July 27th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
Tags: Bad Backs, Benefits Vs. Harms, Christopher Snowbeck, Diagnostic Radiology, Doctor-Patient Encounter, Driving Up Healthcare Costs, Gary Schwitzer, General Medicine, Good Medical Decision Making, Healthcare Cost Drivers, Healthcare Decision Making, Healthcare Economics, Healthcare reform, Healthcare spending, HealthNewsReview.org, Imaging Tests, Jeremy Olson, Lower Back Pain, Medical Imaging, Medical Overuse, Medicare Data, Minneapolis Star Tribune, Minnesota, Minnesota Hospital Association, MRI, Neurology, Orthopedics, Overtreatment, Rate of Utilization, Shared Decision-Making, St. Paul Pioneer Press, Too Many Medical Tests, Too Much Testing
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Kudos to Christopher Snowbeck and the St. Paul Pioneer Press for digging into new Medicare data to report that the state the newspaper serves is out of whack with the rest of the country in how many expensive MRI scans are done on Minnesotans’ bad backs.
Snowbeck artfully captures the predictable rationalization and defensive responses coming from locals who don’t like what the data suggest. Because what they suggest is overuse leading to overtreatment. So here’s one attempt a provider makes to deflect the data:
“The Medicare billing/claims data, which this report is generated from, would not capture conversations between a patient and provider that may have addressed alternative therapies for lower back pain,” said Robert Prevost, a spokesman for North Memorial Health Care. “It’s important to recognize the limitations of this data.”
No, data don’t capture conversations. But wouldn’t it be fascinating to be a fly on the wall during those many patient-physician encounters that led to an MRI to see what level of truly informed shared decision-making (if any) took place? Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
July 27th, 2010 by Medgadget in Better Health Network, News, Research
Tags: Braces, Child Injuries, Child Safety, Contact Lenses, ED, Emergency Department, Emergency Medicine, Emergency Room, ER Visits, Family Medicine, FDA, Food and Drug Administration, Injured Kids, Medical Device Injuries, Medical Device Safety, Needles, Obstetric Exam Tools, Pediatrics, Wheelchairs
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FDA researchers have published a study in Pediatrics that analyzed patient records from child and teen ER visits in 2004 and 2005. The investigators are reporting that 70,000 kids each year go to the ER because of issues caused by medical devices.
About a quarter of the injuries were from contact lenses, while the other major contributors were needles, wheelchairs, braces, and obstetric exam tools. The study also looked at the devices most likely to cause hospitalization, and they were found to be mostly invasive devices like ostomy appliances and implanted defibrillators. Read more »
*This blog post was originally published at Medgadget*
July 27th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
Tags: Anonymity, Formalized System of Reporting, General Medicine, Impaired Colleagues, Incident Report, Incompetent Doctors, JAMA, Journal of the American Medical Association, Not Fit To Practice Medicine, Patient Safety, Physician Incompetencies, Self-Police, Whistleblowing Doctors
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Recently, JAMA published a study concluding that doctors are hesitant to report incompetent physicians or those who were impaired. According to the article:
“…more than a third of docs don’t think they’re responsible for reporting those who aren’t fit to practice, according to the results just published in JAMA. And only 69 percent of the docs who knew about an impaired or incompetent colleague reported them.
To those who advocate that the medical profession self-police, the numbers aren’t encouraging. Read more »
*This blog post was originally published at KevinMD.com*
July 27th, 2010 by Emergiblog in Better Health Network, Health Policy, Opinion
Tags: Advance-Practice Nursing Services, Definition Of Nursing, Family Medicine, General Medicine, Internal Medicine, Knowledge Base for Nursing Practice, Licensed Practitioners, NA, NP, Nurse Extender, Nurse Practitioner, Nurses Aide, Nursing Care, Nursing Profession, Physician Assistant, Physician Extender, Primary Care, Registered Nurse, Registered Nurses, RN
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“Physician Extender.” It sounds like the name of a male enhancement product. It’s a term often used to describe a nurse practitioner or a physician’s assistant. I hate it. It’s insulting.
A nurse practitioner is not an adjunct physician. They do not supplement the care of a physician. They provide essential advance-practice nursing services, services that include diagnosis and provision of medical care.
While some of these services overlap those of medicine, nurse practitioners are not extensions of another profession, they provide care in their own right — as educated, licensed practitioners. Sometimes the only care provider for a community is a nurse practitioner. Read more »
*This blog post was originally published at Emergiblog*
July 26th, 2010 by David Kroll, Ph.D. in Better Health Network, Health Policy, News, Opinion, Research
Tags: ACS, American Cancer Society, American Society of Clinical Oncology, Annals of Applied Statistics, Biostatistics, Chemotherapy, Dr. Anil Potti, Duke University, Eric Ferreri, Forensic Bioinformatics, Genetics, Grant Applicants, Grant Funding, Joe Nevins, Keith Baggerly, Kevin Coombes, MD Anderson Cancer Center, Microarray Analysis, Microarray-Based Individualized Chemotherapy, National Cancer Institute, National Institutes of Health, Nature Medicine, NCI, News & Observer, NIH, Paul Goldberg, Personalized Genomics, Research Errors, Research Grant, Rhodes Scholar, The Cancer Letter, Tumors
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This is not good. Not good at all.
Recently Paul Goldberg of The Cancer Letter reported on an investigation into Duke cancer researcher Anil Potti, M.D., and claims made that he was a Rhodes Scholar in Australia. The misrepresentation was made on grant applications to National Institutes of Health (NIH) and the American Cancer Society (ACS).
The Cancer Letter, a $375 per year go-to newsletter on cancer research, funding, and drug development, has made this issue free at this PDF link.
News & Observer higher education reporter Eric Ferreri has a nice overview of the situation. Potti has been placed on administrative leave by Duke, and the ACS has suspended payments on his grant and initiated their own investigation. Read more »
*This blog post was originally published at Terra Sigillata*
