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.

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

A Comprehensive Framework for Human Resources for Health System Development in Fragile and Post-Conflict States

From the report at Plos Medicine

Summary Points

  • Responding to the global human resource crisis requires systems thinking if a more comprehensive approach to human resource management and development is to be achieved.
  • We present a comprehensive and visible framework for human resource system development. This has been derived from the lessons learned in supporting human resource system development in three fragile and post-conflict health systems in Afghanistan, the Democratic Republic of Congo, and Cambodia.
  • The efforts of development partners and the government typically concentrate on the “production” and training of health personnel, but this approach neglects other elements and often the necessary linkages between them. While there is potential value in focused forms of support, they will be much less effective, with negative effects on both systems and population health, when they are unbalanced, incomplete, or miss the necessary linkages between them.
  • While the “house model” contains elements similar to the World Health Organization HRH Action Framework, some functions are extracted in order to draw more attention to them. Issues such as the legal and regulatory framework, coordination, and monitoring are often neglected. We also place particular emphasis on the linkages among elements by highlighting some core functions of human resource management (production-deployment-retention), or by separating the foundation components (policy and planning, finances, legal) as primarily the responsibility of the government.
From the Background section

Responding to the global crisis in human resources for health (HRH) requires systems thinking if a more comprehensive approach is to be promoted. This differs substantially from the traditional emphasis on pre-service education, in-service training, and personnel management [1]. The elements to be included in a more comprehensive assessment and response to HRH system development need to be derived from experience and evidence from the field, and should be validated into the future in different settings.

In post-conflict situations, large numbers of development partners, including United Nations (UN) agencies, international and local non-government organizations (NGOs), and various others, literally “rush in.” The situation is often characterized by a weak health system, and is complicated by the limited quantity and quality of human resources [2]. New governments and emergent ministries typically have limited capacity to manage all the tasks necessary for reconstruction. ….

January 6, 2012 Posted by | health care | , , , | Leave a comment

   

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