Why EHRs aren’t meaningful to doctors and hospitals

Health Technology
November 18, 2010

Electronic health record (EHR) advocates in Washington don’t seem to get it. They don’t seem to understand that hospitals and doctors aren’t rushing to install EHRs because many EHRs, despite the constant talk that EHRs are a prerequisite for good care. Caregivers are not walking the talk, because in their view, EHRs,

  • aren’t ready for prime time
  • slow productivity
  • decrease revenues,
  • show scant returns on investment
  • don’t talk to one …

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Why EHRs aren’t meaningful to doctors and hospitals

A National Quality Strategy can create improve patient safety

Health Policy
November 18, 2010

Among the many provisions in the Patient Protection and Affordable Care Act are elements intended to assure that every American has access to healthcare that is patient-centered, affordable, and of the highest clinical quality.

In my mind, one of the act’s most essential goals is to establish a National Health Care Quality Strategy — one that integrates disparate federal and private sector initiatives, building on and expanding current quality assessment and …

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A National Quality Strategy can create improve patient safety

Our malpractice system needs to focus on patient safety

Physician
November 18, 2010

A malpractice lawsuit claims that a doctor treated a patient negligently and that this treatment caused harm, and it seeks monetary compensation. Negligence means that a physician failed to provide the standard of care expected by the prevailing medical custom. Juries decide cases that are tried, but most cases are settled or dropped. Lawyers get paid (typically 35 percent) only when they win or settle a case.

A successful malpractice system …

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Our malpractice system needs to focus on patient safety

EMR is here to stay, which will be good for doctors and patients

Health Technology
November 17, 2010

The electronic medical record, the EMR, is upon us.

For those of us who learned medicine entirely with paper charts, some have enthusiastically embraced the EMR and some have refused, to the extent they can, to deal with it at all. But most of us have plowed ahead into learning how to use it as best we can. It seems to me that the degree of enthusiasm physicians show for the …

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EMR is here to stay, which will be good for doctors and patients

How the health care industry competes for patients

Physician
November 17, 2010

On my drive in to work this past week I came across this:

A bus-side advertisement for a local hospital (sadly, not mine) claiming that it was “home to the city’s best transplant outcomes.” Normally I drive right by these moving billboards without paying much attention. But this time I immediately got excited, whipped out my cell phone and snapped …

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How the health care industry competes for patients

Addressing the physician shortage in Texas

Medical Education
November 17, 2010

by Tayson DeLengocky, DO

The physician shortage in Texas has commanded an unusual amount of public interest in recent weeks.

The Houston Chronicle (Oct. 17), Star Telegram (Oct. 19) and Fort Worth Business Press (Oct. 27) all devoted space to the growing shortage of physicians in Texas and the steps necessary to correct the problem. The three articles recognized that the availability of residency slots is the determining factor in addressing the …

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Addressing the physician shortage in Texas

CAHPS measures are as important as profit and loss for hospitals

Physician
November 17, 2010

by Steve P. Sanders, DO, MBA

Are hospitals coming clean? An article recently published in Health Affairs reveals details of a government–required survey conducted in 2008 and 2009.

The Hospital Consumer Assessment of Healthcare Providers and Systems survey or CAHPS is required of all hospitals receiving and hoping to continue to receive federal funding. Analysts compared CAHPS responses between 2008 and 2009 and gleaned what they believed …

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CAHPS measures are as important as profit and loss for hospitals

Taking a multivitamin, vitamin D and fish oil every day

Conditions and Diseases
November 17, 2010

There is very little doubt that if we eat the diet we were designed to eat and spend adequate time in the sun that we will get most if not all the nutrients we need.

That’s the ideal, but not the reality for a lot of us.  I was recently advised by a group of physicians who are experts in the area that it is reasonable, and probably preferable, for adults …

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Taking a multivitamin, vitamin D and fish oil every day

Medical jargon leads to poor communication between physicians and patients

Patient
November 16, 2010

An article in the Wall Street Journal, Taking Medical Jargon Out of Doctor Visits, emphasizes that the use of medical jargon leads to poor communication between physicians and patients, and consequently leads to ineffective medical care. Federal and state officials are now pushing healthcare professionals to use simpler language to communicate medical advice to patients.

I could not agree more with this mission. The gap …

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Medical jargon leads to poor communication between physicians and patients

What does the NYC Marathon have to do with health reform?

Health Policy
November 16, 2010

Legend tells of an Athenian named Pheidippides who, in 490 B.C., ran from the battlefield at Marathon to Athens, telling of the victory over the Persians. Proclaiming the news that Athens would be spared pillage and fire, the Athenian dropped dead. The story is a myth.

But the marathon, like most things worth doing, does offer both risks and rewards. Because it gives a chance to go beyond usual boundaries, with …

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What does the NYC Marathon have to do with health reform?

Design solutions by truly understanding how humans use tools

Health Policy
November 16, 2010

The Futurama exhibit from the 1939 World’s Fair, although pretty in exhibition form, looks like a terrible place to live. It’s a world of machines, concrete, and efficiency. How boring! Futurists have always imagined the “what can we do?” scenarios. They’ve never really asked the questions:

  • What should we do?
  • What do people want that would make them feel more alive and more happily human?

Jane Jacobs, in her excellent book The Death …

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Design solutions by truly understanding how humans use tools

How to create your medical family tree

Conditions and Diseases
November 16, 2010

The holidays are a great opportunity to ask family members about their health history.

Learning about your family’s health history can help you answer your doctor’s medical history questions. It can even help your doctor determine if you may be at risk for an inherited cancer like breast, colorectal, ovarian, prostate or endometrial cancer, which sometimes run in the family.

Keep in mind that just a small portion of cancers – about 5 …

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How to create your medical family tree

Why medical students are burning out and lacking altruism

Medical Education
November 16, 2010

by mdstudent31

Recently, AAFP News Now released an article titled, Unprofessional Conduct Among U.S. Medical Students Linked to Burnout.

It focused on an article recently released in JAMA entitled, Relationship Between Burnout and Professional Conduct and Attitudes Among US Medical Students.

I had the opportunity to be interviewed for this article and was featured on an inset within the article that shared a minority of my interview. …

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Why medical students are burning out and lacking altruism

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EMTALA threatens the safety net of community care

Physician
November 15, 2010

President Bush once said something along the lines of, “We do have universal health care in this country — just go to the emergency room.”

EMTALA.  The law requiring emergency rooms to treat everyone’s emergent conditions, a well meaning act that has had disastrous consequences for hospitals’ bottom lines.  A disgustingly flawed law on many levels.

How do you prove it is not an emergency condition?  You work it up.  …

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EMTALA threatens the safety net of community care

Neoplastic epidural spinal cord compression is an oncologic emergency

Conditions and Diseases
November 15, 2010

There are very few oncologic emergencies. Neoplastic epidural spinal cord compression is one of them. The delay in diagnosis and treatment is often explained by the non-specific nature of the presenting signs and symptoms.

The patient developed urinary retention a couple of weeks prior to presentation. On the morning of admission he was fully functional. Later he sat down to have a cup of coffee and boom – he couldn’t feel …

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Neoplastic epidural spinal cord compression is an oncologic emergency

Physicians the government wants to see

Medical Education
November 15, 2010

I was talking with a pre-med student recently.  He had completed his very first medical school interview and was, understandably, excited.  But he told me the interviewer had asked him what he thought would be the outcome of the current health-care reform measures.

I laughed to myself.  After 17 years in practice, even I don’t know the outcome, though I have my suspicions.  It seemed a loaded, almost unfair question.  After …

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Physicians the government wants to see

First aid rules that everyone needs to know

Patient
November 14, 2010

First aid is defined as the immediate care given to an acutely injured or ill person.  It can literally be life-saving so it behooves all of us to know some basic principles.

What follows are some rules that cover common conditions and general practices:

  1. Don’t panic.  Panic clouds thinking and causes mistakes.  When I was an intern and learning what to do when confronted with an unresponsive patient, a wise resident advised …

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First aid rules that everyone needs to know

Medical students taking a mandatory rotation in geriatrics

Medical Education
November 14, 2010

What happens when you randomly assign medical students to either a mandatory two week rotation in specialized geriatric training or to a traditional non-geriatric clerkship that sees a lot of old people?

Will there be any difference in the knowledge of geriatric conditions, the attitudes toward older adults, or geriatric clinical skills between the two groups?  Or does mere exposure to an aging patient population give students the training they need to …

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Medical students taking a mandatory rotation in geriatrics

Side effects of medication sometimes confuse patients

Medications
November 14, 2010

Side effects.  Every medication has them.  Some are mild, some are annoying, and some are downright dangerous.

When doctors write a prescription, they mention that some people experience side effects, and if certain bizarre things happen, the patient should phone the doctor.

How do we keep track?

If you get one antibiotic to take for two weeks, it isn’t so hard.  First, because it’s for a short time period, and also because it’s …

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Side effects of medication sometimes confuse patients

How dietary guidelines can help prevent disease

Physician
November 13, 2010

Most of the illnesses that occur today are chronic like diabetes, heart disease, cancer or kidney disease.

These stay with us for the rest of our lives, are debilitating, and are expensive to treat. But in many cases they are not all that difficult to prevent. Unfortunately, our dietary guidelines are of little or no help in this regard but could be.

In 1941, following studies that demonstrated …

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How dietary guidelines can help prevent disease

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