Popular Weight Loss App Ineffective In Achieving Weight Loss
This study serves as a reminder that “popular” and “effective” do not always go hand-in-hand when it comes to weight loss interventions. While mHealth apps are expected to earn $26 billion by 2017, one is left to wonder if this money will be well spent or if we’ll all be “somewhat to completely satisfied” with the apps without anything medically significant to show for it? (Source: Better Health)
Source: Better Health - November 17, 2014 Category: American Health Authors: Dr. Val Jones Tags: News Research Annals Of Internal Medicine Apps Ineffective mFit mHealth Mobile App Mobile Fitness Study MyFitnessPal No Weight Loss Primary Care Smart phone UCLA Source Type: blogs
How Not To Interrupt Patients But Also Get The Information You Need In A Timely Manner
Much has been made about physicians’ tendencies to interrupt patients. Studies have shown that patients are permitted 12-18 seconds of talk time before they are redirected (or interrupted) by their doctor. This leads to patients feeling that the physician didn’t listen or didn’t care. I believe that there is a way to solve the problem without wasting time or being rude. I have used this technique with great success over the years and it works especially well in the inpatient setting, when beginning a formal “history and physical exam.” In three simple words:
Physician goes first.
Before I ent...
Source: Better Health - November 13, 2014 Category: American Health Authors: Dr. Val Jones Tags: Health Tips Opinion Conversation Interruption History And Physical Exam Interruptions Physicians Rudeness Source Type: blogs
Medical Errors Reduced By 30% When Doctors Required To Speak To One Another At Shift Change
I have spent many blog hours bemoaning the inadequate communication going on in hospitals today. Thanks to authors of a new study published in the New England Journal of Medicine, I have more objective data for my ranting. A prospective intervention study conducted at 9 academic children’s hospitals (and involving 10,740 patients over 18 months) revealed that requiring resident physicians to adopt a formal “hand off” process at shift change resulted in a 30% reduction of medical errors.
What was the intervention exactly? Details are available via mail order from the folks at Boston Children’s Hospit...
Source: Better Health - November 6, 2014 Category: American Health Authors: Dr. Val Jones Tags: Opinion Research Boston Childrens Communication HHS Hospital Handoffs I-PASS Handoff Curriculum Medical Errors New England Journal of Medicine Pediatrics Physicians Residents Shift Change Source Type: blogs
Hospital Pharmacists: Protecting Patients From Electronic Medical Record Errors May Be Their Most Important New Role
Most hospitalized patients and families don’t realize that life-threatening medication errors are regularly thwarted by pharmacists. They are truly the unsung heroes of patient care. I just finished a locum tenens assignment at a hospital that uses EPIC as their electronic medical records system, and I was stunned by the impossibly complex medication reconciliation process. Each time a patient is admitted to the hospital, or transferred to another part of the hospital, a physician must review, approve, and re-order their medications. While this may seem like a good way to insure that medication errors are avoided, it...
Source: Better Health - November 3, 2014 Category: American Health Authors: Dr. Val Jones Tags: Health Tips Opinion Dangers Electronic Medical Records EMR EPIC Excessive Complexity fail Hospital Pharmacists Medical Errors Medication Errors Medication Reconciliation Source Type: blogs
Glen Campbell “I’ll Be Me” Movie Documents His Final Years With Alzheimer’s Disease
Country music legend Glen Campbell is dying of Alzheimer’s disease. In an effort to raise awareness of the illness he and his family made the brave decision to bare their lives by creating a documentary of Glen’s farewell tour. I highly recommend that you watch this film with your loved ones… and a box of Kleenex.
One of the most remarkable aspects of Glen’s disease was the preservation of his musical abilities despite severe cognitive impairment. Although he rarely knew where he was or even how to tie his shoes, he was able to perform songs in front of live audiences. With redirection and prompting...
Source: Better Health - October 27, 2014 Category: American Health Authors: Dr. Val Jones Tags: Announcements Medical Art Alzheimer's Alzheimer's Association Aricept Behavioral Problems Cognitive Impairment Country Music Dementia Documentary End Stage Alzheimer's Glen Campbell I'll Be Me Mayo Clinic Movie Movie Review Source Type: blogs
EMRs And The Dangers Of Digital Dependency And Drop-Down Medicine
Electronic medical records (EMRs) now play a part in the daily documentation routine for most physicians. While improvements in access to patient data, legibility of notes, and ease of order entry are welcome enhancements, there is a significant downside to EMRs as well. Although I’ve blogged about my frustrations with nonsensical, auto-populated notes and error carry-forward, there is a more insidious problem with reliance on EMRs: digital dependency.
The idea of digital dependency first occurred to me during a conversation with a young medical resident at a hospital where we share patients. I was bemoaning the fact...
Source: Better Health - October 17, 2014 Category: American Health Authors: Dr. Val Jones Tags: Opinion True Stories Computer Algorithm Digital Dependency Drop Down Medicine EMR Humanism In Medicine Limitations Narrative Patient Care Problems Technology Source Type: blogs
Medicare Advantage Physician Evaluator Jobs: Reality Versus Advertising At CenseoHealth
Physicians looking for part-time jobs to supplement their income may have run across advertisements for “lucrative” Medicare Advantage evaluation opportunities at CenseoHealth. Here’s a typical ad:
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Vision | History | Leadership | Services | Contact Us
CenseoHealth is the leading Risk Adjustment provider for Medicare Advantage plans – with a network of more than 1,800 credentialed providers conducting over 20,000 member health evaluations a month. Due to our continued growth, we are currentl...
Source: Better Health - October 14, 2014 Category: American Health Authors: Dr. Val Jones Tags: Health Policy True Stories Censeo Health CenseoHealth Dangers False Advertising Frail Elderly Geriatrics Health Insurance Companies Managed Medicare Plans Medical Missionary Medicare Advantage Evaluations Part Time Work Physician Source Type: blogs
Why I Still Don’t Hate Being A Doctor
Judging from recent articles, surveys, and blog posts, the medical profession is remarkably demoralized. Typical complaints range from “feeling like a beaten dog” to “living in humiliating servitude,” to being forced to practice “treadmill medicine.” Interestingly, the public response to these complaints is largely indifferent. The prevailing attitude (if the “comments sections” of online articles and blog posts are representative) seems to be unsympathetic: “Poor doctors, making a little less income and not being treated like gods anymore? You have to do extra paperwor...
Source: Better Health - September 15, 2014 Category: American Health Authors: Dr. Val Jones Tags: Opinion Concierge Medicine Demoralization Direct Pay Doctors Dr. Jauhar Hate Medicine Job satisfaction Locum Tenens Patient Satisfaction Physicians Quit Medicine Work Environment Source Type: blogs
A Cautionary Tale: Acute Hepatitis In The Rehab Unit
I recently treated a patient who was hospitalized with paraplegia. During some routine lab testing I noticed that his liver function tests were elevated, and so I began looking for a cause. I discussed the patient’s drinking habits (he rarely drank alcohol), risks for viral hepatitis (no IV drug use or exposure to those with known hepatitis), and general medical history (nothing relevant to liver disease). I reviewed his current medication list, and found little to explain a potential drug-induced hepatitis. He denied any history of acetaminophen use.
Next I ordered a hepatitis panel – all normal. And finally a...
Source: Better Health - September 10, 2014 Category: American Health Authors: Dr. Val Jones Tags: Health Tips True Stories Acetaminophen Alcohol Cold Medicine Drinking Cold Medicine Hepatitis Liquid Liver Damage Liver Failure NyQuil Overdose Source Type: blogs
Five Things That Electronic Medical Records (EMRs) Can Learn From Social Media
As a physician who openly despises many aspects of current EMRs (see “How An EMR Gave My Patient Syphilis” or “The Medical Chart: Ground Zero For The Deterioration Of Patient Care” ) I recognize that they are here to stay. And so, since we’re all stuck with these digital middlemen, I have some suggestions (based on popular social media platform functionality) for making them better.
1. Likes. Healthcare providers should be able to “vote up” an excellent note in the medical record. Let’s face it, not all doctors are equally good at documentation. Untold hours of our time are s...
Source: Better Health - September 5, 2014 Category: American Health Authors: Dr. Val Jones Tags: Health Policy Opinion Confidentiality Electronic Medical Records EMR Facebook Like Privacy Search Social Media Tagging Twitter Source Type: blogs
What Is The Most Important Quality In A Physician?
Medical errors are estimated to be the third leading cause of death in America’s hospitals. Though some of these errors are beyond physician control, many are the direct result of physician action and inaction. I spend a lot of time thinking about how to reduce these errors and I (like many of my peers) lose sleep over the mistakes I witness.
When you ask patients what quality is most important in a physician, they often answer, “empathy.” I think that’s close, but not quite right. I know many “nice” and “supportive” doctors who have poor clinical judgment. When it comes to e...
Source: Better Health - July 24, 2014 Category: American Health Authors: Dr. Val Jones Tags: Opinion Curiosity Empathy Healthcare Quality Medical Errors Most Important Physician Quality? Vigilance Source Type: blogs
Why It’s So Tempting To Over-screen: A Personal Perspective
Health screening is part of good preventive care, though over-screening can lead to increased costs, and potential patient harm. Healthcare professional societies have recently developed excellent public service announcements describing the dangers of over-testing, and new research suggests that though additional medical interventions are associated with increased patient satisfaction, they also lead (ironically) to higher mortality rates.
And so, in a system attempting to shift to a “less is more” model of healthcare, why is resistance so strong? When the USPSTF recommended against the need for annual, screeni...
Source: Better Health - July 14, 2014 Category: American Health Authors: Dr. Val Jones Tags: Opinion True Stories Benefits Cancer Colonoscopy Guidelines Harms Mammogram Over-testing Over-treatment Screening Tests USPSTF Source Type: blogs
Hospitalist Group Uses “Altered Mental Status” Code For All Inpatient Testing
Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.
“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from be...
Source: Better Health - July 11, 2014 Category: American Health Authors: Dr. Val Jones Tags: Friday Funny Humor Altered Mental Status Dementia Fake News Geriatrics Healthcare Costs Hospitalists ICD-9 Medicine Mental Status Changes Nurses Over-testing Parody Satire Side Effects Urinary Tract Infection UTI Source Type: blogs
How To Be A Bad Gastroenterologist
I am a regular reader of patient blogs, and I find myself frequently gasping at the mistreatment they experience at the hands of my peers. Yesterday I had the “pleasure” of being a patient myself, and found that my professional ties did not protect me from outrageously poor bedside manners. I suppose I’m writing this partly to vent, but also to remind healthcare professionals what not to do to patients waking up from anesthesia. I also think my experience may serve as a reminder that it’s ok to fire your doctor when conditions warrant.
I chose my gastroenterologist based on his credentials and the q...
Source: Better Health - July 10, 2014 Category: American Health Authors: Dr. Val Jones Tags: Opinion True Stories Bad Bedside Manner Bad Doctors Colonoscopy Compassion Empathy Gastroenterologist Lack Lack of Caring Source Type: blogs
How To Create Medical Research To Support Bogus Therapies, In Nine Easy Steps
Twenty years ago I started my job as ‘Professor of Complementary Medicine’ at the University of Exeter and became a full-time researcher of all matters related to alternative medicine. One issue that was discussed endlessly during these early days was the question whether alternative medicine can be investigated scientifically. There were many vociferous proponents of the view that it was too subtle, too individualised, too special for that and that it defied science in principle. Alternative medicine, they claimed, needed an alternative to science to be validated. I spent my time arguing the opposite, of course,...
Source: Better Health - July 7, 2014 Category: American Health Authors: admin Tags: Humor Quackery Exposed Research Alternative Medicine Bad Research Bogus Claims CAM Complementary And Alternative Medicine False Claims Misinformation Pseudoscience Statistics Source Type: blogs
