Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Why Improved Patient Care Isn’t “In The Chart”

Why do we physicians chart the way we do? Hopefully, we do it perfectly well and have no concerns at all. But where I practice emergency medicine, we are approaching maximum inefficiency in charting.

It all became much clearer when we started using our new EMR system. Let me make it clear, I’m not against EMR. In fact, typing and templates work better for me than dictating. My dictations were usually a mine field of blanks and misunderstood words.

Furthermore, if I wanted to use it, we have a new voice recognition dictation system in addition to our templated chart. Though admittedly, the voice recognition program clearly hates some of my partners, as evidenced by the way they grasp the screen and yell at it (‘Chest Pain, not west rain!’) and by its inexplicable use of profanity in the occasional chart.

But I digress. The problem as I see it is the evolution of the medical record. Why does the medical record exist? Read more »

*This blog post was originally published at*

Voice Transcription Adventures With A Southern Accent

The patient has fluferculosis, buperculosis, conbumption, arg!

The patient has fluferculosis, buperculosis, conbumption, arg!

I’ve dictated charts since I started private practice 16 years ago.  Although I like to think that I’m pretty good with the English language, it turns out that when I speak it, I mumble, slur and frequently dictate things that make no sense to the transcriptionist.

A standard chart for me might look like this:

‘This 44-year-old_____ complains of several days of ______ severe in the_______right______explosive and sudden in quanset.  (Unable to understand physician)….and stated that she(he) {please clarify} would not be short of ______ usually has no pain in _____ when she (he) falls onto the crown?’

Now, this is difficult enough, as you might expect.  And  often worse when I’m finishing a night shift, and the chart says ‘the patient is awake, alert and sleeping quietly at discharge,zzzzz.’

But voice transcription takes it to a new level.   Read more »

*This blog post was originally published at*

A Cheating Radiologist

via The Trial of a WhiteCoat – Part 14.

The radiologist that read the film had a habit of going to the surgeons the following day and asking them what they had found. He would open up a blank report so that it looked as if it was dictated at the time of the exam, but would then hold the reports as “preliminary” and finalize them after dictating in the results of the surgeries. That way it looked like he had picked up on all these small findings before anyone else knew about them. He was a decent radiologist, so no one seemed to mind that he was adding all these findings after the fact. Now it burned me.

I’m offended.


That’s too light.

I’m pissed off as hell.

I believe the Americans call this kind of thing “Monday morning quarterbacking.”

Whatever you might call it, this is cheating in my book.

I don’t know why they let that radiologist get away with this kind of behaviour.

Moreover, I can’t believe that anyone would take the man’s reports seriously, leave alone the surgeons that he got information from. If by chance I was a surgeon in that hospital, I would intentionally throw him red herrings.

In case you haven’t been following Whitecoat’s account of his malpractice case, see previous posts of his epic saga here. Far better than reading any crime/legal thriller, cheap or otherwise. John Grisham could take lessons from Whitecoat.

*This blog post was originally published at scan man's notes*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »