Showing posts with label Patients. Show all posts
Showing posts with label Patients. Show all posts

Thursday, April 24, 2014

15-Minutes or less Visits Take Toll on Doctor-Patient Relationship

 Patients – and physicians – say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements. 
It’s not unusual for primary care doctors’ appointments to be scheduled at 15-minute intervals. Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes. 
And the problem may worsen as millions of consumers who gained health coverage through the Affordable Care Act begin to seek care — some of whom may have seen doctors rarely, if at all, and have a slew of untreated problems.
“Doctors have one eye on the patient and one eye on the clock,” said David J. Rothman, who studies the history of medicine at Columbia University’s College of Physicians and Surgeons.
By all accounts, short visits take a toll on the doctor-patient relationship, which is considered a key ingredient of good care, and may represent a missed opportunity for getting patients more actively involved in their own health. There is less of a dialogue between patient and doctor, studies show, increasing the odds patients will leave the office frustrated.
>READ FULL ARTICLE about the struggle for control from medscape.com

Thursday, April 3, 2014

Will Medicine Ever Become Safer?

Hello and welcome. I am Dr. George Lundberg and this is At Large at Medscape.
Hospitals are dangerous places. I no longer work in a hospital, and I try never to go to hospitals even to visit, unless, of course, I or my family were to become really sick and would obviously stand to benefit from hospitalization. I feel almost the same about surgicenters, free-standing emergency rooms, and urgent care facilities.
...
In 1999, the Institute of Medicine published the sentinel report To Err is Human, [2] still a best-seller. They pegged the annual number of American hospital deaths secondary to errors and adverse effects of treatment to be 44,000 to 98,000. In an interview earlier this year, I asked Lucian Leape whether that number still held. He said no, it was much larger. I asked whether we had made any progress. He said yes, but only in narrow fields.
In 2013, a new report[3] in the Journal of Patient Safetyestimated American hospital deaths following adverse events at 210,000 to 440,000 per year. Medicare patients are reported to die at a rate of 180,000 per year from or with nosocomial infections and other medical care-related problems

Wisely Choosing the Right Care

Hello and welcome. I am Dr. George Lundberg, at large for Medscape.
In about 1989, then-Secretary of Health and Human Services of the US government Dr. Louis Sullivan stated that between 30% and 40% of American medical care was unnecessary, wasted, or inappropriate. In 2013, Massachusetts health dignitaries stated that 30% of medical care in Massachusetts is unnecessary or inappropriate.
If they are correct, why have we in the American medical profession not fixed that in more than 20 years? Could it be that generation after generation of people who populate the system simply like it the way it is -- veritable pigs addicted to the money trough?

Medscape Reference

Medscape's clinical reference is the most authoritative and accessible point-of-care medical reference for physicians and healthcare professionals, available online and via all major mobile devices. All content is free.
The clinical information represents the expertise and practical knowledge of top physicians and pharmacists from leading academic medical centers in the United States and worldwide.
The topics provided are comprehensive and span more than 30 medical specialties.

Diseases and Conditions
More than 6000 evidence-based and physician-reviewed disease and condition articles are organized to rapidly and comprehensively answer clinical questions and to provide in-depth information in support of diagnosis, treatment, and other clinical decision-making. Topics are richly illustrated with more than 40,000 clinical photos, videos, diagrams, and radiographic images.
Procedures
More than 1000 clinical procedure articles provide clear, step-by-step instructions and include instructional videos and images to allow clinicians to master the newest techniques or to improve their skills in procedures they have performed previously.
Anatomy
More than 100 anatomy articles feature clinical images and diagrams of the human body's major systems and organs. The articles assist in the understanding of the anatomy involved in treating specific conditions and performing procedures. They can also facilitate physician-patient discussions.
Drug Monographs
More than 7100 monographs are provided for prescription and over-the-counter drugs, as well as for corresponding brand-name drugs, herbals, and supplements. Drug images are also included.
Drug Interaction Checker
Our Drug Interaction Checker provides rapid access to tens of thousands of interactions between brand and generic drugs, over-the-counter drugs, and supplements. Check mild interactions to serious contraindications for up to 30 drugs, herbals, and supplements at a time.
Formulary Information
Access health plan drug formulary information when looking up a particular drug, and save time and effort for you and your patient. Choose from our complete list of over 1800 insurance plans across all 50 US states. Customize your Medscape account with the health plans you accept, so that the information you need is saved and ready every time you look up a drug on our site or in the Medscape app. Easily compare tier status for drugs in the same class when considering an alternative drug for your patient.
Medical Calculators
Medscape Reference features 129 medical calculators covering formulas, scales, and classifications. Plus, more than 600 drug monographs in our drug reference include integrated dosing calculators.
Image Collections
Hundreds of image-rich slideshow presentations visually engage and challenge readers while expanding their knowledge of both common and uncommon diseases, case presentations, and current controversies in medicine.

Tuesday, April 1, 2014

Remote Patient Visits/Prescriptions - Playing with Scorpions

Prescribing by Phone Is Like Playing With Scorpions

Can you practice medicine over the phone? What is an appropriate way to use communication technology to help treat patients? Recently on Medscape Connect, an all-physician discussion group, members discussed how they had used the phone and other devices to diagnose, prescribe, or otherwise deal remotely with medical issues.
A primary care physician started things off: "Given my experiences with my own patients, I always insist they come into the office before I prescribe antibiotics if I haven't just seen them. Have you had experiences where you were glad you made your patient come in to your office before treating them based on what they told you over the phone, or a time when you wish you had?"

Electronic Patient–Physician Communications Face Barriers

Telephone calls and emails by patients can be very efficient, but these electronic communications may never be widely used unless physicians are reimbursed for them and are given extra time to do the work, according to a new study published in the August issue of Health Affairs.
Despite the potential advantages associated with e-communications, a 2008 study has found that less than 7% of physicians regularly communicate with their patients electronically.

Saturday, March 29, 2014

Free Patient Websites. Nonprofit Organization. | CaringBridge

CaringBridge provides free websites that connect people experiencing a significant health challenge to family and friends, making each health journey easier. CaringBridge is powered by generous donors.
CaringBridge websites offer a personal and private space to communicate and show support, saving time and emotional energy when health matters most. The websites are easy to create and use. Authors add health updates and photos to share their story while visitors leave messages of love, hope and compassion in the guestbook.

When to Argue With the Doctor - AllHealthcare.com

Most of our daily problems, including common annoyances such as arguments with coworkers, are dismissed as not life or death. However, when nurses, healthcare professionals, and doctors are involved, it can be a matter of life or death. Egos need to be left outside the hospital by the professionals entrusted with the health and safety of the patients they care for, which sometimes means you must argue with doctors.The problem is that a hospital isn’t really conducive to arguing. And doctors aren’t like lawyers, who argue for a living. They’re used to having everyone accept their opinion as gospel, and can take it as a personal affront when anyone disagrees with them. Unfortunately, doctors are people and people make mistakes, and with nurse practitioners and RNs taking on more and more duties, nurses and doctors butting heads is becoming increasingly common.
When to Argue With the Doctor

Doctor Visit Preparation and Communication

The Empowered Patient Coalition Choosing a Doctor Fact Sheet
Prepare for Doctor’s Visits from the Partnership for Healthcare Excellence
Be Prepared for Doctor’s Visits from AHRQ
Tips for Talking to your Doctor from AHRQ
Communicating with your Doctor from the Ohio State University Medical Center
Questions to Ask the Doctor for Cancer Patients
How to Communicate Your Loved One's Symptoms from the National Family Caregiver Alliance

Speaking Up About Your Medical Care

The Empowered Patient Coalition’s Preparing for Discharge Fact Sheet
The Joint Commission Speak Up about Medications Program
The Joint Commission Speak Up Program to Prevent Errors in Your Care
Five Steps to Safer Healthcare from AHRQ
Become More Involved in your Healthcare from AHRQ
Getting the Health Care You Need from The Health Consumer Alliance
Know Your Rights from the Joint Commission
Anesthesia & Me Checklist from the American Society of Anesthesiologists

Lists of Things Physicians and Patients Should Question

Nine United States specialty societies representing 374,000 physicians developed lists of "Five Things Physicians and Patients Should Question" in recognition of the importance of physician and patient conversations to improve care and eliminate unnecessary tests and procedures.
These lists represent specific, evidence-based recommendations physicians and patients should discuss to help make wise decisions about the most appropriate care based on their individual situation. Each list provides information on when tests and procedures may be appropriate, as well as the methodology used in its creation.
What tests and procedures should patients and physicians talk about? Read the lists:

Empowered Patient - The Wise Patient's Guide to Being an Empowered Patient

Patients find more and more that their healthcare is being compromised. Patient safety issues, money issues, lack of time and communication with their doctors... These days, wise patients are empowered patients, learning everything they can about the healthcare system, the obstacles to good care, and the steps they can take to get the best care possible.
Researching diagnoses and treatments

Topics patients.about.com

Friday, March 28, 2014

Medical conspiracy beliefs change health behavior

NEW YORK (Reuters Health) - About half of American adults believe in at least one medical conspiracy theory, according to new survey results.
For example, three times as many people believe U.S. regulators prevent people from getting natural cures as believe that a U.S. spy agency infected a large number of African Americans with the human immunodeficiency virus (HIV).
J. Eric Oliver, the study's lead author from University of Chicago, said people may believe in conspiracy theories because they're easier to understand than complex medical information.
"Science in general - medicine in particular - is complicated and cognitively challenging because you have to carry around a lot of uncertainty," Oliver said.
"To talk about epidemiology and probability theories is difficult to understand as opposed to 'if you put this substance in your body, it's going to be bad,'" he said.
Like the theories about conspiracies to infect African Americans with HIV and to prevent citizens from accessing alternative medicines, the other theories on the list had mistrust of government and large organizations as themes.
They include the theory that the government knows cell phones cause cancer but does nothing about it, that genetically modified organisms are being used to shrink the world's population, that routine vaccinations cause autism and that water fluoridation is a way for companies to dump dangerous chemicals into the environment.
Some 49% of the survey participants agreed with at least one of the conspiracies.
In fact, in addition to the 37% of respondents who fully agreed that U.S. regulators are suppressing access to natural cures, less than a third were willing to say they actively disagreed with the theory.
With regard to the theory that childhood vaccines cause psychological disorders like autism and the government knows it, 69% had heard the idea, 20% agreed with it and 44% disagreed.
The survey results suggest people who believe in medical conspiracy theories may approach their own health differently, the researchers said.
For example, while 13% of people who did not believe in any conspiracies took herbal supplements, 35% of those who believed in three or more theories took supplements.
Overall, the researchers say people who believed in conspiracies were more likely to use alternative medicine and to avoid traditional medicine.
Oliver said the findings may have implications for doctors.
Instead of viewing patients who believe in conspiracy theories as crazy, he said doctors should realize those patients may be less likely to follow a prescription regimen.

About Choosing Care Wisely | An Initiative of the ABIM Foundation

Choosing Wisely®
aims to promote conversations between physicians and patients by helping patients choose care that is:

Supported by evidence
Not duplicative of other tests or procedures already received
Free from harm
Truly necessary
In response to this challenge, national organizations representing medical specialists have been asked to “choose wisely” by identifying five tests or procedures commonly used in their field, whose necessity should be questioned and discussed. The resulting lists of “Five Things Physicians and Patients Should Question” will spark discussion about the need—or lack thereof—for many frequently ordered tests or treatments.
This concept was originally conceived and piloted by the National Physicians Alliance, which, through an ABIM Foundation Putting the Charter into Practice grant, created a set of three lists of specific steps physicians in internal medicine, family medicine and pediatrics could take in their practices to promote the more effective use of health care resources. These lists were first published in Archives of Internal Medicine.
Recognizing that patients need better information about what care they truly need to have these conversations with their physicians, Consumer Reports is developing patient-friendly materials and is working with consumer groups to disseminate them widely.