Confronting Scandalous Physician Behavior: The Annals Of Internal Medicine Takes The First Step

Val Jones, MD

This post first appeared on Better Health.

If you have not read the latest essay and editorial about scandalous physician behavior published in the Annals of Internal Medicine (AIM), you must do so now. They describe horrific racist and sexist remarks made about patients by senior male physicians in front of their young peers. The physicians-in-training are scarred by the experience, partially because the behavior itself was so disgusting, but also because they felt powerless to stop it.

It is important for the medical community to come together over the sad reality that there are still some physicians and surgeons out there who are wildly inappropriate in their patient care. In my lifetime I have seen a noticeable decrease in misogyny and behaviors of the sort described in the Annals essay. I have written about racism in the Ob/Gyn arena on my blog previously (note that the perpetrators of those scandalous acts were women – so both genders are guilty). But there is one story that I always believed was too vile to tell. Not on this blog, and probably not anywhere. I will speak out now because the editors at AIM have opened the conversation. (more…)

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Newly Minted Doctors Begin Their First Jobs In July: Should You Be Afraid?

Val Jones, MD

Today’s post first ran on Better Health on July 4.

The short answer, in my opinion, is yes.

The long answer is slightly more nuanced.  As it turns out, studies suggest that one’s relative risk of death is increased in teaching hospitals by about 4-12% in July. That likely represents a small, but significant uptick in avoidable errors. It has been very difficult to quantify and document error rates related to inexperience. Intuitively we all know that professionals get better at what they do with time and practice… but how bad are doctors when they start out? Probably not equally so… and just as time is the best teacher, it is also the best weeder. Young doctors with book smarts but no clinical acumen may drop out of clinical medicine after a short course of doctoring. But before they do, they may take care of you or your loved ones.

It has been argued that young trainees “don’t practice in a vacuum” but are monitored by senior physicians, pharmacists, and nurses and therefore errors are unlikely. While I agree that this oversight is necessary and worthwhile, it is ultimately insufficient. Let me provide an illustrative example. (more…)

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Data Independence Day Series

my dataOur posts this week will all focus on health data and individuals right to access it in honor of “Data Independence Day”. Data Independence Day initiated by Former National Health IT Coordinator Dr. Farzad Mostashari (you will hear more from him later this week) is a movement that will come to a head on July 4 when the Get My Health Data effort launches. The movement is focused on consumers demanding electronic access to their health information. It began when patient advocates responded to the recently loosened rules governing the “meaningful use” EHR Incentive Program. In April, CMS announced it was changing the provision that requires eligible providers to prove that five percent of EHR users have viewed, downloaded, or transmitted information contained in their patient portal. The change, eligible providers now only need to prove that “equal to or greater than 1” patient has interacted with their record. You can see why patient advocates were outraged. (more…)

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“What If 1 Million Americans Asked for Medical Records on the Same Day?”

Jane Sarasohn-Kahn

farzadThe following post ran yesterday on Health Populi, see the original post here.

This was not a theoretical question Dr. Farzad Mostashari, former head of the Office of the National Coordinator of Health IT in the Department of Health and Human Services, asked yesterday at the closing keynote of Day 1 of the Patient Engagement Forum.

Dr. Mostashari issued a challenged to the community of mischief-makers in health/tech patient advocacy: tell everyone you know to contact their doctors — by phone, email, patient portal, or in-person, on one designated day which he called a “Day of Action.”

Health IT journalist Neil Versel (disclosure: also a long-time friend in the field) covered this news story here in MedCity News.

In the meantime, here is my (abridged) transcript of Dr. M’s talk, thanks to my note-taking skills. My own words are between carrots <> to provide additional context. (more…)

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A Call to Consumers to Lead the Shift in Healthcare

Sharon TerryRecently Sharon Terry a Disruptive Woman and CEO of the Genetic Alliance joined Mendelspod to kick off their new series, Personalized Medicine and the Consumerization of Healthcare. Over the last twenty years Sharon has worked tirelessly as a patient advocate, advocating for the sharing of patient data long before others were doing so.

Here what Sharon had to say on the topic here.

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  • January 13th, 2015 Filming in the ER: A Policymaker Perspective
    By Glenna Crooks
  • January 12th, 2015 Filming in the ER: A Patient Perspective
    By Glenna Crooks
  • In Observance of Jessie Gruman

    jessie-gruman picOn July 14th, 2014 we lost a truly outstanding woman to her battle with a long time illness. Jessie Gruman was the president and founder of the Center for Advancing Health. A true patient advocate, she promoted not only patient engagement but the use of evidence-based medicine to support the adoption of healthy behavior.  In addition to her professional career, Gruman defined herself as a musician, avid reader of poetry and interested in foreign policy, the media and global health. She was a true disruptive (more…)

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    Patient Engagement: Here to Stay

    jessie-gruman picA few years after my treatment for Hodgkin’s lymphoma finally limped to its end in the mid-1970s, I looked back and was amazed at my casual approach to that devastating, life-changing diagnosis: At times I had been completely absorbed by it, every moment governed by the demands of the treatment and illness. At other times, well, the contingencies of life intervened, and I went dancing. Or to class. Or on vacation, with little regard for the risks, the medications and all my doctors’ directives.

    How could this be? Why would I take such a chance with my own health, my own (more…)

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    Saving Patients – One at a Time

    Some days I wonder how I wound up where I am today – doing what I do. Then certain days remind me, grab hold of me, and confirm, I was put here for this reason and THIS is my calling.

    As a medical malpractice paralegal, I had a clear interest in the medicine, as well as the law. Working on these files stirred a passion inside me. I knew I was onto something. With each case came a new type of medicine, illness, and surgical procedure I had to learn about. This was certainly filling my craving for knowledge. Then, the personal aspect of these cases kicked in. Each case was someone who died unnecessarily and left behind a traumatized family, or a brain damaged child with overwhelmed and distraught parents, and even people who were given a terminal diagnosis, as the result of a delay or mistaken diagnosis, and were looking for answers and justice. Each one unique – with its own story. Every story and every person – affecting me to my core. That is when I began to realize that beside the job I was doing for them at the firm, I needed to do more. (more…)

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    How to Make the Most of Your Doctor Visit

    jessie-gruman picI recently wrote about how common it is for those who work in and deliver health care – physicians, nurses, clinics and hospitals – to overestimate our knowledge about our bodies, our illnesses and how the health care system works. This overestimation of our familiarity happens with even the most seemingly simple and straightforward aspects of care, such as: Who is the nurse practitioner? Where is Dr. X’s office? When is “soon”? Why are you recommending this test?

    To help people find good health care and make the most of it, CFAH has created a library of Be a Prepared Patient tips and resources including two videos. The two-minute video below shares tips for How to Make the Most of Your Doctor Visit by explaining how to effectively describe your symptoms in four key steps. Being prepared with this information will allow you and your doctor to discuss the best treatment for you, including next steps. (more…)

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    Where Fashion and Health Intersect

    Anita-Dolce-VitaPeople often look perplexed when I mention that I am a Clinical Research Nurse by day and a fashion blogger by night.  Some find it peculiar, if not interesting, that I am passionate about and committed to two fields that most people consider completely unrelated. However, fashion and health care do intersect, and at this intersection exists opportunities to improve health and wellness.

    Studies have revealed that patients judge their health care providers based on the way their providers dress. It is not incredibly surprising that patients have greater trust and confidence in providers who are neat and professional in appearance, with preference given to starched white lab coats, business attire (e.g., neckties and suit jackets), and scrubs. So, what does this mean for providers and patients with respect to health and wellness? Well, the provider’s style of dress can impact the provider’s credibility and patient mistrust could lead to poor treatment adherence and low patient self-disclosure.  (more…)

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  • October 7th, 2013 Today’s Government Shutdown: No Paradise
    By Glenna Crooks
  • The Consumer’s Ongoing Dilemma: Making Sense of Hospital Prices

    Trudy LiebermanRecently the Washington Post’s health policy columnist Sarah Kliff waded into the muddy waters of hospital disclosures. Kliff had heard that North Carolina Gov. Pat McCrory had signed legislation requiring the state’s hospitals to publish the rates for the services they’ve negotiated with insurance companies.

    That indeed would be a big step and builds on Medicare’s release earlier this year of what hospitals charge the government to treat Medicare beneficiaries. Surprise, surprise! The data show huge differences among hospitals even in the same city, a phenomenon well documented in the academic literature. (more…)

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    An Interview with Jessie Gruman: A patient, health care reformer, and the recipient of caregiving

    Jessie GrumanJessie Gruman is president and founder of the Center for Advancing Health (CFAH), a nonprofit, Washington-based policy organization which, since 1992, has been supported by foundations and individuals. CFAH works to support people’s engagement in their health and health care. Prior to founding CFAH, Gruman worked on these concerns in the private sector (AT&T), the public sector (National Cancer Institute) and the voluntary health sector (the national office of the American Cancer Society). DW talked with Gruman recently about her work and her perspectives on her role as a patient, health care reformer, and the recipient of caregiving. (more…)

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