Trending issues in medicine 2015 – #2 Regulations
“If you make ten thousand regulations you destroy all respect for the law.” – Winston Churchill
2015 medicine suffers from a plague of regulations. Having graduated from medical school 40 years ago, the difference that these regulations make is palpable and frustrating.
Here is my list, and I strongly encourage comments of regulations that I have omitted.
Meaningful use – I wrote about these regulations yesterday. Ask physicians and they will confirm that meaningful use requirements have made EHRs slower. If physicians thought that the requirements truly led to better care, then we could have...
Source: DB's Medical Rants - December 27, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Trending issues in medicine 2015 – #3 EHRs
Spend some time talking with physicians. It does not matter if they work in outpatient offices or hospitals. It does not matter if they practice full-time or part-time. It does not matter if they work in an academic center or a rural community. They all will tell stories about the electronic health records.
The idea behind electronic health records is pure. But the implementation in 2015 is horrible.
I highly recommend Wachter’s book – The Digital Doctor – if you want to understand the details of how we have arrived at such dysfunctional computer programs.
My next trending issue will cover regu...
Source: DB's Medical Rants - December 26, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Trending issues in medicine 2015 – #4 MOC
Maintenance of certification has created great controversy over the past 2 years. Rather than discuss the pros and cons of ABIM and ABMS, their decision making, and money, I prefer to give my opinions on what physicians need and what organized medicine should provide.
Here are my assumptions. I finished my residency in 1978 and became board certified that year. While an academician, I have done both outpatient practice and inpatient supervision. Over the past 20+ years, I have averaged rounding the equivalent of around 120 days each year. I have the final responsibility for major decisions and care for patients w...
Source: DB's Medical Rants - December 25, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Trending issues in medicine 2015 – #5 Diagnostic accuracy
As the year ends, we have a responsibility to survey the medical landscape and identify the major issues that are impacting physicians and therefore patients. I have chosen 5 topics to discuss. Today I will focus on one that I have addressed often over the past decade – diagnostic accuracy.
Today’s NEJM has an article that, in my opinion, misses the point –Reducing Diagnostic Errors — Why Now? As most readers know, the Institute of Medicine has published their opus on the topic –Improving Diagnosis in Health Care
Here is my take. As we practice medicine and teach medicine we have time lim...
Source: DB's Medical Rants - December 24, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
On becoming a better educator
Readers are slowly learning about my admiration for the Farnam Street Blog. The “about” page describes the blog in this way:
My goal is to help you go to bed each night smarter than when you woke up. I’ll do this by giving you tools, ideas, and frameworks for thinking.
I’m not smart enough to figure all of this out myself. I try to master the best of what other people have already figured out. Sounds simple, doesn’t it?
The best way to do this is to read a lot. And so I make friends with the eminent dead.
Along the way I write about what I’m learning. I’d encourage you to look around and decide for ...
Source: DB's Medical Rants - December 17, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
