October 15th, 2009 by Happy Hospitalist in Better Health Network, Opinion
Tags: CMS, Hand Washing, Hospitalists, Hospitals, Internal Medicine, JCAHO, Paperwork, Patient Safety, Physicians, Punishment, Surgery, Time Out
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Over at the WSJ Health Blog, some academic docs, such as hospitalist Dr. Wachter are suggesting just that.
Punishments such as revoking privileges for a chunk of time tend to be used for administrative infractions that cost the hospital money – things like failing to sign the discharge summaries that insurance companies require to pay the hospital bill. By contrast, hospital administrators may just shrug their shoulders when it comes to doctors who fail or refuse to follow rules like a “time out” before surgery to avoid operating on the wrong body part.
Docs and nurses who fail to follow rules about hand hygiene or patient handoffs should lose their privileges for a week, Pronovost and Wachter suggest. They recommend loss of privileges for two weeks for surgeons who who fail to perform a “time-out” before surgery or don’t mark the surgical site to prevent wrong-site surgery.
This couldn’t have come at a better time. At Happy’s hospital there is a massive witch hunt to crack down on not signing off verbal orders within 48 hours. This has nothing to do with patient safety. It has everything to do with meeting the requirements of CMS so the hospital does not lose their funding. Read more »
*This blog post was originally published at A Happy Hospitalist*
October 15th, 2009 by RamonaBatesMD in Better Health Network
Tags: Circumcision, HIV, Plastic Surgery, Urology
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There has been recent debate over whether circumcision should be made mandatory as a way to prevent the spread of HIV, so I thought I would share the section on circumcision from the 1908 textbook, A Text-Book of Minor Surgery by Edward Milton Foote, MD.
Circumcision
This little operation can be performed in a number of ways. The practice among the Hebrews when circumcision is performed as a religious rite is to draw the foreskin well forward, to cut it off with one stroke of a long knife, to immerse the penis in wine held in the mouth of the rabbi to stop the hemorrhage, and then to wrap it in linen rags. It is not surprising that dangerous hemorrhage and infection sometimes follow this procedure, and a few lives have been lost in consequence.
Equally reprehensible is the practice among some surgeons of trying to perform this little operation in the shortest possible time. For this purpose clamps have been devised to hold the foreskin so that both the external and reflected portions can be cut away by a single stroke of the knife. It is obvious that the amount of skin thus removed cannot be controlled with certainty, and even if the line of incision be a perfectly smooth circular one, a thing which rarely happens, the adjustment in length of the external and internal portions of the prepuce is at best uncertain. There is no part of the body concerning which most patients are more sensitive, so that the surgeon ought to be willing to give up a few minutes of his time in order to secure a perfect result. Read more »
*This blog post was originally published at Suture for a Living*
October 15th, 2009 by Steve Novella, M.D. in Better Health Network, News
Tags: Autism, Causes, Hypothesis, Neurology, Pediatrics, Prevalence, Vaccines
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Two recent studies concerning the prevalence of autism in the US have been getting a lot of attention, because they indicate that autism prevalence may be higher than previously estimated. This, of course, fuels the debate over whether or not there are environmental triggers of autism.
One study was conducted by the CDC but has yet to be published. The results were announced ahead of publication by the US Health and Human Services Secretary Kathleen Sebelius to the autism community. She reports that the new prevalence of autism spectrum disorder (ASD) is now estimated at 1% or 100 in 10,000 children. This is an increase over the last few years. In 2002 the prevalence was estimated to be 66 per 10,000.
The second study was published in the journal Pediatrics and is a phone survey of 78,037 parents. They asked if they had any children who had ever been diagnosed with an ASD. Here are the results: Read more »
*This blog post was originally published at Science-Based Medicine*
October 14th, 2009 by Shadowfax in Better Health Network, True Stories
Tags: Emergency Medicine, headache, Infectious Disease, Instincts, Meningitis, Migraine, Pediatrics
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Saw a nine-year old with a headache today. His dad brought him in, and explained that all the men in his family get migraines; he figured this was his son’s first one. The kid seemed perfectly well, with a positive Cheetos sign and my gut instinct was that I would discharge him with no work-up. But when I flexed his neck fully, he winced. Read more »
*This blog post was originally published at Movin' Meat*
October 14th, 2009 by DrWes in Better Health Network, Humor
Tags: Attorneys, Billing, Coding, Finance, Healthcare reform, Healthcare System, Lawyers, Paperwork
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Imagine if lawyers had to bill like doctors:
Beginning July 1, 2010, under the Legal Billing Obfuscation Act of 2009, lawyers will receive their payments for services rendered after approval by a central US government Payment Distribution Authority (USPDA). To receive payment from the Authority plaintiff and defendant complaints must be coded and filed electronically using the International Classification of Legal Complaints, 10th edition (ICLD-10), copyright © 2009, American Bar Association and Legal Proceeding Terminology (LPT) codes, copyright © 2009 American Bar Association. The full publication of each of these codes will be available in print March 1st 2010 and in electronic form on DVD in July 2011.
To familiarize lawyers with the new coding scheme requested by the USPDA, a small sample for the complaint of “Spilling” is shown below: Read more »
*This blog post was originally published at Dr. Wes*
