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Is there a place for religion in the exam room?

Joyce Ho, MD

Physician

March 12, 2014

As part of a family medicine rotation, we recently discussed the importance of bringing spirituality into the hospital. The conversation was led by Stanford Hospital’s chaplain, Dr. Bruce Feldstein, an ER doctor in a former life. We began with definitions of spirituality, discussed personal experiences surrounding a spiritual moment, and concluded with how to take a “spiritual history,” a series of questions that explore patients’ spiritual or religious beliefs.

We even …

Patient safety and the human toll of inaction

Ashish Jha, MD, MPH

Health Policy

March 12, 2014

March 2nd through the 8th was National Patient Safety Awareness Week — I don’t really know what that means either. We seem to have a lot of these kinds of days and weeks — my daughters pointed out that March 4 was National Pancake Day — with resultant implications for our family meals.

But back to patient safety and National Patient Safety Awareness Week. In recognition, I thought it would be useful to …

How much will it cost to die?

JaBaris Swain, MD, MPH

Physician

March 12, 2014

It was probably the most awkward question I had been asked before, and I did not have an answer.

He was a middle-aged gentleman, neatly dressed — very simple and unassuming. He blended like a lifeless statue in the waiting area. What sparked my notice of him was his accompanying robust file, crammed with familiar pink discharge slips from the ED. He was clearly what we call a “frequent flyer,” but …

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How much will it cost to die?

Physician time means nothing to programmers and policy makers

Wes Fisher, MD

Physician

March 12, 2014

I have been a way from blogging for a bit and tried to clear my head a bit with a vacation skiing. I left the computer at home, disconnected (as best I could), and had the luxury of feeling the knees working less fluidly than they had before, but still had some fun for a brief 3 day stint. It was nice to notice that there’s a whole world out …

Stop being a doormat for your patients

Starla Fitch, MD

Physician

March 12, 2014

One of my goals is to help doctors be happier in their day jobs. This does not mean you put on a fake smile, and grin and bear it through your day. What it does mean is you consciously set your boundaries for what you need. Stick with them and let others know. Because the truth is, you teach people how to treat you.

This is not only reserved for your …

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Stop being a doormat for your patients

Can the pharmaceutical industry move beyond the pill?

Joseph Kvedar, MD

Medications

March 11, 2014

What an amazing time to be a champion of new health care delivery models. Three megatrends are driving change at a pace that I only wished for 20 years ago. Back then, I first had the insight that care could be improved, in some instances, if we separate doctor and patient in time and space.

The first trend is provider reimbursement reform. For provider organizations going at risk with their payers, these are …

Surrogate decision making: Families are much more than visitors

Ken Covinsky, MD

Physician

March 11, 2014

An innovative study in JAMA Internal Medicine on surrogate decision making has profound implications for how we take care of older hospitalized patients. The study, by Lexy Torke and colleagues at Indiana University, systematically described the involvement of surrogates in decision making for hospitalized patients.

Surrogate decision making refers to the phenomenon in which someone other than the patient is making or helping to make the key medical decisions. In older …

The impersonal nature of medical school personal statements

Kenneth Lin, MD

Medical Education

March 11, 2014

Since becoming a full-time medical school faculty member again, I’ve volunteered to interview about two applicants each month from September through March. When I first started doing this, I was surprised that the admissions office did not provide me with a copy of the applicant’s resume and essay until the time of the interview, carried in a manila folder by the applicant.

But I quickly realized that it wasn’t necessary to …

A physician approach to a missing child

Abigail Schildcrout, MD

Physician

March 11, 2014

There was a brief scare in our neighborhood this past weekend. Our phone rang. Our friend, who lives nearby, asked if her 12-year-old son was at our house. He wasn’t.

The child had been gone for about 15 minutes. Their family had just returned from a shopping trip with a family friend, and that family friend had forgotten one of his items at our neighbors’ house. The child said, “I’ll run …

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A physician approach to a missing child

Patients should silence their phones in the exam room

Suzanne Koven, MD

Physician

March 11, 2014

I wrote a column recently about the role computers play in the doctor patient relationship, and my concern that screens shift physicians’ focus away from their patients. This column is part of a large conversation going on nationally and beyond about what I’d call “distracted doctoring.”

A Wall Street Journal opinion piece by my colleague Dr. Victoria McEvoy addresses the issue of whether all the digital box checking now required of doctors as part …

Whine or win: How retail clinics will affect pediatricians

Justin Smith, MD

Physician

March 11, 2014

“AAP Criticizes Retail-Based Clinics — Again.”

I noticed the headlines rolling in about the AAP updated policy statement regarding retail based clinics. The one above particularly caught my eye. Something about the tacking on of “again” caught my attention. It came across to me like we (pediatricians) were perceived to be saying something that was unnecessary, maybe even that we were just complaining.

Throughout the day, I monitored my Twitter …

The real reason doctors hate ICD-10

Ira Nash, MD

Physician

March 10, 2014

It has been freezing cold in much of the country for the last two months, but things have been heating up in the controversy over the implementation of ICD-10. First, a quick primer for those of you who have not been following this.

The “ICD” in ICD-10 stands for International Classification of Diseases. The “10” refers to the version of the taxonomy, which is maintained and revised periodically by the World Health …

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The real reason doctors hate ICD-10

One physician’s story of weight loss

Robert Centor, MD

Conditions and Diseases

March 10, 2014

Having now lost more than 30 pounds, I am very close to declaring victory (maybe a few more pounds over the next few months). A colleague has asked me to write my tips as a handout for patients. This is a daunting task, but that has never stopped me!

The weight loss formula is simple and well known. Achieving lasting weight loss remains challenging. The mathematical formula is simple. Weight loss …

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One physician’s story of weight loss

Let’s do something about teen stress

Claire McCarthy, MD

Conditions and Diseases

March 10, 2014

Adults are the ones who are supposed to be stressed, not kids. Childhood is supposed to be the stress-free part of life, right?

Well, maybe not. At least not for teens.

According to a recently released survey from the American Psychological Association, teens are actually more stressed than their parents.

Researchers surveyed 1950 adults and 1,018 teens last summer and asked them a whole bunch of questions about the stress in their lives, and how …

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Let’s do something about teen stress

Reversing the epidemic of drug overdoses

Robert Pearl, MD

Medications

March 10, 2014

The evening news is filled with fatal car crashes and shootings. But drug overdoses kill nearly 40,000 people a year, accounting for more deaths than vehicular accidents or homicides.

Drug overdoses are on the rise in America, fueled largely by prescription meds. Reversing the course of this epidemic will require some dramatic changes.

The facts

Drug overdose rates climbed more than 100 percent between 1990 and 2012. But what most people don’t recognize …

The doctor’s customer has become the insurer

Stephen C. Schimpff, MD

Health Policy

March 10, 2014

Next in a series.

You the patient are really not the customer of the physician. Since the insurer will determine whether and how much the physician will be paid for attending to your needs, you are largely a bystander in the relationship. The doctor’s customer has become the insurer.

Our system of care is definitely not customer-focused. Doctors truly believe that they have the patient’s best interests in mind and they …

We are in the age of copy and paste medicine

Heidi Roman, MD

Physician

March 10, 2014

I’ve been working with the latest electronic medical record (EMR) for almost a year now. You know the one. There are many positive changes, to be sure. It has helped me more than a few times with calculating doses for kids’ medications. I can now easily check in on my patients’ progress when they are admitted to the hospital. And, of course, the notes are far more legible.

But what do …

The disturbing confessions of a medical scribe

Anonymous

Physician

March 9, 2014

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As a medical scribe working with a large, well-known scribe company, unnamed to protect my job, it makes me proud reading all the articles published about how much having a scribe benefits a physician, especially in the emergency department. I enjoy my job immensely and I am grateful for the opportunity to learn and engage in patient care. However, as a …

What can health care learn from Amazon?

Nick Dawson

Health Technology

March 9, 2014

There’s that line about art, “good artists copy, great artists steal.” There’s some debate about if Picasso said it first, but most of us geeks know it from Steve Jobs.

Often, I see things from companies and industries outside of health care — processes, products, best practices — which inspire me. I like these little inspirations because they often aren’t rocket science, but nonetheless fuel some creative thoughts about their applicability …

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What can health care learn from Amazon?

Tips for expats working in health care

Rajka Milanovic Galbraith, MD

Physician

March 9, 2014

How does a working mom and physician keep practicing medicine when her husband’s career brings her halfway around the globe? For me, it was an adventure. While it can be challenging, I encourage other physicians to experience the world with their families while still practicing medicine.

As a 14 year family practitioner from Ohio, I suddenly found myself in Qatar with two young children because of my husband’s job. Qatar is …

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Tips for expats working in health care