Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Robot Performs Surgery For Obstructive Sleep Apnea: Is It Over The Top?

I came across this article the other day regarding use of the daVinci robot to perform base of tongue surgery for obstructive sleep apnea.

For those who don’t know, the daVinci robot system made by Intuitive Surgical is a robotic system whereby the surgeon directs the arms of the robot to perform surgery in difficult-to-access areas of the body.

My feeling is that using a robot to perform sleep apnea surgery is way overkill akin to using a $50,000 sniper rifle to kill an ant on the wall.

Everything the daVinci robot can do can also be done without the robot with equivalent patient outcomes. In fact, Read more »

*This blog post was originally published at Fauquier ENT Blog*

Does The EHR Carry The Risk Of Making All Patients Look Alike?

I saw it begin to happen in the ’90′s.  Residents came to rounds with their daily notes produced on a word processor.  The notes were impressive.  Legible, lengthy and meticulously detailed at first glance.

Then I started to notice a pattern.  The impressive notes began to look very much alike.  The thorough exam varied little from patient to patient.  And problems that occurred on previous days seemed to persist in the medical record, even when it had resolved.  In some cases the previous day’s note was printed only to have one or two additional elements added by hand.  It was never really clear what was worse: the lack of effort or the illegible writing.

Our electronic health records (EHR) offer similar options.  We can smart text our way to clinical efficiency.  Some doctors have entire impressions and elements of the history pre-generated for common conditions.  These are advertised features of the most common EHRs.  Technology can make us look Read more »

*This blog post was originally published at 33 Charts*

The Health Care Rush During The Holiday Season

Like Christmas season advertising, the holiday crunch for procedural medicine is coming earlier every year.

Perhaps that’s why the posting on this blog as suffered: we’re busier than ever.

Why is this?

I suspect it’s because of a variety of forces that are coming together to create the great procedural “perfect storm” this time of year.

Perhaps the most important contributor to the holiday rush is the patients themselves. Patients are Read more »

*This blog post was originally published at Dr. Wes*

Are Regulations Preventing Hospitalists From Reaching Their Full Potential?

How many patients should a hospitalist average on any given day?   What do you think?  The Hospitalist asked that question to hospitalists and  421 of them responded.  They were given responses in quintiles of 10 or fewer,  11-15, 16-20, 21-25, and more than 25 total patient encounters per day.

Go check out their results.  I’m not surprised.  But, as they say,  there is no right answer.  The right number is the number that brings WIN-WIN-WIN-WIN to the patient-doctor-hospital-insurance quadrangle.   WIN-WIN-WIN-WIN is possible.  It just takes a great understanding of removing the barriers to efficiency.  Efficiency and quality of care can move in the same direction.  They don’t have to be opposing forces.  You can be better and faster if given the tools, whether those tools are driven by IT support, systems process changes, communication enhancement, physical and structural hospital layout changes or documentation support tools.  There are many others. Read more »

*This blog post was originally published at The Happy Hospitalist*

What Patients Are The Lowest Quality Hospitals Serving?

Hospitals that provide the lowest quality care at the highest cost care for more than twice the proportion of elderly minority and poor patients as the nation’s best performers, researchers found. And patients at the “worst” institutions are more likely than patients elsewhere to die of certain conditions, such as heart attacks and pneumonia.

These hospitals and their patients may be the ones most at risk under new Medicare payment arrangements that could cut payments to hospitals that fail to meet quality metrics, reported researchers from the Harvard School of Public Health.

The researchers examined how quality, costs and patients served correlated among 3,200 hospitals nationwide. They then identified 122 “best” hospitals, those that were in the highest quartile of quality and lowest quartile of risk-adjusted costs, and 178 “worst” hospitals, those in the lowest quartile of quality and the highest quartile of costs.

Hospital quality and performance data were Read more »

*This blog post was originally published at ACP Hospitalist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »