July 2nd, 2007 by Dr. Val Jones in Medblogger Shout Outs
Tags: Geriatrics, Personal
1 Comment »
I was really touched by Signout’s blog post about a charming octogenarian. It’s patients like these that make you glad to be a doctor… Signout writes:
I have a secret crush on one of my patients, an 85-year old man
who’s recovering from a bad pneumonia. After a weeklong stay in the
intensive care unit, he has recovered at a remarkable pace: the day
after he was extubated, he was out of bed with a physical therapist,
making his way slowly around the ward with a walker and a big smile.
What motivates him to work so hard at recovery, the
nurses say, is his love for his wife. They have been married 60 years.
She comes in to see him every day, wheeled around by their daughter.
The whole time she is there, they say, he holds her hand as if it is
the last time he will see her…
This man is the cutest patient ever… and the dear fellow reminds me of my husband (only a little bit older – the patient is older, not my husband – er, you see what I mean). One of my single friends asked me how I knew that Steve was the man I wanted to marry, I told them this:
“One day it suddenly occurred to me that if I had a traumatic brain injury or suffered from severe dementia and was totally incapacitated – Steve would faithfully care for me, never leave my side, and devote his entire life to my recovery or best quality of life. When I realized that he would do this for me without a second thought… I knew I had to marry him.”
Now, I’m not sure that Steve finds that image particularly romantic – but I do. It’s a doctor thing I guess.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 22nd, 2007 by Dr. Val Jones in Medblogger Shout Outs
Tags: Consumer Directed Healthcare, Hospitals, Quality, Technology
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Dr. Richard Reece wrote a wonderful personal reflection on the value of hospital ratings. As you may know, there has been much recent debate about their usefulness. With all the different rating systems, a single hospital can be ranked #1 in the country by one source and middle of the pack by another. It’s true that there are many variables to be considered, and that measuring quality is a tricky business. But one would hope that if we were getting close to observing something real about a hospital, most different scoring systems would lead to the same general conclusion.
The fact that this isn’t the case yet says to me that there is a lot of work to be done in standardizing scoring, developing transparency in the system, and removing hospital marketing efforts from objective data.
I am glad that we’re beginning to shine the light on institutional quality, but there is an elephant in the room. When it comes to good medicine, the most important factor is the individual healthcare provider.
I have personally witnessed outstanding medical care in the midst of hospitals with poor reputations, and I have observed horrific outcomes at top ranked hospitals as well. What made the difference? The provider taking care of the patient.
My insider perspective is that consumers are on the right track with physician ratings – worrying more about getting into the hands of a good doctor, than into the hands of the right hospital. But physician ratings can be dangerous – if left open to the public without any form of moderation or intelligent analysis, one patient with borderline personality disorder and a grievance could hijack the rating system and destroy a physician’s public reputation. Safeguards against that sort of behavior can and should be put in place.
The most helpful physician rating system will offer data from multiple sources (patient ratings, peer ratings, health plan ratings) and include sophisticated anti-sabotage algorithms. It’s also important for the ratings to be protected from self-interests (so that the physician herself doesn’t game the system and use it as a marketing tactic).
Rating quality care is complex, and there will always be a subjective element to it. Hospitals are run by flawed humans, healthcare providers make mistakes, and yet everyone wants the same thing: consistently excellent medical care.
And that will never happen – so long as humans are imperfect.
As Dr. Reece says,
Unfortunately, variable costs, variable quality, and variable outcomes
are a function of humanity, regional cultures and their constituencies.
Independent variables are part of the human condition. Some of these
variations may be beyond managerial control…
It’s going to take a while to establish criteria to judge and sort out
the good, the bad, and the ugly. Public disclosure of outcome data and
performance data on the processes of care may help, but they are only
part of a complicated human equation.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 20th, 2007 by Dr. Val Jones in Medblogger Shout Outs, News
Tags: Genetics, News, Parenting, Reproductive Endocrinology
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I was perusing Dr. Hsien Hsein Lei’s blog and noticed a link to a pretty interesting tool. Dr. Lei describes it as a “low tech paternity test” and it’s a probability calculator that relies on 3 traits: blood type, eye color, and ear lobe type. Yep, it’s sometimes possible to exclude certain father candidates based on these traits.
Apparently attached earlobes (that don’t hang) are a recessive trait, so if a child has unattached earlobes, both parents can’t have attached earlobes. And as far as eye color is concerned, two blue eyed parents can’t have a brown eyed child – so there’s some opportunity for exclusion there (I was interested to see that two dark brown eyed parents can have a blue eyed child, though it’s rather unlikely).
Did you know about the genetics of ear lobes? I learn something new every day.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 18th, 2007 by Dr. Val Jones in Medblogger Shout Outs
Tags: Humor, Personal
No Comments »
My friend Dr. Rob tagged me with the “8 random facts” meme. I’m supposed to list 8 little known facts about myself, and then tag 8 other bloggers to go and do likewise. Although I’ve never participated in chain mail, I’m a sucker for a good blog meme and will bite on this one.
Eight little known things about Dr. Val…
1. I once worked for a marketing research firm that regularly sent me and a camera crew to the homes of wet vac owners to videotape their home use technique. That was some entertaining videography, I can tell you.
2. I have 3 citizenships – US, Canada, and the UK
3. My dad once unionized a group of pickle factory workers, and was fired the next day.
4. I worked as a bartender in Manhattan while I was in medical school.
5. My car was hit by a drunk driver once, so I chased him down, forced him off the road and demanded his license and registration. Probably a dangerous move, but I was really angry.
6. As a child I wanted to grow up to be a Hollywood special effects artist. I still love to watch movies like Lord of the Rings and Alien because of the special effects.
7. I was a precocious little kid – when I was 6 years old my mother’s friend asked me what I wanted to be when I grew up. I said, “a philanthropist.”
8. I worked as a nanny in Quebec for a summer. The kids called me the “monstre de betteraves” (the “beet monster”) because I ate so many beets from their garden. They had a pressure cooker – and the fresh beets were so sweet and tasty! How could I resist?
Ok, well those are my 8 random facts… now I will nominate 8 bloggers to give me the dirt on themselves (if they’re up to the challenge):
Resilient Mom
Sandra Foschi
Dr. Glode
Dr. Silver
Dr. Brown
Dr. Hill
Dr. Herndon
Dr. Poceta
Let’s learn a little about each other, shall we?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 17th, 2007 by Dr. Val Jones in Medblogger Shout Outs
Tags: Medical Ethics, News
No Comments »
In response to recent concerns about healthcare blogging (potential privacy violations in particular), a group of bloggers got together to create the first Healthcare Blogger Code of Ethics. All health bloggers who agree to abide by the ethical principles listed in the code will be given the HBCE seal to display on their blogs. If anyone suspects the bloggers of violating that code, they can be reported to the HBCE website for further investigation.
I think this is a great step forward for health blogs – and a good reminder to respect confidentiality, transparency, and courtesy while blogging. To request a copy of the seal for your blog, please write to: healthcare.bloggers@gmail.com
Many thanks to Dr. Rob for taking the lead on this project. Also thanks to Medi-mation who worked on the logo with me.
The 5 principles:
- Clear representation of perspective – readers
must understand the training and overall perspective of the author of a
blog. Certainly bloggers can have opinions on subjects outside of their
training, and these opinions may be true, but readers must have a place
to look on a blog to get an idea of where this author is coming from.
This also encompasses the idea of the distinction between advertisement
and content. This does not preclude anonymous blogging, but it asks that even anonymous bloggers share the professional perspective from which they are blogging.
- Confidentiality – Medical bloggers must
respect the nature of the relationship between patient and medical
professionals and the clear need for confidentiality. All discussions
of patients must be done in a way in which patients’ identity cannot be
inferred.
- Commercial Disclosure – the presence or
absence of commercial ties of the author must be made clear for the
readers. If the author is using their blog to pitch a product, it must
be clear that they are doing that. Any ties to device manufacturer
and/or pharmaceutical company ties must be clearly stated.
- Reliability of Information – citing sources when appropriate and changing inaccuracies when they are pointed out
- Courtesy – Bloggers should not engage in
personal attacks, nor should they allow their commenters to do so.
Debate and discussion of ideas is one of the major purposes of
blogging. While the ideas people hold should be criticized and even
confronted, the overall purpose is a discussion of ideas, not those who
hold ideas.
Happy blogging!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
