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More Stupid Hospital Documentation Rules
Today I was notified by Medical Records at my hospital that one of my OR/surgery reports was incomplete. I had done hemorrhoid surgery on a patient 6 weeks ago. Someone in the medical records department flagged a deficiency in my OR note. I had left out the “drain” section – whether a drain was used or not. For my lay readers, you need to know that while drains can be used in abdominal surgery, I have never used one for hemorrhoid surgery in 27 years. In fact I can’t think of any colorectal surgeon ever using a drain for hemorrhoidectomy. In any case I was in violation as the hospital Medical Record Procedure Committee stated that Drain recording is a requirement and has to be addressed in the Operative report. I was directed to Rules and Regulations page 14. Was the documentation of drains a ‘requirement’ of the committee because of government regulatory agency rules or did the committee feel that drains should be used in hemorrhoidectomy? I doubt anyone sitting on this committee knows anything about anal surgery, so it’s likely a misinterpretation or misapplication of a badly written regulation. If this documentation of drains is required, then this should be mentioned in all surgery despite clinical relevance or common sense. Taking this to a ridiculous end in my hospital, drain use should be documented for anal fissure surgery, removal of rectal foreign body and colonoscopy performed in the OR in spite of logic that drains are never used in these procedures. It is thoughtless mindless enforcement of such ‘rules’ and regulations which lead to more and more doctors leaving medicine in frustration.
How I Use Twitter
With all the buzz online and in the news about the Twitter – how it should be used, the stock, can it make a profit, I decided to write about how I came to embrace Twitter. Before October 2013, I knew nothing about Twitter. I only started an account after attending a course in Social Media at the Mayo Clinic.
Around that time everyone, everywhere was chatting about the upcoming Twitter IPO. People asked what was Twitter, what was its role, how could one use it. Many predicted the IPO would not do well as it had yet to make a profit and some felt its growth was slowing.
I read “Hatching Twitter” by Nick Bilton who wrote there “were two completely different ways of using Twitter. Was it about me, or was it about you? Was it about ego, or was it about others? In reality, it was about both.”
For some, like celebrities, it is about sharing status, where they are, or what they are doing. For others it is about sharing news, more a “communication network, not just a social network” Bilton writes.
This disagreement underpinned that of two Twitter founders, Evan Williams and Jack Dorsey, which lead to each falling out as friends and partners.
I don’t care if Twitter ever makes a profit. I am happy to use it my own way as each and everyone of you can use it as yours.
As a professional, I avoid Tweeting about myself as much as possible. I use Twitter to post links to interesting articles about my work, health care and surgery. I can always go back to these references later. In that way, Twitter is a catalogue of my online professional musings and learning.
I attend several medical conferences a year. Twitter allows me to share what I learned from these meetings and some have gone so far as to say that social media tools like Twitter may make attendance at these meetings obsolete. I hope not. While at a meeting, I use Twitter to share information, start conversations, and share my adventure as a tourist with pictures of local sights, restaurant finds, and discussions of things to do.
On a personal note, I do use Twitter as a form of a diary. It matters little to me if my followers read it as I am tweeting for myself. I spend a lot of my leisure time travelling, eating out, reading and at the movies. Sometimes I forget what I did or when I saw something or travelled somewhere. I attribute this to age. So I record most of my day on Twitter so I can reflect back on these experiences and memories later. I expect that with time and a growing number of posts, going back to review these will become more difficult.
How you use Twitter will not be the same as how I do it. Perhaps you want chat about a topic, investigate an interesting topic, market or sell something. I wanted to write about the particular way I use this social tool.
Social Media and Surgery 