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Showing posts from March, 2022

EMR - Promises Made, Promises Broken

 Over the past 15 years or so, I have endured several electronic medical record (EMR) systems. Indeed, there is an entire category, EMR Quality , on this blog where I share with readers the good, the bad and the ugly in the EMR space.  If you are suffering from insomnia, I invite you to review these posts nightly. When EMR was creeping onto the medical landscape, physician grunts like me were salivating over the prospect that one of our thorniest and frustrating challenges was about to be solved.   EMR promised that all of our patients’ records could be accessed with a couple of keystrokes in our own offices.   This made sense as we all knew that the digital world could create linkages that would permit access to all of a patient’s medical experiences.   Regrettably, this promise that was made to medical professionals and the public remains unfulfilled. Here’s why physicians were so ripe for the EMR seduction.   Consider this typical scenario in the pre-EMR era. A patient comes t

Is the West Doing Enough for Ukraine?

 The world is watching as a maniacal dictator methodically levels a country, displaces millions of citizens and attacks civilian infrastructure and lives.  The Ukrainian response has been unexpected, effective and downright inspiring.  To paraphrase JFK’s iconic remark in a 1963 speech in West Berlin, ich bin ein Berliner , we are all Ukrainians today. By all accounts, the Russian military assault or war or invasion has stalled.   Their current ‘military’ strategy now appears to be that if you can’t occupy a Ukrainian city, then destroy it.   The ghastly footage is reminiscent of newsreel footage from London in 1941, when the city was bombed for months by another maniacal dictator.   The entire world, except one country, is aware of the deliberate targeting of maternity wards, schools, residential neighborhoods and civilians.   Of course, the Russians deny all of this and maintain that they are liberating Ukraine from genocide and other crimes. The West, under the guidance of the A

A Plea for Medical Education Reform

On the day before writing this, I attended a seminar on medical professionalism.  The room was filled with physicians at all stages of our careers.  I enjoy opportunities to think about aspects of my profession that are beyond the digestive organs that I dally with daily.   At the seminar, a video clip was shown from the 1991 movie The Doctor.  The scene depicted an attending physician berating an intern in the presence of the medical team after he casually referred to the next patient to be seen as being ‘terminal’ without identifying him by name.  If fact, it became clear that the young doctor did not even know the patient’s name.  While the attending physician was correct to recognize that patients are living breathing human beings, not diseases or hospital room numbers, it was a breach of professionalism to humiliate an intern in public. After a few comments were offered by seminar attendees chastising the senior physician’s cruel approach to an intern, I raised my hand.  I sh

Reforming Medical Education

Medical school, residency and specialty fellowship cannot prepare physicians for every eventuality.   Many important skills must be acquired on the job.   And, of course, physicians need to remain current with respect to cognitive and procedural advancements.   Here are just few critical subjects that I was not prepared for when I entered the healing profession. What happened to my phone medicine lectures? Phone medicine.   Treating a patient with abdominal pain at night on the phone requires different skills than when the patient is in my exam room. And, te phone call may be the first time I have ever spoken to this patient. Breaking bad news to patients and their families.  Wouldn’t you think that we would have received training for such a critical skill? Nutrition.  Patients are understandably amazed at my paucity of nutritional knowledge.  I suspect that most gastroenterologists can make the same claim.  Wouldn't you think that nutrition science would be part of a