July 5th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
Tags: ACEP, American College of Emergency Physicians, American Medical Association, Angela Gardner, Associated Press, Battery Of Tests, Cardiology, Chest Pain, Doctor Sued, Doctor-Patient Communication, Dr. Robert Bitterman, Emergency Department, Emergency Medicine, Emergency Room Doctors, ER, Evidence-Based, Health Reformers, Malpractice Insurance, Malpractice Protection, Medical Lawsuits, Medical Malpractice, Overtesting, Pros And Cons Of Testing, Shared Decision, Standardized Guidelines, Suspected Heart Attacks, Unhappy Patients, Unnecessary Medical Tests, X-ray
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Emergency physicians are in a dilemma. Risk missing a diagnosis and be sued, or be criticized for overtesting.
Regular readers of this blog, along with many other physicians’ blogs, are familiar with the difficult choices facing doctors in the emergency department.
The Associated Press, continuing its excellent series on overtesting, discusses how lawsuit fears is a leading driver of unnecessary tests. Consider chest pain, one of the most common presenting symptoms in the ER:
Patients with suspected heart attacks often get the range of what the ER offers, from multiple blood tests that can quickly add up in cost, to X-rays and EKGs, to costly CT scans, which are becoming routine in some hospital ERs for diagnosing heart attacks …
… and the battery of testing may be paying off: A few decades ago insurance statistics showed that about 5 percent of heart attacks were missed in the emergency room. Now it’s well under 1 percent, said Dr. Robert Bitterman, head of the American College of Emergency Physicians’ medical-legal committee.
“But you still get sued if you miss them,” Bitterman added.
The American Medical Association’s idea of providing malpractice protection if doctors follow standardized, evidence-based guidelines makes sense in these cases. Furthermore, it can also help reduce the significant practice variation that health reformers continually focus on. Read more »
*This blog post was originally published at KevinMD.com*
July 5th, 2010 by Berci in Better Health Network, Health Policy, News, Opinion, Research
Tags: Cost Of Healthcare Reform, Healthcare Economics, Healthcare reform, New U.S. Healthcare Bill, Who's Paying For It
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Ever wondered who’s paying for the U.S. healthcare bill? My new favorite blog just published an infographic describing this issue in detail (click on the image for the original larger version):
*This blog post was originally published at ScienceRoll*
July 5th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News, Opinion, Research
Tags: Care Management, Course Of Treatment, Doctor-Patient Communication, Doctors In A Hurry, Evidence Based Medicine, Family Medicine, General Medicine, Health Affairs, Highly-Desired Treatments, Internal Medicine, Medical Evidence, Medical Language Lesson, Medical Research, Medical Specialists, Medical Terminology, More Expensive Treatments, Patient Education, Patient Understanding, Primary Care, Quality Guidelines, Quality Standards, Rushed Office Visit
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Doctors trying to help patients understand a course of treatment must teach them new terms such as “medical evidence,” “quality guidelines” and “quality standards.” Patients might not be willing to accept that language lesson.
A study in Health Affairs concluded that 41 percent of patients didn’t ask questions or tell doctors about problems. The main barriers were that patients didn’t know how to talk to doctors, or their physicians seemed rushed. Only 34 percent of patients recalled physicians discussing medical research in relation to care management.
But, physicians say, that’s only half the problem. Sometimes, patients demand to see specialists when they don’t really need to. Or, they don’t accept it when evidence shows that highly-desired treatments aren’t the best ones for care. One reason may be that one in three patients believe that more expensive treatments work better than less expensive ones, according to the study in Health Affairs. Once the evidence is laid out, it can be a delicate negotiation to get patients to accept that. (American Medical News, Health Affairs, RangelMD, KevinMD)
*This blog post was originally published at ACP Internist*
July 5th, 2010 by DrWes in Better Health Network, Health Policy, News
Tags: ChicagoBreakingNews.com, Construction Companies, Employee Benefits, Employee Health, Healthcare Benefits, Healthcare Economics, Healthcare Packages, Healthcare Policy, Healthcare reform, Labor Unions, Road Construction
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Road and construction projects have stopped all over town, thanks to concerns about future healthcare benefits. From ChicagoBreakingNews.com:
Construction companies and labor unions are divided over healthcare packages. The unions seek a 15 percent annual benefits increase over three years, while contractors have countered with a 1 percent annual increase.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
July 4th, 2010 by RamonaBatesMD in Better Health Network, Health Tips, News, True Stories
Tags: Daily News, ED, Emergency Department, Emergency Medicine, Emergency Room, ER, Fireworks Safety, Fireworks-Related Injuries, July 4th, Lauren Johnston, Preventive Medicine, Safe Fireworks Use, Shannon Elliott
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Time for a reminder about safe fireworks use. This Daily News article by Lauren Johnston — Doctors replace woman’s missing thumb with big toe transplant –- shows and tells you why. An excerpt:
A Long Island woman’s big toe will adapt to function as a thumb after doctors performed a rare transplant operation to replace the vital missing digit.
Shannon Elliott, 25, lost the thumb and two fingers from her left hand in November when a firework exploded in her palm…
Have a safe and happy July 4th — and stay out of the ER. Please follow these fireworks safety tips:
- Never allow children to play with or ignite fireworks.
- Read and follow all warnings and instructions.
- Fireworks should be unpacked from any paper packing out-of-doors and away from any open flames.
- Be sure other people are out-of-range before lighting fireworks. Small children should be kept a safe distance from the fireworks; older children that use fireworks need to be carefully supervised.
- Do not smoke when handling any type of “live” firecracker, rocket, or aerial display.
- Keep all fireworks away from any flammable liquids, dry grassy areas, or open bonfires.
- Keep a bucket of water or working garden hose nearby in case of a malfunction or fire.
- Take note of any sudden wind change that could cause sparks or debris to fall on a car, house, or person.
- Never attempt to pick up and relight a “fizzled” firework device that has failed to light or “go off”
- Do not use any aluminum or metal soda/beer can or glass bottle to stage or hold fireworks before lighting.
- Do not use any tightly closed container for these lighted devices to add to the exploding effect or to increase noise.
- Never attempt to make your own exploding device from raw gunpowder or similar flammable substance. The results are too unpredictable.
- Never use mail-order fireworks kits. These do-it-yourself kits are simply unsafe.
For more information on injuries that can occur from unsafe use of fireworks, see:
Fireworks-Related Injuries (CDC)
Facts About Fireworks Injuries (Prevent Blindness America)
*This blog post was originally published at Suture for a Living*
