David Troxel, MD
David Troxel is a physician executive.
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Latest articles
Health technology
Historically, the doctor-patient relationship has been at the heart of medical practice, with administrative tasks and record-keeping at the border. Today, that critical balance is at risk. Nearly all hospitals and 80 percent of medical practices use electronic health records…
Historically, the doctor-patient relationship has been at the heart of medical practice, with administrative tasks and record-keeping at the border.
Today, that critical balance is at risk. Nearly all hospitals and 80 percent of medical practices use electronic health records (EHRs), presumably to help improve access to health information and increase productivity. The problem is that none of these digital tools were designed specifically to advance the practice of good medicine.
Consider …
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EHRs can advance good medicine: if doctors are aware of the risks
Physician voices
A 42-year-old patient arrived for her annual gynecologist appointment complaining of a self-detected breast lump. She had several questions about her condition and wanted to tell her doctor about a family history of breast cancer. The doctor was in a…
A 42-year-old patient arrived for her annual gynecologist appointment complaining of a self-detected breast lump. She had several questions about her condition and wanted to tell her doctor about a family history of breast cancer. The doctor was in a hurry and advised her to ask the staff, but the staff was busy with other patients and told her to call them later. The patient did not call.
The gynecologist ordered …
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Engage patients to improve outcomes and reduce risks
Physician voices
Physicians are struggling to adapt to a sea change in the health care delivery system. Solo physician practices are disappearing, small group practices are merging to become larger, and large group practices are being acquired by hospitals and integrated delivery…
Physicians are struggling to adapt to a sea change in the health care delivery system. Solo physician practices are disappearing, small group practices are merging to become larger, and large group practices are being acquired by hospitals and integrated delivery systems. All of this is occurring in a milieu of decreased fee-for-service reimbursement from government and private insurers, bundled payments and pay for performance, increased levels of student loan debt, …
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3 changes that can improve maintenance of certification
Patient voices
Whether your office has wireless access or not, there will be patients texting, surfing the Internet, Facebooking, and otherwise engaging with the outside world on their smartphones while in your office. These smartphones have another function: the ability to record…
Whether your office has wireless access or not, there will be patients texting, surfing the Internet, Facebooking, and otherwise engaging with the outside world on their smartphones while in your office.
These smartphones have another function: the ability to record audio or video. It is understandably tempting for patients to record consent discussions, medication and follow-up instructions, and other physician or staff interactions.
Recording a medical discussion via video or audio is …
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Should patients be allowed to record their office visit?
Patient voices
Search engines and the Internet are impacting patient behavior—eight out of 10 people use the Internet to look for health information, but only 25 percent of those people verify the credibility of their information source before self-diagnosing. It gets even…
Search engines and the Internet are impacting patient behavior—eight out of 10 people use the Internet to look for health information, but only 25 percent of those people verify the credibility of their information source before self-diagnosing. It gets even more complicated when patients order drugs directly over the Web.
The debate among physicians about the credibility of online information is as old as the Internet itself. As a caregiver, …
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Manage malpractice risks with self-diagnosed patients
Health technology
The more things change, the more they stay the same. The increasing use of Electronic Health Records (EHRs), "cloud-based" applications, Application Service Providers (ASPs), and offsite electronic storage has led to an increase in laws and court rulings governing them—and…
The more things change, the more they stay the same. The increasing use of Electronic Health Records (EHRs), “cloud-based” applications, Application Service Providers (ASPs), and offsite electronic storage has led to an increase in laws and court rulings governing them—and these could affect your practice.
Expect more oversight from federal and state governments. Two reports recently issued by the inspector general of the Department of Health and Human Services found …
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Liability considerations with electronic health records
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