Author's posts
Asking primary care clinicians to work harder isn’t a solution
“Sorry Dr. Pelzman, just one exam room today.” This is how our medical technician greeted me as I arrived for my Wednesday morning practice session earlier this week, with a full panel of patients on the schedule set to see me over the next…
A smarter EMR will make visits more patient-focused
What do our patients really want from us? When a patient calls up to schedule an appointment, or sends us a message through the patient portal, or calls our front desk staff to leave a message, what is it that they’re looking for? I think, more t…
How can we reduce the no-show rate in primary care?
At a quality and patient safety meeting recently, one of the departments was presenting their annual report on all they have done, reviewing progress that has been made around several quality and patient safety initiatives. One of their project centere…
We need to make better use of the health team and technology
Nearly a quarter of a century ago (good heavens, I can hardly believe I have to say that!), when I was just starting out as a junior faculty attending, I remember one of my mentors taking me to the hospital with him on morning rounds to see all of his …
When physicians order tests: a tale of 2 patients
Sometimes things go just the way you want them to, and sometimes they don’t. Compare and contrast the case of two different patients, and how things went trying to get them the care they needed. The first patient, let’s call him Mr. Smith, called up one day last week with a brand-new symptom, which after […]
Clicking checkboxes doesn’t meaningfully improve care
Earlier this week, I was pleased to learn that my practice had achieved a statistically significant increase in box clicking. In reviewing data from our accountable care organization, graphs were shown to us demonstrating improved compliance with several of the measures that they’ve instituted institution-wide for the purpose of reporting back to Medicare on how […]
Health care has too many moving parts
So many moving parts. Just last week, a patient I’ve cared for over 20 years came to see me, and she was despondent over a number of issues. First and foremost was that her partner of over 60 years has had progressive dementia, and finally things got so bad that he had to be transferred […]
It’s time for an army of people to help take care of our patients
This was the end-of-the-hallway conversation with an elderly patient after wrapping up a recent office visit, as we walked away from the exam room toward the front desk to schedule her follow-up appointment, and she realized that we were “celebrating” 20 years together. I met her when she was admitted as an inpatient when I […]
Making the world a better place for new medical interns
It’s that time of year again. The start of a new academic year, marked by the arrival of a brand-new class of interns starting out in their training. Clutching their freshly-minted medical degrees, they appear so ready, so anxious, so excited, so eager to learn. Now it’s our job to make sure they stay this […]
A better way to handle patient handoffs from the hospital
As we all know, the time around discharge from the hospital is a tricky one. In more ways than one can imagine, patients are in a delicate state, judged by those caring for them to no longer be sick enough to need to remain in the hospital, but possibly not quite completely ready to be […]
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