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'July Effect' Revisited: Why Experienced Docs May Not Deliver the Best Care
July is when the new interns -- fresh out of medical school -- start work. It's also when the senior trainees, the residents and fellows, graduate to supervisory, self-managed patient care roles. In other words, it's when everyone is most inexperienced. The worry is that this inexperience leads to mistakes.
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Simple Design: What Health Care Can Learn from a TV Remote Control
What can health care learn from Apple and TV remote-control evolution? The first lesson is to consider carefully the user interface before marketing a new product. New ways of delivering health care should be designed in clever ways to make the patient-user or the doctor-user experience smoother. This means a system that streamlines doctors’ interaction with computers and builds in alerts that recognize errors before they happen, without sounding too many false alarms.
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Can Better Access to Health Care Really Lower Costs?
Concierge medicine and the patient-centered medical home both offer the promise of better access to care. The former has been around for years, but the medical-home model is just catching on, spurred by provisions of the Affordable Care Act. Figuring out the differences between the way these models work is very confusing, even to people who work in the health-care field.
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Should Your Doctor Be Napping on the Job? Studies Find Naps Can Prevent Performance Errors
Sleep scientists have demonstrated that naps can prevent performance error. One 2006 study randomly assigned medical residents to take optional naps and found that on average, they actually did manage to get extra rest. A newer study is currently testing the effect of required naps: residents hand off all duties for short periods of time in the middle of the night.
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Can Doctors Have Work-Life Balance? Medical Students Discuss
Are physicians who elect to work part-time violating some sacred aspect of their calling? In this latest column, Dr. Zack Meisel explores Penn medical students' response to an idea promoted in a New York Times op-ed piece by Dr. Karen Silbert. The students disagree with Silbert's opinion that doctors are so "special," they should willingly work more hours than other professions. |
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Narrative vs Evidence-Based Medicine -- And, Not Or
Recent national debates about childhood vaccinations or cancer screenings demonstrate how the personal stories of junk science gurus routinely drown out physician researchers who make their point with arcane equations and line graphs. In this essay in The Journal of the American Medical Association, Meisel and fellow Penn MD Jason Karlawish call for broader use of storytelling techniques in the health services research field.
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The Night-Weekend Effect: Why Medical Outcomes Can Be Worse Depending on What Day You Get Sick
Pennsylvania hospitals have nearly eliminated tge 'night-weekend' effect in their ERs. Changes in staffing and management in the state's trauma centers have made patient outcomes "remarkably similar" day and night, seven days a week. But, keeping a full range of trauma care available 24/7 is an expensive process that continues to challenge health systems across the country. |
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Why Secret 'Doctor Shopping' Studies Are Necessary
Secret "Doctor Shopping" -- investigations that use phone requests by fake patients to assess how easy it is for certain types of patients to obtain doctor appointments -- is a hot button controversy. Emergency physicians Zachary Meisen and Jesse Pines explain why it is necessary in our rapidly-changing national health care system which has many disparities. |
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Jane Fibber, M.D.: Why Do Doctors Tell White Lies?
Is it ever acceptable to lie to achieve some emergency room treatment goal? Well-meaning mistruths have always been used to circumvent red tape and at times, can serve the real needs of a patient. But how will the changes of the Affordable Care Act impact an ER doctor's ability -- or motivation -- to use white lies as a tool of the trade? |
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Post-HMO Health Care: Are ACOs the Answer?
Designed to slow the growth of health care costs without infuriating patients the way HMOs did in the 1990s, Accountable Care Organizations are things of promise and potential problems. Two physicians talk us through the strengths and weaknesses of the concept whose rules and exact practices are still being defined. |
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Should Drug Companies Get to See What Your Doctor Is Prescribing?
A Vermont law that prohibits the commercial sale of doctor-prescription records has outraged data mining companies and triggered a legal counterattack that ended up in the U.S. Supreme Court last week. But in oral arguments, the justices appeared highly skeptical of restricting commercial free speech. |
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Is My County Healthier Than Yours? Why Rankings Matter
While they may seem like dry and lifeless data printouts to some, the second annual County Health Rankings published by the University of Wisconsin and the Robert Wood Johnson Foundation offer an effective tool for improving local health care. |
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Why Belly Pain Is Such a Headache for Emergency Department Doctors
Abdominal pain is the most common reason Americans visit hospital emergency departments. The difficulty of treating it highlights some major issues facing the health care system at large: the risks and benefits of diagnostic tests, medical malpractice, and patient expectations. |
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McDonald's Medicine: Too Impatient to Wait for Care?
Spend time in a busy hospital emergency department and you'll hear a recurrent theme among the harried staff: patients in the U.S. want their health care like they want their food -- served up speedily and made "your way." Is that wrong? |
Zachary Meisel, MD, is the Medical Editor of the LDI Health Economist, a columnist for Time.com, a Robert Wood Johnson Clinical Scholar, an emergency department physician at the Hospital of the University of Pennsylvania, and a Senior Fellow at the Leonard Davis Institute of Health Economics. |
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University of Pennsylvania's Paul Offit Addresses Association of Health Care Journalists |
Dissects White House's 'Fundamentally Managerial" Mistakes |
RWJF Clinical Scholars' and Penn Faculty Articles |
Full Integration With Primary Care |
In-House 'Incubator' for Investigators |
A Roundtable Explores Some Stark New Realities |
The Fastest Rising Segment of Health Care Costs |
Unchanged a Decade After Landmark IOM Report |
Penn Experts Outline Challenges at D.C. Forum |
50 Scholars Compete in Fast-Paced Behavioral Economics Idea Pitch; $20,000 Awarded |
Only Industry Segment Where Innovation Doesn't Lower Cost |
Why It Costs Employers Money to Discriminate |
A Closer Look at a New NBER Working Paper |
Inside Healthcare's Rapidly Expanding 'Digital Nervous System' |
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