. As a token of my regard, I came bearing a gift. It was a copy of my book Obama, Doctors, and Health Reform.

I knew he had qualms about Obamacare. He expressed doubts about the health reform bill’s merits. The bill will roll out over the next ten years. …

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Why Obamacare scares this cardiologist

American cigarettes contain more carcinogens

Medications
June 27, 2010

by Todd Neale

Levels of tobacco-related nitrosamines — known carcinogens produced when curing tobacco — are higher in popular brands of American cigarettes compared with those from other countries, potentially leading to more cases of lung cancer, researchers found.

The study of 126 smokers in four countries found that exposure to one carcinogen — 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) — was highest among those from the U.S. compared with smokers from England, Canada, and Australia, …

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American cigarettes contain more carcinogens

Reducing salt is a good idea but won’t save your life

Patient
June 26, 2010

In case you missed it, salt is the new fat.

It seems that everybody from the FDA to Steven Colbert of the Colbert Report has set their sights on limiting our consumption of salt. In the past week, I’ve seen dozens of articles from the blogosphere to the front page of USA Today and a recent edition of Time on reducing our alarming levels of salt consumption.

Many of us are aware …

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Reducing salt is a good idea but won’t save your life

Supplemental oxygen during cardiac arrest resuscitation

Conditions and Diseases
June 26, 2010

by Michael Smith

Administering high concentrations of supplemental oxygen during resuscitation after cardiac arrest is associated with increased inhospital mortality, researchers said.

So-called blood hyperoxia resulting from being given pure oxygen after cardiac arrest was associated with an 80% increase in the risk of death, compared with patients whose blood gases were normal on admission to the intensive care unit (ICU), according to Stephen Trzeciak, MD, of Cooper University Hospital in Camden, …

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Supplemental oxygen during cardiac arrest resuscitation

Lifestyle tips for aging family members

Patient
June 26, 2010

Thanks to modern medicine, more people are living longer, but a longer life isn’t always a healthier one. According to the American Cancer Society, about 77 percent of people diagnosed with cancer are 55 or older.

Living a healthy lifestyle is important to reducing cancer risks. But as we age, it’s sometimes easy to forget the importance of exercise, proper nutrition and stress management, which is why I like to solicit …

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Lifestyle tips for aging family members

Being sick is not always abnormal

Patient
June 26, 2010

“You can’t afford to be sick!”

I hate these ads.

You’ve seen them. They’re in newspapers and regional magazines across the country. Some smiling mom and her cute kid. It’s an ad for some local clinic, always with a tagline like “You can’t afford to be sick!” or “You don’t have time to be sick!”

And they list things they treat, like headache, sore throat, ankle sprain, runny nose, and skinned knees. They …

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Being sick is not always abnormal

Difficult needs to be embraced in medicine

Physician
June 25, 2010

When I was a second-year medical student I remember thinking, after meeting with an attending physician in a physical diagnosis class, how impossible it seemed that my brain would ever contain as much medical knowledge as his.

And even if somehow one day it did, how would I ever be able to call on it, manipulate it, twist it, bend it, and turn it upside down with the same apparent ease …

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Difficult needs to be embraced in medicine

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