Archive for January 2013

Doctors, Tend to Your Online Reputations. KevinMD’s Terrific New Book Tells How

Kevin Pho, better known as KevinMD, is the nation's leading physician-social media guru. He and his colleague Susan Gay were nice enough to invite me to write the foreword to their book, "Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices," which was published today. I think it's a terrific book, well written and chock-full of useful advice and insights. Here is that foreword, reproduced with permission: Information technology is transforming the way we teach, learn, communicate, work, play, and think. And there are few areas in which the changes have been more deeply felt than in healthcare. A few years ago, one prominent physician-leader told me he wouldn’t read blogs. “I already have too much on my plate,” he said. He reads them today. I’ve heard from others who once refused to use e-mail, or text messaging, or electronic health records, or…

Hospitalist work volume and perceived effects on patient care

In this large survey of hospitalists, 40% reported that their patient volume exceeded safe levels at least once a month, the that high volume often affected their ability to fully discuss treatment options, delayed admits or discharges, affected their ability to safely cross cover patients, or affected their ability to adequately hand off patients. Many also reported high volumes affected their utilization of tests, readmission rates, patient satisfaction, and quality of care. Hospital medicine programs need to continue to monitor workload, to ensure too high workloads do not result in care detriments for patients (abstract).

JAMA Readmissions, Part II

My last post alluded to the JAMA theme issue on readmissions.  I planned on writing a synopsis, but having read a related post from a friend—one I cannot improve upon—I will defer to his.  However, a few housekeeping chores before the guest summary below. (more…)

“Doctor, Step Away From That Cookbook!”

A middle-aged man develops chest pain at home. Minutes after calling 911, he’s in an ambulance, whizzing through traffic to the nearest emergency room. The paramedics radio ahead, and by the time the patient arrives in the ER, the hospital’s heart attack team has been activated. A stat electrocardiogram shows an ST-elevation myocardial infarction (STEMI), and suddenly It’s Showtime: the patient enters the “chest pain pathway,” automatically triggering a pre-prescribed set of actions: medications, blood tests, oxygen, and more. The cardiologists, nurses and technicians congregate in the cath lab, waiting for the handoff. Nothing is left to chance: the STEMI team even has a special key that allows them to commandeer the elevator. This is life-and-death choreography – George Balanchine meets Dr. John Carter – and it works. In the old days, it might have taken 3 or 4 hours to get a catheter into the patient’s coronary artery. By…