Watching the training of medical students this last month, I am appreciative of the skills and scholarship of many of their teaching attendings, but also am noticing that there is a difference between a physician who has spent his or her time entirely at an academic medical institution and a good community physician.
I am a classic “late adopter.” I get around to trying gizmos and new products long after they have been released. I’m not a Luddite exactly, but I do need to be convinced that a new device or product will benefit my patient and make surgery simpler before I embrace it. I guess the main problem is my pervasive skepticism of “new stuff.” I don’t need one colleague to tell me some innovation is great – I need FIVE colleagues to tell me.
While not all hospitals have the resources to support a development team, hospitals need at least to demand better solutions. Administrators need to stop looking at EMRs as off-the-shelf solutions and meaningful use as a checkbox item. Only then can we leverage the power of technology to improve patient care.
The historian sorts and organizes the past, identifying the important and meaningful events from the trivial, and then interprets the story in order to explain the circumstances of the present. That, I agree, is my task. It is my job to make sense of the events told by the patient and his family. It is my job to create a record of his prior health so that our team move forward and safely develop a plan to help him.
For several years now, healthcare experts have been issuing warnings about an impending severe shortfall of primary care physicians. Policy makers have suggested that nurse practitioners, nurses who have completed graduate-level studies and up to 700 additional hours of supervised clinical work, could fill the gap.
A study analyzed data from 31 hospitals that participated in patient satisfaction surveys, the CMS Surgical Care Improvement Project (SCIP), and employee safety attitudes questionnaires. They found that patient satisfaction did not correlate at all with the rates of hospital compliance with SCIP process measures nor the opinions of employees about the culture of the institution for half the categories questioned.
Dr. Rafael Grossmann appears to be the first person ever to use Google Glass during a surgery. To say it’s too early to fully understand the technology and its potential applications in healthcare is a painfully obvious statement to make. However, that doesn’t mean we can’t allow our imaginations to run wild and speculate about potential procedures and situations where Google’s new-fangled device may come in handy in an operating room.
Maybe the biggest change has been the advent of the Internet. In the palm of my hand, I can instantly access huge amounts of information formerly available only in print books and journals. To look up a paper, we had to use Index Medicus, an encyclopedic series of books listing every article by subject in most journals.
I wanted to figure out how we could use a Google Docs to track patients and facilitate easier communication between the front desk and the medical department. The front desk staff would note in the doc that they had checked a patient in, and then the medical staff would see the update to the doc on their own computers at their station. No longer would it be necessary to crane their necks down the hall and squint to see a chart in the bin.
As a response to the hidden variability in healthcare prices, an increasing number of states have passed price transparency legislation. But will healthcare price transparency help reduce costs? Seems it would. But healthcare can be a strange and unique sect of economics. Could price transparency backfire and cause spending to increase?
Let’s get one thing clear from the start: I love nurses. Nurses have been by my side for the most frightening and important experiences in my life (in the hospital and out). However, I’m not a nurse. I’m a doctor. And when someone calls me nurse, I hate it. Here’s why.
With the exceptions of more paperwork and the burden of the electronic medical record, I’m not so sure residents are busier today, but if they are, what’s making them busier is reduced work hours. As a result, I don't think resident training hours should be limited to 40 hours per week.
When electronic health records exist in an organization, the patient may have no way to contain their information to those who provide treatment. While the public may not think about this as a major deal, as an employee of a hospital, I do.
Over the years, I’ve had more than my share of difficult cases. I’ve had patients with life threatening conditions whom I wished I could offer more than to just shake my head and speak empty words of encouragement. They stare back at me and I see their eyes full of hope. How many times have been forced to say: “I’m sorry, there’s nothing I can do that will make you better, or cure you, or ease your pain.”
All surgeons do that move: keeping an instrument in half a hand while doing something else, then regaining full use of it. Still, mundane as it is, that “third eye” part of my brain notices and likes that I can do it. It’s part of that little voice that constantly reminds me, whispers in amazement, that I’m here doing this stuff.