[SUSPICIOUS MESSAGE] [IMPROVEDX] Hello

Shantanu Nundy shantanu at HUMANDX.ORG
Thu Jan 21 21:35:06 UTC 2016


I agree!

Reminds me of the quote: Not everything that counts can be counted, and not
everything that can be counted counts.

My EHR notes have a lot of data in them, but not much of what matters.

-Shantanu
www.humandx.org


On Thu, Jan 21, 2016 at 2:45 PM, Leonard Berlin <lberlin at live.com> wrote:

> Steve,
>
> I agree with you, but I would strengthen your comment much more  as follow:
>
> "It seems that *clicking computer keys has been given priority over both
> clarity in writing and  clarity in thinking*, and that's bad for both
> providers and patients."
>
> Lenny
>
>
> ------------------------------
> Date: Thu, 21 Jan 2016 17:05:56 +0000
> From: Stevelane at LANE-LANE.COM
> Subject: Re: [IMPROVEDX] [SUSPICIOUS MESSAGE] [IMPROVEDX] Hello
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>
>
> From my perspective, the EMR charts I've seen do little good beyond making
> the entries legible. I see plenty of bad...cookie-cutter, cut and paste
> repetition, drop-down menu selection entries. It seems that clarity in
> writing has been given priority over clarity in thinking, and that's bad
> for both providers and patients.
>
> Sent from my iPhone
>
>
> Steve
>
> Please respond to:
>
> Stephen I. Lane
> *P**artner*
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> stevelane at lane-lane.com
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>
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>
>
>
> For more information about our firm, please visit our website at
> www.lane-lane.com.
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>
> On Jan 21, 2016, at 10:41 AM, Grubenhoff, Joe <
> Joe.Grubenhoff at CHILDRENSCOLORADO.ORG
> <Joe.Grubenhoff at childrenscolorado.org>> wrote:
>
> Brilliant. Thanks for sharing. I don't think the EMR has done anything to
> help the formulaic completion of the H&P. I wonder how much it derails our
> thinking (or worse, suspends our thinking) as we approach a patient's
> health problem. I see many of my colleagues focusing on how quickly they
> can complete their documentation and with the fewest keystrokes. It reduces
> the patient story to a an impressionistic painting or abstract art rather
> than the rich tapestry it should be. It robs us of the ability to digest
> their story into an illness script that focuses our thought processes.
>
> jg
>
> Joe Grubenhoff, MD| Assistant Professor of Pediatrics
> Section of Emergency Medicine | University of Colorado
> Children's Hospital Colorado
> 13123 East 16th Avenue, Box 251  |  Anschutz Medical Campus  |  Aurora, CO
> 80045 | Phone: (303) 724-2581 | Fax: (720) 777-7317
> joe.grubenhoff at childrenscolorado.org
>
> Connect with Children's Hospital Colorado on Facebook and Twitter
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>
> For a child’s sake…
>                 We are a caring community called to honor the sacred trust
> of our patients, families and each other through
>                 humble expertise, generous service and boundless
> creativity.
> …This is the moment.
>
> -----Original Message-----
> From: Elham Yousef [mailto:yousefe at CCF.ORG <yousefe at CCF.ORG>]
> Sent: Thursday, January 21, 2016 6:27 AM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> <IMPROVEDX at list.improvediagnosis.org>
> Subject: [SUSPICIOUS MESSAGE] [IMPROVEDX] Hello
>
> Dear listserv and SIDM members, Good Morning.
>
> I am a new member with the SIDM and of course the listerv.
> I just recently started to have an access to the listserv, and as I am
> trying to understand the dynamics of this communication and sharing
> thoughts and giving feedback, I figured it would be a good idea to
> introduce myself to all of you.
>
> My name is Elham Yousef , I am a staff hospitalist at Cleveland clinic
> foundation, main campus. I share the same passion as all of you - to make
> diagnosis safe , accurate and timely for our patients. they put their trust
> and confidence in us and we have no choice but to be up to the level of
> trust.
>
> I agree that the challenges are huge,  complicated , and deep rooted, but
> I believe the most imported step is to figure out how we got there in the
> first place and then figure out why ???
>
> being an Egyptian native, studying medicine their was very fascinating,
> medical school is 6 1/2 years right after high school , followed by one
> year as a house officer and after completing the 7 1/2 years we obtain our
> medical degree, after that we go for 3 years of residency and the rest is
> just like here in US.
>
> what made studying medicine very fascinating in Egypt, is that- because
> it's a 3rd world country, majority of people are uninsured, dysfunctional
> health care system and corrupted government- the main focus was how to
> "make" physicians who are capable of making accurate diagnosis by taking a
> very comprehensive history, perform comprehensive physical examination and
> create an accurate differential diagnosis with the least possible resources
> ( labs, images, procedures) because patients will have to pay for all
> diagnostic work up,  with a very high poverty rate , telling a patient that
> " good news your CT was normal will make him/her ask you why did you need
> to order it in the first place, i had to borrow the money for that'- which
> was absolutely not acceptable.
>
> I think because we were all economically oriented of the social status of
> the majority of our patients, we invested our time, effort on physical
> examination, differential diagnoses, critical thinking and clinical
> reasoning more than any thing.
>
> After moving to America 15 years ago, and going through another residency,
> I started to learn/ study a completely different medicine. H&P became just
> a template , we complete it for the purpose of documentation, ordering work
> up and reviewing it even before talking the  patient was the normal and I
> have to say that this was my " true medical cultural shock", 15 years later
> I still can't get over that shock !!
>
> Of course I understand to some extent why it is like this here and why it
> is like that in Egypt. I am not saying that Egypt is the best or US is the
> worse, absolutely not , that's not my point but because I have the
> privilege of being part of 2 different medical cultures, I just can't help
> it but to compare with a goal of trying to get the best out of those 2
> cultures and this makes me very fortunate.
>
> I think we lost track of the true purpose of H&P, the true indication for
> diagnostic work up, what it means to be a critical thinker, we lost track
> of the true medicine and what it mean to be a good doctor.
>
>
> SIDM is all about putting us back on the right track, do what is right for
> our patient, see them as human, treat them as human, talk to them as human,
> engage them as human, respect them as human because they are human who just
> happened to be patients.
>
> In Egypt, they used to call the doctor " Hakeem" which mean the " wise
> man" and this is what we need now, to become " hakeem ( male)  and hakeema
> ( female).
>
> Thank you all for your time.
>
> Thank you for accepting me as new member and for giving me such an honor
> to make a difference.
>
> Elham
>
>
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