Treo 600

Watch – out Bill — I'm wireless now too. 

After a few months of watching and waiting, I did finally get a treo 600.  It is a useful tool that combines the cellphone and PDA.  It doesn't have any true paging technology (like Motorola's FLEX protocol) so it can't (yet) replace a pager.  It should.  Palm and Motorola had this idea five years ago .. I wonder why it didn't move into these devices.

While I do find the device useful as a PDA (it's got all of the old standbys installed: epocrates, 5mcc, shots) … and of course a phone …  the best thing about this device is something that I thought was just a toy beforehand:  Instant Messaging.

Huh?  (you say) ..

For physicians who are not always in the office, this device can significantly improve your life.  Since I work at the Miracle Center 1/2 time … and I'm at the office 1/2 time, I'm often getting pages from one when I'm at the other.  I can't leave a meeting, or interrupt a patient visit to make a phone call, but I CAN respond to an IM quickly and without too much distraction.

Nurse Kathy and I had several little conversations last week with IM.  It saved me four or five phone calls … and got her immediate answers to her patient care questions .. so patients got better service.

I'm using chatter - which is a wonderful little program .. and she's using yahoo.  Yeh .. not very secure.  So no PHI.  I've looked into Jabber  — and we'll probably use that once I can figure out how to install a jabber server.

 

ESF

Since we're on the topic of RSS (see the previos post) … take a look at John Bristowe's Weblog — where ther is discussion of how ESF feeds (a superset of RSS) can be used to generate (via newsgator) schedule entries in Outlook automatically.  Not bad.  We'll have to give that a go .. eh Dave?

Yahoo and RSS

Yahoo's RSS aggregator is a wonderful adjunct to my.yahoo.com portal. 

Despite the advertising, my.yahoo remains my home page on most of the computers I use   .. though I recently moved to oddpost for web-based e-mail as it's much faster than Yahoo – and it's MUCH easier to manage my mail.

oh yeah .. back to Yahoo.  It's pretty easy to use ..

The Oncalls physician scheduling system has supported RSS for about 6 months – though most users don't know how to do that. 

  1. Log in to Oncalls with your username and password (or use "demo"  "demo" if you don't have an account and you want to play with this)
  2. Click on "options"
  3. Now RIGHT-click on the orange "XML" icon at the top of the page .. and choose "copy shortcut."
  4. Now go to the my.yahoo RSS editing page.  If you don't have a my.yahoo account this won't work.  YOu'll also have to be logged in to Yahoo to make this work.
  5. Ok .. we're in Yahoo .. and about 1/3 of the way down the page it says "Add New Source."  In the box there where it says "Enter a keyword, site, or URL"  .. right-click again and choose "Paste"  It should look like lots of gobbeldygook .. but that's ok.  It's your Oncalls username and password in encrypted form. 
  6. Click "Search" and Yahoo will go and get the RSS feed from Oncalls, and will include it on your my.yahoo.com home page.

Here's what it looks like:

YAHOORSS.jpg

Pretty cool .. eh?

Lending Library

Starting a lending library at the office …any other suggestions?  .. I'm light on hypertention, diabetes & smoking cessation. Heavy on parenting.  Leave comments if you have any other suggestions for "must have" lending library books.

 

 

1

"Art of Speed Reading People, The: Harness the Power of Personality Type and Create.."
Paul D./Barron-Tieger Tieger;Paperback; $11.87

1

"Changing for Good"
James O. Prochaska;Paperback; $10.36

1

"Siblings Without Rivalry: How to Help Your Children Live Together So You Can Live Too"
Adele Faber;Paperback; $10.40

1

"How to Talk So Kids Will Listen and Listen So Kids Will Talk : 20th Anniversary Edition"
Adele Faber;Paperback; $10.40

1

"Helping Your Child Sleep Through the Night"
Susanna Schevill;Paperback; $10.36 

1

"8 Weeks to Optimum Health"
Andrew Weil M.D.;Paperback; $11.16

1

"Breaking the Antibiotic Habit: A Parent's Guide to Coughs, Colds, Ear Infections, and Sore Throats"
Paul A. Offit;Paperback; $10.36

1

"Caring for Your Baby and Young Child: Birth to Age 5"
American Academy Of Pediatrics;Paperback; $14.00

1

"Solve Your Child's Sleep Problems"
Richard Ferber;Paperback; $11.20

1

"Feed Me! I'm Yours : Revised and Expanded Edition"
Vicki Lansky;Plastic Comb; $9.00

1

"The Pocket Parent"
Gail Reichlin;Paperback; $8.76

1

"Well Child Assessment for Primary Care Providers"
Margaret R. Colyar;Paperback; $42.95

1

"Spontaneous Healing : How to Discover and Embrace Your Body's Natural Ability to Maintain and Heal Itself"
Andrew Weil M.D.;Mass Market Paperback; $7.99

1

"The Schwarzbein Principle: The Truth About Losing Weight, Being Healthy, and Feeling Younger"
Diana Schwarzbein;Paperback; $10.36

1

"The Habit Change Workbook: How to Break Bad Habits and Form Good Ones"
James Claiborn Ph.D.;Paperback; $13.97

1

"No More Amoxicillin: Preventing and Treating Ear and Respiratory Infections Without Antibiotics"
Mary Ann Block;Paperback; $9.60

1

"The South Beach Diet: The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss"
Arthur Agatston;Hardcover; $14.97

1

"500 Low-Carb Recipes: 500 Recipes from Snacks to Dessert, That the Whole Family Will Love"
Dana Carpender;Paperback; $13.97

 

1

"The Myth of Laziness"
Mel Levine;Hardcover; $7.99

 

1

"Allergy Free Naturally: 1,000 Nondrug Solutions for More Than 50 Allergy-Related Problems"
Rick Ansorge;Hardcover; $7.99

 

1

"Your Pregnancy Week by Week"
Glade B. Curtis;Paperback; $4.99

 

Trust

Marcus posted recently about trust.  I think he's talking about it in the context of the physician-patient relationship .. but maybe he's discussing it more globally.

The physician-patient relationship (or the physician-parent relationship) is very tricky .. to some degree because the physician may need to trust the patient much less than the patient needs to trust the physician.   Yet without risking anything, aren't we expecting too much of our patients to trust us .. if we don't invest some trust in them?

The EBM/Malpractice discussion that went on about a month ago seemed to focus on trust. 

  • Our trust in evidence-based medicine as a way to deliver good care.
  • Our patients' trust in their physicians.

The trouble is that the perceptions and expectations can become cloudy in the context of fear and insecurity. 

Reading Ross' discussion (1st link above) – he puts this very clearly:

How can they possibly determine how to conform to the "standard of care," when they could be dragged into a lawsuit for doing exactly what they've been trained to do? How can a doctor be doing the right thing by keeping up to date with his medical education and respectful of his patient's autonomy, and yet be found wrong by being too curent and not being directive enough?

No kidding.  By presenting choices to our patients, we risk providing a window into the true uncertanties of medicine (of which there are many!) In so doing, we are sharing decisions with them – and trusing them with this vulnerability.

I'm convinced it's better healthcare, but as my legal advisor reminds me, this decision entails risk.  So be it.  Paternalistic physicians who dictate the mythical "standard of care" to their patients are at less risk legally, yet the care they provide can hardly be fulfilling — or even challenging!