Want to know the secret to successful care of ICU patients? Think back to the advice your grandmother always gave, joked American Thoracic Society conference speaker Renee Stapleton, M.D., recently:
– Wash your hands.
– You can’t sleep your life away.
– Get some exercise.
– Sit up straight.
– Take your medicine.
– If you can’t remember it, write it down.
*This blog post was originally published at ACP Hospitalist*
I just read a Wall Street Journal article about a new web-based service called MedWaitTime that allows patients to check if their doctor is running late before heading to the office for their appointment — kind of like you can check to see if your flight is late before heading to the airport.
Brilliant.
Nothing peeves me more than sitting in a doctor’s office reading 4-month-old tattered magazines on topics I care nothing about (saltwater fishing, seriously?), and not because the doctor had an emergency (when is the last time a dermatologist had to run out to save someone), but because the office staff routinely double books. I can’t count the number of times I walked out (my limit is 30 minutes unless I’m in agony) after giving the front office a targeted piece of my mind. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
The recent discussion of the appropriateness of bringing patients back to the office has really gotten me thinking about my overall philosophy of practice. What are the rules that govern my time in the office with patients? What determines when I see people, what I order, and what I prescribe? What constitutes “good care” in my practice?
So I decided to make some rules that guide what I think a doctor should be doing in the exam room with the patient. They are as much for my patients as they are for me, but I believe that thinking this out will give clarity in the process.
Rule 1: It’s the Patient’s Visit
The visit is for the patient’s health, not the doctor’s income or ego. This means three things:
Rule 2: Minimize
Many doctors and patients have a “more is better” mentality. This not only costs more money to the system, but it can cause harm to the patient. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
Much has been recently made about the bureaucratic obstacles that primary care doctors face. With good reason. The impetus was a recent New England Journal of Medicine paper from Richard J. Baron that I mentioned recently.
The New York Times’ Pauline Chen interviewed Dr. Baron, who shared some interesting insights on what needs to be done. He contrasts the inertia in primary care to drug manufacturing.
If you took the resources that went into drug development, for instance, “and put them into a program like this that achieves meaningful levels of behavior change, a lot more patients could be better off.” In other words, research into new primary care models isn’t taking off because the money isn’t there.
But Dr. Baron also notes that money isn’t everything, since “primary care practitioners have been saying that we either already do or would do certain things if you paid us more. It’s true that you can’t do things consistently, reliably and across scales without additional payment. But payment is not enough. People have to change what they are thinking about when they go to work.” Read more »
*This blog post was originally published at KevinMD.com*
What if the average patient (person) knew what healthcare insiders, providers and expert patients know?
Take the process of looking for a new personal physician. Conventional wisdom tells people that when looking for a new physician they need to consider things like specialty, board certification, years in practice, and geographic proximity. Online services like Health Grades allow you to see and compare the satisfaction scores for prospective physician candidates.
But industry insiders know different. Consider those patient satisfaction scores for physicians. In reality, “one can assume that the quality of care is actually worse than surveys of patient satisfaction would seem to show,” according to a 1991 lecture by Avedis Donabedian, M.D.:
“Often patients are, in fact, overly patient; they put up with unnecessary discomforts and grant their doctors the benefit of every doubt, until deficiencies in care are too manifest to be overlooked.”
Given the constant drumbeat about the lack of care coordination and medical errors, it would seem that some people (patients) are beginning to reach the breaking point alluded to by Dr. Donabedian. The empowered among us are starting to compare physicians (and the hospitals that employ them) to a higher standard — a higher standard that reflects the nature and quality of the medical services physicians actually provide. Empowered patients today are “being taught to be less patient, more critical, and more assertive.” Read more »
*This blog post was originally published at Mind The Gap*
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