Kensington, Minn. is barely a dot on the map. This small grid of concrete, where fewer than 300 people live, is a brief interruption amid the sprawling acres of green corn, soybean and wheat fields that cover Minnesota’s western plains.
Similar tiny villages exist every seven or so miles along the Soo Railroad route. These once busy agricultural hubs are now skeletons of commerce with rapidly aging populations.
About one-fifth of Americans live in rural areas, and providing health care to them is a challenge financially and logistically. Only 10 percent of the nation’s doctors practice in rural areas, and rural residents tend to be poorer and less likely to have employer-based insurance than urban dwellers. The list of challenges is long.
It’s that time of year when nursing and medical students shed their label (and protection) of student and head out to the workforce with their new licenses. Over at Emergiblog, veteran emergency room nurse Kim McAllister shared advice with new nursing graduates.
Here are her words of wisdom.
To the new nursing classes of 2008:
Your first year will be the most difficult as you acclimate to your new role as a professional nurse. Hang in there! Keep your focus on why you went into nursing to begin with.
Keep your eyes and ears open. Watch the nurses around you. You will be surrounded by role models. Take the best of what you see and incorporate it into your own practice. It may be hard to believe, but by the time the next class enters the profession YOU will be the role model they look up to.
Should doctors and nurses be subject to different penalties for
precisely the same infraction? Of course not. Are they? Sure. Just ask
Britney Spears.Britney was hospitalized at UCLA at least
twice in the past few years –
once when she gave birth to her first son in 2005, and again in early
2008 for psychiatric care. Both times, dozens of UCLA staff members
peeked at her medical records, despite having no clinical reason to do
This voyeurism, of course, is hard wired into our DNA, and
we aren’t about to purge our inner paparazzis any time soon. But even
celebs have a right to keep their medical records private. Although the Health Insurance Portability and Accountability Act
(HIPAA) has caused some real mischief, one of its beneficial effects is
that it put the issue of medical record snooping on our radar screen.
Whether the victim is a Hollywood starlet or your next-door neighbor,
it is just plain wrong.
Most organizations have hired HIPAA
police and done extensive HIPAA training with their staff.
Nevertheless, all the UCLA snoops were documented to have passed an
on-line HIPAA tutorial. When Britney hit the door, Inquiring People
just wanted to know.
Lest you think this is a UCLA thing, we had
a similar situation (with another famous actress) a few years ago, as
have dozens of other hospitals. In fact, human nature being what it is,
I can’t imagine this not happening – unless the rules are clear, widely disseminated, and strictly enforced.
Careseek CEO Gale Wilson Steele writes in to comment on the ongoing controversy over physician ratings:
"It’s not surprising that physicians are uncomfortable with the idea of others "rating" them. After all, what do others know about how well they provide healthcare?
This, actually, is very similar to the reactions professors first had on RateMyProfessors, where professors protested that students only cared about whether their tests were fair, and scoffed saying that the “kids” knew nothing about the professors’ degrees, research projects, etc. In the minds of those who stood at the lectern, it was about academic qualifications; for those in the seats, it was about staying awake. Today, professors are much more comfortable with the fact that they can be listed on a website and reviewed, and in fact, are somewhat insulted if no student has taken the time to list them. Secretly they even hope to receive a few “chili peppers”, meaning that they are “hot” professors!
Ultimately, a few professors responded in kind and created Rateyourstudents.blogspot.com, a sort of RateMyStudents site. By now it has turned into a cynical professorial rant about teaching.
So with new physician rating and review sites coming online nearly every week, how are doctors going to handle being rated by their patients? Physicians also complain “What does a patient know about how well I practice medicine?…Patients don’t know about my years in school, my research, my etc.”
Will doctors ultimately create a site called RateMyPatients, where they can rant over the injustices of healthcare and the assaults they take daily from their patients? Or will they praise these sites as a place to learn how to improve their practices or as sources of patient testimonials to their excellence?
The latest twist on who rates whom is eliminating the issue of reviewer qualification, namely NursesRecommendDoctors.com. No one will deny that this population of over 3,000,000 trained medical professionals has a keen insight into the practices of physicians, their bedside manners and clinical competence. It will be interesting to see if this trusted group of patient advocates will have the willingness to share what everyone wants to know…who are the best doctors?"
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