July 22nd, 2011 by StevenWilkinsMPH in Opinion
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“I don’t have the time…I don’t get reimbursed for that.” This is an all too common refrain from primary care physicians and practice managers when ever the subject of improving physician-patient communications comes up.
I get it. Primary care physicians in particular are under tremendous pressure to produce. Just imagine…physicians in small primary care practices spend about 3.5 hours/week just on dealing with insurance-related paperwork. Then there’s keeping up with recommended treatment guidelines, journals, and IT issues and routine staffing issues…not to mention routine patient care, much of which they in fact do not get paid for. Physicians do have it rough right now.
But Doctors Can Sometimes Be Their Own Worst Enemies
Currently, in just about every State, Read more »
*This blog post was originally published at Mind The Gap*
July 16th, 2011 by Dinah Miller, M.D. in Opinion
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Dr. Maureen Goldman talks about self-disclosure for psychiatrists and brings the topic up in the context of Marsha Linehan’s recent announcement that she was treated for a psychiatric disorder as a teenager.
In Clinical Psychiatry News, Dr. Goldman notes:
Psychiatric care and psychotherapy are different from the Alcoholics Anonymous fellowship, where the mutual sharing of personal experience is an integral part of helping people maintain sobriety. I believe that there is middle ground between disclosing personal information and presenting myself as a blank slate. In my practice, I show myself to be a real person. I make mistakes and admit them. I joke about my poor bookkeeping skills and inferior technological skills. I look things up during sessions if necessary, and I tell patients when I need to do research or consult with a colleague. I treat them as real people, too, not just as patients.
I do not, however, share my own story. Mostly, I think that I can help people feel heard, understood, and known, and create a therapeutic plan without personal disclosure. I communicate that “I get it” without being clear that “I really get it.”
I cannot speculate about the motivation behind Dr. Linehan’s decision to allow her mental health history to be chronicled in the New York Times. The story was a very public disclosure, and in that way quite different from a disclosure made in the context of a one-on-one, doctor-patient therapeutic relationship.
We’ve talked in detail about self-disclosure before, and specifically about whether psychiatrists should tell their patients if they’ve suffered from a psychiatric disorder. See Read more »
*This blog post was originally published at Shrink Rap*
July 14th, 2011 by Bryan Vartabedian, M.D. in Opinion
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It’s the age of medical disconnect.
The disconnect describes the emotional and intellectual detachment that physicians feel from their patients and patients from their doctors. This disconnect is the result of a confluence of factors, some from within the profession itself, others are more broadly social and economic.
To understand the disconnect you need look no further than your neighbor or your parents. Dissatisfaction is evolving as the norm. Patients feel increasingly marginalized in their experiences with physicians. Shrinking length of visits, indifferent attitudes, poorly coordinated evaluations, difficulty obtaining test results, an institutional feel to the patient experience, and the overall sense of not feeling at all important.
The truth is that many of us are really not aware of the disconnect. Most of us have been born into a system of dysfunctional provider relationships and we know nothing else. As physicians we’ve been trained to be detached. As patients we’ve been conditioned to live happily detached.
Of course there are plenty of physicians who Read more »
*This blog post was originally published at 33 Charts*
July 12th, 2011 by EvanFalchukJD in Opinion
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The New York Times says “In Medicine, New Isn’t Always Improved.”
Who can argue with this?
“In Dining, New Restaurants Aren’t Always Better.”
Yes, that’s true, too. But does it mean anything?
The article is about a type of hip that is apparently going to be the focus of a lawsuit. The story goes that a lot of people wanted the new hip when it came out, because it was thought to be better than the older ones. Unfortunately, the hip seems to have hurt some people, some of whom may have been better off getting the older one in the first place.
A doctor quoted in the article suggests it’s part of a uniquely American tic. We want all of the latest and greatest things for ourselves, it seems. This story is supposed to be a cautionary tale of what can go wrong when we do.
On the other hand, the latest and greatest things don’t appear out of nowhere. In America, when people demand something, there will be someone who supplies it. Read more »
*This blog post was originally published at See First Blog*
June 28th, 2011 by Happy Hospitalist in Humor, Opinion
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You ever wonder what doctors really think but are afraid to say out loud? Here’s one example:
“I wish all my patients were on a ventilator”
There’s a reason vented and sedated patients are considered desirable. In addition to the obvious economic benefits of
There are the less talked about, but equally pleasant side effects most hospitalists, ER doctors, cardiologists, gastroenterologists, pulmonologists, surgeons, infectious disease doctors, endocrinologists, psychiatrists, rheumatologists, dermatologists, nurses, respiratory therapists and physical therapists wouldn’t admit, but would agree, without hesitation. As a general rule:
- Patients on ventilators are just faster, easier and more pleasant to take care of. Read more »
*This blog post was originally published at The Happy Hospitalist*
I get it. Primary care physicians in particular are under tremendous pressure to produce. Just imagine…physicians in small primary care practices spend about 3.5 hours/week just on dealing with insurance-related paperwork. Then there’s keeping up with recommended treatment guidelines, journals, and IT issues and routine staffing issues…not to mention routine patient care, much of which they in fact do not get paid for. Physicians do have it rough right now.
