ADVANCE Perspective: HIM : patient care

Mammography and the Right to Choose

Lisa Algeo — Fri, 20 Nov 2009 17:59:00 GMT

(Editor's note: This is a guest blog written by Valerie M. Chapman, RN, MSN, a pediatric nurse for 25 years. She is a 3-year breast cancer survivor and lives in Medford, NJ, with her husband and two children.) I am a wife, a mother of two awesome kids,...(read more)

Mammography Screenings Changing?

Lisa Algeo — Tue, 17 Nov 2009 20:25:00 GMT

(Editor's note: This is a guest blog by Lorettajo A. Kapinos, an ED nurse at Baystate Medical Center in Springfield, MA.) Last month was Breast Cancer Awareness month and I blogged about my experience with a false positive mammogram. Ironically, this...(read more)

Veterans Health Care

Cheryl McEvoy — Wed, 11 Nov 2009 17:51:00 GMT

No matter your stance on war, it's only right to honor and thank veterans who put their lives on the line for our country. Military personnel witness firsthand what most of us find too hard to watch through a camera lens, and it's bound to have an impact....(read more)

H1N1: After the Vaccine

Cheryl McEvoy — Thu, 22 Oct 2009 14:13:00 GMT

Everyone's sick of swine flu (pun not intended, I swear), so apologies in advance for striking up yet another conversation about it, but I couldn't help posting when I heard about post-vaccine monitoring . What? What's that you say? Monitoring? As in...(read more)

Public Tweets, Private Matters

Cheryl McEvoy — Wed, 16 Sep 2009 15:33:00 GMT

I'm wrapping up an extensive print and online package about social media for our September issue (Look for it next week!), and with all the reading, interviewing and, yes, tweeting I did to research the phenomenon, I thought I'd heard everything. Well,...(read more)

Copay Collection Dilemma

Cheryl McEvoy — Fri, 21 Aug 2009 15:54:00 GMT

(Editor's note: This is guest commentary from Lorettajo Kapinos, BSN, RN, who writes the " Tales From an ED Nurse " blog for ADVANCE for Nurses . For more information on upfront billing, read our Web article, " Cover Charge .") Most insurance companies...(read more)

Health Care Reform: What Women Need

Lisa Algeo — Wed, 22 Jul 2009 15:50:00 GMT

Guest commentary by Sabrina Corlette, director of health policy programs for the National Partnership for Women & Families In the halls of Congress, in the media, in the coffee shops and restaurants of Washington, D.C. -- health care reform is dominating...(read more)

Health Care Nation?

Cheryl McEvoy — Wed, 15 Jul 2009 13:40:00 GMT

Theory: health care is going the way of the fast food industry. A bit counter-intuitive, I know, given the usual wars between those factions over nutrition facts, whole grains and "lighter" meal options. But I'm talking about the business model. More...(read more)

HIPAA be damned?

Lynn Jusinski — Tue, 14 Jul 2009 12:05:00 GMT

[Editor's note: This is a guest blog by ADVANCE for Nurses editor Lyn A.E. McCafferty, who contributes to the "ADVANCE Perspective: Nurses " blog featured on the ADVANCE for Nurses Web site.] If you think the fictional Nurse Jackie and HawthoRNe are bad...(read more)

How Do I Chart That?

Cheryl McEvoy — Mon, 06 Jul 2009 17:13:00 GMT

[Editor's note: This is a guest blog by Bridgette Williams, whose " Transition to RN " blog is featured on the ADVANCE for Nurses Web site.] How do I chart that?" Has this question come up after caring for a challenging patient or after a crisis has occurred?...(read more)

Retail Clinic Check-up

Lynn Jusinski — Thu, 25 Jun 2009 19:30:00 GMT

I'm what you might call "doctor phobic." I haven't had a check up since 2001, and that was required to get into college. After high school, I moved to the Philadelphia suburbs from quiet nook upstate in a rural area lovingly referred to as the "Polish...(read more)

Doctors Face Patient Scrutiny

Cheryl McEvoy — Wed, 24 Jun 2009 17:42:00 GMT

For the past few weeks, I've had Michael Jackson's "Somebody's Watching Me" stuck in my head. I blame Geico for making it the theme song for its ubiquitous ad campaign. (Seriously, that bug-eyed bundle of money is everywhere .) But today, the ditty popped...(read more)

Another Form to Fill Out

Lynn Jusinski — Wed, 04 Mar 2009 19:59:00 GMT

How do you, as HIM professionals, shop for doctors? Being in the health care field, HIM professionals have a unique view of how they should be treated as patients and the care they can expect to receive. Jacque Taylor, AHDI-F, one of our Top 10 in HIM, told her story of how she shopped for a new family doc in my interview with her. You can listen to the excerpt here. Basically, Taylor, a medical transcription educator, said the doctor she ultimately chose was the only one who allowed her to meet his MT.

Many patients might not be that savvy. With many Web sites popping up to rate doctors, patients can go online and review their physicians much the same way they'd review that new Nicholas Sparks book they just garnered on Amazon.com. Likewise, patients seeking out a new doc might turn to those sites and those reviews to get a feel for how the doctor treats his or her patients--medically and personally.

Some of those sites, however, might be getting a bit of a behind-the-scenes makeover, according to an Associated Press article. In some doctors' offices, patients sign waivers that prevent them from posting reviews online. Neurosurgeon Jeffrey Segal started Medical Justice, which provides physicians with a waiver they can have patients sign that says the patient will not review the doctor on the Internet. An attorney questioned for the AP article said he wasn't sure the waivers would hold up in court, but still, the waivers might be enough to dissuade patients from reviewing their doctors online. Nearly 2,000 doctors use the waivers from Medical Justice.

While the reviews on the sites, like most things on the Internet (hello Wikipedia!) should be taken with a dose of caution, they might at times also give a peek into how well or how poorly a physician is doing. Would you go to a physician for the first time if you saw a review that called him or her "the worst doctor very high strung never on time not caring" (sic), as someone referred to one of my hometown docs on RateMDs.com?

And then there's the waiver issue. On a first visit to a doctor, patients are already presented with a mile-high stack of papers to fill out. What would your reaction be if you were presented with this type of a waiver at your next medical appointment? Do the waivers impinge on a patient's right to free speech or are physicians simply trying to protect themselves from the one crotchety patient who catches them on a bad day and has a high-speed Internet connection and a penchant for flaming?

Surgery Goes Web 2.0

Lynn Jusinski — Tue, 17 Feb 2009 21:06:00 GMT

One of these things is not like the other: "Watching a good bootleg of The Wrestler." "Holy cannoli, unhappy baby. Early bedtime for you, kiddo." "Dr rogers (sic) has adequately sutured closed the urinary collecting system and any bleeding vessels."

The first two come directly from the people I'm following on Twitter. The last one is also from Twitter, the microblogging/short messaging service. While the first two are entertaining, or at least mildly informative, the last one is obviously a bit more serious.

On the morning of Feb. 9 at Henry Ford Hospital, the chief resident sat by on a computer tweeting about the live tumor removal being performed by lead surgeon Dr. Craig Rogers at the same time, in the same room. The resident managed to capture the surgery blow-by-blow in 140-character "tweets" as it happened. Here's the stream of the surgery on Twitter.

According to CNN, "Dr. Craig Rogers, the lead surgeon in the Henry Ford surgery, said the impetus for his Twittering was to let people know that a tumor can be removed without taking the entire kidney. ‘We're trying to use this as a way to get the word out,' Rogers said."

With social networking sites abounding, there's likely to be more of this happening. Are there limits to what should be shared on the Internet? Just this morning, I was contemplating updating my Facebook friends on the status of a broken sewer pipe in my apartment. No, that's not pretty information at all, and yes, I just told the Internet via this blog. Is "tweeting" the surgery as it happens progress, or just pushing the limits of privacy?

I personally think the idea is pretty cool, as long as the patient consents to being tweeted about. If the information is helpful to others performing or curious about the surgery, then it might be worth it for more than just a novel Internet trick.

I look at it from two angles. If I was getting ready to go through a robotic partial nephrectomy, as the patient did in the Tweetstream above, I would probably be scouring the Web for information beforehand, and coming across the tweets would either calm my fears or seriously wig me out. And if I was getting ready to go under the knife and was asked if I would mind being tweeted about during surgery, well, I might hesitate a bit on that one. What are your thoughts?

He’s No Dr. Quinn

Cheryl McEvoy — Tue, 27 Jan 2009 13:55:00 GMT

I usually like to share a newsworthy item or intriguing tidbit on our staff blog, but today I'm in the mood for some personal griping.

Despite my daily immersion in health care at the office, I've had limited experience with hospitals outside of work. My immediate family has a generally clean bill of health, so when my mom had surgery two weeks ago, it was a big deal.

As timing would have it, I was researching my upcoming article on hospital-acquired conditions as my mom prepared for her procedure; anything that could go wrong on the operating table or in that (hopefully) hygienic hospital bed, I knew about it. Naturally, I used this newfound knowledge to designate myself as patient safety adviser, reminding my mom to check that medical staffers wash their hands and to please, please, please make sure they mark the correct hip. Fortunately, the surgery went well and my mom was up and about--OK, shuffling down the hall--within 24 hours.

But recovery hasn't been all hunky-dory. My mom's had some complications--let's just say the physical therapist called it "not so common"--and lackluster concern from her surgeon isn't helping. Sure, the doctor was great before the procedure, but he apparently becomes the invisible man post-op; my mom never saw him in the recovery room and instead of stopping by the waiting room to give my sister the thumbs up, he called the waiting room's phone extension. Last week, after a host of frustrations including a 10-hour stint in the ED, my mom tried to contact her surgeon only to find out he was out of town--apparently to Siberia because it took more than 48 hours to get a hold of him. His reassuring, patient-centric, post-op advice? As relayed by the nurse: take any problems up with your PCP.

I know, I know--surgeons can't always be in the office, and maybe his advice is just standard procedure, but with everyone from the Centers for Medicare and Medicaid Services to private insurers to President Obama calling for higher quality of care, it's disheartening to have a doc that just doesn't give a darn. We're not asking for a personal visit; a simple phone call would have sufficed. When you boil it down, it's the little things that make a difference in patient care; sometimes all we need is a compassionate word or nice pat on the hand to know everything will be all right.