This is another post derived from a presentation given at the 2011 Annual Summer Meeting of the Wilderness Medical Society. Tracy Cushing, MD, of the University of Colorado School of Medicine gave an excellent presentation on submersion injury—i.e., the dangers of becoming submerged under water. What follows is some of what we learned.
Historically there have been many terms and definitions, such as “drowning,” “near-drowning,” “dry drowning,” and others. Current experts favor the term “submersion injury” as any adverse effect from submersion in water. This commonly causes difficulty breathing, for many reasons. “Immersion syndrome” refers to the situation where there is a lethal heart rhythm during or after a cold-water exposure, usually attributed to stimulation of the vagus nerve, which slows the heart rate. “Shallow water blackout” refers to a person becoming unconscious after hyperventilating prior to attempting a lengthy period of breath-holding underwater.
Drowning is the Read more »
This post, Preventing Drowning And Other Submersion Injuries, was originally published on
Healthine.com by Paul Auerbach, M.D..
Last week, Medicare’s Center for Medicare and Medicaid Innovation announced a Comprehensive Primary Care (CPC) Initiative, which asks private payers and state Medicaid programs to join with Medicare to “help doctors work with patients to ensure they:
1. Manage Care for Patients with High Health Care Needs;
2. Ensure Access to Care;
3. Deliver Preventive Care;
4. Engage Patients and Caregivers; and,
5. Coordinate Care Across the Medical Neighborhood,”
according to an email from CMS’s press office. The initiative will provide qualified practices with risk-adjusted, per patient per month care managements payments, in addition to traditional fee-for-service payments, along with the opportunity to share in savings achieved at the community level.
I believe that the Initiative is a potential game-changer in helping to support and sustain primary care in the United States. But Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
Eight preventive health services for women should be added to the services that health plans will cover at no cost to patients under the Patient Protection and Affordable Care Act of 2010, according to a report by the Institute of Medicine.
The recommendations encompass diseases and conditions that are more common or more serious in women than in men. They are based on existing guidelines and an assessment of the evidence on the effectiveness of different preventive services. They include:
1) screening for gestational diabetes in pregnant women between 24 and 28 weeks and at the first prenatal visit for women at high risk for diabetes,
2) adding high-risk human papillomavirus DNA testing in addition to conventional cytology testing in women with normal cytology results starting at age 30, and no more frequently than every 3 years,
3) offering annual counseling on sexually transmitted infections for all sexually active women,
4) Read more »
*This blog post was originally published at ACP Internist*
Author-physician Dr. Atul Gawande has done it again with a well-written article in The New Yorker magazine entitled, “The Hot Spotters.” It deals with the fact that 5 percent of people with chronic illness make up over 50 percent of all healthcare costs.
If we can zero in on providing better preventive care for those people, we can finally get our arms around runaway healthcare costs. How great that you don’t even have to have a New Yorker subscription to read it. Here are a few cliff notes until you get to it:
— In Camden, New Jersey, one percent of patients account for one-third of the city’s medical costs. By just focusing attention on the social and medical outpatient needs of those people, they not only got healthier but costs were cut in half.
— Our current system is unable to reign in costs. We need to completely re-design and fund how we do primary care.
— Charging high co-payments to people with health problems just backfires. They avoid preventive care and end up hospitalized with expensive and life-threatening illnesses that are much worse and more costly. Read more »
*This blog post was originally published at EverythingHealth*
It is important to listen to what physicians are saying. An article appeared in SERMO, a physicians’ social network, which expressed a physician’s frustration. It is appropriate to publish some of that physician’s thoughts:
“I first heard this statement over twenty years ago, when I was an intern in general surgery, struggling to find my professional self.”
“My chief resident said; “The patient owns the disease,” “You’re not trying to make them suffer, you’re trying to help. They’re sick, you’re not.”
“The human body is unpredictable. Disease complications happen.”
The author thought his chief resident was heartless and callous. In a way, he was but he was getting at the heart of the matter. What is the patient’s responsibility in the evolution of disease? Read more »
*This blog post was originally published at Repairing the Healthcare System*