It’s been five years since she was told she was cancer free. Today she was told it was back, and the future was quite grim.
My job was to make sure she understood how to properly take the medication that would reduce the swelling around the tumor so radiation could start as soon as possible.
That was my job. Clinically speaking it wasn’t the most challenging or difficult issue of the day as I …
Experiencing an uninvited gift
What could be so simple as a blood test?
A quick prick with a needle, a wait of a day or two for results and a discussion with the doctor about those results. In the words of our vaunted politicians, it would be an “up or down vote” on whether there was anything to deal with.
That was the thinking of my wife’s physician when she ordered a test called the “CA-125.” …
How the CA-125 became a $50,000 blood test
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and the healthcare industry.
However, their origin and the ulterior motives currently driving their adoption is sowing the seeds of their failure. First, what is actually happening out there? The most recent CDC data would seem to be encouraging for EMR adoption, with EMR use (finally) passing 50%.
Too bad …
Why EMR is a dirty word to many doctors
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009.
The objective of Measure 12/15 of Meaningful Use regulations of the HITECH act which refer to electronic health records, states that eligible professionals “provide patients with an electronic copy of their health information (including diagnostic test results, problem lists, medication …
Why patients with implantable defibrillators deserve their data
Many healthcare professionals find fibromyalgia difficult to believe as “a real disease” and most of all difficult to handle, and to be honest it is not so difficult to see why. Doctors and other healthcare professionals have learned how to search for diseases based on the specific symptoms the patients present, but fibromyalgia – and several other chronic pain syndromes – do not fit into that model.
The patients are presenting …
Understanding the pain of fibromyalgia
When I relocated my radiation oncology practice from Jacksonville to Tampa, Florida, I had to figure out how to compete against urologists in a market that was radically different from the one I had left. Unlike their peers in Jacksonville, Tampa urologists owned their own radiation centers, guaranteeing I wouldn’t receive referrals from them.
To break the referral pattern, I updated and posted my physician profile for free on an online …
How a doctor uses Google to market and recruit patients
There comes a moment when you’re forced to step beyond the things you know. It’s a split second — an instant adjustment from the safety of recollection to the insecurity of the unknown. Day after day we head into the library, hunching over twice-reviewed notes and hidden behind piles of books yet to be read. We push ourselves to work harder, study longer. We toil knowing that each page holds …
A medical student is forced to step beyond the things he knows
As diabetic patients and their physicians continue to work together to combat this metabolic disorder, researchers and medical organizations are uncovering new ways to fight this illness. With 26 million Americans currently battling the disease and 79 million already diagnosed with pre-diabetes, this disease poses a serious threat to our society and our overall healthcare system.
With these startling statistics in mind, the Northern States Ambulatory Research Network (NORTHSTAR), a practice-based …
3 best practices for both physicians and patients to treat diabetes
EHRs are not ready for prime time. EHR benefits are questionable and there are documented instances where patients’ deaths were directly attributed to an EHR. EHRs are cumbersome and slow. They are unnecessarily complex and built on very old technology. The people who build EHRs have no concern for the end user and therefore EHR usability is pretty abysmal. And EHRs are expensive to buy and expensive to maintain, not …
How adopting an EHR is like treating cancer
While in residency, I took care of a toddler who was hospitalized following an anaphylactic reaction. During a diaper change at home the child suddenly developed lip swelling and severe difficulty breathing for no apparent reason. The child was urgently brought to the hospital by ambulance and initially treated in the emergency room. By the time I met her on the inpatient floor her breathing and swelling had significantly improved. …
Are physicians addressing the root causes of health problems?
President Barrack Obama delivered a 6,944 word State of the Union address to the American people. Of the speech, less than .01% was devoted to healthcare, which is remarkable considering the major changes in healthcare that are on the horizon if Obamacare survives a challenge in an upcoming U.S. Supreme Court case. During the speech, there were only three sentences that mentioned healthcare.
The first was this: “I will not go …
Analyzing what the President said about health care
I come back into the exam room, keeping my best poker face, sit down and turn to face her. She’s on the edge of her seat, nervous and barely able to contain herself, maybe not even sure which answer she wants.
“Congratulations,” I say. She lets out her breath and smiles, huge.
“Thanks!”
Once the adrenaline settles down and she can hear me again, …
Be aware of your food choices, especially when pregnant
One day, about 5 years into using the electronic medical record in my practice, I came to the realization that I wasn’t having fun anymore. I was sitting throughout most of every office encounter facing a computer screen, my back to the patient on the exam table across the room. The joy of face to face interaction with people, the real reason I went into medicine in the first place, had been replaced with …
How changing patient workflow can make using an EMR fun
ADVERTISEMENT
Years ago, if you were elderly, had diabetes, high blood pressure, low back pain, needed a yearly flu shot and came to see this electronic health record-enabled physician (now with the nom de plume “Disease Management Care Blog”), you would have had your diabetes, high blood pressure and low back pain reassessed, you would have been given a flu shot and, for good measure, the DMCB would have tossed in a discussion …
Natural language processing in EMRs can improve disease tracking
Whenever someone is scheduled for an operation, the assigned nurse is required to fill out a “pre-op checklist” to ensure that all safety and quality metrics are being adhered to. Before the patient is allowed to be wheeled into the OR we make sure the surgical site is marked, the consents are signed, all necessary equipment is available, etc. One of the most important metrics involves the peri-operative administration of …
How algorithm driven medicine can affect patient care
A great deal of effort in the current health care environment is being put into improving communication – between patients and families and members of the health care team, among family members, and among members of the team. The case can be made that good communication is at the heart of patient safety, cultural sensitivity, and the pillar of palliative care — aligning patient’s wishes and goals with treatment plans.
So …
Good communication in health care is about listening
If you’ve ever spent time in the operating room, you are already familiar with the words the circulating nurse uses to signal the time out – the few minutes before a procedure begins when the surgical and anesthesia teams review a patient’s case. If you’re a non-medical type, or a medical student whose surgical rotations are scheduled late in the 3rd year, then you’re just as clueless as I was …
Appreciating the beauty of a time out in the OR
At the end of the year, I find myself thinking about patients usually—and especially those that have passed away. I wonder how their families are coping, how their children are, and whether each day has gotten easier. I think about how my patients died—and whether or not I did enough to ensure that they did not suffer.
It’s an odd thing …
The sense of loss extends beyond the death of a patient
For many celebrities, their livelihoods depend on their physical appearance and they rely on armies of personal assistants, schedulers, stylists, trainers and chefs to plan, manage and measure their diet and exercise regimens.
Obviously, most of us don’t have the time or resources to diet and exercise like celebrities do, but new technologies are closing the gap. As an introduction to some of these new platforms and methods, we describe and …
New classes of devices to diet and exercise
It has taken 13 years for us to revisit the issues in To Err Is Human, the 1999 landmark government report that shocked our nation with its revelation that 98,000 people died yearly in hospitals due to doctors’ errors. For decades, and through one administration after another, the lack of safety in our healthcare system has gone un-addressed, placing us at greater and greater risk. Hospitals have disappeared, …
Improve patient safety to improve healthcare quality
Get free updates delivered free to your inbox.
