I realized last week one of the hardest mindset transitions that I’m having to make as a medical student. It has to do with not really feeling like I belong, and the need to really make my patients … well, MY patients!
As a medical student, you can actually function reasonably well without ever having to actually see a patient.
You can read …
Medical students are part of each patient’s health care team
On the night of October 4, 1984, a young girl named Libby Zion was admitted to New York Hospital in Manhattan for fever, agitation and strange jerking movements. No one knew that her death the next morning would, 27 years later, drastically change the quality of physician training, for better or worse.
When Libby was evaluated in the emergency room that night, neither the ER physician nor her family physician Dr. …
New ACGME work hour regulations for interns: friend or foe?
There are many aspects to being a doctor. Just as important are the many aspects that go into being a patient. Of course, the difference is that one has been perceived as being a position of power and the other one has not. I don’t believe this distinction is useful or true in today’s world.
Patients and doctors work …
Cooperation between patient and doctor is essential today in health care
So now, in addition to the many other bits of medical meddling we have from CMS (Centers for Medicare and Medicaid Services), there’s this.
Reimbursements to hospitals, from Medicare, will be partly tied to patient satisfaction scores. We’ve seen payments already being tied to ‘quality indicators,’ as dictated by the federal government; rewards for doing a better job on care for heart attacks, pneumonia, etc. At least that’s quantifiable, whether scientifically …
Why patient satisfaction scores won’t decrease health care costs
Until recently, I had but the vaguest idea of what hospice and palliative care and medicine (hpm) entailed.
Until tuning into the #hpm Twitter group – hospice and palliative medicine – both words conjured a gloomy atmosphere of despair, grief, anger, pain en route to dying. I wondered at those working in the field: they must be a bit weird.
I now know differently, …
The mission of the hospice and palliative care is to ease patient suffering
The 2009 Health Information Technology for Economic and Clinical Health Act (HITECH) authorized incentive payments, potentially totaling some $27 billion over ten years, to clinicians and hospitals when they implement electronic health records in such a way as to achieve “meaningful use,” in terms of advances in health care processes and outcomes.
But, are EHRs really “meaningfully useful” or are …
Why quality did not improve with hospital EHR implementation
What links belief in tarot cards, UFOs and vaccine rejectionism? Yes, they are all forms of superstitious or magical thinking, but are there characteristics that predict who will believe in such nonsense? That’s one of the questions that psychologists Marjaana Lindeman and Kia Aarnio seek to answer in their paper, Superstitious, magical, and paranormal beliefs: An integrative model.
Lindeman and Aarnio postulate that believers in superstition, paranormal phenomena and pseudoscience make …
Explaining why belief in pseudoscience is often evidence resistant
by Chris Chen
Recently in lecture, our professor wryly mentioned that in his many years of teaching, he had never seen so many laptops out as well as so many people taking advantage of the option to watch videos instead of attending class.
That was fine with him, he commented, as long as people were learning—although he was skeptical that students on laptops would learn as much, …
How skipping medical school lecture is preparing doctors for the future
Now that I’m well out of my reckless youth phase of my life, I try to preserve the efficacy of my brain. With my lifestyle, there’s three actions I take to ensure the integrity of my brain.
The first two …
Direct primary care and a do it yourself health plan
To my friends and colleagues in the CME community, I ask of you today a simple favor: involve yourself in social media.
Immerse yourself in social media. Do what it takes to make social media a part of your, and your place of employment’s, daily routine.
Do it.
If you don’t know how …
The CME community is late to adopt social media
I hate infant sleep positioners. They are not safe or helpful. If you have one or know a family/friend who uses one for their infant, throw it out. Trash compact it. Stomp on it. Cut it up in bits. This is one rare thing you should feel good about putting in landfill.
When I was first started in practice, I didn’t even know sleep positioners existed; I …
How the fear of SIDS keeps infant sleep positioners on the market
A version of this op-ed was published on April 12, 2011 in USA Today.
“Would you like to discuss your end-of-life plans today?”
It’s a question that I ask my patients, although not as often as I would like. Talking about death may be uncomfortable, but it’s a conversation that needs to happen more often.
We can never know …
End of life care is being influenced by politics
In 1994 Jeff Bezos revolutionized how consumers shop. He founded Amazon.com.
Shortly after, Ebay followed suit—solidifying a paradigm shift that has redefined shopping from an in-person to online experience. In 2004, Facebook capitalized on another trend: individuals were becoming more comfortable sharing personal information online. Interestingly, people did not wake up one morning and decide it would be convenient to shop from home, or that sharing pictures with their friends online …
Medicine’s paradigm shift is a microcosm of a trend occurring in society
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During the election season, the biggest loser appears to be civility. Anger, attack ads and name calling ruled the day. We are faced with enormous and complex challenges, issues not easily addressed in sound bites. Yet that is what we usually get from our representatives. I find myself asking are we not willing or able to do the hard work of examining the issues before us?
During the ongoing discussions over …
People feel anger and fear over our health care situation
Whenever I speak about social media to doctors across the country, I often get asked, “How do I deal with a negative online review?”
Here’s one way not to handle it: sue the patient writing the review.
There’s a well publicized case in Minnesota, where a resident posted a screenshot of …
Dealing with a negative online review on a physician rating site
by Jeffrey L. Cohen
The current fixation on Accountable Care Organizations (ACOs) is causing an enormous amount of two things: 1) talking, and 2) inactivity.
Yes, the concept of delivering care in a manner that reduces or at least controls costs is important and interesting. Yet, the marketplace is replete with people and businesses that have adopted …
Physician responsibility and leadership is critical for ACO implementation
Medicare is thinking of using patient satisfaction scores in part to determine bonuses to hospitals.
According to Kaiser Health News,
… patient gripes soon will affect how much hospitals get paid by Medicare.
The Centers for Medicare & Medicaid Services is finalizing details for the new reimbursement method, required by last year’s health care law. Consumer advocates say tying patient …
Patient satisfaction should not influence how doctors are paid
Every morning at 5:30 AM, I am at my computer scouring the Wall Street Journal, the New York Times, the Philadelphia Inquirer, and other news sources for articles about health care and wellness.
These articles are then summarized in 140 characters with a link to the original article and tweeted. As of today there are 3700 followers of my informal aggregated health care news service, and I hear about it if …
How Twitter changed the life of this physician executive consultant
A guest column by the American College of Physicians, exclusive to KevinMD.com.
by John Tooker, MD, MBA, MACP
There are over 11 million undocumented immigrants in the United States — about 3.7% of the U.S. population — according to a 2011 report from the Pew Hispanic Center.
Although there are many reasons why immigrants elect to come …
ACP: National immigration policy and health care
Pharmaceuticals are amazing stuff. You can bitch and moan about their costs, side effects, or the number of them you’re taking, but what they’ve done to extend life and improve its quality is truly remarkable.
And for all the bad raps they get, I salute the pharmaceutical industry, and those who work anonymously in labs around the world, to bring us these miracles.
But …
The trend from drugs of value to medications of convenience
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