Fred N. Pelzman, MD

Fred N. Pelzman is an internal medicine physician who blogs at MedPage Today’s Building the Patient-Centered Medical Home.

Why electronic medical records should be standardized

Fred N. Pelzman, MD

Physician

October 22, 2019

How can we possibly get to standardization in medicine? And is that a good thing?

Standardized checklists save lives; rigid procedures for sterilization of equipment saves lives; universal compliance with recommended beneficial treatments saves lives. And while it’s sometimes a wonderful thing to let a surgeon solve a problem creatively or to allow a patient visit to go overtime in order …

Can answers to after hours calls be automated?

Fred N. Pelzman, MD

Physician

October 15, 2019

At a certain point, we’ve all got to go home.

Whether it’s the end of the shift when the factory whistle blows and the assembly line stops rolling for a brief period while new people take our place, or late in the day after the last patient has been seen and our notes are all written and our portal messages have …

We have to do better than DNR tattoos

Fred N. Pelzman, MD

Physician

October 9, 2019

Returning from my week of vacation, I was greeted by the usual stack of mail, faxes, forms to be signed, throwaway journals, and a fully loaded group of in-basket messages that had piled up in the electronic medical record that needed attending to.

One of the pieces of mail was an unsolicited package with a bright red label on it, along with …

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We have to do better than DNR tattoos

20 minutes isn’t long enough for an office visit

Fred N. Pelzman, MD

Physician

October 3, 2019

As many of you know, if you’ve read my columns regularly, once a year the whole family escapes from the city, and we travel up to New Hampshire to stay at the lake house that’s been in my wife’s family for over 100 years.

A modest wooden house perched out over the water, situated just right for sunset viewing, for a few …

The keyboard is the sworn enemy of physicians

Fred N. Pelzman, MD

Tech

September 26, 2019

During one long ago very hot Washington, DC summer, at the suggestion of my parents, I enrolled in a typing course that was given at our elementary school.

This was the summer between sixth and seventh grades, and there were lots of things I would’ve preferred to have been doing, but my dad, who started out in advertising, felt that touch-typing …

How pneumatic tubes symbolizes our health system

Fred N. Pelzman, MD

Physician

September 24, 2019

About once or twice a day, everyone on our hospital’s computer network gets an emergency message that scrolls across the bottom of our screens, highlighted in the colors of danger and warning.

They include things like a notification that a particular data system is down and that a backup on paper will have to be used for documentation, or the hospital …

How EMRs can actually help physicians

Fred N. Pelzman, MD

Tech

September 12, 2019

Collaboration is the key.

When I think about how hard it is to take care of our patients, and how many different people are involved in their care, it’s a wonder that anything ever gets done.

We need to simplify systems, and harness the power of the information systems available to us, as well as the promise of the electronic medical record, …

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How EMRs can actually help physicians

How can we address retention in the era of physician burnout?

Fred N. Pelzman, MD

Physician

September 6, 2019

As we’ve seen, the lives of those working in the health care system has become overwhelmingly challenging, burdened by all of the excess nonmedical stuff that has been added into our lives as we try to take care of patients.

From prior authorizations, to clicking in the electronic medical record, to endless streams of regulatory requirements, to the continuous onslaught created by …

Just because EMRs can document everything doesn’t mean they should

Fred N. Pelzman, MD

Tech

August 29, 2019

It’s always kind of a surprise when you read a patient’s chart, and you see an examination of a body part they just don’t have.

Just the other day, I was reading a consult note on a patient of mine who had been seen by a subspecialist for evaluation of a serious issue, and I received back a long detailed office …

A physician’s first telemedicine video visit

Fred N. Pelzman, MD

Physician

August 22, 2019

I just did my first telemedicine video visit.

The concept seems so strange, the idea of carrying out an “office visit” without the patient actually being in the office.

Right now we have it structured so that when a patient calls up requesting to see me on a day when I am already fully booked (or, as is usually the case, overbooked), …

New doctors are prioritizing the wrong things

Fred N. Pelzman, MD

Physician

August 16, 2019

Every year, there’s this rite of passage, the passing of the baton, as our graduating senior residents move on to fellowships, or into spots as hospitalists, or to practice jobs here in New York City or other cities, and a fresh new group of newly-minted physicians arrives ready to take up the gauntlet of training as Internal Medicine doctors under our …

Stop nickel and diming doctors

Fred N. Pelzman, MD

Physician

August 11, 2019

So, who doesn’t want a better health care system?

We are barraged with stories in the medical literature and in the public press about the terrible state of our health care system, what poor outcomes we have, the inefficiencies in care, complaints about the electronic medical record, inflated costs, lives ruined by medical bankruptcy, and massive social inequities in terms of access …

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Stop nickel and diming doctors

Fred N. Pelzman, MD

Physician

June 12, 2019

Recently, I was called to task — and probably rightly so — for signing something I know I didn’t read.

This was several months ago, when one of my partners was out on family medical leave, and we divided up all of the coverage of her patients while she was away, making sure that forms for home health aides were signed so …

When gender identity confuses the electronic health record

Fred N. Pelzman, MD

Physician

June 5, 2019

One little thing.

Somehow, with the changeover to the latest release of our electronic medical record, something happened to some of the demographic information on our patients. Suddenly, an enormous number of patients were now labeled as choosing not to disclose their gender.

When I first noticed this, it was flagged in bright yellow on the banner in a patient’s chart when I …

How did we let insurance companies get so intimately involved with patient care?

Fred N. Pelzman, MD

Physician

May 30, 2019

Who works for who?

How did we allow ourselves to let a system get built up around us that makes it so hard for us to take care of our patients?

Our job is to advocate for our patients, to help guide them towards their best health, to help them understand the difficult choices and to live healthy lifestyles, to give them …

Fred N. Pelzman, MD

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