Recent article From the Sunday New York Times: "Doctor, shut up and listen!"

Carroll, Thomas Thomas_Carroll at URMC.ROCHESTER.EDU
Wed Jan 7 16:05:03 UTC 2015


Generally speaking, the reimbursement for 2 visit at 6-10 min is about double that of 1 visit at 15 min.  Generally speaking.

Thomas M. Carroll M.D., Ph.D.
Assistant Professor, General Medicine & Palliative Care
University of Rochester
thomas_carroll at urmc.rochester.edu<mailto:thomas_carroll at urmc.rochester.edu>
Pager 5-1616 #3872
Tel: 585-275-7424 (General Medicine Office)
Tel: 585-273-1154 (Palliative Care Office)

From: Vic Nicholls [mailto:nichollsvi2 at GMAIL.COM]
Sent: Wednesday, January 07, 2015 9:32 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Recent article From the Sunday New York Times: "Doctor, shut up and listen!"

For the professionals who treat patients on the list:

the "avg" time is 6-10 min per patient for an office visit. Do you think that if this went to 15 min each patient, that would help? I understand Mr. Latino's point below, however the driver I see is more admin/finance rather than common sense in that 6-10 min. visits don't allow for proper 'do it right the first time'.

I would think that the reimbursement for 2 visits at 6-10 min is less than 1 visit at 15 min?

Thanks,

Victoria

On 1/7/2015 8:43 AM, Bob Latino wrote:
We never seem to have the time and budget to do things right, but we always seem to have the time and budget to do them again!

Robert J. Latino, CEO
Reliability Center, Inc.
1.800.457.0645
blatino at reliability.com<mailto:blatino at reliability.com>
www.reliability.com<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.reliability.com&d=AwMD-g&c=4sF48jRmVAe_CH-k9mXYXEGfSnM3bY53YSKuLUQRxhA&r=R16GG-MhGQFeEbiQbUUeP30HTmJHZlqL3XxjDPQtyXcSwB0zl0UIXhhofztdrEG1&m=HsXbb22gBHGaSnN5wx415yFeQ00x3kDOXv6fw6AC_oA&s=G96Iku_-quR3zVs68Ly0Xs3pBZuHCypIYXssOs2a1hI&e=>

From: Jason Maude [mailto:Jason.Maude at ISABELHEALTHCARE.COM]
Sent: Wednesday, January 07, 2015 4:39 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: Re: [IMPROVEDX] Recent article From the Sunday New York Times: "Doctor, shut up and listen!"

Thanks for alerting us to this article. One of the really positive things about the article is not just the improved care now being given but a great example of the Chief Medical Office and his senior colleagues managing/leading and setting a standard of care. He states in the article "I realize that many colleagues may see methods like ours as too intrusive on their clinical practice and may say that they don't have the time." I believe we need to see much more of this in hospitals. Too often, for example, we see DDS viewed as an end in itself rather than a tool to help with setting a standard of care and I think this explains why adoption of these tools is still relatively low.

Regards
Jason

Jason Maude
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890
www.isabelhealthcare.com<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.isabelhealthcare.com_&d=AwMD-g&c=4sF48jRmVAe_CH-k9mXYXEGfSnM3bY53YSKuLUQRxhA&r=R16GG-MhGQFeEbiQbUUeP30HTmJHZlqL3XxjDPQtyXcSwB0zl0UIXhhofztdrEG1&m=HsXbb22gBHGaSnN5wx415yFeQ00x3kDOXv6fw6AC_oA&s=44EFdqooq0tq3wtl_FwZ2csX1TSrCKhGDMtju7tNjvo&e=>

From: <Bruno>, Michael <mbruno at HMC.PSU.EDU<mailto:mbruno at HMC.PSU.EDU>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, "Bruno, Michael" <mbruno at HMC.PSU.EDU<mailto:mbruno at HMC.PSU.EDU>>
Date: Tuesday, 6 January 2015 20:23
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: [IMPROVEDX] Recent article From the Sunday New York Times: "Doctor, shut up and listen!"

Greetings IMPROVEDX List-serve colleagues, and Happy New Year!

Thanks to Jason and Thomas for starting this years' discussion.

The attached article appeared in the Sunday New York Times.   I thought it was relevant to our group's discussion.

http://www.nytimes.com/2015/01/05/opinion/doctor-shut-up-and-listen.html?_r=0<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.nytimes.com_2015_01_05_opinion_doctor-2Dshut-2Dup-2Dand-2Dlisten.html-3F-5Fr-3D0&d=AwMD-g&c=4sF48jRmVAe_CH-k9mXYXEGfSnM3bY53YSKuLUQRxhA&r=R16GG-MhGQFeEbiQbUUeP30HTmJHZlqL3XxjDPQtyXcSwB0zl0UIXhhofztdrEG1&m=HsXbb22gBHGaSnN5wx415yFeQ00x3kDOXv6fw6AC_oA&s=haimNKjfQ-xYgyA_JnNZkN0drDH435ZE1IblAraplMA&e=>


All the best,

[cid:image001.png at 01D02A69.C988E8F0]
Michael A. Bruno, M.D., F.A.C.R.
Professor of Radiology & Medicine
Director of Quality Services & Patient Safety
The Milton S. Hershey Medical Center
Penn State College of Medicine
500 University Drive, Mail Code H-066
Hershey, PA  17033

Phone: (717) 531-8703
Fax:      (717) 531-5596

e-mail: mbruno at hmc.psu.edu<mailto:mbruno at hmc.psu.edu>

[cid:image002.png at 01D02A69.C988E8F0]

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From: Carroll, Thomas [mailto:Thomas_Carroll at URMC.ROCHESTER.EDU]
Sent: Tuesday, January 06, 2015 1:44 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: Re: [IMPROVEDX] "Early diagnostic suggestions improve accuracy of GPs"

Interesting.  My question would be how this would translate to the real world.  In this artificial environment we know whether or not the "correct" dx is in the list of suggested dx's.  That would not be the case in the real world.

Thomas M. Carroll M.D., Ph.D.
Assistant Professor, General Medicine & Palliative Care
University of Rochester
thomas_carroll at urmc.rochester.edu<mailto:thomas_carroll at urmc.rochester.edu>
Pager 5-1616 #3872
Tel: 585-275-7424 (General Medicine Office)
Tel: 585-273-1154 (Palliative Care Office)
Tel: 585-341-6775 (Resident Practice, Highland Hospital)

From: Jason Maude [mailto:Jason.Maude at ISABELHEALTHCARE.COM]
Sent: Tuesday, January 06, 2015 1:25 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] "Early diagnostic suggestions improve accuracy of GPs"

This is very interesting study just published in the British Journal of General Practice which also highlights the potential value of patients using symptom checkers and handing the results to their doctor at the start of the consultation. This would get over the current technical challenges of a system automatically producing a differential from more complex cases with multiple symptoms.

http://bjgp.org/content/65/630/e49<https://urldefense.proofpoint.com/v2/url?u=http-3A__bjgp.org_content_65_630_e49&d=AwMFAg&c=4sF48jRmVAe_CH-k9mXYXEGfSnM3bY53YSKuLUQRxhA&r=R16GG-MhGQFeEbiQbUUeP30HTmJHZlqL3XxjDPQtyXcSwB0zl0UIXhhofztdrEG1&m=eGvrWf26LmmmVkGW0vnRf9XeztEuR6JjBE8n1vgrIvU&s=uIrQIXl54eDZI6b32fN7ALZnLQKX_yTntnGzo_z3mD0&e=>

Regards and Happy New Year to the group.
Jason

Jason Maude
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890
www.isabelhealthcare.com<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.isabelhealthcare.com_&d=AwMFAg&c=4sF48jRmVAe_CH-k9mXYXEGfSnM3bY53YSKuLUQRxhA&r=R16GG-MhGQFeEbiQbUUeP30HTmJHZlqL3XxjDPQtyXcSwB0zl0UIXhhofztdrEG1&m=eGvrWf26LmmmVkGW0vnRf9XeztEuR6JjBE8n1vgrIvU&s=rZEhyq7LgURp9ngavWrjRLodS2ccXYnsmuk6_HzmETc&e=>


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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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