July 27th, 2011 by Happy Hospitalist in Health Policy, Opinion
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A physician asked me a question regarding what should be the role of hospitalists in carrying out discharge orders written by other physicians.
I have been following your blog since I was a resident and recommend it to a lot of people. Thank you so much for enlightening me on so many day to day hospital issues. I wanted to know your opinion about something that puzzles me. When a specialist changes a medication or requires a lab to be done as outpatient after a discharge order is written (for example you write: okay to D/C if okay with cardiology, and they change a dose or request stress test out-pt) who is required to write the new scripts and arrange that test? Is it the hospitalist’s responsibility to do it? Or is the specialist who changed the dose after you rounded required to handle it? It was easier during residency due to abundance of residents/fellows and the fact it was electronic RX access. What are your thoughts? As so far I always return back and make the adjustments needed for the patient welfare, and the fact I don’t know whether I should take stance and request that physician to do their job.
Dear physician, there is nothing puzzling here. It’s black and white. Read more »
*This blog post was originally published at The Happy Hospitalist*
July 27th, 2011 by Elaine Schattner, M.D. in News, Opinion
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Recently the Times ran a leading story on a new med school admission process, with multiple, mini-interviews, like speed dating. The idea is to assess applicants’ social, communication and ethical thinking (?) skills:
…It is called the multiple mini interview, or M.M.I., and its use is spreading. At least eight medical schools in the United States — including those at Stanford, the University of California, Los Angeles, and the University of Cincinnati — and 13 in Canada are using it.
At Virginia Tech Carilion, 26 candidates showed up on a Saturday in March and stood with their backs to the doors of 26 small rooms. When a bell sounded, the applicants spun around and read a sheet of paper taped to the door that described an ethical conundrum. Two minutes later, the bell sounded again and the applicants charged into the small rooms and found an interviewer waiting. A chorus of cheerful greetings rang out, and the doors shut. The candidates had eight minutes to discuss that room’s situation. Then they moved to the next room, the next surprise conundrum…
This sounds great, at first glance. Read more »
*This blog post was originally published at Medical Lessons*
July 27th, 2011 by CodeBlog in Book Reviews, Interviews
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Well, not my heart.
I was contacted awhile ago and asked if I wanted the chance to read and review Tilda Shalof’s new book, Opening My Heart. (Amazon link, but NOT an affiliate link – I live in California and due to a new law, Amazon has cut all ties with us).
I had the chance to include a story in a book that Tilda edited a couple of years ago called Lives in the Balance. So I had fond memories 🙂
I’ll say up front that I enjoyed the book. I had a range of emotions while reading it – frustration, worry, happiness. Frustration because although Tilda is a very experienced ICU nurse, she doesn’t take her own health seriously at all. I read with disbelief as she described her incredible denial of the obvious need to treat the heart condition she was born with.
I was amused at her doctor’s and husband’s reactions when she tried to tell them that if anything went wrong with her surgery, she didn’t want to be kept alive on machines. She explained that she used to have a dog and her husband absolutely refused to euthanize the miserable thing. I liked this passage in particular: “To Ivan, love means never stopping love or giving up. This is what families say. They can’t let go because of love. I hope no one loves me this much, ICU nurses often say to one another.”
Amen, sister.
Tilda writes about Read more »
*This blog post was originally published at code blog - tales of a nurse*
July 27th, 2011 by Lucy Hornstein, M.D. in Humor, Opinion
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Many people ask why the United States, unlike other countries, has no national system of electronic medical records.
Here’s why:
Insert the number 576 instead of 14, by the way. Each of which Read more »
*This blog post was originally published at Musings of a Dinosaur*
July 27th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
4 Comments »
The National Institute for Healthcare Management Foundation is a nonprofit, nonpartisan organization focused on healthcare. The foundation just published an excellent report on the distribution of healthcare costs in the population.
The results indicate that reducing healthcare cost is all about reducing and managing chronic diseases.
U.S. healthcare spending has sharply increased between 2005 and 2009 by 23 percent from $2 trillion to $2.5 trillion per year.
This is a result of a combination of factors. Chief among them is the increasing incidence of obesity.
Who spends the money? Read more »
*This blog post was originally published at Repairing the Healthcare System*