This burned out physician was happier as a resident
I log onto KevinMD every day to get my much-needed dose of physician commiseration. At least once a day, one of us writes an article about burnout. It typically leaves me feeling quite validated. I particularly enjoy reading the comments section, as many of you make me laugh with your physician reality-based humor. I am more burned out than I ever hoped to be. I work in primary care, have a family and my spouse is a surgeon. My spouse and I are equally burned out, despite our differing specialties. I have “PCP burnout” qualified by: patient-centered care, clicks, forms, feeling like a doormat, patient satisfact...
Source: Kevin, M.D. - Medical Weblog - May 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs

What to do if you want to be a cruise ship doctor
In 2013 I began searching for ways I could change my career to reduce my workload, but not give up medicine altogether. During that time I took a cruise and looked at various jobs I could do on a cruise ship. One of the jobs I was qualified for, I thought, was to be a Cruise Ship Doctor. After talking with the ship’s doctor to find out what it was like to be the doctor on a ship, I realized that I would enjoy that life. When I arrived back home I sent in an application to a cruise line. I was promptly informed that general surgeons were not qualified to be a ship’s doctor. They only accept physicians who practi...
Source: Kevin, M.D. - Medical Weblog - May 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/cory-fawcett" rel="tag" > Cory Fawcett, MD < /a > Tags: Physician Practice Management Primary Care Source Type: blogs

The Top 12 Health Chatbots
Meet Molly, Eva, Ginger, Replika, Florence, Izzy – your new chatbot friends aiming to make your life better. In the last years, smart algorithm-powered, text or voice-based interfaces have multiplied, and they are also taking their place in healthcare. The Medical Futurist believes they will ease the burden on doctors in primary care and help patients learn to take care of their health responsibly. Do you want to try one? Check out the following health chatbots! The age of chatting algorithms is coming Last week, Google stunned the world with the latest feature of the Google Assistant, Duplex, that was able to m...
Source: The Medical Futurist - May 25, 2018 Category: Information Technology Authors: nora Tags: imported AI artificial intelligence chatbot chatbots digital health future health chatbot Innovation List medical Medicine Personalized medicine technology Source Type: blogs

A Picture is Worth a Thousand Words
By MEGHAN CONROY These days I’m spending a lot of time getting in depth with many tech companies. From time to time I’ll be asking those innovators to tell their story on THCB, and suggest what problems they are solving. First up is Meghan Conroy from Captureproof—Matthew Holt Today’s doctors are communicating with their patients less than ever before, even as their days grow longer and busier. Physicians are pressured to see more patients in shorter encounters, while at the same time shouldering more of the administrative and documentation tasks associated with electronic medical records (EMR). The...
Source: The Health Care Blog - May 23, 2018 Category: Consumer Health News Authors: Matthew Holt Tags: Health 2.0 Captureproof Meghan Conroy Source Type: blogs

What does curiosity have to do with patient safety?
Why do we say “curiosity killed the cat?” Isn’t curiosity what drives people to ask insightful questions? To keep an open mind? And to continue learning at age 6 or 60, alike? Curiosity is what sets apart people who are fixed in their opinions and beliefs and those who adjust in light of new information. Recently, I read an article in The New Yorker that suggested that Donald Trump doesn’t read books unlike most of his predecessors. One aspect of my transition to academia from industry that continues to surprise me (every day!) is how much people read — they not only read peer-reviewed literat...
Source: Kevin, M.D. - Medical Weblog - May 23, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/elizabeth-lerner-papautsky" rel="tag" > Elizabeth Lerner Papautsky, PhD < /a > Tags: Patient Primary Care Source Type: blogs

Why the battle against being called a provider is probably lost
I recently needed to transfer my patient to a larger medical center for some urgent care. As I sat there in my relatively small hospital working out where they would be best served, a famous academic medical center that was not too far away, came to mind. I placed a call to the facility’s bed facilitator, who took the patient’s details from me, and was told to await a callback from the medicine resident team on-call. I didn’t have to wait very long before I got the call. “Hello” “Hello, did you want to talk to us about a patient?” “Yes, I am the attending physician taking car...
Source: Kevin, M.D. - Medical Weblog - May 22, 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 Practice Management Primary Care Source Type: blogs

The best medical specialty you ’ve never heard of
The most common response when I introduce myself as a preventive medicine resident is an interjection, “You mean family medicine?” I have come to realize that the majority of the healthcare field has never heard of preventive medicine as a unique medical specialty. It’s a shame, because preventive medicine is truly the best medical specialty you’ve never heard of. Preventive medicine practices at the intersection of public health and clinical medicine — we are population doctors. Sure, we love vaccines as much as the next physician, but we do so much more than give flu shots. We provide clinic...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jennifer-chevinsky" rel="tag" > Jennifer Chevinsky, MD < /a > Tags: Physician Primary Care Source Type: blogs

A Hippocratic Oath for technology
Modern technology needs to do better. This is the message delivered by every CEO after every Silicon Valley scandal in recent memory. This time, they should really do it. Medicine can show them how. Let’s have the professionals building our future abide by industry-wide standards, just as doctors do. As both a startup founder and a physician, this idea makes intuitive sense to me. Drawing on my experience treating patients and running a digital platform, here’s what a Hippocratic Oath for tech might look like. First, it shouldn’t say “first do no harm.” Not that I’m in favor of doin...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/joshua-landy" rel="tag" > Joshua Landy, MD < /a > Tags: Tech Mobile health Primary Care Source Type: blogs

Healthcare Should Be Invisible
What if healthcare worked as an unseeable fairy mother with a swarm of digital helpers? In the background, many digital tools, smart algorithms, health trackers and wearables would work for your well-being discreetly, you could be sure that you are taken care of, but you would only sense that on rare occasions. How would you fancy the invisible healthcare system? The Medical Futurist believes that we should move in that direction. Healthcare should be what Zorg showed us in The Fifth Element Do you remember the scene from the brilliant Luc Besson movie, The Fifth Element, where Gary Oldman as one of the leading antagonist...
Source: The Medical Futurist - May 22, 2018 Category: Information Technology Authors: nora Tags: Future of Medicine Healthcare Design AI artificial intelligence chatbot digital health health chatbot health trackers healthcare system Innovation robotics sensors technology VR wearables Source Type: blogs

The unscientific lure of antibiotics
Although my father did not discover penicillin, he helped do the research showing its effectiveness in curing infective endocarditis. As an internist, he then became enamored with the role antibiotics could play in treating infections. Growing up, my siblings and I can attest to his unbridled enthusiasm, as every time we contracted a cold, we would get a shot of the wonder mold in our butts. The fact that colds were caused by viruses and not bacteria did little to dissuade him from the utility of the treatment. When I finally developed a rash after another shot, I celebrated the fact that the painful solution would never e...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/david-mokotoff" rel="tag" > David Mokotoff, MD < /a > Tags: Physician Infectious Disease Primary Care Source Type: blogs

Health in 2 point 00, Episode 25
It’s late late at #hin2pt00 central. But somehow Jessica DaMassa wakes me up enough to get my views on Redbrick & Virgin Pulse, the VA finally inking the Cerner deal and Iora Health getting another $100m to build out their primary care model. Be warned, Jessica thinks I’m not full of cheer about any of it!–Matthew Holt (Source: The Health Care Blog)
Source: The Health Care Blog - May 22, 2018 Category: Consumer Health News Authors: Matthew Holt Tags: Health in 2 point 00 Jessica DaMassa Matthew Holt Cerner Iora Health Redbrick Health VA Virgin Pulse Wellness Source Type: blogs

Dr. Ronny Jackson: A victim of political accusations, or physician burnout?
It is no secret that President Trump’s former nominee to run the Veterans Administration, Navy Rear Admiral Ronny L. Jackson, has withdrawn his nomination amidst allegations related to his behavior: that he drank on the job, was a bully in the office and improperly gave out prescription medication.  He has vehemently denied the allegations and characterized them as false and fabricated. Dr. Jackson is an Iraq War veteran who President Trump has called an “American hero.” The rear admiral has previously also served presidents Obama and George W. Bush as White House physician.  By many accoun...
Source: Kevin, M.D. - Medical Weblog - May 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/shawn-c-jones" rel="tag" > Shawn C. Jones, MD < /a > Tags: Physician Primary Care Psychiatry Source Type: blogs

Why all physicians need mentors
Having a mentor leads to a more successful and satisfying career for doctors. So how does one go about finding a mentor mid-training or after training? Many medical schools and residency programs have mentorship requirements for trainees. But those mentorship needs may change if a student or resident (like myself!) changes their mind about what they want to be when they grow up. I have been enthusiastic about a different specialty every one to two years during training which led to frequent frantic searches for mentors. Even now as an attending four to five years into my career, I continue to seek advice from peers and mor...
Source: Kevin, M.D. - Medical Weblog - May 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/joannie-yeh" rel="tag" > Joannie Yeh, MD < /a > Tags: Physician Medical school Primary Care Source Type: blogs

How mindfulness helped this physician ’s primary care journey
“Paying attention in a particular way: on purpose, in the present moment and nonjudgmentally.” That’s how Jon Kabat-Zinn, PhD, describes mindfulness. In the book Zen Mind, Beginner’s Mind, another thought leader in mindfulness, Shunryu Suzuki, says that, “In the beginner’s mind there are many possibilities, but in the expert’s there are few.” In my experience, I’ve found that cultivating a beginner’s mind opens doors and improves clinical diagnosis. Medical training has phases, and clinicians in different phases think differently. In medical school, students learn...
Source: Kevin, M.D. - Medical Weblog - May 20, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/heather-finlay-morreale" rel="tag" > Heather Finlay-Morreale, MD < /a > Tags: Physician Primary Care Source Type: blogs

How this physician handles burnout
“Put me out of my misery!” I’ve pleaded to anyone within earshot in the throes of a grueling day, a rant from one feeling burnt out. There are days I want to pull my hair out, even the ones that aren’t gray. One night I caught myself grunting, “I hate my life,” while heading out the door at 12 a.m., after an already exhausting day in the OR. No sane person should ever say that. But the world of medicine nowadays is far from sane. After returning home for two hours of sleep, I drag myself to the office with a full patient-load, which is not bad in itself if it weren’t for that unset...
Source: Kevin, M.D. - Medical Weblog - May 19, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/randall-s-fong" rel="tag" > Randall S. Fong, MD < /a > Tags: Physician Primary Care Source Type: blogs

Stop shaming those with addiction
He was younger than I was — still in his twenties — but the patient had already had his chest opened twice. Deadly bloodstream infections contracted from sharing needles had destroyed his heart valves on two separate occasions. And now six months out from his most recent operation, he was back with fever and chills: ominous signs of another infection. That was years ago. The opioid epidemic hadn’t yet been declared a public health emergency. I had just begun my training in cardiology, and he was the first such patient that I had ever taken care of. In the ensuing years, there would be many more like him: ...
Source: Kevin, M.D. - Medical Weblog - May 19, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/akshay-pendyal" rel="tag" > Akshay Pendyal, MD < /a > Tags: Physician Emergency Medicine Primary Care Source Type: blogs

6 ways to address the opioid epidemic
The devastating opioid epidemic is one of the largest public health problems facing the U.S. Over 2.5 million people in the U.S. suffer from opioid use disorder. Four in five new heroin users started out misusing prescription painkillers. A 2015 analysis by the Centers for Disease Control and Prevention found people who are addicted to painkillers are 40 times more likely to be addicted to heroin. The epidemic actually began more than three decades ago. In 1980, crack and cocaine addiction contributed to the thousands of overdose deaths, whereas now people die from pain relievers and synthetic opioids such as fentanyl. In ...
Source: Kevin, M.D. - Medical Weblog - May 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/nabila-el-bassel" rel="tag" > Nabila El-Bassel, PhD < /a > Tags: Conditions Pain Management Public Health & Policy Source Type: blogs

Too many things need physicians ’ signatures
Just sign here. How many times a day are we asked to do this? “Just sign here.” “Just put down your license number.” “We need a stamp with your doctor’s info on it.” “Give us your NPI.” “Initial here, here, and here.” If we took the time to read all the things we’re signing, we wouldn’t have time to do any doctoring. 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 - May 18, 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 Practice Management Primary Care Source Type: blogs

Primary care home: community pharmacy integration and innovation
This report aims to inspire further integration of community pharmacy within primary care homes to improve patients ’ health and support them to manage their conditions. The paper concludes that by learning from those leading the way and exploring innovative ways of working together they could have a bigger impact on improving the health and care needs of their local population.ReportNational Association of Primary Care - news (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - May 17, 2018 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Integrated care Source Type: blogs

NHS England ’s management of the primary care support services contract with Capita
This report assesses whether NHS England managed the contract effectively to secure the intended benefits. It examines how the PCSE contract was set up; performance issues , including action taken by NHS England and Capita to address these issues; the reasons for the contract failures; and the current status of the contract.ReportSummary reportNational Audit Office - publications (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - May 17, 2018 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: NHS finances and productivity NHS measurement and performance Source Type: blogs

How do we keep women physicians in medicine?
Undoubtedly, my favorite part of my non-clinical work is hearing from fellow physicians about their lives in medicine.  Every once in a while, I receive an email that puts beautifully into words some of my own struggles. A few weeks ago, I received an email from a colleague outlining her personal journey through her career, which she was hoping other physicians would benefit from as well.  I know it spoke to me, and wanted to share it (with permission) after anonymizing some of the details. Hi Nisha, I did my residency and fellowship in (…).  During my residency, I decided to have a bab...
Source: Kevin, M.D. - Medical Weblog - May 16, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/nisha-mehta" rel="tag" > Nisha Mehta, MD < /a > Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs

Blockchain technology can dramatically transform health care delivery
Blockchain technology has the potential to dramatically transform health care delivery by facilitating data exchange between providers and electronic health record (EHR) systems. A decentralized and transparent platform, blockchain technology provides an authenticated platform that applies a consensus-driven approach to facilitate the interaction of multiple entities through a shared ledger. For the health care sphere, blockchain is simply the sharing of medical information through EHRs across numerous hospital systems that are part of the same distribution group. Any health care organization, regardless of their native EH...
Source: Kevin, M.D. - Medical Weblog - May 16, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/ashwini-m-zenooz" rel="tag" > Ashwini M. Zenooz, MD < /a > Tags: Tech Health IT Hospital-Based Medicine Primary Care Source Type: blogs

Why some physicians thrive and some struggle to survive
I’m sitting in the waiting area across the endoscopy room of a major hospital. Mindless talk show TV runs in the background. Patients are waiting patiently. They anxiously look up every now and then from their phones towards the reception desk. It’s a scene I’ve experienced for years while working in health care while waiting for doctors. But there’s something different in the air now. Patients, like those around me, will encounter a doctor who’s excited and enthusiastic. But some will meet another who’s dreading her career. Health care is changing faster than ever before. It’s jus...
Source: Kevin, M.D. - Medical Weblog - May 15, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/praveen-suthrum" rel="tag" > Praveen Suthrum < /a > Tags: Policy Primary Care Public Health & Source Type: blogs

Physicians: Let us rise. Let us lead.
As has been much discussed in the last few years, our health care system is in crisis. We spend $3 trillion a year on Medicare. MRIs bill out at $5,000. My recent bilateral mastectomy totaled $33,000 with $800 of that actually going to my surgeon. I left my role as an employed physician in the traditional insurance-based fee-for-service structure because I spent 80 or more hours a week typing, collecting data, coding, answering to documentation requirements and saying, “I’m sorry.” “I’m sorry I’m late.” “I’m sorry we can’t address this now.” “I’m...
Source: Kevin, M.D. - Medical Weblog - May 15, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/julie-k-gunther" rel="tag" > Julie K. Gunther, MD < /a > Tags: Physician Primary Care Public Health & Policy Source Type: blogs

HOW TO Improve Doctors ’ Work Environment With Digital Technologies
Work environment has a massive impact on doctors’ empathy, focus, and overall performance. Although some factors are hard to change, such as the location of the medical practice, relationships with colleagues, the payment structure or the patient population, there are marvelous technological responses, which could ease the burden on physicians and help decrease stress. And who says that great solutions can only come from outside? Here are some tips for medical professionals, how they could improve their workspace. Workplace optimization for higher medical career satisfaction Taking care of patients is not a job, it&r...
Source: The Medical Futurist - May 15, 2018 Category: Information Technology Authors: nora Tags: From Chance to Choice Future of Medicine AI artificial intelligence digital digital health Healthcare Personalized medicine technology telemedicine wearables work environment Source Type: blogs

A relatively simple solution to physician burnout
Physician burnout is increasing at an alarming rate. According to a January 2017 AMA Wire report, physician burnout rate has increased from 2013 to 2017 across every specialty in medicine. Greater than 50 percent of primary care providers are burned out. Therefore, every patient at the entry point of medical care is, more likely than not, going to be treated by a burned out physician. The question is why are we so burned out. Self-determination theory (SDT) offers a plausible answer. According to SDT, we all proactively seek to gain mastery over internal and external forces in our lives in order establish our own well-bein...
Source: Kevin, M.D. - Medical Weblog - May 15, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/david-e-hockman" rel="tag" > David E. Hockman, MD < /a > Tags: Physician Health IT Primary Care Public Health & Policy Source Type: blogs

How this physician became a financial advisor
Growing up with a father who is a physician made for a natural draw to medicine. However, as young people are prone to do, I did my best to rebel. Early into my undergraduate career I proudly announced to my father that I had decided to go to law school. And perhaps to dig the needle a little deeper, I told him I planned on going into medical malpractice, on the plaintiff’s side. Fortunately, thanks to genetics and a small degree of maturity, eventually I found myself in medical school. From that point on I naturally assumed I would be a practicing physician for the rest of my life. Not so fast. As my mother was fond...
Source: Kevin, M.D. - Medical Weblog - May 14, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/blake-mcgowan" rel="tag" > Blake McGowan, MD < /a > Tags: Finance Primary Care Source Type: blogs

Burnout: Don ’t blame the clinicians; blame the system
Physician burnout is the depression of the medical world. We are aware of its presence and the detriment it can cause, but yet, we don’t really like to talk about it. The problem is, just like depression, if we don’t talk about it or seek to address it, it persists and leads to a number of unwanted outcomes including decreased productivity, decreased patient satisfaction, and increase in medical errors. And if you are one of those, who thinks this only occurs to a select few, I want you to rethink that. Most statistics suggest that 50 percent of physicians have experienced burnout at one time or another. Thus, ...
Source: Kevin, M.D. - Medical Weblog - May 14, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/anh-le" rel="tag" > Anh Le, MD < /a > Tags: Physician Practice Management Psychiatry Source Type: blogs

Mastering Intensive Care 029 with Claire Davies
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Listen to our intensive care nurses This week was International Nurses Week, which culminated in International Nurses Day on Saturday May 12th, the date on which Florence Nightingale was born. To celebrate this, my special guest this week is an intensive care nurse, Claire Davies. Claire is my wife. To me, she is intelligent, caring, kind and compassionate, as both a nurse and a person. So after struggling for a while with the choice of who I should have as my first ...
Source: Life in the Fast Lane - May 12, 2018 Category: Emergency Medicine Authors: Andrew Davies Tags: Mastering Intensive Care Andrew Davies claire davies ICU nurses intensive care nurses Source Type: blogs

Physician burnout shouldn ’t be linked to resilience
Recently, I was asked to give a talk on resilience and its role in reducing physician burnout.  I was excited by the opportunity, but asked if I could focus more on cultural change and institutional solutions for burnout.  When they said no, I declined.  Why? Well, it’s not that I don’t see the value in resilience.  A lot of physicians that I really respect write and speak about resilience.  I think it’s a valuable concept and think that we (or anyone, really) could benefit from becoming more resilient.  But I’m really hesitant to link my work with physician burnou...
Source: Kevin, M.D. - Medical Weblog - May 12, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/nisha-mehta" rel="tag" > Nisha Mehta, MD < /a > Tags: Physician Practice Management Primary Care Source Type: blogs

Addressing Disparities in Senior Hearing Health Care
Discussion CDC Study Links Noisy Workplaces to Cardiovascular Disease Participant: Has there been any research that points to a decline in cognition changing the way the auditory system functions? Nieman: I think that reflects on the limitations of our traditional audiograms and reliance on pure-tone audiometry. We know that individuals with dementia and Alzheimer’s are able to complete pure-tone audiometry, but higher-order processing that may be required for something like speech-in-noise testing may change for someone with cognitive impairment. Fitting hearing aids or devices for older adults with cognitive impai...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - May 10, 2018 Category: Speech-Language Pathology Authors: Carrie Nieman Tags: Audiology Health Care Private Practice Slider Aging and Hearing Loss audiologist disparities health literacy Hearing Aids patient-centered care Source Type: blogs

How Technology Helped My Family Receive a Better Healthcare Experience
The following is a guest blog post by Brittany Quemby, Marketing Strategist for Stericycle Communication Solutions, as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms When was the last time you had a truly outstanding patient experience? For my family, two healthcare facilities located hours apart recently teamed up to make our lives significantly more convenient. Without modern technology, however, our new reality may never have been possible. Let’s start from the beginning. A few years ago, my family member suffered a heart attack that caused a tra...
Source: EMR and HIPAA - May 10, 2018 Category: Information Technology Authors: Guest Blogger Tags: Care Management System Digital Health Healthcare Healthcare Communication HealthCare IT mHealth Patients Brittany Quemby Communication Solutions Series Health Care Communications Healthcare Personalization Patient Communication Pat Source Type: blogs

Google, Please, Could You Make Me A Dentist ’s Appointment?
Mm-hmm, that’s right, Google just stunned the world at I/O 2018 with the new feature of its Google Assistant. CEO, Sundar Pichai replayed an astonishingly natural-sounding conversation recording on stage which he said was a real dialogue between the colleague of a hair salon and the A.I. making an appointment. In a couple of years, it will be common to make doctors’ appointments through A.I. assistants and health chatbots; while our prearranged meeting will be noted down in an electronic calendar by another algorithm. The age of talking algorithms is here! Natural-sounding A.I. with John Legend’s voice Pi...
Source: The Medical Futurist - May 9, 2018 Category: Information Technology Authors: nora Tags: Artificial Intelligence in Medicine Telemedicine & Smartphones AI chatbot digital assistant future google health chatbot Healthcare technology Source Type: blogs

Using Technology to Coordinate Care and Improve Outcomes in Behavioral Health – #HITsm Chat Topic
We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 5/11 at Noon ET (9 AM PT). This week’s chat will be hosted by Bryan Wempen (@bryanwempen) from Netsmart on the topic of “Using Technology to Coordinate Care and Improve Outcomes in Behavioral Health.” Technology is advancing rapidly and access to individual health and mental health data is starting to become more readily accessible to care providers; reimagining how care will be delivered and supported is a priority.  Example: mobile crisis team on the move utilizing mobile technol...
Source: EMR and HIPAA - May 8, 2018 Category: Information Technology Authors: John Lynn Tags: #HITsm Digital Health Healthcare HealthCare IT Healthcare Social Media #HITsm Topics Behavioral Health Bryan Wempen Coordinated Care Netsmart Source Type: blogs

Undoing what we ’ve done: Why deprescribing is so difficult
A guest column by the American College of Physicians, exclusive to KevinMD.com. I recently saw a 74-year-old patient to establish ongoing care. In reviewing her medical history, she presented me with the list of the 15 medications she was taking. I was a bit shocked given her medical history which really consisted of only the “usual” issues commonly seen in her age range, including hypertension, hyperlipidemia, and osteoarthritis. But she had no complex medical conditions for which a larger number of medications would be expected. She also did not seem like someone who would actively seek out overly aggressive ...
Source: Kevin, M.D. - Medical Weblog - May 8, 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: Physician American College of Physicians Geriatrics Primary Care Source Type: blogs

Spotlight on the 10 High Impact Actions
This report assesses NHS England'sTime for Care programme - specifically, its10 High Impact Actions, which aim to cut workload in general practice. Every GP surgery should be funded to have access to a dedicated social prescriber in a bid to tackle crippling GP workload, and free up their time for those patients most in need of medical care, according to the report.ReportPress release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - May 8, 2018 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Developments in primary and community care Local authorities, public health and health inequalities Source Type: blogs

Funding Disruptive Innovation
“Innovation” is a provocative word. For some, it invokes an eye-roll of disdain: “why can’t we just get our work done?” They rhetorically ask.  Sometimes, the way we are doing things is just fine.  Why distract ourselves with new variants of people, processes, or products just for the sake of doing something new? These folks have a point.  Sometimes we just need to do what needs doing. And sometimes the way we’ve been doing it (or even what we’ve been doing) isn’t optimal.  “There must be a better way” says … someone. That someone is the...
Source: Docnotes - May 7, 2018 Category: Primary Care Authors: Jacobr Tags: Uncategorized Source Type: blogs

Insurance denials: the law of the land
It all started out with Malaysian methimazole, and didn’t end until two highly trained medical professionals sat on opposite ends of a telephone call, scratching their heads and wondering how two digits being transposed could lead to so many problems. Those two transposed digits caused a thyroid uptake scan to become a bone marrow scan (whatever that is). But look at all it took to get there. Mystery illness, mystery medicine It started when a new patient came to see one of my colleagues with a mystery illness, and a medication in a pill bottle with a label in another language. After figuring out what this medicine w...
Source: Kevin, M.D. - Medical Weblog - May 7, 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 Primary Care Source Type: blogs

Take control of your health care (exert your patient autonomy)
Autonomy means being in control of your own decisions without outside influence — in other words, that you are in charge of yourself. It is considered an essential development step toward maturity. We all make decisions about how to live our lives, although sometimes we have less choice than we might like. When it comes to your health care, how much autonomy is the right amount? There’s lots of interest in what the term means. Here’s a definition from MedicineNet: Patient autonomy: The right of patients to make decisions about their medical care without their health care provider trying to influence the d...
Source: Harvard Health Blog - May 7, 2018 Category: Consumer Health News Authors: Carolyn A. Bernstein, MD, FAHS Tags: Health Health care Source Type: blogs

Doctors sometimes lie to their patients. Is it ever OK?
Doctors shouldn’t lie to their patients, even now when the parsing of words and the telling of white lies is common at the highest level of our government. But they do it all the time — sometimes for personal reasons but most of the time for what they believe is the good of their patients. As a neonatologist and a pediatric cardiologist, we know that truth and honesty are key parts of the foundation of the doctor-patient relationship. “Commitment to honesty with patients” is a primary responsibility for physicians set out in the Charter on Medical Professionalism. Yet physicians &mdas...
Source: Kevin, M.D. - Medical Weblog - May 7, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/nana-matoba-and-angira-patel" rel="tag" > Nana Matoba, MD and Angira Patel, MD < /a > Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs

Refuel and engage: small tweaks towards addressing burnout
Picture an alternate universe where you as a physician look forward to your lunch break so that you can refuel and engage with your fellow colleagues. In this imaginary world, not only do you have time to eat and converse with others, but you also have time to throw on your sneakers and go for a walk outside before you start your afternoon. And the best part of all, while you are taking this fantasy break, work isn’t piling up, you haven’t left any patients in the waiting room, and you feel zero guilt because this is accepted workplace culture. I don’t present this scenario to have you long for something ...
Source: Kevin, M.D. - Medical Weblog - May 6, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/sara-taylor" rel="tag" > Sara Taylor, MD < /a > Tags: Physician Primary Care Psychiatry Source Type: blogs

When a physician gets yelled at
It was not so much the words as the overall tone of the interaction. The doctor-patient relationship had been generally affable. There was the usual exchange of pleasantries over the years. Questions about family, children, and grandchildren. It was a good relationship — until Harvey got sick, that is. Originally, there was weight loss and fatigue. The initial physical exam and slew of testing showed nothing but a frail, cachectic, middle-aged man. A few CT scans later, and he was in the oncologist’s office discussing chemotherapy. A regimen was decided on, and therapy began the next day. Therapy was hard. Naus...
Source: Kevin, M.D. - Medical Weblog - May 4, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jordan-grumet" rel="tag" > Jordan Grumet, MD < /a > Tags: Physician Primary Care Source Type: blogs

Creating Sustained Improvement in Primary Care Infrastructure Will Require Long-Term Funding and Targeted Investments
Because of its value and cost-effectiveness, primary care has long been a focus of federal health policies aimed at improving care for low-income, medically vulnerable populations and communities. Building and sustaining a strong primary care system — the foundation of health care — requires a long-term commitment to sustainability and targeted investment in access enhancement and quality improvement.         (Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - May 4, 2018 Category: International Medicine & Public Health Source Type: blogs

Your patient has judged you 7 seconds after meeting you
A doctor is working down their long list of patients, powering through the day, striving to use their skills to get them better. Some of the patients will be follow-ups who they already know; others will be brand new patients, who they are meeting for the first time. Of course, the job of any doctor is first and foremost to heal their patient in whatever way they can. That’s what all the medical school and residency training was all about: to get them to a position where they can safely and competently do this. But the crucial aspect of health care which is notoriously under-taught, is how to communicate with your pa...
Source: Kevin, M.D. - Medical Weblog - May 3, 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

Why physicians should respect the pain patients report
We’re all human beings, but we’re not all alike. Each person experiences pain differently, from an emotional perspective as well as a physical one, and responds to pain differently. That means that physicians like myself need to evaluate patients on an individual basis and find the best way to treat their pain. Today, however, doctors are under pressure to limit costs and prescribe treatments based on standardized guidelines. A major gap looms between the patient’s experience of pain, and the limited “one size fits all” treatment that doctors may offer. Concerns about the opioid epidemic&...
Source: Kevin, M.D. - Medical Weblog - May 3, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/karen-s-sibert" rel="tag" > Karen S. Sibert, MD < /a > Tags: Physician Hospital-Based Medicine Pain Management Primary Care Source Type: blogs

What A Stupid Policy
I guess I am back to blogging. I woke up this morning and read the paper. I could not believe this policy." Breast cancer screening is offered to all women aged 50 to 70 in England every three years; they are sent invitation letters to make an appointment for the test. "Apparently in the UK, patients are'sent invitations'every THREE years for a mammogram. The parts that piss me off are that patients are only invited for a mammogram (shouldn't it be automatically scheduled by their primary care's - or another doctor's - office?) everythree years. What's wrong with annually? Or is it too expensive for the NHS?And t...
Source: Caroline's Breast Cancer Blog - May 3, 2018 Category: Cancer & Oncology Tags: breast cancer cancer diagnosis mammogram stupidity Source Type: blogs

The opioid crisis: Doctors cannot lose hope
While our elected officials in Washington spin political rhetoric and quote scary statistics around the opioid epidemic, New Jersey was one of the first states to take actual action. In February of this year,  New Jersey Attorney General Gurbir Grewal declared its plan of combat: a 24-hour response team, improvements to the prescription monitoring program, and over a million dollars in federal grants. In fact, the Office of the New Jersey Coordinator for Addiction Response and Enforcement Strategies was created to oversee the task. Other states have yet to step up to the plate. But will it have any impact? T...
Source: Kevin, M.D. - Medical Weblog - May 2, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/linda-girgis" rel="tag" > Linda Girgis, MD < /a > Tags: Meds Pain Management Primary Care Source Type: blogs

When preventive care becomes upselling in medicine
For many years, I’ve held a brief huddle with my team every morning to make sure we are ready for the day: Anybody with complex problems coming in today? Anybody who’s been in the ER? How is Mrs. Jones’s husband over at the nursing home, is she worried about his condition? Where can we squeeze in more add-on’s? Now other people have tried to hijack the word “huddle” for a completely different purpose. They want to use it to slow us down instead of helping get us get through the avalanche of issues we’re already expecting. In my other office, they call it pre-visit planning. It&rsqu...
Source: Kevin, M.D. - Medical Weblog - May 2, 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 OB/GYN Primary Care Source Type: blogs

The ADHA Is Using The Primary Health Networks To Train Propagandists For Their myHR!
I noticed this a few days ago.My Health Record in General Practice - CESPHN Ashfield Presented by The Australian Digital Health AgencyLearning Outcomes:List the features and benefits of My Health Record in general practice.Describe how to communicate the benefits of the My Health Record system to patientsDescribe the privacy and security measures taken to protect My Health Record and how to discuss privacy concernsDescribe how more comprehensive clinical information (access via My Health Record) can contribute to patient care.This workshop will introduce the My Health Record system and explore its features and functi...
Source: Australian Health Information Technology - May 2, 2018 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs

A physician makes the case for some routine labs
Many medical organizations have recently been promoting focused and individualized lab testing for routine screening or when pursuing a diagnosis. Research has shown that the “shotgun” approach to lab testing usually leads to further invasive testing which has not been proven to significantly alter morbidity or mortality. Additionally, tests rely on pre-test probabilities and can have false-positive or negative results and even lead to adverse events from the follow-up testing. In response to this, medical organizations have created many resources to help educate and guide physicians from over-testing. The Amer...
Source: Kevin, M.D. - Medical Weblog - May 1, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/shmuel-golfeyz" rel="tag" > Shmuel Golfeyz, MD < /a > Tags: Conditions Gastroenterology Hospital-Based Medicine Primary Care Source Type: blogs