Yes to Skype!

Two weeks ago, one of my partners suggested we start using Skype at the office for our long-distance calls. Gold star to you, doctor!

Skype is one of several VoIP services that let you place phone calls over the internet. You need a USB headset/microphone connected to your computer and a Skype account. You can call from your computer to another computer for free. If you want to call from your computer to a telephone (handy!), you have to pay. Well, if you call $30 a year, "paying"! (Unlimited calls within North America.)

We spend many thousands of dollars a year on long-distance calls, as many of our patients and referring physicians live outside urban Saskatoon. If Skype works for us, we'll be saving plenty.

I've been using it for the last week and it has been very good. There are the occasional calls with poor quality, but almost all the calls are crystal clear. I've also occasionally found that the system doesn't always let both people talk at once and there are sometimes voice delays. These are the exception, however.

Also, I can use Skype wherever I have my laptop and a wireless network. I can make long-distance calls at the hospital (or from home) without having to bill the office calling card.

I'm going to continue the trial for a few more weeks, but so far, Skype gets high marks.

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Twice in a week!

Being in the national news, I mean. Not the other thing that is good twice a week.

Advanced Access in Saskatoon made the front page of the National Post last week. (Sorry if this link dies in the future.)

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Realpolitik

Just so you have the context of this post, I originally intended to post it on my HQC Advanced Access blog, following the recent Saskatchewan provincial election (which shut down any potentially politically inflammatory communication for the duration). However, perhaps it's a little too politically spicy for HQC, so here it is on PBW.

I'm back! Sorry to abandon you for a few weeks, but our provincial election rules prohibit propaganda. Any organization linked to the government (including health regions and this blog's sponsor, Health Quality Council) had to put the lid on anything that smelled political for the duration of the campaign. What do they think I could possibly say that could be considered subversive?


How about this: Advanced Access is the saviour of Canada's public health care system!


OK, it's no Communist Manifesto, but I sincerely believe it.


When proponents of privately-funded health care point out the failings of our system, long wait times are their major argument for creating a parallel delivery system. They assume that the present situation can't change; that it's inevitable to have these access problems.


But, how would a privately-funded system guarantee access to services? By using industrial methods of matching supply and demand, AKA Advanced Access! That's just good business.


You tricky M.B.A.'s! You know that managing supply and demand properly is the key to eliminating wait times. So why don't you put your resources into doing this in the public system rather than undermining it with a privately-funded one? Provide incentives for physicians and health regions to implement Advanced Access. Train project managers to implement the principles of clinical office redesign, and make their services available at no cost. (It's working for us... thanks, Karen and HQC!)

How much money would go into creating the infrastructure of a parallel, private system? I’ll bet if we took a fraction of that amount, we could significantly improve wait times through appropriate management. (Note: I’m not a professional economist and so am entitled to make blatantly unfounded claims like this.)


Ideological fights waste time, energy and resources. We can improve our current system. Lobby for Advanced Access in physicians’ offices, CT scanners and surgical wait lists. If you’re already involved in improvement projects like this, then spread the word. Encourage your co-workers to get involved.


If you support a parallel, private system, then you're a bad, bad person. But, you can probably be rehabilitated. Comrade.

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"Sorry about this slide" redux

PBW hit the national press! My griping about Powerpoint presentations got mentioned in "Death by Powerpoint" (National Review of Medicine).

There's some great tips from Dave Paradi on tuning up presentations. Also, check out Art of Speaking Science (courtesy of a comment from Lisa B. Marshall).

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Yes, it's annoying... so what?

I had 2 medical students with me yesterday at my cystoscopy clinic. One of them raised an interesting point about Internet-savvy patients.

One of the patients about to undergo cystoscopy had done some homework. She had Googled "cystoscopy" and read up on the procedure and possible complications. She had also spoken to some family members who told her about other complications (including some that just weren't applicable to the cystoscopy procedure).

We talked about the cystoscopy and some common complications like blood in the urine, burning urination for a short time afterward and the small chance of getting a bladder infection. I also corrected some misconceptions she had about the procedure and possible adverse events. The procedure went fine.

Afterward, one of my students commented that it must be annoying to have people research a medical condition or procedure, but not really have the background, education or context to let them understand which information is accurate or pertinent, and which information is misleading.

I know exactly what she means. I admit to having cringed mentally when someone arrives for a consultation, hauling a file folder full of print-outs, cross-referenced with colored Post-it notes. But, I'm learning to use a mental trick to approach such a situation more positively (see the post "Switch" in my Advanced Access blog.)

After all, my job is to gather and interpret information for people. Being a surgeon, I also do procedures and operations, but any physician's main job is to be a data processor. And, I should be doing it in a way that makes sense to my patient and helps advance their understanding of their condition.

It really should be the patient's choice. Sometimes that means a 77-year-old retired farmer telling me "You're the doctor. Just do what you think is best." Other times, it means spending an hour with a 50-year-old business man reviewing the latest studies on how to treat his enlarged prostate.

My main point was: Embrace the idea of an informed patient. When someone walks into your office with reams of research, tell yourself "Great! Here's someone who's interested in their own health. They trust me to help them wade through the thicket of information that is the Internet." Be prepared to schedule an additional visit so that neither of you feels rushed. Don't be alarmed if you don't have all the answers to their questions ("specialist" doesn't mean omniscient). It's more important to know how to find the answers.

It looks like the Internet is here to stay. Better get used to it, doc.

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What's wrong with this picture? - III

Doctor's parking lot - Nov. 8 12:10 pm



Doctor's parking lot - Nov. 8 15:23 pm
Different car

To be fair, even though there was no visible handicapped sticker on either car, it's possible that the drivers were handicapped in some way. I mean, other than morally.

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Practice website puttering

I've been gradually working on my practice website. It's template-based and so is pretty simple to use. On the other hand, it's template-based and so has limited capabilities. As such, I was pleased with myself when I figured out a useful way to work around its limitations.

The website template (courtesy of Mydoctor/Canadian Medical Association) includes a way to show a Yahoo or Google map to your clinic location. I wanted to show maps to several local hospitals, radiology clinics, etc., but the template won't do that.

I could put a long list of links on the site, but that clutters up things. I started by putting a list of links in a Word document and then uploading that to a page on the site. It turns out that the template converts Word documents into PDFs. That would be fine, but the links wouldn't work on the PDF page. A little Googling revealed that links on Word docs (generated on a Mac) don't survive conversion to PDF.

The fix: Upload the Word doc to Google Documents, convert it to PDF and upload that file to my practice website. The links survived that translation. Now I have a single link that gives Yahoo maps to various healthcare facilities.

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