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All Patients Are Empowered: And Other Myths About The E-Patient

Irrational exuberance was a term once used to describe the stock market before the last crash.  It also seems an apt description for much of the talk these days about empowered health consumers.

To be sure, patients today have unprecedented access to health information.  Patient decision-support tool can be found on just about every provider, payer and self-insured employer website.  Consumers can go to any number of websites to find quality data about hospitals, physicians and health plans.  Personal health records (PHRs) promise to make our personal health data portable for meaning that all our treating physicians will be “singing off the same song sheet.”

That’s what the industry experts tell us.  But what’s really going on?  Here I will describe what I see as the top 5 myths about empowered health consumers. Read more »

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

Can Physician De-Skilling Be Attributed To The Use Of EMRs?

Turns out there is an unintended consequence of many of the current efforts to standardize the way doctor’s practice medicine.  It is called de-skilling.  De-skilling can occur when physicians and other providers try to adapt to standardized, new ways of doing things.  Examples of such standardization include clinical based care guidelines, electronic medical records (EMRs), Pay for Performance (P4P), Patient Centered Medical Home (PCMH) requirements and so on.

Examples of physician de-skilling were revealed in a recent study which consisted of in-depth interviews with 78 primary care physicians regarding EMR use.  EMRs are all about standardization – what data is captured and recorded, how data is reported, how data is used, and so on.

Over the course of the interviews, physicians in the study described significant examples of de-skilling behavior.  Most indicated  that Read more »

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

Improving Doctor-Patient Communication To Provide Patient-Centered Care

The first experience patients are likely to have with your hospital is not in an ER visit or inpatient stay.  A patient’s first experience will most likely be in one of your primary-care physician offices.  That because a person is 10 times more likely during a year to end up in the physician’s office for a routine visit than they are to require an overnight hospital stay.

As a hospital marketer or patient experience officer this should raise an interesting question. How well do your physicians–particularly your primary-care physicians–represent your brand?

Take “patient-centeredness.” Lots of hospitals these days are promoting themselves as providing patient-centered care.  You know … when the hospital and its staff try where possible to be sensitive to and honor the wishes of patients.   But when it comes to patient-centeredness, “walking the talk” is hard in physician offices and even tougher in the hospital.

The fact is that most physicians, with some exceptions, are Read more »

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

Interaction With A Patient Shows Physician A Major Transition In Medicine

Sometime around 1998 in the Texas Medical Center:

DrV: (enters exam room) Hey, How are you? I’m Bryan Vartabedian (extends hand).

Father: (arms crossed, smiling, leaning against wall) Oh I know who you are, Doc.  And I know where you went to school, where you’ve lived, if you’ve been sued and a few other things. And I’m fine, by the way.

DrV: Um, Okay. (Shakes hands with father. Looking to child, scruffing his hair).  And this must be Caleb.

An odd moment, for sure. When it happened I didn’t know what it was about. After similar encounters I understood.  It was about where patients found themselves in the early days of the information revolution.  And there was the father who wheeled into the exam room two large boxes of printouts perched on a dolly.  Inkjet validation of his role in the decision about his son’s surgery.

These situations illustrate Read more »

*This blog post was originally published at 33 Charts*

Financial Concerns Are Not The Primary Barrier To Health Care In America

It’s not just about money – Americans Face Barriers to Health Care Beyond Cost.  A study released recently in Health Services Research found that while financial concerns prevent 18% of Americans from getting needed health care, more Americans – 21% – delay health care for nonfinancial reasons.  These barriers include getting to the doctor, getting a timely appointment and taking time out of other responsibilities.  Lead author Jeffrey Kullgren, M.D. adds what he believes is the crux of the issue: “We need to think about how to organize the existing resources we have in ways that are going to improve access to care.”

In Would You Lie to Your Own Doctor?, Connie Midey of The Arizona Republic reports on a common practice that can “compromise [doctors’] ability to diagnose and treat patients effectively.”  The reason? Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

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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