October 23rd, 2009 by DrRob in Better Health Network, Opinion
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It was a legitimate challenge.
When I mentioned to a fellow blogger that I was appearing on NPR, and he raised a very important question: ”Is that really a good thing? I thought that the point of blogging was to pose a challenge to the mainstream media, but it seems like bloggers feel like they have made it when that same media pays attention to them.”
This hits at the core of what I do as a blogger (and a podcaster). Why do I spend so much of my time doing something on that takes a bunch of time and energy, when I already have a very busy life? Why blog? Why podcast? Why do interviews? Why llamas? Why spend a weekend in Las Vegas? OK, the last question has any of a number of answers, and I have no idea about the llamas. But you get my drift: given the busyness of my life, why should I do all of this? Read more »
*This blog post was originally published at Musings of a Distractible Mind*
October 19th, 2009 by Happy Hospitalist in Better Health Network, True Stories
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I have a patient that comes in every so often that demands a PICC line (peripherally inserted central catheter). PICC lines are convenient for patients and nurses and doctors because they can be used to obtain blood without needing to stick the patient on a daily basis. They can be kept in for weeks and weeks and weeks with proper care. They can maintain adequate IV access when old ladies and drug addicts present with poor veins. Often they save the patient during acute decompensations of their critical illness. However, they come with frequent complications. I have had my share of patients return to the hospital with sepsis from their PICC line. Read more »
*This blog post was originally published at A Happy Hospitalist*
October 15th, 2009 by Happy Hospitalist in Better Health Network, Opinion
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Over at the WSJ Health Blog, some academic docs, such as hospitalist Dr. Wachter are suggesting just that.
Punishments such as revoking privileges for a chunk of time tend to be used for administrative infractions that cost the hospital money – things like failing to sign the discharge summaries that insurance companies require to pay the hospital bill. By contrast, hospital administrators may just shrug their shoulders when it comes to doctors who fail or refuse to follow rules like a “time out” before surgery to avoid operating on the wrong body part.
Docs and nurses who fail to follow rules about hand hygiene or patient handoffs should lose their privileges for a week, Pronovost and Wachter suggest. They recommend loss of privileges for two weeks for surgeons who who fail to perform a “time-out” before surgery or don’t mark the surgical site to prevent wrong-site surgery.
This couldn’t have come at a better time. At Happy’s hospital there is a massive witch hunt to crack down on not signing off verbal orders within 48 hours. This has nothing to do with patient safety. It has everything to do with meeting the requirements of CMS so the hospital does not lose their funding. Read more »
*This blog post was originally published at A Happy Hospitalist*
October 14th, 2009 by DrRob in Better Health Network, Opinion
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There’s a big buzz about primary care being a great thing; and there are a lot of people touting it as a lynchpin of financial reform. I believe this is true. But there is a condition that must be met for any of this true. It must be primary care done well.
The idea of good primary care is an assumption that may not be valid for many PCPs. There are many good PCPs out there, and I believe they constitute the majority, but there are also those who have frustrated and discouraged patients. I think this is mostly due to a payment system that has discouraged everything that primary care should be, but as the discussion goes on there needs to be more than just warm bodies labeled as PCPs.
Here is what I see as the essentials for good primary care: Read more »
*This blog post was originally published at Musings of a Distractible Mind*
October 12th, 2009 by Dr. Val Jones in Expert Interviews
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I’ve been following the career trajectory of Dr. Gordon Moore since I first became aware of his low-overhead, high-tech model of medical practice. He’s come a long way since the AAFP first interviewed him in 2002. I had the chance to catch up with him at the recent Health 2.0 conference in San Francisco, and we discussed the future of primary care and a practice model that I believe in (I just joined DocTalker Family Medicine myself!) Here’s our peek into our healthcare crystal ball…
Dr. Val: Tell me about what got you interested in creating a new practice model for primary care?
Moore: I came into healthcare with a somewhat Pollyannaish vision of reducing suffering and improving health. Without any docs in my family, I had no understanding of what it meant to actually practice. About 5 years after residency, I realized that there was an increasing disparity between my vision of practicing medicine and its reality. At that time I joined a quality improvement initiative at the University of Rochester, and we looked at increasing efficiency in primary care, including creating the idealized design of clinical office practices. Read more »
