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Box-Top Board Certification For Doctors

Remember when you were a child and an offer to be a member of a special spy club appeared on your morning cereal box? You knew — yes, KNEW — that the offer was the real deal. All you had to do is send in 3 cereal box tops and you’d be sent all the prerequisite items. Of course, when the plastic trinkets arrived weeks later, there always seemed to be the air of buzzkill when the reality of what you received for your efforts was revealed.

This could never happen with board certification for doctors, could it?

Yesterday we learned that this year every specialist has to recertify to maintain their status as a board-certified specialist. In the past, this was a voluntary process that doctors participated in to show a jury of their peers that they had the right stuff to practice medicine at the highest level possible. It was a respected term. Doctors generally knew that a board-certified specialist meant something.

Even though doctors pay thousands of dollars to the American Board of Internal Medicine for the opportunity to study for and take the certification exam, once passed doctors were proud to hang that certificate on their wall. In effect, it is the crowning achievement of one’s career.

But what if that certificate on the wall had the value of certificate purchased from a cereal box top spy club? Doctors might be pretty upset, right? Well guess what. Although the majority of those certificates hanging on the wall are the real deal, many are not. Read more »

*This blog post was originally published at Dr. Wes*

We Need More Linchpin Doctors

Images-1I just finished Seth Godin’s Linchpin. Seth makes the case that in a hypercompetitive world the stakes are higher than ever to make an indispensible contribution to something you care about. The linchpin is the essential element, the piece of a wheel or organization that is absolutely irreplaceable.

Seth references business, but he might as well have been talking about obstetricians or internists. We need more linchpin doctors.

Modern patient care is progressively marginalizing physicians. Care that is increasingly “managed” and dependent upon automated diagnostics is leaving physicians as powerless cogs in a system of mechanical patient care.  Patients have become naturally detached as they search for solutions of their own.

Physicians have to be remarkable to remain relevant. Physicians have to offer something not available anywhere else. Physicians need to make a difference and in their own way and serve as real leaders and innovators in their relationships with patients and their communities. Physicians have to be linchpins. Read more »

*This blog post was originally published at 33 Charts*

New Medical Drama “21” And The Evil SGR Conspiracy To Cut Medicare

Name: “21” (% to be cut from Medicare)

Protagonist: Dr. Rob and a cast of thousands of physicians (Kiefer Sutherland wouldn’t work for such small payment.)

Villain: Evil SGR (Sustainable Growth Rate) conspiracy to cut Medicare by 21% across the board.

Victim: The elderly population depending on Medicare for payment of their medical care.

Plot:  A follow-up to the popular drama “Lost” where members of congress were stranded in Washington D.C. with the task of reforming healthcare without any contact or communication from doctors and patients. This new drama “21″ tells the tragic tale of an industry under siege and a population facing possible disaster.

Already stretched to the limit by the paltry reimbursement from Medicare for primary care office visits, Dr. Rob and his band of physicians is hit by the evil conspiracy of SGR, a secret society whose goal is to harm the elderly people in the country by driving away all people willing to give them care. The congress, tired out from haggling over the healthcare reform bill, allows evil SGR to exert its power in the name of “fiscal responsibility.” Read more »

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

Medical Errors And Pager-Free Time For Doctors

When nurses sign out during the end of shift, it’s done so in a quiet setting. Contrast that to medical residents — at least when I was a resident 8 years ago — where pager interruptions during sign out were the norm.

PookieMD compares the situation to the “sterile cockpit” that airline pilots enjoy:

“Pilots have the sterile cockpit–a situation in which, if the plane is below 10,000 feet, only conversation directly relevant to flying is allowed. The rule was developed because take offs and landings are the most likely time a crash will occur, and take offs and landings occur below 10,000 feet. Simple enough, and it saves lives.”

Physicians enjoy no such luxury. Patient discussions with other doctors often take place in distracted settings, under the threat of a pager going off at any time.

Changing this, PookieMD argues, requires a cultural shift. As mentioned earlier, when nurses sign out, it’s sacred time. Doctors need something similar. Studies show that medical errors can arise during the patient hand-off to another physician. Signing out patients in an undisturbed setting may minimize the risk of poor communication, and subsequently, potential mistakes. “Page early and often needs to be replaced with ‘page urgently when appropriate,’” writes PookieMD.

Let’s see if hospital administrators have the courage to make this happen.

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

Will Hospitals Who Ban Physicians From Paid Pharma Speaking Engagements Lose Employees?

Doctors have been coming under increasing scrutiny for their relationships with pharmaceutical companies.

Many hospitals and medical schools have outright banned any involvement of their physician staff with drug companies. This isn’t a contentious issue most of the time.

But a recent case at Boston’s Brigham and Women’s Hospital raised some eyebrows. Apparently, an asthma specialist was so dependent on drug company money, that he chose to quit the hospital instead. According to the Boston Globe, “Out of thousands of US doctors hired by drug-maker GlaxoSmithKline to talk about its products, [this physician] was the highest paid during a three-month period last year, the company recently disclosed: He made $99,375 for giving 40 talks to other physicians last April, May, and June, almost one every other day.” 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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