The Physician-Patient Interaction: The Key Elements of Mastering the Moment
September 26, 2018
Behavioral neuroscientists talk about the moment, the exact second we make a decision and act upon it. They describe in almost obsessive detail all the neuronal pathways and neuronal firings that occur in our brain. They talk about influences of past and present, knowledge acquired and remembered, skills honed and sculpted, abilities, beliefs, social backgrounds,…Read More
Retained Surgical Sponge: Never Means NEVER!
September 5, 2018
The Problem The term “Never Events” was used in 2001 to describe a subset of medical errors that, ideally, should never occur. Also known as “Serious Reportable Events,” they encompass a wide variety of surgical, device, patient protection, care management, environmental, radiologic and criminal events. The Agency for Healthcare Research and Quality currently defines 29…Read More
Pay for Performance: Destroying the Essence of Medicine!
August 28, 2018
According to Sir William Osler, “Medicine arose out of the primal sympathy of man with man; out of the desire to help those in sorrow, need and sickness.” I will highlight two words: “primal sympathy.” Empathy and sympathy have been researched extensively in the human brain. To summarize, being altruistic, having sympathy, and being empathetic are…Read More
Top 10 Risks in Ambulatory Practice
August 21, 2018
In 2014, there were 885 million physician office visits. Over half of these visits occurred in primary care –family medicine, internal, medicine, pediatrics and others – but there are still hundreds of millions of visits to medical and surgical specialists as well. Based on information available from journal publications and claims data, we assembled this…Read More
Optimizing Post-Delivery Care with Breastfeeding
August 13, 2018
World Breastfeeding Month gives us an opportunity to highlight the benefits of breastfeeding as a life-saving infant feeding practice. In support of the importance of breastfeeding exclusivity and skin-to-skin (STS) for the reduction of infant morbidity and mortality, Bill Gates recently wrote, “Some of the best breakthrough ideas don’t involve technology at all. There is…Read More
Who is Competent to Triage?
August 7, 2018
How do you determine who is actually competent to triage? If you do have a competency assessment plan, is it documented in writing? How do you know it is effective? Is it up to date? These and many other questions arise when exploring the development and documentation of a triage competency validation process. Answers to…Read More
Avoiding the Dead Leg: Acute Limb Ischemia (ALI)
July 23, 2018
Medical errors related to vascular emergencies are common and costly. From head to toe, the vascular system is a fertile field for risk and error waiting to entangle the unwary practitioner. Starting at the top, the high-risk vascular entities include a trio of hemorrhages (subarachnoid, subdural, and epidural) and the ischemic duo of TIA and…Read More
Beware of the “Dirty Urine”
July 18, 2018
Every day in the practice of medicine, hundreds of thousands of urine samples are tested. The maxim that states “all females between ages 10 and 60 with abdominal pain must have a urine pregnancy test” has been ingrained into our cerebral cortexes. Since the times of ancient medicine, the urinalysis has been used to screen…Read More
10 Medical-Legal Basics Every Provider Must Know
July 2, 2018
Regulations, rules, litigation, and medical errors are not the most popular topics for the busy clinician. Most of us would rather gargle nuclear waste than spend a precious evening reading about these issues that plague the pure and honorable practice of medicine. However, we avoid such matters at the peril of our patients’ safety as…Read More
