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Latest Posts

Sometimes Little Changes Can Add Up: The Extra Work Of The EMR

“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*

The Health Care Rush During The Holiday Season

Like Christmas season advertising, the holiday crunch for procedural medicine is coming earlier every year.

Perhaps that’s why the posting on this blog as suffered: we’re busier than ever.

Why is this?

I suspect it’s because of a variety of forces that are coming together to create the great procedural “perfect storm” this time of year.

Perhaps the most important contributor to the holiday rush is the patients themselves. Patients are Read more »

*This blog post was originally published at Dr. Wes*

Energy Star Food Rating System: Another Futile Attempt To Promote Healthy Eating?

The Institute of Medicine has just released it’s recommendation that all foods be rated with an ‘energy star’ system: three stars = good, zero stars = bad:

The Energy Star system is a model because it’s simple and easy to use, and also because it’s gained traction with industry, which now develops products with the rating in mind, committee members said.

Except that this rating system hasn’t gained traction with industry:

But the Grocery Manufacturers Association and Food Marketing Institute announced their own front-of-the-pack system, called Facts Up Front, in January. It gives information on calories, saturated fat, sodium and added sugars but doesn’t rate foods according to those components.

In a statement today, the GMA said it has “concerns about Read more »

*This blog post was originally published at Dr. Wes*

Would The Occupy Wall Street Movement Be Effective In Health Care?

As Occupy Wall Street spread across the nation, I can’t help but wonder if the same movement could occupy health care. After all, the basic tenants of the movement involve protesting against social and economic inequality, corporate greed, and the influence of corporate money and lobbyists on government. In the “Occupy” movement, there is a feeling there’s an inside game and the game is rigged.

It would seem, then, that our new health care law, written by corporate interests and heavily influenced by lobbyists, could become a ripe target for the movement. We are beginning to see Read more »

*This blog post was originally published at Dr. Wes*

There’s Always Something New To Learn

There they were, little maroon flags outside three patient exam room doors. You could almost hear the game show host ask the question:

Will it be Door #1, Door #2, or Door #3?”

So I asked the medical assistant, “Who’s next?” and she pointed me to Door #2.

It was a new patient with a familiar problem, one I’ve seen probably a thousand times before. Another day, another case. Bada bing, bada boom. Nothing to it. You would think that all cases, and all people are the same in some ways. Certainly, those managing our health care system of the future would like us to believe it’s so simple: just another case of heart failure (what can go wrong?) or supraventricular tachycardia (love that one, there’s NOTHING hard about that!) or maybe a few PVC’s (Check). Read more »

*This blog post was originally published at Dr. Wes*

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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