August 7th, 2011 by Happy Hospitalist in Opinion, Research
No Comments »
I’ve been telling my smoking patients for years that nothing I do for them is going to make an ounce of difference until they quit smoking for good. And the Italians are out to prove me right. The American Journal of Cardiology reported July 11th, 2011 on the Effect of Smoking Relapse On Outcome After Acute Coronary Syndrome.
In a study of just under 1,300 patients, Reuters reports that just over 1/2 the patients started smoking within 20 days of hospital discharge, despite in-hospital smoking cessation consultation for all patients. Researchers also found that resuming smoking increased death 3-fold compared with those that did not relapse and quitting smoking had a similar lifesaving effect as taking cholesterol and blood pressure medications. And I’m sure these folks all landed themselves back into the hospitals for a very expensive dying process.
That’s why billing the patient or their insurance for smoking cessation (CPT® 99406 and 99407) is so important. And that’s why I give many of my smoking patients my smoking lecture. You know how much Medicare pays for a ten minute consultation to help cardiac patients quit smoking right now? Read more »
*This blog post was originally published at The Happy Hospitalist*
August 3rd, 2011 by Happy Hospitalist in Opinion, True Stories
1 Comment »
Childbirth hospital costs these days aren’t cheap. Some studies suggest the cost of raising a child exceeds $200,000, not including education expenses. Most insurance companies charge women of childbearing age more for their insurance because the actuarial tables say so. Mrs Happy and I now have a 3 month old Zachary in our wings. He is a cute little peanut. His two brothers, Marty and Cooper adore him.
Forty-two days after his April 21st, 2011 delivery, we still had not received our explanation of benefits from Blue Cross Blue Shield for the midwife charge. I had previously received a statement from them saying the charge was under review. Perhaps they believed that delivering Zachary was not medically necessary. I can’t explain it.
When I called to ask them why this charge had not been approved, they said they could not give me a reason why my explanation of benefits statement had not been finalized after 42 days. I pressed for more information, but to no avail. I was given no reason other than to say that they had a lot of claims to review. That’s not an acceptable reason to delay a payment of a claim. Read more »
*This blog post was originally published at The Happy Hospitalist*
July 27th, 2011 by Happy Hospitalist in Health Policy, Opinion
No Comments »
A physician asked me a question regarding what should be the role of hospitalists in carrying out discharge orders written by other physicians.
I have been following your blog since I was a resident and recommend it to a lot of people. Thank you so much for enlightening me on so many day to day hospital issues. I wanted to know your opinion about something that puzzles me. When a specialist changes a medication or requires a lab to be done as outpatient after a discharge order is written (for example you write: okay to D/C if okay with cardiology, and they change a dose or request stress test out-pt) who is required to write the new scripts and arrange that test? Is it the hospitalist’s responsibility to do it? Or is the specialist who changed the dose after you rounded required to handle it? It was easier during residency due to abundance of residents/fellows and the fact it was electronic RX access. What are your thoughts? As so far I always return back and make the adjustments needed for the patient welfare, and the fact I don’t know whether I should take stance and request that physician to do their job.
Dear physician, there is nothing puzzling here. It’s black and white. Read more »
*This blog post was originally published at The Happy Hospitalist*
July 2nd, 2011 by Happy Hospitalist in Health Policy, Opinion
No Comments »
Over the last few years, you may have heard a lot about the value of checklists in ICU medicine and their ability to reduce mortality, reduce cost and reduce length of stay. But a recent study took the concept one step further and suggested that checklists by themselves may not be effective unless physicians are prompted to act on the checklist.
As reported in the American Journal of Respiratory and Critical Care Journal, a single site cohort study performed at Northwestern University Feinberg School of Medicine’s medical intensive care unit compared two rounding groups of physicians. One group was prompted to use the checklist. The other group of physicians had access to the checklist but were not prompted to use it.
What they found was shocking. Both groups had access to the checklist. However, patients followed by physicians who were prompted to use the checklist had Read more »
*This blog post was originally published at The Happy Hospitalist*
June 28th, 2011 by Happy Hospitalist in Humor, Opinion
No Comments »
You ever wonder what doctors really think but are afraid to say out loud? Here’s one example:
“I wish all my patients were on a ventilator”
There’s a reason vented and sedated patients are considered desirable. In addition to the obvious economic benefits of
There are the less talked about, but equally pleasant side effects most hospitalists, ER doctors, cardiologists, gastroenterologists, pulmonologists, surgeons, infectious disease doctors, endocrinologists, psychiatrists, rheumatologists, dermatologists, nurses, respiratory therapists and physical therapists wouldn’t admit, but would agree, without hesitation. As a general rule:
- Patients on ventilators are just faster, easier and more pleasant to take care of. Read more »
*This blog post was originally published at The Happy Hospitalist*
