How does this work? part 2 Grassley's question number 6

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from page 13 of this document, that Dr Steve Balt placed on Twitter, in attempt to expose a colleague

Question 6

Have any of the prescribers identified to this Committee been referred to your state medical board?


Read the list of questions and ask yourself if Senator Grassley would be interested in the 2009 top 10 prescriber of Seroquel Dr Steve Balt, and his medical license being suspended (on probation) during the 2009 writing of over 1000 rx for Seroquel. Seroquel is known to be used off-label, and one must question the medical office setting where Balt worked at the time as being a player in the Medicaid, Medi-Cal fraud investigation. Were those patients rx'd Seroquel (antipsychotic) for indication use approved in 2009? or was it off-label? were the bulk of the recipients of the prescriptions Medicaid patients?

Book review: Between the Lines--Finding the Truth in Medical Literature by Marya Zilberberg, MD

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"Has regulation of the medical field 
assured integrity and patient safety?"

Asks the author, Marya Zilberberg, MD, in her new book Between the Lines: Finding the Truth in Medical Literature. The book, states Zilberberg, is intended to give "basic tools" for the consumer (we are all medical consumers) to use to examine medical literature critically, and systematically. The book is useful reading for a diverse group, such as medical librarians, medical professionals, patients, clinicians and just about anyone who may walk into a doctor's office or medical building, who wants to be informed and armed with the knowledge to ask smart questions, as well as review medical journals with a critical eye.

Zilberberg takes the reader step-by-step in learning terms, definitions, lists of questions to ask doctors as well as questions to ask yourself when reading and reviewing medical literature.

The book is a useful tool intended to help the consumer prevent "falling prey" to quackery and disease-mongering. What could be one of the worst days of a person's life with a diagnosis of cancer ( one example in the book) could end up being a preventable and costly mistake if the patient knew to question the alternative treatment offered by the doctor; and would have saved the patient angst if the patient asked for a 2nd opinion as well. Zilberberg wants the patient to be empowered, informed, to ask questions and be an "educated consumer".



There is a great list of 12 questions for the patient to ask their doctor:

Example: #6: "If I need an invasive test, what are the odds that it will yield a useful diagnosis that will alter my care?"  
               #12 How much will all of this cost....."


Zilberberg states that most doctors should understand the value of participatory medicine and shared decision making (decisions made with the patient in open conversation) and if your doctor does not appear to be on the same page regarding being an active participant, then "educate them", by opening the conversation. In the end, the quality of care for the patient goes up and the chances of future litigation can go down for the doctor, when participatory medicine is used.

The book goes into great detail in the 2nd part explaining several types of studies and how to read them critically, with questions listed for the reader to ask themselves while reading the studies and conclusions.

The book is easy to read, enjoyable, and gives us all a lesson in how to critically evaluate medical literature.



                                                         ~~~~~~~~~~~~~~~~~~~


About Marya Zilberberg, MD: (from her website, linked below)

Between the Lines

About Marya

Marya Zilberberg, MD, MPH, has studied, practiced and taught evidence-based medicine for two decades. Her passion is teaching everyone how to evaluate scientific evidence with a critical eye. She is the Founder, President & CEO of EviMed Research Group, LLC, a research and scientific communication consultancy. She is also an Adjunct Associate Professor of Epidemiology at the School of Public Health and Health Sciences at the University of Massachusetts, Amherst, as well as a Senior Fellow at the Jefferson School of Population Health at the Thomas Jefferson University in Philadelphia. She has authored or co-authored over 150 peer-reviewed articles, abstracts and book chapters. A veteran peer reviewer for a number of medical journals, she serves on the editorial boards of Critical Care Medicine and Comparative Effectiveness Research journals. She chairs the Clinical Research NetWork of the American College of Chest Physicians.

A dynamic and witty speaker, Zilberberg is frequently invited to deliver keynote presentations and Grand Rounds lectures on critical thinking, research methods, evidence-based healthcare and healthcare-associated complications. She tweets and blogs at Healthcare, etc. In her spare time she loves to take hikes in the foothills of the Berkshires in Western Massachusetts, where she lives with her family. 
Amazon--Between the Lines

Pharma! "citizens as human guinea pigs for secret clinical trials in return for hard currency"

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VIA 1 Boring Old Man blog:  an unimaginable story... 

Snippet:


East Germany let drugs companys use its citizens as guinea pigs
^{The East German communist state allowed Western pharmaceutical companies to use its citizens as human guinea pigs for secret clinical trials in return for hard currency, it has been revealed.}
Daily Telegraph
By Matthew Day
05 Dec 2012^{East Germany made millions of deutschemarks from the trade that ran for six years and only came to an end with the collapse of the socialist state in 1990 despite the fact that some patients died during the trials. The allegations of the use of unwitting human guinea pigs came in a documentary called "Tote und Deaths" Death and Tests which was aired on German television earlier this week. Although the destruction of old East German health ministry files made it impossible to determine the exact number of sick people involved, the documentary estimated that over the years thousands were caught up the deadly testing.}

It's National VNA Week!

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The following is from an email I just sent to our fantastic staff:

This week, we celebrate National VNA Week and acknowledge and celebrate the invaluable work we do to keep patients home, where they most want to be. It’s even more special this year because we also are celebrating 125 years of providing excellent care for our community. We have a proud history and we can look forward to our future…. the VNA of Boston & Affiliates is more relevant now than ever before.

We are there at the start of life and we are there at the end of life providing compassionate care so that patients have the best quality of life they can with dignity and independence. Here is a sampling of some of the comments we receive from our patients:

“VNA of Boston is consistently excellent! VNA has improved my quality of life & sense of wellness!!!”

“I was treated with the greatest respect and courtesy.”

“They made me feel safe and secure in helping me get better and made a good recovery in regaining my health back.”

“We have had multiple experiences - OT's, PT's, nurses - all have been great.”

“I was very impressed with the professionalism of all who helped me. Thank you very much!”

“The care was excellent and I would highly recommend the VNA to anyone. Everyone was great.”

Thank you all – to all the clinicians in the field and the staff in the office who support their work – for your expertise, your passion and commitment, and your contribution to the future of the VNA of Boston & Affiliates.

Rey

"It's what we do... we are nurses..."

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For most of my career, I've been fortunate enough to work with clinicians who heal and who care.  Who bring skill and experience, and a frequently unquenchable compassion, into situations that many of the rest of us would do nearly anything to avoid.  I may be inclined to exit... while they rush in.

Meet Barbara, a nurse manager from the Visiting Nurse Association of Boston.  And here are a few of her photos of her native Haiti.  Idyllic and beautiful, as in the sunlit bay above.  Tragic and devastating, as in what follows.

Tuesday, January 12, 2010.  A catastrophic magnitude 7.0 earthquake with an epicenter only 25 kilometers west of capital city, Port-au-Prince.  Ultimately... 316,000 dead.  300,000 injured.  1,000,000 homeless.

And Barbara rushed in.

Here's her story... from the beginning.

Barbara grew up in Carrefour, a suburb of Port-au-Prince, with her mom, a teacher, and dad, an owner of an auto repair business, and brother and sister.  It was a happy, largely uneventful time... until her father became sick.  Among his ailments, Barbara's father also suffered from decubitius skin ulcers, which then (and even still today in Haiti) were poorly understood.  Barbara, then 13 years old, remembers being angry when her father, a proud man who resisted family pressure to move to the United States, told her "not to worry" and that he would be around for "another ten years".  Unfortunately, that was not to be the case.

At the age of 16, Barbara and her remaining family members moved to Florida and then eventually to Cambridge, Massachusetts.  Barbara and her sister, Beatrice, held a variety of jobs and when Barbara decided she wanted to become a nurse, Beatrice, then a medical assistant, helped her to pay for the training.  When Barbara completed nursing school, she began working and then helped to finance Beatrice's nursing education.  Barbara continued on to earn her bachelor's degree and is now studying for a master's in health care administration.

Barbara remembers well that day in January, 2010.  Reports of an earthquake began surfacing, with no one fully aware of its magnitude or impact.  Beatrice called Barbara and gave her an update.  It was far worse than expected.  Far worse.

Barbara recalls: "We were looking at the news.  We couldn't believe it.  Nobody knew what was happening.  We started calling our family there but no lines were open.  We were so worried.  We couldn't sleep.  We tried calling the UN but couldn't get through.  We just didn't know what to do.  I was desperate..."

The overwhelming emotion was helplessness.  "People there were dying and I thought, I'm a nurse.  I have to help."  Partners in Health, an organization dedicated to improving the quality and access to health care services in poor and developing areas, called Beatrice on Saturday and asked to deploy her to Haiti on the following Monday.  A month later, Barbara's call came.

It was a two week assignment.  The lead time was limited.  According to Barbara, "you just pack your bag and go."

She recalls departing the airport in Haiti.  She remembers looking around at the rubble, the devastation, the places where buildings once stood.  "It was tough to see a country you left and is no longer there."

Barbara was stationed at the General Hospital in Port-au-Prince.  "Once you got there, the gate was closed and you couldn't leave."  And once there, she and her companions worked for 10 days straight, during 7PM to 7AM shifts.  Barbara remembers being struck when she saw the former sight of a nursing school next to the hospital which she had seen as a child.  "It was no longer there.  It was completely flat.  I wondered how many people were trapped underneath."

After a quick orientation from the physician-in-charge, Barbara was given a brief tour and was immediately "put to work."  She described the first day as "one of the worst days of my life.  There were 300 to 400 patients there all needing care... from TB to fractures to missing limbs to wounds... to people who were just dying.  Just name it - it was right there looking at you..."

When asked how she responded to that, Barbara describes: "You start to work.  Your forget about everything else.  You just tried to save everyone you could.  You just do whatever you can."

She remembers one young girl at the hospital.  She had lost nine members of her family in the tragedy.  "She was so thin.  You could see only bones.  She would not eat or drink... and she never spoke... except at night, she would scream out the names of her family who were now lost to her.  I remember seeing a lady who stayed with her.  She was from the local church and she slept on the floor, giving the girl a sip of water."  Despite their efforts, the patient passed away.

Another patient, a 27 year old woman with renal failure and high blood pressure, was experiencing significant physical and emotional stress.  Barbara knew the patient needed oxygen and fast, so she ran down the hall looking for a tank.  A simple tank of oxygen.  Plentiful in every hospital where Barbara has worked, but scarce in Port-au-Prince's General Hospital.  Barbara called out: "This girl's going to die, her heart's going to give out soon... "... and remembers seeing the desperate look in the woman's eyes.  The patient said to Barbara: "Please don't leave me.  If you leave me, they're going to let me die."  Barbara knew she was right.

The patient eventually received the oxygen and the vital dialysis she required and lived.

There was also an older woman patient who "could have been my mother."  She had two wounds in her lower legs; "it looked to be a diabetic ulcer".  Barbara watched this patient fade from an amiable, even joking, favorite among the nurses, to one who became more and more ill and despondent.  At one point, she had no clothing or even sheets, leaving one of the nurses to donate some of her own clothing to the patient.  The patient died, alone and in pain.  Per Barbara, "there was no reason for her to die that way..."

Barbara looks back at the experience and feels that: "We didn't do enough.  There's so much more to do there.  And it's not over there.  It's terrible what's happening in the tent cities there now.  It's just horrible still... but I want to go back."

When asked why she wants to return, Barbara lowered her eyes and said, simply and solemnly: "It's what we do... we are nurses..."

If you're interested in learning more about Partners in Health, please click here.

If you'd like to help, click here.

 

Posted by Rey

What a Day. And Then There's Tomorrow.

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Yesterday I left my hotel at 5:30am and took a cab to Boston Logan Airport to pick up a rental car for the day. I then spent 11 hours traveling across Massachusetts meeting with physicians, office managers and referral coordinators at various medical practices. Days like this, where I am in the field visiting practices and listening to healthcare professionals, are so rewarding. I learn so much. And I always return to my hotel exhausted.

However, yesterday was a little different in that I knew I was going to have dinner with my good friend Chris Boyer. You see, Chris Boyer, healthcare social media and digital media rock star, is our keynote speaker today (Friday) at a one-day conference held by the Massachusetts Hospital Association and the New England Society for Healthcare Communications. I served on the planning committee for the conference and helped to put together the panel of speakers which also includes Zoe Finch Totten, CEO of the Full Yield, an organization committed to improving public health by making high-quality food, high-quality behavioral support, and high-quality education about food and health systemically sustainable. It is a treat to have both Zoe and Chris speaking at this event!

Several weeks ago a physician I know in the Boston area, Dr. Merlin, recommended Myers & Chang, knowing my love for Asian food. With Chris coming to town, I thought this was the perfect opportunity to give the restaurant a try. So at 8pm last night Chris and I strolled down Washington Street and entered the world of Myers & Chang. It was a hit from the moment we walked in the door. The place was buzzing with activity. The staff was attentive, and the food was extraordinary. At Myers & Chang they serve the food family style and everyone at the table shares the offerings. Here's what Chris and I savored:

Fresh rolls - herbs, lettuce, tofu, spicy peanut sauce

Pot stickers - shiitake and chinese greens

Stir fried clams with fermented black bean sauce - island creek clams, watercress, vermicelli

Wok charred octopus + grilled corn - sriracha butter, spring onion

Chicken and waffles - ginger-sesame waffle, hot + sweet sauce

The dinner was sensory overload. The flavors were unreal. And getting to spend the evening catching up with Chris was spectacular. I am grateful for times like this. And I am grateful for the friends I've made over the years - and for those I have yet to make.

Above all, I can't wait to get home to my family tonight. I have been gone too long, It is time to get home. I'm looking forward to a weekend with Scotti and Meg.

Note: Myers & Chang retweeted our Tweets from the restaurant and sent us a thank you Tweet! (@myersandchang) These people know what they are doing. Dinner there is a total experience.

It's Another Pink Glove Championship for Lexington Medical Center

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Against all odds, the team at Lexington Medical Center (my client) has repeated as the Pink Glove Dance Video Contest champion! This would be a remarkable accomplishment for any organization, not to mention a mid-sized community hospital in West Columbia, South Carolina. If you'd like to watch Lexington Medical Center's 2012 Pink Glove Dance Video, click here. I embedded it in an earlier blog post.

The process of participating in the Pink Glove Dance Competition, and then actually winning the contest, led to a significant amount of press coverage: local, regional and national. It was exciting Friday to watch hundreds of Lexington Medical Center employees dancing on national television, as the Fox & Friends Morning Show did live shots from the hospital. Of course, these dedicated employees gathered at 4am for the morning show appearance! Below are some screen shots that I took of some of the press coverage.

Congratulations to the employees at Lexington Medical Center, the marketing team, and members of the community who all rallied to support the hospital's Pink Glove video. This is an amazing example of audience engagement, on so many levels. It is also a testament to the culture at Lexington Medical Center - a culture that clearly resonates with employees and members of the community.

Now my only question is: Will Lexington Medical Center go for a third Pink Glove Dance Video Championship? Yikes!

Meet the Crouse Hospital Germinators!

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Earlier this week I was contacted by Bob Allen, the VP of Communications at Crouse Hospital in Syracuse, New York. I am grateful to Bob for sharing with me a special project that was undertaken by a small group of Crouse clinicians. Dave Martin, RN, Infection Control; Todd Olrich, CNS; Waleed Javaid, MD, Infection Control Medical Director; Mickey Lebowitz, MD, Senior Medical Quality Director; and Dennis Brown, MD, Senior Surgical Quality Director all got together and created a video titled "The Germinator." Not only did they create the video, but they starred in it as well! As Crouse states on its website, "this team produced a ‘homemade’ video that uses music and humor to convey a very important message: Hospital Acquired Conditions (HACs) are deadly serious – and Crouse Hospital is deadly serious about reducing and eliminating them." My understanding is that the idea for the video came from the very fertile and active mind of Mickey Lebowitz, MD, who serves as senior medical quality director for Crouse Hospital.

According to Bob, employees who have seen the video love it. What more can you ask? If it's generating talk among hospital employees, then I judge it to be a success. Congrats to the team at Crouse Hospital.

Check out the video below. Enjoy! Isn't it cool that these clinicians took the initiative to produce this video all on their own? I applaud the initiative. For more info on the campaign, click here.

Instagram & Facebook Have Gone Too Far

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(For an update to this story - news of a recent retraction by Instagram - go to this story on Mashable. Here's a link to the Instagram blog post retracting the new policy.) I love Instagram. It allows me to shoot photos, apply cool filters, and then easily post them on multiple social media platforms. So why do I plan to cancel my account later this month? Well, a few months ago Facebook bought Instagram. That was okay, at first. Now Facebook/Instagram has announced a new policy whereby it has the right to sell or license any public Instagram photos without paying for them or even informing the photographers. So every photo I have posted on Instagram can be used by Instagram/Facebook without my permission! Here's the actual language of the policy:

“Some or all of the Service may be supported by advertising revenue. To help us deliver interesting paid or sponsored content or promotions, you agree that a business or other entity may pay us to display your username, likeness, photos (along with any associated metadata), and/or actions you take, in connection with paid or sponsored content or promotions, without any compensation to you.”

So, it appears they can sell your photos to any business or individual - including photos that contain images of you and your family members. Essentially, as I understand it, Instagram would become this amazing stock photo outlet, without having to pay for the images. What a business model!

That's why I'm closing out my Instagram account later this month. Users who fail to close out their accounts by January 16, 2013 will lose the rights to their images posted on Instagram - unless Instagram and "big brother" Facebook change their minds. If you are currently using Instagram, I suggest you give this some thought. This is not to be taken lightly.

Giving Back - December 2012

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When I'm feeling down (it happens on occasion) I make a special effort to do something nice for others, knowing that giving will typically pull me out of a funk. It makes me feel better. Given the tragedy that our nation has been facing over the last few days, the timing could not have been better for Jennings' annual holiday outreach event. This year we decided to cook dinner for the guests at Family House at UNC Hospitals. Family House provides housing and hope to families with an adult patient being treated for a critical illness or injury at UNC Hospitals or its affiliated clinics. I was fortunate to serve on the organization's board of directors in 2005 as we sought funding to build this remarkable facility. Family House serves approximately 2,400 patients or family members in a given year. To date, Family House has provided more than 114,000 stays to patients/patient families from all 100 of NC’s counties, 35 other states and 7 foreign countries.

So last night my team and I packed up our vehicles with the dishes we had prepared and we ventured over to Family House to serve the meal to its 35 guests. I was so impressed with the care my staff took to deliver an amazing holiday meal. The menu included green bean casserole, roasted carrots, mashed potatoes, corn casserole, ham, turkey, macaroni and cheese, chicken marsala, sweet potatoes, chicken tetrazzini and a number of desserts. The guests claimed to thoroughly enjoy the feast!

We each headed back to our homes last night feeling a little less depressed and with more hope in our hearts. I know it might sound trite, but it is the absolute truth. I am grateful that we had this opportunity to give back. Happy Holidays. Below are some photos from the event.

Today's Lesson on How to Rid Society of People with Disabilities

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Just when you think that you've heard all of the ways that the USA tries to eliminate people with disabilities, the USA comes up with another strategy to catch more of us in the net. Today's atrocity can be read about here:

Cindi Silvers Davis and her husband, have tried very hard to work with their bank, Wells Fargo, but they say they have been mislead, they have been treated poorly, and now Wells Fargo is trying to put an advanced stage cancer victim out on the street.

I have an incurable cancer, but these days lots of folks like me and others with advanced stage cancers can go on to live decades beyond diagnosis IF WE RECEIVE THE PROPER TREATMENT.

In order for me to get it, my partner and I had to forgo any state-recognized marriage. Cindi Davis is married with a (modest) home. It sounds like she's stuck in the same situation that I faced. She's not going to be able to get Medicaid without selling all they have. The state expects the person to use all of your resources before it will even consider letting you into the program.

If she was pregnant, she might qualify for a Medicaid program in some states, but not all. Of course, getting pregnant while you're in cancer treatment is disastrous, ill-advised, life-threatening. So, she's stuck.

Cindi and her husband tried to hold on to some sense of stability by continuing to make payments on their house, despite having to bear the cost of her needed treatments at the same time. The bank could have accepted the payments that they tried to make. They could suspend their payments for a period of time and just tack on interest.

Wells Fargo could work with the Davis family, still make money off of the loan and allow the family to stay in their home. But they don't want that. Instead, they're foreclosing on them. If the succeed, it will mean that all of the payments that the Davis' have already paid would be money down the drain. The bank would have their previously paid payments and the house. Doesn't that sound like a pretty sweet deal for the bank? I think so! It's unconscionable and the Davis family would be homeless, but why would that be a problem for Wells Fargo? They can simply re-sell the home and sucker yet another family into a mortgage they may never be able to pay off.

The Davis' are already struggling to afford Cindi's treatment. If Wells Fargo takes house, then they won't have to make any more mortgage payments. That should make it easier to afford her treatment right? Wrong! Anyone who has ever had to live out of a motel room for an extended period of time knows how much more expensive it is than when you're in a home.

There's no stove, so you have to eat out for each meal. There's no privacy. "Room Service" comes in whenever they want to. There's no storage space. So, if you have any belongings you're trying to hold on to until you get back on your feet (e.g. your great-great grandmother's dining table, your bed, your pots and pans, a refrigerator, washing machine, stove) they have to be put in storage. Unless you have a friend whose willing to allow you to keep this stuff on their property for an undefined period of time, you will have to pay for storage space. The more stuff you try to hold on to (so that you don't have to spend money buying it all again, if you do find an apartment or house to rent), the more you'll have to pay to store it. If you keep fewer possessions, your storage fee will be cheaper, but it may wind up costing you more in the end, because you'll need money to replace those items if you find another home.

I hope that anyone reading this will now understand how easy it is for someone to find themselves living on the streets for years, just because you or your partner made the mistake of getting sick in the United States of Hellmerica.

Being Poor Doesn't Mean You're Stupid or Wasteful

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I saw this on Facebook today and started thinking about my childhood.


My mom had done things "right". She was a married church-going mom with 4 kids. She sewed most of our clothes and cooked every meal from scratch. When I was 8, my dad got a great job offer to transfer to a new city. Unfortunately, the bastard used that opportunity to tell his wife he'd been having an affair and was leaving us behind.

My mom found a job, but had to work overtime just to keep the lights on. Our house went into foreclosure and we moved into a rental.

She never took the welfare cash, but did apply for food stamps. And why the hell shouldn't she?! She'd done what society says a woman was supposed to do, but still got screwed. Food stamps didn't enable us to get the sort of food that we used to eat when my dad was around, but it kept us from starving.

My mom kept seeking better work. She got a job at Marshall's and the employee discount allowed her to buy me clothes nice enough to avoid getting teased. My brothers were so tall that they wore sizes that aren't carried at discount stores.

We practically stalked the local second-hand stores. If you've never been to one, you'd probably be surprised just how much brand new stuff you can find. Some of the stuff still had the original store tags on them.

As an adult, I'm in a better financial state, but I still the second-hand stores are my first stop when I'm looking for clothes. I can't tell you the last time I bought a shirt for more than $10. My daughter bought her gown for the homecoming dance for five bucks and it was prettier than any of the stuff we saw at Macy's.

The Doctor's Office. Reinvented.

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I subscribe to a daily eblast about trends in NYC. The blast is called DailyCandy. Earlier this week the folks at DailyCandy sent out an HTML email promoting One Medical Group in Manhattan. The email shows a photo of a non-traditional environment that looks more like a European boutique hotel than a medical practice. But what caught my attention was the advertising copy that accompanies the image. Here's the copy:

You exercise, moisturize, and otherwise prioritize the temple that is your body. So why do you still go to a doctor’s office that feels like a livestock car on the Trans-Siberian Railway?

Now you can say so long to that rotating roster of zombies so sleep-deprived you end up giving them health advice. One Medical Group teams you up with a primary care physician who gets to know you personally (and even answers questions by email).

The practice operates on the basic principle that your time is valuable — so appointments start on time, last longer, and are easy to book online, even for the same day. Plus, six convenient Manhattan locations provide treatment options beyond the UES.

One Medical accepts most insurance plans and provides services beyond what insurance covers, supported by an annual membership fee of $199. Right now, the group is offering DailyCandy readers 20 percent off their first year’s membership (use code DYNYX20) when they sign up by January 10, 2013. (Offer is good for new members only.)

Think of it as a health club that’s really about your health.

Join One Medical by January 10, 2013 and enter code DYNYX20 on the membership confirmation page to receive 20 percent off your first year’s annual membership fee.

One Medical is effectively differentiating itself via this well-crafted copy. There's no reason a doctor's office (or hospital, for that matter) should feel like a "livestock car on the Trans-Siberian Railway." But they often do! And patients are often treated like livestock - herded around from one holding pen to another - poked and prodded without much explanation. I applaud One Medical for this brand positioning and redefinition of the medical practice. Below is a screen shot of the actual HTML ad. If you click on it you can see an enlarged version. Enjoy!

What a Day. And Then There's Tomorrow.

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Yesterday I left my hotel at 5:30am and took a cab to Boston Logan Airport to pick up a rental car for the day. I then spent 11 hours traveling across Massachusetts meeting with physicians, office managers and referral coordinators at various medical practices. Days like this, where I am in the field visiting practices and listening to healthcare professionals, are so rewarding. I learn so much. And I always return to my hotel exhausted.

However, yesterday was a little different in that I knew I was going to have dinner with my good friend Chris Boyer. You see, Chris Boyer, healthcare social media and digital media rock star, is our keynote speaker today (Friday) at a one-day conference held by the Massachusetts Hospital Association and the New England Society for Healthcare Communications. I served on the planning committee for the conference and helped to put together the panel of speakers which also includes Zoe Finch Totten, CEO of the Full Yield, an organization committed to improving public health by making high-quality food, high-quality behavioral support, and high-quality education about food and health systemically sustainable. It is a treat to have both Zoe and Chris speaking at this event!

Several weeks ago a physician I know in the Boston area, Dr. Merlin, recommended Myers & Chang, knowing my love for Asian food. With Chris coming to town, I thought this was the perfect opportunity to give the restaurant a try. So at 8pm last night Chris and I strolled down Washington Street and entered the world of Myers & Chang. It was a hit from the moment we walked in the door. The place was buzzing with activity. The staff was attentive, and the food was extraordinary. At Myers & Chang they serve the food family style and everyone at the table shares the offerings. Here's what Chris and I savored:

Fresh rolls - herbs, lettuce, tofu, spicy peanut sauce

Pot stickers - shiitake and chinese greens

Stir fried clams with fermented black bean sauce - island creek clams, watercress, vermicelli

Wok charred octopus + grilled corn - sriracha butter, spring onion

Chicken and waffles - ginger-sesame waffle, hot + sweet sauce

The dinner was sensory overload. The flavors were unreal. And getting to spend the evening catching up with Chris was spectacular. I am grateful for times like this. And I am grateful for the friends I've made over the years - and for those I have yet to make.

Above all, I can't wait to get home to my family tonight. I have been gone too long, It is time to get home. I'm looking forward to a weekend with Scotti and Meg.

Note: Myers & Chang retweeted our Tweets from the restaurant and sent us a thank you Tweet! (@myersandchang) These people know what they are doing. Dinner there is a total experience.

It's Another Pink Glove Championship for Lexington Medical Center

To contact us Click HERE
Against all odds, the team at Lexington Medical Center (my client) has repeated as the Pink Glove Dance Video Contest champion! This would be a remarkable accomplishment for any organization, not to mention a mid-sized community hospital in West Columbia, South Carolina. If you'd like to watch Lexington Medical Center's 2012 Pink Glove Dance Video, click here. I embedded it in an earlier blog post.

The process of participating in the Pink Glove Dance Competition, and then actually winning the contest, led to a significant amount of press coverage: local, regional and national. It was exciting Friday to watch hundreds of Lexington Medical Center employees dancing on national television, as the Fox & Friends Morning Show did live shots from the hospital. Of course, these dedicated employees gathered at 4am for the morning show appearance! Below are some screen shots that I took of some of the press coverage.

Congratulations to the employees at Lexington Medical Center, the marketing team, and members of the community who all rallied to support the hospital's Pink Glove video. This is an amazing example of audience engagement, on so many levels. It is also a testament to the culture at Lexington Medical Center - a culture that clearly resonates with employees and members of the community.

Now my only question is: Will Lexington Medical Center go for a third Pink Glove Dance Video Championship? Yikes!

What Do Referring Physicians Want?

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Recently I've spent a lot of time visiting primary care practices and listening to physicians and their staff talk about making referrals to specialists. What I heard may not surprise you; but, at a minimum, it is always good to have your assumptions confirmed. So what did these referring physicians have to say?

1. They want happy patients who are satisfied with their experience.
2. They don't want you to complicate their life! If they send you a referral, don't make them regret it.
3. If making a referral turns into a big hassle, they will avoid referring to that physician in the future. The last thing a referring physician wants is to hear from a patient that they weren't treated well or had difficulty getting an appointment.
4. They want timely communication from the specialist - particularly some kind of discharge summary.
5. Physicians want their patients seen relatively soon. Long waits lead to unhappy patients. So you have a competitive advantage if you can get the patient in to see one of your specialists in a timely fashion.
6. They want their patients returned. Don't thank a referring physicians by stealing his or her patients.
7. Often it is not the physician who makes the actual referral. Often it is a referral coordinator, medical assistant, practice manager or staff person who helps select the specialist that will get the referral.
8. Many patients leave the physician's office with a recommendation, but then choose to make their own choice after speaking with friends and family. A recommendation from a friend on Facebook may carry as much weight as a recommendation from the primary care physician.
9. Although a physician may have a strong preference for a specific specialist, if the patient or family has strong opinions of their own, the physician will typically relent.
10. The longer the relationship between they physician and the patient, the more likely the patient will be to follow that physician's recommendation.
11. According to physicians, patients like knowing that there is an established line of communication between their primary care doctor and the specialist.

Carolinas Healthcare Public Relations and Marketing Conference This Week

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This Wednesday through Friday the Carolinas Healthcare Public Relations and Marketing Society (CHPRMS) will hold its annual fall conference in Charleston, SC. I've been a member of this organization for ages now and always enjoy attending its conferences. The quality of the speakers and presentations often rivals some of the national conferences and attendance is always impressive. This isn't what I would call a "small regional conference." From my perspective, this is a major event.

My team is heading down on Tuesday afternoon to set up our booth and prepare for day one. I'll be driving down on Thursday hoping to take in as much of the conference as possible. Although the educational sessions are always terrific, the highlight of the conference is the Wallie Awards reception and dinner. Although Jennings' clients are spread out across the county, primarily up and down the east coast, we do have a couple of hospital clients in the Carolinas: Vidant Health and Lexington Medical Center (West Columbia, SC). It is always exciting to see them garner recognition for their marketing and public relations efforts. Both hospitals/health systems have gone through big years with Vidant rebranding its health system and with Lexington Medical Center winning the national pink glove dance competition for the second year in a row.

Attending the conference for Jennings will be Dewey Mooring and Ashley Andrews. If you happen to be attending the event, please say hello to Dewey and Ashley. They are both smart healthcare marketers. Amazingly, this is the first CHPRMS conference for each of them. (Dewey is a regular at the New England Society's annual conference and at SHSMD.) Usually Bruce Wlach, Cassie Stox and I have represented Jennings at CHPRMS. With so many healthcare marketing shows, we have to divide and conquer.

I hope to see you at the 2012 CHPRMS conference. Charleston, here we come!

30th Annual Healthcare Advertising Awards

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The deadline for the 30th annual Healthcare Advertising Awards (HAA) competition is fast approaching. I received an email reminder today about the early deadline for entries. This is a sure sign that we are once again in the middle of awards season. It is the oldest and largest among healthcare advertising competitions. Last year's Healthcare Advertising Awards had nearly 4000 entries. A national panel of judges grants awards to those entries that exemplify exceptional quality, creativity and message effectiveness.

Deadline and cost: Entries must be postmarked no later than Friday, February 15, 2013 for the regular rate of $40. Early Bird Special: $30/entry before Jan 29th. Late entry deadline is March 8, 2012 at the $50 late entry fee.

For more information about the Healthcare Advertising Awards, click here.

Other awards competitions on the horizon include the Aster Awards and the Tellys. For those of you who work in New England, the Lamplighter Awards deadline is January 28th. Lamplighters are the annual awards of the New England Society for Healthcare Communications. Last week I attended the Wallie Awards dinner and reception. The Wallies are the advertising and PR awards given out the the Carolinas Healthcare Public Relations and Marketing Society. For my team, this event usually kicks off awards season.

It's National VNA Week!

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The following is from an email I just sent to our fantastic staff:

This week, we celebrate National VNA Week and acknowledge and celebrate the invaluable work we do to keep patients home, where they most want to be. It’s even more special this year because we also are celebrating 125 years of providing excellent care for our community. We have a proud history and we can look forward to our future…. the VNA of Boston & Affiliates is more relevant now than ever before.

We are there at the start of life and we are there at the end of life providing compassionate care so that patients have the best quality of life they can with dignity and independence. Here is a sampling of some of the comments we receive from our patients:

“VNA of Boston is consistently excellent! VNA has improved my quality of life & sense of wellness!!!”

“I was treated with the greatest respect and courtesy.”

“They made me feel safe and secure in helping me get better and made a good recovery in regaining my health back.”

“We have had multiple experiences - OT's, PT's, nurses - all have been great.”

“I was very impressed with the professionalism of all who helped me. Thank you very much!”

“The care was excellent and I would highly recommend the VNA to anyone. Everyone was great.”

Thank you all – to all the clinicians in the field and the staff in the office who support their work – for your expertise, your passion and commitment, and your contribution to the future of the VNA of Boston & Affiliates.

Rey

"It's what we do... we are nurses..."

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For most of my career, I've been fortunate enough to work with clinicians who heal and who care.  Who bring skill and experience, and a frequently unquenchable compassion, into situations that many of the rest of us would do nearly anything to avoid.  I may be inclined to exit... while they rush in.

Meet Barbara, a nurse manager from the Visiting Nurse Association of Boston.  And here are a few of her photos of her native Haiti.  Idyllic and beautiful, as in the sunlit bay above.  Tragic and devastating, as in what follows.

Tuesday, January 12, 2010.  A catastrophic magnitude 7.0 earthquake with an epicenter only 25 kilometers west of capital city, Port-au-Prince.  Ultimately... 316,000 dead.  300,000 injured.  1,000,000 homeless.

And Barbara rushed in.

Here's her story... from the beginning.

Barbara grew up in Carrefour, a suburb of Port-au-Prince, with her mom, a teacher, and dad, an owner of an auto repair business, and brother and sister.  It was a happy, largely uneventful time... until her father became sick.  Among his ailments, Barbara's father also suffered from decubitius skin ulcers, which then (and even still today in Haiti) were poorly understood.  Barbara, then 13 years old, remembers being angry when her father, a proud man who resisted family pressure to move to the United States, told her "not to worry" and that he would be around for "another ten years".  Unfortunately, that was not to be the case.

At the age of 16, Barbara and her remaining family members moved to Florida and then eventually to Cambridge, Massachusetts.  Barbara and her sister, Beatrice, held a variety of jobs and when Barbara decided she wanted to become a nurse, Beatrice, then a medical assistant, helped her to pay for the training.  When Barbara completed nursing school, she began working and then helped to finance Beatrice's nursing education.  Barbara continued on to earn her bachelor's degree and is now studying for a master's in health care administration.

Barbara remembers well that day in January, 2010.  Reports of an earthquake began surfacing, with no one fully aware of its magnitude or impact.  Beatrice called Barbara and gave her an update.  It was far worse than expected.  Far worse.

Barbara recalls: "We were looking at the news.  We couldn't believe it.  Nobody knew what was happening.  We started calling our family there but no lines were open.  We were so worried.  We couldn't sleep.  We tried calling the UN but couldn't get through.  We just didn't know what to do.  I was desperate..."

The overwhelming emotion was helplessness.  "People there were dying and I thought, I'm a nurse.  I have to help."  Partners in Health, an organization dedicated to improving the quality and access to health care services in poor and developing areas, called Beatrice on Saturday and asked to deploy her to Haiti on the following Monday.  A month later, Barbara's call came.

It was a two week assignment.  The lead time was limited.  According to Barbara, "you just pack your bag and go."

She recalls departing the airport in Haiti.  She remembers looking around at the rubble, the devastation, the places where buildings once stood.  "It was tough to see a country you left and is no longer there."

Barbara was stationed at the General Hospital in Port-au-Prince.  "Once you got there, the gate was closed and you couldn't leave."  And once there, she and her companions worked for 10 days straight, during 7PM to 7AM shifts.  Barbara remembers being struck when she saw the former sight of a nursing school next to the hospital which she had seen as a child.  "It was no longer there.  It was completely flat.  I wondered how many people were trapped underneath."

After a quick orientation from the physician-in-charge, Barbara was given a brief tour and was immediately "put to work."  She described the first day as "one of the worst days of my life.  There were 300 to 400 patients there all needing care... from TB to fractures to missing limbs to wounds... to people who were just dying.  Just name it - it was right there looking at you..."

When asked how she responded to that, Barbara describes: "You start to work.  Your forget about everything else.  You just tried to save everyone you could.  You just do whatever you can."

She remembers one young girl at the hospital.  She had lost nine members of her family in the tragedy.  "She was so thin.  You could see only bones.  She would not eat or drink... and she never spoke... except at night, she would scream out the names of her family who were now lost to her.  I remember seeing a lady who stayed with her.  She was from the local church and she slept on the floor, giving the girl a sip of water."  Despite their efforts, the patient passed away.

Another patient, a 27 year old woman with renal failure and high blood pressure, was experiencing significant physical and emotional stress.  Barbara knew the patient needed oxygen and fast, so she ran down the hall looking for a tank.  A simple tank of oxygen.  Plentiful in every hospital where Barbara has worked, but scarce in Port-au-Prince's General Hospital.  Barbara called out: "This girl's going to die, her heart's going to give out soon... "... and remembers seeing the desperate look in the woman's eyes.  The patient said to Barbara: "Please don't leave me.  If you leave me, they're going to let me die."  Barbara knew she was right.

The patient eventually received the oxygen and the vital dialysis she required and lived.

There was also an older woman patient who "could have been my mother."  She had two wounds in her lower legs; "it looked to be a diabetic ulcer".  Barbara watched this patient fade from an amiable, even joking, favorite among the nurses, to one who became more and more ill and despondent.  At one point, she had no clothing or even sheets, leaving one of the nurses to donate some of her own clothing to the patient.  The patient died, alone and in pain.  Per Barbara, "there was no reason for her to die that way..."

Barbara looks back at the experience and feels that: "We didn't do enough.  There's so much more to do there.  And it's not over there.  It's terrible what's happening in the tent cities there now.  It's just horrible still... but I want to go back."

When asked why she wants to return, Barbara lowered her eyes and said, simply and solemnly: "It's what we do... we are nurses..."

If you're interested in learning more about Partners in Health, please click here.

If you'd like to help, click here.

 

Posted by Rey

4Medica Electronic Medical Records Company Signs Agreement With MMRGlobal (MyMedicalRecord) To License Health IT Patents

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Recently in the news it was announced 4medica EHR systems will be collaborating with MyMedicalRecord to enable lab report sand prescription history.  This was in the news about the same time the company came on board as a sponsor for the Medical Quack.  If you missed the patent article and what it covers see the link below where I spent some time finding out what this was all about the the background on the Health IT Patents that MMRGlobal has filed since 2005.  Below is a copy of a letter that was sent to all hospitals across the US with reference to licensing the current patents in place.  This may affect all electronic medical records systems in the US and abroad. 

This appears to be one of the first major license agreements signed but there could be more I am not aware of.  Bob and I talked about the patents on a prior blog post (link below) at the Medical Quack and you can also visit  Bob Lorsch’s Blog at MMRGlobal where he further elaborates beyond our discussion discussion and interview with more details about the technologies and patents. 

MMRGlobal Patent Portfolio, Bob Lorsch, CEO Answers Questions Relative to Patented Technologies

MMR Letter to Medical Entity

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MMRGlobal Files Form 8-K Regarding Signing of Patent License Agreement, Dr. Shekhar Challa to Medical Board of Advisors

Dec 10, 2012 (Marketwire via COMTEX) --MMRGlobal, Inc. (OTCQB: MMRF) today announced it filed a Form 8-K regarding the signing by MyMedicalRecords, Inc. (MMR) of a Non-Exclusive Patent License Agreement with 4medica, Inc. to license U.S. rights for the health IT patents owned by MyMedicalRecords, Inc. These include but are not limited to U.S. Patent Numbers 8,321,240; 8,301,466; 8,117,045; 8,117,646; and 8,121,855, as well as any other health IT patents to be issued pursuant to pending applications filed by MyMedicalRecords in the United States and all divisions, continuations, reissues, and extensions (the "MMR Patents"). The initial term of the Agreement is five years and automatically renews to the expiration date of the last licensed patent to expire, which currently in the U.S. is twenty years from the date of filing. MMRGlobal is a leading provider of Personal Health Records (PHRs) including its MyMedicalRecords.com PHR and MMRPro document management and imaging systems for healthcare professionals.

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