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Using servant leadership to teach medical students

Medical Education

November 11, 2010

I spend much time talking with medical students. It is part of my job, but more than that I like medical students.

What should be the goal of medical schools? I believe we have an obligation to help our students grow into great physicians. What philosophical principles should we use?

Perhaps the answer to success is Servant Leadership. As I learn more about this concept, I hope that have become a servant …

Why moral hazard fails in health care

Aaron E. Carroll, MD

Health Policy

November 11, 2010

I’m going to take the time to review a topic that is one my pet peeves, one you hear bandied about all the time in discussions of more consumer directed health care. It’s a topic I came back to repeatedly on my old blog – the moral hazard.

Basically, the moral hazard is the idea that people insulated from risk behave differently than people exposed to risk. For instance, …

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Why moral hazard fails in health care

Medical malpractice reform in exchange for paying doctors less

Kevin Pho, MD

KevinMD

November 11, 2010

The bipartisan debt commission appointed by President Obama recently released its recommendations on how to pare the country’s debt.

Of interest to doctors is the suggestion to change the way doctors are paid. Physician lobbies have been advocating for removal of the Sustainable Growth Rate formula — the flawed method by which Medicare, and subsequently private insurers, pays doctors.

According to this method, physicians are due for a pay cut of …

How medical students can improve our health system

Aaron J. Stupple, MD

Medical Education

November 11, 2010

Many fellow medical students are eager to improve “the system.”

However, an overeager attitude offers both promise and peril — promise that budding physicians are inspired to improve the inner workings of their chosen field, peril in that our naiveté may simply clutter the very complexities we seek to improve.

How do we strike a balance between getting involved and getting in the way?

I found guidance in law professors Raustiala’s and Sprigman’s …

The patient experience needs to be improved: here’s how

Kevin

Patient

November 10, 2010

by James Merlino, MD

The patient experience is the right thing to do, and a business necessity. But improving it is not necessarily easy.

The fact is, large medical centers are at a real disadvantage when it comes to performing well on HCAHPS. The Centers for Medicare & Medicaid Services (CMS) do not discriminate or differentiate the scores of small community hospitals from those of large academic tertiary care …

MKSAP: 44-year-old man with chronic joint pain

mksap

Conditions and Diseases

November 10, 2010

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 44-year-old man is evaluated for a 2-year history of joint pain in the wrists, hands, knees, ankles, and feet. He also has a 12-year history of plaque psoriasis. His current medications include acetaminophen for joint pain, topical hydrocortisone and calcipotriene ointments, and a …

Patients seeing the visit notes their primary physicians entered

Dave deBronkart

Patient

November 10, 2010

This item has nothing to do with OpenNotes itself – it’s what I’m seeing now that I’ve started accessing my doctor’s notes. In short, I see the clinical impact of not viewing my record as a shared working document.

Here’s the story.

In OpenNotes, patient participants can see the visit notes their primary physicians entered. Note – primary, not specialists. I imagine they needed to keep the study design simple.

So, …

Understand your options before monitoring Internet use

Peter J. Polack, MD

Health Technology

November 10, 2010

As medical practices become more advanced, staff members gain improved access to the Internet during work hours. Cyber-slacking is a well-known problem in corporations; in fact, one study found that over thirty-five percent of employees admit to using the Internet for personal surfing at work.

The New York Times cited that twenty-five percent of Net use on work computers isn’t actually work-related. Although it is unknown how severe the problem is …

Will the new Congress allow the physician Medicare cuts to pass?

Dan McCoy, MD

Health Policy

November 10, 2010

Well it’s that time of year again.

No, not Thanksgiving or Christmas, or even the venerable Interim Meeting of the AMA. It’s the time that physicians nationwide anticipate another mandatory cut in Medicare reimbursement rates.

This time the recurrent temporary fix will result in a cut of 23.6 percent on December 1st. Assuming political gridlock the rate will fall another fraction of 6.5 percent on …

How EMRs are failing nurses

Jared Sinclair, RN

Health Technology

November 9, 2010

Among the litany of complaints about the (un)usability of EMRs, it’s easy to lose sight of the big picture. More than the poor design choices and overall ugliness of existing software, by far the single biggest failure of HIT companies is that none of them has yet to produce an EMR that nurses actually need.

There is a huge opportunity being wasted here. Other industries have been able to incorporate computers …

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How EMRs are failing nurses

Patient safety suffers when doctors are forced to learn multiple EMRs

angienadia, MD

Health Technology

November 9, 2010

As a new intern at a well-endowed medical institution, I was disappointed despite the flurry of excitement that comes with orientation. I was disappointed despite the brand new privilege to save lives and relieve human sufferings. And the disappointment was made clear to me over the past two days.

What has happened in the past two days? As I will be working at two separate hospitals, for the past two days …

Uninsured Americans cannot afford many medications

Brad Wright, PhD

Health Policy

November 9, 2010

I went to the doctor recently and got a new prescription.

The doctor was kind enough to give me some free samples, and a voucher that I could redeem to fill the prescription once at no cost. In the future, it will cost me $50 if I decide to refill it. If I didn’t have pharmaceutical benefits through my insurance coverage, the medication would set me back about $500 for a …

Why patients are leaving our practices

Jordan Grumet, MD

Physician

November 9, 2010

She was like … Superwoman. A strapping medical visionary probably in her forties. Gray long coat falling below the knees. She strode confidently down the hallway towards the elevator, a father hurrying beside her with his young lanky daughter cradled in his arms. The girl’s head nuzzled into her father’s shoulder. She was old enough to walk by herself…but clearly she was sick. Unable.

Undoubtedly they were headed from the medical …

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Why patients are leaving our practices

An ACO may or may not reduce health insurance premiums

Paul Levy

Health Policy

November 8, 2010

Is the move towards accountable care organizations (ACOs) and capitated (aka, global) payments likely to reduce health care costs and insurance premiums, or will it do the opposite?

Being an economist, my answer will be, “On the one hand … On the other hand …”

On the one hand, ACOs offer the potential for a better integration of care across the spectrum of primary care, hospitalization, skilled nursing, rehabilitation, and hospice. If …

Is your child’s behavior due to ADHD?

Orly Avitzur, MD

Conditions and Diseases

November 8, 2010

When my oldest son was 13 he began to do poorly in school. He often forgot to do his homework, or he did it but forgot to hand it in. He had difficulty paying attention during tasks, was extremely disorganized, and his teachers said he was easily distracted. They suggested that his behavior fit with many of the symptoms of attention deficit hyperactivity disorder (ADHD), but since this was mostly …

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Is your child’s behavior due to ADHD?

Primary care private practice will die, will patients benefit?

Kevin Pho, MD

KevinMD

November 8, 2010

Having more primary care physicians doesn’t necessarily improve the quality of care.

That may come as a surprise to regular readers of this blog, but that’s one of the findings that came from a recent analysis of the Dartmouth Atlas.

As reported by the WSJ’s Health Blog,

having regular primary-care visits isn’t a guarantee of receiving recommended care. There was “no relationship” between rates of breast cancer screening for women age 67-69 …

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Primary care private practice will die, will patients benefit?

Coping with frightening circumstances after a cancer diagnosis

Bruce Campbell, MD

Conditions and Diseases

November 8, 2010

For myself I am an optimist — it does not seem to be much use being anything else.
-Winston Churchill

Even before I met him, I could tell that his cancer was extensive. His problems had started several months before with a cough, a voice change, and some trouble swallowing. His primary doctor had not spotted anything but had kept an eye on him. Antibiotics and cough medicine had not helped. After …

Can a social media manager convince doctors to get online?

Kevin Pho, MD

KevinMD

November 8, 2010

A social media manager is becoming an imperative position for hospitals.

Medical institutions are waking up to the fact that they need to engage their patients and physicians online. No where is there more fertile growth than in the various social media platforms that are prevalent today — like Facebook, Twitter, and YouTube.

American Medical News recently profiled the phenomenon, highlighting the position of social media manager, which some institutions pay between …

Alzheimer’s disease: 5 reasons why awareness matters

Kevin

Conditions and Diseases

November 8, 2010

by Dennis Fortier

More so than with any other major disease, our near-term progress in the battle against Alzheimer’s will be determined largely by our ability to improve awareness about several aspects of this encroaching threat.

Summarized here are five reasons why greater awareness about Alzheimer’s disease, and a deeper public understanding of risks and prevention strategies, will play a key role in the nation’s ability to triumph against the prospect of …

Questions about the early diagnosis of Alzheimer’s disease

Juliet K. Mavromatis, MD

Conditions and Diseases

November 8, 2010

Alzheimer’s disease made headlines recently, first with news about a new biomarker test that is able to diagnose the disease with increased accuracy, then with a follow-up story detailing the collaborative model of data-sharing that contributed to the success of recent research.

As I read the news with interest I couldn’t help but feel that in our current climate, the manner in which it was reported was …