by John LaBine
What are the root causes of communication inefficiencies in hospitals? Hovering around any given patient/case are many players, each with a huge variety of demands for his/her time, attention and presence. And they know there are costs of certain outcomes (medical errors, stress, wasted nurse/physician time, etc.). Each caregiver has his own long list of things to do, places to be, people …
Hospitals need healthcare flight crews
Looking back, some of my biggest medical mistakes have been times when I was reactive rather than proactive when faced with a clinical problem. A doctor may have to be one or the other depending on the circumstances, but knowing when and which approach to take is one of the harder skills of medicine, taking time and experience to master.
What do I mean? Here are some examples from my field.
Treating …
Difference between proactive and reactive medicine
One of the central tenets of the patient safety movement is that modern medicine is a team sport. Unfortunately, its players – particularly physicians – were trained and socialized to be free-spirited individualists. We need the Celtics of the 80s; what we have is a collection of young John McEnroes.
While this theory has been generally accepted, there is less agreement regarding how to change things. When I speak about Read more…
Teamwork helps doctors with patient safety
Heads up folks in the Neonatal Intensive Care Unit (NICU), parents of premature babies want you to succeed more than you may realize. It is just hard for them to communicate this through the fog of stress and exhaustion that has consumed them for countless hours, days and even months.
So here is a little insight into the parent mind and what they want you to know about what it is …
Top 5 NICU tips from a preemie parent
There are many reasons to sell your practice. Physicians attempt to sell their practices for various reasons. Some physicians are reaching the age of retirement, while others are looking to add a partner, who, in time will take over the practice as a whole. Whatever the reason, attempting to get a quality price for the practice can, at times, be a challenge in this current …
Why physicians should sell their practice
by Katherine Fullerton, MD
As a pediatric emergency physician in Northern Virginia, I have the good fortune to work with an amazing staff in a busy pediatric emergency department (ED) that sees a wide range of patients with both minor and life-threatening illnesses. Of note, we have a wonderful electronic medical record (EMR) that allows us to see past visits, lab tests, and medical problems.
My last shift was an overnight …
Insurance status when arranging follow-up from the ED
Implantable defibrillators are truly life saving devices that have prevented sudden death in thousands of patients. No bigger than an iPod nano, the device can sense when the heart is beating irregularly and deliver an electrical jolt that kicks it back into proper rhythm. But like so many of medicine’s miracles, defibrillators are not always used on the right patients. According to a study published recently in the …
Shared decision making to determine implantable defibrillator need
Very few of us are untouched by the tragedy of suicide. Whether in our own family, through friends, or one of our colleagues, most of us have been affected by suicide. We are often left alone, with the painful questions,
“Why?”
“What could we have done differently?”
Now we learn from a study by Shanafelt et. al, in the Achieves of Surgery, that one in 16 surgeons had suicidal ideations in the …
Your physician may be thinking about suicide
A recent post in the Wall Street Journal’s Health Blog noted that a study found electronic medical records don’t improve outpatient quality. The authors of the Archives of Internal Medicine article, Electronic Health Records and Clinical Decision Support Systems, correctly points out that we should be skeptical and “doubt [the] argument that the use of EHRs is a “magic bullet” for health care quality improvement, as some advocates imply.”
This …
Why this doctor loves electronic medical records
by VeronicaB, MD
We’ve all had that hysterical patient. The one that comes in during a busy shift. Grabbing at their head, their chest, their abdomen. Yelling out that they are in pain.
You know the one. They makes the nurses’ eyes roll. They add to an already chaotic scene. Other patients stop to watch as the gurney rolls by.
You debate how long you’re going to wait to …
The hysterical patient during a busy ER shift
Abdominal pain is the bane of many emergency physicians.
Recently, I wrote how CT scans are on the rise in the ER. Much of those scans look for potential causes of abdominal pain.
In an essay from TIME, Zachary Meisel discusses why abdominal pain, in his words, is the doctor’s “booby prize.” And when you consider that there are 7 million visits annually by people who report abdominal pain, that’s a …
When in the ER with abdominal pain, adjust your expectations
With little notice, UnitedHealth released a major paper recently considering diabetes in America.
First the bad news: a large portion of our population either has the disease or is pre-diabetic.
Now, the really bad news: diabetes and pre-diabetes rates are going to soar in the coming decade, according to the analysis, in part driven by the obesity crisis.
I’ll return back to the study in a moment, but it underscores a …
Our health is worsening at a time when medicine has never been better
Adapted from Generation Earn: The Young Professional’s Guide to Spending, Investing, and Giving Back.
by Kimberly Palmer
Young professionals today aren’t exactly known for our financial expertise. Dubbed “generation debt,” we’re stereotyped as over-spending shopaholics, easily enticed by credit cards, lattes, and the latest smartphone. But that reputation, it turns out, isn’t fair.
Yes, we have more student loan debt than previous generations, and average credit card debt among twenty-five- to thirty-four-year-olds …
Smart money tips for young doctors and medical students
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What makes your doctor’s education unique from that of other health care providers?
Recently, I was sitting in on a lecture by one of my favorite physician-teachers (certainly my favorite neurologist). I’ll call him Dr. Deeds (for his resemblance to a character from the movie, Mr. Deeds). He was giving a sort of broad, generalized lecture to prepare us for a series of lectures on neurodegenerative diseases …
Why your doctor’s education is unique
The recent explosion of interest in onsite clinics – not just by employers, but by health plans, hospital systems, public health programs, and others – is anything but just another health care fad. At once, clinics’ growing popularity signals purchasers’ weariness with an intransigent, self-interested health system, as well as their guarded optimism about a better way.
Today’s best clinics are single-mindedly focused on what works best for the patient and …
Onsite clinics within a competitive health care marketplace
by Jeffrey L. Cohen
In the 90s, physicians were told “The sky is falling. You have to find a tree to stand under or you will be crushed.” The “trees” were things like IPAs and PHOs. The future outlook was bleak. All patients were going to be part of some system with which the physician would have no input or control. Decisions would be made on purely …
What physicians should believe about Accountable Care Organizations
I am licensed to practice medicine and surgery in Georgia. But that doesn’t mean I should, or that you ought to let me—at least not the surgery part. I’m actually pretty good at carving a turkey, but that’s pretty much the only kind of surgery that I’m qualified to do.
Don’t let the license fool ya, I’m no surgeon. So what, exactly, does a doctor have …
How to become a licensed, board certified doctor
by erdoc85, MD
When I arrived for my shift this am, I was passed off the following patient.
EMS responded to a 50-year old guy laying alongside the Interstate. He had no idea who he was or how he got there. He complained of knee pain and shoulder pain. They were kind enough to tote him to my ER where his evaluation revealed that he had a fracture …
Why a patient waited 80 hours in the ER for placement
Tobacco is the single biggest cause of preventable death and disability in the United States. But nicotine is highly addictive, and quitting the cigarette habit can be extremely tough.
L.J., a 55 year old man who gave up smoking after 35 years, proves that it can be done. In L.J.’s words, he was “sick and tired of being sick and tired.” But he didn’t do it alone; his success depended on …
Strategy and support is needed to quit smoking
I exchange thoughts with healthcare IT people on a daily basis over at Twitter. So many of them seem perplexed at why we patients look at putting our medical records on the internet with trepidation.
Then along comes this video from Elizabeth Cohen at CNN. In a matter of minutes, she was able to pull up one of her CNN colleague’s medical records, his …
Health records need to be online to improve health and save money
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