October 23rd, 2010 by DrRob in Better Health Network, Health Policy, Opinion
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Joe Boyd hated the Yankees. “Those damn Yankees. Why can’t we beat ‘em?” Then he got the opportunity to save his beloved Washington Senators by making a deal with the devil — giving up his soul in exchange for being transformed into “Shoeless Joe” to propel his team to win the World Series.
Interesting. I think a lot of doctors are making their deal with the devil. They are looking for a small gain in comparison to a long-term of misery. True — Joe Boyd made out in the end, but that will only happen if someone from Hollywood writes our script.
Here’s the problem: At the core of our problems with healthcare is the total lack of cohesive communication. Doctors have no idea what other doctors have done with a patient. Tests get ordered, medications get changed, procedures, hospitalizations, even surgeries are done without communication to other doctors who would benefit from this information. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
October 15th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Opinion, True Stories
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I read this article about a young child with heterotaxy syndrome with great interest. Not because I find heterotaxy syndrome something of great fascination, but because of the lack of communication — on both ends of the spectrum:
Even though 5 other Dr. all came in and listened to his lungs and said that he didn’t sound like he was wheezing and that his lungs sounded really good. But because this hospital is overly political, process driven, bureaucratic, and in a constant state of litigious fear they are unable to make any conclusions based on actual medicine and patient care. Common sense is blown out the window when you have a system were a hospitalist one year out of medical school has an opinion that is as valuable as a cardiologist with 25+ years experience.
But in fairness, they all had to “really consider her opinion.”
So they went and got a pulmonologist to evaluate him, which Scott and I were very happy about because there was nothing in the world that would’ve made me more happy in that moment than to have her proven wrong. Which she was.
The whole article is a case study in stress, distrust, and legalism. Read more »
*This blog post was originally published at The Happy Hospitalist*
September 1st, 2010 by Toni Brayer, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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In a surprising report from the Archives of Internal Medicine, we learn that most hospitalized patients (82 percent) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted.
If that isn’t enough, when the researchers queried the physicians, 67 percent thought the patients knew their name and 77 percent of doctors thought the patients “understood their diagnoses at least somewhat well.” I would call that a pretty significant communication gap.
Ninety percent of the patients said they received a new medication and didn’t know the side effects. Although 98 percent of physicians thought they discussed their patients’ fears and anxieties with them, only 54 percent of patients thought they did. Read more »
*This blog post was originally published at ACP Internist*
August 31st, 2010 by Happy Hospitalist in Better Health Network, Opinion, True Stories
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What do you do when doctors and nurses don’t get along? A reader asks for my advice:
Hi Happy,
I have this problem and wanted some advice from someone with more experience dealing with this.
I have been bashed by nurses because they expect me to know all the bureaucratic issues, when you don’t have more than a month in the hospital. I have noticed that nurses get mad, when you give them an instruction they don’t understand, or they aren’t used to, not because you are wrong, but instead, their lack of ignorance, or their narrow process of thought. One example of this is when they laugh at me cause i prescribed a generic medication of a common drug that they weren’t familiar with the generic name.
Days ago, a first-year family doctor was yelled at badly by some nurse because she filled in the prescription chart where she shouldn’t — she didn’t know because no one told her. I have seen that attitude several times from different nurses — they yell in a very unproper manner. Read more »
*This blog post was originally published at The Happy Hospitalist*
June 22nd, 2010 by StevenWilkinsMPH in Better Health Network, Health Policy, News, Opinion, Research
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The New York Times reported recently on efforts by providers and payers to increase patient medication adherence through the use financial incentives paid to patients. The article cited the use of small financial payments (<$100), awarded via lotteries, to patients that take Warfarin –- an anti-blood clotting medication.
There is certainly nothing wrong with financial incentives. Incentives have been proven successful in changing selected provider (quality and safety improvement) and patient behavior (stop smoking, weight loss and taking health risk surveys). But paying patients to take their medication is different. Actually, the evidence suggests that it is a just plain stupid idea for a whole lot of reasons. Read more »
*This blog post was originally published at Mind The Gap*
