In 1994 when I was a first year gastroenterology fellow cell phones were expensive and scarce. When I was on call I stayed close to the house and my personal land line phone. If I was paged out at dinner I used a pay phone or begged the hostess to borrow the house phone. So we petitioned our division chief to buy a cell phone for fellow use during weekend call. It ... Continue Reading about Who Owns a Physician’s Smartphone?
Medicine’s Exponential Future and Past
Within a week two tweets showed how doctors see medicine: one predicted that doctors would soon be obsolete and the other linked to a study reporting the ‘resurrection of physical exam.’ If you listen to doctors and their conversations you’ll find two polarizing views reflected in these tweets. There are those who see a brilliant future with technology and others ... Continue Reading about Medicine’s Exponential Future and Past
Medicine’s Race with the Machines
Like many professionals, I'm trapped in the now. I function with dated workflows and connect with patients like doctors did a hundred years ago. Elements in our world are moving, however, but no one notices. Even those of us with a remote sense of the changes ahead have a hard time understanding what’s happening to us. According to tech visionary Kevin Kelly we are ... Continue Reading about Medicine’s Race with the Machines
EHRs and the Problem of Efficiency
Some doctors worry about how EHRs slow them down. I worry about how fast they let us go. Too much dropdown makes documentation too easy. And when it comes to doctors and their EHRs, there’s a fine line between efficient and lazy. Seeing the line is important because when it comes to workflow the drive to completion typically overpowers the obligation to showcase ... Continue Reading about EHRs and the Problem of Efficiency
The Exam Room Entrance
It used to be that the paper chart was found on the exam room door. Before I entered I’d flip to my last visit, review my impression, check the plan and then enter. Then records went electronic. Now there’s nothing on the door. This has lead to an interesting evolution in my process. Now after a moment of reflection, I just walk in. But that’s not a ... Continue Reading about The Exam Room Entrance
The Exam Room Door
Of the things I face each day perhaps the most remarkable is the exam room door. It’s the gateway to what I do. As a conduit to the patient, it punctuates the beginning and end of the patient encounter. The ultimate moment of clinical focus There’s a process that happens during the moments before I enter. There’s something of a ritual or process that plays out in my ... Continue Reading about The Exam Room Door