Faced with a New Diagnosis? 10 tips to be your own best advocate, Martine Ehrenclou, @Med_writer #nurseup

Faced with a New Diagnosis? 10 tips to be your own best advocate, +Martine Ehrenclou, @Med_writer:"You’re sitting in your physician’s exam room, clothed in a gown. Your test results are in and you are about to discuss them with your doctor.  You’ve had symptoms that prompted those tests and worst-case scenarios are flooring the accelerator on your fears. Your doctor walks in and greets you with a smile and asks how you are, a question you’d be happy to answer after she discloses the results.

Your physician introduces a diagnosis that requires treatment, perhaps a few more tests or even a procedure. While your thoughts are tripping over the medical information, the image of your kids at school comes to mind along with the question, “Who will pick them up if I’m undergoing treatment?” You’re now ten steps ahead of the doctor, plotting what to do next. Should you surrender and simply let the doctor handle everything? Not exactly."
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http://martineehrenclou.com/2013/12/faced-with-a-new-diagnosis-10-tips-to-be-your-own-best-advocate/

Patient complaints do not fit the primary care office visit

by Kevin Pho, MD

Primary care physicians often have to see patients with a litany of issues.  Often within a span of a 15-minute office visit.

This places the doctor in the middle of a tension — spend more time with the patient to address all of the concerns, but risk the wrath of patients scheduled afterwards, who are then forced to wait.

And, in some cases, it’s simply impossible to adequately address every patient question during a given visit.

It’s a situation that internist Danielle Ofri wrote recently about in the New York Times.

In her essay, she describes a patient, who she initially classified as the “worried well”:

via kevinmd.com

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Electronic Health Records: Status, Needs and Lessons – 2011 Report Based on 2010 Data

The use of electronic health records (EHRs) by medical practices and other organizations in the United States has increased measurably in the past decade. Despite the potential to improve the quality of patient care and enhance practices' financial performance, the technology remains far from universal.

To better understand the current state of EHR use, MGMA conducted a study funded by PNC Bank to explore the barriers and benefits of EHR adoption. MGMA collected data between Oct. 1, 2010, and Nov. 9, 2010, from 4,588 healthcare organizations nationwide that responded to the survey. The data represent the aggregate experience of more than 120,000 physicians in medical practice.

via blog.mgma.com

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amednews: Model legislation drafted for out-of-network balance billing :: March 29, 2011 ... American Medical News

A legislative organization calls on hospitals, insurers and physicians to disclose when patients must pay for care.

By Emily Berry, amednews staff. Posted March 29, 2011.

As several states consider whether, or how, to restrict balance billing by out-of-network physicians, the National Conference of Insurance Legislators on March 6 adopted model legislation on the issue.

Rather than explicitly banning or allowing physicians to bill patients when insurance doesn't cover what a physician is owed, the model legislation calls for greater transparency on the part of hospitals, insurers and doctors to alert patients to the possibility that they could end up paying out of pocket for care.

The model bill builds on laws recently adopted in Louisiana and Texas, according to NCOIL's announcement.

via ama-assn.org

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Primary care needs more than 15 minutes for patients, KevinMD.com

Psychotherapy appointments have traditionally lasted 50 minutes with 10 minutes for paperwork. This has lead to the expression, “the 50-minute hour”.

More recently there has been talk of incorporating psychotherapy techniques in brief visits in primary care. The provoking title “The Fifteen Minute Hour” is from a book about addressing the emotional aspects of disease in primary care during brief appointments. The title and the concept seem relevant to much of what we do in my specialty.

In primary care we seldom spend more than 15 minutes at a time with an established patient. Yet we are required to cover infinitely more details and consider more outside authorities in every visit today than when I first started practicing medicine. Between health insurance and office administration, there are now many more mouths to feed from the office charges than there were then. Sometimes it feels like we are not alone in the exam room even for the short time we do have.

Except for doctors in concierge medicine or micropactices, most of us cannot change the amount of time we have with each patient. Even if we hope to change the system, the patients we see today deserve the best we can give them in today’s 15-minute visits.

via kevinmd.com

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Most Americans Take Doctor's Advice Without Second Opinion

Despite the advent of health websites and other widely available sources providing medical research and information, 70% of Americans feel confident in the accuracy of their doctor's advice, and don't feel the need to check for a second opinion or do additional research. Americans' confidence in their doctor is up slightly from eight years ago.

The latest results are from Gallup's annual Health and Healthcare Survey, conducted Nov. 4-7, 2010.

Older Americans are the most likely to be confident in their doctor's advice, with 85% of those 65 and older expressing confidence. This compares with 67% among those 50 to 64 and 65% among those under 50.

While one might expect that interest in a second opinion and doing additional research would be higher among Americans with college degrees or postgraduate education, that is not the case. There is little difference in confidence in one's doctor across the educational spectrum.

via gallup.com

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Doctors' house calls making a comeback - USATODAY.com

Dr. Ina Li walked down the seventh-floor hallway of a local apartment building recently, pausing at each door to check the number.

She finally found the one of her patient, Katherine Talmo.

It's easier for Talmo if Li, a geriatrician, comes to her. The 90-year-old doesn't get out nearly as much since she stopped driving nine years ago. But she is determined to stay in her home.

"If I was in a nursing home, I'd only live for one more year," she said. "But if I live at home, I'll live to be 100."

The notion of doctors making house calls harkens back to an era before HMOs, medical centers and outpatient surgery centers.

Those visits offer insights not available during a 15-minute office visit. Doctors learn more about a patient's lifestyle, eating habits, their ability to take medicine and exercise.

via usatoday.com

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