To do the math right, you have to get your numerator and denominator correct, or else things just don’t work.
Recently, in the midst of a large patient safety and quality improvement project trying to bridge gaps in breast cancer screening among our patients, we discovered that one of the large databases of patients who were attributed to us contained innumerable …
How one insurer’s mistake wrecked a practice’s quality score
Marie Kondo, the best-selling guru of organization and “sparking joy” has established the foundation of getting a space organized and functional. Her do-it-all-once method, known as the KonMari Method, is considered healthy and life-altering for those seeking organization and productivity in their space. One of the ideal places to organize is the home office especially for doctors, nurses and medical professionals who have reading, studying and research to do. You …
How physicians can use Marie Kondo’s KonMari Method
This article is sponsored by Careers by KevinMD.com.
Academic and education environments tend to use the word curriculum vitae, or CV, more frequently than resume. But, a CV’s purpose is the same: to get you a job.
Although a CV generally contains more information than a standard resume, the keys to a successful CV are still brevity and …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 66-year-old man is evaluated in the hospital following ST-elevation myocardial infarction treated with primary percutaneous coronary intervention of the left anterior descending artery 4 days ago. His initial presentation was complicated by the presence of heart failure and pulmonary edema. He is asymptomatic and ambulating, and he is …
MKSAP: 66-year-old man with ST-elevation myocardial infarction
Instead of driving on the highway, let’s imagine you drove upwards from wherever you are. You’ll reach space in about an hour.
On your way up, you’ll begin to see everything differently. Cities, roads, and trees slowly blur out to make way for a new kind of reality. Converging. Diverging. Both at the same time.
What appears dissimilar on the ground (trees and shrubs) will appear similar (green). What unites on the …
Imagine viewing health care from space
For Apple iPhone users, the release of iOS 12 included a new feature called “Screen Time.” Although a number of productivity apps that offered a similar snapshot of phone usage were available before this update, I was never interested in quantifying my usage. Now, on a weekly basis, I get a reminder of the exact percentage breakdown of how I’m using my phone.
In true millennial fashion, a review of my …
A physician’s addiction to social media
As I walk into the well-upholstered elevator lobby of the hospital and make my way toward the stairs for another night of covering the ICU, I am again inundated with plaques, advertisements and a six-foot-tall cardboard cutout depicting an executive in a suit reminding us that this hospital is among the best in the nation in providing “value.” As I was previously made aware during a resident education session sandwiched …
Quality is more than documentation designed to meet billing and data metrics
I recently received a scathing email criticizing an article I wrote about the care of patients in underserved areas. “Should you really even get to write articles about poor, underserved populations when you run a concierge practice?” the author wrote. “This is called hypocrisy. You are what is wrong with the medical field.”
What the author of this email didn’t know was that I spent six years working for the underserved …
Direct primary care physicians are not concierge doctors
My friend, Lello Tesema, and I were sitting in a restaurant in Harvard Square. It was the first, feverish bit of spring when it seems like the entire city has emerged en masse from their winter dens. We were sitting outside under patio lights, wearing regular clothes instead of our usual scrubs. I should have been happy.
As often happened in those days, I asked Lello if things were ever going …
How to talk with a struggling physician colleague
We were in the middle of the morning routine – sign out between mouthfuls of eggs and homefries – when the call came in overhead, “Code Blue, 9 West. Code Blue, 9 West.” Just like that, our team snapped into action, the continued banter only thinly concealing a change in demeanor: backs straight, jaws set, we walked with a sense of purpose. There was a life on the line.
By the …
Reflections after a medical student’s first code blue
Medical practice in England in the 1500s was poorly regulated, and there was no way to distinguish between various medical practitioners. A small group of distinguished physicians petitioned King Henry VIII to form a College to grant licenses to those qualified to practice medicine and to penalize charlatans. King Henry VIII thus granted a royal charter to establish the Royal College of Physicians, London, in 1518, which was extended to …
The most important piece of advice I can give to incoming medical students is to be vigilant about how you are feeling day-to-day and to be aware of your actions. As is often said, our personalities, the distinctive makeup that makes us who we are, are set in stone. If you are a mindful person, you’ll stay that way even as you get older. If you are someone who likes …
Why medical students should develop and increase self-awareness
One of the great teaching experiences in a young medical student or resident’s life is to be placed in front of his or her peers with an attending physician quizzing him or her on the spot about a particular patient.
Often, when radiology imaging is involved, the said victim will be asked to interpret the study and point out any salient features.
I have been subject to this numerous times in my …
How a radiology trick can surprisingly help your finances
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Brittany Maynard was diagnosed with grade 2 astrocytoma, a form of brain cancer on January 1, 2014, her cancer also returned in April 2014, where her diagnosis was elevated to grade 4 astrocytoma, also known as glioblastoma, with a prognosis of just six months to live. She decided to take lethal drugs prescribed by her physician to end her life on November 1, 2014, at her home in Portland, Oregon. Under Oregon’s “Death …
The growing role of end-of-life activists
Penicillin allergies are fake news. More than 95 percent of people with penicillin allergies are not allergic. A recent article highlighted the opportunity anesthesiologists have in helping evaluate beta-lactam allergies, in particular to cephalosporins. The author was correct, these allergies are common and usually not real. Unfortunately, premedication with antihistamines as suggested may mask allergic reactions and not clear the allergy, though the idea to think about retesting …
Are penicillin allergies fake news?
Our team is nearing the end of our call day when the ER pages us with one last admission. The ER attending starts with an apology — “I’m sorry,” she sighs, “this patient is a handful. He is homeless, belligerent, has a significant psychiatric history. He came in with ocular trauma. The ophthalmology resident thinks he may need surgery.” One of the interns on the team is busy with a …
What should physicians do when patients are racist?
In a recent article for Pain Medicine News, “4 Steps Every Provider Must Take Before Prescribing an Opioid,” two lawyers detail the voluminous documentation doctors must collect and maintain to protect themselves against all these new anti-opioid rules.
When even so many doctors don’t understand chronic pain, it’s no surprise that lawyers don’t either. They are trying to fit the practice of pain management into a legal framework to defend themselves …
How the war on opioids has harmed some patients
There is something both intimate and mysterious about the waiting area for mammograms. You sit in a relatively small space; chairs close together with a gown tied to cover your nakedness, your normally restrained lady parts flopping free against the scratchy fabric. There are young and old, black and white, grey and blond and even sometimes bald. There are women with coiffed hair and manicured fingers bright with diamonds and …
“The Wait” after a mammogram changes lives
If you think that you might have the flu, don’t head to the emergency room at the first sign of fever.
Emergency departments were created to handle emergencies – heart attacks, strokes, severe trauma, and other life-threatening emergencies. No matter how awful it feels, the flu typically doesn’t fall into this category – unless you are in a high-risk category for complications. This includes children younger than 2, adults over 65, …
For most, the flu is a misery, not an emergency
“Didn’t you just have a baby? When are you going to stop?”
Those words weren’t directed to me but to a colleague by a patient’s parent who was frustrated that they wouldn’t be able to see her for follow-up. Yet, they could have easily been uttered by another physician in our group discussing coverage during her planned maternity leave. These are words as a male physician I will never be forced …
Male physicians don’t have to choose between family or career
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