Physicans and Blogs; Explaining the RUC; Nice Use of Second Life

March 18th through March 19th:

  • The ‘World Wide Computer’?Another HAL? – Businessweek’s Review of “The Big Switch” – I used it for comparison
  • NPR: Doctor Blogs Raise Concerns About Patient Privacy – I agree with points raised – a patient should never seek care and then discover that they have been written about on a blog. Instead, they should receive a copy of the medical record that has been created about them. At the same time, physician bloggers are doing something very important – they are testing the boundaries of transparency, to support a more accountable health care system. If anyone saw the 60 minutes story about Dennis Quaid and his family, the rationale for this become very clear.
  • What Every Physician Should Know About the RUC – January 2008 – Family Practice Management – The information is useful. As primary care providers I think we need to be careful to include our specialty colleagues in the conversation, not distance themselves from it. As a member of a large multispecialty medical group, I know that there is interest across the physician community in supporting community health and the best experience for patients.
  • MindBlizzard blog: Virtual Healthcare 2: Palomar Pomerado Health – All right – More news about the utility of Second Life – testing a hospital before it launches
  • What is the ROI on employee suggestion systems? – A nice example from the toothpaste industry. But not necessarily one that supports the evidence, that far less toothpaste than people think is needed to protect teeth…..Maybe a customer suggestion system might be in order.


The NPR piece is thought-provoking. I hadn't heard about it – thanks.

IMO, doctors MUST not publish any profile that's personally identifiable. As Dr. Wachter says, the details must be changed substantially.

Most of my case is very public, due to MY choices, but in policy-making we must always bear in mind the worst cases. A horrid outcome would be if people stop seeking care for a virulent condition that they consider embarrassing because they think there's even the slightest chance that they could be identified. All that would take would be one highly publicized horror story.

Please, blogging doctors, keep blogging your butts off, and thank you; but never ever post something that could become that horror story.


Sure – The Quaid family suffered a near catastrophic loss of newborn twins when they were given a super-human dose of heparin, a blood thinner. What was revealed in the story was that the exact same event happened in a hospital in Indiana a year earlier, resulting in three infant deaths.

There were two important things that were confirmed for me in watching the story – as Steve Kroft said, patients are not interested in punishing the health care system for mistakes. They are interested in mistakes never happening to another patient. The second thing is that actors in the system are not rewarded for bringing problems forward, it is actually the opposite in many institutions.

See this blog entry I wrote about another industry:

I wrote about taking time to explore problems as well:

In a LEAN/Toyota Management System organization, problems are gold, worthy of individual attention, because they usually point to needed improvement.

This is a challenge to the mental model in many organizations that problems are meant to be buried.

Here's my quote from that piece:

"Our customers don’t expect us to be perfect, they expect us to recognize our imperfections quickly."

Thanks, Dave, for the support for physicians and blogging!

I think you captured the role of privacy well – it allows people to seek care comfortably.

I think some people (doctors) included sometimes don't understand the reach of the blogosphere, so it always pays to ask, "If my patients read this, what would they think?" before hitting the publish button. I do.

I've been surprised myself to find out who reads what I write – usually when I see them and they say, "Yes, I read about that on your blog." It's a diverse group with a lot of different interests. And, it reminds me I have to save some stories for in person conversations :).

Ted Eytan, MD