Transcript of #MDchat for November 2, 2010

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Twitter.com/MD_chat
MDchat.org

Welcome to #MDchat! If you're new, just follow along & you'll

MD_Chat figure it out. We'll get started in a moment but first, introduce yourselves!
Doctor_V @PhilBaumann I'll be joining #mdchat about 15 after
RT @hjluks: RT @EllenRichter Frustrating! "Docs, patients use
smartphones, but cant make mobile connection" http://is.
Healthcare3dot0 gd/gD2pf #hcsm #MDchat
@hjluks @EllenRichter I'm not sure how phones should safely connect
docs&pts - perhaps med monitoring & "
drpauldorio safe" Q/As? #hcsm #MDchat #mdchat
Family doc working in #RVA; trying to multitask a conference call and
RichmondDoc #mdchat
RT @EllenRichter: Frustrating! "#Doctors, patients use
smartphones, but can't make mobile connection" http://is.
joegormally gd/gD2pf #hcsm #MDchat #RNchat
MD_Chat @RichmondDoc Welcome! #mdchat
Hey gang! Paul from Albert Einstein College of Medicine here. Looking
EinsteinMed forward to 2nte's discussion #mdchat
@drpauldorio Phones in this decade are like PCs in the past. They are the
Srini2000 most widely used platform. Future emphasis- phones #mdchat
EllenRichter Lurking @ #MDchat while on a phonecall! Hi folks! :)
@MD_Chat Thanks! Hopefully my multitasking won't mess me up too badly.
RichmondDoc #mdchat
Srini2000 Srini, developer medical instrumentation. Hello everyone #mdchat
Evening all! Jenn from Braiv.com - career resource for the healthcare
BraivHC industry. #MDchat
EinsteinMed Reminder tweeps #Mdchat live now. #hcsm #meded
BraivHC @RichmondDoc Impressive multitasking. #MDchat
 @EinsteinMed @EllenRichter Welceome - It's election night, so we'll see how
MD_Chat turnout is - either way, always fun. ;) #MDchat
OK, we'll get started in a moment. We have 2 topics. When responding to a
MD_Chat topic, prepend tweets with T1, T2, etc. Enjoy! #MDchat
RT @hjluks: RT @EllenRichter Frustrating! "#Doctors, patients
use smartphones, but cant make mobile connection" http://is.
westr gd/gD2pf #hcsm #MDchat #mdchat
RichmondDoc @BraivHC We shall see how impressive... #mdchat
Blausen Group, focused on patient education w 3 D medical animations
blausengroup listening in to #mdchat
EllenRichter Twitter #doctors come join in for #MDchat starting now! :)
T1 Empowered Patient: Is the word ePatient meaningful to you? From your
MD_Chat view, how would you define an “empowered patient”? #MDchat
@MD_chat Actually #MDchat a respite from wall-to-wall news coverage.
EinsteinMed #mdchat
MD_Chat @EinsteinMed Yep. ;) #MDchat
LOL yes! EinsteinMed: @MD_chat Actually #MDchat a respite from wall-to-
EllenRichter wall news coverage.
#MDchat High everyone. Coming in late and likely lurking or at least
westr multitasking tonight.
mkmackey Good turnout for #mdchat tonight Are you joining? #mdchat
T1 Empowered pts should be a goal for all health care providers. We need to
RichmondDoc help pts understand and actively participate in care. #mdchat
Agreed! :) RT @EinsteinMed: @MD_chat Actually #MDchat a respite from
BraivHC wall-to-wall news coverage. #MDchat
RT @EllenRichter: Twitter #doctors come join in for #MDchat starting now!
Trybarefoot :)
hjluks Hi folks... sharing computer with a 6 year old :-) Will be off/on... #mdchat
T1: Empowered patient=informed pt. Not afraid to independently do
EinsteinMed research, set goals 4 treatment and ask docs tough questions. #MDchat
Hi there, ICU nurse & legal nurse consultant who loves health care
EllenRichter & its expansion to social media #MDchat
 T1 Health care providers spend only a few minutes/visit w/ pts. Goal should
RichmondDoc be to empower pts to improve their health at all times. #mdchat
apjonas #mdchat HI AP Jonas, Holistic FM in OH
T1 personally prefer the word engaged as opposed to empowered patient
mkmackey #mdchat
BraivHC @hjluks Welcome and good luck with that! #MDchat
T1 Having said that, I don't personally put much weight on the "
ePatient" term b/c I hope I am already practicing that way.
RichmondDoc #mdchat
T1 We all are empowered patients. We seek better answers to medical
EllenRichter predicaments. We ask questions. We partner with our #doctors #MDchat
RT @EinsteinMed: T1: Empowered patient=informed pt. Not afraid to
independently do research, set goals 4 treatment and ask docs tough
ability4life questions. #MDchat
Patients are empowered by knowledge and understanding... and their ability
hjluks to share that amongst other pts and MDs too #mdchat
RT @EinsteinMed Empowered pt=informed pt. Not afraid to independently
do research, set goals 4 treatment & ask docs tough questions.
quality1 #MDChat
@mkmackey T1 Those have very different connotations - I like engaged as
BraivHC well. #MDchat
hjluks @BraivHC thx :-) Tweetchat and spelling bee #mdchat
T1 I think that the term might have its greatest value in getting docs to
RichmondDoc recognize this as a goal and as a developing movement. #mdchat
Shoutout to @mkmackey @ RichmondDoc @westr @quality1 Gang in the
EinsteinMed house! #MDchat
RT @EinsteinMed: T1: Empowered patient=informed pt. Not afraid to
independently do research, set goals 4 treatment and ask docs tough
RichmondDoc questions. #MDchat
@mkmackey T1 I kinda think empowered & engaged are similar?
EllenRichter No? #MDchat
 RT @EinsteinMed: T1: Empowered patient=informed pt. Not afraid to
independently do research, set goals 4 treatment and ask docs tough
CellSociety questions. #MDchat
Doctor_V Better question: why doesn't anyone call me an e-doctor? #MDchat
RichmondDoc @EinsteinMed @mkmackey @westr @quality1 Huzzah! #MDChat
#mdchat Kathy Kastner in Toronto. next months Soc.4Teachers of Fam meds
ability4life conf asks: 2 twitter or not
T1: Empowered patient=informed pt. Not afraid to do research, set goals 4
treatment & ask MDs tough questions #MDchat -via
HealthGlobal @EinsteinMed
@EllenRichter T1 I think one can be engaged (in terms of being aware of their
RichmondDoc care), but the system may limit a pt's empowerment. #mdchat
RT @RichmondDoc ..term might have its greatest value in getting docs to
recognize this as a goal & as a developing mvmt <Agreed
quality1 #MDChat
@EllenRichter T1 I think that an empowered pt is clearly engaged, but I don't
RichmondDoc think that it always works the other way...sadly. #mdchat
@RichmondDoc Ah, OK I see what U mean. But to me, empowerment is
EllenRichter about self, not system. I understand your perspective though :) #MDchat
Isn't empowered, engaged-- a patient who takes ownership for body and what
Srini2000 is done to it? #mdchat
RT @RichmondDoc: @EllenRichter T1 I think one can be engaged (in terms
of being aware of their care), but the system may limit a pt's empowerment.
ability4life #mdchat
@Doctor_V Wait for it - T2 will come up in a bit and we'll start calling you
philbaumann that officially. I plan this stuff, man. ;) #MDchat
T1 #mdchat Empowered patient.. great concept, pts should be involved in
joegormally mgt, lots don't even know what meds they're on though
@RichmondDoc not all do though, some do spend time with patients, just
HealthGlobal came from one of those appointments #mdchat
@EllenRichter Hi Ellen. IMO empowered takes engaged to higher level. Put
EinsteinMed pts in more control. U can be engaged w/out being empowered #MDchat
 @RichmondDoc: @EinsteinMed @westr @ellenrichter Good to see you all;
quality1 always learn from you! #MDChat
RT @hjluks: RT @EllenRichter Frustrating! "#Doctors, patients
use smartphones, but cant make mobile connection" http://is.
HealthGlobal gd/gD2pf #hcsm #MDchat #mdchat
#Mdchat T1 Yes that term is meaningful to me and expresses my desire to be
westr fully Participatory in my HC decisions
Same here. RT @quality1: @RichmondDoc: @EinsteinMed @westr
EinsteinMed @ellenrichter Good to see you all; always learn from you! #MDChat
http://j.mp/d5Z8gi ♻ @EinsteinMed Reminder tweeps #Mdchat live
healthgist now. #hcsm #meded
gr8 point RT @quality1: RT @RichmondDoc term might have greatest value
in getting docs 2 recognize this as goal & as developing mvmt
ability4life #MDChat
@HealthGlobal T1 I agree that systems and providers *should* empower pts,
RichmondDoc but that approach bucks institutional practices/habits. #mdchat
A Prevention Revolution http://huff.to/cqtGBj #mdchat #healthcare -via
HealthGlobal @mkmackey
Insightful RT @EinsteinMed...empowered takes engaged to higher level. Put
quality1 pts in more control. U can be engaged w/o being empowered #MDChat
RT @joegormally: T1 #mdchat Empowered patient.. great concept, pts should
ability4life be involved in mgt, lots don't even know what meds they're on though
T1 empowered pt= human, consumer, steward, Pt, neighbor who engages
human physician steward consumer protector Dr neighbor to WIN.
apjonas #MDCHAT
RT @RichmondDoc: @HealthGlobal T1 I agree that systems and providers
*should* empower pts, but that approach bucks institutional practices/habits.
HealthGlobal #mdchat
@EinsteinMed @EllenRichter I would have thought most docs would love
joegormally their patients more engaged in decision making etc. #mdchat
RT @EinsteinMed IMO empowered takes engaged to higher level. Put
BraivHC patients in more control. U can be engaged w/out being empowered #MDchat
 @EinsteinMed Do you think having a patient advocate improves
quality1 empowerment? #MDChat
RT @BraivHC: RT @EinsteinMed IMO empowered takes engaged to higher
level. Put patients in more control. U can be engaged w/out being empowered
ability4life #MDchat
Yes BTW thats a great article in amednews! #Doctors, patients use
smartphones, but can't make mobile connection http://j.mp/aJbW4M
EllenRichter #MDchat
@joegormally T1 We would like to think that docs want pts engaged, but some
RichmondDoc docs (training/personality) want to be in control. #mdchat
RT @HealthGlobal: T1: Empowered patient=informed pt. Not afraid to do
research, set goals 4 treatment & ask MDs tough questions
westr #MDchat -via @EinsteinMed
I think engaged patients would ask for more "office"
mkmackey time on behalf of the physician #mdchat
Great Question -->RT @quality1: @EinsteinMed Do you think having
BraivHC a patient advocate improves empowerment? #MDchat
great article amednews! #Doctors, patients use smartphones, but can't make
HealthGlobal mobile connection http://j.mp/aJbW4M #MDchat -via @EllenRichter
@joegormally T1 Some docs approach pts from a paternalistic POV: &
quot;I am doc, you are pt; I tell, you do." Outmoded; still out there.
RichmondDoc #mdchat
@EinsteinMed Yes I agree about the levels. I'd rather be empowered than just
EllenRichter engaged. But engaged is better than apathetic, for sure #MDchat
@mkmackey T1 If we get more ePatients, maybe eventually we'll convince
RichmondDoc payers that office visits need to value face-to-face care. #mdchat
Yeah, lets start that grass roots movement! RT @Doctor_V: Better question:
westr why doesn't anyone call me an e-doctor? #MDchat
@hjluks #mdchat Wish I could join in but phone in a restaurant is wrong
ePatientDave platform & time!
@joegormally Some docs resistant to true empowermt and as @HealthGlobal
EinsteinMed pts out - approach runs counter to institutional practices. #MDChat
 @RichmondDoc true... but many patients still desire a paternalistic approach
hjluks ... #mdchat
mkmackey @RichmondDoc good point #mdchat
hjluks @ePatientDave enjoy ur dinner #mdchat
RT @EinsteinMed: T1: Empowered patient=informed pt. Not afraid to
independently do research, set goals 4 treatment and ask docs tough
NAKAYAMAkazhiro
questions. #MDchat
RT @RichmondDoc: @HealthGlobal T1 I agree that systems and providers
*should* empower pts, but that approach bucks institutional practices/habits.
westr #mdchat
@hjluks T1 Some pts still do want a paternalistic approach, and I use
RichmondDoc occasionally when I feel the need. Tides are turning, though. #mdchat
#mdchat @mkmackey coalition/alliance of healthcare providers and patients
HealthGlobal would have more leverage but they work at odds often
I think patients seek physicians with personalities and style that work best for
mkmackey their needs #mdchat
@RichmondDoc @joegormally Good news, rarely are PC Docs too pushy
apjonas w/paternalism. They are more maternalistic and nurturing. #mdchat
Frightens me! RT @hjluks: @RichmondDoc true... but many patients still
westr desire a paternalistic approach ... #mdchat
Without question.Pts want 2 b empowered but some don't know how. RT
@quality1: @EinsteinMed Does a pt advocate improve empowerment?
EinsteinMed #MDChat
@RichmondDoc i agree... and u know I am an e-advocate... but mny patients
hjluks still look to me to make decision..can be frustrating #mdchat
Trybarefoot @ability4life Living #MDchat vicariously thru you tonite! Am on my BB.
@hjluks T1 When I am put in the position of making a decision on pt's behalf,
RichmondDoc I work hard to ensure discussion and understanding. #mdchat
Some PTS r frightened! RT @RichmondDoc: @hjluks Some pts still want
ability4life patern approach, I use occasionally when feel the need. #mdchat
Often not that much choice RT @mkmackey: I think patients seek physicians
westr with personalities and style that work best 4 their needs #mdchat
 RT @RichmondDoc @hjluks Some pts still do want a paternalistic approach..
quality1 use occasionally when I feel the need. Tides are turning #MDChat
hjluks @RichmondDoc yup #mdchat
@mkmackey A good point about style and fit. Pts for a short time will have
apjonas choice about their Dr. Then huge shortage of PC doc. #mdchat
@hjluks T1 But I agree that sometimes pts *do* look to docs for answer. If so,
RichmondDoc docs need to ensure they take care re: pt autonomy. #mdchat
Absolutely. Pts dread docs they dislike. RT @mkmackey: I think pts seek docs
EinsteinMed w/personalities & style that work best for their needs #mdchat
RT @EinsteinMed: Without question.Pts want 2 b empowered but some don't
know how. RT @quality1: @EinsteinMed Does a pt advocate improve
westr empowerment? #MDChat
@RichmondDoc absolutely right.. I agree in less urgent like chemo for
joegormally malignancy etc patient should def be fully involved #mdchat
T1 The most patient-centered and humanistic docs will occ still have to make
RichmondDoc decisions for pts--but it can be done better or worse. #mdchat
@hjluks T1 Even when pts look 2 U for decisions U can gently ease them into
EllenRichter participating in decision-making & taking responsibility #MDchat
@mkmackey re: pts seek physicians w personalities &...4 their
needs. <<Sadly, health plan often restricts &
quality1 provider must adapt #MDChat
Good 2 hear RT @RichmondDoc: @hjluks When pt in positin of makng
ability4life decision on pt's behalf, I work 2 nsure discussion understanding #mdchat
T1 Unless an emergency, if docs put in a paternalistic role we should do it in
RichmondDoc the most pt-centered manner possible. #mdchat
Not sure what patients want is a paternalistic MD. What they probably want
HealthGlobal is a caring MD. That may mean many things #mdchat
RT @RichmondDoc: T1 The most patient-centered and humanistic docs will
occ still have to make decisions for pts--but it can be done better or worse.
ability4life #mdchat
RT @RichmondDoc: T1 The most patient-centered and humanistic docs will
occ still have to make decisions for pts--but it can be done better or worse.
EinsteinMed #mdchat
 RT @quality1: @mkmackey re: pts seek physicians w personalities &
amp;...4 their needs. <<Sadly, health plan often restricts
westr & provider must adapt #MDChat
T1 Just like some doctors dont understand concept of e-patients, many pts
EllenRichter dont understand it either! Learning curve for both ends! #MDchat
I live in Houston with access to so many helpful physicians &
mkmackey institutions I sometimes forget this is not the norm #mdchat
RT @EllenRichter: @hjluks T1 Even when pts look 2 U for decisions U can
gently ease them into participating in decision-making & taking
westr responsibility #MDchat
@EllenRichter easier said then done... believe me I try... a lot! SoMe, e, etc
hjluks not for all patients... #mdchat
drseisenberg Steven present. #MDchat
RT @HealthGlobal: Not sure what patients want is a paternalistic MD-What
BraivHC they probably want is a caring MD-That may mean many things #MDchat
@RichmondDoc @hjluks Drs and pts seek answers from each other in a
apjonas human-human, neighbor-neighbor, pt-dr relationship. Not one way. #mdchat
RT @HealthGlobal: Not sure what patients want is a paternalistic MD. What
westr they probably want is a caring MD. That may mean many things #mdchat
@HealthGlobal T1 Some pts still defer to docs' expertise/experience; docs
RichmondDoc need to try and engage them instead of accepting... #mdchat
BraivHC @drseisenberg Welcome! #MDchat
RT @EllenRichter: T1 Just like some doctors dont understand concept of e-
patients, many pts dont understand it either! Learning curve for both ends!
philbaumann #MDchat
TY Ellen! RT @EllenRichter:Just like sme docs dnt get concept of e-patients,
ability4life many pts dnt understand either! Learning curve 4 both #MDchat
@EllenRichter What can we do to facilitate the learning curve for
quality1 empowerment - at both ends? #MDChat
RT @HealthGlobal: Not sure what patients want is a paternalistic MD. What
ability4life they probably want is a caring MD. That may mean many things #mdchat
 @HealthGlobal T1 ...w/o question. But I agree w/ @hjluks: some pts really
*do* look for the doc to give the "right" answer.
RichmondDoc #mdchat
@hjluks T1 I know. Its frustrating. But we are definitely at the cusp of a great
EllenRichter new step in health care & we are part of the change #MDchat
MD_Chat @drseisenberg Welcome & cheers! #MDchat
T1 Docs need to be willing to engage pts, & pts need to be willing to
be active participants & share responsibility in care/outcomes
RichmondDoc #mdchat
@quality1 T1 The best way to facilitate learning is to provide a great deal of
EllenRichter education on the topic. To pts & healthcare providers #MDchat
@EllenRichter perhaps... hopefully it has legs... we have not done a good job
hjluks at modifying behavior... smoking, obesity,etc... #mdchat
@EllenRichter To learn more abt being an #e-patient this w/paper is a MUST
EinsteinMed READ. The best I've read on topic http://bit.ly/3ok4p #mdchat
Docs do have more training ;) RT @RichmondDoc: @HealthGlobal @hjluks:
some pts really *do* look 4 doc 2 give "right" answer.
ability4life #mdchat
RT @EinsteinMed @EllenRichter To learn more abt being an #e-patient ...
quality1 MUST READ. Best Ive read on topic http://bit.ly/3ok4p #MDChat
@quality1 @EllenRichter promote human centering 1st be4 pt-dr centering.
apjonas Commit as humansto inc respect 4 each other be4 pt-dr roles #mdchat
We really need to work it RT @quality1: @EllenRichter What can we do to
westr facilitate the learning curve for empowerment -at both ends? #MDChat
RT @LeadConn: Let's remember 1 of the greatest definitions of #leadership,
EinsteinMed real progress solving issues 2 years fr now. Applies to #mdchat
Thanks! Cant wait to read it! RT @EinsteinMed: To learn more abt being an
EllenRichter #e-patient this w/paper is a MUST READ http://bit.ly/3ok4p #MDchat
@EllenRichter Do you think providers open to this education and change
BraivHC (present company excluded)? #MDchat
Listening also nb RT @EllenRichter: @quality1 Best way 2 facilitate learning :
ability4life 2 provide education To pts & healthcare providers #MDchat
 RT @apjonas @quality1 @EllenRichter promote human centering 1st be4 pt-
quality1 dr centering. Commit as humans to inc respect 4 each other #MDChat
T1 Accepting change in communication and adopting new solutions can take
mkmackey time for everyone #mdchat
@quality1 T1 We need bilat openness and willingness to discuss and dialogue
RichmondDoc in order to bend the learning curve on doc and pt sides. #mdchat
RT @apjonas: @quality1 @EllenRichter promote human centering 1st be4 pt-
dr centering. Commit as humansto inc respect 4 each other be4 pt-dr roles
ability4life #mdchat
@EllenRichter Oops, meant to say "are" open to this...
BraivHC #MDchat
@ability4life Agree that change starts w listening, respect for one another,
quality1 strong communications #MDChat
Shoulder tap: Next topic coming up in a couple minutes! We'll move from
MD_Chat looking at patients' empowerment to physicians'. :) #MDchat
RT @RichmondDoc @quality1 We need bilat openness &
willingness 2 discuss & dialogue in order 2 bend learning curve on
quality1 doc & pt sides #MDChat
@BraivHC @EllenRichter PC docs stressed to gills by med indust complex,
apjonas ready to find alt models. Love pts, will learn to change. #MDCHAT
@ability4life Docs have more training, but it's the patient's life. We need to
RichmondDoc respect that and need to facilitate that connection #MDCHAT
Awriight! RT @quality1: @ability4life Agree that change starts w listening,
ability4life respect for one another, strong communications #MDChat
@RichmondDoc Tough to do, as also takes precious time. I see patient
quality1 advocates as helping to bridge the gap a little #MDChat
RT @RichmondDoc: @ability4life Docs have more training, but it's the
patient's life. We need to respect that and need to facilitate that connection
westr #MDCHAT
@quality1 T1 we also need to make sure we're training new docs to approach
RichmondDoc pts from a pt-centered/pt-first standpoint. #mdchat
 T2 Physician Empowerment: Now let’s discuss your side. In what ways do you
feel "dis-empowered"? (See next tweet as an example.)
MD_Chat #MDchat
@BraivHC T1 I think there could be CMEs on e-patient & e-doctor
EllenRichter concepts. Even those resistant would need to take it. Might sink in! #MDchat
T1 We are colored by present company. The people (D/P) who are not here
Srini2000 may be in no position to engage like we want everybody to ! #mdchat
BraivHC @EllenRichter Great idea! #MDchat
T2 So, for instance, how much are changes in reimbursement, insurance
MD_Chat bureaucracy, etc. stripping away at your resources? #MDchat
Yup 2 both. RT @RichmondDoc: @ability4life Docs have training, but it's the
ability4life pts life. Need 2 respect and facilitate thtconnection #MDCHAT
Gr8 pt! RT @RichmondDoc @quality1 We also need 2 make sure were tring
quality1 new docs 2 approach pts from pt-centered/pt-first standpoint #MDChat
hjluks @MD_Chat in 140 ch ???? #mdchat
T1 epatients position themselves to know their options ... online resources can
StrategicGen assist with the process #MDCHAT
@MD_Chat Reimbursement and bureaucracy issues are major issues; under-
RichmondDoc recognized issues in health care reform. #mdchat
:) RT @Doctor_V Better question: why doesn't anyone call me an e-doctor?
rlbates #MDchat
EllenRichter @hjluks LOL! Definitely laughing. I hear U! #MDchat
RT @EllenRichter: @BraivHC T1 I think there could be CMEs on e-patient
& e-doctor concepts. Even those resistant would need to take it.
westr Might sink in! #MDchat
@Srini2000 That's OK - we need to hear physician perspectives. This is a
MD_Chat little curl in a very long river. Think of it that way. ;) #mdchat
2 true RT @RichmondDoc: @quality1 T1 we also need 2 make sure we're
ability4life training new docs 2 approach pts from pt-centred/pt-1st. #mdchat #hcsmca
T2 I think we need health care payment/delivery reform to improve care and
RichmondDoc reduce costs. Need to value face/face care. #mdchat
Should we? :) RT @rlbates: :) RT @Doctor_V Better question: why doesnt
mkmackey anyone call me an e-doctor? #mdchat
 RT @MD_Chat: T2 Physician Empowerment: Now let’s discuss your side. In
what ways do you feel "dis-empowered"? (See next
philbaumann tweet as an example.) #MDchat
G8 Q! RT @MD_Chat: T2 Physician Empowerment: Now let’s discuss your
side. In what ways do you feel "dis-empowered"?
ability4life #MDchat #hcsmca
hjluks @mkmackey nope #mdchat
@EllenRichter @BraivHC "Need to take it" Won't fly
w/physician. Instant rebellion w/mandates. Drs are people 2. Respect us as
apjonas human #mdchat
@MD_Chat Thanks for comment. I agree. WE have to start somewhere
Srini2000 #mdchat
T2 We can develop office systems to try and reduce admin issues, but the 15-
RichmondDoc 20 minute visit is a limit to providing best care. #mdchat
MD_Chat @hjluks 'Cmon, you can squeeze it in. ;) #mdchat
T2 I hear from medical salesmen that reimbursement ( amount and
Srini2000 procedure) consume an inordinate amount of time. #mdchat
RT @RichmondDoc: T2 We can dev office systems to try &reduce
chukwumaonyeijeadmin issues, but the 15-20 minute visit is a limit to providing care. #MDChat
@apjonas Not advocating for it to be a mandate, but w/o some sort of driving
BraivHC force many will avoid it. #MDchat
. @RichmondDoc @HealthGlobal @hjluks don't disagree w/this but correct
HealthGlobal answers do not mean paternalism. This is contextual. #mdchat
@apjonas Wait a sec. Are U saying doctors dont have to take any continuing
ed that is mandatory? Many professns do & are still human
EllenRichter #MDchat
T2 So long as our system/reimbursement is based on the premise that the
RichmondDoc more you do (tests, visits, etc) the more you get paid... #mdchat
T2: 2008 survey. 49% of p/care docs consider leaving profession due in part 2
EinsteinMed red tape/hassles with insurers. http://bit.ly/aA791b #MDChat
RT @quality1: Gr8 pt! RT @RichmondDoc @quality1 We also need 2 make
sure were tring new docs 2 approach pts from pt-centered/pt-first standpoint
ability4life #MDChat
 T2 ...it becomes very hard to slow down and focus on face-to-face patient
RichmondDoc care. That is a hard fact to face, and very frustrating. #mdchat
hjluks @EinsteinMed and wht are they going to do? cmon.... #mdchat
mkmackey .@hjluks I respect your opinion and agree with you #mdchat
hjluks @mkmackey :-) #mdchat
EllenRichter @EinsteinMed Looking forward to it! :) #MDchat
RT @HealthGlobal: . @RichmondDoc @HealthGlobal @hjluks don't disagree
w/this but correct answers do not mean paternalism. This is contextual.
ability4life #mdchat
T2: we need health care payment/delivery reform to improve care + reduce
HealthGlobal costs. Need to value face/face care #mdchat RT @RichmondDoc //YEP
Agree w/ Howard RT @hjluks: @EinsteinMed and wht are they going to do?
chukwumaonyeijecmon.... (#emptywords) #MDChat
@RichmondDoc Money drives the #visits. Ins has $. Ins calls the shots so doc
apjonas has to work for hosp to get $ and protection. Lose-lose #mdchat
#mdchat T2 we can slowly change the training culture for med students, but
westr that still leaves the problem of educating patient-consumers
T2: W/ new mandates on reporting, ACOs, EMR, sm MD practices cannot
survive & will have to align. No power in forced practice chg
quality1 #MDChat
T2 If e-patients would just start calling us e-doctors we wouldn't have any of
Doctor_V these problems #MDchat
#mdchat sorry I'm late evry1 :) I find the biggest resource hog for minimal
peds_id_doc gain is fighting the ins co's...
T2 There is no question, physicians are strained with administrative
mkmackey demands. Patients respect and acknowledge this #mdchat
T2 Will be interesting to see if the push into ACOs ends up making docs feel
RichmondDoc empowered by taking the reins, or more frustration... #mdchat
RT @EinsteinMed 2008 survey: 49% of p/care docs consider leaving prof d/t
quality1 in part red tape/hassles w insurers http://bit.ly/aA791b #MDChat
Totally RT @EllenRichter: @hjluks LOL! Definitely laughing. I hear U!
drseisenberg #MDchat
 RT @Doctor_V: T2 If e-patients would just start calling us e-doctors we
jodyms wouldn't have any of these problems #MDchat
EllenRichter @Doctor_V LOL you have the answer! :) #MDchat
Good reality check RT @RichmondDoc: bcomes very hard 2 slow dwn and
ability4life focus on face-2-face pt care. Hard fact 2 face, very frustrating #mdchat
RT @Doctor_V: T2 If e-patients would just start calling us e-doctors we
PracticalWisdom wouldn't have any of these problems #MDchat
@quality1 very true... most docs will be hosp affiliated in 5-10 yrs... will not
hjluks encourage empowered MDs #mdchat
@mkmackey T2 I'd like to think that pts understand--many do, many don't.
RichmondDoc Pt requests indicate many *don't* understand admin issues. #mdchat
RT @Doctor_V: T2 If e-patients would just start calling us e-doctors we
philbaumann wouldn't have any of these problems #MDchat
RT @Doctor_V: T2 If e-patients would just start calling us e-doctors we
ability4life wouldn't have any of these problems #MDchat
#mdchat t2 definitely disempowering to have ur plan thwarted by paperwork
peds_id_doc and bureaucracy
#mdchat @EinsteinMed Consumer-patients need to bond together and
westr demand that that change
Sad but true RT @hjluks: @quality1 very true... most docs will be hosp
quality1 affiliated in 5-10 yrs... will not encourage empowered MDs #MDChat
@EllenRichter Disrespectful to imply that you know what docs must learn.
apjonas Yes, almost NO CME is mandatory. Just the #hrs #mdchat
RT @westr: #mdchat @EinsteinMed Consumer-patients need to bond
PracticalWisdom together and demand that that change
Another reality check RT @peds_id_doc: #mdchat t2 definitely
ability4life disempowering to have ur plan thwarted by paperwork and bureaucracy
@mkmackey T2: True re: pts seeing docs overwhelmed. Many pts frustrated
EinsteinMed with rude, disorganized, poorly trained office staff. #mdchat
RT @philbaumann: RT @Doctor_V: T2 If e-patients would just start calling
askmanny us e-doctors we wouldn't have any of these problems #MDchat
.@RichmondDoc I like reading physician's thought bc it helps us appreciate
mkmackey both sides of the fence and hopefully help #mdchat
 T2 My biggest frustration is lack of time. I feel I could do a much better job
RichmondDoc (and use fewer resources) if I had more time w/ pts. #mdchat
RT @EllenRichter: Thanks! Cant wait to read it! RT @EinsteinMed: To learn
more abt being an #e-patient this w/paper is a MUST READ http://bit.
ctsinclair ly/3ok4p #MDchat
RT @EinsteinMed: @mkmackey pts seeing docs overwhelmed. Many pts
ability4life frustrated w rude, disorganized, poorly trained sdmin staff. #mdchat
T2 Current hc dilemmas R frustrating to no end but change will create new
EllenRichter answers-maybe not soon but e-doctors will push forward IMO #MDchat
RT @EinsteinMed: @mkmackey T2: True re: pts seeing docs overwhelmed.
Many pts frustrated with rude, disorganized, poorly trained office staff.
PracticalWisdom #mdchat
T2 However, taking time to have long, engaged discussions w/ pts is not how
RichmondDoc one pays the bills. #mdchat
RT @peds_id_doc: #mdchat t2 definitely disempowering to have ur plan
westr thwarted by paperwork and bureaucracy
T2 It can take me 15 minutes to take a good history and do a good physical for
RichmondDoc abd pain; takes 15 secs to order a $1000 CT scan. #mdchat
Agree RT @mkmackey@RichmondDoc I like reading mds thought bc helps us
ability4life appreciate both sides of the fence and hopefully help #mdchat #hcsmca
@hjluks regarding survey Docs have other career options - esp in
business/pharma/consulting. System pushes some docs over the edge.
EinsteinMed #MDchat
RT @RichmondDoc It can take me 15 min to take a good history &
do a good physical for abd pain; takes 15 secs 2 order $1000 CT scan
quality1 #MDChat
RT @RichmondDoc: T2 My biggest frustration is lack of time. I feel I could do
a much better job (and use fewer resources) if I had more time w/ pts.
westr #mdchat
@RichmondDoc T2 "Engaged' doesnt necessitate lengthy visits. U
can provide links, literature & other info to "
EllenRichter empower" your pt too. #MDchat
 @BraivHC As should be their right. Manipulating professionals=losing game.
apjonas Human respect first for all, then we don't diss ea othr #mdchat
RT @RichmondDoc: T2 It can take me 15 minutes to take a good history and
do a good physical for abd pain; takes 15 secs to order a $1000 CT scan.
PracticalWisdom #mdchat
hjluks @EinsteinMed we'll see #mdchat
RT @RichmondDoc: T2 It can take me 15 minutes to take a good history and
do a good physical for abd pain; takes 15 secs to order a $1000 CT scan.
peds_id_doc #mdchat
@nicolaziady - you're missing a good #mdchat. Check out the stream later.
EinsteinMed #hcsm
RT @RichmondDoc: T2 It can take me 15 minutes to take a good history and
do a good physical for abd pain; takes 15 secs to order a $1000 CT scan.
westr #mdchat
RT @EllenRichter: @RichmondDoc T2 "Engaged' doesnt
necessitate lengthy visits. U can provide links, literature & other
ability4life info to "empower" your pt too. #MDchat
RT @RichmondDoc: T2 It can take me 15 minutes to take a good history and
do a good physical for abd pain; takes 15 secs to order a $1000 CT scan.
jodyms #mdchat
RT @RichmondDoc: T2 My biggest frustration is lack of time. I feel I could do
a much better job (and use fewer resources) if I had more time w/ pts.
peds_id_doc #mdchat
@EllenRichter T2 Once you have established a relationship w/ a pt, can
RichmondDoc empower in shorter visits. But need to lay groundwork. #mdchat
MD_Chat Our hour is almost up. We'll wrap things up in a few minutes. #MDchat
@westr @EllenRichter @BraivHC I'm considering developing such CMEs
ePatientDave #mdchat
@EllenRichter Especially if one empowers patients by discussion and
RichmondDoc dialogue; that takes time and cannot be rushed. #mdchat
Can one not require the patient to do a lot of preparatory work BEFORE
Srini2000 coming to the doctor so quality of face/face time is high? #mdchat
 @hjluks I'm not advocating the exodus by any means. We need as many good
EinsteinMed docs to stay as possible. But the system has to change. #mdchat
@RichmondDoc To suggest that a CT scan gives you any information even
Doctor_V approaching a history is absurd. #MDchat
RT @RichmondDoc @EllenRichter Once you've established a relationship w/
quality1 pt, can empower in shorter visits. But need 2 lay groundwork #MDChat
@MD_chat T2 About 12% per year is stripped away by the medical industrial
apjonas complex of ins, hosp, pharma, etc. #mdchat
I think thats just wonderful & they WILL help! RT @ePatientDave
@westr @EllenRichter @BraivHC I'm considering developing such CMEs
EllenRichter #MDchat
Bravo to you for that!! RT @ePatientDave: @westr @EllenRichter @BraivHC
westr I'm considering developing such CMEs #mdchat
RT @quality1: RT @RichmondDoc @EllenRichter Once you've established a
relationship w/ pt, can empower in shorter visits. But need 2 lay groundwork
EinsteinMed #MDChat
I'm growing tired of the world empower. Can we all decide on a new word?
Doctor_V #MDchat
@Doctor_V Agree--but look at the rate if CT and other imaging in ER
RichmondDoc settings. Think it's done b/c it's faster, not b/c it's better. #mdchat
RT @RichmondDoc: @EllenRichter Especially if one empowers patients by
westr discussion and dialogue; that takes time and cannot be rushed. #mdchat
Wow - that was fast! Before we leave, give us your parting thoughts -
MD_Chat anything: from today's election to cool iPad apps. #MDchat
RT @Doctor_V: @RichmondDoc To suggest that a CT scan gives you any
ability4life information even approaching a history is absurd. #MDchat
We all need the care of our dedicated physicians. Hoping we can help ease the
mkmackey burden #mdchat
BTW - If you'd like to keep chatting about a topic, feel free to do so. The wrap-
MD_Chat up is for those who need to go. #MDchat
RT @RichmondDoc @EllenRichter Esp'ly if one empowers patients by
discussion & dialogue; that takes time & cannot be
quality1 rushed<exactly! #MDChat
 Wonderful! RT @ePatientDave: @westr @EllenRichter @BraivHC Im
BraivHC considering developing such CMEs #MDchat
@Doctor_V Instead of empower, how about "get gutsy"
MeredithGould #MDchat
LOL RT @Doctor_V: I'm growing tired of the word empower. Can we all
ability4life decide on a new word? #MDchat #hcsmca
@philbaumann - Great choice of topics ,..thanks for hosting..I always learn a
Srini2000 lot. #mdchat
RT @mkmackey: We all need the care of our dedicated physicians. Hoping we
jodyms can help ease the burden #mdchat
@Srini2000 T2 One can't require pts to do anything, though it can be
RichmondDoc suggested. Post about that: http://tinyurl.com/2dqffs2 #mdchat
@RichmondDoc T1 But just think. Once you spend that initial time laying a
EllenRichter great foundation to the relationship, U come out ahead #MDchat
We can only really disempower ourselves by becoming resigned. Connection
drseisenberg transforms resignation. #MDchat
BraivHC @MD_Chat Great chat! Thanks. #MDchat
Agreed! RT @EinsteinMed: @hjluks I'm not advocating the exodus. We need
westr as many good docs as possible. But system has to change. #mdchat
T2: Hate that my hosp & I are paid more to give chemo to pts in last
rsm2800 6 wks of life than to talk about why they shouldn't take it #mdchat
Good tweet! RT @mkmackey: We all need the care of our dedicated
EllenRichter physicians. Hoping we can help ease the burden #mdchat #MDchat
RT @westr: Bravo to you for that!! RT @ePatientDave: @westr
quality1 @EllenRichter @BraivHC Im considering developing such CMEs #MDChat
You will be banned from #MDchat for the following words: empowerment,
Doctor_V relationship economy, digital democracy, hive ...
@RichmondDoc T2 Correct. Same pt in ED gets 2 min interview/exam and
apjonas $2200 CT and that's called quality and gets reimbursed far more.#mdchat
RT @drseisenberg: We can only really disempower ourselves by becoming
resigned. Connection transforms resignation. <<well said, thx
quality1 #MDChat
 @EllenRichter Agreed: once the groundwork is set, the relationship is
RichmondDoc fantastic. But challenging to find time early on. #mdchat
RT @rsm2800: T2: Hate that my hosp & I are paid more to give
chemo to pts in last 6 wks of life than to talk about why they shouldn't take it
jodyms #mdchat
@rsm2800 T2 Yes situations like you just mentioned are very sad &
EllenRichter amp; frustrating #MDchat
@Doctor_V Endow. Of course, "well-endowed" patient
MD_Chat could be a lawsuit. #MDchat
Ditto! RT @jodyms: RT @mkmackey: We all need the care of our dedicated
westr physicians. Hoping we can help ease the burden #mdchat
Agree. Lotta md bashing 4 not embracing e RT @mkmackeyWe all need the
ability4life care of r dedicated mds. Hoping we cn help ease burden #mdchat #hcsmca
LOL RT @Doctor_V: You will be banned from #MDchat for the following
WendyBlackburnwords: empowerment, relationship economy, digital democracy, hive ...
@apjonas Yup. We see that daily. Longer and more detailed H&Ps
RichmondDoc are a losing proposition when #s and volume pay the bills. #mdchat
RT @RichmondDoc: @Srini2000 T2 One can't require pts to do anything,
though it can be suggested. Post about that: http://tinyurl.com/2dqffs2
westr #mdchat
F/thoughts. Ever wonder what it would be like to live to 100 or more? Ck out
EinsteinMed our new #SuperAgers video series http://ein.st/c7fYoq #MDchat
RT @rsm2800: T2: Hate that my hosp & I are paid more to give
chemo to pts in last 6 wks of life than to talk about why they shouldn't take it
westr #mdchat
Gotta run. Great discussion as usual. Have a good week everyone . And stay
EinsteinMed empowered! #MDChat #hcsm
THANK YOU, everybody! Another fun #MDchat. If you'd like to moderate let
MD_Chat us know! One of our goals is to empower Physicians. :)
mkmackey Thanks for interesting perspectives! Enjoyed #mdchat
Of course patients can be required to do things. They're equal partners in a
Doctor_V relationship #MDchat
 #mdchat Thanks for the escape and connection in 140 or less. Peace this
apjonas week. pj
RT @rsm2800 Hate that my hosp & I are paid more 2 give chemo 2
quality1 pts in last 6 wks of life than 2 talk about why they shouldnt take it #MDChat
Very interesting chat folks! Thanks for the great topics @philbaumann!
EllenRichter Thanks to all participating! :) #MDchat
The transcript for tonight's #MDchat will be up later. Next chat is Tuesday
MD_Chat 11/9 9pm Eastern. More moderators: more times! Cheers! :-)
Love it RT @Doctor_V: You will b banned from #MDchat for the following
ability4life words: empowerment, relationship economy, digital democracy, hive ...
Excellent discussion tonight. Thanks to all the "e-docs"
quality1 for open discussion of important issues. #MDChat
EinsteinMed @MD_Chat Thank you for moderating. Until next time.... #MDChat
#mdchat great to have physicians getting involved in#hcsm and voicing their
westr ideas and concerns. Night all!
RT @westr: #mdchat great to have physicians getting involved in#hcsm and
EinsteinMed voicing their ideas and concerns. Night all!
Very cool #MDchat tonight - good humor. Any physicians interested in being
philbaumann the first to moderate one of these, let me know.
ability4life #Mdchat gr8 convo, topics, spirit. tnx all.
@Doctor_V Respectfully disagree: pts can't be forced to do anything any
more than docs can. But can agree on ground rules & proceed
RichmondDoc #mdchat
RT @md_chat The transcript 4 tonight's #MDchat will be up later. Next chat
quality1 is Tuesday 11/9 9pm EST. More moderators: more times! Cheers! :-)
RT @PhilBaumann: Very cool #MDchat tonight - Any physicians interested
westr in being the first to moderate one of these, let me know. #pm101
#MDchat I'm going to Fam Med Practice Improve conf 2 particpate in topic:
ability4life to twitter or not to twitter
@sesiegler Do you mean this? http://mdchat.org/about/ If not, let me know.
philbaumann #mdchat
RT @quality1: RT @md_chat The transcript 4 tonight's #MDchat will be up
ability4life later. Next chat is Tuesday 11/9 9pm EST. #hcsmca
 RT #MDchat I'm going to Fam Med Practice Improve conf 2 particpate in
ability4life topic: to twitter or not to twitter #hcsmca
RT @philbaumann: Very cool #MDchat tonight - good humor. Any physicians
FutureDocs interested in being the first to moderate one of these, let me know.
END CHAT
Twitter.com/MD_chat
MDchat.org
Moderated by @PhilBaumann
Twitter.com/PhilBaumann
PhilBaumann.com