July 27th, 2011 by Happy Hospitalist in Health Policy, Opinion
Tags: Convenience, Convenience Creep, Critical Lab Values, Discharge, Doctor-Doctor Communication, Doctor-Nurse Communication, Hospital Communication Protocol, Hospitalist, Medications, Nurses, Patient Safety, Physician Responsibility
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A physician asked me a question regarding what should be the role of hospitalists in carrying out discharge orders written by other physicians.
I have been following your blog since I was a resident and recommend it to a lot of people. Thank you so much for enlightening me on so many day to day hospital issues. I wanted to know your opinion about something that puzzles me. When a specialist changes a medication or requires a lab to be done as outpatient after a discharge order is written (for example you write: okay to D/C if okay with cardiology, and they change a dose or request stress test out-pt) who is required to write the new scripts and arrange that test? Is it the hospitalist’s responsibility to do it? Or is the specialist who changed the dose after you rounded required to handle it? It was easier during residency due to abundance of residents/fellows and the fact it was electronic RX access. What are your thoughts? As so far I always return back and make the adjustments needed for the patient welfare, and the fact I don’t know whether I should take stance and request that physician to do their job.
Dear physician, there is nothing puzzling here. It’s black and white. Read more »
*This blog post was originally published at The Happy Hospitalist*
July 27th, 2011 by Elaine Schattner, M.D. in News, Opinion
Tags: Academic Requirements, Analytical Thinking, Education, Ethical Thinking, Interviews, MCAT, Med School Applicants, Medical Education, Medical Ethics, Medical School, Multiple Mini Interview, New York Times, Science
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Recently the Times ran a leading story on a new med school admission process, with multiple, mini-interviews, like speed dating. The idea is to assess applicants’ social, communication and ethical thinking (?) skills:
…It is called the multiple mini interview, or M.M.I., and its use is spreading. At least eight medical schools in the United States — including those at Stanford, the University of California, Los Angeles, and the University of Cincinnati — and 13 in Canada are using it.
At Virginia Tech Carilion, 26 candidates showed up on a Saturday in March and stood with their backs to the doors of 26 small rooms. When a bell sounded, the applicants spun around and read a sheet of paper taped to the door that described an ethical conundrum. Two minutes later, the bell sounded again and the applicants charged into the small rooms and found an interviewer waiting. A chorus of cheerful greetings rang out, and the doors shut. The candidates had eight minutes to discuss that room’s situation. Then they moved to the next room, the next surprise conundrum…
This sounds great, at first glance. Read more »
*This blog post was originally published at Medical Lessons*
July 27th, 2011 by Lucy Hornstein, M.D. in Humor, Opinion
Tags: Business Enterprise, Coders, Electronic Medical Records, EMR, Quality Control, Sales, Standards, Support Staff, United States Healthcare System
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Many people ask why the United States, unlike other countries, has no national system of electronic medical records.
Here’s why:
Insert the number 576 instead of 14, by the way. Each of which Read more »
*This blog post was originally published at Musings of a Dinosaur*
July 27th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
Tags: Chronic Disease, Chronic Disease Treatment, Diabetes, Diabetes Mellitus, Disease Management, Healthcare Costs, Healthcare spending, High Blood Pressure, Hyperchloesterolemia, Hypertension, Insurance Companies, National Institute for Healthcare Management Foundation, Obamacare, Obesity, Patient Responsibility, Self-reliance
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The National Institute for Healthcare Management Foundation is a nonprofit, nonpartisan organization focused on healthcare. The foundation just published an excellent report on the distribution of healthcare costs in the population.
The results indicate that reducing healthcare cost is all about reducing and managing chronic diseases.
U.S. healthcare spending has sharply increased between 2005 and 2009 by 23 percent from $2 trillion to $2.5 trillion per year.
This is a result of a combination of factors. Chief among them is the increasing incidence of obesity.
Who spends the money? Read more »
*This blog post was originally published at Repairing the Healthcare System*
July 26th, 2011 by DavedeBronkart in Opinion
Tags: Auto-immune disease, Availability, Emergency Room, Facebook, Facebook Friends, HealthisSocial, Kawasaki Disease, Life Saving, Phil Baumann, Social Networking
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“Health is social,” says SPM member Phil Baumann, RN (@PhilBaumann) at HealthIsSocial.com.
Slate has a dramatic story of how a mother’s Facebook network helped spot – rapidly – Kawasaki Disease, a rare auto-immune disease that the family’s doctors had initially missed.
Her social network contains some medically knowledgeable people. (Do you have any docs, nurses, etc in your Facebook circle?) Note that friends’ availability is sometimes far greater than a doctor’s office.
Read how the diagnosis unfolded. And read what her family physician said, when she called from the E.R.:
“You know what?” he said, “I was actually just thinking it could be Kawasaki disease. Makes total sense. Bravo, Facebook.”
Then this, as the crisis wound down: Read more »
*This blog post was originally published at e-Patients.net*
