LITFL Review 329
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 329th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM.
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The Most Fair Dinkum Ripper Beauts of the Week
Laura Duggan re...
Source: Life in the Fast Lane - April 29, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs
Moonlighting is the side hustle for the not so lazy
Physicians-in-training make a pittance when one looks at the hourly rate, Especially when I was residency, in the early 2000’s. I often worked upwards of 100 hrs per week and made $30,000 per year. The first year, called internship, is replete with long hours and crushing responsibilities. Opportunities to make an extra buck are all but impossible. In the second and third years, however, there is much more elective time. During these rotations, it is common for a doctor to feel like they have a normal nine-to-fiver. Those of us with ingenuity, and adapted to little sleep, found it the perfect time to deve...
Source: Kevin, M.D. - Medical Weblog - April 26, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/docg" rel="tag" > DocG, MD < /a > Tags: Finance Practice Management Source Type: blogs
Measles information for hospitalists
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - April 26, 2018 Category: Internal Medicine Tags: hospital medicine infectious disease Source Type: blogs
Making Electronic Health Records Great Again
By ROBERT WACHTER and JEFF GOLDSMITH
After a blizzard of hype surrounding the electronic health record (EHR), health professionals are now in full backlash mode against this complex new tool. They are rightly seen as a major cause of professional burnout among physicians and nurses: Clinicians are spending almost half their professional time typing, clicking, and checking boxes on electronic records. They can and must be made into useful, easy-to-use tools that liberate, rather than oppress, clinicians.
Performing several tasks, badly. The EHR is a lot more than merely an electronic version of the patient’s chart. It ...
Source: The Health Care Blog - April 7, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Fix the EHR!
By ROBERT WACHTER and JEFF GOLDSMITH
After a blizzard of hype surrounding the electronic health record (EHR), health professionals are now in full backlash mode against this complex new tool. They are rightly seen as a major cause of professional burnout among physicians and nurses: Clinicians are spending almost half their professional time typing, clicking, and checking boxes on electronic records. They can and must be made into useful, easy-to-use tools that liberate, rather than oppress, clinicians.
Performing several tasks, badly. The EHR is a lot more than merely an electronic version of the patient’s chart. It ...
Source: The Health Care Blog - April 7, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Some Details about Hospital-at-Home (HaH) Services for Selected ER Patients
In a recent note, I discussed the question of whether hospitals are becoming obsolete (see: Are Hospitals Becoming Obsolete; Consequences for Pathology and the Labs). I believe that the answer to this question is partly true with some supporting evidence provided by the emergence of"bedless hospitals." They are being built primarily to provide ambulatory care services, clinical labs, radiology, operating rooms, and telemedicine (see, for example:The Design of Bedless Hospitals Continue to Evolve Based on Cost and Technology;Some Additional Ideas About the Bedless Hospitals of the Future). These ideas ...
Source: Lab Soft News - April 2, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Innovations Hospital Financial Quality of Care Telemedicine Source Type: blogs
When medical coders blame physicians
An interesting paper in CMAJ Open reports on a series of interviews with coders concerning their perceptions of their interactions with doctors. The study was done in Canada, but it rings true to what we experience in the U.S. The fundamental objective of coding is the same: to translate information about the patient’s story into a series of numeric ICD-10 codes for various administrative purposes. Several themes emerged from these interviews. Form the abstract of the paper:
Results:
Five themes emerged regarding physician-related barriers in coding of high-quality administrative data: 1) coders are limited in their...
Source: Kevin, M.D. - Medical Weblog - March 16, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/robert-donnell" rel="tag" > Robert Donnell, MD < /a > Tags: Physician Practice Management Primary Care Source Type: blogs
It ’s time to widen the clinical footprint of hospitalists
“We are playing the same sport, but a different game,” the wise, thoughtful emergency medicine attending physician once told me. “I am playing speed chess – I need to make a move quickly, or I lose – no matter what. My moves have to be right, but they don’t always necessarily need to be the optimal one. I am not always thinking five moves ahead. You guys [in internal medicine] are playing master chess. You have more time, but that means you are trying to always think about the whole game and make the best move possible.”
In recent years, the drive toward “efficiency” has intensified on the wards. I am see...
Source: Kevin, M.D. - Medical Weblog - March 11, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/christopher-moriates" rel="tag" > Christopher Moriates, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Source Type: blogs
Many medical nouns need adjectives
Last week on twitter I wrote a series of tweets about necessary qualifiers. Here are the tweets which represent an incomplete sample of the problem:
1st tweet on importance of qualifiers w/ “diagnoses”
Do not label the patient as COPD exacerbation without saying why: Differential includes acute bronchitis, pneumonia, pneumothorax, left side heart failure, anemia, opiates, PE etc.
2nd qualifier tweet – Never tell me the patient has CKD without giving me the stage and the cause. Corollary – do not give me the eGFR for patients with AKI – the estimates do not work with increasing creatinine levels...
Source: DB's Medical Rants - March 5, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Jellybean 91 with SMACC Poet Sanaah Sultan
LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
In Berlin, in the footlights, with heart in throat.
In London, in the headlights, with heart in hands.
In her heart, in Kashmir, always in Kashmir.
A young woman that rather took the stage by storm at dasSMACC shares a little bit of her own heart and a lot more of someone else’s heart. Sanaah demands attention. She demands attention because attention is required. Not for herself. Attention is demanded on behalf of the disputed territory of Kashmir. On behalf of more t...
Source: Life in the Fast Lane - February 28, 2018 Category: Emergency Medicine Authors: Doug Lynch Tags: JellyBean dasSMACC Kashmir poet Sanaah Sultan Sufayed Source Type: blogs
Why do we treat psychiatric illness different from other illness?
I recently had the opportunity to be the informal medical navigator for a friend with an acute psychiatric crisis. This previously “normal” friend lives alone, is a high-functioning professional and was unable to sleep, to eat, to finish a coherent thought or to carry on his business for several weeks.
I was called to help after an embarrassing public meltdown. The first problem was finding a doctor who would deal with the situation. After all, even if patients have a primary care provider (and not all do), this PCP is usually not a psychiatric expert. In general, we want to run in the opposite direction when we encoun...
Source: Kevin, M.D. - Medical Weblog - February 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/banu-symington" rel="tag" > Banu Symington, MD < /a > Tags: Conditions Emergency Medicine Psychiatry Source Type: blogs
Three Pillars of Clinical Process Improvement and Control
The following is a guest blog post by Brita Hansen, MD, Chief Medical Officer at LogicStream Health.
In a value-based care environment, achieving quality and safety measures is a priority. Health systems must have the capabilities to measure a process following its initial implementation. The reality, however, is that traditional improvement methods are often plagued with lagging indicators that provide little (if any) insight into areas requiring corrective actions. Health systems have an opportunity to make a significant impact on patient care by focusing on three pillars of clinical process improvement and control: qual...
Source: EMR and HIPAA - February 21, 2018 Category: Information Technology Authors: Guest Blogger Tags: Care Management System Health Care Healthcare Analytics Healthcare CIO HealthCare IT Brita Hansen LogicStream Health Source Type: blogs
Why are there vending machines in hospitals?
This seems like an odd question to ponder, and it certainly would seem to have nothing to do with the current state of medicine and health care in our country. But it is a question that I am having a hard time wrapping my brain around. Certainly, most hospitals do have vending machines that sell snacks and soda, and they are by no means hidden in the basement. On the contrary, vending machines are positioned close to as much foot traffic as possible, advertised without shame. Less common but more reprehensible are hospitals that have a McDonald’s in them. If you Google “fast food in hospitals,” you can find the loca...
Source: Kevin, M.D. - Medical Weblog - February 16, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jered-haynor" rel="tag" > Jered Haynor, DO < /a > Tags: Policy Hospital-Based Medicine Obesity Source Type: blogs
What the hospitalist needs to know about interstitial lung disease
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - January 15, 2018 Category: Internal Medicine Tags: pulmonary Source Type: blogs
What ’s going to replace hospitals that downsize?
I recently rounded on patients at Providence Hospital as the attending physician on the family medicine residency program’s inpatient service. Providence recently closed its maternity ward as the first step in a planned redevelopment of the hospital grounds into a “health village.” In the short term, the hospital’s decision to stop delivering babies may worsen maternal health disparities, as the entire eastern side of Washington, DC is now a “maternity care desert” with no labor and delivery services. In Providence’s defense, it lost $23 million in fiscal year 2016, and its long...
Source: Kevin, M.D. - Medical Weblog - January 3, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/kenneth-lin" rel="tag" > Kenneth Lin, MD < /a > Tags: Policy Hospital-Based Medicine Public Health & Source Type: blogs
