More and more hospitals are realizing that the 30 to 50 percent of waste occurring within their organizations is not only real, but a tremendous opportunity. This is good news for both our patients and our health care system. The bad news is that many hospital executives believe that this waste is largely limited to processes like materials management, ER wait times and operating room first-starts.
The next step in our …
Where is the waste in health care?
I read with interest the recent article written by Dr. Rourke Stay, “What ESPN doesn’t tell you about MRI in professional athletes,” and couldn’t agree more. The bigger issue, however, is what ESPN may leave out of broadcasts about sports injuries. Prominent figures on the air often espouse their knowledge with enough charisma to convince even the most doubting fan that their opinion is more than just an armchair …
Consult experts in sports medicine when discussing players’ injuries
To most physicians my illness is a routine incident in their rounds, while for me it’s the crisis of my life. I would feel better if I had a doctor who at least perceived this incongruity.
– Anatole Broyard
For medical students to treat illnesses of all kinds, we must first fill our brains with thousands of facts, everything from anatomy, to physiology, to microbiology, and biochemistry. We essentially become robots, pounding …
Are we sacrificing our humanism in medicine?
In medical school, I was taught to keep my distance. To remember that the patient is the one with the disease. I was told to protect my heart, to be a little cynical, a little deprecatory, to keep a separation between me and the patient. Because they can hurt you.
For 18 years, I met people on what was arguably the worst …
Stop trying to be God. Be human.
Please choose one:
The three words blink in front of me on the computer screen.
Please choose one:
Patient is-
☐Male ☐Female
I click FEMALE.
I watch as the auto-template feature fills in the paragraph for me based on my choices.
Patient #879302045
Patient is: 38-year-old female status post motor vehicle accident. Please acknowledge you have reviewed her allergies, medications, and past medical history.
I click YES.
Have you counseled her about smoking cessation?
I click NO.
A little, animated icon of a …
I am sorry that you are in the hospital. You are feeling ill. The noises are loud, people are walking in and out of rooms, and you aren’t sure of what to expect. You are probably nervous. This whole situation is a disturbance to your life. You would rather be at home — I can understand that. Few people want to …
Dear patient: Apologies from your medical student
This morning, a friend of mine posted an article on Facebook that was titled, “Dear anti-vax parents, we’re not mad at you. Sincerely, your doctor.” She had captioned it, “Maybe when all the vitriol and anger and judgment dies down, maybe we can start having conversations like this, instead.”
The funny thing is that I had posted the exact same …
As a mother, I’m angry at vaccine refusers. As a physician, I’m scared.
There are many good reasons for Congress to enact President Obama’s proposal to raise the Federal minimum wage to $9 per hour. Many of these reasons, from economic stimulus to possible reductions in gaping income inequality to much-needed financial relief for working families, have been extensively discussed in the public sphere. However, one important benefit of increasing wages has not received enough attention: improving mental health.
Numerous studies show that poverty …
Increase the minimum wage for better mental health
Just because it’s simple doesn’t make it easy. Take a look at habits.
Do you floss? We all know the advantages, and it doesn’t take a rocket scientist to do it. Yet only 28 percent of people say they floss regularly. How about covering your mouth when you cough? Again, it’s not difficult, but we all know people who fail to grasp the concept.
Unfortunately, the same is true for hand-washing. It’s …
A helping hand: Continuing improvement in hand hygiene
I went to the retired firefighters dinner last week and had a great time, probably because I happened to land on a table full of contemporaries: men who worked at pretty much the same time I did.
Inevitably, conversation turned to our memories of some of the older firefighters we had to deal with as we worked our way up the seniority ladder; “getting time on” is what it was called. …
What a retired firefighter has to do with health care today
Over 100 million Americans suffer from chronic pain such as spinal disorders (lower back pain, disc disease, pinched nerves and neck pain), complex regional pain syndrome, fibromyalgia and headaches. The cost of chronic pain in human suffering, lost worker productivity and in health care dollars is counted in the billions.
Yet despite newer, expensive and invasive treatments like spinal fusions and disc surgery, spinal cord stimulators, steroid and painkiller injections, nerve “burning” and of …
How the health care system is making pain patients worse
My father’s sister Mary died from measles when she was six years old. Her death haunted my grandparents for the rest of their lives.
She was one of the thousands who died each year from measles before there was a vaccine to prevent this life-threatening disease.
Her story has always stayed with me — from my days as a child to my years in medical school. And once again I’m reminded of …
Eliminating personal belief exemptions will save lives
There’s been a lot written about the measles outbreak and antivaccine parents. Fact is, the current situation is a direct and predictable result of many social/political trends that have emerged in America over the last generation. I am sharing five easy steps to take if you want to create an epidemic just like this.
1. Raise a generation ignorant about science. The majority of Americans are Read more…
How to create a measles outbreak in 5 easy steps
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On Valentine’s Day weekend last year I found myself at Paddles, the local dungeon in New York City’s Chelsea neighborhood, for the first time. I was perched at the alcohol-free bar when a man politely introduced himself as a human carpet. He asked that I tread on him and lay on the floor to demonstrate. A professional dominatrix-in-training stepped onto his …
Doctors should pay more attention to their kinky patients. Here’s why.
Recently, the American College of Surgeons — our profession’s premier organization encompassing all surgical sub-specialties — launched its updated website. Included in this website are online communities where surgeons from around the country and even further away, can connect. In my interpretation of these communities, surgeons can connect over shared subspecialty topics (e.g., colorectal surgery, general surgery, orthopedic surgery), shared clinical interests (e.g., ethics, geriatric surgery, surgical safety), or shared circumstances (e.g., surgeons practicing …
How can female surgeons break through the glass ceiling?
Hospital leaders who are successful managers today are successful because they manage change. The great hospitals leaders by now have become masters at it. But there’s a difference between change you can see coming (bundled payments, EHR implementations, declining reimbursements) and change that shows up unannounced on the front door.
That’s often what it feels like when a huge, publicly traded company acquires a smaller physicians group. It can feel like …
Your ER group was just bought. What next?
I’m late! I’m late! For a very important date! No time to say hello, goodbye! I’m late! I’m late! I’m late!
– The White Rabbit, Disney’s Alice in Wonderland
It is in the very words, “running late.” It is not walking late, or strolling late, or even meandering late. It is always running late, the phrase itself active, implying urgency and speed, rush and anxiety. The distress, just like the White Rabbit. The …
Running late: The bane of every doctor
March is colon cancer awareness month. We have made tremendous strides in the fight against cancer especially colon cancer.
Between 1991 and 2011, U.S. cancer death rate decreased by 22 percent (1.5 million lives saved), and colon cancer death rate decreased by almost 50 percent. This decrease coincides with widespread adoption of colorectal cancer screening particularly colonoscopy.
Despite this progress, colon cancer is still the 2nd leading cause of cancer death in …
3 ways to prevent colorectal cancer
Despite the well-known rollout problems for hospitals and clinics across the nation, there are many palpable and welcome advantages to using electronic health records.
Chief among these are the ability to access the chart from anywhere, rapidly search for information needed, and reducing the centuries-old problem of illegible doctors’ handwriting. But with the good comes the bad, and in these still relatively early stages of health care information technology adoption — …
How can we make the EMR note more legible? Here are some ideas.
Incentive structures in health care have to change. Right now, we pay for services, or have a so-called, fee-for-service system. The idea is that the more patients doctors see, the more expensive tests doctors order and the more patients doctors hospitalize, the more money clinics and hospitals make. This incentive structure has transformed our health care into sick care.
The reality is, in America, we are adept at caring for complicated medical problems that require …
3 ways to change the way we pay for care
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