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Reduce Hospital Readmission Rates or Else!

I attended a medical staff meeting recently.  These are required meetings and attendance is taken, as was done when we were in kindergarten.   While some folks are interested in these meetings’ content, many are not and simply sign the attendance sheet and then slither out in a stealth fashion.   Sly doctors grab their pagers and then leave hurriedly pretending that they were summoned to an urgent medical situation, when they are actually heading for Starbucks.   One of the community hospitals I attend initiated a dastardly procedure when administrators would not post the attendance sign-in sheet until the conclusion of the medical staff meeting.   Under the threat of picketing, a massive walk out, letters to the local paper and other unspecified measures, the evil decree was rescinded. Who says that physicians have no power today? Sadly, most of these meetings have nothing to do with making us better doctors.  The agendas...

Boston Marathon vs Terror: Boston Wins

Ohio Stands With Boston I called my son, a Tufts sophomore, hours after the Boston bombs exploded.  I already knew that he was ok, but a horror in your own neighborhood reaches deep into your gut, as I learned when senseless evil descended upon the small town of Chardon, Ohio a few years ago. I couldn't reach him on his cell phone.  Later, he explained that cell phone coverage was blocked in order to prevent a phone from being used as a detonator.  This seemingly innocent comment demonstrates the shattering of innocence that has affected us all. Yes, our society knows fear and anger more than ever before.  We stare evil directly in the eye and wonder if it is lurking beyond our view.  But when it strikes, resilience, fortitude, selflessness, bravery and love have prevailed every time, as we saw in the great city of Boston last week.  While the pain of those who suffered directly is unimaginable, the actions of good people are as real as it get...

Medical Office Efficiency - The Times They are a Wastin'

Medical practices, particularly private businesses like mine, strive for efficiency. This has become more necessary as medical reimbursements inexorably decline while overhead and other expenses rise. This may be the point in this post when a reader will jump to the comment section below and carp how I and every other doctor are only in it for the money. Not so fast here. Yes, I would like to make a living and I believe that I deserve a decent one. In my case, I do not seek, and have never sought wealth. For small private medical groups, particularly in northeast Ohio, we are aiming to survive more than to thrive. These days wasted time during the work week can be the tipping point that buries a private practice. Where are the time sinkholes in medical practice? No show patients – This is the ‘Wonder Bread’ of medical practices. It torments doctors in 12 different ways. Younger readers may need to Google to get this reference. Late Patients – While these folks are ...

Does Medical Resident Work Hour Reform Reduce Medical Errors?

One of the points I offer in this blog and elsewhere is to be skeptical to assume that something is true because we think it should be. We’ve been brainwashed to believe that obesity is a killer, despite research performed this year concluding that a little more weight may add years to your life.  Many argue that an assault weapons ban will save lives despite the absence of social science research that supports this.  Fewer guns should save lives, right? When skeptics like me point to Chicago which boasts extremely strict gun control legislation while being a murder theme park, we are given excuses to reject the data that contradicts gun control dogma.  Isn’t the term assault weapon itself unfairly charged and loaded?  I have supported medical education reform advocating that medical residents and interns should not be worked to exhaustion and yet be expected to administer high quality and compassionate care to ill patients.  I had believed that somna...

Medical Overdiagnosis and Overtreatment - Do Physicians Want Cost Control?

Truth is more absurd than fiction.  Mayor Michael Bloomberg’s wacky ban on certain sizes of sugary beverages, a scheme which was riddled with inconsistencies and exceptions, was properly squashed by a New York judge.  The mayor’s next play was to order all establishments that sell cigarettes to hide them from patrons.  I hope that this policy is examined in the same courtroom that ruled that the leaky soda ban was illegal.  Is this guy a mayor or an emperor?  Who can legitimately defend the government dictating to private businesses how they can display legal products to its customers?  Where would candy, potato chips and other poisonous snack foods be sequestered?  Speaking of sequestration, which the president warned would crush the country, the earth still rotates, the sun rises in the morning and congress has a 15% approval rating.  In other words, not much has changed.  We learned that there was not enough cash to fund White Hou...

Sequestration Closes the White House

Fortunately, the sequester did not incinerate Caribou Coffee, where I suck down several hot chocolates each week.  Luckily, Cleveland hasn’t passed a Big Government Big Edict against Big Beverages, as Mayor Michael Bloomberg rammed through last year in New York City.  Recently, a New York state judge refused to drink the mayor’s Kool Aid and ruled against the absurd, loophole-ridden government intrusion.   Sorry, Mike.  I suggest that you console yourself with a beer, which apparently is much safer than soda since no restrictions were placed on sizes of alcoholic beverages that may be sold.      I will try to crank out at a blog post now, but my heart is ponderous as I contemplate the plight of our nation’s children.   The barricades have been erected at 1600 Pennsylvania Ave.  White House tours have been cancelled, yet another apocalyptic consequence of sequestration.  It’s not clear to me who was responsible f...

Metatstatic Medical Regulations and Health Care Reform - Job Security for Bureaucrats

This week I promised you specific examples of dumb rules that we doctors must comply with. Here are just a few.  There are enough ridiculous regulations to fill multiple blogs devoted only to this issue posting hourly around the clock.  Yeah, I sound a mite cranky now.  The truth is that I still enjoy the work of doctoring.  I love my time with my patients.  There is, however, an increasing burden of stuff thrust upon us that takes time, energy and money away from our healing mission.   Perhaps, these regs are solving someone’s problem somewhere.  I suppose that this should comfort me knowing that somewhere in a government cubicle, a bureaucrat is smiling. Floor Plan of Cubicles Where Health Care is Reformed          We are required to ask patients their ethnicity.   Of course, many of them including myself are uncertain how to respond to this accurately.   I’m sure that our staff conveys an impression...