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 …
The art of medicine and mastering relationships
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 …
Comparative effectiveness research (CER) needs honest discussion
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 …
Social media helps doctors manage their online reputation
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 …
An ice cream label as a health literacy tool
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 …
The cost of keeping the terminally ill alive
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 …
A physician story of addiction and recovery
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 …
How to intubate: Teaching a medical student during anesthesia residency
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 …
What the perfect EMR would look like
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 …
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 …
A nurse and the system to deal with medical errors
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 …
The commercial health IT ecosystem and its implications for patients
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 …
A poetry reading at Bellevue Hospital
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 …
Medical errors that involve handwritten prescriptions
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Early last year, I wrote that conservatives should have been happy with health reform.
Maybe they just didn’t realize it yet, because they’re rejoicing after yesterday’s news of a federal judge ruling the individual mandate unconstitutional.
But by supporting repeal, conservatives should be careful what they wish for.
The fact is, the Affordable Care Act is a moderate piece of legislation. There’s no public option. It leaves private insurers intact. There is …
Health reform repeal should make conservatives nervous
by Paul M. Cinciripini, PhD
If you smoke, quitting the habit is the best New Year’s resolution you could make — and keep — in 2011. That’s true even if you’re just a social smoker.
A new report from the Surgeon General shows that even occasional smoking and secondhand smoke cause immediate damage to the body.
The good news is that people who stop smoking before age 50 cut their risk of dying …
Quit smoking in 2011: 5 steps you need to know
by VeronicaB, MD
A baby died today; a very small infant. One minute I’m excited by the end of my overnight shift quickly approaching, and the next I am hearing the words you never want to hear come over the radio, “En route to home for infant not breathing.” I think the whole ED staff stopped for a minute waiting for the next report.
Then we begin to …
Infant resuscitation in the ED
About 60% of patients suffering from depression do not find any benefit from their first antidepressant. Up to 20% of patients find depression impossible to overcome even after 1 year. Assertive treatment of depression from the get go is essential to helping recover from depression.
Psychiatrists don’t have a shared definition of treatment resistant depression. However, most would agree that your depression may be treatment resistant if it has not resolved …
Solving treatment resistant depression
Being a physician always has been a busy job.
This is especially true for primary care physicians who set as their goal the delivery and coordination of comprehensive care for patients. Achieving such a goal requires availability, a broad spectrum of medical knowledge, effective use of the local health care system, and attention to both the “big picture” and the details of a patient’s life and …
Physician time should be considered a resource
Call it the McVictim syndrome. Too many pundits, public health experts and politicians are working overtime to find scapegoats for America’s obesity epidemic.
In his latest book, former FDA Commissioner David A. Kessler argues that modern food is addictive. In it, he recounts how he was once helpless to stop himself from eating a cookie. In a paper in this month’s Journal …
Obesity patients are not victims
by Kevin Fickenscher, MD
In the great healthcare alphabet soup, it’s easy to lose sight of the differences between proposed solutions for making healthcare more efficient and effective.
Rather than tackling payment reform in isolation of care delivery, Accountable Care Organizations (ACOs) and Medical Homes offer a consolidated approach to both issues. While the models are still developing, various pilot programs are being implemented around the …
Accountable care organization (ACO) and medical home differences
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