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Betsy Lehman

Twenty years ago this month, the Boston Globe disclosed that health columnist Betsy Lehman, a 39-year-old mother of two, had been killed by a drug overdose during treatment for breast cancer at Dana-Farber Cancer Center. In laying out a grim trail of preventable mistakes at a renowned institution, the Globe prompted local soul searching and a new focus on patient safety nationally.

Although I didn’t know Betsy personally, we were about the same age, had two kids about the same ages and were in the same profession. (I, too, was a health care journalist.) That’s why I was particularly disappointed by a recent conference celebrating the reopening of the Betsy Lehman Center for Patient Safety and Medical Error Reduction. It was heavy on statistics and poll results; e.g., one in four Massachusetts adults say they’ve seen an error in their own care or the care of someone close to them.

While it’s true that Boston is the epicenter of thinking, writing and speaking about patient safety, words do not always translate into deeds.

Continue reading “The “Business Case” For Patient Safety”

flying cadeuciiIn January, Ezekiel Emanuel – one of the country’s foremost health experts – threw a presumptive grenade into the national discourse: the annual physical is worthless. As we watched the initial burst of reactionary fervor following hisNew York Times opinion piece, we weren’t quite sure what to think.

Then we realized why: in our training and burgeoning careers in primary care, neither of us has ever scheduled an “annual physical” for a patient. To us, the notion of such a visit – for scheduled, non-urgent care, and one not specifically for chronic disease management – is already dated. Given current trends in American health care delivery and professional training, we argue it is one that may well soon be obsolete.

But does that obsolescence change the value of that time – whether 15 minutes or 60 – with a patient, on a regular interval? Our perspective from medicine’s emerging front line offers a resounding no.

The most obvious argument for regular primary care visits is preventive care. Dr. Emanuel bases much of his argument on the validity (or lack thereof) of annual physicals. Drawing off that same evidence base, the U.S. Preventive Services Task Force sets recommendations for evidence-based screening in various populations. Even the young and healthy benefit from cervical cancer screening, initiated at 21 years of age and continued every three years provided negative results until the age of 30 (when the recommendations change slightly). Patients with higher risk earn further screenings, based on whether they smoke, their weight, their age and their family history.

Continue reading “What Zeke Missed on an Annual Physical”

Starcraft

Contrary to what you may think, most doctors do want to make eye contact. They aren’t antisocial. They want to engage. But they can’t. They’re too distracted by one of the worst computer games ever invented—the electronic medical record (EMR).

You may be surprised to see the EMR compared to a computer game, but there are many similarities. Both offer a series of clicks with an often-maddening array of tasks to solve. There are templates to follow, boxes to fill in & scoring. However, unlike most electronic games, the points accrued in the EMR often translate into payment—real dollars for either your doctor or the hospital.

Although these clicks and boxes may be necessary to document your visit, it’s distracting. And your doctor begins to feel more like a librarian cataloging information rather than, say, a historian capturing your story. Continue reading “Meet the Worst Video Game Ever Invented: The Electronic Medical Record …”

flying cadeuciiIt’s really quite easy to kill a doctor. Here’s a step-by-step process guaranteed to succeed at least 400 times a year:

Start early.

Be sure to denigrate medical students whenever possible. Even if they’ve come to the profession later in life and have accomplished all kinds of amazing things personally and professionally (which don’t count, of course, since those are other professions) they don’t know squat about medicine and you do. Make sure to emphasize their ignorance and inexperience at every turn, because it’s the only way to prove that you know more than they do, which of course means that you’re a better person than they are. The fact that as a group they’re all at the very top of their peer group in motivation and intelligence is irrelevant. Continue reading “How To Kill a Doctor”

Matthew Holt, Co-Chairman of Health 2.0 interviewed Amy Cueva, Chief Experience Officer of Mad*Pow to discuss some of exciting themes behind HxRefactored and what it means to change the experience of health care through design and technology. Amy will be speaking during the HxRefactored conference coming up on April 1-2.

Health 2.0 Co-Founder, Matthew Holt recently interviewed Alan Joseph Williams, Product Designer and User Researcher at Code for America’s Health Lab, which develops digital services for Californians eligible for or enrolled in social services like SNAP and Medicaid. Alan will be presenting at the HxRefactored Conference April 1-2 in Boston, MA.

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Epic’s Faulkner Shares Charitable Foundation Plans

In an interview with Modern Healthcare, Epic founder/CEO Judith Faulkner reveals that she will leave much of her wealth to a specially created charitable foundation that will operate and fund not-for-profit organizations in healthcare and other areas. The 71-year-old Faulkner says that almost all her shares of Epic stock will go to the foundation upon her death, or sooner if she chooses.

The plan is also designed to keep Epic private. “My stock will go to the foundation,” Faulkner said. “The foundation will control the stock. This plan is designed to preserve the company as a private company forever.”

Faulkner, who has an estimated worth of $2.8 billion, says she never wanted the money personally or for her family and wonders, “What would you want with all that money? It doesn’t seem right and I can’t tell you why.”

What’s not to like about Faulkner’s values or her plan?

Continue reading “HIT Newser: The Judy Faulkner Foundation or Whatever We’re Calling It”

THCB_CorepointHealth_Inline

Pharos Cover Art

In 1994, I recorded a fictitious interview with the person whom I imagined to be the last well person on earth. (1)  I mistakenly thought well people were disappearing and I wanted to call attention to their disappearance. I missed the big picture and now want to correct my misconceptions. Well people are not disappearing; instead, a new species of man is emerging:  homo clinicus.

An evolution of the symbiotic relationship between man and medicine has been going on for some time. Lewis Thomas deserves the credit for an early spotting of the new species, first observed in America. He called our attention to this phenomenon in the 1970s.

Nothing has changed so much in the health-care system over the past 25 years as the public’s perception of its own health. The change amounts to a loss of confidence in the human form. The general belief these days seems to be that the body is fundamentally flawed, subject to disintegration at any moment, always on the verge of mortal disease, always in need of continual monitoring and support by health-care professionals. This is a new phenomenon in our society.

Continue reading “Clinical Man *”

Stanford neurosurgeon Paul Kalanithi died March 9th at the age of 37. This is his story.

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MATTHEW HOLT
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JOHN IRVINE
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