Tuesday, April 28, 2009

NPs and Primary Care Shortages

Here is a news-worthy article and clip about NP practice in New York. The piece is from East Syracuse, New York and highlights how NPs can be part of the solution to primary care shortages.

Also, April is Nurse Practitioner month in New York State. This would be a fine time to recognize NP's contributions to the health care system and patient care.

Monday, April 27, 2009


Undoubtedly, most are aware of the swine flu by now and the potential impact it has on pandemic fears. While cause for concern, it isn't cause for panic...yet.

Know the symptoms of the flu. That is, remember that influenza is a respiratory illness. Typically, if one doesn't have a cough (usually non-productive), fever and body aches, then it is unlikely that it is classic influenza. Common sense precautions are in order,
  • stay home if you are sick with mild symptoms, seek care if they worsen
  • wash your hands frequently, especially after touching your nose & mouth. (Most people don't wash their hands properly if you can believe it. You should wet your hands with water, use soap and scrub for at least 30 seconds {sing "Happy Birthday" twice to yourself}; be sure to get your wrists and under jewelry.
  • Phone your health care provider if you have specific questions. Also visit credible sites such as the CDC.
  • Anti-viral medications exist for pre or post exposure to the flu. Of course, these are not without their potential side effects and issues.
  • Seasonal flu vaccine probably doesn't protect against this strain of swine flu.

This is a trying time for the whole international community as this has the potential to negatively impact so many. Compound that with an already taxed healthcare system and it highlights the need for enhanced communication among providers and health reform. Now more than ever is the time to work together, collaborate and show how we can take care of one another. I, for one, will be ready.

Thursday, April 9, 2009

Your Chart: Do you know what's in there?

This is a wonderful post over at The New Life of e-Patient Dave's website about electronic health records. I strongly encourage patients and clinicians to read it. While there has been much debate about whether EHRs actually improve patient care and save money (I believe they will do both) the move to electronic records will enable transparency when it comes to viewing and reviewing your own chart.

Have you ever tried to get a copy of your own record? It is not exactly the easiest process. Most providers offices require you to complete a records release form which is filled with legal jargon and makes you seriously question if you really want to get these records in the first place. Some providers charge you per page to photocopy your record and good luck in thinking that this will be processed promptly by the staff. Once you get your hands on a traditional paper chart copy, it is nearly impossible to decipher. Is this acceptable? Maybe accessing your health record should be like getting your credit report. I know that in a matter of seconds I can log on to one of the credit reporting websites, enter some information and have complete access to my full credit report.

So now that you have access to your chart, I am reminded by the Seinfeld episode, "The Package" where Elaine has a rash and sees a few doctors only to be shunned by what is written in her chart:

Should patients have the right to question what's in the chart or make their own comments? Can subjective data be debated? Would clinicians document differently if they knew that patients had unfettered access to what's in there? Is our system of charting archaic and does it truly capture the essence of the visit? Could we be making better use of technology and snap digital photos of certain conditions and attach them electronically to the record? If we are to be patient-centric, how much input should patients have in their records? Would clinicians have to "defend" their charting if questioned? These are many questions that could make for some interesting debate. What do you think?

I think we have a long way to go when it comes to transitioning to electronic records. Yet, the time has come. We need to stop talking about it and thoughtfully start implementing it. It all goes back to communication and understanding about disease processes and steps that can be taken to improve health. After all isn't your health record just as important as your credit score?