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Latest Posts

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*

Years Of Planning And Construction Lead To A One-Day Transition

Tomorrow we’ll be far away

Tomorrow is the judgement day

Tomorrow we’ll discover what our God in heaven has in store

One more dawn…

On an unrelated note, tomorrow morning at 5AM our new ER opens and the old one closes down. I’ll be there working clinically. To the degree that it doesn’t interfere with patient care, I’ll live-tweet the experience.

For those not familiar with the institution or the project — it’s a 110,000 annual visit ER closing down and reopening next door in a new, state of the art 83 bed ER, with an entire new 10-story hospital opening directly above at the same time, more or less. The logistics of the transition are pretty staggering. The ER will be the first unit to open. The old ambulance bay will have a barrier put up at 5AM and the new department’s ambulance bay and drop-off will be illuminated at that time and all new patients will go there. The staff closing out the old shop will dispo all the patients they can, and at a certain point, maybe by ten AM, any patients still in the old ER will roll across the skybridge to the new facility. We will open one cath lab and one OR in the new hospital while retaining capability at the old rooms. New patients admitted will go to the new tower and the old inpatient units will start discharging patients. By Friday, any patients still in the old tower will move across to the new inpatient units. They’ll be bringing the other ORs and interventional labs online in a stepwise fashion during the week. Interestingly, a lot of expensive equipment is being “salvaged” from the old hospital. For example, the telemetry monitors in the ICU — about half of the new ICU beds have monitors now. When a patient is discharged from the old ICU, they will take that monitor across to the new building and install it in a new ICU bed, which will only then become open for a new patient. Eventually, all the monitors will be re-installed in the new units. Elective surgeries are pretty much out this week. When everything is open we will have 16 ORs and 8 cath/vascular/EP labs with room for four more as need demands.

For the ER (and more importantly for ER patients) this will be Read more »

*This blog post was originally published at Movin' Meat*

When A Patient Outgrows A Childhood Disease

At a [recent] session on caring for adult survivors of pediatric diseases, Bradley J. Benson, FACP, and Niraj Sharma, FACP, had some interesting statistics to share.

For example, more than 90% of children with a chronic or disabling health condition are expected to live more than 20 years, meaning they’ll eventually need an internist’s care, and every year more than 500,000 children with special healthcare needs turn 18.

As Dr. Sharma noted, “We’re not talking about a handful of folks.” Read more »

*This blog post was originally published at ACP Internist*

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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