The Internal Medicine Residency newsletter is posted each week to share important news, announcements and updates about the residency program. Please contact Randy Heffelfinger with corrections, contributions and suggestions.
From the Director
Hi! Happy holidays to all! Whether you are here or off, wishing you the best from my family and me! Hard to believe we're halfway done with this year! Looking forward to a great 2012.
What Did I Read This Week (by Murat Arcasoy, MD)
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Walker et al, “Inviting Patients to Read Their Doctors’ Notes: Patients and Doctors Look Ahead” Annals of Internal Medicine 155:811-918, December 20, 2011 [/box]
Why I read this article?
In my clinic practice for several years now, I have been routinely offering my patients paper copies of their clinic visit notes if they would like to have them. Some patients almost always do (especially a one-time consultation visit for a complex Heme-Onc issue), but many of my patients (usually long-standing patients) do not wish to have their visit notes. I was interested to see that an Original Research report was published in the Annals specifically about this practice (but in electronic form) that would make visit notes available for access to patients via computer.
What did the investigators do?
The goal was to explore physicians’ and patients’ attitudes toward potential benefits and harms if PCPs offered patients ready access to visit notes. PCPs and patients completed surveys before
voluntary participation in a program (OpenNotes) to provide electronic links to notes was launched. Only baseline data was collected.
What did the investigators find?
-96% of participating PCPs (110/114), 45% of non-participating PCPs (63/140), and 42% of patients (37,856/90,203) completed the surveys.
-69-81% of participating PCPs and 92-97% of patients thought open visit notes was a good idea compared with 16-33% of non-participating PCPs who were concerned about the downsides for the patients.
-Some physicians worried about frightening and confusing patients, recording their thoughts candidly, and writing about such issues as mental health, substance abuse, cancer and obesity, however,
-Patients were overwhelmingly positive about the prospect of reading visit notes, in contrast to the expectations of their PCPs
Questions raised and concluding thoughts
“Are patients overly optimistic about how helpful open notes will be?
or
Do doctors underestimate patients’ resilience and resourcefulness when patients encounter arcane or worrisome language?”
-Since OpenNotes has gone live, unanticipated consequences have apparently emerged. For instance, as they learn what sorts of information doctors write down, patients reported withholding information that they would rather not have recorded. Also, patients may spot mistakes and help doctors avoid potential errors but they may also question a doctor’s competence and or the veracity of what is being documented.
-In my own clinic, I find “open notes” to be an overall positive practice that contributes to the patient-doctor relationship based on trust and partnership as well as improved communication. I try to be much more thoughtful when dictating “sensitive” information into patient records (issues as mental health, substance abuse, obesity…). I ask my patients to call me with any questions regarding visit notes and to provide me with feedback regarding corrections to prevent inadvertent propagation of inaccuracies in the medical record. Our patients already have the right to review their records anytime. In the future it is likely that electronic health records will increase patient access to their doctor visit notes.
What do you think?
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From the Chief Residents
Grand Rounds
Grand Rounds will resume on Friday, January 6, 2012
Noon Conference
The noon conference series will resume after the holidays.
Residents - and Faculty - Show off Holiday Spirit
Last week was the start of a new tradition in the residency program - the wearing of the "Tacky Christmas Attire". Although sweaters were the main target, the event drew quite an assortment of decorations - including everything from ties to socks. For those who missed seeing the unique collection, check out the following picture.
Tacky Christmas Attire
Rising JAR and SAR Preferences - 2013 Academic Year
Reminder - categorical rising JAR's and SAR's, please complete submission of schedule preferences for the next academic year no later than Sunday, January 8, 2012. Should you need assistance or have questions, contact Laura Kujawski.
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From the Residency Office
Duty Hours
Although this is the holiday season please note that you still need to submit your duty hours. Failure to do so will result in being pulled from service and notification of duty hour violations being sent to both Dr. Zaas and Dr. Klotman. If you are locked out - or need to enter adjusments - please contact Lauren Dincher.
Rhea's FAQ's
This is an excellent resource and has been added as a "Resource Document" in MedHub for easy access. Below is a quick link as well for those who would like to see what your colleagues ask and answers to your questions.
Rhea's FAQ's.
In-training Results
In-training examination reports have been distributed to internal medicine residents. Please review and schedule time to discuss with your advisor.
Dates to Add to Your Calendars
Recruiting Days - January, 2012
| 6-Jan |
Medicine Recruitment Day |
Friday |
| 6-Jan |
Med-Psych Recruitment Day |
Friday |
| 9-Jan |
Medicine Recruitment Day |
Monday |
| 10-Jan |
Med-Peds Recruitment Day |
Tuesday |
| 13-Jan |
Medicine Recruitment Day |
Friday |
| 13-Jan |
Med-Psych Recruitment Day |
Friday |
| 17-Jan |
MD PhD Recruitment PM |
Thursday |
| 20-Jan |
Medicine Recruitment Day |
Friday |
| 23-Jan |
Medicine Recruitment Day |
Monday |
| 27-Jan |
Medicine Recruitment Day |
Friday |
March 9 - Charity Auction
June 13 –Resident Research Event, 5-7pm
Opportunities
Osteopathic Hematology-Oncology Fellowship Program
Useful links
