July 20th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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President Obama, where is your promise about transparency and accountability in Obamacare?
A major problem in the healthcare system is the lack of transparency and accountability. It has been unchecked for a very long time.
Both primary and secondary stakeholders act in their self-interest. These stakeholders have had ample opportunity to be non-transparent and non-accountable. All the stakeholders have abused the healthcare system.
I hit a nerve with my last blog “Patients And Physicians Must Control Costs”. Multiple readers responded with the usual comments:
“Patients are not smart enough to handle their own healthcare dollars.”
“Your basic idea makes sense, but in reality I doubt that a patient knows enough to make intelligent medical/financial decisions, because there are too many unknowns and variables.”
“Physicians over use the fee for service system in order to make more money.”
“If a physician tells a patient that there is only a 1/10,000 chance that an MRI will yield something useful, if the patient doesn’t have to pay for it, the patient wants the MRI.
Patients (consumers) must be taught and motivated to manage their own healthcare dollars. Patients’ choice Read more »
*This blog post was originally published at Repairing the Healthcare System*
June 26th, 2011 by DrWes in Opinion, Research
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Alright doctors, time to give up the cell phones. (Never mind that there has not been a study linking cell phones and hospital acquired infections).
From the American Journal of Infection Control:
A cross-sectional study was conducted to determine bacterial colonization on the mobile phones (MPs) used by patients, patients’ companions, visitors, and health care workers (HCWs). Significantly higher rates of pathogens (39.6% vs 20.6%, respectively; P = .02) were found in MPs of patients’ (n = 48) versus the HCWs’ (n = 12). There were also more multidrug pathogens in the patents’ MPs including methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Escherichia coli, and Klebsiella spp, high-level aminoglycoside-resistant Enterococcus spp, and carabepenem-resistant Acinetobacter baumanii. Our findings suggest that mobile phones of patients, patients’ companions, and visitors represent higher risk for nosocomial pathogen colonization than those of HCWs. Specific infection control measures may be required for this threat.
What specific measures might they consider?
They better be careful what they wish for or they might also have to take away all those dirty EMR computer keyboards, too.
*This blog post was originally published at Dr. Wes*
June 18th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
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Customer or patient?
I can’t remember; are they patients or our customers?
Are our patients really customers? Are they clients? Does this term, borrowed from the business world, really hold water in the current climate of health care? I believe if you ask most practicing physicians and nurses, other than those in charge of administration of groups and hospitals, they would say that they have patients, not customers, and that the whole idea is driving them batty.
The customer service model is very popular. Entire lectures and conferences exist to enforce this enlightened way to view patient care. I understand the drive, to an extent. The people we see in our hospitals and emergency departments need to feel valued and need to feel we are competent and caring. This matters especially in highly competitive markets because the ones who are happy keep coming back. This also matters because people who feel valued may be less likely to sue us. There is some logic to the customer service world view.
Unfortunately, Read more »
*This blog post was originally published at edwinleap.com*
January 14th, 2011 by Elaine Schattner, M.D. in Opinion
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An online friend, colleague, and outspoken patient advocate, Trisha Torrey, has an ongoing e-vote about whether people prefer to be called a “patient,” a “consumer,” a “customer,” or some other noun to describe a person who receives healthcare.
My vote is: PATIENT. Here’s why:
Providing medical care is or should be unlike other commercial transactions. The doctor, or other person who gives medical treatment, has a special professional and moral obligation to help the person who’s receiving his or her treatment. This responsibility — to heal, honestly and to the best of one’s ability — overrides any other commitments, or conflicts, between the two. The term “patient” constantly reminds the doctor of the specialness of the relationship. If a person with illness or medical need became a consumer like any other, the relationship — and the doctor’s obligation — would be lessened.
Some might argue that the term “patient” somehow demeans the healthcare receiver. But I don’t agree: From the practicing physician’s perspective, it’s a privilege to have someone trust you with their health, especially if they’re seriously ill. In this context, the term “patient” can reflect a physician’s respect for the person’s integrity, humanity and needs.
*This blog post was originally published at Medical Lessons*
October 12th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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One of the supposed strengths of electronic medical records is better tracking of test data. In theory, when using more sophisticated digital systems, doctors can better follow the mountains of test results that they encounter daily.
But a recent study, as written in the WSJ Health Blog, says otherwise. Apparently, a study performed in 2007 found:
VA doctors failed to acknowledge receipt of 368 electronically transmitted alerts about abnormal imaging tests, or one third of the total, during the study period. In 4% of the cases, imaging-test results hadn’t been followed up on four weeks after the test was done. Another study, published in March in the American Journal of Medicine, showed only 10.2% of abnormal lab test results were unacknowledged, but timely follow-up was lacking in 6.8% of cases.
Consider that the VA has what is considered the pinnacle of electronic systems — their unified, VistA program that permeates all their hospitals and clinics. Apparently the problem is one of alert overload:
Hardeep Singh, chief of the health policy and quality program at the Houston VA’s health and policy research center, led both studies. He tells the Health Blog that doctors now receive so many electronic alerts and reminders — as many as 50 each day — that the important ones can get lost in the shuffle.
This is not unlike the alarm fatigue issue that I recently wrote about. Too much data — whether it is written or on the screen — can overwhelm physicians and potentially place patients at harm. Curating test results by prioritizing abnormals will really be the true power of electronic test reporting.
*This blog post was originally published at KevinMD.com*
