My oncologist’s office implemented a new EMR system when I was in the middle of chemo. Once the nurses learned the system, I saw no difference in the care I got from them.
Not quite so with the doctor. My experience with him changed dramatically.
Before EMR I would enter the exam room and sit on a chair, play Angry Birds on my iPhone and wait. My doctor would walk in, make …
Coverage requests get rejected when the requested service does not fit within an insurance company’s initial guidelines for approval.
This happens for a number of reasons, but usually it comes down to poor documentation or inappropriate care, or in some cases care that is appropriate but can’t be supported in the literature. When a denial occurs, the physician or patient has several opportunities to appeal this decision. The first appeal is …
Successfully appeal an insurance company reviewer decision
That there are some serious misunderstandings out there about the difference between name-brand drugs and generics, as well as some bizarre assumptions about the merits of newer drugs. So here’s a quick primer on how you (and everyone else) are sometimes not getting accurate information about your pharmaceuticals.
As a society, we’re addicted to drugs. Almost all of them are legal, and we’re not abusing them per se, but we want …
A primer on brand name drugs and generics
by Carolyn Savage
Our names will be forever connected with one of the most significant medical errors ever made inside a fertility clinic.
In February 2009, through a process referred to as a frozen embryo transfer, another couple’s embryos were mistakenly transferred into my body. Eight months later, I gave birth to a baby boy who we relinquished to his genetic parents a few minutes after …
Medical error in a fertility clinic
Prostate enlargement, or benign prostate hyperplasia (BPH), is a common, non-cancerous condition affecting nearly 14 million men over the age of 50.
The symptoms of prostate gland enlargement include a decrease in the force and caliber of the urinary stream, frequency of urination, urgency, a feeling of not emptying the bladder despite urination and nocturia, or the need to get up at night to urinate. Although lifestyle changes will not cure …
Lifestyle changes to control the symptoms of prostate enlargement
An excerpt from In Stitches.
I see dead people.
Eighteen bodies covered with plastic, lying on gurneys. An occasional toe protrudes to verify that beneath the shiny black tarp, a dead person lies.
I smell dead people, too.
Or at least the thick chemical stench of formaldehyde, tearing at my eyes and packing my nose, enough liquid preservative in here to float a yacht. The smell rises from the bodies and from a dozen …
I see dead people, an excerpt from In Stitches
I believe primary care docs are rebelling against the system. The system has made primary care physicians suffer emotionally and financially. The system has taken the greatest form of medical care – that consisting of continuity, comprehensiveness, complexity and completeness – and denigrated it.
Now I talk about “the system” in an anthropomorphic sense, but “the system” is virtual. “The system” has no conscious, it is not deliberate, rather it represents …
Primary care physicians are rebelling against the system
by Rima Rudd, ScD
We take the written word for granted.
Signs and billboards are everywhere – offering directional information, alerts, warnings, and advertisements. Streets, public squares, buildings, agencies, and institutions are numbered and named. We are surrounded by the written word in public locations and within public and private institutions. Individual entrances and even elevators in some large buildings carry names. The lobby, the inside hallways, …
Literacy related difficulties in health settings and the written word
Friday in my office is like happy hour for the oldest of the old.
They come. 90, 95, 100. Always on Fridays. Some come in wheel chairs. Others walking. Some alone. Others with family. 5,6, 7 sometimes even more in just one short morning. And we talk about life, about their children, about growing old. I apologize that at that age I really have little to offer. After all, they know …
Entering the golden age of hospice care
Our colleague Susannah Fox of the Pew Internet & American Life Project has done much research about trends in mobile, particularly about health.
In contrast, Meeker focuses on overall big trends. She sees aspects I’ve never noticed, like what-all constitutes mobile: when I hear the term, I think handheld phones (iPhone, Droid, Blackberry), but she makes the case that mobile web access (and other wireless) is much more than phones.
As we …
How the mobile internet can transform healthcare
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 64-year-old man is evaluated for a new right-sided headache that began 1 day ago. He awoke yesterday with a dull ache over his right forehead that has gradually increased in intensity. He also notes some right eye discomfort, sensitivity to light, and that his eye …
MKSAP: 64-year-old man with a new right-sided headache
In February, IBM supercomputer Watson won Jeopardy! against its two human opponents, Ken Jennings and Brad Rutter.
Watson’s victory rests on its power in speech recognition and the ability to understand colloquial human language used in game shows like Jeopardy!. The most interesting development of this story is that after Watson’s celebrated win on national television, IBM will partner with Nuance Communications to explore how Watson could help with medical diagnosis …
Welcome our new (doctor) computer overlords
About 8 years ago or so, our practice decided to move from paper records to electronic records. The decision was helped along by the fact that we were literally running out of space for our paper charts. I had been looking at electronic medical records systems (EMRs) for years prior to this but could not justify the cost to my partners – apart from the “gee-whiz” factor – until we …
How to hire an IT director for your medical practice
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Last weekend I had the privilege of supervising University of Miami Miller School of Medicine students at a free public health screening in Pompano Beach, Florida. The screening was sponsored by the medical school, with the assistance of community leaders, and held in a local public school. The program organization, recruitment of student and faculty volunteers and management of the program was undertaken and implemented by the students. It is …
Free health screening: A service to our community’s health
The system we had before health reform became law was simply not working. I think we can all agree on that. A significant number of people oppose “Obamacare.” I can understand that. But repeal doesn’t really solve the problem. Sure, if you think that health reform has or will actually make our system worse than it was before, it seems prudent to undo the legislation, but that brings us back …
Repeal of reform won’t fix our health system
by Kate Gray
I call William my spirited child. Like many 3 year-olds, he loves to run and jump, and does it without the slightest sense of fear. His boundless energy has always been one of his most endearing features, but in a split second, it also almost took him from us forever.
A few days before Christmas, my husband Mark and I had some last minute holiday …
Forever grateful to the doctors and nurses who saved my son
It’s not easy being a parent of teens these days. Previously rational children transform into moody, unreasonable creatures whose need to shock is only surpassed by their efforts to fit in.
Add a measure of impulsiveness and experimentalism, and it’s no wonder risky behavior skyrockets during these years. What a parent can do is to keep the lines of communication open, stay informed of the health dangers of some of the …
10 health dangers that your teen may face
One of the benefits, or aberrations, depending on your point of view, of the fee-for-service model is that we surgeons are remunerated for correcting our mistakes and complications.
At first glance this seems wrong. But perspectives differ, and when a doctor has to deal with serious, undeserved complications and is self-employed he deserves to be compensated adequately. So what really is the difference between the two?
A complication may be described as …
Surgical error: The difference between mistake and complication
The following op-ed was published on February 2, 2011 in USA Today.
Last fall, a surgeon at Johns Hopkins Hospital was shot by the distraught son of a patient for whom he was caring. The man later killed his mother, then himself. A week earlier, a patient in a Long Island, N.Y., hospital beat his nurse with a leg from a broken chair, causing serious injuries. The following month, a psychiatric …
Understanding patient violence against health care workers
Proton beam therapy is an effective modality for killing certain types of cancer cells. New England and the Northeast are fortunate to have a proton beam machine at Massachusetts General Hospital, where it has been in use for some time effectively treating patients. This is a valuable resource, serving the entire region and beyond.
But what happens when everyone wants one? Well, we see the medical arms race at work again.
These …
Proton beam therapy and the medical arms race
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