September 11th, 2011 by DrWes in Health Policy, Opinion
Tags: Affordable Care Act, Central Patient Safety Authority, Do Not Disturb, Drug Rounds, Government-directed health care, Health Care Reform, Lowering Cost, medicaid, Medicare, Medications, Nurses, Quality, Quantity, uninsured
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It was supposed to be one of a series of “measures to improve safety, reliability, patient experience, staff satisfaction and efficiency of medicine management.” Instead, the wearing of red “tabards” by nurses that read “Do Not Disturb” while they distributed medications has proven to be the straw that broke the camel’s back in England. While the “Do Not Disturb” message on the tabards was replaced with a message that reads “Drug Round in Progress,” isn’t the message the same?
Directive Number 99365.23a: “In the Name of Safety, Do Not Bother Me While I Hand Out Medications.”
It seems almost too incredible to believe and yet, this is how it’s playing out now in England’s National Health Service. Read more »
*This blog post was originally published at Dr. Wes*
September 11th, 2011 by Happy Hospitalist in Health Policy, Opinion
Tags: Age, Cancer, Cancer Diagnosis, Cancer Treatment, decision-making, Elderly, ER Doctor, Hospitalist, Internist, Lawsuit, Malpractice, Missed Diagnosis, Old, Risk
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Missed Diagnosis Lawsuit and the Dynamics of Age Related to Risk
Years ago I had the opportunity to care for Mr Smith, a 101 year old man who presented to the hospital with chest pain and shortness of breath. Besides having 101 year old heart and lungs that tend to follow their own biological clock, this man also had a massive chest tumor filling 85% of one side of his thorax.
Whoah really? What does that mean in a 101 year old man? Most folks this age have exceeded the normal bell curve distribution of life and disease. When you reach 101 years old, there isn’t a lot of chronic anything you can catch with the expected time you have left on earth.
Every now and then, however, we find patients who are the exception to the rule, such as the 101 year old guy that present with a new cancer diagnosis. That’s where being an internist comes in handy. Read more »
*This blog post was originally published at The Happy Hospitalist*
September 10th, 2011 by Davis Liu, M.D. in Opinion
Tags: Apple, Atul Gawande, Doctor Patient Relationship, Harvard Medical School, Health Care System, Healthcare reform, Information Technology, Inspiration, John Wooden, Mentor, Redefining Health Care, Steve Jobs
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I’ve been reading A Game Plan for Life: The Power of Mentoring written by famed UCLA basketball coach John Wooden. Wooden spends half of his book thanking the people who had a powerful influence on his life, coaching, philosophy, and outlook on life. Important people included his father, coaches, President Abraham Lincoln, and Mother Theresa.
Yes, President Abraham Lincoln and Mother Theresa.
Though clearly he could have never met the former and didn’t have the opportunity to meet the latter, Wooden correctly points out that as individuals we can be mentored by the writings, words, and thoughts of people we have never and will likely never meet.
Which seems like the most opportune time to thank one of my mentors, founder and former CEO of Apple, Steve Jobs.
Now, I have never met nor will I ever meet Steve Jobs. Lest you think I’m a devoted Apple fan, I never bought anything from Apple until the spring of 2010. Their products though beautifully designed were always too expensive. I’m just a little too frugal. I know technology well enough that people have mistaken me for actually knowing what to do when a computer freezes or crashes. Yet, the value proposition was never compelling enough until the release of the first generation iPad. Then the iPhone 4. Finally the Macbook Air last Christmas.
No, thanking Steve Jobs isn’t about the amazing magical products that have changed my life as well as millions of others. It’s more than that. What he has mentored me on is vision, perspective, persistence, and leadership. Nowhere is this more important than the world I operate in, the world of medicine. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
September 9th, 2011 by John Di Saia, M.D. in Opinion
Tags: Blame, Causation, Cosmetic Surgery, Fault, Infection, Long term problems, Malpractice, Patient Choice, Plastic Surgery, Surgeon
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When things are done properly, infection is pretty uncommon in a plastic surgery practice. Surgery and infection are unfortunately related however and will co-exist at least occasionally even when everything is done correctly. This is just a fact of life.
People interestingly enough seem to believe that an infection is evidence of malpractice. Infection can be present when malpractice has occurred but by itself is not evidence of anything.
Minor infections can often can be treated and cause no long term problems. More serious infections can Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
September 9th, 2011 by Bryan Vartabedian, M.D. in Opinion
Tags: 21st century medicine, Artificial Intelligence, Clayton Christensen, Endemic Insecurity, Evidence Based Medicine, health care, Intuition, Intuitive Medicine, Precision Medicine, Predictive Care, The Innovator's Prescription
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In The Innovator’s Prescription Clayton Christensen details how technology is disrupting health care. He describes the provision of medical care as occurring on a spectrum ranging from intuitive medicine to precision medicine. Intuitive medicine is care for conditions loosely diagnosed by symptoms and treated with therapies of unclear efficacy. Precision medicine is the delivery of care for diseases that can be precisely diagnosed and with predictable, evidence-based treatments. Intuitive medicine is almost entirely dependent upon clinical judgment. Precision medicine not as much. 19th century medicine was intuitive; the 21st century will prove precise.
When we think about our role as doctors, we like to see ourselves as providers of intuitive medicine. It’s how we were all trained – products of 20th century mentoring. And so we see of ourselves just as indispensable as we were 100 years ago. But as medicine makes its march toward predictive care all of this will change.
There’s an endemic insecurity among the 21st century doctors: Read more »
*This blog post was originally published at 33 Charts*
