There’s a concept in manufacturing called tolerance. It’s the error allowed as part of the process of making stuff. Engineering tolerance is the permissible limit or limits of variation in: a physical dimension; a measured value or physical property of a material, manufactured object, system, or service ... — Wikipedia In medicine patient care is increasingly ... Continue Reading about Physician Tolerance and the Six Sigma Clinic
Getting Rid of Stupid Stuff – How to Clean Clinical Workflows
If you want to see how the machine of medicine can be changed, read Getting Rid of Stupid Stuff in the New England Journal of Medicine. Under the leadership of Dr. Melinda Ashton at Hawaii Pacific Health, getting rid of stupid stuff was initiated to improve the inefficiencies of health professionals at the ground level. This program sought nominations for EHR ... Continue Reading about Getting Rid of Stupid Stuff – How to Clean Clinical Workflows
High-Deductible Insurance – 3 Consequences to Patient Care
Possibly the biggest change that I’ve seen in clinical practice is the rising burden of health care costs on patients. On a daily basis I have difficult conversations with families as they face the grim reality of health costs offset in their direction. It’s captured pretty nicely here in this Bloomberg piece, Doctors are Fed Up with Being Turned Into Debt Collectors. ... Continue Reading about High-Deductible Insurance – 3 Consequences to Patient Care
Technology and the Power of Human Inconvenience
Over time I suspect that patients have the ability to do more on our own without the oversight of doctors. Much like the slow obsolescence of the bank teller, our interface with the health system will move from human exchange to something more algorithmic and automated. Right now we want this. We don't like human inconvenience. But we still want the old thing. ... Continue Reading about Technology and the Power of Human Inconvenience
The Human Nature of Clinic Schedules
Doctors have clinic schedules. Based on these schedules, patients are expected to arrive at a certain time. In turn, they expect a certain amount of face time with the doctor. In my clinic, a new patient is scheduled for 30 minutes and a follow-up 15 minutes. But humans and their problems rarely fit into 15 and 30 minute blocks. So how does it work? Something ... Continue Reading about The Human Nature of Clinic Schedules
Keep Mama Happy
“We’ve gotta keep Mama happy” I hear this from time to time from pediatricians. The idea is that if we don’t give a mother what she’s looking for, she’ll walk. As a resident I had a preceptor who loved to pull me aside to teach me the ‘inside baseball’ of pediatrics. One day after prescribing antibiotics to a child with a runny nose, he remarked with a wink and ... Continue Reading about Keep Mama Happy