June 16th, 2010 by Edwin Leap, M.D. in Better Health Network, Health Policy, Opinion, True Stories
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Why do we physicians chart the way we do? Hopefully, we do it perfectly well and have no concerns at all. But where I practice emergency medicine, we are approaching maximum inefficiency in charting.
It all became much clearer when we started using our new EMR system. Let me make it clear, I’m not against EMR. In fact, typing and templates work better for me than dictating. My dictations were usually a mine field of blanks and misunderstood words.
Furthermore, if I wanted to use it, we have a new voice recognition dictation system in addition to our templated chart. Though admittedly, the voice recognition program clearly hates some of my partners, as evidenced by the way they grasp the screen and yell at it (‘Chest Pain, not west rain!’) and by its inexplicable use of profanity in the occasional chart.
But I digress. The problem as I see it is the evolution of the medical record. Why does the medical record exist? Read more »
*This blog post was originally published at edwinleap.com*
June 9th, 2010 by RamonaBatesMD in Better Health Network, Health Policy, Opinion, Research, True Stories
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Dr. Wes and Kevin, M.D. have both written reviews of the documentary film “The Vanishing Oath.” I started the process rolling of trying to get the film shown locally. No date yet, but looks like it will happen before the year is out.
This is not a new phenomenon in medicine (or any profession). Dr. Robert Goldwyn wrote a nice essay on the some of the issues that can lead to burnout, though not once did he mention burnout specifically. The title says much:
“I Bargained on Working Hard as a Surgeon, Not Working Hard to Be Able to Work Hard as a Surgeon”
The preceding title is a quote from a letter written by a resident in the last year of his training (S. A. Teitlebaum, August 20, 1994). It reflects the gloom besetting the young in particular but certainly not them exclusively. We all are uneasy about our futures, professionally and economically. Bandied in the corridors at a national meeting was a dismal figure: 1:100,000, the presumed proper ratio, as determined by Health Maintenance Organizations, of plastic surgeons to population. That 1 million Americans need only 10 plastic surgeons seems wrong and idiotic to me, but it makes good economic sense to health providers and insurance companies. Their coffers swell as they collect the same or higher premiums while curtailing what they provide. Read more »
*This blog post was originally published at Suture for a Living*
May 17th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy, Opinion, Research
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I recently stumbled onto the “Minimally Disruptive Medicine” blog maintained by Dr. Victor Montori from the Mayo Clinic. I have to admit that the name caught my attention so I scoped it out.
According to Dr. Montori, “minimally disruptive medicine refers to the practice of medicine that seeks to design effective treatment programs for patients while minimizing the burden of treatment.” He describes this as an emerging field.
I have to admit that I was simultaneously puzzled and intrigued. After all, how is this different from the way good medicine is practiced? I, for one, like to think that I create individually-tailored programs that meet my patients’ needs while minimizing their treatment burden. Read more »
*This blog post was originally published at 33 Charts*
April 16th, 2010 by BarbaraFicarraRN in Better Health Network, Health Policy, News, Opinion, Research
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By Barbara Ficarra, RN, BSN, MPA
“This is a smoke-free institution. Thank you for your compliance.”
Nurses and doctors and other members of the healthcare team strive every day to provide quality patient care. We focus on patients by understanding their needs. We listen, assess and evaluate. We work together as a team focusing not only on the patient, but family members as well. We formulate individual care plans addressing each and every need.
Providing quality patient care is the single most important goal for any hospital, and it’s important to note that patients need to understand that there are policies within the hospital. Read more »
*This blog post was originally published at Health in 30*
April 14th, 2010 by Shadowfax in Better Health Network, Opinion, True Stories
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Intueri (Maria) has it. Go read. Really. I’ll wait. Go read then and come back here, because I have something to say, too. She writes beautifully, and it’s a hard read. I almost stopped before I finished it, and I did flinch more than once. The man she writes about was in my ER today, or at least someone very like him.
He was rolled onto a hallway gurney, given a cursory inspection, and left to sleep it off before being given the “bum’s rush out” when he became more sober and obnoxious. He was viewed by the staff as an irritation, a burden, an annoyance. Smelly, dirty and creepy. Scaring the children as they walked by to their rooms. Nurses were short-tempered and brusque to him, and the doctors avoided him as much as possible. Read more »
*This blog post was originally published at Movin' Meat*
