Archives for April 13, 2005

When the Specialists are Done

Medpundit has something to say about the docs in the ivory tower, and more:

But, I do know that all too often, when the treatment has been exhausted and the patient ends up in the closer hospital in extremis, the miracle-working specialists are nowhere to be found.

  We see this in the ED more than we want.  It’s usually a patient who couldn’t be cured by a specialist, or even a subspecialist, and the patient is told ‘there’s nothing else I can do’ for your problem (please go away), so the patient comes to the ED, because there’s got to be something that can be done.  Give humans credit, hope lasts.

I don’t blame the patients for this, and the specialists have, IMHO, done all they could once I look into the problem.  Where I have seen this most often is in patients who don’t have a strong Primary Care doctor; they’ve bounced from specialist to specialist without coordination or guidance.  The end of the specialist line comes, and the patient has no-one to turn to.

The demise of the generalist, marginalized by payors, specialists and sometimes patients themselves goes on.  Someone needs to coordinate the care of the patient so that there’s still a chair when the music stops. 

That’s your doctor.


symtym has an article that’s serious, about germ-resistant bugs on keyboards, but finishes it with an amusing visual.  You’ll just have to go see.

Dept. of Blog Corrections

No, not prison for bloggers.  I said something that was wrong, and will correct it.

Per HIPAA Blog:

…The fact that something bad happens doesn’t mean there’s a HIPAA violation. The fact that PHI gets improperly disclosed doesn’t mean that there’s a HIPAA violation. HIPAA doesn’t require that PHI never get out wrongly, it just requires that covered entities take reasonable steps to try to prevent that.

This was in response to my comment in yesterdays’ Grand Rounds that the loss of computers with patient names, etc, was a violation.  HIPAA Blog is written by a lawyer who specializes in those matters, so he’s better able to judge whether an error was made.

An error was made, and it was mine.  I stand corrected.

via HIPAA Blog, which is different than the above referenced HIPAA blog.  Not very original with their names.