Richard Gunderman, MD, PhD
Richard Gunderman is Chancellor's Professor, Schools of Medicine, Liberal Arts, and Philanthropy, Indiana University, Indianapolis, IN.
Physicians
According to the American Board of Medical Specialties, its program for maintenance of certification (MOC) serves the patients, families, and communities of the United States and improves patient care by establishing high standards for ongoing learning, practice improvement, and assessment…
According to the American Board of Medical Specialties, its program for maintenance of certification (MOC) serves the patients, families, and communities of the United States and improves patient care by establishing high standards for ongoing learning, practice improvement, and assessment activities. Whether this is true or not has been a hotly contested topic in the medical profession for about two decades, when MOC was first introduced. Proponents claim that MOC …
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How excessively regulating doctors can harm patients
Physicians
In his "Nicomachean Ethics," the ancient Greek philosopher Aristotle points out that anger is not always a moral failure. To be sure, it is usually wrong to give in to it, but situations can arise when a good person naturally…
In his “Nicomachean Ethics,” the ancient Greek philosopher Aristotle points out that anger is not always a moral failure. To be sure, it is usually wrong to give in to it, but situations can arise when a good person naturally experiences a sense of moral indignation. The human mission is not always to hold anger at bay but sometimes to feel it appropriately – why, with whom, when, where, and …
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The tragic case of the anguished physician
Tech
The introduction of electronic health records (EHRs) was accompanied by a great deal of fanfare. Such systems, which replace old paper-based charts in doctor’s offices and hospitals, were designed to make patient data more accurate, safer and more accessible. It…
The introduction of electronic health records (EHRs) was accompanied by a great deal of fanfare. Such systems, which replace old paper-based charts in doctor’s offices and hospitals, were designed to make patient data more accurate, safer and more accessible. It was also claimed that they would make it easier for doctors and other health professionals to monitor medical care and ensure that guidelines were followed. The federal government was so …
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Electronic health records cannot replace a doctor who knows you
Physicians
Long-time “Jeopardy!” host Alex Trebek announced in March that he had been diagnosed with stage 4 pancreatic cancer. Within days, he offered thanks to “the hundreds of thousands of people who have sent emails, texts, tweets, and cards wishing me…
Long-time “Jeopardy!” host Alex Trebek announced in March that he had been diagnosed with stage 4 pancreatic cancer. Within days, he offered thanks to “the hundreds of thousands of people who have sent emails, texts, tweets, and cards wishing me well regarded my health.” Then last month, Trebek reported that his cancer was in “near remission,” saying that his doctors “hadn’t seen this kind …
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The Trebek effect: the benefits of well wishes
Physicians
Medicine need not be confined to the role of cultural bellwether, a sheep with a bell on its neck that reveals where the whole flock is headed. Along with other professions such as law, clergy, and education, medicine can and…
Medicine need not be confined to the role of cultural bellwether, a sheep with a bell on its neck that reveals where the whole flock is headed. Along with other professions such as law, clergy, and education, medicine can and should play the leadership role of a shepherd, helping our society to develop more thoughtful, balanced and generous approaches to the challenges that face us. After all, the word …
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The medical profession can help heal divisions as well as diseases
Physicians
On a Saturday morning, Michael, a physician, was making his way through the hospital atrium after his weekend rounds. On his way out, he noticed a family he knew well. They were talking quietly and appeared distraught. He asked them…
On a Saturday morning, Michael, a physician, was making his way through the hospital atrium after his weekend rounds. On his way out, he noticed a family he knew well. They were talking quietly and appeared distraught. He asked them if they were okay. They said that the husband’s mother had been admitted overnight with a malignant pleural effusion, and since all beds on the oncology floor were full, she …
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Should a HIPAA-questionable good deed go unpunished?
Tech
Ironically, the same electronic health records (EHRs) initially designed as a tool to help physicians diagnose diseases have largely evaded diagnostic scrutiny. Talk to physicians who utilize them on a daily basis, however, and it becomes abundantly clear that today’s…
Ironically, the same electronic health records (EHRs) initially designed as a tool to help physicians diagnose diseases have largely evaded diagnostic scrutiny. Talk to physicians who utilize them on a daily basis, however, and it becomes abundantly clear that today’s EHRs are ailing. They are adding hours to the physicians’ workday, siphoning attention from patient care, and sowing the seeds of demoralization across the profession of medicine. To address this …
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The impaired interactivity of EHRs
Physicians
Gratitude may be more beneficial than we commonly suppose. One recent study asked subjects to write a note of thanks to someone and then estimate how surprised and happy the recipient would feel – an impact that they consistently underestimated.…
Gratitude may be more beneficial than we commonly suppose. One recent study asked subjects to write a note of thanks to someone and then estimate how surprised and happy the recipient would feel – an impact that they consistently underestimated. Another study assessed the health benefits of writing thank you notes. The researchers found that writing as few as three weekly thank you notes over the …
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Behold the power of gratitude
Policy
You can tell a lot about a job and the people doing it by asking them to describe their best day at work. For Ali, a 28-year-old pediatric cancer social worker, that day occurred one year ago. A 17-year-old cancer…
You can tell a lot about a job and the people doing it by asking them to describe their best day at work. For Ali, a 28-year-old pediatric cancer social worker, that day occurred one year ago. A 17-year-old cancer patient who had been given two months to live made a bucket list. On her list were graduating from high school and getting accepted into college. So Ali and her …
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Social workers are medicine’s unsung heroes
Physicians
Earlier this month, one of us visited a prominent U.S. medical school to give a lecture on the topic of burnout and how physicians can find more fulfillment in the practice of medicine. Sadly, that very day, a fourth-year medical…
Earlier this month, one of us visited a prominent U.S. medical school to give a lecture on the topic of burnout and how physicians can find more fulfillment in the practice of medicine. Sadly, that very day, a fourth-year medical student there took her own life.
The problem was not personal failure. She had recently matched into a competitive residency program at the one of the nation’s …
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Medicine leads the professions in suicide. What can we do about it?
Physicians
Margaret Edson’s 1999 Pulitzer Prize winning play, Wit, tells the story of the final hours of Vivian Bearing, PhD, an English professor dying of cancer. Early in the course of her disease, one of her doctors sees the value of…
Margaret Edson’s 1999 Pulitzer Prize winning play, Wit, tells the story of the final hours of Vivian Bearing, PhD, an English professor dying of cancer. Early in the course of her disease, one of her doctors sees the value of her case from a research point of view and asks her to enroll in a clinical trial of an investigational therapy. In the film version of the play, which stars …
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The decline and fall of informed consent
Physicians
The news was bad. Mimi, a woman in her early 80s, had been undergoing treatment for lymphoma. Her husband was being treated for bladder cancer. Recently, she developed chest pain, and a biopsy showed that she had developed a secondary…
The news was bad. Mimi, a woman in her early 80s, had been undergoing treatment for lymphoma. Her husband was being treated for bladder cancer. Recently, she developed chest pain, and a biopsy showed that she had developed a secondary tumor of the pleura, the space around one of her lungs. Her oncology team’s mission was to share this bad news.
Mimi’s case was far from unique. Each year in the …
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Can a dying patient be a healthy person?
Physicians
Many Americans have never visited a predominantly Muslim country and may know relatively little about the faith of Islam. This is relevant in light of the Trump administration’s recent executive order attempting to reduce terrorist threats to the U.S. by…
Many Americans have never visited a predominantly Muslim country and may know relatively little about the faith of Islam. This is relevant in light of the Trump administration’s recent executive order attempting to reduce terrorist threats to the U.S. by halting the issuance of visas to travelers from seven predominantly Muslim countries.
Having returned this month from Sudan, one of the countries affected by the ban, I wish to …
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I’m a U.S. doctor just back from Sudan, where hospitality from Muslims greeted me everywhere
Education
A recent study in the Journal of the American Medical Association concludes that 27 percent of medical students around the world exhibit symptoms of depression and 11 percent have thought of taking their own lives. Equally troubling is the fact…
A recent study in the Journal of the American Medical Association concludes that 27 percent of medical students around the world exhibit symptoms of depression and 11 percent have thought of taking their own lives. Equally troubling is the fact that, among students experiencing depressive symptoms, only 16 percent seek psychiatric treatment.
Other studies have suggested that the prevalence of depression in medical students may …
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We need a more humane approach to medical education
Tech
A decade ago, electronic health records were aggressively promoted for a number of reasons. Proponents claimed that they would facilitate the sharing of health information, reduce error rates in health care, increase health care efficiency, and lower costs. Enthusiasts included…
A decade ago, electronic health records were aggressively promoted for a number of reasons. Proponents claimed that they would facilitate the sharing of health information, reduce error rates in health care, increase health care efficiency, and lower costs. Enthusiasts included the technology companies, consultants, and IT specialists who stood to reap substantial financial rewards from a system-wide switch to electronic records.
Even some health professionals shared in the enthusiasm. Compared to the …
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If meaningful use is a great idea, why isn’t it employed more widely?
Education
George Orwell said, “If people cannot write well, they cannot think well, and if they cannot think well, others will do their thinking for them.” If Orwell was right, the profession of medicine and the patients it cares for could…
George Orwell said, “If people cannot write well, they cannot think well, and if they cannot think well, others will do their thinking for them.” If Orwell was right, the profession of medicine and the patients it cares for could be in big trouble. As a result of ongoing changes in healthcare, today’s medical students and residents are being asked to write much less than in the past, with a …
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The decline and fall of medical writing
Physicians
Many hospitals around the nation have been stung by dreadful physician engagement scores. Engagement is a problem not only for demoralized physicians, but for health care organizations, their employees, and everyone they serve. They should take note, because low levels…
Many hospitals around the nation have been stung by dreadful physician engagement scores. Engagement is a problem not only for demoralized physicians, but for health care organizations, their employees, and everyone they serve. They should take note, because low levels of engagement are associated with higher physician turnover, increased error rates, poorer rates of patient cooperation in treatment, and lower levels of patient satisfaction.
Definitions of engagement vary, but it generally …
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Physician engagement scores are poor. How hospitals can improve them.
Policy
Dr. Melos is a gastroenterologist in solo practice in a medium-sized Midwestern city. One day she hears a knock on her door. When she answers, she finds two representatives of Athenian Health System, who request a few minutes of her…
Dr. Melos is a gastroenterologist in solo practice in a medium-sized Midwestern city. One day she hears a knock on her door. When she answers, she finds two representatives of Athenian Health System, who request a few minutes of her time. She invites them to take a seat in her office.
After exchanging pleasantries, the visitors get down to business. They extend Dr. Melos an …
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What happens when moral physicians stand up to power
Physicians
As kids growing up in the Midwestern United States, my friends and I loved baseball. We spent many hours each summer day playing the game, and when we weren’t out on the sandlot, we were reciting the stats of top…
As kids growing up in the Midwestern United States, my friends and I loved baseball. We spent many hours each summer day playing the game, and when we weren’t out on the sandlot, we were reciting the stats of top players, arguing the merits of our favorite teams, and trading baseball cards. Baseball is more than America’s pastime. It is a sport …
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Taking a page from medicine to improve the quality of baseball
Policy
Life is tough for physicians in solo and small group practice. The federally mandated introduction this fall of ICD-10 requires physicians and their staffs to learn a new system of coding diseases. “Meaningful use,” another federal program, requires physicians to…
Life is tough for physicians in solo and small group practice. The federally mandated introduction this fall of ICD-10 requires physicians and their staffs to learn a new system of coding diseases. “Meaningful use,” another federal program, requires physicians to install and use electronic health records systems, which are complex and expensive. And PQRS, the Physician Quality Reporting System, is beginning to penalize physicians for failing to report individual data …
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How can independent physicians survive the new health care climate?
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