HIV and ID Observations

May 13th, 2018

Why Experienced HIV/ID Doctors Leave Clinical Practice

Three of my good friends — they’re way more than just colleagues after all this time — in the HIV/ID world have left clinical practice recently. Abigail (Abbie) Zuger, Joel Gallant, and Chuck Hicks, each of them brilliant in different ways, won’t be caring for people with HIV anymore, something they’ve all been doing since the […]

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May 14th, 2017

Poll: Which Feature of Electronic Health Records is Most Important to Patient Care?

The first electronic medical record I used regularly — called “BICS” — initially had one purpose. It was a tool to look up a patient’s lab results. Simple, reliable, and blazingly fast, it did one thing remarkably well. Later, one of our Emergency Department doctors, who happens to have impressive coding skills, worked with a team to add a simple ambulatory medical […]

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December 6th, 2015

Do Electronic Health Records Make You a Better (or Worse) Clinician?

Earlier this week, JAMA Internal Medicine published a study entitled, “Level of Computer Use in Clinical Encounters Associated with Patient Satisfaction”. A more descriptive title would have been “More Computer Use in Clinical Encounters Associated with Reduced Patient Satisfaction”, as here’s the take home point: High computer use by clinicians in safety-net clinics was associated with lower patient satisfaction […]

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September 20th, 2015

EHR and Drug Prescribing Warnings: The Good, the Bad, the Ugly

Part 1. The Good. Recently, an ENT colleague (fictionally named “Clint” below), sent me two emails triggered by drug-drug interaction warnings he received while seeing HIV patients. Here’s #1: Hey Paul, I saw Mark C yesterday for hoarseness, and his exam was negative. Thought we’d try a PPI for reflux, but when I wrote the script, I […]

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February 24th, 2013

Solve This Problem Please — Microbiology Results in Electronic Medical Records

Our hospital and affiliated practices have had electronic medical record (EMRs) of some sort for decades, so I’ve had my chance to try my hand at multiple “platforms,” both commercial and home-brew. (Weirdly — and I kid you not on this — a version of the first iteration from the 1980s is still around, running parallel […]

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June 11th, 2010

Plays at the (Culture) Plate

Some quick ID/HIV/other thoughts while we marvel in all that is Strasburgian: Did you know that HIV medication adherence improves over time? So much for “pill fatigue.” By the way, this anecdotally fits with my experience as well. And right now, the biggest reason for patients’ stopping their HIV meds is financial, usually due to loss of or […]

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