“If any Shrink Rapper ever has the time and inclination it would be interesting to read about what you would do to fix the mental health system, particularly the issue of involuntary hospitalization, if you had unlimited funds and political resources. You’ve been in the trenches, it would be great to hear your thoughts.”
Hospital dramas are not very short on excitement, but for some reason, anesthesiologists never seem to get the glamour treatment. Maybe that’s because our job is so difficult to transition onto the silver screen. After all, it would be pretty boring to see only one …
Our nurses will soon have “scripting” guidelines for their interactions with patients. This is apparently widespread in many industries. The idea being, patients will be more satisfied with their care if certain key phrases are repeated to them; phrases which might, possibly, just maybe find their way onto satisfaction surveys. Wink, wink!
Whether I will have to engage in this tawdry bit of theater remains to be seen. But bless the …
At tumor board recently, we discussed what we tell our patients about prognosis. Some oncologists give detailed information, including specific survival times. Others never discuss the future, and let the events of the illness teach patient and family. All try to adjust what they say by what the patient needs, because each physician expressed one core goal; “Whatever I say I don’t want the patient to lose hope.” I thought …
The preliminaries are over. Sponges, needles, and instruments have been counted and checked, their number recorded on a whiteboard on the wall, as well as a clipboard. The checkoff is a comforting hum of words; the tuned machinery of the workplace. As the bottle of local is opened and poured into a sterile bowl on …
In these early days of pay for performance (P4P) reimbursement, as the size of your paycheck begins to reflect your patient satisfaction scores, let’s have a frank discussion about three important topics all healthcare providers and organizations must understand going forward.
How your performance will be measured
How to get the highest patient satisfaction scores and be a happier doctor at the same time
The Saturday after Sandy hit, I was the medical student in a Cambridge, Massachusetts emergency room. Around the time my shift started, Andrew, a man about my age, couldn’t bear the pain in his nose any longer. The ED nurse still talks about the “huge booger” bulging from his nose. A few days before coming to the ED, he’d left behind his flooded, powerless Brooklyn apartment seeking refuge in his …
I’ve now discovered something even more time-consuming and annoying: a 202 page paper record mailed to me by a major medical system. (I won’t name names right now; suffice to say this system uses Read more…
An email was waiting for me one morning from my wonderful nurse, Laura. “Very sad day,” it said in the subject line. I opened the email quickly upon receiving it and read that one of my patients had died. This age-old dilemma again made me wonder what I should do: Should I call the family? Send an email or a card …
Are there really too few primary care physicians? And if so, what can we do to solve the PCP shortage? The standard answer to the first question is “yes, we have too few PCPs.” And the standard solution is to train more such docs, or allow more foreign-trained primary care docs into the country or, better yet, simply pay PCPs more money, so that graduating medical students will be more …
I have it on good authority that it’s not easy being green. But I’m willing to wager that it’s a whole lot easier when you have a lovable name like “Kermit.” Imagine being green (or brown) with a name like “Ramachandran”? Growing up with a name like mine certainly had its disadvantages. While most neighborhoods have a local bully who kicks ass and takes names, in my case, he would …
If you haven’t seen the movie, “Amour”, but are planning to, you might want to skip this commentary – but by all means do go!
It starts and ends with love, but not in Hollywood’s usual youthful romantic fashion. It also starts and ends with death after much caring, love and suffering. The agonizing toll on the patient and caregiver are equally …
Whether we call them “unnecessary,” “not indicated,” “inappropriate,” or “overused,” certain tests and procedures add little or no clinical benefit to patients and in some cases they cause harm. They also contribute to the cost of care without improving care. At a time when payers are challenging payment …
My [spouse] and I are 63 and childless. We are thinking of spending $99 to get genetic screening on the theory that it could help us plan a little better for our old age. Just as a random example, if I knew my chances for getting Alzheimer’s disease were high, I might want to move into assisted living sooner rather than later. We have many questions. Is …
I’m not quite sure how to describe this, but I’ll try.
Every day, I look at a computer screen for health care delivery with an increasing number of menu options. I tried counting these menu options once and after scrolling through them, I never reached all of them after counting up to 275 items.
I recently received this email message from one of my residents who has moonlighted in a local commercial urgent care center. This message is reprinted with his permission just as I received it, except I removed the brand name.
Hey Dr. Young, I’m looking for some basic mentoring advice. I’ve been moonlighting at ZZZ Urgent Care for about a year. Not my favorite work, but oh well. I don’t routinely prescribe antibiotics …
Since I started my new practice, it’s been an über hectic and very draining time, but I am happy to report that the end of the week was significantly better than the beginning.
Here are some things I am learning.
1. Starting a business is really, really hard. I did my best to make my business as simple as possible, mainly because I understand my own deficiencies when it comes to business-related activities. …
These should be the best of times for the patient safety movement. After all, it was concerns over medical mistakes that launched the transformation of our delivery and payment models, from one focused on volume to one that rewards performance. The new system (currently a work-in-progress) promises to put skin in the patient safety game as never before.
Yet I’ve never been more worried about the safety movement than I am …
Recently I’ve been wondering if pediatricians are out of touch when it comes to media and kids.
Our messaging is pretty straightforward: turn it off. The recommendation of the American Academy of Pediatrics is that children under the age of 2 should not watch TV at all, and everyone else should watch no more than 2 hours a day. And when we talk …
When a patient dies in the hospital, we go through a checklist that has become eerily mundane. Examine the patient to confirm the death. Notify the family, the senior doctor, the local organ bank, the admitting office, and (in some cases) the medical examiner. Fill out the report of death. Write a death note. Brace yourself against the emotional weight of the event and get on with your work. Nowhere …
