December 2nd, 2010 by KevinMD in Better Health Network, News, Opinion
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Medical students today consider lifestyle an essential criteria when choosing a specialty. It’s become a cliche that most are looking towards the ROAD (radiology, ophthalmology, anesthesiology and dermatology) to happiness.
There’s been some recent media attention at how women are lured to specialties that offer a greater balance between their family lifestyle and professional demands. Claudia Golden, a Harvard economics professor, recently noted that,
high-paying careers that offer more help in balancing work and family are the ones that end up luring the largest numbers of women. Surprisingly, colon and rectal surgery is one of these, because of rapid growth in routine colonoscopies that can be scheduled in advance, giving doctors control over their time. Goldin says 31% of colon and rectal surgeons under 35 years of age were female in 2007, compared with only 3% of those ages 55 to 64, and 12% of those ages 45 to 54, reflecting the fact that younger women are flocking to the field.
Of course, what’s not said is the grueling training that it takes to become a colorectal surgeon — but the numbers cited above do not lie. The new generation of doctors — both men and women — want greater control of their time. That means more shift-work and a predictable call schedule. Read more »
*This blog post was originally published at KevinMD.com*
November 27th, 2010 by KevinMD in Better Health Network, News, Opinion, Research
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The following op-ed was published on October 27th, 2010 in USA Today:
When I ask new patients how they found me, frequently they say on the Internet through search engines such as Google.
Out of curiosity, I recently Googled myself. Numerous ads appeared, promising readers a “detailed background report” or a “profile” of me. Among the search results was information about my practice, whether I was board certified, had any lawsuits against me, and reviews from online doctor rating sites. Thankfully, most were favorable, but some were not.
Can patients reliably choose a good doctor online?
People already choose restaurants, movies, and their college professors based on what they read on the Internet, so it’s inevitable that many will research their doctors on the Web as well. But there are some good reasons consumers should be wary of the information they find online about doctors.
Random information?
An Archives of Internal Medicine study in September found that most publicly available information on individual physicians — such as disciplinary actions, the number of malpractice payments, or years of experience — had little correlation with whether they adhered to the recommended medical guidelines. In other words, there’s no easy way to research how well a doctor manages conditions such as heart disease or diabetes. That kind of relevant performance data are hidden from the public. Read more »
*This blog post was originally published at KevinMD.com*
November 24th, 2010 by BarbaraFicarraRN in Better Health Network, Health Tips, Opinion
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Do you feel patients are the most important part of the medical (healthcare) team?
In a recent post on Health in 30, “When Doctors and Nurses Work Together,” I wrote about the team-based approach for caring and treating patients, and it addressed the relationship between nurses, doctors, patients and the importance of a multidisciplinary, team-based approach to patient care.
The healthcare team is comprised of a diverse group of specialized professionals, and the most important part of the medical team is the patient.
Subsequent to publishing this post, I received an email from an author and patient advocate stating that patients are not the most important member of the medical team. I value and respect this comment, however I politely and passionately disagree. As a registered nurse and consumer health advocate, I emphatically say that patients are the most important part of the medical team. Read more »
*This blog post was originally published at Health in 30*
November 20th, 2010 by KevinMD in Better Health Network, Health Policy, News, Research
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Hospitals have recently been stepping up their infection control procedures, in the wake of news about iatrogenic infections afflicting patients when they are admitted. Doctors are increasingly wearing a variety of protective garb — gowns, gloves, and masks — while seeing patients.
In an interesting New York Times column, Pauline Chen wonders how this affects the doctor-patient relationship. She cites a study from the Annals of Family Medicine, which concluded that,
fear of contagion among physicians, studies have shown, can compromise the quality of care delivered. When compared with patients not in isolation, those individuals on contact precautions have fewer interactions with clinicians, more delays in care, decreased satisfaction and greater incidences of depression and anxiety. These differences translate into more noninfectious complications like falls and pressure ulcers and an increase of as much at 100 percent in the overall incidence of adverse events.
Hospitals are in a no-win situation here. On one hand, they have to do all they can to minimize the risk of healthcare-acquired infections, but on the other, doctors need to strive for a closer bond with patients — which protective garb sometimes can impede. Read more »
*This blog post was originally published at KevinMD.com*
November 15th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion
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The bipartisan debt commission appointed by President Obama recently released its recommendations on how to pare the country’s debt.
Of interest to doctors is the suggestion to change the way doctors are paid. Physician lobbies have been advocating for removal of the Sustainable Growth Rate (SGR) formula — the flawed method by which Medicare, and subsequently private insurers, pays doctors. According to this method, physicians are due for a pay cut of more than 20 percent next month.
According to the commission:
The plan proposes eliminating the SGR in 2015 and replacing it with a “modest reduction” for physicians and other providers. The plan doesn’t elaborate on what constitutes a “modest reduction” in Medicare reimbursement.
Meanwhile, the Centers for Medicare and Medicaid Services (CMS) should establish a new payment system — one that rewards doctors for quality, and includes accountable care organizations and bundling payments by episodes of care, the report said.
The commission also said in order to pay for the SGR reform, medical malpractice lawyers should be paid less, there should be a cap on noneconomic damages in medical malpractice cases, and that comprehensive tort reform should be adopted.
There’s little question that associating physician reimbursements with the number of tests and treatments ordered is a major driver of health costs. Removing that incentive, and better valuing the time doctors spend with patients, is a positive step in the right direction. Read more »
*This blog post was originally published at KevinMD.com*