I once had a clinic nurse who wouldn’t talk to me. First a little history. Clinical workflow in my early career included the ritual of phone messages. Every day, at least once and usually in the afternoon, I would sit with my clinic nurse and a pile of manilla folders to discuss phone calls. Details were discussed, recommendations were made, triage assessments ... Continue Reading about EHR and the Failure to Communicate
Yesterday Twitter carried a query from a Vox journalist about doctors and fax machines. Why do we use them? The response by the health infosphere was predictable: Why can't doctors just get with the program? And why are they so behind the times? It's not that complicated. And it's not because we don't read Wired. Just the fax EHRs don't talk to one another. We ... Continue Reading about Fax Machines: Why Doctors Use Them
In clinic I do my best to run on time. I bend every which way to see on time patients on time. It drives my staff crazy. Consequently, I prefer that my patients arrive in a reception area rather than a waiting room. The space is the same but the intent is different. Language is powerful in healthcare. Image via Donald West on Flickr ... Continue Reading about The Waiting Room
Not long ago received a review book from a mainstream New York publisher. Written by an power-hitting academic physician and intended for a general audience it was a beautifully produced book. So I did what I do when I want to learn about someone, I searched. My query turned up nothing. No conversation, content or even a bio. There were, however, lots of ... Continue Reading about Relevance is Optional
There's lots of talk about physician bias. Confirmation bias, attribution error, etc. Jerry Groopman's How Doctors Think provides a great primer on how patterns of physician thinking impact care. Unfortunately there's less talk about patient bias. Google 'patient bias' and you'll find only links to physician bias. Patients bring their own biases to the exam ... Continue Reading about Should We Consider Patient Bias?
When candidates for the Navy SEALS enlist they go through a punishing trial involving midnight runs, sleep deprivation and carrying logs. When trainees have had enough, they are invited to ring a bell which absolves them of any further obligation. But Navy special forces operatives aren't called to go behind enemy lines to carry logs. Their training is a test for ... Continue Reading about Doctors, Training and the Test of Will