MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'encounter'. Sat, 03 Sep 2011 02:54:11 +0100 http://www.medworm.com/index.php?rid=4382766&cid=t_290895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-doctors-feel-about-patients-who-google-their-symptoms%2F2011.01.21 Many doctors roll their eyes whenever patients bring in a stack of research they printed out, stemming from a Google search of their symptoms. A piece by Dr. Zachary Meisel on TIME.com describes a familiar scenario: The medical intern started her presentation with an eye roll. “The patient in Room 3 had some blood in the toilet bowl this morning and is here with a pile of Internet printouts listing all the crazy things she thinks she might have.” The intern continued, “I think she has a hemorrhoid.” “Another case of cyberchondria,” added the nurse behind me. It’s time to stop debating whether patients should research their own symptoms. It’s happening already, and the medical profession would be better served to handle this new reality. According to the Pew Internet and ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4382766 Fri, 21 Jan 2011 14:00:37 +0100 4382766 http://www.medworm.com/index.php?rid=4272293&cid=t_290895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F11-healthcare-predictions-for-2011%2F2010.12.18 Here are 11 things that are absolutely going to happen* in 2011 (they’re in no particular order….or are they?): 1.  There will be no big compromise between President Obama and the Republicans on healthcare reform. Why? Because the law is such a massive collection of, well, stuff, that it is pretty much impossible to find pieces of it that you could cut a deal on, even if you wanted to. And no, the federal district court decision on the individual mandate doesn’t change my mind…and in fact may breathe new life into other parts of the law). State governments, insurance companies, and private businesses have made all kinds of important and hard to reverse choices based on the law as is. There’s not much of an appetite outside of people trying to score political points for m... Better Health blogs http://www.medworm.com/rss/comments.php?id=4272293 Sat, 18 Dec 2010 20:00:44 +0100 4272293 http://www.medworm.com/index.php?rid=4258868&cid=t_290895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fblood-print-am-i-the-doctor-bleeding%2F2010.12.14 I’m diligently writing a detailed note in the patient’s chart as he speaks of his multiple concerns — severe depression, headaches, and dizziness. I’m not making good eye contact. Often this is effective because I can resist the allure of passively following his narrative to its own diagnostic suspicions. Instead I can record his intuitive guesses without persuasion, formulating my own independent ideas even as I value his. Except that as I write in his chart I notice streaks of red blood appearing among the black script. Am I hallucinating? Am I capable of making paper bleed? Am I, the doctor, bleeding? With closer inspection I notice three small cuts on my chapped knuckles and fingers, products of the incessant and obsessive handwashing compelled by modern medicine. We are ob... Better Health blogs http://www.medworm.com/rss/comments.php?id=4258868 Tue, 14 Dec 2010 13:00:50 +0100 4258868 http://www.medworm.com/index.php?rid=3812978&cid=t_290895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-error-free-is-your-doctors-care%2F2010.08.02 According to the Annals of Internal Medicine, doctors make the wrong medical decisions surprisingly often. Using a “mystery patient” technique –- in which actors pretended to be patients –- researchers found that doctors made errors in complicated cases in 60 percent to 90 percent of cases. Sixty to ninety percent. In uncomplicated cases, they made errors in nearly 30 percent of cases. As one study participant put it, “I was shocked.” The study took place over three years, and included more than 100 doctors in six Chicago-area hospitals. The doctors had agreed to participate in a study on medical decision making, but had no idea that they might see a patient who was actually an actor. The actors recorded their conversations with the doctors. (more…) *This bl... Better Health blogs http://www.medworm.com/rss/comments.php?id=3812978 Mon, 02 Aug 2010 16:00:06 +0100 3812978 http://www.medworm.com/index.php?rid=3794772&cid=t_290895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fminnesotans-get-more-lower-back-mris-why%2F2010.07.27 Kudos to Christopher Snowbeck and the St. Paul Pioneer Press for digging into new Medicare data to report that the state the newspaper serves is out of whack with the rest of the country in how many expensive MRI scans are done on Minnesotans’ bad backs. Snowbeck artfully captures the predictable rationalization and defensive responses coming from locals who don’t like what the data suggest. Because what they suggest is overuse leading to overtreatment. So here’s one attempt a provider makes to deflect the data: “The Medicare billing/claims data, which this report is generated from, would not capture conversations between a patient and provider that may have addressed alternative therapies for lower back pain,” said Robert Prevost, a spokesman for North Memor... Better Health blogs http://www.medworm.com/rss/comments.php?id=3794772 Tue, 27 Jul 2010 20:00:39 +0100 3794772 http://www.medworm.com/index.php?rid=3690839&cid=t_290895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fkeeping-the-primary-in-care%2F2010.06.23 He came in for his regular blood pressure and cholesterol check. On the review of systems sheet he circled “depression.” “I see you circled depression,” I said after dealing with his routine problems. “What’s up?” “I don’t think I am actually clinically depressed, but I’ve just been finding it harder to get going recently,” he responded. “I can force myself to do things, but I’ve never have had to force myself.” “I noticed that you retired recently. Do you think that has something to do with your depression?” I asked. “I’m not really sure. I don’t feel like it makes me depressed. I was definitely happy to stop going to work.” I have taken care of him for many years, and k... Better Health blogs http://www.medworm.com/rss/comments.php?id=3690839 Wed, 23 Jun 2010 16:00:00 +0100 3690839 http://www.medworm.com/index.php?rid=3662672&cid=t_290895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fless-is-more-in-medicine-why-patients-arent-buying-it%2F2010.06.14 In a recent article, the editors of the Archives of Internal Medicine make the case that too much unneeded care is being delivered in physician’s offices these days. According to the authors, “patient expectations” are a leading cause of this costly problem. Their solution? Get physicians to share with patients the “evidence” for why their requests are crazy, wrong, ill-informed or just plain stupid. But getting patients to buy into the “less is more” argument is a daunting task as most physicians already know. The problem is complicated by the fact that patients have a lot good reasons for not buying it. (more…) *This blog post was originally published at Mind The Gap* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3662672 Mon, 14 Jun 2010 20:00:18 +0100 3662672 http://www.medworm.com/index.php?rid=3538095&cid=t_290895_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F9-tips-to-improve-patient-satisfaction%2F2010.05.05 Some interesting points were raised at a recent Society of Hospital Medicine (SHM) session by Winthrop Whitcomb and Nancy Mihevc on patient satisfaction. To improve satisfaction scores: 1. Review the patient’s chart before you go in the room. It makes a big difference if the patient perceives you know what’s going on without having to bury your face in a chart. 2. Patients are often confused about who they are supposed to see after discharge. This, of course, is a safety issue as well as one that affects patient satisfaction. 3. Sit down when you are visiting a patient. Patients are happiest when they perceive you’ve spent enough time with them, and they are more likely to perceive this if you are sitting than standing with your hand on the doorknob. (more…) ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3538095 Wed, 05 May 2010 18:00:00 +0100 3538095 http://www.medworm.com/index.php?rid=2513406&cid=t_290895_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F06%2F17%2Fplacebo-response-in-osteoarthritis-what-does-it-mean-in-practice%2F One of the most maligned but to me most fascinating aspect of health care is the human response to placebo. Placebo is an inert substance – or at least, a substance that is objectively without specific activity for the condition being treated. Dan Moerman has written about the so-called ‘placebo response’ and suggests that it should be called the ‘meaning response’ because humans attribute meaning to the interaction between a health care provider and a patient, and he argues that it is this meaning that influences the response in the patient. This definition is helpful for moving the source of ‘action’ in a placebo away from the inert substance and on to the interaction between the treatment provider and the person in whom the response occurs. Ther... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2513406 Tue, 16 Jun 2009 19:24:27 +0100 2513406 http://www.medworm.com/index.php?rid=886212&cid=t_290895_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F9%2F20%2Fhow-might-information-technology-actually-change-health-care.html Brian KlepperToday I’m in San Francisco for the Health 2.0 conference, billed as “User-Generated Health Care.” Organized by my pal Matthew Holt and his partner, Indu Subaiya, "Health 2.0" references "Web 2.0," social networking, applied to health care.  The meeting will feature top executives from high and low profile IT firms that either are already dedicated to or hope to play an important role in health care, like Google, Microsoft, Yahoo, Intel, Cisco, WebMD, Revolution Health, AthenaHealth, Sermo, and many other lesser known organizations, all discussing their strategies for leveraging data in new ways to create value for all health care constituencies.Elsewhere, I’ve referred to this as a “significant portion of market-based heal... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=886212 Thu, 20 Sep 2007 04:31:08 +0100 886212 http://www.medworm.com/index.php?rid=790533&cid=t_290895_117_f&fid=34612&url=http%3A%2F%2Fwww.thedoctorweighsin.com%2Fjournal%2F2007%2F8%2F9%2Fshow-me-yours-and-ill-show-you-mine-transparency-and-health-.html Brian Klepper Mention a health plan to doctors or hospital administrators, and they’ll likely bend your ear about how the performance feedback data they get from them are wrong, how their reimbursements are based on inaccurate data, and how they think the inaccuracies are intentional.Because they aggregate huge volumes of claims, health plans have the best patient and provider information. While many providers dismiss claims data as wholly inaccurate, they in fact contain a wealth of useful information about patients and their care that can be teased out using the very sophisticated analytical tools that are now readily available. These techniques permit credible evaluation of the relative performance of doctors by specialty and hospitals by service.  Virtually all analytic... The Doctor Weighs In blogs http://www.medworm.com/rss/comments.php?id=790533 Thu, 09 Aug 2007 22:41:34 +0100 790533