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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*

What Patients Really Need: A 360 Degree View Of Their Illness

As we often say at Patient Power, there is no one source for medical information. The same is true when it comes to support for patients. No one organization is THE place to go and has all the answers.

That may sound obvious. But just as it has taken a long time to dislodge the “Doctor as God” perception or “I’m the doctor and you’re not” put-down of “problem patients,” there have been some non-profit advocacy groups that have seen themselves as the “be all and end all” for conditions they cover. In both cases, the arrogant doctor and the “100,000 pound gorilla” organization, neither took what I call the “big tent” view. In their view, they were the tent and there was no room for anyone else. That’s never been our view and I wanted to tell you how we are celebrating our relationships with a multitude of partners, many of whom are becoming friends. Read more »

*This blog post was originally published at Andrew's Blog*

Patients, Doctors And Informed Medical Decision Making

You can’t be well-empowered if you hear advice wrong. That’s why in a participatory relationship, an essential skill is accurate handoff of information.

The Foundation for Informed Medical Decision Making (FIMDM), catchily pronounced “fimdim,” has been working for years to improve patients’ knowledge of options and alternatives. In [the September 20th] Boston Globe Liz Cooney talks with people from FIMDM about the issue. An excerpt:

What doctors explain and what patients understand might be two very different things, recent research suggests.

Ideally, patients talk with their doctors about the pros and cons of a particular treatment, weighing the risks and benefits, exploring alternatives — including doing nothing — and then come to a conclusion. That’s the goal of the informed consent process, best known by the paperwork patients sign at the end saying they heard doctors describe what they may be getting into.

If only it were that simple.

[This] article springboards off Cooney’s piece two weeks ago on heart stents, reported here by Dr. John Grohol as Doctors Say One Thing, Patients Hear Another.

A Boston non-profit, FIMDM is the force behind Gary Schwitzer’s excellent Health News Review service, which analyzes health news in the media, teaching e-patients and policy people to sift the gold from the garbage.

*This blog post was originally published at*

Patient Safety: “Are You Safe?” Awareness Video

Today [Aug 28] I’m participating in the workshop “Engaging Minority Communities in Safer Healthcare” organized by MITSS (Medically Induced Trauma Support Services), a Boston non-profit I’ve written about before.

The current speaker is Lisa O’Connor, VP of Nursing at Boston Medical Center. She just showed this four-minute safety awareness video, produced by Quantros. Much of its content will be familiar to our readers here (the frequency of medical errors and hospital acquired infections), but I’m posting it because of its good, concrete, specific actions every patient should know.

The part with specific actions for patients starts around 2:30. (My highlights are below.) Read more »

*This blog post was originally published at*

Healing The Spirit: More Profitable Than Healing The Body

Yes, it’s true – most doctors may soon be government employees. No, not the Lasik surgeons, the plastic surgeons, or the dentists — they were clearly more focused on career day. But is it necessarily a bad thing if all of your income comes from federal, state, or local governments?

If your business is caring for the medical needs of the less fortunate, a Medicaid doctor or a VA doctor perhaps, then your luxury box may be something more Thoreau-like, maybe some nice lawn furniture in the backyard. On the other hand, if your business model involves caring for recently-released prisoners or drug addicts, then you are in the financial sweet spot. Read more »

*This blog post was originally published at Dr John M*

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…

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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…

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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…

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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…

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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…

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