The importance of a person's spirit and eternal destiny are eclipsed in American medi- cine. ... more The importance of a person's spirit and eternal destiny are eclipsed in American medi- cine. The most alarming effect of this eclipse is that the prevalence of burnout among physicians is high (about 46 percent) and growing.' It is alarming because trends that deplete the physician's spirit tragically impair the physician's capacity as a healer and as one who renews the spirit.
If we believe that healthcare and our health systems are important, then we need to pay attention... more If we believe that healthcare and our health systems are important, then we need to pay attention to the wellbeing and engagement of healthcare professionals. The work of health professionals drives all the clinical- and health-related processes in our health systems. If our healthcare professionals cannot consistently perform well, organizational leadership is not paying enough attention to the human factors in productivity, safety, and quality.
1. Health Forum J. 1999 Sep-Oct;42(5):46-8. Collaborations that work. Strategies for building com... more 1. Health Forum J. 1999 Sep-Oct;42(5):46-8. Collaborations that work. Strategies for building community health partnerships. Hageman WM, Harmata R, Zuckerman H, Weiner B, Alexander J, Bogue R. PMID: 10621219 [PubMed - indexed for MEDLINE]. Publication Types: ...
Major organizational changes among hospitals, like system affiliation, merger, and closure, would... more Major organizational changes among hospitals, like system affiliation, merger, and closure, would seem to offer substantial opportunities for hospitals and health systems to be strategic in the local reconfiguration of health services. This report presents the results of a unique survey on what happened to hospitals after mergers occurring between 1983 and 1988, inclusive. Building on an ongoing verification process of the American Hospital Association, surviving institutions from all 74 mergers that occurred during the study frame were surveyed in the fall of 1991. Responses were received from 60 of the 74 mergers (81%), regarding the primary, postmerger use of the hospitals involved. Topics surveyed included the premerger competition between the hospitals and in their environment, and what happened to the hospitals after their mergers. Mergers frequently served to convert acute, inpatient capacity to other functions, with less than half of acquired hospitals continuing acute services after merger. In the context of health care reform, mergers may offer an expeditious way locally to restructure health services. Evidence on the postmerger uses of hospitals and about the reasons given for merger suggests that mergers may reflect two general strategies: elimination of direct acute competitors or expansion of acute care networks.
Background: Overweight children are often not identified or counseled. Purpose: We assessed the d... more Background: Overweight children are often not identified or counseled. Purpose: We assessed the documentation rate and clinical management of overweight children before and after an electronic medical record (EMR) upgrade calculating body mass index (BMI) percentile for age and gender. Methods: Family Medicine resident and faculty physicians at two sites received an EMR upgrade; Site1 physicians also received BMI training and education. From two years before to one year after the upgrade, randomly selected charts were reviewed for all encounters with overweight children for documentation of obesity and clinical management. Results: After the EMR upgrade, documentation and counseling rates significantly improved at both sites but the rate of change was greater for Site 1; postintervention documentation was significantly greater for Site 1 vs. Site 2 (40% vs. 28%, P<0.01). Conclusions: We found an increase in documentation and management of overweight children following an EMR upgr...
It’s no secret that physicians today face myriad challenges and changes—from increased medical ma... more It’s no secret that physicians today face myriad challenges and changes—from increased medical malpractice litigation to shrinking reimbursements, from cost containment to privacy, security and patient safety concerns. The country’s health care system remains perpetually in a state of flux, and physicians often feel caught in a cyclone of new missions and mandates. Research supports that many physicians experience high levels of dissatisfaction with their profession, and that dissatisfaction may be on the rise. The ramifications of this are quite serious and pose threats to health care providers and patients alike. Physician career dissatisfaction has been found to be associated with physician stress, disruptive behavior, burnout and career exit, medical errors, reduced patient care quality, reduced patient compliance with medical instructions and higher health care costs.1-9 How can doctors not only survive, but thrive in this ever-changing environment? While some physicians are quick to place blame, fall “victim” and even lash out due to the challenges they face, others facing the exact same challenges persevere, remaining dedicated, determined and closely connected to their passion and commitment to serve. What is their secret? And what can physician executives do to anticipate and help physicians address these emerging challenges? Special Report: Discouraged Doctors
It’s no secret that physicians today face myriad challenges and changes—from increased medical ma... more It’s no secret that physicians today face myriad challenges and changes—from increased medical malpractice litigation to shrinking reimbursements, from cost containment to privacy, security and patient safety concerns. The country’s health care system remains perpetually in a state of flux, and physicians often feel caught in a cyclone of new missions and mandates. Research supports that many physicians experience high levels of dissatisfaction with their profession, and that dissatisfaction may be on the rise. The ramifications of this are quite serious and pose threats to health care providers and patients alike. Physician career dissatisfaction has been found to be associated with physician stress, disruptive behavior, burnout and career exit, medical errors, reduced patient care quality, reduced patient compliance with medical instructions and higher health care costs.1-9 How can doctors not only survive, but thrive in this ever-changing environment? While some physicians are quick to place blame, fall “victim” and even lash out due to the challenges they face, others facing the exact same challenges persevere, remaining dedicated, determined and closely connected to their passion and commitment to serve. What is their secret? And what can physician executives do to anticipate and help physicians address these emerging challenges? Special Report: Discouraged Doctors
The importance of a person's spirit and eternal destiny are eclipsed in American medi- cine. ... more The importance of a person's spirit and eternal destiny are eclipsed in American medi- cine. The most alarming effect of this eclipse is that the prevalence of burnout among physicians is high (about 46 percent) and growing.' It is alarming because trends that deplete the physician's spirit tragically impair the physician's capacity as a healer and as one who renews the spirit.
If we believe that healthcare and our health systems are important, then we need to pay attention... more If we believe that healthcare and our health systems are important, then we need to pay attention to the wellbeing and engagement of healthcare professionals. The work of health professionals drives all the clinical- and health-related processes in our health systems. If our healthcare professionals cannot consistently perform well, organizational leadership is not paying enough attention to the human factors in productivity, safety, and quality.
1. Health Forum J. 1999 Sep-Oct;42(5):46-8. Collaborations that work. Strategies for building com... more 1. Health Forum J. 1999 Sep-Oct;42(5):46-8. Collaborations that work. Strategies for building community health partnerships. Hageman WM, Harmata R, Zuckerman H, Weiner B, Alexander J, Bogue R. PMID: 10621219 [PubMed - indexed for MEDLINE]. Publication Types: ...
Major organizational changes among hospitals, like system affiliation, merger, and closure, would... more Major organizational changes among hospitals, like system affiliation, merger, and closure, would seem to offer substantial opportunities for hospitals and health systems to be strategic in the local reconfiguration of health services. This report presents the results of a unique survey on what happened to hospitals after mergers occurring between 1983 and 1988, inclusive. Building on an ongoing verification process of the American Hospital Association, surviving institutions from all 74 mergers that occurred during the study frame were surveyed in the fall of 1991. Responses were received from 60 of the 74 mergers (81%), regarding the primary, postmerger use of the hospitals involved. Topics surveyed included the premerger competition between the hospitals and in their environment, and what happened to the hospitals after their mergers. Mergers frequently served to convert acute, inpatient capacity to other functions, with less than half of acquired hospitals continuing acute services after merger. In the context of health care reform, mergers may offer an expeditious way locally to restructure health services. Evidence on the postmerger uses of hospitals and about the reasons given for merger suggests that mergers may reflect two general strategies: elimination of direct acute competitors or expansion of acute care networks.
Background: Overweight children are often not identified or counseled. Purpose: We assessed the d... more Background: Overweight children are often not identified or counseled. Purpose: We assessed the documentation rate and clinical management of overweight children before and after an electronic medical record (EMR) upgrade calculating body mass index (BMI) percentile for age and gender. Methods: Family Medicine resident and faculty physicians at two sites received an EMR upgrade; Site1 physicians also received BMI training and education. From two years before to one year after the upgrade, randomly selected charts were reviewed for all encounters with overweight children for documentation of obesity and clinical management. Results: After the EMR upgrade, documentation and counseling rates significantly improved at both sites but the rate of change was greater for Site 1; postintervention documentation was significantly greater for Site 1 vs. Site 2 (40% vs. 28%, P<0.01). Conclusions: We found an increase in documentation and management of overweight children following an EMR upgr...
It’s no secret that physicians today face myriad challenges and changes—from increased medical ma... more It’s no secret that physicians today face myriad challenges and changes—from increased medical malpractice litigation to shrinking reimbursements, from cost containment to privacy, security and patient safety concerns. The country’s health care system remains perpetually in a state of flux, and physicians often feel caught in a cyclone of new missions and mandates. Research supports that many physicians experience high levels of dissatisfaction with their profession, and that dissatisfaction may be on the rise. The ramifications of this are quite serious and pose threats to health care providers and patients alike. Physician career dissatisfaction has been found to be associated with physician stress, disruptive behavior, burnout and career exit, medical errors, reduced patient care quality, reduced patient compliance with medical instructions and higher health care costs.1-9 How can doctors not only survive, but thrive in this ever-changing environment? While some physicians are quick to place blame, fall “victim” and even lash out due to the challenges they face, others facing the exact same challenges persevere, remaining dedicated, determined and closely connected to their passion and commitment to serve. What is their secret? And what can physician executives do to anticipate and help physicians address these emerging challenges? Special Report: Discouraged Doctors
It’s no secret that physicians today face myriad challenges and changes—from increased medical ma... more It’s no secret that physicians today face myriad challenges and changes—from increased medical malpractice litigation to shrinking reimbursements, from cost containment to privacy, security and patient safety concerns. The country’s health care system remains perpetually in a state of flux, and physicians often feel caught in a cyclone of new missions and mandates. Research supports that many physicians experience high levels of dissatisfaction with their profession, and that dissatisfaction may be on the rise. The ramifications of this are quite serious and pose threats to health care providers and patients alike. Physician career dissatisfaction has been found to be associated with physician stress, disruptive behavior, burnout and career exit, medical errors, reduced patient care quality, reduced patient compliance with medical instructions and higher health care costs.1-9 How can doctors not only survive, but thrive in this ever-changing environment? While some physicians are quick to place blame, fall “victim” and even lash out due to the challenges they face, others facing the exact same challenges persevere, remaining dedicated, determined and closely connected to their passion and commitment to serve. What is their secret? And what can physician executives do to anticipate and help physicians address these emerging challenges? Special Report: Discouraged Doctors
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