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Cookbook Medicine: Using “Treatment Standardization” To Bar Doctors From Hospitals

Is the need for cookbook medicine being used as a ploy to bar cardiologists from practicing at competing hospital systems in Colorado? An excerpt from the Reporter Herald:

Banner Health, the owner of McKee Medical Center in Loveland and the operator of North Colorado Medical Center in Greeley, soon will bar cardiologists who are not on the Banner payroll from practicing at the Greeley hospital. The denial of hospital privileges to cardiologists outside the Phoenix-based Banner system is the latest step in carving up the heart of the Northern Colorado health care market, where two dominant hospital groups — Banner and Poudre Valley Health System — vie for shares. Read more »

*This blog post was originally published at Dr. Wes*

Health Insurance Goes Up For Doctors, Too

Physicians aren’t exempt from the struggles with personal health insurance coverage, affordability, denied coverage, etc.  

When I finished my medical training and opened my practice 20 years ago, I had to buy individual coverage. All options included a rider that excluded coverage on my uterus and ovaries due to fibroid surgery during my training, so when I had my TAH & BSO a few years later, the entire cost came out of my pocket. Fortunately I knew how to ask for cost reductions, but still.

My husband and I are both small business individuals. I have always carried our health insurance under my name (office). Over the years we have gone to a health savings account with a high deductible to keep the cost reasonable. Fortunately, we have been mostly healthy. Last month we received a letter from Assurant Health. Read more »

*This blog post was originally published at Suture for a Living*

When Patients Attack Doctors And Nurses

With the attention rightly focused on patient safety, what about healthcare workers? It’s somewhat of a hidden phenomenon, but attacks on doctors and nurses are on the rise.

Rahul Parikh writes about this in a recent Slate piece. He cites data from the Bureau of Labor Statistics, which found “healthcare workers are twice as likely as those in other fields to experience an injury from a violent act at work, with nurses being the most common victims.”

In the article, Parikh goes on to detail an attack on a physician who initially refused to give his patient opioid pain medications. Read more »

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

Box-Top Board Certification For Doctors

Remember when you were a child and an offer to be a member of a special spy club appeared on your morning cereal box? You knew — yes, KNEW — that the offer was the real deal. All you had to do is send in 3 cereal box tops and you’d be sent all the prerequisite items. Of course, when the plastic trinkets arrived weeks later, there always seemed to be the air of buzzkill when the reality of what you received for your efforts was revealed.

This could never happen with board certification for doctors, could it?

Yesterday we learned that this year every specialist has to recertify to maintain their status as a board-certified specialist. In the past, this was a voluntary process that doctors participated in to show a jury of their peers that they had the right stuff to practice medicine at the highest level possible. It was a respected term. Doctors generally knew that a board-certified specialist meant something.

Even though doctors pay thousands of dollars to the American Board of Internal Medicine for the opportunity to study for and take the certification exam, once passed doctors were proud to hang that certificate on their wall. In effect, it is the crowning achievement of one’s career.

But what if that certificate on the wall had the value of certificate purchased from a cereal box top spy club? Doctors might be pretty upset, right? Well guess what. Although the majority of those certificates hanging on the wall are the real deal, many are not. Read more »

*This blog post was originally published at Dr. Wes*

Medical Errors And Pager-Free Time For Doctors

When nurses sign out during the end of shift, it’s done so in a quiet setting. Contrast that to medical residents — at least when I was a resident 8 years ago — where pager interruptions during sign out were the norm.

PookieMD compares the situation to the “sterile cockpit” that airline pilots enjoy:

“Pilots have the sterile cockpit–a situation in which, if the plane is below 10,000 feet, only conversation directly relevant to flying is allowed. The rule was developed because take offs and landings are the most likely time a crash will occur, and take offs and landings occur below 10,000 feet. Simple enough, and it saves lives.”

Physicians enjoy no such luxury. Patient discussions with other doctors often take place in distracted settings, under the threat of a pager going off at any time.

Changing this, PookieMD argues, requires a cultural shift. As mentioned earlier, when nurses sign out, it’s sacred time. Doctors need something similar. Studies show that medical errors can arise during the patient hand-off to another physician. Signing out patients in an undisturbed setting may minimize the risk of poor communication, and subsequently, potential mistakes. “Page early and often needs to be replaced with ‘page urgently when appropriate,’” writes PookieMD.

Let’s see if hospital administrators have the courage to make this happen.

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

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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