Physicians just can't move fast enough to get on the World Wide Web. But in the rush to develop slickly designed, interactive sites, it can be all too easy to make yourself a target for lawsuits, according to a new study by the Physician Insurers Association of America.
The Maryland-based PIAA recommends including disclaimers in Web sites, even for purely educational sites. The disclaimers spell out that the information exchange doesn't substitute for actual physician-patient contact. Users should have to read and agree to such disclaimers before going further in the site, the association says.
Physicians also should avoid linking their sites to others, which can confuse patients and lead them to inaccurate information.
The study also cautioned physicians who dabble in telemedicine, the blanket term for using electronics to bring in specialists to consult on cases.
Patient information should be closely guarded, and anyone with access to it should sign an agreement to keep it confidential. Physicians should also document everything about these televisits: the names of all participating doctors, staff and technicians, as well as the patient's family members.
The PIAA's report is available for a $20 fee by calling 301-947-9000.
Wake-up call. Sleep problems often are on the edge of the American consciousness, but a new effort by the National Sleep Foundation could open people's eyes to the issue-and just in time for National Sleep Awareness Week, which runs through April 5.
The foundation last week released a survey that found only 14% of 1,027 respondents passed a "Sleep IQ" test. Many Americans falsely believe that people need less sleep as they age, that the human body can adjust to night-shift work and that raising the volume on the radio can help sleepy drivers stay awake, the survey found.
Two-thirds of respondents reported a sleep-related problem such as snoring, insomnia or sleep apnea, and 23% owned up to falling asleep at the wheel in the past year. Not surprisingly, nearly one in three sleeps as little as six hours or less during the work week. The average night's sleep is seven hours, one hour less than doctors recommend.
"In my view, we need Americans to wake up to the crucial importance of sleep in their lives," says William Dement, M.D., chairman of the NSF's government affairs committee. "At the same time, the nation needs a new set of public policies demanding that sleep be taught in every component of our educational system."
Referring to the health consequences of a lack of sleep, Thomas Roth, M.D., the NSF's health and scientific adviser, said the findings are "a source of great concern. Good health demands good sleep. Conversely, lack of sleep and sleep problems have serious, often life-threatening consequences. This is a case where what we don't know can harm us and harm those around us."
There are at least 100,000 vehicular accidents related to lack of sleep, the NSF noted.
Outliers is having nightmares just thinking about all this.
Buddy system. When Bruce Spivey, M.D., president and chief executive officer of Columbia-Cornell Care in New York, said last week that he had hired G. Aubrey Serfling as the new chief financial officer and chief information officer of the 1,700-member physician organization, he cited Serfling's "vision and understanding" of integrated delivery systems.
What Spivey didn't say was this won't be the first time he has been Serfling's boss.
Spivey, 63, was president and CEO of California Healthcare System, which operated California Pacific Medical Center in San Francisco. Serfling, 53, was president and CEO of the hospital. Spivey left CHS in 1992, and Serfling left in 1996, a year after the system merged with Sutter Health.
Jesus as CEO. Bringing the management style of Jesus Christ into the nation's hospitals will be a featured topic among healthcare executives in Dallas later this spring.
"The Health Care Fellowship: A Call to Values Conference" is expected to draw some 200 healthcare executives who will discuss ways to avoid sacrificing their hospitals' missions while achieving certain financial goals.
"The program doesn't have a religious bent, but there will be a speaker addressing leadership skills of Jesus Christ and putting them in a business context," says Betty Ann Bird, executive director of Fort Worth, Texas-based Quest Leadership Consulting, the sponsor of the two-day meeting, which will be held May 11 and 12 at the DFW Airport Marriott in Irving, Texas.
Laurie Beth Jones, author of the national bestseller Jesus CEO: Using Ancient Wisdom for Visionary Leadership, is a featured speaker. "She will provide an analogy to giving leaders the benchmark of Jesus as a leader," Bird says. Other topics will include business ethics, compliance programs and potential conflicts that might arise among physicians, board members and hospitals. Other speakers include Dan Wilford, president of Memorial Hermann Healthcare System in Houston, and William Pollard, chairman of Downers Grove, Ill.-based ServiceMaster.
Playing patient. It took a recent episode of the sitcom "Seinfeld" to bring "standardized patients" into the public eye.
Kramer, as played by actor Michael Richards, got an offbeat acting job posing as a patient with gonorrhea in the light-hearted Seinfeld skit.
Once again art imitates life. Increasingly, actors are playing patients to help train medical students and to serve as test subjects during some licensure exams. And New York's Mount Sinai School of Medicine, where the "Seinfeld" episode was set, is a leader in training and using these actors. It seems a natural connection given the medical school's proximity to the Great White Way.
"I work with the cream of the crop here," says Devra Cohen, education director at Mount Sinai's Morchand Center for Clinical Competence, the largest standardized patient program in the country. "There's a plethora of unemployed or underemployed actors." Mount Sinai has trained almost 300 actors to play patients and regularly calls on about 100 of them to help teach students at six New York medical schools.
But a role as a standardized patient is anything but fun and games-despite the "Seinfeld" representations.
"We deal with a lot of difficult subject matters," Cohen says. For instance, the standardized patients help medical students learn how to tell a patient bad news, to take difficult sexual histories and to deal with victims of domestic violence. "They really appreciate the opportunity to make a mistake here instead of with a real patient," she says.