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Twitter Highlights from AMIA17

Posted on November 15, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Last week I had the privilege of attending the 2017 American Medical Informatics Association (AMIA17) annual conference in Washington DC. I thoroughly enjoyed the experience and came away with new appreciation for the work informaticists do. Check out this blog for key AMIA17 takeaways.

One of the most enjoyable aspects of AMIA17 was the quantity and quality of the live-tweeting. My twitter feed hadn’t been that active at a healthcare conference since HIMSS17. There were no less than 20 attendees actively tweeting throughout the conference.

Below is a selection of memorable AMIA17 tweets.

I wasn’t familiar with Carol Friedman’s work, but her lovely tribute video was riveting – almost Hidden Figures-esque. Friedman not only had to overcome being a female data scientist, she was one of the few in her field to believe Natural Language Processing could be applied to healthcare. Her acceptance speech was filled with humor and funny stories.

One of the major announcements at AMIA17 was the creation of a new open access journal – called JAMIA Open. This new publication will be AMIA’s attempt to break down one of the biggest barriers to innovation – a lack of access to research papers. It will be interesting to track the progress of JAMIA Open in the months and years to come.

A very interesting concept discussed at AMIA17 was the use of EHR audit logs as way to identify areas for improvement. This included finding opportunities where retraining might be needed and where bottlenecks exist in clinical workflows. Suddenly it’s not so bad that EHRs record every action…or maybe it is if you are a bottleneck.

Genomics is very exciting. Carolyn Petersen, an Editor at Mayo Clinic, tweeted one out an interesting use case during AMIA17 – using genomic info to prevent adverse drug reactions. Amazing.

This was an extremely interesting question posed by Dr. Danny Sands. In the OpenNotes session he attended the presenters found that physicians were more honest in their documentation notes than they were with the patients they were seeing face-to-face. This makes for an intriguing scenario when patients gain access to those notes after a visit.

One of the more prolific live-tweeters at AMIA17 was Dr Wayne Liang. I enjoyed reading his tweets from sessions that I was unable to attend. This tweet stood out for me. He expertly summarized the 5 ways HealthIT systems could be improved to allow for better data analytics.

Another active live-tweeter was Pritika Dasgupta, PhD student at University of Pittsburgh Department of Biomedical Informatics. This tweet nicely summed up how sensitive the issue of decision support tools has become. Patients and clinicians both want the latest and greatest tools that will lead to the best outcomes. From that perspective, evidenced-based decision support tools can be very effective. However, medicine is more than simply a set of if/and/or statements. It is truly a craft and there is a concern that we lose something when we try to reduce patients to a set of input parameters.

It is always a special treat to listen to a Ross D Martin live performance. At AMIA17 he performed his latest creation – a theme song for #digituRN, an initiative to transform nursing through digital innovation. You can listen to the song on YouTube.

Shout out to Pritika Dasgupta, Dr Wayne Liang, Carolyn Petersen, Rebecca Goodwin, Dr Paul Fu Jr, Dr Arlene Chung, Jenn Novesky, Scott McGrath, Dr Danny Sands, Ross Martin, Alex Fair and Michael Rothman. It was fun to live-tweet with you at AMIA17.

New EHR Virtual Assistant: Samantha from NoteSwift

Posted on November 14, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Sometimes in a blog post, it’s much easier to show something than it is to write about something. That’s definitely the case with the recently announced EHR Virtual Assistant from NoteSwift called Samantha. That’s why I asked NoteSwift to create a demo video of Samantha at work so you could see what they’re doing. Check out the video demo of Samantha working with Allscripts Professional below.

Samantha currently works with Allscripts Professional EHR and athenaClinicals EHR and they’re looking at integrating with other EHRs in the future.

When NoteSwift first reached out to me with this tool I told them that it sounded a lot like the voice recognition and NLP solutions that I’d seen previously. I remember one EMR a long time ago that had really deeply integrated voice navigation that got pretty close to this type of interface. Plus, I’d seen demos of NLP that would pull out the granular data elements from a narrative text before.

The key question for me was how tightly integrated the voice recognition and NLP technology was with the EHR software. As you can see from the demo above it’s quite integrated. I do still have some questions on what the learning curve for some of the specific voice commands will be for the NLP to work properly and document the visit the right way. Plus, similar to voice recognition I’m interested to know if the mistakes you have to correct are as time intensive as just clicking the boxes yourself. I’m sure there will be the full spectrum of experiences.

One thing that really impressed me about NoteSwift’s implementation of Samantha was the verification process that the doctor goes through near the end of the video (about 2 min and 12 seconds in for those keeping track at home). I’ve always thought that, at least for now, this was an essential part of using NLP in the medical world. The doctor still needs to verify that everything is accurate before moving on. The way NoteSwift has implemented this is quite slick.

In talking with Wayne Crandall, the President and CEO of NoteSwift, he also told me that Samantha can work with any input mechanism including voice recognition from Nuance or MModal. He even told me that some doctors believe they can type faster than they can do speech recognition which isn’t a problem for Samantha either. The real magic of Samantha is in taking a narrative text, however it’s produced, parsing the structured data, assigning the coding and entering it into the correct areas of the EHR.

Pretty slick solution and one that I think many doctors would like to try so they can stop their slow death by a million clicks.

MIPS Penalties Include Medicare Part B Drugs – MACRA Monday

Posted on November 13, 2017 I Written By

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

I’m sure most regular readers can tell that we’re pretty worn out and tired of MACRA, MIPS, and related government regulation. No doubt you’ll see us posting fewer MACRA Mondays going forward, but we’ll still try to cover major MACRA events as they occur. We just won’t be publishing MACRA Monday every Monday like we’ve been doing.

Jim Tate recently posted about the Real MIPS Timeline which included:

  • Phase 1 – Denial
  • Phase 2 – Shock/Anger
  • Phase 3 – Acceptance

You should read his full writeup, but he’s right. There’s a lot of denial that’s going to lead to shock and anger until the majority of healthcare have to finally accept that MIPS and MACA aren’t going anywhere.

Jim Tate also wrote another important piece related to the MIPS penalties and Medicare Part B drugs. You can read the full details of the change, but for those too lazy to click over, here’s the summary:

  • Many organizations argued that Medicare Part B Drug Costs Shouldn’t be Included in the MIPS Penalties (I mean…payment adjustments)
  • The MACRA Final rule still includes Medicare Part B drug costs (for the majority of people) in the MIPS reimbursement and eligibility calculations

If you’re a practice with a high volume of part B drugs, you better start figuring out your MIPS strategy now! Otherwise, that payment adjustment is going to hit pretty hard.

Thanks Jim for the great insights into MACRA and MIPS. If you need help with MIPS, be sure to check out Jim’s company MIPS Consulting.

Elderly Doctor May Lose Medical License Due In Part To Lack Of Computer Skills

Posted on November 10, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Do physicians need to be computer-literate to run a safe and effective medical practice? The question has come into high relief recently as an 84-year-old New Hampshire physician fights to get her medical license reinstated.

Dr. Anna Konopka, who recently lost her license due in part to a lack of computer skills, is suing the New Hampshire Board of Medicine in an effort to get it reinstated.

Back in September, Konopka had signed an agreement to surrender her license with the medical board. The agreement settled pending allegations regarding her “record-keeping, prescribing practices, and medical decision-making,” according to an article in Ars Technica. The agreement reportedly permits her to apply to regain her license, but to succeed in doing so she’d have to prove that she did no wrong.

In her interview with the publication, the elderly physician denied any misconduct and said she was under duress when she voluntarily surrendered her license previously. She has said that she wants to continue practicing medicine, but does not want to participate in what she calls “electronic medicine.”

“I am getting the patients from the system [her term for the medical bureaucracy surrounding the use of EMRs today], and I see how badly they are mistreated and misdiagnosed or not diagnosed at all,” she told Ars Technica. “Therefore, I am not going to compromise patients’ lives or health for the system.”

For what it’s worth, Konopka’s troubles with the state medical board didn’t arise from computer use or lack thereof. They were triggered when a formal complaint was filed with the board alleging that she treated a young patient with asthma incorrectly.

The dispute resulted in a formal reprimand from the medical board in April 2017. The board also required her to undergo 14 hours of medical training as a condition of continuing to practice. After that, other investigations followed, including disputes over the scope of her original agreement with the medical board.

Ordinarily, Konopka’s struggles for reinstatement might never have come to public view. What differentiates them from others is the role her unwillingness to use computers has played in the process. Specifically, unless she learns to use the Internet, she won’t be able to comply with the state’s new law requiring her to access an online opiate monitoring program. (As part of her attempts to regain her license, she’s agreed to do so.)

It’s hard to tell who is right in this particular case, but the situation does raise interesting questions about the role of computer use in medical practice generally.

Should physicians be required to use computers as part of their practice in this day and age, and if so, what level of competency should they be required to attain? Are there specific pieces of software, such as EMRs, they have become as important to medicine as a stethoscope was in a prior era? Should use of health IT software be a required part of all medical training at this point?

I don’t have any answers to these questions, and you may not either. But if a doctor’s license can be threatened, even in part, by failing to use computer technology, we’d better work on finding some.

Wearables Makers Pitching Health Trackers For Babies

Posted on November 9, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

When my older son was born, we relied on a low-tech “sense of hearing” solution to track crying alerts from his crib at the other end of the hallway.

But were he born today, my son would never have settled for such pedestrian technology. Today’s discriminating newborn expects his parents to collect a wide array of data points and conduct advanced analytics on them to optimize his health.

You think this is ridiculous? Wipe that smile off of your face, you slackers. Ever sensitive to the expanding needs of today’s modern baby, wearables manufacturers have begun testing health trackers designed to monitor their tiny bodies, according to an article appearing on the CNN.com site.

In fact, there are already dozens of wearables for babies on the market, CNN found, including devices that monitor their heart rate, smart socks that track oxygen levels and a baby monitor button that snaps onto the child’s clothes. Any of these could cost a few hundred dollars. But there’s also smart thermometers and pacifiers, such as Vick’s or Blue Maestro’s Pacif-i, which start around $20 and go up from there, the site reports.

The CNN article also shares the tale of Crystal King, an Atlanta mom who’s monitoring her six-month son Avery using one of these emerging trackers.

The piece describes how using her cell phone, King can check her baby’s temperature on her cell phone and get app-driven alerts when it’s time for Avery’s next bottle feeding.

Meanwhile, if King picks up her tablet, she can also monitor her son’s breathing, body position, skin temperature and sleeping schedule. (Back in the Stone Age, I had to settle for keeping his body in position with pillow wedges and tracking his sleeping schedule using a little trick known as “staying awake.”)

As part of his work with CNN, Avery has been testing a number of different wearable devices. He seems to be a tough critic. On the one hand, he seemed pretty comfy wearing a biometric-tracking onesie while playing on his mat, but kept spitting out the smart pacifier, which was apparently a nonstarter.

Of course, we don’t actually know what Avery thinks about these devices, but his mom has developed some ideas. For example, King told CNN she thinks it would be good to help parents control the number of notifications they get from baby-monitoring apps and technologies.

If nothing else, equipping their baby with a health tracker may offer parents a little extra reassurance that their child is safe. He might still erupt in deafening screams at 3AM now and again, but if he’s wearing a health tracker, you might at least know why.

Patients May like Their Physician…But That Doesn’t Mean They’ll Stay

Posted on November 8, 2017 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Medical providers are dealing with a more impatient, demanding patient base than ever before. Armed with research, awareness, and a plethora of online data, today’s consumer patients treat their search for a medical provider in much the same way they would any purchasing decision.

They weigh the pros and cons of each provider, evaluating how each practice would fit their lifestyle and then make a decision.

Unfortunately, that is not the end of the process. Even after a patient chooses a specific practice, they are not even close to becoming loyal patients.

Smooth processes trump provider loyalty

It often surprises medical practices to discover that retaining patients has less and less to do with the medical competence of the office. Today, it may not be enough for a patient to simply like their physician.

For busy patients, the road to loyalty goes directly through the processes and procedures of an office. Studies back this up. Consider this. Sixty-one percent of patients say they are willing to visit an urgent care clinic instead of their primary care clinic for non-urgent issues. This is true regardless of whether they like their primary care provider or not.

The #1 reason they prefer urgent care? Because of difficulty scheduling appointments and long wait times with a primary care physician. According to a study by Merrit Hawkins, wait times have increased by 30 percent since 2014. Patients have noticed.

These long wait times were also noted as one of the key reasons patients will switch practices according to respondents of the Patient Provider Relationship study:

  • Sixty-eight percent say that wait times in their medical office are not reasonable.
  • Sixty-six percent say that they have to wait too long to schedule an appointment.
  • Sixty-eight percent say they feel like messages are not returned in a timely manner.

Reducing wait times is crucial to patient retention

In order to increase patient retention levels, practices must find ways to offset the frustration of long wait times. Consider implementing these three methods of wait-time optimization.

  1. Self-scheduling. It is common for doctors to have calendars booked out months in advance. This can cause patient frustration and turnover. When practices allow patients to schedule themselves, however, this frustration is minimized. With self-scheduling, they can quickly see which doctors are available and when. Since 41 percent of patients would be willing to see another doctor in the practice to reduce their wait, this is a simple way to optimize your scheduling without sacrificing patient experience.
  2. Communication. There are times when long waits are unavoidable. This is where communication is key. Studies show that 80 percent of patients would be less frustrated if they were kept aware of the issue. When you know an appointment is going to be delayed, send out an email or text letting them know.
  3. Texting. If your patient has a question, texting can save them a lot of time. Research shows that it takes just 4 seconds to send the average text message. Compare that to the several minutes it takes to make a phone call. Factor in playing phone tag and you’ve saved both time and headaches. Unfortunately, the Patient-Provider Relationship Study found that while 73 percent of patients would like to be able to be able to send a text message to their doctor’s office, just 15 percent of practices have that ability. Practices in that 15 percent will stand out from their competitors.

In this era of consumer-driven behavior, practices need to prioritize ways to create smooth processes for patients. Medical offices should look at ways to optimize their processes to reduce frustration and wait times for patients.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff. Learn more about the Patient-Provider relationship survey here.

Digital Health Venture Snags $10M Investment After Buzzword Upgrade

Posted on November 7, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Melon Springs, FL – In a deal observers are calling “disruptive,” “groundbreaking” and “lemon-scented,” high-profile wellness startup ICanHazHealth has closed a $10 million investment round on the heels of its recent buzzword upgrade.

Investors participating in ICanHazHealth’s Series B round include Bracelet Capital, Two Right Thumbs LLC and Window Dressing Digital. Few details of the agreements were disclosed, though Bracelet’s Jared Spoon-Monicker told Wired that its investment contract included an agreement to provide buzzword platform to its other portfolio companies. “We’re calling it ‘BaaS’ — buzzwords-as-a service,” said Spoon-Monicker, an early backer of exaggeration engine JIVETalk. “It will be the Uber of monetizing incremental marketing hyperbole.”

Launched in 2010 to tap the emerging market for digital health investment catchwords, the vendor’s BLOviATE platform offers both employer-and consumer-compatible content libraries. “Today, it’s not enough for consumers to use digital health buzzwords,” said ICHH founder P. Foster Bellbottom. “If we want to improve outcomes, we need to increase their level of buzzword engagement.”

The latest iteration of ICHH’s enterprise jargon platform, BLOviATE nACTION, now offers modules supporting several functional areas, including bragging, wishful thinking, puffery, exaggeration, self-deception, embellishment, and hyperbole.

Hospitals and health systems can also opt for a 10-year buzzword maintenance contract which supports BLOviATE deployment over existing SLANG and LinGO databases. However, ICHH won’t be offering distortion upgrades for BLOviATE past 2020, so after that point facilities will need to do their own grandiloquence support.

When asked what they thought of the emerging doubletalk startup’s prospects, analysts noted that ICHH faces several competitors with well-established client bases. Many pointed to iNtercAP, iNc., a niche buzzword developer specializing in novel tech company names, whose customers include Hangzhou No Trouble Looking for Trouble Internet Technologies (usually referred to as HNTLFTIT for short) and connected health giant Slippers and Sonograms.

“The issue is not whether there’s enough demand to support a bunch of balderdash startups,” said Warren Wallaby, head of the braggadocio research consulting firm the Seesaw Group. “At the moment there’s definitely a market for a range of bravado solutions.” The thing is, there’s no guarantee that the buzzword market won’t go soft at some point. “Health IT buyers have to be ruthless,” Wallaby says. “The day CIOs can get the same results from a few white lies and a little dissembling, these startups will be out of business.”

Note: This is a parody for those so inundated by buzzwords that it’s hard to tell.

Accomplishing Great Things in Healthcare

Posted on November 6, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m just finishing off my busy healthcare IT conference season. It’s amazing how many healthcare IT conferences want to pack themselves into October and the start of November. My last one is this week and then it’s pretty slow until the new year. That makes me happy even though I love meeting so many people at conferences and hearing so many first hand perspectives.

However, with this scheduling in mind, I thought I’d keep this post short and sweet and share this really interesting quote from Anatole France that was shared by Shereese:

I was talking to a healthcare entrepreneur today and I said that running a business is hard. He said that if it was easy, everyone would do it. I guess that’s true. It takes a whole lot of work and effort to build a great business that can do amazing things. The same is true for anyone wanting to improve healthcare. it takes work, dreams, plans, and belief.

Alert Fatigue: It May Be Worse Than You Thought

Posted on November 3, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Until recently, I didn’t take the problem of clinical decision alert fatigue that seriously, or at least not as seriously as I should have. After all, it’s just an alert, right? You can just shut it off if you don’t like hearing it. Or so it seemed to me, admittedly a naïve pundit from the peanut gallery who’s never treated a patient in her life.

But despite my ignorance, researchers have continued to unearth evidence that alert fatigue may be one of the worst safety hazards afflicting medicine today. After all, this fatigue comes from a deadly one-two punch: the excess noises camouflage the alerts clinicians really need to hear while distracting them from what they’re doing with useless sounds. (If you put me in a situation like that I’d get booted out the door for throwing particularly noisy devices out the window.)

Sadly, alert fatigue is far more than a nuisance. The latest evidence to this effect comes from the Journal of the American Medical Informatics Association, where an article published last month underscored how often alerts cause clinicians to ignore important information.

To conduct their study, a group of researchers conducted a cross-sectional study of medication-related clinical decision support alerts. They collected data at a 793-bed tertiary-care teaching institution, measuring the rate of alert overrides, the reasons cited for overrides and the appropriateness of those reasons.

The results of their analysis were disquieting. On the one hand, they found that roughly 60% of overrides were appropriate overall. In particular, 98% of duplicate drug overrides, 96.5% of patient allergy overrides and 82.5% of formulary substitution overrides were appropriate. That’s the good news. On the other hand, they concluded that 40% of physician alert overrides were inappropriate.

All told, overrides of alerts in certain categories were inappropriate greater than 75% of the time. Let’s take a moment to think about that. Seventy. Five. Percent. Now, I know that “inappropriate” doesn’t mean that the patient would’ve died if the error was corrected, or even that they incur serious harm, but this still isn’t great to hear.

Not surprisingly, researchers said that future studies should optimize alert types and frequencies to improve their clinical relevance so clinicians don’t slap them down over and over like a snooze alarm.

The truth is, studies have been drawing this conclusion for quite some time now, and from what I can see little has changed here.

My assumption is that vendors keep doing what they do because nobody has pressured them enough to make them rethink their CDS logic and drop needless alarms. I’m also guessing that some misinformed health leaders might be reassured by the sound of alerts going on and equating it with higher safety ratings. If so, let’s hope they get disabused of this notion soon.

The Whole Healthcare System is Burnt Out

Posted on November 2, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


We’ve all seen charts and graphs like the one above. Physician burnout has become a real problem. The EHR has largely become the scapegoat for the physician burnout, but I believe it’s much more complex than that. There are a lot of pressures on doctors that are causing burnout and even physician suicide (a topic which many don’t like to talk about).

Physician burnout is indeed an important topic and one that needs to be addressed. However, I recently saw someone tweeting about physician burnout and in response, someone suggested that we should be talking about Patient Burnout as well. The idea really resonated with me. Especially because I’d never heard anyone talk about patient burnout despite it being a real problem. To better understand the effort, I asked Erin Gilmer to host this week’s #HITsm chat on Patient Burnout. I think we’ll learn a lot about this topic during the chat.

This week I’m at the CHIME Fall Forum with a wide variety of healthcare CIOs. During one of the keynotes, the speaker mentioned physician burnout and it prompted the following tweet:


Indeed. Many healthcare CIOs are burnt out as well. They have so many regulations, so many intiatives, cybersecurity issues, and much much more that’s hitting them from every angle. it’s no wonder that they’re burnt out.

This all made me realize, the whole healthcare system is burnt out. Is there anyone in healthcare that isn’t a little burnt out? Some deal with it better than others, but there’s a lot of burnout all around in healthcare.

This tweet captured the issue of burnout nicely.


How then do we fix all this burnout? I wish I knew the answer. Acknowledging it is the first step, but that still leaves us a long way from a solution. Hopefully we can work towards it for everyone involved.