The EMR has become a focal point in the physician burnout discussion. Although I believe EMRs are a necessary evil, current iterations of them are just not good. Each click on a mouse is a prick on the many good souls that figuratively bleed until they are physically and mentally burned out. Scribes are not a solution either. That is just a workaround. EMRs are one of many things that …
5 steps to fix our EMR disaster
We live in a fractured country and opinions are becoming more polarized. It’s getting harder to find common ground as everyone slowly recedes further into their social media or cable news echo chambers. One of the best things about working in health care is that these opinions don’t matter. We take it as our duty to treat everyone equally, with the utmost respect, regardless of race, religion, sexual orientation or …
Practicing medicine in a divided country
I recently stopped by our local grocery store after work to pick up a handful of items to bring home. With only four items in hand, I luckily found a short checkout line behind this lovely elderly couple who were almost done and ready to pay. As they smiled and made small talk with the cashier, I imagined a typical geriatric medical story about them.
They appeared in good health which …
The elderly couple who bought vitamins at the grocery store
When it comes to the review of systems, I’ve been a natural, a savant — a prodigy you might say.
During my first few weeks of medical school, I remember doing mock interviews with fake patients. This was long before I learned anything about “HPI,” “ROS,” physical exams, billing or anything medically relevant for that matter. As other students stuttered, trying to figure out what to ask a lady pretending to …
Let’s get rid of the review of systems
A free moment to read my favorite health care blog is hard to find. The days are packed with complex and time-intensive patients. In between them, I struggle to complete documentation and take care of a myriad of tasks, making phone calls and plodding through cumbersome electronic medical records. Then, there’s still actual paperwork to review and complete. I still have to make time to read clinical literature in addition …
Focus on the outcome, not what’s negative
30 day hospital re-admission rates.
It’s a statistic that keeps hospital administrators up at night. Whether you agree or disagree with the use of this statistic as a quality and reimbursement metric, if it creates change, reduces hospital re-admissions and improves patient care, then in theory I support it.
I’m reminded of Mrs G. She is emblematic of today’s chronic disease patient. She was admitted to our hospital for a congestive heart …
Beating the 30 day readmission: Why there’s little to celebrate
There’s nothing better than sitting down with a patient, going though an entire visit, and collaborating on a well thought out plan that meets everyone’s expectations.
Shared decision making is a wonderful and necessary concept in modern patient care. Paternalistic attitudes are fading away in the medical community as the next generations of doctors continue to get educated on how to manage patients who are very knowledgeable and yearn to be …
Shared decision making is a necessary concept in modern patient care
I have the great privilege of being a medical educator. Everyday, I have an incredible time working with internal medicine residents at their continuity clinic, teaching the art of ambulatory medicine. Our working environment here is academically rich and fulfilling. The name of the legendary Dr. Martin Leibowitz (an iconic figure in ambulatory medicine here) stands outside our conference room as a constant reminder of how medicine is practiced and …
How an EMR makes connecting with the patient more difficult
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