Better Bedside Manners Improve Patient Care, Says Cleveland Clinic Chief Experience Officer

Nurses, aides and doctors need to have an awareness of the impact of bedside manner and patient health, Dr. James Merlino, chief experience officer at the Cleveland Clinic, says. WSJ video:



From the WSJ:

"Cleveland Clinic Chief Executive Delos "Toby" Cosgrove, a heart surgeon by training, says he had an epiphany several years ago at a Harvard Business School seminar, where a young woman raised her hand and told him that despite the clinic's stellar medical reputation, her grandfather had chosen to go elsewhere for surgery because "we heard you don't have empathy."

Things have changed quite a bit now.

"The hospital launched a program known as HEART—for hear the concern, empathize, apologize, respond and thank—that empowers employees to handle patient concerns from the moment they arise. Healing Services team will call a "Code Lavender" for patients or family members under stress who need immediate comfort. Of patients who had pain, 31% reported a significant decrease after a healing service."

References:

A Financial Incentive for Better Bedside Manner - WSJ http://buff.ly/1pCHitL

What's new in pulmonary, critical care, and sleep medicine from UpToDate

35% of UpToDate topics are updated every four months. The editors select a small number of the most important updates and share them via "What's new" page. I selected the brief excerpts below from What's new in hematology:

Asthma

When evaluating patients for occupational asthma, sputum eosinophil counts at 7 and 24 hours after specific inhalation challenge have a greater sensitivity and positive predictive value than exhaled nitric oxide (eNO).

Critical care

Proton pump inhibitors (PPIs) may be slightly more effective than histamine-2 (H2) blockers at preventing gastrointestinal (GI) bleeding in critically ill patients. However, the difference is small if real.

Idiopathic pulmonary fibrosis

Sildenafil, tyrosine kinase inhibitor imatinib, and pirfenidone, an anti-fibrotic agent, were each no more effective than placebo for treatment of idiopathic pulmonary fibrosis.

Pleural effusion

Using ultrasonography to identify a site for diagnostic thoracentesis is associated with significantly lower risk of pneumothorax, than using the physical exam for site selection.

Pulmonary embolism

PE is frequently asymptomatic. Among 5233 patients with a DVT, 32 percent had asymptomatic PE.

References:
What's new in pulmonary, critical care, and sleep medicine. UpToDate.

"Choose primary care, give up $2.5 million"

Researchers at Duke University modeled the earning potential of cardiologists and primary care physicians between the ages of 22 and 65, taking into account medical school debt, earning potential and the age at which doctors begin earning an income. They conducted similar analyses for the average b-school, physician assistant and college graduate.

Over a career, a typical cardiologist earns more than $5 million, primary care physicians earn $2.5 million and business school grads earn $1.7 million. Meanwhile, physician assistants earn about $846,000 and college graduates earn about $340,000.

References:

Choose primary care, give up $2.5M. MedCityNews.

Primary Care Doctors Make $3 Million Less Than Cardiologists Over The Course Of Their Careers. Kaiser Health News' Daily Report.

Image source: OpenClipArt.org, public domain.