Managing opioid discrepancies with your patient

managing opioidsAs a clinician, you are aware of the many complications that arise from a patient’s opioid misuse, and you know about the regulatory scrutiny on providers who prescribe opioids. You are not only ultimately responsible for patient safety, but you are also responsible for how you respond and react in the face of challenging scenarios.

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Can we improve the accuracy of orders given to radiologists?

radiologist with head scanCase study

A 49-year-old male patient arrived at the ER with a chief complaint of dizziness and vertigo with nausea and vomiting. The treating physician ordered a noncontrast head CT scan, indicating a history of “headache” for the radiologist to review.

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Finding the words to help a traumatized colleague

iStock_000003517620Large-blogFor many in health care, experiencing a patient’s death is an extremely stressful experience. Some are able to process the experience in a short period of time and resume caring for patients. For others, the experience can be significantly worse—leading to high stress that doesn’t resolve, a repeated reliving of the experience, and a change in the way they function as caregivers. Continue reading

Ensuring effective handoffs

Verbal handoff of patient chartMiscommunication contributes to as much as 80 percent of medical errors, much of it occurring when care is transferred from one health care provider to another.1 In fact, in a 2006 survey of residents at Massachusetts General Hospital, 58.3 percent revealed that at least one patient was harmed in the course of their most recent rotation because of a problem with the handoffs. Even more troubling, 12.3 percent said that major harm occurred.2
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Improving how physicians and patients talk about medical tests

Physician talking to patient about medical testKnow Your Choices—Ask Your Doctor is a campaign sponsored by the Washington State Medical Association to promote better physician-patient relationships when discussing treatment options, expected outcomes, and quality-of-life choices. One of the campaign’s three initiatives, Choosing Wisely, a national program created by the ABIM Foundation and Consumer Reports, encourages patients and physicians to talk about the risks and benefits of medical tests and treatments. Continue reading

How can I convince my patient to get healthy?

Physician convincing patient to get healthyPhysicians arrive at medical school excited and hopeful. They come out of medical school exhausted, in great debt, mentally beaten down, and cynical. In our new practices, we quickly become overloaded, and our mission is just to get through the day—seeing patient after patient—without making any mistakes. We want patients to get better, but where is the time? Shouldn’t we expect patients to take our advice and follow through so they can get better? Why aren’t they listening to us? Continue reading

The most important part of the electronic health record

Physician and patient discussing the EHRAt my clinic, we are using an integrated electronic health record, and many of us have achieved meaningful usage targets. While this success has been building, however, a critical element of documentation in the EHR has been given less attention than it deserves: discussion of clinical decision-making rationale. Continue reading

Managing patient self-referrals in radiology

radiologist examining mammography testThough most of a radiologist’s patients are provider referrals, more and more patients are self-referring for services such as mammography. This trend establishes a different level of responsibility for the radiologist in the provider-patient relationship.

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