The Efficient Physician


Book Description

Completely updated and expanded, this one-minute manager for medical groups helps users cope with the arrival of electronic health records. Written in an easy-to-read, conversational style, it includes Delios newest guiding principle: real-time work.




The Art of Effective Physician Communication


Book Description

Apparently, a clean and sparkling car can lead to a whole discovery of how to more effectively communicate with physicians! At least that was Dr. Harry Wilkins and Hedi Aguiar's experience. If you find it challenging to communicate with and engage physicians, you may be missing some tools and insight into how to interact with physicians in context of physician culture. This book will take you through a discovery of human interactions and behavioral science in context of physician culture and will provide you with the tools and techniques that you need. Case scenarios are utilized to illustrate the points, reflection questions challenge the reader to self-evaluate, and application tips provide practical considerations for real-life application of the tools and techniques discussed.







Physician Leadership


Book Description

You know how to practice medicine. Now learn how to lead with this insightful resource from one of medicine’s most accomplished leaders. In Physician Leadership, renowned medical leader Dr. Karen J. Nichols delivers a concise guide for busy physicians doing their best to successfully lead people and organizations. The book covers foundational leadership essentials that every physician needs to master to transform themselves from a highly motivated novice leader into an effective, skilled, and productive leader. Each chapter offers readers a summary of the crucial points found within, sample questions, exercises, and a bibliography of the relevant academic literature for further study. Ideal for doctors who don’t have the time to peruse an unwieldy collection of the latest research and thought on organizational leadership, or to take a multi-day course on effective leadership, Physician Leadership distills the author’s extensive research and personal experience into a short and practical handbook. Physician Leadership provides actionable, real-world advice for practicing and aspiring physicians: A thorough introduction to personal approach and style when interacting with patients, managers, boards, and committees An exploration of how to employ the principles of effective communication to achieve desired results and practical techniques for implementing those principles Practical discussions of the role that perspectives play in shaping an organization’s culture and how those perspectives affect leadership efficacy In-depth examinations of approaches to decision-making that get buy-in from others and achieve results Perfect for doctors stepping into a leadership role for the first time, Physician Leadership also belongs on the bookshelves of experienced physician leaders seeking to improve their leadership abilities and improve the results of their organizations.




The Healthcare Imperative


Book Description

The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.




Manners, Morals, and Medical Care


Book Description

This book is a unique reference for medical students, residents, and allied healthcare workers who are just entering the medical field. It outlines in an anecdotal, yet pedagogical manner what one should expect and what is expected of an individual when embarking on a career at a clinic or hospital. Organized into two sections, the book defines in clear terms student responsibilities, expectations, and appropriate collegial interactions through the implementation of historical, moral, and ethical narrative techniques. Chapters discuss the justification of “medical professionalism” as defined in medical school core curriculum, and how and why such ideological norms exist. The book employs clinical scenarios based on incidents chosen to illustrate appropriate behavioral guidelines. The book also addresses common but difficult interpersonal problems all practitioners deal with that require empathy including delivering bad news, working with families, sexual harassment, the importance of diversity, and burnout in the work place. Each chapter includes short biographies meant to give context of the integral role of medicine in the development of our modern complex diverse society. Comprehensive, socially conscious, and written in an engaging yet didactic narrative style, Manners, Morals, and Medical Care serves as an authentic source and a practical guide on the responsibilities of a practitioner when caring for patients.




Key Capabilities of an Electronic Health Record System


Book Description

Commissioned by the Department of Health and Human Services, Key Capabilities of an Electronic Health Record System provides guidance on the most significant care delivery-related capabilities of electronic health record (EHR) systems. There is a great deal of interest in both the public and private sectors in encouraging all health care providers to migrate from paper-based health records to a system that stores health information electronically and employs computer-aided decision support systems. In part, this interest is due to a growing recognition that a stronger information technology infrastructure is integral to addressing national concerns such as the need to improve the safety and the quality of health care, rising health care costs, and matters of homeland security related to the health sector. Key Capabilities of an Electronic Health Record System provides a set of basic functionalities that an EHR system must employ to promote patient safety, including detailed patient data (e.g., diagnoses, allergies, laboratory results), as well as decision-support capabilities (e.g., the ability to alert providers to potential drug-drug interactions). The book examines care delivery functions, such as database management and the use of health care data standards to better advance the safety, quality, and efficiency of health care in the United States.




Health System Efficiency


Book Description

In this book the authors explore the state of the art on efficiency measurement in health systems and international experts offer insights into the pitfalls and potential associated with various measurement techniques. The authors show that: - The core idea of efficiency is easy to understand in principle - maximizing valued outputs relative to inputs, but is often difficult to make operational in real-life situations - There have been numerous advances in data collection and availability, as well as innovative methodological approaches that give valuable insights into how efficiently health care is delivered - Our simple analytical framework can facilitate the development and interpretation of efficiency indicators.




Patients at Risk


Book Description

Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare exposes a vast conspiracy of political maneuvering and corporate greed that has led to the replacement of qualified medical professionals by lesser trained practitioners. As corporations seek to save money and government agencies aim to increase constituent access, minimum qualifications for the guardians of our nation’s healthcare continue to decline—with deadly consequences. This is a story that has not yet been told, and one that has dangerous repercussions for all Americans. With the rate of nurse practitioner and physician assistant graduates exceeding that of physician graduates, if you are not already being treated by a non-physician, chances are, you soon will be. While advocates for these professions insist that research shows that they can provide the same care as physicians, patients do not know the whole truth: that there are no credible scientific studies to support the safety and efficacy of non-physicians practicing without physician supervision. Written by two physicians who have witnessed the decline of medical expertise over the last twenty years, this data-driven book interweaves heart-rending true patient stories with hard data, showing how patients have been sacrificed for profit by the substitution of non-physician practitioners. Adding a dimension neglected by modern healthcare critiques such as An American Sickness, this book provides a roadmap for patients to protect themselves from medical harm. WORDS OF PRAISE and REVIEWS Al-Agba and Bernard tell a frightening story that insiders know all too well. As mega corporations push for efficiency and tout consumer focused retail services, American healthcare is being dumbed down to the point of no return. It's a story that many media outlets are missing and one that puts you and your family's health at real risk. --John Irvine, Deductible Media Laced with actual patient cases, the book’s data and patterns of large corporations replacing physicians with non-physician practitioners, despite the vast difference in training is enlightening and astounding. The authors' extensively researched book methodically lays out the problems of our changing medical care landscape and solutions to ensure quality care. --Marilyn M. Singleton, MD, JD A masterful job of bringing to light a rapidly growing issue of what should be great concern to all of us: the proliferation of non-physician practitioners that work predominantly inside algorithms rather than applying years of training, clinical knowledge, and experience. Instead of a patient-first mentality, we are increasingly met with the sad statement of Profits Over Patients, echoed by hospitals and health insurance companies. --John M. Chamberlain, MHA, LFACHE, Board Chairman, Citizen Health A must read for patients attempting to navigate today’s healthcare marketplace. --Brian Wilhelmi MD, JD, FASA




Who Is an Efficient and Effective Physician? Evidence From Emergence Medicine


Book Description

Improving the performance of the healthcare sector requires an understanding of the effectiveness and efficiency of care delivered by providers. Although this topic is of great interest to policymakers, researchers, and hospital managers, rigorous methods of measuring effectiveness and efficiency of care delivery have proven elusive. Through Data Envelopment Analysis (DEA), we make use of evidence from care delivered by emergency physicians, and develop scores that gauge physicians' performance in terms of effectiveness and efficiency. In order to validate our DEA scores, we independently use various Machine Learning (ML) algorithms, including Support Vector Machines (SVM), K-Nearest Neighbors (KNN), Classification and Regression Trees (CART), Random Forest (RF), a Generalized Linear Model (GLM), and Least Absolute Shrinkage and Selection Operator (LASSO). After validating our DEA scores via comparison with predictions made by these algorithms, we make use of them to identify the distinguishing behaviors of highly effective and efficient physicians. We find that highly effective physicians order less tests compared to their peers and maintain their effectiveness when working under high workloads. We also observe that highly efficient physicians order less tests on average and become even more efficient during high-volume shifts. Importantly, our results indicate a statistically significant positive relationship between a physician's effectiveness and efficiency scores suggesting that, contrary to conventional wisdom, effectiveness and efficiency in care delivery should be viewed as compliments not substitutes. In addition, we find that effectiveness is lower among physicians who have higher job tenure or average test order count. Efficiency, however, is lower among physicians with less experience (measured in number of years after graduation from medical school) or high average test order count. Furthermore, our results indicate an increase in a physician's average efficiency and a decrease in his/her average effectiveness when faced with high workloads. Finally, we find evidence of peer influence on a focal physician's effectiveness and efficiency, which suggests an opportunity to improve system performance by taking physician characteristics into account when determining the set of physicians that should be scheduled during the same shifts.