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Posts by:

Craig Joseph, MD


The term “OK BOOMER!” (capital letters intentionally and ironically used) has been omnipresent lately. I first took notice of it last month when a member of the New Zealand parliament used it against an arguably older fellow member who was heckling her during a speech about the climate crisis. The recipient of her retort may not have understood its meaning, but those of her generation certainly did. Similar to “talk to the hand,” this expression dismisses the other party and ends the conversation, yet it’s more biting than that. “OK BOOMER!” implies that the recipient can’t even understand where the other party is coming from – as if there’s no common background or even language, hence there’s no need to continue.

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Healthcare IT Guiding Principles

I’m no project manager (PM), I promise you that. I don’t like deadlines; I sometimes skip over details that I find boring or monotonous; for the love of all things holy, I do not live for spreadsheets. I believe all of these character flaws rule me out of any project management position. That said, I acknowledge that without project managers, nothing would get done. I’m glad PMs exist and that they’re good at what they do. While I don’t have the skillset or mentality of a project manager, I wholeheartedly agree with a key PM credo: the need for a guiding principles statement for information technology (IT) projects big and small.

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Agile Development of Clinical Decision Support Tools Using Stories

I recently read a fascinating article in JAMIA about using Agile development techniques and stories to prioritize, create, and test clinical decision support (CDS) tools in healthcare information technology (IT). I wanted to share it because I think Agile in general, and stories specifically, can be leveraged in many different ways that benefit clinicians and patients.

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Less is More

I’ve always been fascinated by minimalism. Be it philosophy, architecture, or design. The ethos of “less is more” seems contradictory at first, but it proves accurate and predictive in many aspects of life, or at least in my life. Much as the Fibonacci sequence shows up in random places all throughout nature, I find the concept of minimalism popping up in my clinical world and professional world.

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Physician, Train Thyself. Or Not. It’s Up to You, Really. You Tell Me.

I’m a smart aleck. Maybe you’ve figured this out already. Maybe you have another descriptive name for me. Whatever. Back in the day when I was practicing primary care pediatrics 24/7/365, I got to know a lot of my patients’ parents (who am I kidding? – moms) very well. This happens when you practice with only one other physician for many years. It’s a good thing. Often a mom would describe a child with upper respiratory infection (URI) symptoms, and after I heard the history, I’d snidely comment: “Listen, I’m such a good doctor that I’ve already narrowed this down to only two things. It’s either something, or it’s nothing.”

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How to Depress a CMO (or This Is Why We Can’t Have Nice Things)

“Never waste a good crisis.” This quote has been ascribed to various sources, but whoever said it was wise. Often, one can make significant progress in a short amount of time when the environment is unstable. Normal rules go out the door. Maybe this is because there’s an existential crisis and something had to be done to save the organization from doom. Perhaps a leader has exited and before the management vacuum is filled, a long dormant project is resurrected and quickly implemented under the radar. Whatever circumstances led to the crisis, enterprising folks often take advantage to get stuff done.

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Bad Customer Service and Sick Hospital Patients

I was recently reading an article in the Wall Street Journal titled “Everyone hates customer service; this Is why.” It’s an amazing piece detailing how customer service is getting worse while businesses leverage technology to understand how poorly they can treat their customers before they lose sales. Yeah, I just wrote that. Some businesses have learned that they can mistreat their paying customers without deleterious effect, and have taken advantage of these findings to do just that (hello cable and phone companies.) Other more “respectable” groups are using technology to do more with less, and I want to focus on them.

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Secret Shoppers: EHR Style

I recently read an article in the New York Times titled “Undercover in a Hospital Bed.” It describes how hospitals and medical centers are contracting with “secret shopper” consultants. Being a secret shopper at a fast-food restaurant or a retail clothing store is fairly straightforward: walk in, pretend you’re a customer, observe how you’re treated and if employees are complying with company standards, make a purchase, and walk out. When it comes to being a secret shopper in a hospital or emergency department (ED), the stakes are a bit higher.

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