New Physician Directory Smartphone App

I don't know about you, but one of the most frustrating things about online doctor info sites is that they bury key information like phone numbers, fax numbers, addresses, etc. As such, I've developed a new online physician directory called NovaDr. com that has all this information within 3 clicks, whether online or thru the smartphone app. Currently this directory contains doctor information for only 5 hospital systems in Northern Virginia including Fauquier Health , Haymarket M…

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Doctors Incorrectly Diagnose Symptoms 10-15% of the Time

Although we all like to think doctors are infallible... we are far from it. Studies on doctors' diagnostic skills have consistently shown error rates around 10-15% based on different approaches. Why aren't we better? It's because human biology is complex and doctors are human. When a patient comes in with a symptom... let's take dizziness ... there are numerous possible causes for this particular symptom: stroke, medication side effect, alcohol intoxication, BPPV , Meniere…

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Christopher Chang, MD Doppelgangers

Every once in a blue moon, I ( Christopher Chang, MD ) get contacted meant for one of my doppelgängers who has the same name as me and also a physician. However, I recently received one phone call that was particularly interesting as it came from the surgery department of INOVA Fairfax, a hospital system 45 minutes east of where I work. As I was talking on the phone, mentally I was thinking... What in the world is the person talking about? Plastic surgery? Need to attend a meeting? WHO IS T…

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Why are Magazines So Old in Doctor Waiting Rooms?

It certainly is a complaint in our practice... Why is it that magazines in doctor waiting rooms (including ours) tend to be so outdated??? And not just old, but the "boring" ones? One factor is that an office staff member has been negligent in replacing old magazines with new ones. Another is that... gasp... patients are stealing the new ones??? Researchers in New Zealand set out to study this common complaint and did find that new magazines tend to "disappear" resultin…

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Lawsuit Over Neck Cancer Misdiagnosed by Smell

In December 2012, a physician assistant (PA) excised a 3 cm right neck mass from a patient. In perhaps one of the more bizarre steps taken in this case, the physician assistant than smelled the excised mass, declared it non-cancerous, and threw it out in the garbage. Unfortunately, it was actually cancer which was correctly diagnosed 6 months later after the mass which had regrown was excised and sent to pathology by a doctor. The patient ultimately underwent a radical neck dissection and …

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Malpractice Lawsuit for Nerve Damage Sustained After Neck Cyst Excision

Earlier this month, a malpractice lawsuit resulted in a $4 million dollar award to the patient plaintiff who suffered permanent nerve damage after a family practice physician excised a cyst from the neck. [ link ] Briefly, the patient visited the family physician in July 2009 for a lump in his left neck . The family physician recommended that the mass be surgically excised which was subsequently performed by the same family physician (not a surgeon) in the office. After the procedure, the p…

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Do Surgeons Swear When Operating?

Surgeons, whether deserved or not, have a reputation of being mean-spirited and foul-mouthed as a group overall. It does not help that TV shows and movies perpetuate this reputation. Well, a study was actually carried out to see if surgeons are truly foul-mouthed or not and published their findings in the British Medical Journal in 1999. Using a grading system based on how bad the swearing is, researchers secretly tallied how often surgeons used profanity in the operating room. The obs…

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Forbes Critical of Patient Satisfaction Ratings of Physicians

Forbes on January 2, 2013 published a story critical of Press Gainey and other companies that obtain patient satisfaction scores. Please note that the following is a reprint of prior blog articles ( 2/19/12 and  6/8/12 ) written on this subject by Fauquier ENT. Indeed, much has been made about improving patient satisfaction in the healthcare industry in the belief that greater patient satisfaction equates with better health. To this end, patients are routinely asked to complete a survey b…

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Is Social Media Bad for Doctors?

I was recently asked to participate as a speaker in a panel discussion on social media next year in Canada and while preparing my thoughts on this subject, I was pondering several big questions regarding the why and pitfalls of social media for healthcare professionals. There's the obvious "WHY" a physician should participate in social media . But perhaps even a more basic concern for a physician deciding whether to pursue social media or not is whether it may even be a bad …

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What do Earthquakes Have to do with Thyroid Masses?

I'm not sure what is going on within the Italian Court system, but in October 2012, the Italian Court convicted 7 scientists to jail terms for not accurately predicting the 2009 L'Aquila earthquake  that ended up killing over 300 people. Also in October 2012, the Italian Supreme Court ruled that cell phones caused one man's brain tumor . Since when does the Court decide on matters of scientific validity? And even more importantly, what does this have to do with ENT??? I&…

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After Surgery, Do Patients Have Out-of-Pocket Costs for Follow-Up Visits?

Assuming a patient has insurance, the answer is generally no for a certain period of time... For a period of time after surgery, insurance specifies that a surgeon provides any and all routine  post-operative care for "free" without any patient out-of-pocket charges. This period after surgery is called "global period" and is based on the assumption that the insurance has already paid for not only the surgery, but all the post-operative care that goes along with the sur…

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Same Doctor Visit, Double The Cost

On August 26, 2012, the Wall Street Journal published a story describing a situation whereby a patient who sees a physician employed by a hospital essentially pays double out-of-pocket what they would have paid for the same exact office visit with a physician NOT employed by the hospital. I actually wrote about this situation in January 21, 2012. Beyond what the Wall Street Journal reported, what's going on? Assuming all things equal whereby a private practice physician and a ho…

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100% Patient Satisfaction Scores

What if I told you this 100% patient satisfaction score was due to a survey of only two people... that I personally picked? Welcome to the big bad world of patient satisfaction scores. Often (well... pretty much all the time), I come across an article, bulletin posting, or meeting where patient satisfaction scores are announced... but no background information to back it up. HOW many people completed the survey? HOW were the people selected? WHO administered the survey? HOW many people …

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Hospital-Based Practice Versus Physician Private Practice

The other day, an astute patient of mine asked what the difference is between a physician who works for a hospital (hospital-based practice) versus a physician run private practice. After all, a patient still sees a physician in either case... Is there an actual difference from a patient's perspective??? Assuming all things equal whereby a private practice physician and a hospital-based physician are equally competent and the supporting staff for each are both equally good (such a…

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What Makes a Successful Hospital - Where Are the Tweakers???

First off, I don't have a business degree (in fact, I'm a MBA drop-out) nor a degree in hospital administration (does chairing a hospital committee count?), but I do have an opinion (don't we all) in light of having co-founded a bioinformatics company (iCORD, LLC) in the past based on a patent developed during my surgical residency... But I also admit that the company was ultimately unsuccessful if one measures success in terms of monetary profits, but I can say I succeeded in t…

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Dr. House of TV Fame Would Never Survive in Real World

Would YOU as the patient see a doctor who is a well-known jerk, abuses drugs, gives the wrong diagnosis more often than not, and is known to like ordering very invasive tests??? Be honest... The other week, a patient with a chronic cough exclaimed to me that she wished the fictional character Dr. House of TV fame actually existed in real life, because he was somebody who can diagnose anything. I looked her straight in the eye and told her that somebody like Dr. House in the real world …

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The Four Types of Patients Seen in a Surgeon's Clinic

Over the years, I have found that patients can be loosely grouped into 4 different types. Nothing particularly wrong with any type, but it does help me to approach patients appropriately if I can get a sense of what type they are. The four types are: Type A:  If a surgery can "fix" or "cure" me such that I won't have to take medications every day of my life, than let's do it. Type B: I will never consider surgery unless it is a life-threatening situation. I…

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YouTube Ranks Fauquier ENT as Most Viewed for Medical Videos

I was informed that our practice's  YouTube channel  has been ranked as one of the most viewed channels related to medicine  in the world ! As of Oct 6, 2011, our channel  which contains 52 videos has received 198,064,840 views. We currently average over 500,000 views a day! We far surpass other more "prestigious" medical organizations with a YouTube channel. Mayo Clinic Channel Channel 4,936,943 views University of Maryland Medical Center Channel 2,047,260 view…

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HIPAA Allows for Regular Email Communication Between Patients and Physicians

There is a widespread mistaken belief that HIPAA prohibits physicians from communicating with patients using regular un-encrypted email as well as with other physicians about patient care. HIPAA, for those who don't know, is a law that requires patient information to be kept private with safeguards. Email (such as yahoo, gmail, aol, etc) is not considered a secure form of communication. However, HIPAA does allow for such un-secured email communication under certain circumstances. I q…

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United Kingdom Ends $17 Billion Electronic Medical Records Initiative

The Wall Street Journal on Sept 23, 2011 reported that the United Kingdom will scrap the entire electronic medical records (EMR) initiative that has been 9 years in the making with nearly 6.4 billion pounds already spent. That action was hinted at back in August 2011 after a scathing parliamentary report stating the initiative to be wasteful and incapable of delivery. I'm not surprised... It's hard enough to get a group of doctors in one hospital to agree with a treatment plan …

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