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Patient Tests, EHRs, And Medical Homes: The Price Isn’t Right

Healthcare reform is forcing medical students to learn about the financial costs of the tests they order, as well as their clinical importance. Once a taboo topic, it’s being openly taught to students to prepare them for practice.

At Harvard, one physician in training duplicated television’s “The Price is Right” to keep his peers guessing at the costs of tests on a patient’s bill. Molly Cooke, FACP, a Regent of the College, encourages doctors to consider the value of the tests they order as they deliver care. (Kaiser Health News, New England Journal of Medicine)

The price isn’t right for electronic medical records. Even $44,000 in stimulus money isn’t enough to make doctors jump into using computers. Read more »

*This blog post was originally published at ACP Internist*

I’m Your Doctor, And I’m Worth It

Rx Vending MachineI saw the note on the patient’s chart before I opened the door: “Patient is upset that he had to come in.”

I opened the door and was greeted by a gentleman with his arms crossed tightly across his chest and a stern expression. I barely recognized him, having only seen him a handful of times over the past few years. Scrawled on the patient history sheet in the space for the reason for his visit were the words, “Because I was forced to come in.”

My stomach churned. I opened his chart and looked at his problem list, which included high blood pressure and high cholesterol –- both treated with medications. He was last in my office in November — of 2008. I blinked, looked up at his scowling face, and frowned back. ”You haven’t been in the office for over 18 months. It was really time for you to come in,” I said, trying to remain calm as I spoke.

He sat for a moment, then responded with very little emotion. “I’m doing fine. You could’ve just ordered my labs and called in my prescriptions. I don’t know why I had to be seen.” Read more »

*This blog post was originally published at Musings of a Distractible Mind*

The Value Of Social Media For Patients, Doctors And Nurses

A patient apologized to me for asking so many questions. “There’s no need to apologize,” I said to the patient, “It’s wonderful that you have so many questions concerning your healthcare.” I mentioned to her that she is an “empowered and engaged patient,” and that’s a good thing.

It’s no secret that health consumers are turning to the Internet for health information.

In a recent article from MediaPost News, Gavin O’Malley writes that, according to new a study by Epsilon Strategic & Analytic Consulting Group, “40% of online consumers use social media for health information — reading or posting content — while the frequency of engagement varies widely. According to the study, individuals who use healthcare social media fall into two broad groups: the 80% who are highly engaged patients, and take active roles in health management; and the 20% who lack confidence to play an active role in their own health.” Read more »

*This blog post was originally published at Health in 30*

Why Primary Care Doctors Are So Busy

There’s been a lot of commentary on a recent article from the New England Journal of Medicine, detailing the undocumented tasks that a typical primary care physician performs.

For those who haven’t read the piece, entitled, What’s Keeping Us So Busy in Primary Care? A Snapshot from One Practice, it’s available free at the NEJM website. I highly recommend it.

To summarize, primary care doctors are responsible for much more than seeing patients in the exam room. In the cited practice, which has a fairly typical makeup, physicians were responsible for an average of over 23 telephone calls and 16 e-mails per day. Many practices don’t engage their patients over e-mail, so it’s conceivable that the number of telephone calls is lower than average here. Read more »

*This blog post was originally published at KevinMD.com*

Patient Follow-Up: What Doctors Can Learn From Dentists

I have to give my dentist credit. He and his staff know when I am due for a cleaning and call me to schedule an appointment without fail. They also call to remind me the day before an appointment. Many dentists, I understand, do similar kinds of things for their patients.

As a patient, I like being reminded — it’s a great service. I also like the fact that someone’s looking out for me. From a business perspective it makes a lot of sense as well. Fewer “no shows,” more cleanings, more billings, and so on.

It’s too bad that more physicians don’t routinely follow up with their patients, particularly when it really counts. Read more »

*This blog post was originally published at Mind The Gap*

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…

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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…

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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…

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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…

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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…

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