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Use the scientific method in the transition to ICD-10

Health Policy

November 11, 2013

If you are a healthcare provider — physician, administrator, or some other leader at a healthcare site — then you know that you face many challenges. Some seem overwhelming and you may be thinking that you may not be able to handle some of them well. Perhaps the transition to ICD-10 coding is your main concern right now.

The solution to difficult challenges begins with the first step. I am taking …

Reduce stress for both patients and doctors: Limit tests

Matthew Katz, MD

Physician

November 11, 2013

Ordering CT, MRI, or PET scans for my patients when they feel well always makes me nervous. As a radiation oncologist, I’ve chosen to frequently make observations that potentially find active, progressive cancer. And this creates an existential crisis that scares me — but not as much as it scares my patients.

With each test, I set in to motion a real-life application …

What does it mean to be a good patient?

Colleen Crone

Patient

November 10, 2013

As a healthcare writer, I often spend large chunks of the day reading about medical conditions. I often joke when starting work that it’s only a matter of time before I notice signs of the condition in myself. I remember being convinced I had gallstones for a while until I finished working on a gallbladder surgery multimedia program. Suddenly, the symptoms that had been preoccupying me for several weeks vanished.

I …

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What does it mean to be a good patient?

Understanding the intersection of health care and social services

Elizabeth H. Bradley, PhD and Lauren A. Taylor, MPH

Health Policy

November 10, 2013

Providers in all parts of the health care system recognize that troublesome social conditions drive much of their work and costs. Major challenges in people’s social circumstances — layoffs, foreclosures, accidents, violence — can create horrific health care needs, many of which become chronic and carry high price tags. These extreme needs are omnipresent in the nation’s hospitals, which care for about 37 million admissions at a medical expense of …

The benefits of a free, web based EHR

David Wyatt, MD

Health Technology

November 10, 2013

A recent article by Elizabeth Hipp decried the so-called hidden costs of free EMR systems.

As a physician who uses a free EHR, I chuckle at stories trying to drum up fear and uncertainty about these systems. Though free EHRs have become mainstream, there still seems to be a clever news angle in highlighting their supposed pitfalls. We live in a time when Google offers all of its services …

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The benefits of a free, web based EHR

We need a new word for patient

Pat Mastors

Patient

November 10, 2013

In the world of health care, as in most enterprises where we must interact with one another for mutual benefit, we need words to describe one another. And the words we have for us people who use/need/want health care frankly don’t cut the mustard.

We need a new one.

The French gave us tasty food, the Statue of Liberty, and the wonderful phrase, “le mot juste.” Translated literally, it means “the exact …

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We need a new word for patient

Do we really need greater numbers of lesser trained physicians?

Hans Duvefelt, MD

Health Policy

November 10, 2013

My Swedish medical school curriculum was 5 1/2 years, but I remember during a third-year class trip to the Soviet Union hearing that some doctors over there had a much shorter education. My classmates and I were at first surprised to see physicians staffing ill equipped ambulances, riding the streets of Moscow with critically ill patients and no equipment to deliver care. We concluded that physician labor was cheap and …

Financial incentives are the wrong way to compensate physicians

Jeffrey V. Winston, MD

Health Policy

November 9, 2013

Everyone agrees that the US healthcare system is too costly. The challenge of public policy is deliver higher value by improving quality while reducing costs by eliminating waste and increasing efficiency. Historically physician compensation has been tied to productivity, which encourages procedures and over-utilization.

How can we motivate physicians to provide preventive, cost effective and quality care without incentive programs? Alfie Kohn in 1993 published ”Incentive Plans Cannot Work.” Clearly, poorly …

How a letter of intent can help with physician recruitment

Bo Claypool

Physician

November 9, 2013

As someone who has recruited a very large number of physicians over the years, I am quite sold on the benefit of a “letter of intent” or “LOI” as a tool for physician recruitment.

While physicians are highly familiar with medical/surgical concepts and while many are in no way intimidated by dissection within the human body, many to most are not qualified or really desirous of dissecting a complex legal document …

Doctor dinosaur: Physicians may not be exempt from extinction

Dennis Bethel, MD

Physician

November 9, 2013

I grew up in a solidly middle class family. Our home was safe, loving, and we never wanted for anything. My parents believed in hard work and instilled in me the importance of a college education. I was the first kid on the block to have a computer. That Radio Shack TRS-80 was a marvel of modern technology and made me the envy of my friends. Today, a TRS-80 is …

Everything’s my fault: How a surgeon says I’m sorry

Lara Devgan, MD, MPH

Physician

November 9, 2013

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When I started my surgical internship, my chief resident told me some magic words: Whenever something bad happens, stay calm and say, “I assume full responsibility. It won’t happen again.”

As a young surgeon at the bottom of the totem pole, those words were my mantra for the times when someone’s head was going to roll. In those nascent days of my …

How to respond to a Medicare audit: 17 tips from a lawyer

George F. Indest III, JD

Health Policy

November 9, 2013

Although you may speak of a “routine” Medicare audit, there is really no such creature. This is like saying you have a “routine IRS audit.” The fact is that there is some item you have claimed as a Medicare provider or the amount of claims Medicare has paid in a certain category that has caused you or your practice to be audited.

Having too many claims for level five CPT codes …

MKSAP: 32-year-old woman with progressive jaundice

mksap

Conditions and Diseases

November 9, 2013

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

A 32-year-old woman is evaluated for a 10-day history of malaise, right upper quadrant discomfort, and progressive jaundice. She has had no recent travel outside of the United States, does not drink alcohol, and has no recent ingestions of drugs, including acetaminophen or herbal remedies. Up until this time, she has …

7 life lessons I learned from surfing

Elana Miller, MD

Physician

November 8, 2013

surf

Sometimes I’m surprised I wasn’t born with gills.

It’s like I was meant to spend more time in water than on land. I didn’t discover this until I was thirteen or so, when I started high school and had to join a sports team because of a school requirement. I arbitrarily chose water polo, because it was a fall sport. I sucked at …

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7 life lessons I learned from surfing

Handling the delicate balance as an ER patient

Abigail Schildcrout, MD

Physician

November 8, 2013

Sometimes it’s difficult to practice what I preach. But I try.

A couple of weeks ago, I spent the evening in the emergency room with our youngest son (don’t worry – he’s fine). I hate going to the ER, but every once in a while circumstances necessitate it. I called doctor friends in the relevant specialty, as well as our son’s pediatrician, to confirm the need for the trip. They said to …

Mean patients: Do they contribute to physician burnout?

Val Jones, MD

Physician

November 8, 2013

As I sat in my orthopedist’s exam room, the discussion quickly turned from my chief complaint to his: “I don’t know why I’m doing this anymore,” he said. “Medicine is just not what it used to be, and I don’t enjoy my work anymore. The bureaucracy and regulations are bad enough, but what really gets me is the hostility. My patients …

What happens to us when we lie about dying?

James C. Salwitz, MD

Physician

November 8, 2013

It is in our nature to lie. Falsehood is one of the most creative things we do and the most remarkable of the human arts. We construct castles from ether and support their ephemeral walls on a foundation of accepted truths, which themselves are wisps of previous lies. The more we live within lies, the greater the challenge and more the harm. We pay a heavy price for fabrication. What happens …

Physicians are the biggest driver of health costs

Kenneth Lin, MD

Health Policy

November 8, 2013

There are many reasons to be dismayed by the error-filled and managerially incompetent rollout of the federal health insurance exchanges that are in many ways the linchpin of President Obama’s Affordable Care Act. I sympathize with commentators who have called for the resignation of Department of Health and Human Services Secretary Kathleen Sebelius. It’s hard to imagine Franklin Roosevelt not firing someone in his cabinet had social security stumbled this …

Who’s my doctor? The total transparency manifesto

Leana Wen, MD

Physician

November 8, 2013

Our health care system is broken and in dire need of reform. We all know the statistics: the U.S. spends $2.7 trillion on healthcare, 30% of which is waste in the form of unnecessary tests and unnecessary treatments. Conflicts of interest are rampant, with 94% of doctors reporting an affiliation with a pharmaceutical or device manufacturing company, and many more insidious influences including salaries being tied to productivity. Dozens of studies have shown …

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