Christine Sinsky is vice-president, professional satisfaction, American Medical Association.
What does patient safety mean to you?
I believe patients get the safest care when
- The patient is known as an individual.
- The health care team gives the patient their undivided attention.
- The team is well-supported with efficient workflows and organized, easily accessible information.
- The health professionals find joy in their work.
By being “known” I mean, that the nurses and physicians know the patient as a real person, what their life is like, who are their …
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Patient care is at a crossroads in a rapidly changing health care landscape. Going forward, will the majority of patients receive most of their care from a highly trained, well-supported primary care physician and team they know and trust? Or, in contrast, will patients receive care through a series of loosely connected episodes, from a wide array of narrowly focused providers? Who will adjudicate care for the whole person across …
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Can primary care survive? At a time when the services of a well trained, well-supported primary care physician are needed more than ever before to help patients negotiate through the confusing health care maze, the specialty is under siege.
We are overwhelmed. Those of us in primary care are overwhelmed by the growing weight of medical, legal, financial, and clerical responsibilities placed on our shoulders. The quality of care we can …
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We believe in data. We are scientists after all. And yet in this new era of big data is it possible we are measuring the wrong things?
Most measures of physician performance are process or intermediate outcome measures aimed at a production line model of care. Was an A1c done, did the physician use a computer to send an order to the laboratory, were antibiotics given within two hours of presentation.
Yet …
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My general internal medicine practice is equidistant from the three academic institutions and a Veterans Administration facility, and thus I have patients who receive primary, secondary and tertiary care at each of these institutions.
The notes I receive back from one of these organizations are hands down the best of the four institutions. These notes are personal, concise, precise and clear. If …
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How do we motivate physicians and other health professionals to work at their best? How do we create systems of high performance? Is it by a series of top-down highly specific mandates or by setting up general guidelines and providing tools?
I believe it comes down to one’s vision of physicians. Are physicians knights to be empowered in their service of patients …
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Have you ever thought of an x-ray technologist as a key player in promoting high-value, cost-conscious care?
Recently, an x-ray tech saved one of my patients from unnecessary imaging. Here is the story. Last fall we had set up a 6 month follow-up ultrasound to check on a patient’s abdominal aortic aneurysm, an aneurysm that was too small to require surgery, but too large to ignore. The day before the ultrasound …
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Do we really have a looming physician shortage? We may, but even more acutely I believe we have a physician utilization problem, most particularly in primary care. After shadowing approximately 50 primary care physicians across the country and engaging physicians in conversation during 150 or so presentations on improving the delivery model of care, my observation is that 70-80% of the PCPs work output is direct waste: computer order entry, prescription processing, composing the billing …
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“Medication mishaps cause a huge number of hospitalizations and in fact the majority of hospital readmissions. Making more time for visits with aging and complex patients is critical to avoid mishaps of poor communication and rushed decisions. A dose of ‘slow medicine’ may get us to our goal of system sustainability faster,” writes colleague and fellow blogger Dr. David Moen.
Dr. Moen distills Dr. Dennis McCullough’s ideas about slow medicine down …
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Have you ever encountered an intrusive, insistent popup decision support screen while trying to take care of patients? Found yourself stuck in a dead end electronic hallway without egress? A situation where you had to choose an option that was inappropriate for your patient just to exit the screen?
This is the situation with my local medical institution’s “DVT Advisor,” a mandatory decision support screen for all patients.
DVT Advisor was implemented …
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It started with a dead laptop. For the first time in more than 3 years I felt like a doctor again. I had forgotten what it was like.
Having neglected to plug in my laptop the night before, it was without power. (Without power!) An opportunity for an uprising, of consciousness if not full revolt.
For the first 1½ hours of clinic I entered each exam room without the weight of the …
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A few years after I entered my practice as a newly certified internist, about two decades ago now, I started to burn out. I felt I was becoming a documentation drone and a guideline-following automaton. I was embarrassed for some of the care I gave–attempting to fit patients’ round needs into the square peg of the medical model. Patients who came to talk about depression were marched through a complete review …
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