August 11th, 2011 by Bryan Vartabedian, M.D. in Opinion
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I never thought I’d change the way I practice medicine. But I recently enrolled as a provider in the Improved Care Now (ICN) collaborative network and I’m already working differently.
ICN is an alliance of gastroenterologists and patients working in a new model of pediatric inflammatory bowel disease care based on the analysis of thousands of doctor–patient visits as well as the latest studies and treatments. Doctors and patients apply this information, experiences are tracked in an open registry, the results are then shared and refined to improve care. I can see what I’m doing well and where I’m falling short relative to other clinics and pediatric gastroenterologists.
ICN is under the direction of Dr. Richard Colletti of the University of Vermont. ICN is supported by the Chronic Collaborative Care Network (C3N), the brainchild of Cincinnati Children’s qualitymeisters, Peter Margolis and Michael Seid. I flew to Cincinnati earlier this week to catch up on C3N and what appears to be a first step into medicine’s future. More on the specifics later. But suffice it to say that I’m stoked about where this is all headed.
A couple of thoughts after enrolling my first few patients: Read more »
*This blog post was originally published at 33 Charts*
June 23rd, 2011 by PJSkerrett in Health Tips, Opinion
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For several years I’ve been preaching in the pages of the Harvard Heart Letter about the importance of taking part in clinical trials. Why? Because I believe they improve medical care, telling us what works and what doesn’t. Figuring it was time to put up or shut up, I volunteered for a clinical trial. I’m glad I did—I learned a lot, received excellent care, and saw first-hand the effort it takes.
The trial was called Targeting Inflammation Using Salsalate in Type 2 Diabetes, or TINSAL-T2D for short. It was being conducted at 16 centers, including the Joslin Diabetes Center in Boston, a short walk from my office. Its aim was to see if an old drug called salsalate (a cousin of aspirin) could arrest low-grade inflammation that may—emphasis on may—make muscles resistant to the effects of insulin and eventually tip the body into type 2 diabetes.
I responded to an ad for TINSAL-T2D and, after undergoing a few preliminary tests, was accepted to take part in it. I was given a bottle of blue pills and asked to take several of them every day. No one—not lead investigator Dr. Allison Goldfine, not study nurse Kathleen Foster, and certainly not me—knew if the pills were the real thing or a placebo. I was also asked to check my blood sugar every morning, and to show up monthly for blood tests and questions galore.
I just finished my year-long stint, still not knowing whether I was taking salsalate or a placebo. I really don’t care, though I’m keen to know if salsalate worked as hoped, something I’ll learn when the results are published.
Why bother?
Read more »
*This blog post was originally published at Harvard Health Blog*
December 24th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion
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Jenni Prokopy (aka Chronicbabe) put us to the challenge for this week’s Grand Rounds by asking for our 2011 clinical resolutions. I have to admit that I’m not one for resolutions because I can never take them seriously. But admittedly there are things that I need to tighten up. So here goes:
1. Clear my chart rack every afternoon. This is key because my creative mind operates better when my charts are done. Of course this means no more tweeting “47 charts” or “33 charts” when I’m behind. Had I made this resolution for 2009, this blog wouldn’t have a name.
2. Cultivate innovative communication channels with my referring docs. While I need to be consistent and compulsive with my referral letters, I want to improve mobile, real-time communications between me and my referring docs. For example I’d like to get my local community on Doximity so that I can launch a quick, HIPAA compliant, encrypted SMS messages on my iPhone the second I see a patient. Read more »
*This blog post was originally published at 33 Charts*
July 25th, 2010 by Debra Gordon in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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A new survey in the journal Health Affairs synthesizes nearly everything I believe is wrong with the U.S. healthcare system. The survey found that patients believe that more care is better, that the latest and most expensive treatments are the best, that none of their doctors provide substandard care, and that evidence-based guidelines are a pretext for denying them the care they need and deserve.
Sigh.
Until we can retrain consumers (that would be all of us) to understand that in medicine more is NOT better, that evidence-based guidelines may translate in some instances into less but better care, that doctors are falliable and should be questioned, and that the cost of a treatment has nothing to do with the quality, we will never get out of the healthcare quagmire in which we find ourselves.
Your thoughts?
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
