Scribes: “A busy doctor’s right hand, always ready to type”

From the New York Times:

Amid the controlled chaos that defines an average afternoon in an urban emergency department, Dr. Marian Bednar, an emergency room physician in Dallas, entered the exam room of an older woman who had fallen while walking her dog. Like any doctor, she asked questions, conducted an exam and gave a diagnosis — in this case, a fractured hand — while also doing something many physicians in today’s computerized world are no longer free to do: She gave the patient her full attention.

Standing a few feet away, tapping quickly and quietly at a laptop computer cradled in the crook of her left arm, was Amanda Nieto, 27, Dr. Bednar’s scribe and constant shadow. While Ms. Nieto updated the patient’s electronic chart, Dr. Bednar spoke to the woman, losing eye contact only to focus on the injured hand.

Rural medicine reminds physicians of their value

From Dr. Edwn Leap, writing for Kevin MD:

We live in an era of specialists and subspecialists and sub-sub-specialists.  In large cities, the job of the emergency physician is to order the EKG as quickly as possible (hopefully before the patient arrives it seems), and call the right interventional specialist in something like a nano-second.  In some places, we serve as facilitators, almost brokers.  But in the small centers of America, where the advanced technology of medicine isn’t always immediately available, our job becomes absolutely critical.

Community paramedicine Rx for saving costs

From the News-Telegram:

A report released last week by the Massachusetts Health Care Policy Commission found millions of dollars of all health care spending in the state was wasted on unnecessary hospital readmissions and emergency room visits. 

But that could change with a new type of house call on the horizon called community paramedicine. It is aimed at reducing patient readmissions and unnecessary emergency room visits, while increasing patient-centered care and patient satisfaction. 

Community paramedicine, also called mobile integrated health care, is being discussed among fire departments and EMS providers, and has been flagged by the State Department of Public Health as an area of interest, local EMS officials said.