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Latest Posts

Relational Medicine: The Joy Of Primary Care

I was happy when I looked at [the day’s] schedule. Two husband-and-wife pairs were on my schedule, both of whom have been seeing me for over 10 years. Their visits are comfortable for me — we talk about life and they are genuinely interested in how my family is doing. They remember that I have a son in college, and want to know how my blog and podcast are doing. I can tell that they not only like me as a doctor — they see me, to some degree, as a friend.

Another patient on the schedule is a woman from South America. She has also been seeing me for over 10 years. I helped her through her husband’s sudden death in an accident. She brings me gifts whenever she goes on her trips, and also brings very tasteful gifts for my wife. Today she brought me a Panama hat.

I know these people well. I know about their past illnesses and those of their children. I know about their grandchildren, having hospitalized one of them over the past year for an infection. I know about the trauma in their lives as well as what they take joy in. They tell me about their trips and tell me their opinions about the healthcare reform bill.

I spend a large part of their visits being social. I can do this because I know their medical situation so well. I am their doctor and have an immediate grasp of the context of any new problems in a way that nobody else can. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

9 Tips To Improve Patient Satisfaction

Some interesting points were raised at a recent Society of Hospital Medicine (SHM) session by Winthrop Whitcomb and Nancy Mihevc on patient satisfaction. To improve satisfaction scores:

1. Review the patient’s chart before you go in the room. It makes a big difference if the patient perceives you know what’s going on without having to bury your face in a chart.

2. Patients are often confused about who they are supposed to see after discharge. This, of course, is a safety issue as well as one that affects patient satisfaction.

3. Sit down when you are visiting a patient. Patients are happiest when they perceive you’ve spent enough time with them, and they are more likely to perceive this if you are sitting than standing with your hand on the doorknob. Read more »

*This blog post was originally published at ACP Hospitalist*

Connecting With Patients: A Forgotten Piece Of Medicine

I [recently] visited a small town in west Texas to address a local medical society on the emerging role of social media in healthcare.

My presentation involves social media and the evolving relationship that patients share with doctors. I discuss challenges and opportunities -– especially as it relates to transparency, personal boundaries, and even the ethical obligation to participate in the online conversation. I target the disconnected physician and offer education as well as a compelling argument for involvement.

When I arrived at the venue I found that the meeting was attended predominantly by physicians much older than myself.  While waiting to speak, I was concerned that my message of connection and changing relationships would elicit pushback. After all, isn’t it this era of physicians we hold accountable for paternalism and control in dealing with patients? That’s what I’d been lead to believe. Read more »

*This blog post was originally published at 33 Charts*

One More Medical Acronym To Add To The Pile

In medicine, hardly a week passes without the introduction of some new acronym, previously unspoken in the average practice, which then grows to prominence — take HIPAA, PECOS, CPT, ICD, etc. — the list goes on and on.

I believe that after 14 years of practice I’ve earned the right to introduce an acronym of my own: CRAPP. For the last several months, my partner and I have used this term to describe the volumes of denials, pre- and prior- authorizations (is there really a difference?), and faxes that seem to grow like weeds on the fertile planting grounds of our desks.

More specifically, in our office the acronym CRAPP stands for: Continuous Restrictive And Punitive Paperwork. To put it blithely, CRAPP could represent any document you wish someone had put on your partner’s desk instead of yours.

On a more emotional level, this acronym captures the visceral response I have whenever my attention is drawn away from my patients and redirected towards some nonsensical busywork — much like someone yelling at a golfer during their backswing.

Read more »

Patients Are Happier When Doctors Sit

Patient satisfaction, as I wrote about previously, is being increasingly focused upon.

Doctors are often pressed for time, and appear rushed — which can potentially lead to unhappy patients.

I saw this small study showing that the simple act of sitting down while talking to patients can have a profound effect. Many doctors I know already do this, but now there’s some data to support sitting. Read more »

*This blog post was originally published at KevinMD.com*

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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