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The Stories In Medicine That Need To Be Told

I can’t help but think that as time passes we’ll forget about how much medicine has changed with the introduction of the Internet.  We’re witnessing a transition that hasn’t been seen in generations.  We live with the end result but the memory of how we got here is fading quickly.  Like any kind of cultural shift, once we’ve arrived it’s hard to remember what it was like along the way.

How did patients think before the information revolution?  And how did it go down when patients began to search?  How specifically did information clash with the old model of doctor and patient and how did we deal with it?  There are stories here that need to be told.  I think the real stories are in the small details of what went down between doctors and patients. But as early adopters, most of us spend our time looking forward, not back. Read more »

*This blog post was originally published at 33 Charts*

The Age Of Medical Disconnect

It’s the age of medical disconnect.

The disconnect describes the emotional and intellectual detachment that physicians feel from their patients and patients from their doctors.  This disconnect is the result of a confluence of factors, some from within the profession itself, others are more broadly social and economic.

To understand the disconnect you need look no further than your neighbor or your parents.  Dissatisfaction is evolving as the norm.  Patients feel increasingly marginalized in their experiences with physicians.  Shrinking length of visits, indifferent attitudes, poorly coordinated evaluations, difficulty obtaining test results, an institutional feel to the patient experience, and the overall sense of not feeling at all important.

The truth is that many of us are really not aware of the disconnect. Most of us have been born into a system of dysfunctional provider relationships and we know nothing else.  As physicians we’ve been trained to be detached.  As patients we’ve been conditioned to live happily detached.

Of course there are plenty of physicians who Read more »

*This blog post was originally published at 33 Charts*

Doctors And Patients Will Be Harmed By The Debt Ceiling Train Wreck

Watching the negotiations over the debt ceiling legislation is like watching an impending train wreck.

You see a train hurtling down the track, you see an unobservant trucker about to cross, you know that the train engineer and the truck driver have only a few moments to avert disaster, you try to yell and scream to get them to pay attention before disaster strikes—but you have this sinking feeling that your voice won’t be heard until it is too late.

Well, that is how I feel watching the collapsing negotiations over raising the debt ceiling. Responsible persons in both political parties know that a failure by Congress to authorize an increase in the debt ceiling will create incalculable harm to our country, even though some politicians seem to think that default would be no big deal.

But it would be a big deal, and here is why. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Medical Judgment Trumps Medical Innovation

The New York Times says “In Medicine, New Isn’t Always Improved.”

Who can argue with this?

“In Dining, New Restaurants Aren’t Always Better.”

Yes, that’s true, too.  But does it mean anything?

The article is about a type of hip that is apparently going to be the focus of a lawsuit.  The story goes that a lot of people wanted the new hip when it came out, because it was thought to be better than the older ones.  Unfortunately, the hip seems to have hurt some people, some of whom may have been better off getting the older one in the first place.

A doctor quoted in the article suggests it’s part of a uniquely American tic.  We want all of the latest and greatest things for ourselves, it seems.  This story is supposed to be a cautionary tale of what can go wrong when we do.

On the other hand, the latest and greatest things don’t appear out of nowhere.  In America, when people demand something, there will be someone who supplies it. Read more »

*This blog post was originally published at See First Blog*

Can Electronic Health Records Make Disparities Disappear?

According to Kendra Blackmon at FierceEMR.com and a new study published by the National Institute of Standards and Technology (NIST), the answer is maybe.

Earlier this year, NIST published a report – Human Factors Guidance to Prevent Health care Disparities with the Adoption of EHRs – which declares that “wide adoption and Meaningful Use of EHR systems” by providers and patients could impact health care disparities.

Making this happen, however, will require a different way of thinking about electronic health records (EHRs). While the report notes that EHRs primarily are used by health care workers, patients still interact with these systems both directly – such as through shared use of a display in an exam room – and indirectly. For patients to obtain the intended benefits of this technology, EHR systems should display or deliver information in a way that is suitable for their needs and preferences, the report says. Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Latest Interviews

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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How Do Hospital Executives Feel About Locum Tenens Agencies And Traveling Physicians?

I recently wrote about my experiences as a traveling physician and how to navigate locum tenens work. Today I want to talk about the client in this case hospital side of the equation. I ve had the chance to speak with several executives some were physicians themselves about the overall…

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Latest Book Reviews

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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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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