What Are The Qualities Of A Good Physician?

A study of Mayo Clinic patients has found seven behaviors define the 'ideal' doctor and supports an Institute of Medicine recommendation that quality medical care should include a patient-centered approach.

The Mayo Clinic-led study was designed to develop a comprehensive set of ideal doctor behaviors. Telephone interviews were conducted in 2001 and 2002 with 192 patients who were seen in 14 medical specialties of Mayo Clinic in Scottsdale, Ariz., and Rochester.

Reported in the recent issue of Mayo Clinic Proceedings, the article was based on transcripts of patients detailing their best and worst experiences with a Mayo Clinic physician. From the transcripts, study authors identified seven behaviors that describe the ideal doctor -- confident, empathetic, humane, personal, forthright, respectful and thorough.

Conversely, patients who described a "worst physician" experience focused on traits reflecting opposites of desired doctor behaviors, particularly perceived insensitive or disrespectful behavior.

The study suggests that training new and practicing physicians about interpersonal skills could have far-reaching effects for patients. The quality of a patient's relationship with a doctor can affect not only a patient's emotional responses, but also behavioral and medical outcomes such as compliance and recovery.

An editorial in the same issue expands on the patient-doctor relationship, saying health institutions ought to follow the recommendations of the Institute of Medicine to improve quality by fostering a patient-centeredness approach to medicine.

James Li, M.D., Ph.D., Mayo Clinic Division of Allergic Diseases, writes in an editorial that health care can't meet a standard of quality if the patient-doctor interaction is hurried, disrespectful, cold or callous. Dr. Li has been involved with developing programs and curricula for teaching new and practicing physicians at Mayo Clinic about how to strengthen their interactions with patients. Mayo's structure of focusing on the patient also helps nurture strong relationships between doctor and patient, he says.

"A doctor who pays personal attention to the patient, who is respectful, compassionate and competent, that's what every patient wants," Dr. Li says. "It's really the duty and obligation of the medical community to design a health care system so that physicians are best able to exhibit those qualities for the good of the patient during the clinical encounter."

Dr. Li notes the seven behavioral traits identified by scientists as ideal for physicians can be taught in various settings, such as having medical residents witness positive interactions which they can model.

Of the seven behavior traits, "thorough" was named most often by patients. Patients can sense if a doctor is rushed or preoccupied, the study's authors say, just as they can sense a physician's genuine interest.

Source

New Media Medicine

This website is an online community of doctors, medical students and applicants to medical school from around the world.

New Media Medicine was set up in 2002 and now has over 60,000 registered member. 

Improve your health by knowing BLOOD TYPE & making Lifestyle

Healthcare on the Internet

There are many reasons for the growth of healthcare information on the internet. First, the internet is the ideal way to publish this large body of complex and constantly changing information. Second, most people prefer to investigate their health concerns in the privacy of their homes before trotting off to see the doctor. (In fact, a study done by The Pew Internet & American Life Project reported that 41% of Americans used the internet to determine whether or not they would seek medical help). Finally, patients appreciate the opportunity to discuss and commiserate with other patients in internet discussion groups.

Using the internet for health information, treatment information, and drug information is one of the most popular consumer uses of the internet. In fact, online, baby boomers are more likely to visit healthcare sites (66%) than financial information sites (50%)! And surprisingly, among teenagers, gathering health information (albeit much of it about STDs and illicit drugs) is more popular than online games. In 2002, more than 110 million Americans gathered health-related information from the internet, and a study by the California HealthCare Foundation found that 70% of them report that what they find influences their treatment decisions. Women (72%) tend to be more frequent health gathering users than men (51%). Harris Interactive looked at "cyberchondriacs" (frequent users of the internet for health-related information) and found that 82% of this group are age 18 to 29; 84% have a post-graduate education; and 77% have incomes more than $75,000.

Types of Sites

How do people find healthcare information on the internet? Harris Interactive (May 2002) found that, of all users, 53% look for healthcare information first by doing a search to find the best site via a portal or search engine; 26% go directly to a healthcare site; and 12% go to a general site, such as Yahoo or MSN that has a healthcare section.

The many different sites that deal with healthcare information include:

Commercial Health Information Sites

These are sites such as WebMD and Intelihealth that provide consumer information from a variety of reputable sources.

Pharmaceutical-Sponsored Sites

These sites are positioned as general consumer sites and can be easily found when searching for a specific condition. For example, acidcontrol.com and GERD.com are both sites designed and sponsored by AstraZeneca, one of the leading pharmaceutical companies that manufacture proton inhibitors for the treatment of GERD and heartburn. These sites are part of a large direct-to-consumer (DTC) marketing push that includes websites, print, and television.

Government and Academic Sites – USA

Governments and universities have traditionally produced large amounts of health information, which is now readily available online. The National Institutes of Health (NIH), in the United States produces comprehensive information on most major conditions. NIH is also home to the Clinical Trials Database that contains medical studies around the country and information about whether or not clinical trials are right for an individual. In addition, NIH provides a direct link to more than 9,000 medications on Medline. On the NIH site you will also find research on a wide range of subjects including Complementary and Alternative Medicine, Rare Diseases, Minority Health, Bioethics, and Social Science. And the Centers for Disease Control (CDC) is recognized as the leading US federal agency for protecting the health and safety of people in the US and abroad, with their focus on developing and applying disease prevention and control, environmental health, and h ealth promotion and education activities.

Government Sites – Canada

In Canada, Health Canada, is one of the most popular destinations for health information on topics such as healthy living, diseases and conditions, and healthcare.

Non-profit and Association Sites

Most charities and associations now have elaborate websites. These sites are used for general information and often include links to the latest research and clinical trials. The sites are also used to educate people and elicit donations. Almost all major medical charities have websites. Some examples include the American Cancer Society, Canadian Cancer Society, American Diabetes Association, Canadian Diabetes Association, and many more.

Medical Journals

In the United States, medical journal sites are the most visited for healthcare information (45%), followed by commercial health pages (44%) and academic or research institutions (43%). Many doctors depend on these sites to keep up to date. For some consumers, however, these journals are relatively complex and assume the reader has some medical knowledge. Examples include The New England Journal of Medicine, The Journal of the American Medical Association.

Hospital and health plan sites.

In November 2002, Manhattan Research did a study of the use of hospital and health plan sites and found the following: use of hospital sites tripled over the previous year; 38.5 million consumers are now interested in receiving information from hospital websites; users of health plan websites have higher per capita incomes; and people who use health plan websites tend to have chronic health conditions (77%).

General Consumer Sites

In Canada, of the three most popular sites for health information, two are general consumer sites – Sympatico.ca and Yahoo.ca. In the United States, general sites are among the most visited sites on the web. These sites tend to purchase licensed medical information from a number of reputable sources and they often have a physician on staff to answer specific questions, e.g., Dr. Sanjay Gupta on CNN.

Personal Sites

Personal sites can range from the informed to the misinformed to the outright dangerous. Many of these sites can have spurious objectives (selling vitamins or non-approved medications for which there is no proven benefit) to providing a useful service to patients who can talk frankly about what it is like to live with a specific condition. Some sites, though, provide misleading and often dangerous positions. Sites such as those that glorify anorexia are of the most concern to the healthcare profession.

Using the Net in the Doctor's Office

Physicians, while being one of the highest users of email for personal use, have been among the most reluctant to use the web for patient care. A spring 2002 Harris Interactive study found that 90% of surveyed Americans said they would like to be able to contact their physician on the internet; 40% said they would pay for this access; and 77% said they would like to be able to ask questions online rather than visit the doctor's office. Doctors are however reluctant to provide this service. In a Forrester report, "Why Doctors Hate the Net," doctors reported that it would be an additional burden on an already over-crowded schedule. They are also concerned about liability, privacy, and getting paid.

A study by Blue Shield and ConnectiCare found that they could provide online health visits for much less money than in-office visits and compensate the physician fairly. One unexpected, but obvious, benefit of the electronic system is the increased openness of the patient. Many patients feel much more comfortable about writing it down rather than talking about it directly to the doctor.

Increasing Accountability Among Medical Professionals

Consumers of health services can now find out where a physician graduated, if s/he has any outstanding lawsuits, can find out how the hospital they are using is ranked relative to others, and can compare nursing home ratings for their mother-in-law!

Next Generation

A new generation of internet-based tools promises even more interactivity and will make available tools such as interactive buying sites to help consumers choose healthcare benefits. Bringing individual patient records online is on the horizon. And with breakthroughs in guided learning and artificial intelligence, it is possible to see a world where we interact with a machine for many of our health needs! Consumers are driving developments and this is good news for all of us!

By Deborah Moores

The impact of social media on health care

How many Americans are going online for health information?

Just over half of U.S. adults under 65 used the Internet to look up health information over the course of a year, according to the first National Health Interview Survey to collect data on health information technology.
Although Americans are still concerned about security of medical information, the survey showed that 5% of consumers had used e-mail to contact healthcare providers directly.

The survey of 7,192 participants measured consumers’ use of health information technology. Specifically, CDC researchers asked when participants had used a computer to store, retrieve, share, or use healthcare information to make decisions and communicate, to conduct research, and to communicate with healthcare and prescription providers and engage in other forms of Internet dialog.
The study found 51% of adults 18 to 64 used the Internet to look up health information at some point over a 12-month period. Previous research had shown that over 60% of all adults in the U.S. had, at some point, used the Internet to search for health or medical information.
Not surprisingly, 18- to 49-year-olds were more likely than older adults to use health information technology.
Women were more likely than men to use the Internet for health information in all surveyed categories, including:
* Chatting online about health topics (2.5% of men versus 4.1% of women)
* Researching health information (43.4% versus 58%)
* Communicating with healthcare providers (4.2% versus 5.6%) or scheduling an appointment (1.8% versus 3.5%) by e-mail
* Refilling prescriptions online (5.3% versus 6.6%)
The survey was conducted by the CDC and the National Center for Health Statistics.

Originally published in MedPage Today by Cole Petrochko, MedPage Today Staff Writer.

Hospitals are using social media, like Twitter, Facebook, and blogs, for advertising to patients

Traditionally conservative hospitals are opening up on social media platforms.
For those who follow this blog, or are on Twitter, you’ll probably notice that more and more medical institutions are having a Web 2.0 presence. Facebook groups, Twitter, blogs, or YouTube webcasts, for instance. Indeed, there’s even reports of academic centers using Facebook to recruit for difficult to fill clinical trials.
A recent article in The NY Times outlines the phenomenon, and they interestingly note that hospitals were dragged kicking and screaming into the social media fray, perhaps by the uber-competitive nature of attracting patients.
So, although live-Tweets of medical procedures provide a level of transparency that was previously unheard of, and patients can receive a faster response to their concerns, it’s more likely that hospitals are using social media more to gain a marketing edge on their competitors, rather than for the patient’s welfare.
But since much of American medicine is a business anyways, is that really a surprise?

Originally published in kevinmd.

Dental Care : Dental Equipment

The Dental Triangle

NHS follows rules that guarantees failure, says Civitas

The Telegraphhighlights a report on targets and bureaucracy from Civitas, the Institute for the Study of Civil Society, which claims that the NHS is “guaranteed to fail” following “every known rule that guarantees failure in the business world.” The report says a “top-down target culture” has taken focus from providing “high quality care to the patient” and suggests the answer is to “treat patients as customers not as ‘the market.’”

http://www.telegraph.co.uk/news/newstopics/politics/5932832/NHS-follows-rules-that-guarantees-failure-says-Civitas.html



Marcus "My friend and coach Chris Barrow taught me about the customer service triangle



fast service

/ \

/ \

high quality____________low price

You cannot run a sustainable business satisfying all three corners of the triangle. This unfortunately is what they are trying to do in the dental health service.

My work as a private dentist hopefully satisfies two points of the triangle namely high quality and fast service."

Reblogging from  Fresh Dental Care Web Log

Does Market Power Help Patients?

Rob Weisman and Liz Kowalczyk report in today's Boston Globe that the US Justice Department is investigating possible antitrust violations against Partners Healthcare System, the dominant hospital and physician provider group in Massachusetts.

The letter, obtained by the Globe, said the probe sought to determine whether the practices violated the Sherman Antitrust Act, which bars companies from using their market power to limit trade or artificially raise prices.

Since the Attorney General has already reported that rates collected by PHS are clearly higher than most others in the market, I imagine the case will rise or fall on the following proposition: Is the market power of this system necessary to produce an integration of care that brings clinical advantages to the public served by it? You could test this the following way: If you look at the actual data, is the safety and quality of care offered by PHS significantly different (in a positive way) from other academic medical centers, community hospitals, and physician groups in the state?

Note that I include all three components of the provider network. If a Partners GI doctor in the suburbs doing colonoscopies secures higher rates than his non-Partners colleague down the street -- solely because of his affiliation -- can you document that his care is better? If a patient goes to Newton Wellesley Hospital or North Shore Hospital, where the hospital and the doctors are both paid more than other community hospitals, can you document that their care is better? Ditto, of course, for the care given at the academic centers downtown.

Put it another way. Does the absence of such data -- given the paucity of transparency about clinical outcomes -- create a prima facie case that there is no demonstrable clinical benefit from Partners' market power and its resultant higher prices? Perhaps the answer depends on who has the burden of proof in anti-trust cases. Does the government have to prove that there is no demonstrable clinical advantage, or does Partners have prove that there is?

By PAUL LEVY

Fake Facebook Profiles and Other Portents of the End of Times

By DAVID HARLOW

One issue up for discussion in this evening's free-form health care social media tweetchat was the fake Facebook page of eSara Baker, posted as a form of marketing for a company providing online health-related services (which sound like typical patient portal stuff like scheduling appointments and accessing test results). The page prominently states: "If you haven't uncovered our secret yet, here it is: Sara isn't a real person."

The identity of the company and the services provided are not at issue here. The issue discussed in the #hcsm tweetchat was whether using social media to market a health care service through the use of a fabricated profile was unethical and/or harmful to authentic uses of social media for health care.

I disagree with some of my #hcsm cohorts who tweeted their upset with the fake Facebook page, saying it represented a setback for health care social media (i.e., that it would harm "authentic" health care social media efforts).

My take: This is just an example of the medium's coming of age. Marketing on Facebook can now be as fake and manipulative as it may be in other media. Infomercials, product placements, dramatized ads using characters from TV shows, guys and gals in white coats pretending to be doctors in TV commercials, etc., etc. -- social media is not immune to manipulation, because despite the many differences from mainstream media, there are still many ways in which "old media" and "new media" are alike.

Hey, it's the end of the "underground" era, that's all. FM radio started life without ads, and now that it's saturated with ads and hyper-segmented and targeted, many programmers and listeners have migrated to other platforms: internet radio, XM, podcasting, etc. Whether this is the end of the beginning or the beginning of the end, all that the appearance of this fake Facebook profile (which wasn't super-engaging, or convincing, by the way) says to me is that the health care social media pioneers have a choice to make: they can take this to be one more reason to bemoan the collapse of Western civilization, or at least Facebook ("nostalgia isn't what it used to be"), and migrate elsewhere -- or they can have one more reason to keep doing what they're doing incredibly well, because if they maintain a continuing, authentic, transparent interaction with their public, developing trust and influence, then the presence of some fake profiles (that really, at the end of the day, do not pose a threat to this level of engagement) shouldn't really bother anyone all that much.

What do you think?