If I’m learning anything from working locum tenens jobs, it’s that there is a wide, mind-numbing variety of electronic medical records (EMR) systems in place around the country. At my primary work site, we use Med-Host. Like every EMR, it has some bugs. But having seen other systems in other places, it’s clearly a Cadillac product in a great, big car lot of Yugos.
I’m not going to disparage other systems …
EMR tips for locum tenens doctors
Despite the fact that many papers have identified the problem, inappropriate blood transfusions continue in hospitals across the nation.
This topic was featured at the recent Patient Safety Science and Technology Summit that was held in Orange County, California.
Transfusion of packed red blood cells is very common. Over 2 million patients or 5.8% to 10% of inpatients are transfused every year with some …
Inappropriate blood transfusions: Surgeons should lead the way
The second day of TEDMED 2013 began with the curator, Jay Walker, providing a recap of the first day, which set the stage for the first session of the day: “How Can Big Data Become Real Wisdom?” This session was the most technologically focused of the day.
This session started with computer scientist Larry Smarr, an advocate of personalized medicine, …
Physician communication is the number one factor most highly correlated with the likelihood that patients will return to a hospital or medical practice. This conclusion is one that I have personally experienced and highlighted as a speaker at healthcare conferences and seminars and when consulting with fellow physicians on improving communication and building and maintaining a successful practice.
Physician communication is so important because understandably patients are anxious about their health …
Why physicians should welcome patient complaints
As part of the health reform movement, hospitals that meet various quality measures, like reduced readmission rates or improved patient satisfaction measures, get financially rewarded. Those that don’t will be penalized.
How’s it going so far?
Well, it appears that safety net hospitals that can least afford a financial hit are getting dinged, while doctor-owned hospitals are getting rewarded.
Oops.
According to Kaiser Health …
Health reformers should learn from doctor-owned hospitals
Mrs. Smith (not her real name) fidgeted in her chair in my examination room as I scanned the radiology report she had given me. She had visited the emergency room the previous evening with severe abdominal pain that had eventually been diagnosed as gastritis, or swelling of the stomach lining due to a virus. During her evaluation, the ER physician had ordered a CT scan of her abdomen and pelvis. …
Reduce the chance that you will be harmed by an incidentaloma
“I can fix this.”
The neurosurgeon was nothing if not confident.
“The cyst is pushing on your spinal cord. If it continues to expand, it will damage your nerves and you may lose the ability to walk. But I can remove the cyst, and cure you.”
The patient was a business school professor, a man comfortable with risk-benefit ratios and complex decisions. He probed for more information. The surgeon was happy to provide …
Should physicians discuss spirituality with their patients?
I’ve never been one with much affection for cold or inclement weather and as such, between November and April, most of my training is done on the treadmill. While many people lament the monotony and unchanging scenery that treadmill running brings, I take the time to lose myself in podcasts.
Recently, during a set of race-pace intervals, I listened to a podcast that …
Training to become a surgeon: Embrace the journey
New research just out in the journal Psychology and Aging says pessimists live longer and healthier lives. If this is true, then contemplating the future of anesthesiology ought to make us immortal, because our professional prospects don’t look bright. As we teach residents to do what we’ve always done, shouldn’t we ask ourselves honestly if we’re training them for a future that doesn’t exist?
Especially here in California, it seems …
Anesthesiologists are victims of their own success
A phone conference had been arranged. They wanted to talk to me about a denial for payment on a portion of a patient’s pre-authorized procedure after the fact. Its participants: the regional medical director of a large insurance company, his female assistant administrator, and me.
He cordially introduced himself as a pediatrician by trade from a large well-known (and highly respected) academic institution with impeccable credentials responsible for our region of the United States. …
Who are the physicians that make the decision to deny care?
We’re here at TEDMED 2013, excited to be part of a unique group of people passionate about the future of medicine and curious to walk the path that will take us there. We’ll be reporting through the rest of the week on the talks, demos, and people that make TEDMED the world’s premier medical conference.
The first session of TEDMED 2013 opened with performing artist Kishi Bashi setting the stage …
“Great,” I thought, as I stood at my desk, looking at my patient list early in the morning. She was coming in today. “She” was a patient of mine in her forties, with newly diagnosed triple-negative breast cancer, without nodal involvement. Our first meeting had been several months ago, and it had not been a good one.
I had asked about her …
Medicine does not compel us to like everyone we treat
A follow-up to Dear lawmakers: This is what it’s like to be a doctor today.
Thank you to everyone for the positive feedback. Over 60,000 Facebook “likes”, tweets, and newspaper requests was quite a surprise. I was especially moved by the multiple tweets from hospices, physician groups, and individuals recommending my article. This article really has hit a nerve and shed …
Dear Congress: Listen to doctors on the front lines of medicine
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Let’s explore one of the most well-studied health behavior theories – the health belief model (HBM).
The HBM states that our health choices are a direct consequence of our perceived susceptibility to a disease, our perceived severity of a disease, and the perceived barriers that keep us from adopting better habits.
Perceived susceptibility, perceived severity, and perceived barriers are three of the main constructs from the HBM. The word “perceived” is very …
Because I said so: Why that doesn’t work with patients
“If you can’t do this drunk, you shouldn’t be doing it at all.”
The eminent professor was speaking to a friend of mine about heart surgery. He was not supporting operating under the influence, or am I.
The point is that the technical component of surgery — the cutting, the sewing, the rearranging — is very easy. It is true that in the OR, as on the golf course, some are more …
I am a surgeon: Therefore I think
I am just back from my colonoscopy more or less. All went well, but I am still shrugging off the lingering tendrils of my sedation. So let’s chalk up any grammatical snafus to that, shall we?
I had, of late, had some GI symptoms. But those were mostly coincidental and likely due to extensive travel and the havoc changing time zones wreaks on circadian rhythms.
Mostly, it was just time to have …
This is what it’s like to have a colonoscopy
Sometimes, when a parent tells me about something that happened with their child, I think (and say, as nicely as I can): Why didn’t they call right away?
And sometimes, when I’m talking to a parent or seeing their child in the office, I think (but don’t say): Why did they call about this?
It can be really hard to know when to call the doctor.
It’s hard because sometimes you plain old …
How to know when to call the doctor
It’s that time of year when third year medical students are grappling with anxiety as they prepare their residency applications. Those uncertain feelings of ambivalence can only be assuaged by a successful “match.” Critical to recruitment committees, but often overlooked by students, are the influential personal statements.
Everybody coming out of medical school has a long list of accomplishments and abilities. The competition is steep. A powerful narrative has the potential to …
Getting into residency: 5 tips for a dynamic personal statement
A divorced friend of mine who recently started dating was shocked to find that the complete absence of female pubic hair seemed to be an expectation among her potential partners. I’m not surprised, when I was in the dating pool a couple of years back there were men who actually listed full clamscaping required among the personal attributes they were seeking in a girlfriend (and here I was looking for …
So your partner wants to remove your pubic hair
I want to wake up feeling restless and uncomfortable. It’ll be neat to drag myself out of bed to open that first bottle of wine. I’ll drink all of it within an hour. Then I’ll go to the liquor store. The guy behind the counter will know that, everyday, I will buy a pint of vodka from him. He will look at …
When I grow up, I want to be a drunk
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