What's wrong with this picture? - XIV - Oh, my aching neck!

Dictating hospital discharge summaries! Aaarrrgh! I don't know a single doctor who enjoys this necessary evil. (For those of you who haven't had the pleasure, a discharge summary is essentially the story of someone's hospital stay.) Not only does it mean 30 minutes of dictating reports, it also means 30 minutes of cranking my neck into an unnatural position to accommodate the terrible ergonomics of the phone receiver.

Check out the protruding vein on my temple - it's pulsating with annoyance.



Well, you may say, why don't you hold the receiver in your hand and save your neck?



Like this, you mean? Great idea, but that leaves just one hand free to flip through a voluminous, poorly organized and ergonomically-obscene paper chart, to reference lab results, progress notes, etc.

It's a frustrating experience, and that leads to rushed, and possible incomplete, discharge summaries.

I always use a hands-free headset in my office - it's comfortable and convenient. Why don't they have one in the hospital medical records dictating suite? As it turns out - nobody asked for one!

A couple of months ago, I spoke to the person in charge of this area and suggested they try setting up a headset. And...



Now check out the protruding vein on my temple - it's pulsating with joy!

I have 2 hands free to flip through the chart. (Electronic charts would be better!) I'm more likely to dictate a thorough discharge summary, because I'm not frustrated by the unwieldy chart, and my neck isn't cramped.

Not only did they supply the headset: (on one phone, as a pilot - excellent plan!)



They also posted an instruction sheet and a feedback form:





What a great demonstration of how to implement a change:

Address the client's need/problem.

Start with a small test of change.

Make it easy for them to try the new method.

Ask for feedback.

If you don't ask, you don't get! And it only took me 16 years to ask.

Kudos to Sherry M. for setting this up. Thank you very much!

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The grass is always greener on the other side...

Check out US President (not yet, but he might as well be) Obama's video blog of his Economic Recovery Plan. He's going to make sure that all US hospitals and doctors' offices are outfitted with EMRs and are connected to each other (3:50 on the video).

EMR and connectivity are part of his core plan. "Cut red tape, prevent medical mistakes and help save billions of dollars each year..." Looks like his administration gets it.

Who would have thought the American health care system would be showing us the way on this?

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Review of Doctor review sites missing an opportunity

Dr. Kent Sepkowitz informs Slate readers that doctor review sites aren't helpful for patients. But can they be helpful for doctors? I think so - check out this old post.

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More RateMD fodder

Here's a recent article from the Prairie Post. 1762 Sask docs listed on RateMD. There is no escape!

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Welcome CCHSE attendees!

Thanks for coming to my presentation of BOMB! How a (failed) career in standup comedy made me a better surgeon. I look forward to receiving your feedback. Please click here to take the survey. You'll need the password from your souvenir postcard!

This survey closes on Thursday, November 27.

P.S. Got time on your hands? Check out "What's wrong with this picture?"

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Come out swinging on private health care!

In this corner, CMA president Robert Ouellet weighs in on how private health care will improve access for Canadians.

In this corner, former NEJM editor Marcia Angell, takes a swipe at American-style privatization.

Judge's decision: Angell

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Macs rule! But let's not be stupid about it...

The medical community seem to be committed Mac users.  At our recent Departmental Research Day, several presenters made that clear.  But, in a counter-productive way...


The laptop being used for presentations at Research Day was a PC, but several physicians brought their own Mac laptops. Great to see other Mac users promoting the cause, but it turned out to be a distraction. Because they had brought their laptops (rather than just the presentation on a memory stick) there was an annoying delay between presentations while the PC was disconnected from the LCD projector and the Mac was connected.

This was completely unnecessary for some presenters, as they had used PowerPoint on the Mac and could have easily loaded their presentation onto the PC via a memory stick. I do that regularly and the only compatibility issue I have is if I've used pictures from iPhoto without changing their format to a PC-compatible one. I've been burned on that before and so am in the habit of checking such presentations on my office PC.

Other Mac users/presenters were obviously using Keynote, and so couldn't run that program on a PC. I say "obviously using", when perhaps I should say "obtrusively using", i.e. "Hey, I'm using this cool, Mac-only program. Look at these wicked fonts and catchy transitions I can do!" Those bells and whistles are amusing for exactly 2 slides and then they are a distraction from your presentation's message. If that's the only reason you're using Keynote... don't do it. Stick with PowerPoint (on your Mac, of course) and save us the nuisance of switching platforms between presentations.

I admit that I use Keynote for one particular presentation that requires an animation that PowerPoint can't handle. That means I have to take my laptop along whenever I give that presentation. After experiencing the annoyance of several computer changes at Research Day, I'm seriously reconsidering whether that single animation is really worth the grief of lugging a laptop around, rather than just carrying PowerPoint on a memory stick.

Of course, the ultimate solution would be for the AV people to smarten up and start using Mac laptops. As Macs can run either Mac or PC, it makes more sense to be using the more versatile platform.

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