Patient-centered care and cultural conflict
I just finished this fascinating article on cultural conflicts that can exist between patients and physicians. The case presented is simple and realistic, and the commentary provided very thought-provoking. The author touches on a wide array of cultural topics such as autonomy, privacy, and differing cultural standards, along with a thorough dissection of a variety of pre-conceived notions that both patients and physicians may bring to the clinical setting. The article ends with a rational suggestion on how cultural conflicts can still result in quality, patient-centered care, and includes a good justification for when and how to yield to a patient's wishes when they are in conflict with the physician's beliefs.
"Patient-centered medical care is not only a rejection of “my way or the highway” thinking; it is also a commitment to meeting patients on their own terms and respecting their values. We need to enhance our focus on commonality, rather than on difference, especially as the United States becomes more diverse. Providers must avoid thinking in “us versus them” terms—not only because “us versus them” is a false dichotomy but also because such thinking decreases the resolve to meet patients where they are."
Friday round-up
Federal investigators have released a new report stating that only about 1 in every 7 hospital errors are reported. Adverse events ranging from infections to excessive bleeding to even death are supposed to be reported through systems present at almost every hospital in the US. The systems often allow for anonymous reporting, in order to encourage hospital staff to cooperate. However, as it states in the article: "organizations that inspect and accredit hospitals generally "do not scrutinize" how hospitals keep track of medical errors and other adverse events". And if the accrediting bodies do not scrutinize the process (and results thereof), there isn't much incentive for staff to report. It also states in the article that no new federal regulations regarding this are expected.
The National Science Foundation has released the 14 winners of the "Digging into Data" challenge. The 14 winning projects all involve innovative ways to use data analysis and natural language processing (NLP) to enhance research in the humanities and social sciences. Those interested in large-scale data mining and investigation should read through the winning projects, as they all sound extremely interesting. I think my favorite might be the analysis of newspaper reporting on the 1918 flu pandemic (and not just because most of the PIs are from my alma mater!), in order to see how such reports affected public opinion and the idea of "authority" during the outbreak. I will be eagerly anticipating their results. The 14 winning research projects are sharing nearly $5 million in funds.
Dr. Matheson Harris has written a brief and clear tutorial for patients (with some help from the Chicago Tribune) on how to spot a good doctor (and a bad one!) and how to be a good, educated patient. I really like a lot of what is said here, and agree with the vast majority of it; though it might be a little harsh to tell patients not to go see a doctor who can't see them within a few days. I think it greatly depends on the type of doctor you're seeing, and what the appointment for. I make my dermatology appointments a year in advance because it is so hard to get an appointment at the practice (widely considered one of the best in the nation). And many women in the state of Pennsylvania can tell you about the difficulties in getting an OB-Gyn appointment due to the shortage of those specialists. But the gist of the advice and guidance here is very strong, and all patients should read and take it to heart.
Eight technologies for a healthier 2012
With the fast approach of the New Year, most of us have a New Year resolution. One of the biggest New Year’s resolutions is losing weight and with all the new technological advances, some say that this year may be much easier than the others to do so. The article states that the technology that may improve your health are tracking devises, exercise applications, and devices such as FitBit which counts the steps you take and calculates the calories you burn. While such devised may be extremely helpful in losing weight, the biggest contributor is motivation. Having the desire and will power are first on the list, and then technology which is used as an aide.
Breakthrough medical gadgets: The future of healthcare hardware
In today’s society, our technological abilities advance on a daily basis and health technology is no exception. A group of developers gathered for a meeting to present some of the new innovative gadgets and healthcare hardware. The gadgets have potential to changemedical training and improve health with a simple click of a button. Some of the gadgets described in the article include the Xiaflex Injection Trainer-rubber dummy models that assist in training physicians with procedures such as injecting enzymes into diseased tendons, the AccuVien AV 300 which scans for thick blood vessels and projects them onto a patient’s skin allowing professionals to easily locate vessels, the EarlySense Monitoring system which is a bed that monitors your vital signs and alert nurses when someone who is not allowed up has gotten out of bed, and many others
Many of these items are already present in hospitals and have begun to assist health professionals. It is interesting to watch the progression of these gadgets as well as the production of new ones and how they will change our healthcare system.
New social media tool for students and surgeons
Surgery Theater is the first online social media educational portal for all surgical procedures. The site can be used to watch live surgical procedures and conferences, medical document sharing, exploring new surgical techniques, and receiving information on the most up-to-date surgical innovations. This is a great medical education resource for students but can also be used for patients looking to get more information on upcoming surgical procedure. This is a great new educational tool for surgeons, students, and patients.
Mayo Clinic and Swedish Medical University join forces
Mayo Clinic and the Swedish Medical University are collaborating to improve research and education. Both are world leading research organizations that will work to expand research areas, health care innovation, and education programs. The two will be working together to share and develop innovations in education and train health care professionals and scientists worldwide. The two organizations hope to learn off of each other and join forces to advance medicine.
With two such powerful organizations working together, we hope that the quality of our health care truly improves and our healthcare issues are addressed.
Do “nice” doctors make better doctors
Downside of Doctors Who Feel Your Pain
Do "nice" doctors make better doctors
The relationship between a physician and a patient is a crucial factor for health improvement. When physicians possess certain skills, chances are patient will be more inclined to communicate with the doctor and be more involved in their treatment. This article debates whether communication skills can be one of the requirements of medical school entrance and if so, how can it even be measured. Assessing potential medical student’s communication skills is not easy and there is no existing evidence that states that physicians with expert communication skills are better doctors than those lacking the skill. The question is how much of a factor this is and how much emphasis should be placed on communication skills in future physicians.
Friday roundup
A diverse set of interesting articles I've come across recently:
An article describing various viewpoints on taking care of Jehovah's Witnesses in life-threatening situations. I like the idea of talking openly and honestly about sympathy, empathy, and the role of the physician in terms of the patient's personal or religious beliefs. This is a touching and insightful piece that may be a challenging read for some, but highlights the very important topic of cultural sensitivity, and how healthcare professionals can frame religion and culture within the world of medicine.
A thought-provoking piece illustrating some of the thoughts of Seth Godin regarding the future of education. He posits that the "Harvard model" is dead: high-priced institutions that hold classrooms of 15-300 students, being lectured to by professors on the "accumulating credits" system. Instead, he envisions a future of online, collaborative education where students can also be instructors, and physical space is replaced with digital space. He mentions the modern notions of online communities and the free sharing of and expansion upon data and ideas.
The AAMC has released the published responses to their 2011 "Question of the Year": "What improvements in medical education will lead to better health for individuals and populations?" The replies run the gamut from nutrition to financial incentives to competency-based education and beyond. Other topics include diversity, health disparities, leadership, professionalism and global health. Must-reads for anyone interested in medical education, public health, reforming healthcare, professionalism/humanism, patient safety, and pretty much any other healthcare-related topic.
An intriguing summary of the future of computing and IT points out the importance of Natural Language Processing programs, and where they are headed. When thinking about what the next generation of computers and applications will need to do, the ideas of detailed data analytics, human-like "thinking", situation/information comprehension, and insight into users/consumers are top on the list. Sentiment analysis, contextual understanding and those kinds of data manipulation and analysis are already being researched and developed at a frenetic rate (and with astronomical sums of money). Considering the ever-increasing amounts of data being created on a daily basis, it is no surprise that the next wave of computer innovation is going to revolve around making sense of it all.
Teaching doctors to be mindful
Mindful communication training for doctors has been shown to improve physician-patient communication, decreased exhaustion, improves attentiveness and focus, and improves over all engagement with patients. Such meditative training also decreased physician burnout. The physicians who participated in this meditative training found a sense of meaning in their practice and in their patient’s treatment resulting in a higher level of compassion towards their patients.
While there are many great benefits that result in this training, the dilemma is finding the time from physicians busy schedules to participate in such a program. With today’s health system, doctors are torn between patients and paperwork and can barely find time to spare an extra few minutes to patients. Finding time for such a program could result in effective physician-patient relationship and improving patient engagement in their own health.
Reporting mechanism for EHR problems?
This article highlights some of the serious issues that are occuring within EHR systems, and explains that very little is being done about it.
Dr. Dean Sittig of the University of Texas Health Sciences Center is calling for the creation of a regulatory body (similar to the National Transportation Safety Board), in order to report and categorize glitches and negative events that take place in various EHR systems, and to govern or sanction EHR vendors and healthcare providers who routinely ignore the problems and their dangerous consequences.
Some examples of the issues being reported include:
- missing or inaccurate data
- incorrect mapping (resulting in the wrong drug being prescribed)
- doctors ignoring (or not receiving) important information, updates, reminders, etc.
- alerts leading to lengthy delays in patients getting important medications