September 10th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion, True Stories
Tags: Caring For Patients, Doctors' Pay, Dr. John Mandrola, Dr. Saul Greenfield, General Medicine, Less Compensation, Loss of Physician Autonomy, Physicians' Salaries, Uniformity of Medical Practice, Wall Street Journal
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“Ouch! That really hurts! You win, please stop torquing my arm behind my back. “Uncle! I said, Uncle!!”
Yes, the threshold has been reached. We docs no longer need a tennis court or a Mercedes, our kids are fine in public schools, and we will happily buy our own damn pens.
But, please, just give us some modicum of autonomy. Throw us a measly scrap and let us take care of our patients as we see best. Like Dr. Saul Greenfield so beautifully said today in the Wall Street Journal. The paragraph that stood out the most for me is as follows:
Physician autonomy is a major defense against those who comfortably sit in remote offices and make calculations based on concerns other than an individual patient’s welfare. Uniformity of practice is a nonsensical goal that fails to allow for differing expression of disease states.
Really, it isn’t hyperbole to surmise that the overwhelming majority of doctors would decide, if faced with a choice between less compensation and less autonomy, to choose less compensation.
As a teen my dad told me the best part of being a doctor would be the autonomy. He was right, and that’s what hurts the most these days.
JMM
*This blog post was originally published at Dr John M*
September 10th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
Tags: Avoiding Preventive Screenings, Cervical Biopsies, Cervical Cancer Screening, Colposcopies, International Health Policy, Jade Goody, National Health Campaign, Obstetrics And Gynecology, Oncology, Pap Smears, Preventive Healthcare, Preventive Medicine, Public Health Initiative, WHO, Women's Health, World Health Organization
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The Telegraph reports that the number of screening pap smears performed in the UK has declined after an 8 percent blip upwards in 2009 when publicity surrounding the death of Jade Goody from cervical cancer may have led more women to have this important screening test:
NHS laboratories processed 415,497 tests in 2009-2010, about 35,000 fewer than the previous year when 450,522. Miss Goody’s death in March last year prompted a 20 percent increase in the number of Scottish women taking tests. More than 122,000 were processed between April and June last year, the statistics revealed.
The irony of course, is that British reality TV star Jade Goody did have pap smears, but chose to ignore her doctor’s recommendations for treatment when her pap smears came back abnormal.
Nonetheless, the decline in pap smears has led NHS of Scotland to initiate a campaign to reach the up to 25 percent of young women who do not respond to invitations to have pap smears. Read more »
*This blog post was originally published at tbtam*
September 10th, 2010 by BarbaraFicarraRN in Better Health Network, Health Policy, Health Tips, Opinion
Tags: Allied Healthcare Workers, Barrier To Patient Care, Compromising Patient Care, Doctor-Nurse Relationship, Doctor-Nurse Team, General Medicine, Influencing Patient Care, Medical Staff, Medicine Is A Team Sport, Nurse-Doctor Communication, Successful Patient Care, Team-Based Patient Care, Teamwork In Medicine
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Some patients struggle to communicate effectively with their doctors and some doctors and nurses find it difficult to communicate and collaborate with each other.
Historically, the dynamic symbiotic relationship between doctors and nurses has been a little shaky, evidenced by the lack of engagement and respect for one another.
Hospitals are chaotic and stressful. Working in such an environment can lead to frustration and it can take a toll on the staff. Instead of a good working relationship (which may never have been fostered to its full potential from the start), doctors and nurses become a fractured team. As a result, the fractured team will not effectively communicate and patient care may suffer devastating consequences. Read more »
*This blog post was originally published at Health in 30*
September 10th, 2010 by DavedeBronkart in Better Health Network, Health Policy, Health Tips, Opinion
Tags: E-Patients, e-Patients.net, ePatient Dave, General Medicine, Medical Error Reduction, Medical Mistakes, Open Discussion, Open School of the Institute for Healthcare Improvement, Paticipatory Medicine, Patient-Caregiver Partnership, Patient-Doctor Relationship, Patients Injured From Medical Errors, Prefection In Medical Practice
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The “Running A Hospital” blog has another discussion of dealing with medical error. This time, the hospital has opened up an error of its own (a “wrong side” surgery) for examination by the Open School of the Institute for Healthcare Improvement (IHI).
Sample comments:
— From IHI’s Jim Conway: “Our systems are too complex to expect merely extraordinary people to perform perfectly 100 percent of the time. We as leaders must put in place systems that support great practice by people who suffer from being human and will make mistakes.”
— From a patient who had two surgical errors in ten months: “After years of suffering through our incredibly brutal tort(ure) system I finally had the chance to talk to the surgeon. The most meaningful words he spoke were the descriptions of how badly he suffered also from the event we shared in that OR. Finally I was not alone!”
As we’ve often said, participatory medicine brings a new kind of partnership between patient and caregiver. Neither denial nor a Wall of Silence (famous book) has any place in a healthy relationship. It breaks my heart to think of the good lives that are ruined by our cultural inability to deal with honest errors in complex situations.
Yes, as Linda Kenney of MITSS mentions in a comment, some employees (in any industry) are reckless and must be weeded out. That too can be a denial issue. But first, we need open discussion.
*This blog post was originally published at e-Patients.net*
September 10th, 2010 by DrRich in Better Health Network, Health Policy, Health Tips, Opinion, Research
Tags: American College of Cardiology, Athlete's Health, Athletic Screening Program, Dr. Douglas Zipes, ECG, Echocardiography, Electrocardiogram, Exercise-Induced Sudden Death, Hypertrophic Cardiomyopathy, Premature Death, Preventable Death, Preventive Medicine, Routine Cardiac Screening, Sports Medicine, Sudden Cardiac Death, The New York Times, Young Athletes
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It’s the dog days of what seems to have been an unusually hot summer (though DrRich does not know whether it has been sufficiently warm to affect the global cooling trend we’ve been in for the past decade), and as is all too common at this time of year, we are seeing extraordinarily heartbreaking stories (like this one) about healthy, robust young athletes dying suddenly on the practice fields.
Most of these tragic sudden deaths are due to a heart condition called hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy often does not produce any symptoms prior to causing sudden death. But it can be easily diagnosed, before exercise-induced sudden death occurs, by screening young athletes with electocardiograms (ECGs) and echocardiography.
A couple of summers ago, the New York Times wrote about such an athletic screening program at the University of Tennessee. Based on the U of T’s results, “cardiologists and other heart experts say that the screenings could help save the lives of the 125 American athletes younger than 35 who die each year of sudden cardiac death.” Read more »
*This blog post was originally published at The Covert Rationing Blog*
