Electronic Health Record Logs Indicate That Physicians Split Time Evenly Between Seeing Patients And Desktop Medicine + Author Affiliations ↵*Corresponding author Time spent by physicians is a key resource in health care delivery. This study used data captured by the access time stamp functionality of an electronic health record (EHR) to examine physician work effort. This is a potentially powerful, yet unobtrusive, way to study physicians’ use of time. We used data on physicians’ time allocation patterns captured by over thirty-one million EHR transactions in the period 2011–14 recorded by 471 primary care physicians, who collectively worked on 765,129 patients’ EHRs.
Climate change threats to family farmers' sense of place and mental wellbeing: A case study from the Western Australian Wheatbelt Highlights Sense of place is a significant driver of farmers' mental health and wellbeing. Weather influences farmers' emotional and psychological states. Climate change-related mental health risks cumulate over time. A place-based approach may limit climate change mental health risks to farmers. Abstract Shared decision making in patients with low risk chest pain: prospective randomized pragmatic trial Erik P Hess, associate professor1 2 3, Judd E Hollander, professor4, Jason T Schaffer, assistant professor5, Jeffrey A Kline, professor5, Carlos A Torres6, Deborah B Diercks, professor7, Russell Jones, assistant professor8, Kelly P Owen, assistant professor8, Zachary F Meisel, assistant professor9, Michel Demers, patient adviser10, Annie Leblanc, research collaborator and caregiver adviser2 11, Nilay D Shah, associate professor11, Jonathan Inselman, statistical programmer analyst3, Jeph Herrin, biostatistician13, Ana Castaneda-Guarderas, resident1 2 14, Victor M Montori, professor2 15Author affiliationsCorrespondence to: E P Hess firstname.lastname@example.orgAccepted 3 November 2016 Abstract Objective To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. Design Multicenter pragmatic parallel randomized controlled trial.
Myths in Emergency Medicine: Still Prescribing Oseltamivir? : Emergency Medicine News Let's start this one at the end: Oseltamivir, better known as Tamiflu to everyone else on the planet, is a dud of a drug. There is plenty more to discuss on the subject, but these are the highlights, courtesy of a truly remarkable and headline-making Cochrane review by Tom Jefferson, MD, and colleagues: * It does not decrease hospitalizations in patients with influenza. * It does not decrease complications of influenza. * It makes patients vomit. (NNTH=22 in adults, 19 in kids.) Hanafuda Hanafuda (花札?) are playing cards of Japanese origin that are used to play a number of games. The name literally translates as "flower cards." The name also refers to games played with those cards. History
When Evidence Says No, But Doctors Say Yes First, listen to the story with the happy ending: At 61, the executive was in excellent health. His blood pressure was a bit high, but everything else looked good, and he exercised regularly. Then he had a scare. He went for a brisk post-lunch walk on a cool winter day, and his chest began to hurt. Back inside his office, he sat down, and the pain disappeared as quickly as it had come. That night, he thought more about it: middle-aged man, high blood pressure, stressful job, chest discomfort. Section 3: Place and Identity - The People, Place, and Space Reader Likewise, geographer Kay J. Anderson describes how race and class privilege infused the social production of space in late 19th-century Vancouver, Canada. Anderson’s work examines the variety of material and social practices through which both racialized space and constructed notions of racialized difference were produced and naturalized. Her research looks at how “Chinatowns” were fabricated in many cities by white Europeans and Anglo- Americans in the 19th century.
Comparing Traditional and Participatory Dissemination of a Shared Decision Making Intervention Project Information Principal Investigator Hazel Tapp, PhD, BSc Project End Date Click Here! Includes the Research Project Period and may be subject to modification to allow other research-related activities such as peer review. Rethinking cellulitis From the February ACP Hospitalist, copyright © 2017 by the American College of Physicians By Amy Karon Busy hospitalists and emergency department physicians frequently diagnose their patients with cellulitis. But they are often mistaken, research shows. The Amish understand a crucial thing about modern medicine that most Americans don’t — Quartz The Allegheny Plateau, sprawling across northern Pennsylvania and beyond, is an ecosystem of forested hills, with land that supports black bears, bald eagles and wandering turkeys, as well as a patchwork of wild herbs: burdock, jewelweed, chamomile and sheep sorrel. Cellphone reception is spotty and gas stations are few and far between. Tucked away among the streams branching from the Cowanesque river is a cluster of small white and tan buildings, including the office of John Keim, an Amish elder and community healer. In the 1980s, Keim’s young son was scalded by a pot of boiling water, burning off his skin from collarbone to waist.