Physician, heal thyself.
That’s the unwritten rule, sadly, for us. I am a physician. I am therefore invincible and inhuman and all the things my patients cannot be. To seek help is a sign of weakness, and our profession has no place for the weak of body, mind or spirit. We work through illness because our patients deserve that and disease and …
Physician, heal thyself. But is it even possible today?
The war on medical error was officially launched in 1999, when the Institute of Medicine (IOM) published its landmark report To Err is Human, alleging that up to 98,000 yearly deaths in US hospitals were due to human missteps.
Despite significant ambiguities in the definition of a medical error, numerous militias known as patient safety organizations …
We’re losing the war on error. And here’s why.
Some years ago when my father underwent bypass surgery, he was anxious, depressed and in pain as he lay in the hospital bed tied to IV catheters and tubes. Each day, his surgeon, his hospitalist, and other consultant doctors whisked in and out, asking how he was feeling and then ordering a treatment plan. A few years after his full recovery, …
A nurse is an essential partner to patient care
Let’s take a moment to consider what makes a terrific nurse.
First, by way of gathering information, let’s consider the health care industry’s present views on excellence in nursing. Let’s think about how this conception of excellence in nursing aligns with our own perspectives.
In a recent Atlantic article, titled “The Problem with Satisfied Patients,” Alexandra Robbins writes about the economic …
Let’s celebrate nurses by reining in patient satisfaction
I have spent 32 years working in hospitals and the last 16 running them. Hospitals are created for the benefit of the community, a place where people go when they are acutely Ill, injured or have a complex condition that eludes quick diagnosis and treatment. Hospitals historically provided primarily inpatient care and comprehensive diagnostic and treatment facilities for patients.
It took a …
What a hospital CEO learned from Nordstrom
I was recently talking to a patient about having some extra help at home when she left the hospital with home nursing services. The elderly lady — highly intelligent and fiercely independent — politely declined with the reply: “No, I’m fine thanks Dr Dhand — all they’ve done before is just come in with their computers, barely talk to me, enter …
How health IT is a barrier to patient satisfaction
Everyone likes to be recognized for a special achievement or accomplishment. Every career has special awards and commendations for everything. While there’s no reward that matches cold hard cash, many of these honorable mentions have no tangible value whatsoever. Pull into a fast food parking lot and you may see a parking space designated with a sign proclaiming, employee of the …
Getting congratulated on hand washing. Really?
My 85-year-old patient was brought in from home. She was cachectic, contracted, minimally responsive to questions, covered in multiple decubitus ulcers on both hips, both knees, both shoulders, and her sacrum. She had polymicrobial sepsis-bacteremic with two different organisms. She was, in fact, dying.
Despite her profoundly debilitated condition, her son, who cared for her at home wanted “everything” done. So she was placed on IV fluids, antibiotics, received an infectious disease …
Powerless in the setting of patient autonomy? Try maternalism.
Inscribed on a plaque just below a statue of an eagle in front of my hospital is a famous quote from President Abraham Lincoln that begins, “To care for him who shall have borne the battle …” It is the reason why the Veterans Affairs (VA) system exists. It is the reason why we VA physicians come to work each day.
I am honored to care for our special patient population, …
The VA inspires me to be a better physician leader. Here’s how.
There she lay: a 59-year old woman who had become increasingly disoriented and confused. Not only did she have an infection in her bloodstream, years of alcohol abuse had taken its toll on her liver, leaving her skin yellowed.
“Welcome to the ICU,” I thought. In contrast to my previous clinical experience, I found this patient encounter unsettling.
No conversation.
No personality.
No interaction.
She was nothing more than a body in a bed punctured …
A medical student, molded by experiences with patients
“Have you had any horrible problems with wait times?” shouted the reporter as he jogged towards the van pulling out of the parking lot.
Leaning in so far that his head actually crossed the window’s threshold yet still audible from across the street, he continued “We’re looking for people who’ve had terrible experiences here!” So it was last week walking in to work at the Durham VA Medical Center.
One year ago, …
Solving the VA patient crisis the right way
A recent publication from the Mayo Clinic created a lot of buzz regarding the use of unmanned aerial vehicles (UAV), or drones, in medicine. However, in reality, most of the drones being used or tested in the U.S. are for things like aerial photography, small package delivery, and surveillance. While several corporations have been quick to expand existing applications …
Drones in medicine: What are the possibilities?
If you are a doctor, nurse, patient, or just someone interested in patient safety, you should read a five-part story called “The Overdose: Harm in a Wired Hospital” excerpted from a book The Digital Doctor by Dr. Robert Wachter.
Dr. Wachter and the hospital are to be commended for publicizing this incident so others may learn from it. The hospital staff, the patient, and his mother, also deserve credit for allowing their …
The downsides of automating health care
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I just finished reading the Journal of Hospital Medicine article called “The highest utilizers of care: individualized care plans to coordinate care, improve health care service utilization, and reduce costs at an academic tertiary care center.”
Using a multidisciplinary team of volunteers including members from hospital medicine, ER, psychiatry, ambulatory care, social work, nursing and risk management, individualized care plans were developed for high utilizer patients. These patients had multiple co-morbidities, …
The low-hanging fruit of health care costs
A few months ago, I was on call as a cardiology fellow, and I had to go up to one of the inpatient floors to do a stat echocardiogram on a patient. Given how hemodynamically unstable he was, I was rushing to the room as fast as I could with this hefty machine that could give important information about cardiac function …
Sorry, but I’m not part of the ancillary staff. I’m a physician.
An excerpt from The Secret Language of Doctors: Cracking the Code of Hospital Culture.
When it comes to modern medical slang, there’s Before Shem and After Shem. Shem refers to Samuel Shem, the pen name of Dr. Stephen Bergman, psychiatrist and author of the blockbuster novel The House of God, which introduced millions of readers — and generations of doctors — to the argot that is the lingua …
The House of God brought attention to medical slang
I can’t mention the physician by name, because he is currently in contract negotiations. But he lives and works in a Midwestern town of several thousand people, a town where the major social event of the year is a fall festival that features a parade down Main Street. The physician, let’s call him Dr. Smith, has been practicing there for nearly …
There’s a new hospital CEO in town
Party Weekend
– Joe “King” Carrasco
Fight for Your Right (To Party)!
– Beastie Boys
We Just Wanna Dance
– The Flirts
My favorite radio station, WHFS, had a ritual every Friday afternoon to start off the weekend, back in the day. DJs Weasel and Bob Here would exchange pleasantries as they exchanged shifts, and would launch the same set of songs at the same …
Is it time to abandon the 9 to 5 workweek in hospitals?
“He’s just expired,” said the nurse as I approached Ray’s room in the large inner-city hospital where I work as a patient advocate. “And his wife has just arrived. Why don’t you go in?”
I found Natalie bent over Ray’s body. His hollow cheek was drenched with her tears.
“I’m so sor –”
“I told him yesterday to talk to Jesus,” Natalie interrupted, speaking quickly. “I told him if the two of them …
The line between being compassionate and being unprofessional
In my travels up and down the East coast, I’ve worked with a number of health care administrators (and even temporarily been one myself, although quickly discovered that it wasn’t quite my cup of tea). The experiences that I’ve had have been highly variable, and I’ve seen the full spectrum of administrators ranging from the brilliant to the quite dire. As someone who has read many autobiographies of famous leaders, …
Good health care leaders have these 3 traits
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