September 4th, 2010 by BarbaraFicarraRN in Better Health Network, Health Tips, Opinion, Research
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From Kevin Pho’s medical blog, KevinMD, a post archived from 2004, Pho talks about the struggles of communication between doctor and patient during the 15-minute office visit.
Pho sites a New York Times article that explains that more than two decades ago, research shows that patients were interrupted 18 seconds into explaining their problem (on average) and less than 2 percent got to finish their explanations.
Pho sites that he sometimes falls into the “interruption trap,” saying: “I think this is a natural progression to our managed care environment. Physicians are compensated by quantity of patients seen, and are kept to a strict schedule -– in most cases every 15-minutes.” Read more »
*This blog post was originally published at Health in 30*
September 1st, 2010 by Toni Brayer, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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In a surprising report from the Archives of Internal Medicine, we learn that most hospitalized patients (82 percent) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted.
If that isn’t enough, when the researchers queried the physicians, 67 percent thought the patients knew their name and 77 percent of doctors thought the patients “understood their diagnoses at least somewhat well.” I would call that a pretty significant communication gap.
Ninety percent of the patients said they received a new medication and didn’t know the side effects. Although 98 percent of physicians thought they discussed their patients’ fears and anxieties with them, only 54 percent of patients thought they did. Read more »
*This blog post was originally published at ACP Internist*
August 27th, 2010 by RamonaBatesMD in Better Health Network, Health Policy, News, Opinion
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Recently the [state of] New York signed a law requiring hospitals and doctors to discuss breast reconstruction options with the patient prior to her undergoing cancer surgery. It troubled me that this law was needed. Is it not the duty of the physicians and surgeons to educate the patient on the options available?
We need to make sure the patient and their family know of the treatment options which may vary depending on the diagnosis and stage: Radiation, chemotherapy, surgery (lumpectomy, mastectomy, axillary dissection) — a combination of treatments.
Even if the patient and her physicians don’t chose to do immediate reconstruction, isn’t the discussion and information part of the discussion? At least inform the patient of the option.
Do we physicians and surgeons need another law to ensure we do right by our patients? Read more »
*This blog post was originally published at Suture for a Living*
August 25th, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
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My recent post on the subject of email from patients raised more eyebrows than I expected. It also put me in a position I’m unfamiliar with: Looking like a luddite.
Perhaps I’m not forward-thinking enough in my reluctance to embrace this advance. Perhaps I’ve gotten conservative as I’ve grown grey. Electronic communication is a great idea (I’m doing it right now), so why not apply it to my medical practice? Has Ned Lud gotten into my circle of influence?
This is, of course, extremely ironic. I lived so much on the cutting edge that my butt developed calluses. The calluses, however, were not just put there by the edge, they also came from occasional kicking.
The problem is I have an addiction: I’m addicted to change. I’m constantly looking for new and perhaps better ways to do things, then impatiently going after anything new and shiny. This served us well in the sense that I got us on EMR, got it working well, and have continued to keep us away from repeating mistakes too often. If something doesn’t work, I’m quick to look for the cause, and more importantly, how to fix it. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
August 23rd, 2010 by StevenWilkinsMPH in Better Health Network, Health Policy, News, Opinion, Research
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Accountable Care Organizations (ACOs) figure prominently in the new Patient Protection and Affordable Care Act (PPACA). The concept behind ACOs is that by tying both physician and hospital compensation to outcomes via a bundled fee (say for pneumonia) we can expect to see an improvement in quality and value.
In principal, accountable care makes a lot of sense. Practicality speaking, however, doctors and hospitals must address a huge challenge before they can expect benefit financially. Before doctors can be held accountable for the care they deliver, they must first be held accountable for the quality of their communication with patients.
Take hospital readmissions, which are a big healthcare cost driver today. According to a recent study in the New England Journal of Medicine, 20 percent of all Medicare patients discharged from hospitals were readmitted within 30 days, and 34 percent percent within 90 days. The Joint Commission and others rightly believe that inadequate communication between physicians — as well as between physicians and patients — is a major contributing factor. Read more »
*This blog post was originally published at Mind The Gap*
