August 15th, 2011 by Lucy Hornstein, M.D. in Opinion
No Comments »
Seven months into 2011, things look very different than they did this time last year at my office. Not only have I been using an electronic medical record for nine months now, but I’ve also been submitting claims electronically (through a free clearinghouse) using an online practice management system. I’ve also begun scanning patients’ insurance cards into the computer, as well as converting all the paper insurance Explanation of Benefits (EOBs) into digital form. I’ve even scanned all my office bills and business paperwork and tossed all the actual paper into one big box. As of the first of the year I even stopped generating “daysheets” at the end of work each day. After all, with my new system I can always call up the information I want whenever I need it.
How did such a committed papyrophile get to this point? It is the culmination of a process that actually began last summer with the purchase of an adorable refurbished little desktop scanner from Woot ($79.99, retails for $199, such a deal!) The organizational software is useless for my purposes, but it does generate OCR PDFs, which makes copying and pasting ID numbers from insurance cards into wherever else they need to be a piece of proverbial cake. The first step was to start Read more »
*This blog post was originally published at Musings of a Dinosaur*
August 7th, 2011 by Lucy Hornstein, M.D. in Opinion, True Stories
No Comments »
I saw a lady with a boil. It began as a small red bump which got bigger and harder, then drained white stuff, and was now getting better.
The reason she was worried about it was its location: it was on her breast. This was why the chief complaint officially read, “Breast lump” despite the fact that it was technically no such thing.
I examined her carefully, determining that the pathologic process was indeed confined to the skin and clinically did not involve the actual breast tissue in any way. However because she was of an age for screening mammography, I did take the opportunity to urge her to have it; which she did. The problem arrived with the radiology report:
A marker is placed over the area of palpable abnormality. Mammographic images reveal normal breast tissue with no mass or architectural distortion. The pathologic process is confined to the skin. Recommend surgical excision. (emphasis mine)
Um, no. Read more »
*This blog post was originally published at Musings of a Dinosaur*
July 27th, 2011 by Lucy Hornstein, M.D. in Humor, Opinion
No Comments »
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 20th, 2011 by Lucy Hornstein, M.D. in Opinion
No Comments »
62-year-old black man with a two inch (that’s inch; not centimeter) lump under his left arm. It is determined that he needs to have it biopsied in order to tell for sure what it is. The differential diagnosis includes a simple reactive lymph node, lymphoma, leukemia, granuloma, sarcoidosis, and several other more esoteric entities, all of which require tissue for definitive pathologic diagnosis.
The dialogue:
Patient Who Will Not be Reassured: What is it, Doctor Dino?
Me: We won’t know for sure until we get the report from the biopsy.
PWWNBR: But what do you think it is?
Me: I have no idea. We have to see what the pathologist says.
PWWNBR: Could it be cancer?
Me: It could be any one of several different things. Yes, cancer could be one of them, but there’s no way of knowing without the biopsy.
PWWNBR: Dr. Dino, do I have cancer? Read more »
*This blog post was originally published at Musings of a Dinosaur*
June 28th, 2011 by Lucy Hornstein, M.D. in True Stories
No Comments »
I don’t always practice what I preach. Regular mammograms, for instance. Last year I realized I had skipped a few, so I decided to turn my procrastination into an opportunity to reach out to those of my patients guilty of the same thing.
I made arrangements with my hospital to monopolize half their schedule one Saturday morning, put flyers up in my office and talked it up like crazy to every eligible woman I saw. On the appointed day, I brought a whole bunch of bagels, half a dozen spreads (I asked the ladies to bring their own coffee), and we proceeded to have a blast! Or as much fun as you can have getting your boobs squished. Hey; it’s all in the name of early detection.
Last year’s final tally was a bakers dozen (twelve patients plus me), out of which about 5 people were called back for more views (mainly those with old films not readily available from other institutions), 2 benign biopsies were done, and one case of invasive breast cancer was diagnosed and treated. Not bad, I thought. Read more »
*This blog post was originally published at Musings of a Dinosaur*
