I recently said I would describe the essential elements of “true reform.” I realize others might add or subtract from my list, but here it is – at least for today: Payment reform, electronic records, comparability data, and primary care.
An OR nurse with 40 years of experience told me that she thinks robotic surgery might go the way of the laser. Similar to the unusual complications seen with the laser, when robotic surgery goes bad, it really goes bad.
Healthcare should become more about data-driven deduction and less about trial-and-error. That's hard to pull off without technology, because of the increasing amount of data and research available. Next-generation medicine will utilize more complex models of physiology, and more sensor data than a human MD could comprehend, to suggest personalized diagnosis.
Physicians often find themselves in the difficult situation of effectively communicating important information to their patients in a finite period of time without seeming terse or abrupt. This challenge is further complicated by an evolving framework of reimbursement that is focused on rewarding doctors for both quality and performance.
Extensive preoperative testing of ambulatory patients continues at the discretion of the surgeon, anesthesiologist, and probably the patient’s primary care doctor too. And the tab mounts.
Improvement in documented actual patient safety has lagged grotesquely. Part of that retardation can be blamed upon a continuing culture of cover-up.
Hospital length of stay is not simply a matter of the physician deciding that a patient can go home. The patient may not want to leave. There may be no support at home. There may be no one to drive the patient home. The nursing home or rehab center may not have an available bed.
What does it mean when our healers take their own lives? And why aren’t more people talking about physician suicide? Doctors have the highest suicide rate of any profession. In the United States, we lose a physician a day to suicide. That’s two to three entire medical school classes per year.
Surgery team fatigue and shift changes might spell problems for afternoon surgeries, and the time of day you have surgery can affect your outcome.
Here’s a story that illustrates how to operate on the wrong site. In a news article about some sanctions that the State of California imposed on certain hospitals for misdeeds, the following summary of one incident appeared. A six-year-old boy had to undergo a second surgery to remove a growth after a surgeon performed the wrong surgery on his tongue.
A recent study's main findings that readmissions were due to complications and the more complications a patient had, the more likely he was to have been readmitted, are not exactly earth-shattering. The press release and articles accompanying the paper’s publication were a little over the top.
Sure, complications matter, but numbers can deceive. Our most highly experienced physicians have likely had more complications than other medical colleagues, although their complication rate may be very low.
The Federal government has mandated the implementation of EMR in order for providers to be paid at the highest allowable rates and receive certain incentive pay for complying with EMR. EMR has the potential to provide increased patient safety and significant cost savings if developed properly. However, current EMR systems are not really ready for “prime time.”
Outgoing and incoming doctors carefully exchange important information about each patient to ensure that they are properly cared for through the next shift. But many hospitals don’t follow such a process, increasing the risk of medical errors.
Physician a burnout has great current interest. Many authors are worrying about burnout and therefore writing about this problem. What are the common root causes of burnout? Primarily burnout comes from loss of control and overwhelming undesirable activities. Burnout occurs when the job becomes overwhelming.