Should "Diagnosing While Texting" Be Illegal?

I saw an interesting comment at Medscape in the comment thread of the article "<a href="http://www.medscape.com/viewarticle/809237">Do Your EHR Manners Turn Patients Off?</a>" (MedScape subscription required).<br /><br /><div style="margin-left: 40px;">Dr. [redacted] | Neurology<br /><br />I live in a town that has passed legislation criminalizing texting and driving. A driver is more impaired and distracted when texting than when intoxicated.  EHR's and the practice of medicine should be no different. <b>Do you really believe that your physician is actually concentrating on the patient in front of them while their attention is primarily focused on entering data on a computer?</b> The reality is that EHR's true value is data collection for statistical analysis by our government and there is an obvious deficiency for enhancing the physician-patient collaborative experience. </div><div><br /></div><div><br /></div><div>Medicine, like driving, is a very cognition, thinking and concentration-intense activity.   Failures lead to injury and death (although not quite as dramatically in the former compared to the latter).</div><div></div><div><br />I think the point about distraction the commenter makes is valid, or at least worthy of healthy consideration.<br /><br />Unless you're a health IT hyperenthusiast, that is (see <a href="http://hcrenewal.blogspot.com/2012/03/doctors-and-ehrs-reframing-modernists-v.html">http://hcrenewal.blogspot.com/2012/03/doctors-and-ehrs-reframing-modernists-v.html</a>).</div><div></div><div><br />-- SS </div>

Should "Diagnosing While Texting" Be Illegal?

I saw an interesting comment at Medscape in the comment thread of the article " Do Your EHR Manners Turn Patients Off? " (MedScape...

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Medscape re: Class Action suit: "Doctors Who Sued EHR Company Win First Round"

Interesting article about a Class-Action lawsuit against a health IT seller, Allscripts, see Medscape link below (the story is copyrighted so I cannot repost it here).<br /><br />Relevant excerpts:<br /><br /><blockquote class="tr_bq">On Monday, March 4, a group of doctors who are suing their electronic health record (EHR) manufacturer for selling them a "buggy" product and then discontinuing it learned that the defendant's motion to block the lawsuit and compel them to accept binding arbitration was overruled by a judge in Miami, the first step in getting a court date in what is believed to be a first-of-its-kind case.<br /><br />... In December 2012, 4 physician practices -- 2 pain clinics in Florida, 1 in Missouri, and a family medicine practice in Alabama -- became plaintiffs in a class-action suit filed against Allscripts, "an action arising from an expensive, but defective electronic health records software product," according to the complaint. The bottom line: The EHR was "buggy."<br /><br />Says one of the doctors plaintiffs:<br /><br />Anesthesiologist Robert J. Joseph, MD, of the Pain Clinic of Northwest Florida in Panama City, a plaintiff in the suit, makes no bones about it. "Our EHR is a piece of crap," he states.</blockquote><br />-----<br /><br />Link to full article:<br /><a href="http://www.medscape.com/viewarticle/779721" target="_blank">http://www.medscape.com/viewarticle/779721</a><br /><br />(It seems to come up fulltext without Medscape login, but I cannot guarantee this will persist.)<br /><br />-- SS

Medscape re: Class Action suit: "Doctors Who Sued EHR Company Win First Round"

Interesting article about a Class-Action lawsuit against a health IT seller, Allscripts, see Medscape link below (the story is copyrighted ...

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Professional Integrity for Sale? “Sure,” Says Medscape!

Some chiropractors also practice homeopathy. According to <a href="http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=38545">Frank King, D.C.,</a> many more should be doing just that:<br /><br /><br /><blockquote>Homeopathy is an energetic form of natural medicine that corrects nerve interferences, absent nerve reflexes, and pathological nerve response patterns that the chiropractic adjustment alone does not correct. The appropriate homeopathic remedies will eliminate aberrant nerve reflexes and pathological nerve responses which cause recurrent subluxation complexes.<br /><br />Not only does homeopathy correct nerve interferences, it empowers the doctor of chiropractic to reach the entire nervous system. What this means is that we can now better affect the whole person, and all of the maladies that affect us. Homeopathy’s energetic approach reaches deep within the nervous system, correcting nerve interferences where the hands of chiropractic alone cannot reach. Homeopathy is the missing link that enables the chiropractor to truly affect the whole nervous system!<br /></blockquote><br />But that’s not all:<br /><br /><br /><blockquote><strong>Financial Rewards<br /><br /></strong>Homeopathy means a multiple increase in business. Personally, I have been able to see and effectively help more patients in less time. The additional cash flow from broadening your scope of practice, increasing your patient volume and selling the homeopathic remedies is a wonderful adjunct. Better yet are the secondary financial benefits:<br /><br /><ul><li>Homeopathy is like an extension of you that the patient can take with them to apply throughout each day in between visits. The actual therapeutic benefits of homeopathy along with the inner comforts of the patient as they connect you with each dose they take.</li><li>The dynamic broadening of your effective scope of practice multiplies the number of patients you can help and the multiple problems that each patient usually has. As you correct one set of problems, there are commonly other problems most patients don’t even tell their chiropractors. This doesn’t have to be the case anymore. Homeopathy empowers the chiropractor to correct conditions ranging from allergies to warts with incredible effectiveness! </li><li>Obviously, the rule of multiples will exponentially increase when a homeopathic procedure is properly implemented into your practice. Many of the conditions people are suffering with have no viable solution without the dynamic duo of chiropractic and homeopathy.<br /></li></ul>You can be the doctor people will seek out, travel long distances to see, and pay cash for your valuable services. Take it from someone who has experienced it first hand, it’s a great position to be in.<br /><br /></blockquote><br />This is no surprise. Most chiropractors relinquished whatever ethical integrity they might have had when they bought into the “<a href="http://www.sciencebasedmedicine.org/?p=3022">subluxation</a>” myth, and the field as a whole has a fine tradition of “<a href="http://www.quackwatch.org/01QuackeryRelatedTopics/chirosell.html">practice building</a>.”<br /><br />Naturopaths, likewise, don’t mind winking at practice ethics in order to <a href="http://www.sciencebasedmedicine.org/?p=146">make an extra buck</a>. Nor do MD quacks, of course. Hey, it’s getting harder and harder to make a living just by slogging through the morass of needy patients, onerous third-party billing requirements, diminishing payments, increasingly cumbersome practice guidelines, next-to-impossible-to-keep-up-with (nothing to say of tedious and technical!) medical literature, and all the rest. Why not sprinkle your practice with a little ‘<a href="http://www.sciencebasedmedicine.org/?p=4768">diagnostic’ sugar</a> that will appease those clingy patients—for a while, anyway—and that you won’t have to find billing codes for (because there aren’t any)? Heck, why not check out <a href="http://www.bio-proinc.com/site/555888/page/131760">this offering</a> from <strong>“bio-pro, inc. Amazing Anti-Aging Solutions (Healthier Patients, More Patients)”</strong>:<br /><br /><br /><blockquote><p><strong>HOWW TOOOO ….</strong></p><p>The “must do” seminars for those who own or are managing a Complimentary [sic]Medicine Practice.<br /><br /><strong>Three day course teaches you</strong>: </p><p>How to relate to the patient, evaluate, test and diagnose</p><p>How to use solutions, mixtures, methods, supplies and equipment</p><p>How to protocol administration for Chelation, Oxidation, Chelox, TriOx, Ascorbates, UVBI</p><p>How to design and organize your office</p><p>How to hire and fire staff and to computerize</p><p>How to use public relations and marketing</p><p>How to manage compliance with Medicare, State Medical Boards and governmental regulatory agencies </p><p><strong>Manuals included…</strong></p><p>Each attendee receives one set of training materials, including:</p><p>Protocol Manual</p><p>Physicians Manual</p><p>Office Procedure Manual</p><p>Forms Book</p><p>Marketing Manual</p><p>Patient Results Manual</p><p>Employee Manual</p><p>Audio tapes</p><p>and other related material.<br /></p></blockquote><p></p>Bio-pro was founded in 1978 by the late Charles H. Farr, MD, PhD, the self-styled “<a href="http://www.sram.org/1101/charlesfarr.html">father of oxidative medicine</a>,” who was also a founder of the American College for Advancement in Medicine, the Mother of All Pseudomedical Pseudoprofessional Organizations (<a href="http://www.sciencebasedmedicine.org/?p=247">PPO</a>). But none of this is surprising, right? After all, <a href="http://www.quackwatch.org/01QuackeryRelatedTopics/quackdef.html">quacks quack</a>.<br /><br />What may have come as a surprise to beleaguered physicians who still play by the rules was <a href="http://www.medscape.com/viewarticle/720244?src=ptalk&uac=27844PK">this offering</a>, just a few days ago, from <em>Medscape Business of Medicine</em>:<br /><br /><br /><blockquote><strong>Six Ways to Earn Extra Income From Medical<br />Activities<br /><br /></strong>You’re chasing after claims but watching reimbursement sink.<br /><br />It’s a common story, and primary care doctors and even specialists are keeping their ears to the ground for other ways to boost their bottom line. Luckily, doctors have some fairly lucrative options that can help them maintain their income — and perhaps even increase it.<br /><br />We looked at 6 avenues that physicians have taken to earn extra revenue. None of these activities require a tremendous amount of time. Participating in just 1 or 2 activities can put enough money in your pocket to allow you to breathe a little easier when the bills come in.<br /></blockquote><p>So what are those ‘6 avenues’? Let’s see:<br /></p><ul><li><strong>Work with Attorneys </strong></li><li><strong>See Nursing Home Patients </strong></li><li><strong>Serve as a Medical Director<br /></strong></li></ul><p>So far, so not necessarily bad…<br /></p><ul><li><strong>Team Up with Pharmaceutical Companies<br /></strong></li></ul><p>What??! Team up with pharmaceutical companies? Couldn’t that mean, like, just doing legitimate research and trying like hell to do it right? Uh, nope:<br /></p><blockquote><p>Drug and device companies spend billions of dollars each year to discover and promote new medicines and treatments, and they rely heavily on doctors to participate in these endeavors whether through clinical trials or serving as a speaker or consultant. It’s not uncommon for physicians to earn a minimum of 5 figures a year either speaking or doing clinical studies within their medical practice. Some doctors make in excess of $100,000 annually — on top of their income from seeing patients.</p></blockquote><p><br />O’course, you gotta watch out for those pesky <a href="http://hcrenewal.blogspot.com/2010/06/when-key-opinion-leader-questions-hand.html">ethics killjoys</a>, warns Medscape:<br /></p><blockquote>Although some extra money is nice, too much can turn heads — and not in a good way. In late January, The Boston Globe reported on an allergy and asthma specialist who was issued an ultimatum by his hospital, the prestigious Brigham and Women’s Hospital (Boston, Massachusetts): Stop moonlighting on behalf of pharmaceutical companies or resign from your staff position.<br /></blockquote><p>What it all comes down to is this:<br /></p><blockquote><p><strong>Pros</strong>: With typical payments running about $1500-$2500 for a single talk, there’s substantial opportunity to supplement your regular income…<br /></p><p><strong>Cons</strong>: These arrangements are coming under increasing scrutiny from hospitals, legislators, regulators, and the media. In fact, some of the doctors whom we contacted for this article declined to talk about their involvement with drug companies.<br /></p></blockquote><p>Uh, no kiddin’. Funny that the “increasing scrutiny” doesn’t seem to come from organized medicine, medical schools, mainstream medical journals, state medical boards, or doctors in general. A couple of years ago I <a href="http://www.sciencebasedmedicine.org/?p=189">lamented the publication</a> of a couple of book reviews, in the lofty <em>New England Journal of Medicine</em>, that celebrated trendy pseudomedicine. Shortly thereafter I received this from an emeritus editor:<br /></p><blockquote><p>I think the incursion into the bastions of medicine has to do with the fact that everything nowadays—absolutely everything—has become a market. If quackery appeals to the readers of the NEJM, it will be there. ”Is it true?” is no longer the question anyone asks, but “Will it sell?” And I think that applies to the editors of most major journals, as well.<br /></p></blockquote><p>True, dat. As for Medscape, this isn’t its first ethical gaff, and I agree with <a href="http://hcrenewal.blogspot.com/2008/06/medscapes-cme-ethics-part-ii.html">Bernard Carroll</a> that it seems to have “a right hand – left hand problem.” </p><p>Oh yeah: what were the other 2 “avenues”? Those would be:<br /></p><ul><li><strong>Become a Media Personality </strong></li><li><strong>Consult for Wall Street </strong></li></ul>

Professional Integrity for Sale? “Sure,” Says Medscape!

Some chiropractors also practice homeopathy. According to Frank King, D.C., many more should be doing just that: Homeopathy is an energetic...

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