The secret horrors of sleep-deprived doctors

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University of Utah Health Care's CMIO and CIO share how the organization has improved communication among clinicians and with patients, increased the efficiency of multiple departments, and sped response in emergencies where every second counts. [Watch the video](. --------------------------------------------------------------- KevinMD Today: Mar. 16, 2017 [The secret horrors of sleep-deprived doctors]( Recently, the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decision to increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some patient details changed to protect confidentiality): “I did my internship in internal medicine and residency in neurology […] [Are primary care doctors referring too much?]( “I can do that?” During a recent morning practice session, a resident was presenting a patient who had had several episodes of syncope which culminated in a trip to the emergency room. She had a brief stay there, and on the discharge plan was written “follow-up with PCP and with cardiology.” We went through her […] [Please include more patients at our medical meetings]( As a consumer and admirer of movies, I always look forward to the Academy Awards. A celebration of the best movies and performances of the past year. A night filled with spectacular performances, glamor, and amazing speeches. The speeches are truly special for me since we get a glimpse into the true character and soul of […] [Who if not me will make my patients whole?]( Having graduated from medical school in 2008 and internal medicine residency in 2011, I am a physician-child of the Affordable Care Act (ACA) era. The belief that “health care is a human right” ran deep through my upbringing and life experiences, but training during a period of such intense debate over health care reform reinforced […] [Rethinking electronic records of sick cars and sick people]( A few weeks ago, I found myself in the midst of car trouble. A low tire pressure light illuminated my dashboard, and despite my best effort to replenish the air, I had to concede that my front tire was punctured and that I needed to make an emergency visit to an auto shop. As it […] [We are stuck with an impossible dilemma with quality measures]( Quality metrics and pay-for-performance have now been in existence long enough to start accumulating some efficacy data. And the picture does not look good. Paying doctors to improve their quality metrics does not, in general, improve those quality metrics. Like all good scientists, we can now either question the data, or discard the hypothesis. Most […] [Stop judging: Sometimes terminating a pregnancy is necessary]( The women’s health has a history of being a volatile sector, especially of late. It is an area of medicine where politicians think they can have access to intimate and confidential patient-physician relationships. This is unacceptable and an invasion of privacy. Voluntary termination of pregnancy. Voluntary interruption of pregnancy. These are the medical terms for […] [Why Obamacare wouldn’t have worked anyway]( Pause with me for a moment and create an image in your mind of the quintessential healthy person. What do you see? I picture someone who is slim and agile. They probably bike or walk to work and engage in daily exercise. They cook for themselves, use fresh vegetables and few processed foods. They find […] [How to shift focus on America’s health]( Too often, the practice of medicine in the United States is focused on treatment. Doctors are taught to battle disease and treat chronic illness to the bitter end. And we have amazing technologies and treatments that have been proven to save lives, but our costs and health outcomes don’t seem to match what we pour […] [It’s time to reset the medical malpractice insurance conversation]( In the mid-1970s, malpractice lawsuits and skyrocketing jury awards caused commercial insurance companies to raise physicians’ malpractice rates by as much as 400 percent. The practice of medicine was deemed to be “uninsurable.” Thousands of physicians faced cancellation of their policies. As a result, doctors came together to form their own companies to provide affordable […] [Hope and trust are two powerful medicines we should use more of]( Medical science is moving forward at breakneck speed. Advancements in stem cell research, robotics and nanotechnology promise a new era of molecularly targeted medications, replacement body parts, and regenerative treatments to combat disease and decline. But if a picture is worth a thousand words, then the footage of Jimmy Carter, looking healthy at the inauguration, […] [I’m afraid of public humiliation on Match Day]( On Saint Patrick’s Day, my classmates and I will file into a room. Each of us will pick up a small white envelope, and we’ll open them together. Inside those envelopes will be the answer to a question we have wondered for months: Where did I match? Where will I begin my career as an […] [The Republican health plan just doesn’t make sense]( Like they have a gun to their heads, congressional Republicans, led by Paul Ryan, are moving ahead at warp speed to pass a sweeping new health care bill to replace Obamacare. Despite an almost deafening roar of objections from the many people who would lose coverage or whose insurance costs might go up; from major […] [The legal system must change to protect doctors]( Anyone watching daytime or late-night cable TV has to notice that every third commercial is for a toxic tort. As my wife had breast cancer, one, in particular, caught my eye. In it, the claim was made that: “If you suffered from permanent hair loss due to chemotherapy, you might have a claim because less […] [The CBO scores the Republican health plan. What does it mean?]( The Congressional Budget Office (CBO) has estimated that 14 million of people would lose coverage in 2018, 21 million in 2020, and 24 million in 2026 if the House Republican plan is allowed to significantly amend the Affordable Health Care Act (Obamacare). In my last post, I called the House Republican bill “mind-boggling” for the […] [The bigotry in medicine is real]( The surgeon told me: “No offense, but girls really aren’t cut out for this work. They’re too fragile. They get too emotional. It’s not your fault; it’s biological.” Yes — health care is sexist. And it is racist. And just like our country, it is divided. Brilliant people face an uphill battle against prejudice as […] [Doctors: Be careful, your words matter]( Here’s a quote that readers will not readily recognize: “It is a pity that a doctor is precluded by his profession from being able sometimes to say what he really thinks.” I’ll share the origin of the quote at the post’s conclusion. How’s that for a teaser? I’ll give you a hint below. Physicians, by […] [The great unspoken secret]( Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we’re wrong. Perhaps, we dread providing unwanted news. Perhaps, we don’t want to face reality or extinguish our patients’ hope. As a daughter, I felt that sense […] [What the Oscars can teach us about patient safety]( Recently, one of the biggest mistakes ever observed on live television occurred when Warren Beatty and Faye Dunaway, presenters of the award, announced the wrong film as winner of the Academy Award for best picture. Not since Janet Jackson’s costume malfunction has, live television caused such uproar. How could this have happened? How could it […] [Improve the patient experience with anticipatory patient service]( How do you describe the feeling when you are at a restaurant, and the waiter sees your coffee cup at less than half full (never half empty) and without asking they refill the cup or better yet, bring you a fresh cup of coffee? If you are like most customers, you have a nice feeling […] --------------------------------------------------------------- [Follow on Facebook]( | [Twitter]( --------------------------------------------------------------- You are receiving this email because you subscribed to the KevinMD e-newsletter. If a friend sent you this email and you want to subscribe, go to [KevinMD](. --------------------------------------------------------------- 173 Daniel Webster Highway Nashua, New Hampshire 03062 [Unsubscribe]( | [Change Subscriber Options](