I admittedly snorted out loud when I read a New York Times article earlier last week regarding increased physician distraction due to electronic devices, especially with the advent of the smartphone with its emails, text messages, calls, and other alerts that ping intermittently throughout a typical work day.
There is no question that electronic devices distract physicians as the article pointed out… But that’s like complaining about a leaky faucet when there’s a flooded basement and a hole in the roof.
The bigger problem that should be mentioned is hospital bureaucracy which probably creates just as much if not more unintended distractions for physicians and nurses.
What many patients and lay public may not realize is that Read more »
*This blog post was originally published at Fauquier ENT Blog*
“I estimate these changes to your charting work flow will take only five minutes.”
Five minutes is fine if it happens for only one patient. But when it is multiplied by as many as forty patients in a day, the multiples get impressive. Five minutes x forty patients = 200 minutes (more than 1.5 hours a day).
Minor five-minute changes to administrative charting requirements aren’t so minor, especially when you add more time for quality assurance reporting or pay-for-performance initiatives. Suddenly huge swaths of time from a doctor’s opportunity to take care of their patients. We need more care time and less data entry time. Doctors must insist that we not become data entry clerks.
Increasingly, I see the data entry burdens of regulatory health care documentation requirements falling on doctors. On first blush, this seems logical because only doctors (or very capable, highly trained surrogates) understand the nuances required to make potentially life-altering adjustments to the electronic medical record. But when new administrative documentation requirements are added to doctors and other care providers, it Read more »
*This blog post was originally published at Dr. Wes*
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*
Please see my post on Clinical Psychiatry News and yesterday’s post What’s in a Note? along with the reader comments.
One reader asked why it’s weird to want to see your shrink’s notes and why shrinks refuse to show them on the grounds that they may distress the patients. Another reader asked why doctors write “patient denies” as though they don’t believe the patient. These are both great questions worthy of their own post.
Why don’t psychiatrists like to show patients their notes? Are they really going to “harm” the patient? There are a few reasons why a psychiatrist may not want to show a patient her notes. Here is my list of thoughts as bullet points. Please feel free to add to it. Read more »
*This blog post was originally published at Shrink Rap*
Nostalgia for the house-call
Not too long ago, I made a house call. As a physician accustomed to working in the emergency department of a hospital, this was quite a change of pace. But it involved dear friends and their sick child, and it was a joy. We had spoken on the phone and I had some concerns about their infant, who was stricken with a high fever. When I went to their home I took only my stethoscope. That and my experience as a physician and parent of four.
When I walked through the door on Friday evening there were candles burning as dinner was prepared. There were no florescent lights. There was none of the chaos of a waiting room. No ambulances idled outside. No bloody, angry drunk screamed profanities. No one was stood by their exam room door, arms crossed in annoyance with waiting. It was a quiet place to be; and the child, on his worried mother’s hip, was quiet as well. He was in a place where he felt safe and was thus able to tolerate my poking and prodding.
I examined him and decided that he was not seriously ill. Because his mother had described him as lethargic when we spoke, I had been concerned that he might have meningitis. This was not actually the case. His parents and I were obviously relieved.
After he was dosed with ibuprofen and put to bed, I chatted a while with his mom and dad, then left for home. As I drove home I realized that Read more »
*This blog post was originally published at edwinleap.com*