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After many gray days, majestic fire in the sky. My thoughts turn to Shakespeare's sonnet # 73, a companion of three score years.
In me thou see’st the twilight of such day
As after sunset fadeth in the west;
Which by and by black night doth take away,
,
Patients vs. Paperwork
When Hospital Paperwork Crowds Out Hospital Care by Theresa Brown (NY Times, December 20, 2015)
Excerpts:
In the age of electronic health records, computer documentation in health care has morphed into more than an account of our work; it has replaced the work itself.
In home hospice, where I now work, the documentation is even more onerous than in the hospital and seems even more disconnected from actual patients. Hospice care is a covered benefit under Medicare, and the Centers for Medicare and Medicaid Services maintain rigid standards for documentation. They regularly withhold reimbursement if documentation is deemed incomplete or flawed.
Charting a hospice admission usually takes between two and four hours, and requires filling out a seemingly endless number of data fields — some of them defying logic.
Electronic health records present an enticingly clean and clear vision of clinical work, whereas real patients are messy, confusing and unpredictable. Sadly, all the attention given to our paperwork is taking us further and further away from the difficult truth that meeting very ill patients’ needs occurs in real time with real people, not in the paperwork about them.
Goethe wrote: “In the end, we are dependent on creatures we have made. “ This sad truth underlies Theresa Brown’s excellent Op-Ed piece on Patients vs. Paperwork.
Caption reads: The Internet wants to destroy your productivity.
[Always Accept]
These commandments appeared in the British Journal of General Practice. While they refer mostly to therapeutics, they are applicable to most doctor-patient interactions. We have edited the BJGP article as it was too verbose. Please feel free to edit what we provide as it can still be improved.
Download Ten Commandments for Patient Centered Care
As a 16 year-old, Reginald Dwayne Betts was a good student in a magnet school. However, he veered off-course when he and a friend carjacked a man at gunpoint who had fallen asleep in his car. Betts was charged as an adult and spent more than eight years in prison, where he completed high school and began reading and writing poetry. After his release he attended Prince George's Community College in Largo, Maryland and currently is a student at Yale Law School.
Betts, has published a memoir, A Question of Freedom, and a book of poetry, Bastards of the Reagan Era. His powerful, cautionary and inspirational story was featured by Terri Gross’s on Fresh Air, December 8, 2015.
A corollary story is Just Mercy by Bryan Stevenson. (A powerful true story about the potential for mercy to redeem us, and a clarion call to fix our broken system of justice—from one of the most brilliant and influential lawyers of our time.) If Betts had had Stevenson as a lawyer, he may not have been sentenced as an adult.
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