To do the math right, you have to get your numerator and denominator correct, or else things just don’t work. Recently, in the midst of a large patient safety and quality improvement project trying to bridge gaps in breast cancer screening among …
Category: primary care
Direct primary care physicians are not concierge doctors
I recently received a scathing email criticizing an article I wrote about the care of patients in underserved areas. “Should you really even get to write articles about poor, underserved populations when you run a concierge practice?” the author wrote….
Doctors: Never forget the importance of eye contact
Eye contact is one of the most basic mammalian traits that signals an interaction. Anybody who has a dog or cat at home sees on a daily basis how much animals value eye contact (and with dogs, it signals you’ve lost the battle!). In the case of health …
Geriatric medicine is a calling
Often people (mostly residents and medical students) ask why on earth did I choose to do a geriatric fellowship? My response is because it is the medicine of the future. While we are all aging, the fastest growing age groups are those born between 1946…
Sometimes, the biggest challenge to eliminate health disparities is geography
Driving north in a snowstorm Tuesday of Thanksgiving week I certainly took my time. I left after our Suboxone clinic wrap-up conference, around 7:30 p.m., and arrived at my unplowed driveway in Caribou about 1 a.m. On the way up, I saw two ambulances, …
Are clinically integrated networks a cure for checkbox medicine?
Years ago, I was contacted by a health plan about an elderly nursing home patient who had not been screened for osteoporosis. While brittle bones are a big problem in skilled nursing settings, the real problem for this health plan was its low HEDIS sco…
The problem with abbreviations in the medical record
Several patients seen in our practice recently were significantly and dramatically transformed by the electronic health record (EHR). And not in a good way. Take, for instance, the patient whose outside chart was reviewed when she showed up in our offi…
Do huddles really help in primary care?
I’ve huddled since before we used the word for it: You want to be prepared for the patients coming in that day. “Followup MRI” – did they have it and what did it show? “Ankle pain” – do we have X-ray today? “Eye pain” – be sure to check her acuity and …
How customer service breeds bad medicine
“Welcome to our clinic. May we take your order?” Many patients have Googled, Yahoo’ed or Bing’ed their symptoms way before I even lay eyes on them in an examining room. And they have a schema of what they’ll be getting out of the visit. If …
My garden has taught me a lot about health care
Sustainability is a bit of a buzz word these days. To be sustainable means that you only use what you need, leaving the rest to be used by you or others in the future. Sustainability is a popular topic in environmental sciences and refers to renewable …
