August 11th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
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The American College of Graduate Medical Education has enacted further restrictions on resident work hours. No more than 80 hours per week of work for resident physicians, averaged over one month. And no more than 16 hours of continuous work for first year residents (24 after that), which includes patient care, academic lectures, etc.
Whenever they do this sort of thing, everyone seems excited that it will make everyone safer. After all, residents won’t be working as much, so they’ll be more rested and make much better decisions. It’s all ‘win-win,’ as physicians in training and patients alike are safer.
I guess. The problem of course is that after training, work hours aren’t restricted. There is no set limit on the amount of work a physician can be expected to do, especially in small solo practices, or practices in busy community hospitals.
I understand the imperative to let them rest. I understand that fatigue leads to mistakes. I get it! But does the ACGME get it? Read more »
*This blog post was originally published at edwinleap.com*
August 6th, 2011 by Medgadget in News, Research
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Researchers from Columbia University have developed a “lab on a chip” HIV and syphilis test, and are now reporting the first results from tests in the field conducted in Rwanda. The mChip, as it is called, is the size of a credit card and replicates all steps of an ELISA test, at a lower total material cost and within 20 minutes. After application of a blood sample, the chip is inserted into a $100 battery-powered handheld analyzer. It needs only 1 μl of unprocessed whole blood and does not require any user interpretation of the signal, providing a clear-cut yes or no result.
Right now, HIV testing in developing countries either relies on expensive laboratory testing taking a long time, or uses cheaper methods based on lateral flow, which, although very rapid, do not provide very reliable results. The mChip combines Read more »
*This blog post was originally published at Medgadget*
July 31st, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
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Last night I was contacted by a physician in the local urgent-care. I like him, and we made polite, but brief, conversation. ‘So, are you guys busy?’
I gave him the status report. ‘Well, yeah. We have about 25 people waiting to be seen the waiting room is full and every patient room is full. Also, we just received a gun-shot wound to the head by EMS.’
‘Wow, sounds terrible! So, here’s what I need to send you…’
What he sent was, in fact, reasonable. A young woman with signs and symptoms of meningitis (who was treated earlier in the day for and upper respiratory virus…with Amoxicillin, of course.)
She needed a lumbar puncture, which I performed and which was negative.
But I had this thought. I could probably have said, Read more »
*This blog post was originally published at edwinleap.com*
July 30th, 2011 by DavidHarlow in Health Policy, Opinion
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The UnitedHealth Center for Health Reform and Modernization released a white paper today on Modernizing Rural Health Care. To quote from the UHG presser,
- [The paper] projects an increase of around 5 million newly insured rural residents by 2019 – even as the number of physicians in rural America lags
- Quality of care is rated lower in rural areas in 7 out of every 10 health care markets; both physicians and consumers in rural areas more likely to rate quality of care lower than those in urban and suburban markets
- Innovations in care delivery – particularly telemedicine and telehealth – can absorb future strain on rural health care systems
The paper inventories the current state of health care for the 50 million Americans living in a rural setting — and it’s not pretty. The question, of course, is why does rural health compare unfavorably to urban health metrics, and what can be done to improve matters? Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
July 29th, 2011 by MuinKhouryMDPhD in Opinion, Research
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Adverse drug events are a serious public health problem. Consider the following facts:
- an estimated 82% of American adults take at least one medication and 29% take five or more;
- 700,000 emergency department visits and 120,000 hospitalizations are due to adverse drug events annually;
- $3.5 billion is spent on extra medical costs of adverse drug events annually;
- at least 40% of costs associated with adverse drug events occurring outside hospitals can be prevented.
How can genomics help? Pharmacogenomics is the study of genetic variation as a factor in drug response, affecting both safety and effectiveness. The intended applications of pharmacogenomics research include identifying responders and non-responders to medications, avoiding adverse events, optimizing drug dose and avoiding unnecessary healthcare costs. The Food and Drug Administration has added pharmacogenomic information to the labeling for more than 70 drugs. Labels may include information on genetic determinants of clinical response or risk for adverse events.
In spite of current enthusiasm about pharmacogenomics in the research community, Read more »
*This blog post was originally published at Genomics and Health Impact Blog*
