Family Medicine Notes

Ok folks .. time to chime on on a little EMR survey for me.  Entirely optional, of course, but your insight would be helpful. and it will only take about 90 seconds of your time.

Thanks! 

Posted by Jacob Reider, MD at 03:10 PM | Permalink

Over the past two weeks, Sam and I have  been to  Killington:

And we've been to "Fenway - South" .. City of Palms Park in Ft Myers ..

.. where we spent four great days watching the Red Sox play.  Alas .. Sunday's game against the Orioles was Bronson Arroyo's last game for the Red Sox, which makes us sad.  

Sam got lots of autographs .. we saw Johnny Pesky and wished him well (he broke his leg on Saturday) .. and thanks to little packets of sunscreen that were handed out at City of Palms Park courtesy of the SHADE foundation ..we're just as pale as we were before we left Albany. ;-)

Posted by Jacob Reider, MD at 07:55 AM | Permalink | Comments (1)

From this week's NEJM:

...I hope always to uphold the code of proper patient care. But I also realize that to treat a human being well, one must remain human. And therein lies the quandary: How will we ever reconcile our inevitable — and necessary — human imperfections with our desire to abide by the highest standards of professional conduct?

Joking with - and about - patients is a slippery slope.  I often laugh with my patients (somtimes they don't laugh at my adolescent jokes though .. ) ... but I do think that humor is part of the connection that is built between people.  It's fun to laugh, and if we can't have fun (just a little) together - then we're really not sharing much are we?   I don't understand why some physicians feel the need to be separate from their patients on some "higher plane" where humor and sadness can't be shared.

But - let's be honest - just as we joke about our friends, siblings and parents - physicians joke about patients too.   Have I ever said something to/about a patient that I regretted?  Yup.  Have you ever said something to/about your best friend that you regretted?  Yup.

But your best friend isn't your customer - and patients are entrusting their physicians to be kinder to them than we are to our friends. 

Or are they?

I recently said something to a patient that offended him.  Physicians do this all of the time.  Most of my "new" patients are escaping from another physician who insulted them in some way - and I'm sure (ok .. I HOPE) that these insults were not intentional.  Usually it comes up in the first few minutes: 

"what brings you here?" 
"Oh - I used to see Dr Smith but he didn't listen to me/insulted me/never called me back."
"I see - well - do me a favor - if I ever say something to you that makes you upset - or if you feel like I'm not hearing what you are saying - tell me so that we can work through it."
"ok"

I usually emphasize that I'm human too.  Sometimes I have a bad day like any other tired, grumpy person.  Sometimes I say something that I think is funny but it's only funny to me - and is offensive to the other human in the room.

oops.  

So when I offended my patient - he e-mailed me a few days later and told me so.

I'm glad he did - because it gave me the chance to explain what I was thinking - and demonstrate to him that I wasn't as insensitive as my silly comment made me sound.

We worked through it - and I do think that our relationship is stronger now.  I know him a bit better and he knows me a bit better - so our mutual goal - his health - can be a common focus again. 

And - yes - we can have some fun while we get there. 

Posted by Jacob Reider, MD at 05:25 AM | Permalink

The IANA RFC3219 listing shows who the real early adopters are in the SIP namespace.  Dorks who really want to call me will be able to dial my extension (yeh - right - like I'm going to publish that on the weblog!) at phonehost.slingerlands.com.  (No .. it's not really "phonehost" either)

See the ISN cookbook for more on this and how to get your own.

Posted by Jacob Reider, MD at 11:17 PM | Permalink

Posted by Jacob Reider, MD at 07:21 PM | Permalink

• STFM Podcast
  STFM Podcast

Posted by Jacob Reider, MD at 08:22 PM | Permalink

Posted by Jacob Reider, MD at 01:10 PM | Permalink

Posted by Jacob Reider, MD at 12:47 PM | Permalink

Closer Keith Foulke, who is also being brought along slowly after undergoing surgery on both knees last year, threw in the bullpen for the first time yesterday. Foulke was unavailable for comment. The team has refused to comment on reports that Foulke has been receiving injections in the knees this spring to provide lubrication in the joint due to the loss of cartilage. “I’m not permitted to discuss it,” manager Terry Francona said. “What is it, HIPPA? FEMA? Whatever it is, that’s the rules.”

BostonHerald.com - Boston Red Sox: Wells at work: Lefty mum on trade talk

Posted by Jacob Reider, MD at 07:28 AM | Permalink

Click the links to ass the FMDRL RSS feed of recent uploads to:My AOL, MyYahoo, Google, Bloglines

Posted by Jacob Reider, MD at 04:51 PM | Permalink

In this month's JABFM, Robert Taylor's The Promise of Family Medicine: History, Leadership, and the Age of Aquarius provides a wonderful overview of the history of family medicine and summarizes his view of what lies ahead.  An excerpt:

Informatics
We must lead—not merely join—the information technology transformation of health care. If we are to continue to be the leaders in offering continuing, comprehensive, and coordinated health care, then we must become the trailblazers in health information technology. The FFM report mentions the electronic health record (EHR), which should not only increase health care efficiency; it should allow us to monitor the quality of that care. We also must be the innovators in e-mail contact with patients, electronic prescribing, on-line group visits, and virtual office visits and house calls. Today the technology exists for the family physician to record a patient’s blood pressure and pulse, examine the skin, peer into the throat, and listen to the heart—all without being in the same room. Although I enjoy seeing my colleagues at medical meetings, modern information technology can allow me to maintain my CME without getting on an airplane or sleeping in a hotel bed. We must find groundbreaking ways to bring tomorrow’s information technology into our residency training curricula, our CME programs, and our community practices today.

So right, Uncle Bob.  So Right.  The EHR of tomorrow will need to help us to provide this integrated care - building a strong foundation for collaboration between patients and providers.

Speaking of blogging .. (right?) I have been a bad blogger lately - so apologize to my reader (hi mom) for the absence.  With my recent travels to HIMSS and working with the EHR project and now HIXNY heating up .. things are exciting and busy. 

  I'll try harder to post now and then .. 

Posted by Jacob Reider, MD at 04:39 PM | Permalink