Pay close attention to what doctors say to patients

Patient
December 20, 2010

In a report from the Archives of Internal Medicine, it was reported that most hospitalized patients (82%) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted.  Of the physicians, 67% thought the patients knew their name and 77% of doctors thought the patients “understood their diagnoses at least somewhat …

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Pay close attention to what doctors say to patients

Progressive commercialization of American medicine

Health Technology
December 20, 2010

by Lucas Restrepo, MD

There is only one fundamental problem with American medicine: its progressive commercialization.

Every other problem derives from it centrifugally. Medicine, wrote William Osler, is “a calling, not a business.” Patients are not clients, nor physicians businessmen. People do not spend over a decade studying medicine ―living years in poverty or overburdened with debt― merely hoping to get rich. While it is perfectly …

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Progressive commercialization of American medicine

Natural lifespan and whether a woman is designed to give birth

Conditions and Diseases
December 19, 2010

Advocates of alternative health attribute all sorts of fantastical properties to the human body. The body supposedly “knows” how to live a long healthy life; the body is supposedly “designed” to work perfectly. The tenets of natural childbirth philosophy also invoke these fantastical properties. The body “knows” how to give birth; a woman’s body is “designed” to give birth.

On their face these claims are obviously false. The body doesn’t “know” …

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Natural lifespan and whether a woman is designed to give birth

Physician barriers to EMR acceptance

Health Technology
December 19, 2010

Recently, I had my first visit with my new primary care doctor.

I picked him based on recommendations (plus he’s one of the few that accepts my insurance), and also because he seemed to be an eager adopter of electronic medical records (EMR). On his website, there was a portal for making appointments on-line, asking questions of the doctor and staff by e-mail and once a registered patient, I could also …

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Physician barriers to EMR acceptance

Everything about medicine is now big business

Health Policy
December 18, 2010

Med­i­cine used to be different. Doc­tors couldn’t do too much for you. They didn’t get paid very much and they were focused more on helping than on managing a business.

Hospitals were community-based not-for-profit or public entities. Drugs and devices were not as sophisticated or expensive, and they weren’t marketed directly to consumers. Well Toto, we’re not in Kansas any­more.

After witnessing our “health­care reform” process you must have seen that almost …

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Everything about medicine is now big business

Giving children probiotics

Conditions and Diseases
December 18, 2010

I’m becoming more of a believer in giving children probiotics. Not for everything and not for everyone; I really don’t think we should put them in the water.

Probiotics, essentially live “good” bacteria we use to supplement our diet (usually Lactobacillus Acidophilus in the US), are becoming more and more available and recommended by more and more physicians. The role microbes play in our health is a hot …

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Giving children probiotics

Medical school and medical training in Ireland

Medical Education
December 17, 2010

I recently spent a week in Ireland, taking in the sights and spirits.

I was actually there for work too – visiting the University College of Dublin and the Mater Miserecordia Hospital – or the original Mercy Hospital as they refer to it.   As the future of primary care, residency work hours, and the healthcare insurance system continue to cause angst in the US, we often find ourselves referencing what our European …

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Medical school and medical training in Ireland

The art of medicine and mastering relationships

Physician
December 17, 2010

by Kelly, MD

There is a reason why people often say “the art of medicine.”

It’s not just the fact that so much of what we do is based on culture and habit rather than science, but also the fact that there is a lot of finesse when it comes to relationships as a doctor.  Oh sure, we know all about patient-doctor relationships and its importance.  There are …

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The art of medicine and mastering relationships

Comparative effectiveness research (CER) needs honest discussion

Health Policy
December 17, 2010

Comparative effectiveness research (CER) is suddenly a hot topic at all the health care conferences.

How come? Everybody agrees that we have to decrease per-capita cost and increase quality. Why? Government programs like Medicare and Medicaid foot more than 50% of our nation’s health bill, and if everything stays the same these programs will go belly up (bankrupt) in 8 years. Big problem.

Health and Human Services (HHS) has defined comparative effectiveness …

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Comparative effectiveness research (CER) needs honest discussion

Social media helps doctors manage their online reputation

Social Media in Medicine
December 16, 2010

Once a provider realizes the increasing importance of building and managing their online reputation, they need some practical tools and steps. Bear in mind, I am writing this, not for the small percentage of physicians already active with social media, but rather for those of you giving it consideration and looking for some …

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Social media helps doctors manage their online reputation

An ice cream label as a health literacy tool

Patient
December 16, 2010

When is an ice cream label a health literacy tool?

When Dr. Barry Weiss decided to use an ice cream label as a tool to asses whether we (patients) are able to understand medical instructions. Funded by Pfizer-backed Clear Health Communication initiative, Weiss’s research resulted in the creation of “The Newest Vital Sign.”

A health literacy assessment tool, with findings published in the Annals of Family Medicine.

However, the document, Why …

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An ice cream label as a health literacy tool

The cost of keeping the terminally ill alive

Physician
December 16, 2010

Last year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients’ lives.

And it has been estimated that 20 to 30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked. This statistic is from a 60 Minutes story on “The Cost of Dying” and …

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The cost of keeping the terminally ill alive

A physician story of addiction and recovery

Physician
December 16, 2010

by an anonymous physician

I am a physician now in recovery.

I don’t like that term. The correct thing to say is, I am sober.  I am going on a year sober without any problems. Recovery suggests some disease state and I don’t think it is that simple.  It also suggests an ongoing daily struggle or effort to remain sober, and I don’t find that the case, either.  I know this …

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A physician story of addiction and recovery

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How to intubate: Teaching a medical student during anesthesia residency

Medical Education
December 16, 2010

The first time I let a medical student try to intubate was in August. Now in my final year of anesthesia residency, I had volunteered to mentor a third-year medical student for a week. A few weeks in advance I got an email with the form she had filled out. Anesthesia experience: none. Excited to learn: yes.

I met her on Monday morning after she navigated through the preoperative holding area …

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How to intubate: Teaching a medical student during anesthesia residency

What the perfect EMR would look like

Health Technology
December 15, 2010

EMR software is a data repository for clinicians.  Rather than being just a simple database, what would the ideal software package look like?  What exactly is the perfect electronic medical record?

Every clinician that interacts with the medical record has a specific need.  Whether that is an emergency physician which is looking to track down a specific problem or a family practice physician who is looking to keep track of hundreds …

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What the perfect EMR would look like

Why physicians ignore fatigue

Patient
December 15, 2010

Several years ago, I spoke at Baylor College of Medicine in Houston, where Michael DeBakey, the legendary heart surgeon, was master of the universe for nearly half a century.

I heard lots of DeBakey stories during my visit, but one in particular really stuck with me. “A few years back,” someone told me in a voice of hushed reverence usually reserved for descriptions of flawless beach days and single …

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Why physicians ignore fatigue

A nurse and the system to deal with medical errors

Physician
December 15, 2010

by Mary Lynn Summer

I am a nurse. Like most medical practitioners, I am afraid of malpractice attorneys and view them as a threat to my nursing license. Every hospital has a system in place to deal with medical errors and patient complaints. I used to think they worked, but now I don’t.

My mother, in her late 80s, recently broke her hip. She has dementia so is unable to appropriately express …

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A nurse and the system to deal with medical errors

The commercial health IT ecosystem and its implications for patients

Health Technology
December 15, 2010

At “Background On The ‘Ecosystem’ of Commercial Healthcare IT” I wrote:

… In reading about HIT difficulties it is important to understand the “ecosystem” of commercial health IT, that is, the identity and nature of the principal constituents and stakeholders, and their interrelationships. Familiarity with this environment is useful in order to place the social and organizational issues affecting HIT diffusion in the proper context.

By implication, I made the case that the …

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The commercial health IT ecosystem and its implications for patients

A poetry reading at Bellevue Hospital

Physician
December 14, 2010

The waiting area in Bellevue Hospital was full. Every chair was taken. But the people kept streaming in. More chairs had to be brought in. It wasn’t clear if the room could accommodate everyone.

This wasn’t the emergency room or the clinic waiting area, however. It was the scene of the Bellevue Literary Review poetry and prose reading. More than 100 people poured into Bellevue Hospital on a Sunday evening to …

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A poetry reading at Bellevue Hospital

Medical errors that involve handwritten prescriptions

Physician
December 14, 2010

by Daphne Swancutt

Two people in the United States just died in the last hour. Seventeen more will die in the next 7 to 8 hours. Over a year, that number will accumulate to about 7,000.

The reason? Medical errors that include misread or otherwise misinterpreted handwritten prescriptions. Believe it. This means that doctors are being sloppy, pharmacies are making mistakes and people are getting dead.

Even more …

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Medical errors that involve handwritten prescriptions

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