Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Reblog]Technology and the doctor-patient relationship

Technology and the doctor-patient relationship.

From the 1 July 2014 KevinMD article

I often hear people talking about their doctors.  I overhear it restaurants, nail salons, while walking down the street. I hear what people think of their doctors, what their doctors said or what they didn’t say, why people were disappointed by or validated by their doctors.  I hear people analyzing, criticizing, and surmising about this relationship quite a bit, and I don’t blame them. The relationship you have with your doctor is a critical one, and yet it is fraught with misunderstanding, disappointment, and distrust. People didn’t used to doubt their doctors the way they do today, and I believe the essence of the doctor-patient  relationship has degraded in our culture.

 

In large part, I believe this is due to technology.

The Mayo Clinic recently announced they have partnered with Apple to create what they call the Health Kit.  Although the details are still unknown, the product is supposedly one that will allow patients to become more involved in their health care, from diagnosis to treatment delivery. This has always been the doctor’s job, but with the technology booming, it is no surprise that the next step would be computerized health care.

So is this a good thing, or a bad thing? I have mixed feelings, and I think the results will be mixed as well. Statistics show that positive relationships and supportive interactions with others are crucial parts of living a healthy life. Can a computer ever truly replace that je ne se quoi that occurs between a doctor and a patient?  In my own practice, I would like to believe that the interaction between my patients and myself is part of what leads to healing. I don’t believe a computer could do that as well as I can.

Here’s the problem, though.  Doctors are inundated with demands from insurance companies, paperwork, accountability measures, and check lists upon checklists required for medical records, billing, and measurable use. This situation worsened several years ago, with the mandatory implementation of Electronic Medical Records, and then even worse since the implementation of the Affordable Care Act.

These changes have also affected patients, many of whom have had to drop doctors they have had for many years because those doctors didn’t take the new insurance. The message, whether stated outright or not by advocates or detractors of the new systems, is that this doctor-patient relationship is not really all that important.

….

 

 

July 9, 2014 Posted by | health care | , , , , , , | Leave a comment

Doctor Rating Web Site Health Grades is a Time Magazine “Best 50” – How Trustworthy Is the Content??

HealthGrades Logo / Guiding Americans to their Best Health

HealthGrades has been rating doctors, dentists, and hospitals on five star scales for over ten years. Ratings include communication skills, time spent, trust, and office environment. There are also links to board sanctions.

This past August Time Magazine rated Health Grades as one of the 50 best Websites of 2011.

Recently there was a lively discussion on this topic at the medical librarian listserv (Medlib-L).
Among the responses…

  • Two people noted contact information for their doctors was not correct
  • “The self selection process creates a huge bias. The people who are angry and disappointed are the ones motivated to write.”
  • “patient rating is 4.5 stars out of 5, but he’s only had 4 patients comment on him. In skimming through other doctors in Fargo, very few have more than 4 patient comments and everyone has between 4 and 5 stars.”
  • “My doctor is in private solo practice and when you look at the lists by highlighted or popularity they are very institutionally presented. The independents come at the end of the list so this is not a fair representation”
  • “the physician she replaced upon his retirement in April 2008 is still listed (with one review), although he has been gone for almost 4 years”

Although these comments do not compromise an in depth critique of Health Grades they do raise questions about its currency, contact information correctness, and basis of comparison (basically unsolicited input from patients). It would be wise to use Health Grades in conjunction with other sources of information to make good decisions on choosing or evaluating a doctor, dentist, or hospital.

Some additional sources of information

December 26, 2011 Posted by | Finding Aids/Directories | , , , , | Leave a comment

The day our hospital lost its heart (value of “tea time” among health care professionals)

by   in an article at KevinMD.com, where he recalls 10:00 am teatime at his hospital. Doctors , medstudents, and others would gather to discuss, mentor, and informally teach and learn…http://www.kevinmd.com/blog/2011/12/day-hospital-lost-heart.html

From the article

In about 1985, as I remember it, my training hospital underwent a pivotal change. In Cape Town, at the southern tip of Africa, Groote Schuur Hospital was world famous for being the place where in 1967 an arrogant, brash and brilliant surgeon by the name of Christiaan Barnard stunned the world by performing the world’s first heart transplant. Nearly twenty years later, Groote Schuur (Dutch for “Big Barn”) still retained the same aura of celebrity. As a medical student I walked the wards where history had and was being made. Members of the surgical team from that historic event were still to be seen on ward rounds, in the ICU’s, in the operating rooms, and in the communal tearoom. Even Barnard, although no longer operating, maintained a presence – although he missed every lecture scheduled with my class without apology.

 

The tearoom was in the heart of the hospital, close to all wards, departments and lecture rooms. It was bright and roomy, with faded but comfortable lounge chairs and large wooden tables. And at 10am every day tea and coffee was served without charge in huge pots and white cups to every doctor and medical student who wanted it.
Barnard aside, professors and specialists from all departments would sit in the tea room alongside junior medical students, continue case discussions, answer questions, greet colleagues, accept referrals, or debate completely non-medical issues….

December 3, 2011 Posted by | Uncategorized | , | Leave a comment

State Medical Boards Fail to Discipline Doctors with Hospital Actions Against Them

State Medical Boards Fail to Discipline Doctors with Hospital Actions Against Them

March 15, 2011 19:18

Source: Public Citizen

From the press release:

State medical boards have failed to discipline 55 percent of the nation’s doctors who either lost their clinical privileges or had them restricted by the hospitals where they worked, a new Public Citizen analysis of data from the National Practitioner Data Bank (NPDB) shows.Of 10,672 physicians listed in the NPDB for having clinical privileges revoked or restricted by hospitals, just 45 percent of them also had one or more licensing actions taken against them by state medical boards. That means 55 percent of them – 5,887 doctors – escaped any licensing action by the state. The study examined the NPDB’s Public Use File from its inception in 1990 to 2009.

“One of two things is happening, and either is alarming,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group and overseer of the study. “Either state medical boards are receiving this disturbing information from hospitals but not acting upon it, or much less likely, they are not receiving the information at all. Something is broken and needs to be fixed.”

Hospital disciplinary reports are peer-review actions and, as such, are one of the most valuable sources of information for medical board oversight. Subsequent state medical board action against a physician’s license is a crucial next step to protect patients. Boards have the authority to oversee and even limit the practice of a disciplined physician, which not only yields a more complete record for the purpose of patient safety but also serves to inform other state boards and future employers.

 

March 24, 2011 Posted by | Consumer Health, Consumer Safety, Public Health | , , , | Leave a comment

Physicians on Twitter

Physicians on Twitter

From the Dr. Shock MD PhD Blog

In the latest issue of the JAMA the results of a survey is published. The authors did a search on physicians using twitter. They extracted the public profile pages of the physicians using twitter with 500 or more followers between May 1 and May 31, 2010. They analyzed the tweets of these professionals.

Of the 5156 tweets analyzed, 49% (2543) were health or medical related, 21% (1082) were personal communications, 14% (703) were retweets, and 58% (2965) contained links. Seventy-three tweets (1%) recommended a medical product or proprietary service, 634 (12%) were self-promotional, and 31 (1%) were related to medical education.

But what is somewhat worrying were their findings of potential patient privacy violations andconflicts of interest. Thirty-eight tweets (0.7%) represented potential patient privacy violations, of the 27 users responsible for these privacy violations 25 were identifiable by full name on the profile, by photo or link to their personal website. Twelve tweets were about a product they were selling on their Web site or repeatedly promoting specific health products, 10 were statements about treatments not supported by the official guidelines.

Using social media by physicians does broadcast useful medical information, unprofessional content in tweets by physicians is rare.
Chretien KC, Azar J, & Kind T (2011). Physicians on twitter. JAMA : the journal of the American Medical Association, 305 (6), 566-8 PMID: 21304081 ***

*** The abstract of this article may be found here.

For suggestions on how to get the full text of this article (letter to the editor) for free or at low cost, click here

 

 

February 16, 2011 Posted by | Medical and Health Research News | , , , , , , , , , | Leave a comment

Fewer U.S. Docs Accepting Perks from Industry

HealthDay news imageBut nearly 84% still report some relationship with companies, results show

From a November 8, 2010 Health Day news item By Robert Preidt

MONDAY, Nov. 8 (HealthDay News) — U.S. physicians‘ links with drug makers, medical device manufacturers and other health-related companies have decreased since 2004, but many doctors still have ties to these businesses, new research shows.

A 2004 survey found that about four out of five doctors accepted gifts of food and beverages from industry in their workplaces and more than 75 percent were given drug samples. In addition, more than one-third accepted reimbursement from companies for professional meetings or continued medical education, and more than one-quarter accepted payment for consulting, speaking or clinical trials.

The new 2009 survey of 1,891 primary care physicians and specialists found that nearly 84 percent reported some type of relationship with industry in the previous year. Nearly two-thirds (63.8 percent) accepted drug samples, about 70 percent received food and beverages, 18 percent received reimbursements, and 14 percent were paid for professional services.

The findings are published in the Nov. 8 issue of the journal Archives of Internal Medicine [free full text article].

Certain types of specialists were more likely to have industry ties. For example, these connections were more common among cardiologists (92.8 percent) than psychiatrists (79.8 percent). The type of practice also made a difference.

“Physicians in solo or two-person practices and group practices were significantly more likely than those in hospital and medical school settings to receive samples, reimbursements and gifts. However, physicians in medical schools were most likely to receive payments from industry,” the researchers wrote.

“These data clearly show that physician behavior, at least with respect to managing conflicts of interest, is mutable in a relatively short period,” the study authors concluded. “However, given that 83.8 percent of physicians have physician-industry relationships, it is clear that industry still has substantial financial links with the nation’s physicians. These findings support the ongoing need for a national system of disclosure of physician-industry relationships.”

SOURCE: JAMA/Archives journals, news release, Nov. 8, 2010

 

 

November 10, 2010 Posted by | Uncategorized | , , , , | Leave a comment

   

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