Not too far off topic.
A Window on the Unworkable Settings in Which Physicians Practice (Excerpted)
The Annals of Internal Medicine just published an important problem that helps explain why our health care crisis is so intractable.
[snip]
The article arose from the MEMO (Minimizing Error, Maximizing Outcome) study. The study included an initial cross-sectional survey and then longitudinal follow-up of 422 physicians, roughly equal numbers of family practitioners and general internists, in 119 different ambulatory settings in New York City, NY, Chicago, IL, Milwaukee, WI, Madison WI, and smaller towns in WI.
The surveys asked physicians about their work-flow and time pressure, the pace of their practice (from calm to chaotic), their ability to control their own work activities, and five aspects of organizational culture (emphasis on quality, emphasis on information and communication, trust, cohesiveness, and alignment of values between physicians and leaders.)
The results showed how bad the practice environment in primary care/ generalist practice has become. Some important points were:
- More than half of the physicians (53.1%) said they needed more time to do physical examinations, and nearly half (47.6%) for follow-up visits.
- Almost half (48.1%) described the pace of their offices as chaotic.
- Substantial majorities of physicians thought their workplaces’ organizational cultures were deficient, if not hostile.
- Only 23.7% thought there was a high emphasis on quality.
- Only 28.2% thought there was a high emphasis on communication and information.
- Only 30.6% thought there was a great amount of trust.
- Only 33.9% thought there was high work place cohesiveness
- Only 14.2% thought there was great alignment between the values of leadership and physicians.
So, to summarize, many physicians thought they did not have enough time to take care of each individual patient. Most thought their workplaces were nowhere near calm, and nearly half thought they were chaotic.
Few thought that their workplaces emphasized quality or communication and information, or inspired trust or cohesiveness. Very few thought that their leaders’ values were aligned with their professional values.
More:
http://tinyurl.com/lvnmww
Swine flu: London on brink of epidemic as NHS plans are in disarray
Swine flu: NHS ‘muddle’ as London on brink of epidemic
A leaked NHS memo criticises emergency swine flu planning while the Chief Medical Officer says London is almost in an H1N1 epidemic
By Tim EdwardsFIRST POSTED JULY 10, 2009A leaked memo has revealed that senior NHS officials consider emergency plans to combat the swine flu pandemic in Britain are muddled and pointless.
[snip]
Meanwhile, the New Scientist reports three ominous developments:
• Southern hemisphere countries have reported that H1N1 is replacing regular seasonal flu, rendering seasonal vaccines built up over the past year useless. In Victoria, Australia’s hardest-hit state, 99 per cent of all flu cases are H1N1. It is a similar story in Chile and Argentina.
This is exactly what happened during the notorious Spanish flu pandemic of 1918 and is bad news because the northern hemisphere will move into the autumn and the flu season proper with potentially useless seasonal flu vaccines.
• Last week three cases of Tamiflu-resistant H1N1 were discovered. While two of these cases were in people using the drug, the other was found in a girl who had never used Tamiflu, suggesting a Tamiflu-resistant strain of swine flu could be circulating already.
• A mutation in the virus discovered in a sample from Shanghai, China, helps H1N1 replicate more efficiently, potentially making it more contagious and nastier.