Instinct is Learned
Mr. Reynolds is a vivid 83 year old who lived alone at home. He walks everyday int he morning first thing before he has a small cup of coffee. His kids bought him an ipad and he uses it to browse the Washington Post, the Wall Street Journal, and the Pittsburgh Post Gazette while eating breakfast.
Every morning it’s the same breakfast…toast with honey and a small cup of yogurt. Then he’s ready to start the day, just when the rest of his neighbors are waking up.
Today however, he ate hist toast and his stomach grumbled, louder than usual. He thought to himself that he’d better get to the bathroom qu...
Source: Mr. Hassle's Long Underpants - November 10, 2017 Category: Emergency Medicine Authors: Doc Shazam Tags: Clinical Source Type: blogs
The major medical issues of 2017
Periodically we should reflect on what challenges face patients and physicians. Over the past few days I have worked on a list of the issues that concern me the most. I welcome suggestions for expanding the list.
Diagnostic errors – all patient care requires that we make the proper diagnosis. Too often we make errors. A recent paper estimated that 30% of cellulitis admissions did not have cellulitis. A similar paper found almost the same estimate for community acquired pneumonia admissions. The most common reason for successful malpractice claims is diagnostic errors. Have they increased? Members of ...
Source: DB's Medical Rants - November 3, 2017 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
ECMO for hospitalists
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - November 1, 2017 Category: Internal Medicine Tags: critical care hospital medicine Source Type: blogs
5 ways to use your smartphone to improve doctor visits
When I became a caregiver to my dad, I quickly realized that I was not going to be able to keep all of his medical information in my head. My smartphone became my second brain. It helped me to track his symptoms, keep up with the dates for his appointments, document recommendations, and share this information with my sisters in a timely and coherent manner. Here, I share five ways patients and caregivers can use smartphones to enhance their encounters with physicians.
Photos
We’ve all heard the saying, “A picture is worth a thousand words.” Well, smartphones aren’t just for taking selfies. If you or a loved one has...
Source: Kevin, M.D. - Medical Weblog - October 29, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/nicole-rochester" rel="tag" > Nicole Rochester, MD < /a > Tags: Tech Mobile health Primary Care Source Type: blogs
Population Health & the Missing Specialist
By VIKRAM REDDY, MD
I attended a Population Health conference this summer where a number of representatives from large health systems and physician organizations convened to discuss common challenges. Many of my healthcare colleagues assume that anything that carries the label “Population Health” must relate to health disparities and food deserts. While we do address these topics, the vast majority of sessions and conversations had one underlying theme: lowering the total cost of care.
In rebuttal to any charges that our group is far too corporate to be considered a fair example of Population Health advocates, even the...
Source: The Health Care Blog - October 28, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized ACO Medicare Population Health Source Type: blogs
To Achieve Its Goals, Population Health Needs More Specialists
By VIKRAM REDDY, MD
I attended a Population Health conference this summer where a number of representatives from large health systems and physician organizations convened to discuss common challenges. Many of my healthcare colleagues assume that anything that carries the label “Population Health” must relate to health disparities and food deserts. While we do address these topics, the vast majority of sessions and conversations had one underlying theme: lowering the total cost of care.
In rebuttal to any charges that our group is far too corporate to be considered a fair example of Population Health advocates, even the...
Source: The Health Care Blog - October 28, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized ACO Medicare Population Health Source Type: blogs
Why are you seeing the gastroenterologist?
Gastroenterologists, as specialists, are called upon by other doctors to address digestive issues in their patients. For example, our daily office schedule is filled with patients sent by primary care physicians who want our advice or our technical testing skills to evaluate individuals with abdominal pain, bowel issues, heartburn, rectal bleeding and various other symptoms. The same process occurs when we are called to see hospital patients. If a hospital admitting physician, who is usually a hospitalist, wants an opinion or a test that is beyond his knowledge level, then we are called in to assist.
The highest quality re...
Source: Kevin, M.D. - Medical Weblog - October 18, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/michael-kirsch" rel="tag" > Michael Kirsch, MD < /a > Tags: Physician Gastroenterology Primary Care Source Type: blogs
The high cost of hospitalists
Hospitalists, doctors who only see patients in the hospital, almost always in a shift work model, are the fastest growing “specialty” in medicine, from nothing about 15 years ago to about 50,000 today. There were some studies that I won’t review much here that showed some benefits from hospitalists compared to “usual care” in highly controlled environments, outcomes such as a 0.4 per day decrease in length of stay with no reported increase in the readmission rate. Of course, these studies were all conducted within the environment of a screwed up payment system.
I think most family physicians would agree that the ...
Source: Kevin, M.D. - Medical Weblog - October 18, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/richard-young" rel="tag" > Richard Young, MD < /a > Tags: Physician Hospital-Based Medicine Hospitalist Public Health & Policy Source Type: blogs
Valuing Value-Based Payment
By ANISH KOKA, MD
The idea that payment should be linked to the value lies at the heart of most of the transactions we participate in on a daily basis. Yet, value based payment in healthcare has seemingly run into very rocky waters as of late. It is at this precarious time that stakeholders representing large employers and other purchasers of health care’ took to the Harvard Business Review to write in defense of value based payment reform. The authors pepper their article with cherry picked ‘successes’ of the value movement and urge the country to forge ahead on the current path. The picture that c...
Source: The Health Care Blog - October 16, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Value-Based Payment Source Type: blogs
Is “Nonteaching” a Bad Word?
By: Allen B. Repp, MD, MSc, professor and vice chair for quality, Department of Medicine, The Larner College of Medicine at The University of Vermont, Burlington, Vermont
For years I’ve been trying to eradicate a word from my vocabulary. Yet, in my role as an academic hospitalist, I still find myself uttering it almost every day. Everyone around me is saying it, too. The word isn’t vulgar. It’s “nonteaching.”
What does it mean? Medicine services at many academic medical centers (AMCs) in the US are divided into teaching and nonteaching services. Teaching services usually include a team of medical stud...
Source: Academic Medicine Blog - October 10, 2017 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective competencies medical education patient care residency residents Source Type: blogs
The adverse consequences of premature diagnosis
I have spent 3 days at the Society to Improve Diagnosis in Medicine. Whenever I come to this meeting, I have insights from listening to talks and many conversations with leaders in the field.
When one considers diagnostic errors, one must consider two important factors – physician factors and system factors. We have a major system factor that can cause problems. Most hospitals in the US require a diagnosis for admission. I believe this rule increases diagnostic errors.
Currently I am developing a talk based on the lessons we can learn from fictional detectives. One example that I will likely use came from a...
Source: DB's Medical Rants - October 10, 2017 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Hospitalist mission creep: feeling dumped on
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - September 29, 2017 Category: Internal Medicine Tags: hospital medicine Source Type: blogs
