Word: physicians
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...digital revolution. Looking up lab results and x-rays on our computer screens beat out carbon copies and sheet film in an instant. We like e-mail; we shop, take tests and read our journals on line. But the romance, for most of us, began to sour with Computerized Physician Order Entry [CPOE]: entering patients' hospital orders on the computer. This is when we first confronted the downside to uploading our every medical judgment...
...them dangerous. I've ordered MRI's on hospitalized patients that somehow never got done, physical therapy and medication never delivered, because of "unmet requirements" picked up when codes are scanned. When the white blood count isn't high enough to "justify" the hospitalization for IV antibiotics, the physician whose judgment says "this patient is sick and belongs in the hospital" is told his services as well as the hospitalization will not be paid for. When a doctor is convinced a test or treatment is needed, (and his patient doesn't have the money...
...world of painful, pressing questions, the answers might be in there. Or so we thought. Twenty nine years from the night I first sat in a hospital in front of a computer screen the questions persist. And I still don't see the profit-maximizing, cost-controlling physician with his nationwide computer treating patients any better than the great physicians I've known have. With pen and paper, personal commitment to each patient and judgment born of practical experience. None of which I have found in a machine...
...years as an internist, I have found that many of my patients' concerns are, in fact, spiritual. As their treating physician, I am often the first to identify these issues and provide appropriate care, and I continue to refer patients who have spiritual needs I am not trained to manage. My experience shows that physicians can and should get training to skillfully recognize and ethically provide initial spiritual care for patients, and to refer those needing more intensive follow-up. Harvey A. Elder, LOMA LINDA, CALIF...
Although assisted suicide is illegal in most states, voters in Washington State and Montana voted late last year to legalize physician-assisted suicide. Oregon has had a physician-assisted suicide law since 1994, and New Hampshire, Massachusetts and New Mexico are considering whether to pass similar laws. In Georgia, however, assisted suicide is a felony, and members of Final Exit could face up to five years in prison if convicted of that charge. They also face three years for evidence-tampering and 20 years for racketeering...