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Dealing With Medical Error Together

The “Running A Hospital” blog has another discussion of dealing with medical error. This time, the hospital has opened up an error of its own (a “wrong side” surgery) for examination by the Open School of the Institute for Healthcare Improvement (IHI).

Sample comments:

— From IHI’s Jim Conway: “Our systems are too complex to expect merely extraordinary people to perform perfectly 100 percent of the time. We as leaders must put in place systems that support great practice by people who suffer from being human and will make mistakes.”

— From a patient who had two surgical errors in ten months: “After years of suffering through our incredibly brutal tort(ure) system I finally had the chance to talk to the surgeon. The most meaningful words he spoke were the descriptions of how badly he suffered also from the event we shared in that OR. Finally I was not alone!”

As we’ve often said, participatory medicine brings a new kind of partnership between patient and caregiver. Neither denial nor a Wall of Silence (famous book) has any place in a healthy relationship. It breaks my heart to think of the good lives that are ruined by our cultural inability to deal with honest errors in complex situations.

Yes, as Linda Kenney of MITSS mentions in a comment, some employees (in any industry) are reckless and must be weeded out. That too can be a denial issue. But first, we need open discussion.

*This blog post was originally published at e-Patients.net*

Medicine And The Gender Barrier

It’s only a matter of time before female physicians outnumber men, say medical school heads who are seeing more women in their programs. Although women have broken the gender barrier in medicine, they may want to keep going into nursing, because nurse practitioner salaries grew faster than primary care physicians’ pay — nearly 5 percent compared to nearly 3 percent.

Physicians can take some comfort that their average pay is more — $191,000 compared to more than $85,000 — unless they’re women, who among all the life sciences average $13,000 less than their male counterparts in comparable positions and with similar experience. (WCSC TV, Fierce Practice Management, Academic Medicine)

*This blog post was originally published at ACP Internist*

Patients Starved For Time With The Doctor

If you’re into health care consumerism, you’ll enjoy my guest blog post at CDHC Solutions magazine. CDHC Solutions focuses on consumer-driven health plans. Consumer-driven plans are a form of “high deductible” health coverage that is more popular than ever. For whatever you want to say about these plans, one thing is clear: They don’t solve the fundamental problem of patients not having enough time with their doctors.

Here’s a taste of what I wrote:

Researchers have been trying to pinpoint the impact of this time starvation on the quality of medical care, and they’re finding disturbing results. A recent study in the Annals of Internal Medicine found that because of time pressures and related factors, doctors deliver “error-free” care as rarely as 22 percent of the time. The researchers called this a “failure to individualize care,” which is a nice way of saying the doctors just weren’t paying enough attention to the needs of their patients.

Read the whole blog post here.

*This blog post was originally published at See First Blog*

Considering A “Medi-Spa?” 5 Questions To Ask

True or false:

1. Botox and laser treatments are easy and can be done by an aesthtician or spa staff.

2. A physician must be present at all times in a spa that performs procedures.

3. Chemical or facial peels are safe and can be done in a beauty salon.

(Answer to questions 1-3: False.)

The term “spa” is derived from a town in Belgium where healing waters have been used to promote health since Roman times. “Spa” is now loosely used to describe any relaxing environment or beauty salon where rest, health and beauty are promoted.

At one time it was easy to distinguish among a beauty salon, barber shop and a doctor’s office. Not anymore. As cosmetics has become more medical and medicine has become more cosmetic, the two have met in the ubiquitous Medi-Spa. An establishment labelled a medical spa or medi-spa is generally one where medical procedures are performed or medicines are administered in the pursuit of beauty. Read more »

*This blog post was originally published at The Dermatology Blog*

The “e-Patient” Revolution: Is It Over?

There’s a conversation brewing over use of the term “e-patient.” The online health revolution is over, it’s been suggested. Web use, after all, has become so widely adopted  that the term “e-patient” may have more historical meaning.

Dropping the “e” might indicate that we’ve arrived. I’m not so sure. Perhaps the revolution we thought was going on never entirely took off. Or maybe it’s all about how you define the revolution.

Here’s what I see: Day in and day out, over weeks and months, hundreds of patients visit my clinic. I talk to them candidly about the tools they use and how technology and community is changing how they see their problems. I do the same with friends and family members. And like it or not, they’re a lot closer to “e-Patient 1.0” than many of us would like to think. Read more »

*This blog post was originally published at 33 Charts*

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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