July 14th, 2011 by Bryan Vartabedian, M.D. in Opinion
Tags: Connection, Detachment, Disconnect, Dissatisfaction, Doctor Patient Relationship, Doctors, Indifference, Medical Care, Patients, Removed
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It’s the age of medical disconnect.
The disconnect describes the emotional and intellectual detachment that physicians feel from their patients and patients from their doctors. This disconnect is the result of a confluence of factors, some from within the profession itself, others are more broadly social and economic.
To understand the disconnect you need look no further than your neighbor or your parents. Dissatisfaction is evolving as the norm. Patients feel increasingly marginalized in their experiences with physicians. Shrinking length of visits, indifferent attitudes, poorly coordinated evaluations, difficulty obtaining test results, an institutional feel to the patient experience, and the overall sense of not feeling at all important.
The truth is that many of us are really not aware of the disconnect. Most of us have been born into a system of dysfunctional provider relationships and we know nothing else. As physicians we’ve been trained to be detached. As patients we’ve been conditioned to live happily detached.
Of course there are plenty of physicians who Read more »
*This blog post was originally published at 33 Charts*
July 14th, 2011 by DrWes in Health Policy, Opinion
Tags: Automated, Contingencies, Contingency Plans, Digital, Digital Age, Electronic Medical Record, Manual, Power Outage
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* Bzzzzzaaaaapp *
Suddenly, the light went out. There was complete and utter darkness. Then, about 3 seconds later, the lights returned. My computer with its flat screen poised before me, remained dark. I hesitated a moment, then pushed the power button. Within a few more moments, the computer restarted. All seemed intact.
But what if it wasn’t?
Today with our myriad of computer systems, electronic medical records, e-mail messages, paging systems, digital xray machines, blood chemistry analyzers, automated blood pressure cuffs, etc., etc., etc., what would happen if we had no power or functional electronic medical record, just for a week?
Could our health system function?
We have entered the era when our medical students and residents have never entered a written order and “flagged it.” Our unit secretaries wouldn’t have a clue how to take off an order from a “flagged” chart. How would we order a stat portable chest xray without a computer? And what about our written notes. Would they include the date and time in the lefthand column, or would that be forgotten in our hurry to write our manual progress notes? Would our digital phone systems work? How about our pagers? Doctors can no longer find manual blood pressure cuffs on our wards since hospitals have moved to automated blood pressure cuffs that upload their readings into the electronic medical record automatically. Have our nurses and medical assistants lost the art of taking a manual blood pressure? Read more »
*This blog post was originally published at Dr. Wes*
July 14th, 2011 by GarySchwitzer in Opinion
Tags: AARP, Biospy, Cancer, Cecil B. Wilson M.D., CT Scan, Edward Patz Jr., Men's Health, Misleading, Screening, Smokers, Social Media, Tweet, Twitter, Unnecessary Procedure
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This is not a lesson about the limitations of 140-character messages on Twitter.
Rather, it is a warning about careless Tweets that mischaracterize the real meat of the message in longer stories linked to in the Twitter message. As I wrote on Twitter in response to these two episodes, “Better not to Tweet on complex health care topics than to mischaracterize your own story with a misleading 140 characters.”
First, my friend Andrew Holtz caught the fact earlier this week that Men’s Health Magazine tweeted:
If you’re a smoker, you NEED to get a CT scan. Here’s why: http://ow.ly/5x34y
That “here’s why” link took you to a Men’s Health Magazine story, that despite being headlined “The Medical Test Every Smoker Needs,” went on to explain:
Don’t run out and ask for a CT scan, though. More than 96 percent of the positive screens in the study were false positives, which could subject you to unnecessary surgery, cancer treatments, and the complications that come with them. They’re also expensive: A chest CT scan can cost up to several thousands of dollars.
So look at how silly Men’s Health looked on this confusing back-and-forth message:
1. You NEED to get a CT scan.
2. It’s a test “every smoker needs”
3. But don’t run out and ask for one.
Then this morning I caught AARP doing the same thing. They tweeted:
Are you a smoker? CT scan those lungs – they’re proven to cut risk of lung cancer death for 55-plus: http://aarp.us/rdleHu
That links takes you to a story that includes caveats such as the following: Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
July 14th, 2011 by RyanDuBosar in News, Opinion
Tags: CNN, Patient Reimbursement, Physician, Professionalism, Scheduling, Waiting, Waiting Room, Waiting time
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Patients are starting to bill doctors for making them wait, reports CNN.
“When he keeps patients waiting more than 15 minutes, Dr. Timothy Malia, a primary care physician in Fairport, New York, hands them a $5 bill. If patients in Eugene, Oregon, wait more than 10 minutes to see Dr. Pamela Wible, they receive a handmade soap or a bottle of lotion. When Dr. Cyrus Peikari, an internist in Dallas, recently had to miss a day of work because of a family emergency, he gave the patients whose appointments he canceled $50 at their next appointment.”
I’ve been kept waiting at doctors’ offices. I’ve been kept waiting as pharma reps walked past a full waiting room bearing plates of food. But I’ve also been kept waiting as doctors have handled other patients, undoubtedly more complex cases than mine.
Practice administrator and blogger Brandon Betancourt sums up the point nicely, and further extends the idea to every delay faced in life, such as toll booths on turpikes tied up with traffic.
I’ve also been squeezed into the schedule for emergency appointments, undoubtedly making someone else wait. And I’ve also been treated by phone on nights, weekends and holidays, and I’m not so sure that my primary care physician gets reimbursed for that.
So, kudos to those few physicians who respect their patients’ busy schedules enough to reward them. But I’m Read more »
*This blog post was originally published at ACP Internist*
July 13th, 2011 by Davis Liu, M.D. in Book Reviews, Opinion
Tags: Atul Gawande, Healthcare reform, How Doctors Think, Innovator's Prescription, Jerome Groupman, Medical Students, Shannon Brownlee
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I have had the privilege of working at an organization which is actively improving the lives of its members and also was mentioned by the President as a model for the nation. Over the past few years, I have also demonstrated to first year medical students what 21st century primary care should look and feel like – a fully comprehensive medical record, secure email to patients, support from specialists, and assistance from chronic conditions staff.
But as my students know, there are also some suggested reading assignments. I’m not talking about Harrison’s or other more traditional textbooks related to medical education. If the United States is to have a viable and functioning health care system, then it will need every single physician to be engaged and involved. I’m not just helping train the next group of doctors (and hopefully primary care doctors), but the next generation of physician leaders.
Here are the books listed in order of recommended reading, from easiest to most difficult. Combined these books offer an understanding the complexity of the problem, the importance of language in diagnosing a patient, the mindset that we can do better, and the solution to fixing the health care system.
Which additional books or articles do you think current and future doctors should know?
Overtreated – Why Too Much Medicine Is Making Us Sicker and Poorer Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
