Tag: EMR

Reading of the Week: Doctors & Suicidality – the New CMAJ Study; Also, GLP-1 RAs & Eating Disorders, and Chin-Yee on the Death of the Consult Note

From the Editor

His suicidal thoughts were so strong that he had written a suicide note. Yet, during the months before we met in the ED, he had hesitated to seek care. As a doctor, he knew he had severe depression but he told me that he felt he couldn’t get help. 

Such stories are all too common. In a CMAJ study, Dr. An Yi (Annie) Yu (of the University of Toronto) and her co-authors shed light on physicians’ seeking help for suicidality. They drew from the literature (literally): analyzing 52 narratives from academic papers, finding various barriers to seeking care, including aspects of medical culture, and identified facilitators, such as confidential services. “The pressure to achieve in medicine often discourages physicians from acknowledging their need for help, but the value of meaningful work emerged as a positive factor for mental health. The stigma regarding mental health concerns was substantially reduced through role modelling of help-seeking behaviour by colleagues.” We consider the study and its implications.

GLP-1 receptor agonists are having a moment because of the evidence for diabetes and other conditions. In the second selection, Nicholas C. Peiper (of the University of Louisville) and his co-authors focus on those with eating disorders, analyzing data to understand use and misuse in a new JAMA Psychiatry research letter. “This cross-sectional study found that GLP-1 RA use and misuse were common in a targeted sample of people with eating disorders.”

And in the third selection, from JAMA, Dr. Benjamin Chin-Yee (of Western University) writes about consult notes. He wonders what is lost in the “digital transformation” of templates and AI scribes. He worries about the future of the consult note. “The tools may evolve, but the art of pausing, thinking, and telling a story is still ours to preserve.”

DG

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Reading of the Week: Computers & Health Care – Dr. Gawande’s New Essay on “Why Doctors Hate Their Computers”

From the Editor

I’m running late – and I’m more than a bit concerned. I need to get to a meeting at the other campus, but first, I need to discharge a patient. That involves printing out a prescription and writing a short note. I’m in my fourteenth year of inpatient work, not counting residency, and I’m pretty good with prescriptions and notes. I believe I can do this. But does the EHR believe I can do this?

Many of us are frustrated with electronic health records (EHRs). In this week’s selection, we consider a new essay by Harvard University’s Atul Gawande, a surgeon, who considers EHRs and practice. Dr. Gawande talks about his own struggles with computers, and ties into the larger literature.

frustrateddocBig computer system, big problem?

We discuss his essay, and the potential and problems of EHRs. We touch on the Canadian experience and wonder about quality improvement. To that end, we look at “Getting Rid of Stuff,” just published in The New England Journal of Medicine.

DG

 

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