February 28th, 2011 by EvanFalchukJD in Health Policy, Opinion, True Stories
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Media reports on misdiagnosis continue to mount. A recent study on patients with Alzheimer’s found that half had been misdiagnosed. Half.
Another headline blared “4 out of 10 patients being misdiagnosed.” The article encouraged patients to “see another doctor” if they are worried about their diagnosis.
You know what it makes me think about? Starbucks. Why? Because the way Starbucks revolutionized coffee drinking shows a way forward for healthcare.
Starbucks realized that since our lives focus on two places — home and work — most of us don’t have a “third place” to go. A place where we can be free of everyday distractions and take care of ourselves. Starbucks set out to create that “third place” by making its shops comfortable, inviting places. It works. “Third place” makes customers’ lives better — and Starbucks has almost 20,000 shops to prove it.
It’s time for a kind of “third place” in healthcare. Healthcare focuses on two places, too: The doctor’s office and the hospital. Both places are difficult for patients. Patients complain of not getting enough time from their overworked doctors, and studies of things that go wrong in hospitals are equally disturbing.
There really isn’t a “third place” to go to in healthcare. Somewhere that you can step outside of the difficult process of being sick. Somewhere you can get a quiet, clear perspective of what is going on.
Now, some people are lucky and can turn to relatives or friends who are doctors to provide some of that “third place” experience. But most people can’t. At Best Doctors, we’re creating the experience of a healthcare “third place.” We do it by taking the time to review each case, have doctors think about what’s happening, consult with experts, and share advice. Read more »
*This blog post was originally published at See First Blog*
February 19th, 2011 by KevinMD in Health Policy, Research
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The recurring narrative among health reformers is that hospitals that provide more care raise health costs, but don’t necessarily improve quality. This has lead to a backlash against so-called “aggressive” hospitals and doctors, with upcoming financial penalties to match. But the situation, as always, appears to be more nuanced than that.
In her column in the New York Times, Dr. Pauline Chen looks at one subset of patients who actually may benefit from aggressive care: Those who suffer surgical complications. The study,
found no difference in the rate of complications for aggressive and nonaggressive hospitals. But when they looked at all the patients who had complications and examined their outcomes, the researchers found that regardless of the urgency of their operations, those patients who were cared for at more aggressive hospitals were significantly more likely to survive their complications than those who had their operations at less aggressive hospitals.
In addition, the investigators found that characteristics associated with intensity of care treated surgical complications better:
… a hospital’s failure or success in treating surgical complications correlated consistently with factors that also characterized intensity of care — general expenditures, intensive care unit use and the total days of hospitalization — they found that benefits of this more aggressive care extended well beyond the time of the operation.
I constantly remind readers of this blog that more medicine isn’t necessarily better. The counter-intuitive findings from the Dartmouth Atlas study have been instructive in convincing patients that they are, in many cases, overtreated. Read more »
*This blog post was originally published at KevinMD.com*
December 24th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion
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Jenni Prokopy (aka Chronicbabe) put us to the challenge for this week’s Grand Rounds by asking for our 2011 clinical resolutions. I have to admit that I’m not one for resolutions because I can never take them seriously. But admittedly there are things that I need to tighten up. So here goes:
1. Clear my chart rack every afternoon. This is key because my creative mind operates better when my charts are done. Of course this means no more tweeting “47 charts” or “33 charts” when I’m behind. Had I made this resolution for 2009, this blog wouldn’t have a name.
2. Cultivate innovative communication channels with my referring docs. While I need to be consistent and compulsive with my referral letters, I want to improve mobile, real-time communications between me and my referring docs. For example I’d like to get my local community on Doximity so that I can launch a quick, HIPAA compliant, encrypted SMS messages on my iPhone the second I see a patient. Read more »
*This blog post was originally published at 33 Charts*
June 7th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Research
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The worst-kept secret in journalism circles recently was that the New York Times was planning an article critical of the Dartmouth Atlas. Among the main points in the article:
• “The mistaken belief that the Dartmouth research proves that cheaper care is better care is widespread.”
• “The atlas’s hospital rankings do not take into account care that prolongs or improves lives.”
• “Even Dartmouth’s claims about which hospitals and regions are cheapest may be suspect.”
• “Failing to make basic data adjustments undermines the geographic variations the atlas purports to show.”
The Times has also published the correspondence it had with the Dartmouth team about methodology questions.
The Dartmouth team challenges each of these criticisms. The team says the Times made at least five factual errors and several misrepresentations. They write:
“What is truly unfortunate is that the Times missed an opportunity to help educate the American public about what our research actually shows — or about the breadth of agreement about what our findings mean for health care reform.” Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
