Recently I wrote about the problems with maintenance of certification requirements. One of the phrases I repeatedly read when I was researching the piece was “the patient as customer.” Here’s a quote from the online journal produced by Accenture, the management consulting company:
Patients are less forgiving of poor service than they once were, and the bar keeps being raised higher because …
Six years ago, just after arriving in Baltimore for a winter conference, I fell sick with fever and a bad sore throat.
After a night of feeling awful, I went looking for help. I found it at a Minute Clinic in a CVS near the hotel. I was seen right away by a friendly NP, who did a rapid strep test …
One of my biggest pet peeves in life is tardiness. I hate it when other people are late. It’s as if they are not respecting my time. But you know what? I hate being late myself even more. In fact, I cringe at the thought. Conscientious, successful people are on time.
Always.
So you can imagine that nothing irks me more than being …
I do not think that word means what you think it means.
– Inigo Montoya, The Princess Bride
Stick to Facts, sir! … In this life, we want nothing but Facts, sir: nothing but Facts!
– Charles Dickens, Hard Times
“Information without context isn’t transparency” flashed across my Twitter feed. So now I am thinking about context, and communicating context, in medical care.
This quote, from Heather Pierce, JD, MPH, Director of Science Policy and Regulatory …
Sick of phone trees, endless refill requests, packed waiting rooms, out-of-control bills, and other medical misadventures?
Follow these seven simple steps to get your doctor to do what you want.
1. Get organized. Be clear about what you need from your appointment. Make a comprehensive list of all the issues you want to discuss — and your ideal outcomes for each. Patients who are …
The nationwide shortage of physicians is a very real crisis across all 50 states, causing a huge strain at all levels of health care. Hospitals and clinics are struggling to hire, current physicians are overworked, and ultimately patients have to wait longer.
There are a number of reasons why this has happened, but one thing’s for sure: With the aging population, the …
I recently went to Boston to see the Goya exhibit at the Boston Museum of Fine Arts and was thrilled to see one of my favorite paintings by this artist: Self Portrait with Dr. Arrias. The painting was on loan from the Minneapolis Institute of Arts — a museum I never had the …
My friend, Trent, is an auto mechanic. When he was growing up, he loved to work on old cars. He rebuilt his first one when he was fourteen — and drove it for 11 years. He loved finding problems and figuring out how to fix them. He never cared about getting rich; his goal was to make a decent living doing …
Many physicians I know are struggling to make ends meet while making several hundred thousand dollars per year. Despite growing incomes, their savings rates remain extremely low due to ever increasing expenses. What they do manage to save, they turn over to professional money managers.
How does this happen? Why are some of the smartest, hardest-working and most responsible members of our society unable to create real wealth? The answer is …
In his popular tome, The Innovator’s Prescription, Clayton Christensen proposes several cures to health care’s cost disease, known as disruptive innovations. One is the replacement of physicians by advanced practice clinicians (APCs). That is, by nurse practitioners and physician assistants. APCs meet the requirements for Christenson’s disruptive innovators: They cost less (than physicians) and are good enough.
There is little doubt that APCs …
I am a doctor today because of Dr. J.W. Epstein, my pediatrician in Cleveland in the 1950s. An immigrant from the Nazi terror in Europe (it was family lore that he had escaped the Holocaust), he had trained in Vienna and spoke English with a Germanic accent. His house calls are etched permanently in my memory. His visits were heralded by a fury of activity, led by my mother. “The …
Doctors have a difficult time adjusting to other cultures and because of this flaw, patients, and the medical profession suffer. By culture, I do not mean religious or philosophical background, socio-economic difference, country of origin, nor even the silence created by language and education barriers. I am referring to the communication and comprehension chasms that exist between different occupations and physicians.
What …
If F. A. Hayek were alive today, he would support the revival of labor unions in general and professional labor unions in particular. Towards the end of the Second World War, Hayek wrote a book warning us all that allowing governments to engage in extensive central planning of economic activities is nothing more than a road to serfdom for humanity. F.A. …
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Is it medically professional for a non-profit organization to use physician testing fees to “choose wisely” a $2.3 million luxury condominium complete with a chauffeur-driven BMW 7-series town car? In my view, obviously not. To most people, such an action would conjure up images of hypocrisy, waste, and corruption.
After a review of public and tax records, it appears to me this is exactly what has happened.
Background
In 1999 for reasons that …
In the United States, we train health care providers on poor people. This is no secret — most medical schools and residencies are in lower income areas. If you have Medicaid or no insurance, you are more likely to find care in an office or hospital where medical students, residents, nursing students, and other trainees rotate; Blue Cross patients don’t let interns watch their childbirth. Even though my residency emphasized …
There once was a kind, humble physician who worked for years in an office building across the street from the hospital, toiling day to day to take exceptional care of his patients. He was open and deliberate, calm and thoughtful. He himself hired every secretary and medical assistant, every nurse, and biller. His staff formed a protective family who fiercely advocated …
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Dear HMO,
As I prepare to #getcovered or #staycovered, I realize that as a physician, I have an advantage in that I know what specific types of insurance plans would best fit my needs. Unfortunately, this is not the case for many Americans. Most importantly, I know to avoid signing up for certain health maintenance organizations (HMOs). Although I am a strong …
There’s been a lot of talk recently about low morale and disgruntlement among doctors. A recent article on focused on a list of reasons when doctors know it’s time to quit. I found the article a bit sad and unfortunate, but I’m sure the feelings behind it were sincere.
Another excellent article in the Wall Street Journal last week extensively discussed the factors behind …
I keep six honest serving-men
(They taught me all I knew);
Their names are What and Why and When
And How and Where and Who.
– Rudyard Kipling
Medicine has become a very complex, multifaceted science, ranging from pharmacogenetics to psychoneurobiology. Doctoring, however, is increasingly viewed as so simple that you don’t actually have to be a doctor to know how it should be done.
What else could explain why IT people tell doctors what “workflows” …
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I was invited to a “networking party.” I went. I was horrified by what transpired there. And disgusted. And felt blindsided. And angry. And blown away by the prevalence of what I couldn’t decide was greed, ignorance, or an unseemly combination of the two. And what magnified the intensity of my repulsion was the fact that a large proportion of the people involved have the …
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