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9 websites that savvy medical practices use

Physician

April 28, 2011

It’s easy to get caught in the surf on the Web. But plug these URLs into your browser and explore some simple tools that can help not only keep your practice above water but help it ride high.

www.digitalassent.com

Digital Assent automates the patient intake process with a PatientPad instead of the clipboard and an online tool for advance registration. It does integrate with EMR systems, but it provides another strong operational …

Health advocacy organizations and the lack of transparency

Kevin

Medications

April 28, 2011

by Patrick Fitzgerald, MPH

Health advocacy organizations (HAOs) are typically organizations of prominent, trusted stakeholders who conduct campaigns to promote disease awareness, update members to new diagnostic tests and drugs, facilitate physician referrals, deliver health care services, and advocate for policies believed to be in their member’s best interest.

They range in size from national organizations with many thousands of members focused on widespread disease to smaller …

The advance directive is only a part of end of life decision making

Richard N. Fogoros, MD

Physician

April 27, 2011

On January 1, the White House announced a new policy that would have paid doctors for discussing end-of-life planning during their Medicare patients’ annual wellness visit.

Under this policy, physicians would be paid to encourage their patients to establish an advance directive, which would guide medical care if the patient became incapacitated from illness, and could …

Advances coming in medical science that will have a high impact

Stephen C. Schimpff, MD

Physician

April 27, 2011

There are a series of medical megatrends outlined in my book The Future of Medicine – Megatrends in Healthcare that will profoundly affect health care in the coming five to fifteen years and beyond. Some are due to the explosion of basic understandings of cellular and molecular biology. Others are related to advances in engineering and computer science. Here is a very brief overview.

These are the megatrends in medical …

When money gets involved, good medical ideas suffer

Dr. Martin Young

Health Technology

April 27, 2011

I read an interesting link via Reuters about how students have developed a smart phone application with a microscope attachment to diagnose malaria.

The article shows a picture of a child at risk somewhere in Africa.

This is a great idea, and one that can go a long way to help people who really need it. But the last word from the project’s software engineer in the article was the one that was …

A physician assistant writes to the doctors of America

David Mittman, PA

Physician

April 27, 2011

I’m a physician assistant, having graduated from PA school over thirty-six years ago. There is angst in my profession, but many PAs don’t openly voice it. I felt compelled to write to you because I still believe in my profession, and I believe in yours, as well. Sometimes I think it might be time to embrace a new belief system. …

Should a hospitalist be given more information on hospital costs?

David Williams

Physician

April 27, 2011

In Today’s Hospitalist, Jeremy Graham, DO discusses implications of research he’s published about hospitalists and costs: How much is that bed on the ward? Hospitalists are clueless about patient charges.

Not surprisingly, hospitalists, like almost everyone in the hospital, have no idea what anything costs.

That’s no real shock, as Graham points out:

It’s often hard for hospitalists to know these charges, …

Read more…

Should a hospitalist be given more information on hospital costs?

An ACO must make the patient experience meaningful

Patricia Salber, MD

Health Policy

April 26, 2011

Accountable Care Organizations (ACOs) are supposed to be provider-led (physician groups +/- hospitals) and, they are supposed to inject a new accountability, at the provider level, for the value of services delivered.

You know the old equation. Value=Quality/Cost. Those of us inside the health policy “beltway” know this mantra well. We have been talking about it for years (decades, really).

I spent almost …

The exhaustion of emergency physicians, and its toll on patients and family

Jessica Freedman, MD

Physician

April 26, 2011

When I advise students about how to choose a specialty, I suggest that they seek out advice from physicians who are at least 10 years out of residency and leading the type of life they hope to have in the future.

It is difficult, and perhaps impossible, to anticipate in your late 20s or early 30s what practicing a certain specialty will be like when you are 40, 50, or 60.

Find …

How to be heard by your psychiatrist

Dheeraj Raina, MD

Patient

April 26, 2011

How do I get my concerns heard about the direction of my treatment?

On the surface, it seems easy. Just tell your psychiatrist what you want him to pay attention to.

On the other hand, there are many reasons why it not so simple.

Many psychiatrists diagnose a patient’s illness after a 45-50 minute interview, without doing any tests to rule out potential medical causes of …
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How to be heard by your psychiatrist

Arm amputation from a rare sarcoma

Felicity Billings, MD

Patient

April 25, 2011

Harold was 51 years old and needed his left arm amputated. A year ago he noticed some swelling in his forearm and went to his primary care doctor.

An MRI showed something. It was small and hard to define, hard to categorize, probably a collection of blood, but there was an outside chance it could be a sarcoma, a tumor originating from muscle …

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Arm amputation from a rare sarcoma

A moral imperative to address the costs of training our doctors

Kevin

Medical Education

April 25, 2011

by Andrew M. Ibrahim and John A. Brockman

Despite the landmark progress of recent healthcare reform, it missed the mark on long term cost control by failing to address medical education.

Radical changes are needed in the way we finance tuition and how we teach our students.

While last month a new graduating class of medical students celebrated their Read more…

A moral imperative to address the costs of training our doctors

A medical malpractice system that reduces errors and improves quality

Kevin Pho, MD

KevinMD

April 25, 2011

The Affordable Care Act does very little to reform the medical malpractice system.

It only allocates $50 million to various pilot projects around the country.

A recent piece in the New England Journal of Medicine provides more detail. It appears that, instead of capping non-economic damages, many of the projects have a quality …

How to discharge a patient from your practice

Adam Alpers, DO

Patient

April 25, 2011

Occasionally, you may encounter patients who you no longer wish to treat. Reasons for ending the physician-patient relationship may include chronic non-compliance, rudeness to office staff, or non-payment of bills.

While these patient behaviors can affect the interactive care-giving process, they may also identify patients with a propensity to file a claim against you. To help reduce the risk …

Specialty hospitalists joining forces with the generalist hospitalists

Robert Wachter, MD

Physician

April 24, 2011

I recall with fondness many meetings in 1996-98, when the hospitalist field was still in its infancy. We had invented a new medical specialty, and our gatherings were vibrant and purposeful.

We were determined to remake the healthcare system, learn from each other’s triumphs and disasters, and chart a course that would improve the care of hospitalized patients. These were heady …

First, do no harm

Kevin

Physician

April 24, 2011

by Alison Block

It’s one of my earliest memories: I’m wrestling with my brother, and I’m losing, because I’m five and he’s seven, and he’s bigger and stronger than I am. So I bite him, hard.

Instantly I know I’ve crossed some sort of line, and I employ my most primitive defense mechanism, shouting out, “He bit me! Jon bit me!” I feel shame, because I am old …

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First, do no harm

The future of primary care in Accountable Care Organizations

Davis Liu, MD

Health Policy

April 23, 2011

A recent blog post in Health Affairs proclaimed The End of Internal Medicine As We Know It. What the article is really asking is the future of primary care in the world of health care reform and the creation of Accountable Care Organizations (ACOs).

While doctors should be naturally concerned about change, I don’t completely agree with this …

Primary care providers are needed to support health reform

Kevin

Physician

April 23, 2011

by Vanessa Hurley

Like many American patients, the American health care delivery system suffers not only from acute crises, but also from a chronic, poorly managed and debilitating disease.

Primary care is in trouble. Not only are primary care physicians (PCPs) fleeing the profession in droves, but fewer and …

Osteoporosis in patients with HIV

Erin Marcus, MD

Conditions and Diseases

April 22, 2011

At the age of 56, Jules Levin felt pretty invincible, despite being HIV positive. He went to the gym regularly and controlled his disease well by taking his antiretroviral medicines every day.

Then he slipped one day while on vacation and broke his wrist.

He underwent an operation to insert pins in his bones and needed to wear a cast for a month, keep his arm …

Read more…

Osteoporosis in patients with HIV