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What do patients want from the health care delivery team?

Health Policy

May 2, 2012

Ours is a provider-oriented system. Doctors like me and (former) hospital executives like me hate to admit it but it is true. Consumerism will slowly but surely drive it toward being a patient-oriented service model. What do patients and their families want from the health care delivery team? First and foremost is respect followed by service given in a high quality, very safe manner. Patients expect that the information gap …

Speak to a patient as though you were speaking to your grandparents

Rushil Patel

Medical Education

May 2, 2012

It’s hard to believe that nearly 1.5 years ago have elapsed since my first-year orientation to medical school. Much of it seemed protocol with session after session on rules and regulations, but I vividly remember the few hours spent outlining standardized patient encounters and how my assessments over the next four years would be based on my interactions with a complete stranger. As alien as that idea sounded to me, …

ACP: If I were health care king

Fred Ralston Jr., MD

Health Policy

May 2, 2012

A guest column by the American College of Physicians, exclusive to KevinMD.com.

In preparation for a panel discussion at Internal Medicine 2012, the annual scientific meeting of the American College of Physicians, I was asked some questions about changes I would make in health care if I were king. That stimulated some serious thinking. For those of us in practice it is more usual to think about what new regulation …

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ACP: If I were health care king

Long waits at the doctor’s office disrespect patients

Barbara Bronson Gray, RN

Patient

May 1, 2012

I wasted time, and now doth time waste me.
-William Shakespeare, Richard II

A friend recently asked me a simple question: Why do we have to wait so long for doctors and not for other professionals, like lawyers, accountants, or dentists? And what can we do about it?

A study by Press Ganey showed that the average time patients spend waiting to see their health provider is 24 minutes. The research was done …

Will the art of medicine be lost in the sea of guidelines?

Jordan Grumet, MD

Physician

May 1, 2012

I don’t like doctors!

It was always the same with Ronald. After years of absence, he would appear at my doorstep with some particular problem that had progressed to alarming proportions. Once, it was the abscess that seemed to swallow up his whole back. The next time, it was a hernia that had grown to the size of a grapefruit hanging out of his undergarments. But today was different. In fact, …

When a heart attack is textbook perfect, it can be a beautiful thing

Stewart Segal, MD

Conditions and Diseases

May 1, 2012

Participating in a patient’s first heart attack can be an extremely stressful event. Thirty years ago, I was an ER doc. At the end of a typical shift, I would come home to my wife and, often, would remark about how nervous family docs got when dealing with emergencies like heart attacks.

Thirty years later, I’m the family doc and heart attacks are unnerving. Yes, I know what to do. We …

Asking about price is an essential part of a patient’s responsibility

Suzanne Nesmith

Patient

May 1, 2012

My husband and I have been self-employed for many years, and though our income is quite limited, we have always been careful with our finances, have always managed to live within our means, and have always paid our bills without assistance. We had private health insurance coverage and saw premium increases each year. Then to avoid further increases, coverage of office visits outside of deductible was dropped, and our deductible was raised to $4500. Finally, …

Singing the blues about tuberculosis

Jim deMaine, MD

Conditions and Diseases

April 30, 2012

Should we all have the TB Blues? I think you’d agree that we should after listening to this 1931 classic by Jimmie Rodgers who died from TB.

Tuberculosis is known to have existed in ancient Egypt and TB may have even been referenced in the Bible – “The Lord will smite you with consumption, and with fever, inflammation, and fiery heat …” Deuteronomy 28:22.

Many well known authors, artists, musicians, and …

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Singing the blues about tuberculosis

Be honest with yourself about what your true passion is

Susan Biali Haas, MD

Physician

April 30, 2012

In the first week of the 5th grade, our class had a special music afternoon. It was our opportunity to try out the different instruments in the school band. We were to make a decision, that very day, about which instrument we would play almost every day for our school music careers.

I was so excited. I had been busy deafening my parents for years by creating high-pitched squawking melodies on …

How money influences our decisions as doctors

Ido Weinberg, MD

Physician

April 30, 2012

When you ask young medical students why they want to be doctors, you will probably get all sorts of answers. Some may say they like people and want to interact with them and offer them help. Some students will believe this is their calling. Others still may state they are intrigued by the scientific mysteries the human body is filled with. From my experience, not many medical students just starting …

Health care needs the Lollipop man

Vineet Arora, MD

Health Policy

April 29, 2012

I recently watched Dr. Atul Gawande on video describe how what American healthcare needs is pit crews and not cowboys. This sentiment is also memorialized in his thought-provoking writings for the New Yorker.

Interestingly, Dr. Gawande is not the first person I have heard to suggest such a thing. A colleague named Dr. Ken Catchpole actually studied Formula 1 pit crews and used the information to guide improvements in …

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Health care needs the Lollipop man

We often feel at a loss for words when the news is bad

Kate Land, MD

Physician

April 29, 2012

Something difficult has unfolded around here lately and when news got out a dear friend came by with a gift of a story. She told us about a day years ago when one neighbor heard the other had breast cancer. The well neighbor was shocked and saddened. She was at a loss and wanted to help; wanted to do something but, what? In a daze but motivated none the less, …

Patient advocates need to manage expectations

Trisha Torrey

Patient

April 29, 2012

Consider this scenario.

Joan, age 75, living in Ft. Lauderdale, was diagnosed with Stage IV Ovarian Cancer. Joan’s daughter, Beth, who lives in Kansas, contacts Maxine, a private patient advocate and RN who works in Ft. Lauderdale, to help her mother. Joan, Beth and Maxine have extensive conversations about the care Joan will need. The decision is made that Joan will need surgery and chemo. Maxine is hired to oversee the …

Where do our wasted health dollars go to?

Roy Benaroch, MD

Health Policy

April 29, 2012

The biggest problem with health care delivery in the US is cost, which seems to have taken a back seat to other issues meant to be addressed by health care reform. We spend about $2.5 trillion dollars a year on health care—that’s over eight thousand dollars a year for every man, woman, and child. What’s that getting you?

According to the government, about 30% goes to hospitals; 20% goes …

What keeps a hospital CIO up at night

John Halamka, MD

Health Technology

April 28, 2012

Earlier this year, my team presented a list of risks to the Compliance, Audit and Risk Committee at BIDMC. Here’s my list of top risks for 2012:

1. Old Internet browsers. Many vended clinical applications require specific versions of older browsers such as Internet Explorer 6, which are known to have security flaws. We’ve worked diligently to eliminate, upgrade or replace applications with browser specificity. At this point we …

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What keeps a hospital CIO up at night

Every emergency medicine shift teaches something

Marlene Buckler, MD

Physician

April 28, 2012

Tonight a 17 year-old boy came to the emergency room complaining of headache. As I entered his room, in my usual hurry to do an assessment as expeditiously as possible, so as to get on to the next case and attempt to avoid the inevitable backup of patients so common in our ER, I was struck by the vulnerable demeanor of the patient before me. The triage nurse’s report assured …

3 common misconceptions about doctors

Bradley Evans, MD

Health Policy

April 28, 2012

In the current climate of health care reform, it is important to understand doctors and the work they do. I have found 3 common misconceptions, held even by doctors themselves, concerning the job of being a doctor.

The first is the idea that doctors are conservative, resistant to change. Facts show that doctors deal with change all the time. They are familiar with the concept of change for change’s sake and …

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3 common misconceptions about doctors

Our patients live with the fallout of a device recall

Kevin R. Campbell, MD

Conditions and Diseases

April 28, 2012

In the last several weeks there has been much discussion concerning the St. Jude Medical Riata lead Class I recall. Prior to the Riata, there was the Medtronic Sprint Fidelis lead recall. Prior to Fidelis, there were multiple recalls involving Guidant (now Boston Scientific) devices. The common thread to all of these recalls is our patients. Our device patients have endured all of these events. How exactly does the recall …

When doctors are forced to accept malpractice case settlements

William Sullivan, DO, JD

Physician

April 27, 2012

Suppose your malpractice insurance company wants to settle a medical malpractice case against you – even though the case has no merit.

In many cases, insurance policy language may allow the insurance company to do just that.

In the 2011 case of Mohan Papudesu, MD v. Medical Malpractice Joint Underwriting Assn. of Rhode Island, the Rhode Island Supreme Court allowed an insurer to settle a case on behalf of the defendant physician …

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