June 3rd, 2011 by DrWes in Health Policy, Humor
1 Comment »
From AMA Medical News:
New York physicians may have to take off their neckties, jewelry, wristwatches and long-sleeved white coats when caring for patients if a bill under consideration in the state legislature becomes law.
The bill, proposed in April in the state Senate, calls for a “hygienic dress code council” within the New York Health Dept. to consider advancing a ban on neckties and requiring physicians and other health professionals to adopt a “bare below the elbow” dress code in an effort to slash hospital-acquired infections.
Even though there’s no data that this does anything to reduce hospital acquired infections.
But that doesn’t matter.
So why stop there? I say, doctors should do the ultimate for their patients: the Full Monty.
*This blog post was originally published at Dr. Wes*
June 1st, 2011 by DrWes in True Stories
No Comments »
It was just a visit to manage her paroxysmal atrial fibrillation. She was long overdue for the visit. So she arrived as she had so many times before: with little fanfare and folderol. She sat patiently after her weight was obtained, vitals recorded, and medications verified. Clutching her purse, whe sat patiently as the examination door opened.
“Hello, Ms. Smith, how have you been doing?”
“Wonderfully, doctor. I haven’t had any more problems with my heart rhythm.” She leaned sideways to put down her purse on the floor next to her.
“Any dizziness, lightheadedness, shortness of breath, cough?…”
“No, I’m doing fine, thankfully,” her eyes glistening.
I proceeded to complete her history and catch up on a few details with her, then moved on to the physical examination. I watched as she got up on the exam table and noted her moving a bit more slowly than I had recalled.
“Is your strength doing okay?”
“Oh sure. Never better. Just slowing down a bit is all. But I’m not sure how well I’d be doing if it weren’t for my daughter.”
“How’s that?” Read more »
*This blog post was originally published at Dr. Wes*
May 24th, 2011 by DrWes in Opinion
1 Comment »
With the news that Wellpoint, one of the largest insurance companies in America, will cut off annual 8% payment increases to about 1,500 hospitals if they fail to “test” high enough on 51 quality measures, they have officially defined “quality” health care as checkboxes.
Yep, checkboxes.
You see how do insurers know if we offer each of our patient’s nutritional guidance or exercise counseling?
Well, they check to see of doctors have clicked on a yellow warning box advising we do this. If we have, then not only is that doctor a fine, “quality” doctor, but the hospitals (and it’s computer system and scores of administrative staff that compile and submit this data) are real, fine, “quality” hospitals.
That’s all there is to it.
Never mind if we don’t have time to actually perform the counseling.
* click * * check * * click *
Simple as pie. Efficient, too.
Beautiful bureaucratic quality.
Good luck with that.
*This blog post was originally published at Dr. Wes*
May 21st, 2011 by DrWes in Opinion
No Comments »
I wonder if we’re in danger of stifling fun in medicine.
Certainly there are still fun things to do in medicine (ablating a pesky accessory pathway safely, for instance). But as I watch the newly-minted medical school graduates emerge from their long, sheltered educational cocoon, I wonder what their attrition rate will be from medicine once they see our new more-robotic form of health care community.
There is a social camaraderie in medicine when you train. Maybe it’s the “misery loves company” syndrome. In medical school you stick together through thick and thin because few others understand what you’re going through. You strive for the day when, collectively, you earn the designation of “doctor of medicine.” There’s a strength in numbers.
But as our work flows become regimented, our geographic coverage areas more dispersed, and our hours more fragmented, I’ve seen the loss of the collegiality of the doctor’s lounge being replaced with the coldness of e-mail blasts. I’ve seen the loss of summer picnics with my colleagues’ families replaced with “Doctor Appreciation Day.” After work get-togethers that included our spouses and kids are have long since gone – most of us just want to get back home to re-group for the next day ahead. Read more »
*This blog post was originally published at Dr. Wes*
May 12th, 2011 by DrWes in True Stories
No Comments »
It was interesting lunchtime conversation. A lone doctor listening to some highly experienced and capable nurses, reflecting on their work:
“If the patient’s nice, it’s a lot easier to want to go back in that room with them. Their reputation travels at the nurses station. But if they’re mean, well, it’s not as easy to go back in there, so I might not stop by as often.”
“I agree, it’s easier to catch flies with honey than vinegar.”
Words to live by.
*This blog post was originally published at Dr. Wes*
