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Using Social Media To Change The Public’s Perception Of Family Medicine

How should physicians utilize social media in their professional lives? In this video, I was interviewed by Family Practice News at the 2011 American Academy of Family Physicians Annual Scientific Assembly meeting in Orlando. Check out this blog post where there are slides of my presentation at that meeting about social media. (Also FYI, as of this posting, the video above has the most hits of any on the Global Medical News Network channel – Yay!)

Especially for Family Medicine, using social media is very important, in my opinion, to help tell our story. For too long, I believe that we, as a specialty, have let others define who we are. Social media has a chance to change that.

As far as initial use of social media, I advise physicians Read more »

*This blog post was originally published at Family Medicine Rocks Blog*

Insurance Company Begins New Ad Campaign In The Face Of Health Reform

Trudy Lieberman Cigna launched a $25 million “GO YOU” national branding campaign last week signaling that they are gearing up for tons of new customers as health reform rolls towards 2014.   That new business will come from the millions of Americans now uninsured who will start getting government subsidies as an encouragement to buy health insurance coverage.  If those uninsured folks don’t get coverage, they will have tax penalties to pay.

No insurer wants to be left behind in this expanding marketplace, so Cigna, by being first out of the gate, hopes to build brand awareness that will ring bells in 2014 when consumers must buy insurance.  It’s a smart strategy.  One industry consultant says “most insurers have not built enough brand equity with consumers.”

Cigna’s ad campaign positions health insurance as Read more »

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

Social Media Footprint: How Concerned Should Medical Professionals Be?

Hey Docs out there! What if your patients found out about your most embarrassing moment from college? What if they saw a picture of it? I was watching and listening to one of my favorite technology shows over the weekend called “The Tech Guy” with tech journalist Leo Laporte.

In the brief video here, you’ll see the host take a call from an attending physician. The caller stated that back before medical school, he posed for PlayGirl magazine and now some of those pics are showing up on websites and the caller was trying to figure out how to have them taken down. It sounds like the pictures were taken in the pre-internet days. For the full exchange, click here and fast forward to the time 13:21hrs on the clock behind the host.

This call opened up the larger issue of Online Reputation which has been talked about in Health Care Social Media circles for a long time. But, it is interesting seeing what this non-medical tech journalist (and the caller) says about it: Read more »

*This blog post was originally published at Family Medicine Rocks Blog*

Challenges And Opportunities Of Health Care Social Media

I spoke on health care social media and regulatory compliance at the Health Care Compliance Association’s New England Regional Annual Conference last week.  As you may expect, the room was full of the folks who, generally speaking, are the folks who block social media sites on health care organization networks.  I sent a link to an online bio to one of the session organizers in advance, and even that site was blocked by his facility’s network.  Clearly, we have a long way to go in educating health care compliance professionals about the risks and benefits of using health care social media, and an appropriate approach to balancing these risks and benefits so as to establish an appropriate social media presence for each health care organization.

My talk was followed by a presentation by two federal prosecutors, one of whom reminded the audience that they may need to produce copies of all online postings in response to government document requests or subpoenas.  We may quibble about the scope of material that might be covered by such a production request, but the key takeaway from this comment should be Read more »

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

The Power Of Social Media Networking In Health Care

In a recent Harvard Business Review Blog, David Armano writes about the six pillars of influence that lead to measurably favorable outcomes.

To achieve measurably better health, the pillars Armano explains can certainly be adopted.

He notes how the “social web can amplify signals, influence behavior and lead to action.”

Social networking has changed the landscape in health care.  Technology has paved the way for instant communication and feedback.

While some companies continue to question the value of social media networking, debating whether or not they should be on Twitter or Facebook, others have superseded the hesitation, and are presently into the next phase of social networking. Read more »

*This blog post was originally published at Health in 30*

Latest Interviews

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

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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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Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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Click here for a musical take on over-testing.

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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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