Setting the Stage: Why Health Care Needs a Culture of Respect

By Ted A James, MD
July 31, 2018

The Foundation of Respect

Respect is an essential component of a high-performance organization. It helps to create a healthy environment in which patients feel cared for as individuals, and members of health care teams are engaged, collaborative, and committed to service. Within a culture of respect, people perform better, are more innovative, and display greater resilience. On the contrary, a lack of respect stifles teamwork and undermines individual performance. It can also lead to poor interactions with patients. Cultivating a culture of respect can truly transform an organization and leaders set the stage for how respect is manifested. Continue reading “Setting the Stage: Why Health Care Needs a Culture of Respect”

Is “Meaningful Use” Contributing to Physician Burnout?

Aligning quality incentive measures with physician wellness: When “Meaningful Use” leads to less meaning in a physician’s practice

By Ami Bhatt, MD, FACC
July 5, 2018

Lately, I have been struck by how often the phrases physician burnout and meaningful use are used in any given day, leading both to suffer the same fate: neither one is well defined. While speaking with colleagues across the country, I’ve asked the question, “What does meaningful use mean to you?” The answers I’ve received vary from expletives, to “waste of time,” “hoop to jump through,” and “garbage in, garbage out.” Those in leadership or quality improvement positions have a different insight: “My physicians call any task asked of them ‘meaningful use’,” or “The institution has many governing bodies, each with their own expectations, but they all call their needs ‘meaningful use’ which frustrates my physicians.” The logistics of meaningful use in the electronic health record (EHR) are also often noted: “I forget more than I remember it, but now there are prompts,” and “The extra 45 seconds per note adds up with a busy clinic.” Continue reading “Is “Meaningful Use” Contributing to Physician Burnout?”

Creating a High-Performance Health Care Organization

By Ted A James, MD, MHCM
June 28, 2018

“The goal in health care really needs to be zero preventable harm.”
—Lucien Leape

Modern health care has been described as one of the most complex industries in the world. Advances in biotechnology, data analytics, and genomic medicine alone have enabled greater capabilities and more sophisticated care than any other time in history. The problem with complexity is that human beings are imperfect and fallible, leading to the potential for medical error and fragmented care. With greater complexity comes a greater risk of failure, making it challenging to deliver on the promise of safe, reliable, and effective health care. Continue reading “Creating a High-Performance Health Care Organization”

Turning the Tide on Physician Suicide

By Ami B. Bhatt, MD, FACC
June 14, 2018

Since the two very sudden public suicide deaths of Kate Spade and Anthony Bourdain, society has again recognized that we never know what is under the surface of another’s façade. As physicians, these tragic occurrences emphasize that our caregiving requires seeing the entirety of an individual’s many parts.

While we acknowledge that the façade is not fake—it is but one true representation of an individual, well-curated, like pages on Facebook or Instagram—no one mourns the corporate façade created for these individuals. We mourn the fact that despite feeling we know someone, we didn’t see it coming. This is that much harder when it is a loved one, and most frightening when you might see it in yourself.  Especially, if you are a physician. Continue reading “Turning the Tide on Physician Suicide”

Improving Health Outcomes by Healing Our Communities

By Ted A James, MD, MHCM, FACS
May 31, 2018

The Paradox of U.S. Health Care

We are not as good as we should be. Despite incredible technological advances and high-levels of spending, compared to other countries, the U.S. health care system fails to achieve superior outcomes on many key health indicators including life expectancy, infant mortality, and preventable disease. Although we are capable of delivering some of the most exceptional care in the world, we do not do so reliably or in a well-coordinated manner. According to recent studies from the Commonwealth Fund, the U.S. tends to excel in doctor–patient relationships, wellness counseling, shared decision making, and chronic disease management. However, we operate in a system plagued with major disparities in access to primary care and gross social inequities. Innovations in our approach to health care are required in order to address these challenges and remove the barriers they present to providing reliable and sustainable care for all patients.  Continue reading “Improving Health Outcomes by Healing Our Communities”

What Does Trauma-Informed Care Look Like?

May 11, 2018

[The following post by has been shared with us by Harvard Health Publishing where it originally appeared in April of 2018. In light of increased emphasis on engaging patients in shared decision making, we invite you to add your thoughts about, and experiences with, trauma-informed care in the comment section after reading this post.]

Trauma-informed care: What it is, and why it’s important

by Monique Tello, MD, MPH
Contributing editor, Harvard Health Publishing

Many years ago, when I was a trainee, I helped take care of patients at a family medicine clinic.* One day, a school-aged brother and sister came in for their annual physicals. Continue reading “What Does Trauma-Informed Care Look Like?”

Transforming the Patient Experience of Health Care

By Ted A James, MD, MHCM, FACS
April 27, 2018

Leaders of health care organizations facing mounting administrative challenges and diminishing resources may question the importance of focusing on the patient experience of care. Improving patient interactions not only speaks to the inherent values of our profession in health care, but a growing body of evidence correlates improved patient experience with improved clinical outcomes and organizational performance, making patient experience a key strategic priority. I can also attest from my efforts developing patient-centered care models, as well as from my own journey as a patient, just how important the care experience is to overall well-being and satisfaction with treatment. Continue reading “Transforming the Patient Experience of Health Care”