We all start out as idealistic medical students, downright puppy-like in our devotion to our patients, eagerly bounding to their rescue and spending hours listening to their concerns. Somewhere along the way, we start shutting down, seeing patients as demanding and feeling as if we’re always fighting them off.
I used to do it too; hide behind my layers of staff, complain to …
Why doctors are afraid of their patients
You can find reviews on almost anything; we “Yelp” restaurants before we try them, we scrutinize customer feedback when we purchase products on Amazon and we check out how many stars a dry cleaner or car mechanic has. Medicine is, for better or for worse, becoming the same way. You can Google a hospital or physician and find comments or reviews, and this worries many doctors.
Most physicians don’t like the …
Rating health care: There are limits to every method
How many health coordinators does it take to screw in a lightbulb?
Four. But none actually do any screwing. One is your point of contact for screwing lightbulbs. One helps the bulb get screwed. One goes between those two. And one manages the other three, raises funds and writes reports.
My office strives to cut all barriers between the patient and provider. The patient calls me to schedule and comes in, or …
Too many health coordinators means less care for patients
The e-patient movement represents everything that is positive in medicine today. This grass roots force has introduced shared decision making and empowered both physician and patient. The quality of health care dialogue has risen meteorically both in the exam room and out. Today’s health care “consumer” is more engaged, more intelligent, and more agile at wending their way through the confusing maze of sickness and health.
It’s awfully sad that it …
Why health reform will destroy the e-patient movement
A guest column by the American College of Physicians, exclusive to KevinMD.com.
A little over two years ago in this blog, my “EHR report card” evaluated the effect of the electronic health record (EHR) on my practice. I thought it would be interesting to see how things have changed. As in 2012, I will not identify …
The EHR report card 2014: Has it gotten better?
Having a healthy life is more than getting an annual physical examination. It is about having healthy habits. Some of these healthy habits make common sense. Others seen unnatural, but yet are vitally important.
A healthy life is more than feeling well. It is about living life to the fullest and ensuring you are doing your part to improve both your quality of life and longevity.
Which ones are you missing?
How do …
Staying healthy: More than an annual physical
I’ll admit it. I like reality TV. In fact, one of my favorite reality TV shows is Dallas Cowboys Cheerleaders: Making the Team. It shows what it takes to become a Dallas Cowboys cheerleader (DCC). Why am I talking about cheerleading in a health care blog? Because the Dallas Cowboys cheerleaders put more effort into hiring cheerleaders than most health care …
What the Dallas Cowboys cheerleaders can teach us about hiring doctors
Giving prescription refills is not quite as fun as it used to be. Years ago, we doctors would whip out our prescription pads — often sooner than we should have — and we’d scribble some coded language that pharmacists were trained to decipher. I’m surprised there were not more errors owing to doctors’ horrendous penmanship. On occasion, the Food and Drug Administration (FDA) would require a pharmaceutical company to change …
Why your doctor won’t refill prescriptions over the phone
I was on call last night.
Don’t get me wrong, this is not as bad as it sounds.
With over 20 partners sharing evening call, and residents getting the calls first, we do not have it bad at all. And certainly nothing like my obstetrician friends, who seem to go in every time they are on call for labor and delivery and then …
Why do doctors still use pagers?
Over the last few years I started a family practice serving refugees, and have seen 10,000 refugee patient visits. With regards to culturally competent medicine, medical schools teach about traditional remedies such as coining, and maybe role play with interpreters, but stop short of practice design ideas. The AAFP provides a checklist of qualities, which I feel could …
Do you want a culturally competent practice? Here are 15 tips.
It used to be that the greatest cost at a doctor’s visit was paying for the visit itself. Nowadays, the office visit is just a drop in the bucket compared to what medications cost. Medication costs were already starting to rise, but have risen to unprecedented levels since Medicare Part D became law about a decade ago and with the latest government attempt to help with the un-Affordable Care Act. In the last few …
Large lab companies contribute to high patient bills
Many of our patients are besieged with unsolicited Internet advertisements offering them unbelievable solutions and cures to most of mankind’s medical maladies. Patients come to and ask for advice about these promises to magically restore their health.
Since I receive so many requests from patients to evaluate these offerings, I have put together five questions that patients should ask themselves before proceeding to buy from websites offering outlandish claims, including restoring …
Health information on the Internet: 5 questions to ask
“I’ve been with my doctor for years and years,” an elderly man, voice hoarse but lilting with fondness for his caregiver, told a nurse in the primary care clinic where I was waiting to see a doctor. “He’s fantastic.”
I was coming to the clinic for a follow-up appointment about an injury for which I’d been seen a few months prior, but neither the initial appointment nor this follow-up were with …
The problem with primary care residency programs
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She grasps her chest dramatically and falls to the floor. Her eyes flutter as she tries to hold them closed. Her one arm across her chest the other flailed in theatrical fashion to her side. She’s dead. Her heart is broken. The other jumps from the bed, and after landing, reports her leg is broken. She hops about the room, unable to use the leg and there are no crutches …
I will build a practice, but I will also build a life
Team-based care is one of today’s buzzwords without real substance, because unless the payment systems change, only the physician members of the team can bill for their work.
Few people seem to be concerned with the simple but essential question of how physicians spend their time and how medical offices are paid. As a primary care physician who doesn’t do any major procedures, and who in 2014 is essentially paid fee …
Team-based care needs to be more than a buzzword
On September 28, 1864, the first meeting of the International Workingmen’s Association (IWA) was convened at St. Martin’s Hall, London. Among the attendees was a relatively obscure German journalist by the name of Karl Marx. Though Marx did not speak during the meeting, he soon began playing a crucial role in the life of the organization, in part because he was assigned the task of drafting its founding documents.
The work …
Karl Marx foreshadowed the plight of today’s physicians
“Plank? Is that a board?” asked my patient. I had been encouraging her to start doing exercises to strengthen her core in order to stabilize and support her back. My hope was that over time, these exercises would lessen the need for pain medicine. There are times for words and there are times for action. So I got down on the …
Motivate patients to exercise more and eat less
I was finishing tying my shoes as I got dressed to take my lovely wife out to dinner for our 41st wedding anniversary. It was 7:30 p.m. after a hectic day at work and we had a wonderful dinner planned at a local restaurant.
The telephone rang with the caller ID identifying a call on my office work line.
“Hello this is the emergency department, please hold on for Dr. S.” …
Physicians don’t take the time to communicate with their colleagues
Primary care is essential to building a higher-performing health care system that promotes personal well-being and saves consumers and taxpayers money. Research shows that more primary care physicians in a community means lower rates of mortality, better preventive care, and fewer hospitalizations and emergency room visits.
Unfortunately, too many Americans lack easy access to primary care. Approximately 50 million Americans live in areas, mostly rural, with too few primary care physicians. …
3 ways to improve primary care access
There are now so many rules and regulations in medicine that it is difficult for doctors to express any individuality. Like the burgers at McDonald’s that are constructed in such a way that they taste the same regardless of your locale, doctors are expected to behave similarly when confronted with similar circumstances. Or at least that is how the proponents of algorithmic medicine see it.
In addition, electronic health record systems create uniformity by enforcing …
Is there any room for individuality in medicine?
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