This infectious disease physician still finds HIV care rewarding. Here ’s why.
Earlier this year, I wrote a piece about friends and colleagues of mine who have left HIV clinical practice. Something about it touched a nerve. Admittedly, it was kind of a downer — but it might have been slightly misinterpreted. A lot of the problems my friends cited could have easily applied to almost any area of clinical practice; these challenges were by no means limited to HIV care. They mentioned the inscrutable and user-unfriendly EMRs, the lack of appreciation for cognitive specialties, the pain of “quality metrics” that require endless box-checking, the difficulties of funding car...
Source: Kevin, M.D. - Medical Weblog - August 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/paul-sax" rel="tag" > Paul Sax, MD < /a > Tags: Physician Infectious Disease Source Type: blogs

A Caregiver ’ s Perspective on Patient Engagement
The following is a guest blog post by Michael Archuleta, Founder and CEO of ArcSYS, where he shares his experience as a caregiver for his father trying to navigate the healthcare system. My dad is 99 years old. Having moved him to Utah 6 months ago into a retirement home, our first step was to get an appointment with a new primary care physician. I brought along a list of his medications and watched the nurse tediously look up and enter each into the EHR. Dad and the doctor got along great on that first visit. She assured us that she could help manage his medications. There was nothing realistically that could be done to r...
Source: EMR and HIPAA - August 20, 2018 Category: Information Technology Authors: Guest Blogger Tags: Health Care Healthcare Healthcare Interoperability HealthCare IT Patient Advocacy Patients ArcSys Michael Archuleta Patient Stories UpDox Source Type: blogs

A strong doctor-patient relationship: why it matters
Writing in Annals of Family Medicine a few years ago, Chicago obstetrician Benjamin P. Brown vividly described his mentor’s interaction with a patient who had just emigrated from Mexico and had no family support. “When he asked earnestly how she was doing, her hard-won defenses seemed to crumple, and all of a sudden she was sitting on the exam table, sobbing,” Brown wrote. “I watched, rapt, as Dr. Gonzales — or Wilfredo, as he insisted I call him — reached out a steady hand to squeeze her shoulder and offered a tissue.” Did a tissue and a squeeze on the shoulder ensure a better out...
Source: Kevin, M.D. - Medical Weblog - August 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/a-bartley-bryt" rel="tag" > A. Bartley Bryt, MD, MPH < /a > Tags: Physician Primary Care Source Type: blogs

Physicians must reclaim the medical record
A guest column by the American College of Physicians, exclusive to KevinMD.com. I recently saw a new patient who came to our practice following a lengthy hospitalization. He is in his 80s with a fairly complex medical history typical of many in this age range. Yet, after carefully sifting through my first introduction to this gentleman — a 32-page discharge summary — I was completely unable to glean the circumstances that led to his hospitalization. Amid the completed tick boxes, auto-populated forms, a recurring list of medical problems, and a printout of every medical and nursing order written and medication ...
Source: Kevin, M.D. - Medical Weblog - August 16, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/philip-a-masters" rel="tag" > Philip A. Masters, MD < /a > Tags: Tech American College of Physicians Health IT Primary Care Source Type: blogs

Do you run a financially independent business?
Although I would never describe the business of primary care medicine as cutting edge, there are a number of innovations that have come and gone during my short tenure running a medical practice.  The business of medicine is fascinating and leaves much room for personalization and creativity.  I have been lucky to operate at the forefront of practice management and learned quickly how to leverage two bleeding edge philosophies to multiply profits.  First, seeing the inefficiencies of compliance as relates to third-party payers, I started a concierge practice.   In this setting, I collected a y...
Source: Kevin, M.D. - Medical Weblog - August 16, 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

A physician contemplates Medicare blended rates
I am a terrible coder. I think I am a pretty good doctor, but when it comes to coding, the process of figuring out which billing code to pick to assign to a bill for an office visit, I am hopeless. No matter how many times I have had the rules explained to me, or how much feedback I have been given about specific visits, or which “pocket guide” to coding I have been handed over the years, I can’t seem to get it right. Even my errors are non-systematic. Sometimes I “overcode” (picking a visit level insufficiently supported by my note) and other times “undercode.” And the things I ge...
Source: Kevin, M.D. - Medical Weblog - August 15, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/ira-nash" rel="tag" > Ira Nash, MD < /a > Tags: Policy Medicare Primary Care Public Health & Source Type: blogs

Cats & Dogs: Can We Find Unity on Health Care IT Change?
By MATTHEW HOLT Today we have a humming economy and insane politics. In early 2009 we were in economic meltdown and were about one week into the sanest, soberist Administration and even Congress over many recent decades. In February 2009 They passed a stimulus bill that had a huge impact on the health IT market (and still does). At that time there was much debate on THCB about what the future of health IT policy should look like and how the stimulus “Meaningful Use” money should be spent. My January 2009 summary of that whole debate introduced the notion of “Cats and Dogs in health IT”. They&r...
Source: The Health Care Blog - August 15, 2018 Category: Consumer Health News Authors: matthew holt Tags: Matthew Holt 2008 Election EHR Health 2.0 Policy Policy/Politics RHIOs Startups Source Type: blogs

Home cooking: Good for your health
Can you imagine if you went to your primary care doctor’s office for cooking classes? What if your visit included time spent planning meals, discussing grocery lists and the benefits of home cooking, and learning culinary techniques? If that sounds odd to you, it shouldn’t. We already know that the more people cook at home, the healthier their diet, the fewer calories they consume, and the less likely they are to be obese or develop type 2 diabetes. A growing body of scientific evidence supports teaching patients how to cook meals at home as an effective medical intervention for improving diet quality, weight l...
Source: Harvard Health Blog - August 15, 2018 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Food as medicine Health Healthy Eating Source Type: blogs

Raj of the NHS – How doctors from India and Pakistan saved the NHS
By ROHIN FRANCIS  India and Pakistan celebrate 71 years of Independence today. The British National Health Service owes them a debt of gratitude. Great Britain’s national dish is famously chicken curry, but South Asia’s impact on this sceptred isle extends far beyond food. It is a testament to how ingrained into the British psyche the stereotypical Indian doctor has become that in 2005 a poll of Brits found the doctor they’d most like to consult is a 30-something South Asian female. In 2010 the BBC even ran a popular TV series simply entitled ‘The Indian Doctor’ following a story played ...
Source: The Health Care Blog - August 15, 2018 Category: Consumer Health News Authors: at RogueRad Tags: NHS Source Type: blogs

Patient discharge from hospital to general practice: thematic report 2017-2018
Healthcare Inspectorate Wales - This review found some problems with the discharge process, including a lack of awareness from some hospital staff on procedures and poor communication with general practices. As a result, Healthcare Inspectorate Wales has made thirteen recommendations to improve the quality of patient discharge.ReportPress release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - August 15, 2018 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Patient safety Quality of care and clinical outcomes Regulation, governance and accountability Source Type: blogs

Sorry doctor, you ’re already an actor
Following one of my recent articles on how physicians can improve their communication skills and ultimately help attain better patient outcomes, I received an interesting comment from a physician. It went something like this: “Sorry, but I’m not an actor.” This response typifies a small (but not insignificant) subset of responses I get when I’m discussing and promoting techniques that any doctor can utilize to better their skills in this area (I secretly also enjoy trying to engage doctors like this and convince them to see differently). And while I don’t claim to have any monopoly of eternal ...
Source: Kevin, M.D. - Medical Weblog - August 14, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/suneel-dhand" rel="tag" > Suneel Dhand, MD < /a > Tags: Physician Primary Care Source Type: blogs

Commentators and Journalists Weigh In On The MyHR Debate. Lots Of Interesting Perspectives - 4.
Note: I have excluded any commentary taking significant funding from the Agency or the Department of Health on all this to avoid what amounts to paid propaganda. (e.g. CHF, RACGP, AMA, National Rural Health Alliance etc. where they were simply putting the ADHA line – viz. that the myHR is a wonderfully useful clinical development that will save huge numbers of lives at no risk to anyone – which is plainly untrue)-----http://www.abc.net.au/radionational/programs/healthreport/how-are-gps-using-my-health-record/10077244How are GPs using My Health Record?Liste n now (Link will open in new window)Download audio...
Source: Australian Health Information Technology - August 14, 2018 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs

Neighborhood Navigator to address Social Determinants of Health
The EveryONE project is an initiative from the American Academy of Family Physicians focused on helping primary care physicians learn about and address the social determinants of health (SDOH). The Neighborhood Navigator is an output of this project. The navigator allows a user to search for services available in their zip code that will help them with issues such as hunger, paying for medical care and job training. It is important that SDOH are addressed alongside an individual’s physical health needs and this navigator offers a place to start in addressing them. If you’re interested in learning how one SDOH o...
Source: BHIC - August 13, 2018 Category: Databases & Libraries Authors: Erin Seger Tags: General Source Type: blogs

Making the world a better place for new medical interns
It’s that time of year again. The start of a new academic year, marked by the arrival of a brand-new class of interns starting out in their training. Clutching their freshly-minted medical degrees, they appear so ready, so anxious, so excited, so eager to learn. Now it’s our job to make sure they stay this way. (Have I written this column before? Every year …) Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 13, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/fred-n-pelzman" rel="tag" > Fred N. Pelzman, MD < /a > Tags: Education Hospital-Based Medicine Primary Care Source Type: blogs

Top 5 Ways to Create a Stellar Patient Experience
The following is a guest blog post by Sarah Bennight, Marketing Strategist for Stericycle Communication Solutions, as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms Patient experience has always been something healthcare delivery organizations should strive to improve. However, in the past couple of years, patient experience has received a necessary focus as health consumers are presented with more choice, transparency, and data to navigate their healthcare journey. But with so many choices available, what can health providers do to drive loyalty? I recen...
Source: EMR and HIPAA - August 13, 2018 Category: Information Technology Authors: Guest Blogger Tags: Care Management System Digital Health Healthcare Healthcare Communication HealthCare IT mHealth Patients Communication Solutions Series Health Care Communications Healthcare Technology Patient Communication Patient Experience Sarah Source Type: blogs

The nuances of a primary care visit aren ’t always appreciated
I subscribe to a financial newsletter that happens to be written by a non-practicing physician in a highly specialized field. His daily updates are a mixture of financial and health advice, and he is a proponent of evidence-based medicine. Based on the letters from subscribers, they are willing to follow his advice eagerly, and when he gives some references to support his medical opinions this seems logical. But he is so far distanced from clinical practice that some of his advice is not only glib and superficial, but disturbing. Recently, a newsletter contained an exchange where a person wrote in that his doctor told him ...
Source: Kevin, M.D. - Medical Weblog - August 12, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/barbara-l-pierce" rel="tag" > Barbara L. Pierce, MD < /a > Tags: Physician Primary Care Source Type: blogs

As I ’ve always suspected, Health Care = Communism + Frappuccinos
By MATTHEW HOLT Happy 15th birthday THCB! Yes, 15 years ago today this little blog opened for business and changed my life (and at least impacted a few others). Later this week we are going to celebrate and tell you a bit more about what the next 15 years (really?) of THCB might look like. But for now, I’m rerunning a few of my favorite pieces from the mid-2000s, the golden age of blogging. Today I present “Health Care = Communism + Frappuccinos”, one of my favorites about the relationship between government and private sector originally published here on Jan7, 2005. And like the Medicare one from last we...
Source: The Health Care Blog - August 12, 2018 Category: Consumer Health News Authors: matthew holt Tags: Matthew Holt OP-ED 15th Birthday Celebration Commumism Frappuchinos Source Type: blogs

Atul Gawande ’s prescient 2012 TED talk
Health care is buzzing as Atul Gawande has been selected as CEO of the Berkshire-Hathaway/Amazon/JP Morgan strategic venture. I was thrilled they picked a physician, like myself, in the trenches to run their gig. After hearing the news, I remembered Gawande’s TED Talk from 2012 and decided to catch up on it during my flight to the Healthcare Finance Management Association Annual Meeting and Innovation Lab. After watching the talk, “How do we heal medicine,” it occurred to me that while Gawande is a forward-thinking surgeon with good ideas on how to disrupt the systems of health care, he is ...
Source: Kevin, M.D. - Medical Weblog - August 12, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/natalie-hodge" rel="tag" > Natalie Hodge, MD < /a > Tags: Policy Primary Care Public Health & Source Type: blogs

Don ’t throw the E & M baby out with the bath water: the proposed CMS changes
By now everyone has heard that the Centers for Medicare and Medicaid Services (CMS) has proposed to dramatically change the way physicians get paid for evaluation and management (E&M) services in the office as part of the proposed 2019 Physician Fee Schedule Rule. In fact, as of the end of July, CMS has received over 600 comments on the proposed rule, with virtually all of them criticizing the proposal. I suspect very few physicians have read the 55 pages describing CMS’ proposal and basing their comments on reporting by various agencies. I don’t fault anyone for not reading it; understanding CMS regulation...
Source: Kevin, M.D. - Medical Weblog - August 11, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/ronald-hirsch" rel="tag" > Ronald Hirsch, MD < /a > Tags: Policy Practice Management Primary Care Source Type: blogs

What parenting has taught me about doctoring
Last year, my high school aged son took an interest in healthy eating. He began examining nutrition labels and scrutinizing the foods that we routinely keep around the house and came up with a list of criticisms and suggestions — some well-founded, and others a bit extreme. At first, my wife and I were quick to debate him on certain choices like eliminating any breakfast cereal that has enough sugar not to taste like cardboard, but our eating chasm just widened, our advice was ignored, and he became more resolute in his views. Once we showed genuine interest in and openness to his ideas, he relaxed a bit, and we bega...
Source: Kevin, M.D. - Medical Weblog - August 10, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jeffrey-h-millstein" rel="tag" > Jeffrey H. Millstein, MD < /a > Tags: Physician Nutrition Primary Care Source Type: blogs

Lifestyle change as precision medicine
Are you frustrated that you dropped only a few pounds following a new diet, but your best friend lost almost 30? Why did the probiotics that helped your sister’s bloating sensation do nothing for you? Your coworker swears that going gluten-free made his joint pain disappear, but you just came away craving more bread and pasta. In a world where we expect personalized products and services delivered promptly to our screens and doors, medicine is not even close to bringing this level of experience. Why does precision medicine in the 21st century remain so elusive? We are using an old framework to resolve the most common...
Source: Harvard Health Blog - August 9, 2018 Category: Consumer Health News Authors: Marcelo Campos, MD Tags: Health Source Type: blogs

Supertanker partnerships
Is bigger really any better when it comes to primary care? Related items fromOnMedica Conditions in the NHS have worsened, new report shows Scotland to introduce legal requirement on NHS staffing Practices need to seize the opportunity of consolidating IT systems GPs warn government: fund service properly or it will collapse NHS funding falls short of 4% needed for improvements (Source: OnMedica Blogs)
Source: OnMedica Blogs - August 7, 2018 Category: General Medicine Source Type: blogs

Supertanker partnerships
Is bigger really any better when it comes to primary care? Related items fromOnMedica Conditions in the NHS have worsened, new report shows GP contract for England brings overall 3.4% increase NHS funding falls short of 4% needed for improvements Practices need to seize the opportunity of consolidating IT systems GPs warn government: fund service properly or it will collapse (Source: OnMedica Blogs)
Source: OnMedica Blogs - August 7, 2018 Category: General Medicine Source Type: blogs

A better way to handle patient handoffs from the hospital
As we all know, the time around discharge from the hospital is a tricky one. In more ways than one can imagine, patients are in a delicate state, judged by those caring for them to no longer be sick enough to need to remain in the hospital, but possibly not quite completely ready to be fully back in the community, on their own at home. Over the past few years, there have been a lot of interventions aimed at focusing resources on this transition time, trying to figure out the best way to make it a successful one. All parties involved clearly want to make this smooth and error-free — first and foremost, the patient. Re...
Source: Kevin, M.D. - Medical Weblog - August 4, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/fred-n-pelzman" rel="tag" > Fred N. Pelzman, MD < /a > Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs

Can empathy be taught to physicians?
We want competent physicians, but we also want compassionate ones. How do we get them? Is it nature or is it nurture? Is it more important to search out more compassionate students, or should we instill compassion somehow in the ones we start along the training pipeline? I think the answer lies in nurturing what nature has already put there. My background is in pediatric critical care, which I have practiced for thirty-five years. Throughout most of my career, I have taught medical students, residents, and fellows. So I have seen young physicians as they made their way as best they could through the long training process. ...
Source: Kevin, M.D. - Medical Weblog - August 2, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/christopher-johnson" rel="tag" > Christopher Johnson, MD < /a > Tags: Education Hospital-Based Medicine Medical school Primary Care Source Type: blogs

How Proposed Changes to Medicare Documentation Regs Can Impact Palliative Care
by Amy Davis (@MaximizeQOL)(CMS open to comments until Sep 10, 2018. See end of post for details. - Ed.)Centers for Medicare and Medicaid Services (CMS) hasproposed sweeping reforms to documentation requirements, clinician reimbursement, and the Quality Payment Program (QPP), to begin in 2019. (1) If approved in their current form, the changes are likely to have dramatic net negative effects on outpatient palliative care reimbursement. A detailed review and analysis of all 1,473 pages of the Proposed Rule, plus its addenda, would not be practical here. The reader is referred to thecomplete text (1) andothers ’ a...
Source: Pallimed: A Hospice and Palliative Medicine Blog - August 2, 2018 Category: Palliative Care Tags: billing CMS davis The profession Source Type: blogs

Co-Occurring Conditions in Children with Autism: Assessment to Intervention
In an online chat, SLP Donna Murray discusses how to address co-occurring conditions to create an effective learning environment for children with autism spectrum disorder. Participant: If a participant was to remember or put into practice only one idea from your session, what would that one key takeaway be? Donna Murray: I think the most important takeaway is to consider co-occurring conditions when making accommodations for successful intervention. For example, anxiety is very common in children with ASD and providing use of visual supports to predict upcoming activities as well as ending of activities can be very helpfu...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - August 1, 2018 Category: Speech-Language Pathology Authors: Donna Murray Tags: Academia & Research Health Care Private Practice Schools Slider Speech-Language Pathology anxiety autism Autism Spectrum Disorder social communication disorder Source Type: blogs

This Is Really Important And Relevant Information On The myHR For The Young.
This appeared a few days ago and needs more exposure:Freezing out the folks: default My Health Record settings don ’t protect teens’ privacy July 27, 2018 3.28pm AEST There are measures teenagers can take to protect sensitive details in their My Health Record. From shutterstock.com AuthorsMelissa Kang Associate professor, University of Technology Sydney Lena Sanci Interim Head, Department of General Practice, University of Melbourne As the opt-out period for the My Health Record continues, so too does the debate surrounding issues of confidentiality. While possible data breaches have generated widespread c...
Source: Australian Health Information Technology - August 1, 2018 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs

Is double health insurance coverage better?
You have just gotten a job offer that includes health insurance.  You’re lucky enough that your spouse has great family insurance already, but hey that health insurance is going to cover the cracks in the deductible and co-insurance, so you feel great about that double coverage as you sign your contract. Well, you just got scammed.  That is, double coverage is a scam, and you would have been far better off negotiating a higher salary in return for not getting insurance.Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how...
Source: Kevin, M.D. - Medical Weblog - July 30, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/nicholas-fogelson" rel="tag" > Nicholas Fogelson, MD < /a > Tags: Finance Primary Care Source Type: blogs

Who Cares About the Doctor-Patient Relationship? A Review of “ Next In Line: Lowered Care Expectations in the Age of Retail- and Value-Based Health ”
By KIP SULLIVAN, JD A mere two decades ago, the headlines were filled with stories about the “HMO backlash.” HMOs (which in the popular media meant most insurance companies) were the subject of cartoons, the butt of jokes by comedians, and the target of numerous critical stories in the media. They were even the bad guys in some movies and novels. Some defenders of the insurance industry claimed the cause of the backlash was the negative publicity and doctors whispering falsehoods about managed care into the ears of their patients. That was nonsense. The industry had itself to blame. The primary cause of the ba...
Source: The Health Care Blog - July 30, 2018 Category: Consumer Health News Authors: matthew holt Tags: Patients Physicians care advocates Next In Line: Lowered Care Expectations in the Age of Retail- and Value-Based Health patient-provider relationship Value-Based Payment Source Type: blogs

Why we ’ re launching a Consumer Directed Exchange (CDEx) project
If your first question is “what’s Consumer Directed Exchange?” please feel free to google it and come back. Last week, Alliance for Better Health launched the first regional effort in the United States toward facilitating CDEx for Medicaid Members. Here’s my short (?) version of what/why/how We consumers (people?) are becoming increasingly aware of the information that others have acquired about us.  We implicitly trust Facebook, Google, Apple, etc. to keep our information safe, and share it with others only when we choose.  As health care has evolved from paper, there is now an extra...
Source: Docnotes - July 30, 2018 Category: Primary Care Authors: Jacobr Tags: Consumer Source Type: blogs

Is going to medical school a wise financial decision?
It is no secret that medical school is getting very expensive. Over the past 20 years, the cost of medical school has greatly outpaced the rate of inflation, and medical school debt is rapidly rising. The average medical student now graduates with over $192,000 in student loans, but with the cost of attendance for the most expensive private medical schools approaching $100,000, there are some physicians who are finishing residency with $300,000 or even $400,000 in student loans. The rate of increase in medical school tuition, with its increasing student loan burden as a consequence, has not significantly deterred...
Source: Kevin, M.D. - Medical Weblog - July 30, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/wall-street-physician" rel="tag" > Wall Street Physician, MD < /a > Tags: Finance Medical school Practice Management Source Type: blogs

Clinical pharmacists in general practice: pilot scheme evaluation
University of Nottingham - This evaluation report showed that clinical pharmacists significantly increase patient appointment capacity and reduce pressure on GPs. More than 490 clinical pharmacists were placed in over 650 practices across England in the pilot project which supports the aim of having over 2,000 clinical pharmacists working in general practice by 2020/21 – a ratio of one per 30,000 patients. The research team investigated the work of the newly created clinical pharmacist roles from the perspectives of the pharmacists, those working immediately with them in their roles, professional stakeholders an...
Source: Health Management Specialist Library - July 30, 2018 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Changing configuration of health services NHS measurement and performance Source Type: blogs

The simple, powerful question doctors should ask their patients
As physicians, we are used to asking our patients lots and lots of questions. It’s our job to elicit information, listen, and then come up with a management plan. There’s a standard script every doctor goes through, based on the science of medicine, and we usually have this memorized to a tee. And that’s all very well and good. However, as with many things in life — especially those that involve human beings and an emotional (and dare I say, spiritual) component — it’s always more than just the science. There’s one great question, however, that doctors utilize to a lesser degree th...
Source: Kevin, M.D. - Medical Weblog - July 29, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/suneel-dhand" rel="tag" > Suneel Dhand, MD < /a > Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs

What personality type fits your medical specialty?
Both patients and providers realize that an internist is different from a surgeon, but specifically how they differ and how this affects their approaches to patient care is largely under-appreciated. Over the last four years, I have conducted over 250 interviews with physicians across specialties and institutions about what they do and why they do what they do. With each project, I continue finding remarkably distinct, specialty-specific values, perceptions, and ways of thinking that seem to directly impact how physicians interpret medical evidence and, ultimately, care for patients. Medical specialties, like other academi...
Source: Kevin, M.D. - Medical Weblog - July 29, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/eric-j-keller" rel="tag" > Eric J. Keller, MD < /a > Tags: Physician Primary Care Surgery Source Type: blogs

Bread – Let it Sing
Listen closely. That crackling sound you hear is the bread “singing”. It’s why you should never cut into a piping hot loaf of bread fresh from the oven, tempting as that may be. Let it rest and sing for awhile as it finishes the process of baking all by itself. Here’s what Jim Lahey has to say about singing, in his book My Bread, which is where I get my bread recipes and technique – Just after you take a loaf out of the oven, something strange often happens: it begins to make wierd noises, a rapid-fire crackling sound, one pop after another. This “singing” as some bakers call it, i...
Source: The Blog That Ate Manhattan - July 28, 2018 Category: Primary Care Authors: Margaret Polaneczky, MD Tags: Uncategorized Bread Cooling Lahey No-Knead Sing Singing Source Type: blogs

Technology ought to  save lives. So why aren’t we using it better?
Technology can be both a blessing and a curse and nowhere is this more painfully evident than in the U.S. health care system. If technology is to be used to improve the patient-doctor relationship, its systems should be designed by physicians who understand these needs, not by regulators and health care conglomerates for whom business objectives are paramount. When it’s all about billing and meeting documentation checkboxes and hospital requirements, clinicians are diverted from their core mission and patient care suffers. A good use of technology would be the creation of a single compatible medical record system tha...
Source: Kevin, M.D. - Medical Weblog - July 28, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/alan-kadish" rel="tag" > Alan Kadish, MD < /a > Tags: Tech Health IT Source Type: blogs

Serving the underserved: a win-win situation
Medical school was a difficult adjustment for me. Coming from a blue-collar background and lacking a medical pedigree, I did not relate to most of my classmates, and I made very few friends. That changed when I met J., a second-generation physician-to-be without the competitive guile or sense of entitlement implicit in most of the medical students I had met. With a generous personality undoubtedly sculpted by the experience of motherhood, she came across to me as someone who generally cared for others. I could tell that she opted for this career with pure intentions in mind. She modeled what I had thought this calling was ...
Source: Kevin, M.D. - Medical Weblog - July 28, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/cory-michael" rel="tag" > Cory Michael, MD < /a > Tags: Physician Primary Care Public Health & Policy Source Type: blogs

Giving Consumers the Tools and Support They Need to Navigate Our Complex Healthcare System
By CINDI SLATER, MD, FACR As physicians and healthcare leaders, we are already well aware that the majority of patients do not have the information they need to make a medical decision or access to appropriate resources, so we didn’t need to hear more bad news. But that is precisely what new research once again told us this spring when a new study showed that almost half of the time, patients have no idea why they are referred to a GI specialist. While the study probably speaks to many of the communications shortcomings we providers have, across the board our patients often don’t know what care they need, or ho...
Source: The Health Care Blog - July 27, 2018 Category: Consumer Health News Authors: matthew holt Tags: Patients Physicians Health care leaders Health care technology patient-provider relationship Physician's Responsibilities Source Type: blogs

Should I or shouldn ’t I? The dilemmas faced by the chronically ill.
After many years of being mostly housebound by chronic illness (which includes chronic pain), here are a few of the dilemmas I’ve faced over and over. I’m confident that I’m not alone in my “should I/shouldn’t I?” world. Do I accept an invitation from a friend to get together or do I refuse it? If I refuse the invitation, depending on who issued it, it may be the last one I’ll receive from this person. In addition, if I refuse, I’ll feel even more isolated from in-person contact than I already do. If I accept the invitation, I might be too sick to visit when the day arrives. ...
Source: Kevin, M.D. - Medical Weblog - July 26, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/toni-bernhard" rel="tag" > Toni Bernhard, JD < /a > Tags: Patient Infectious Disease Patients Primary Care Source Type: blogs

Every doctor should have a plan B. Here ’s why.
I’ve written previously that financial independence is plan B.  Plan A, of course, is life.  Your work and time are precious, and life is too short to be wading through a morass of unhappiness only to get to some endpoint or goal. While I definitely believe in front-loading the sacrifice, the cost should not have to be misery.  Physicians, in particular, tend to look at their job as a calling.  As such, many continue to work long after they have reached financial independence.  No matter what stage of your career, however, I believe that every doctor should have a plan B. It pains m...
Source: Kevin, M.D. - Medical Weblog - July 26, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/docg" rel="tag" > DocG, MD < /a > Tags: Finance Primary Care Washington Watch Source Type: blogs

The Best Easy Dinner You ’ll Ever Make
Okay. Maybe I’m being hyperbolic about this meal because I’m back on my food delivery diet (I still have a few more pounds to go..) and so all I could do was have a small taste after watching Mr TBTAM cook it. But I really don’t think I’m overstating it. Skillet Chicken With White Beans and Caramelized Lemon. One of the easiest amazing dinners you can make. What makes it special is what Alison Roman at the New York Times calls “the liquid gold in your skillet“, that secret ingredient Jewish grandmothers have been sneaking into their children’s vegetables for centuries – chic...
Source: The Blog That Ate Manhattan - July 25, 2018 Category: Primary Care Authors: Margaret Polaneczky, MD Tags: Meat & Poultry skillet chicken with white beans and carmelized lemons Source Type: blogs

How urgent care rejuvenates this primary care doctor
I volunteered to work Saturdays. And to do walk-ins. And to take all comers, not just our patients. It has been an interesting journey. Some clinics put their newest, least experienced clinicians on the very front line of doing urgent care. Here, it’s the opposite. I’ve got 39 years under my belt, and I see everything from sore throats to people who left the emergency room in the middle of a workup because their anxiety kept them from waiting for their CT scan to rule out a blood clot in their lungs. The waiting room fills up, and it’s just me and a medical assistant. Continue reading ... Your patients a...
Source: Kevin, M.D. - Medical Weblog - July 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/a-country-doctor" rel="tag" > A Country Doctor, MD < /a > Tags: Physician Primary Care Source Type: blogs

The pathologic manifestations of professionalism
Four years ago after moving back to Iowa City, I needed to find a new primary care doctor. I went to the University’s website and scanned the list of general internists. There I noted a physician that I had known when she was a medical student during my prior stint at the University of Iowa 20 years prior. She had been an amazing medical student, very bright, hardworking, conscientious, and intellectually curious. My guess was that she now was an amazing internist. I asked a few colleagues about her and the responses were consistent: a superb clinician, an internist’s internist. Exactly what I was looking for. ...
Source: Kevin, M.D. - Medical Weblog - July 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/michael-edmond" rel="tag" > Michael Edmond, MD, MPH < /a > Tags: Physician Practice Management Primary Care Source Type: blogs

migrant.health
Doctors of the World UK -This website is an online tool for people working in primary care who want to learn about and discuss how to provide high quality care for migrant patients, particularly those who might be in more vulnerable circumstances.Website (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - July 25, 2018 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Local authorities, public health and health inequalities Quality of care and clinical outcomes Source Type: blogs

CHAMP-HF: Heart Failure Treatment in US Remains Subpar
@media print { body { margin: 2mm 9mm; } .original-url { display: none; } #article .float.left { float: left !important; } #article .float.right { float: right !important; } #article .float { margin-top: 0 !important; margin-bottom: 0 !important; } }CHAMP-HF: Heart Failure Treatment in US Remains Subparhttps://www.medscape.com/viewarticle/899433?src=rssCHAMP-HF: Heart Failure Treatment in US Remains SubparMajor gaps remain in use and dosing of evidence-based, guideline-recommended medications for heart failure with reduced ejection fraction (HFrEF), according to a new...
Source: Dr Portnay - July 25, 2018 Category: Cardiology Authors: Dr Portnay Source Type: blogs

Love smart functions in your EMR? This doctor doesn ’t.
How smart do we want our electronic health record to be? Somewhere between as dumb as a piece of paper and a pen, and too smart for our own good. Many, many years ago, before we spent the majority of our office visit staring at a flatscreen LED and typing away, our charts were simple manila folders with those bendy metal bars that allowed you to insert new pages, separated into multiple sections with cool little colored divider tabs. You’d open up the chart, find the most recent progress note, go to the end of that one, and just start writing. Sure, there were red pages that listed allergies, little flags that said w...
Source: Kevin, M.D. - Medical Weblog - July 24, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/fred-n-pelzman" rel="tag" > Fred N. Pelzman, MD < /a > Tags: Tech Health IT Practice Management Primary Care Source Type: blogs

Title X – Free Speech Under Fire. Again.
It’s deja vu all over again, as the current administration, borrowing a never-implemented move from the Reagan administration, attempts to gag physicians who provide reproductive care to women. New proposed regs would forbid Title X funded providers from freely providing information about abortion to their patients, limiting such conversation to the provision of a list of names to women who have already decided to have an abortion. Given that close to 50% of pregnancies in the United States are unplanned and that a significant proportion of women with unplanned pregnancy are unsure what they will do at the time of di...
Source: The Blog That Ate Manhattan - July 24, 2018 Category: Primary Care Authors: Margaret Polaneczky, MD Tags: Abortion Family Planning Uncategorized gag planned parenthood Ruling Title X Source Type: blogs

Is there a case against shared decision making?
In a matter of less than a decade, “shared decision-making” (SDM) has emerged as the uncontested principle that must inform doctor-patient relationships everywhere.  Consistently lauded by ethicists and medical academics alike, it has attracted the attention of the government which is now threatening to penalize doctors and patients who do not participate in SDM prior to providing certain treatments, even if the legal process of informed consent has been fulfilled — and even if the treatment is widely considered to be clinically justified. For example, in a recent issue of JAMA, an editorial&nbs...
Source: Kevin, M.D. - Medical Weblog - July 23, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/michel-accad" rel="tag" > Michel Accad, MD < /a > Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs