July 2nd, 2011 by Happy Hospitalist in Health Policy, Opinion
Tags: Checklist, Critical Care Medicine, ICU, Joint Commission, M.D., Nurse Prompting, Nursing, Quality, RN Communication, Safety
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Over the last few years, you may have heard a lot about the value of checklists in ICU medicine and their ability to reduce mortality, reduce cost and reduce length of stay. But a recent study took the concept one step further and suggested that checklists by themselves may not be effective unless physicians are prompted to act on the checklist.
As reported in the American Journal of Respiratory and Critical Care Journal, a single site cohort study performed at Northwestern University Feinberg School of Medicine’s medical intensive care unit compared two rounding groups of physicians. One group was prompted to use the checklist. The other group of physicians had access to the checklist but were not prompted to use it.
What they found was shocking. Both groups had access to the checklist. However, patients followed by physicians who were prompted to use the checklist had Read more »
*This blog post was originally published at The Happy Hospitalist*
July 2nd, 2011 by DavedeBronkart in Opinion
Tags: BMJ, ePatients, Evidence, JAMA, Medical Journals, Science, Understanding Statistics
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e-Patients who want to collaborate with their physicians, and be responsible for their medical decisions, need to clearly understand what constitutes good evidence. It’s not always easy.
Now Richard Smith, a 25 year editor of the British Medical Journal, has written another piece for the BMJ blog, citing a JAMA study showing “that of the 49 most highly cited papers on medical interventions published in high profile journals between 1990 and 2004 a quarter of the randomised trials and five of six non-randomised studies had been contradicted or found to be exaggerated by 2005.”
What’s an e-patient to do?? Especially when we “patients who google” are so often sneered at by physicians who rely on these same journals.
Well, we need to educate ourselves, and learn to speak calmly, confidently and understandingly to anyone who doesn’t understand – just as we expect clinicians to do with us.:–) In short, we need to Read more »
*This blog post was originally published at e-Patients.net*
July 1st, 2011 by DrWes in Health Tips, Opinion
Tags: Advice, How To Be A Good Doctor, How To Behave, Interns, Medicine, Physicians In Training, Rules Of The Road, Teaching, Tips For Doctors
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He sat in a crisp white coat, staring at a computer screen, note cards in his lap. Occasionally, I noted him jot a note to himself as he compiled his list. A nurse sat next to him, pounding feverishly on the keyboard as she recorded her nurse’s note. He tentatively moved his mouse, then clicked, still staring.
I recall my first day in clinical medicine: no computer, an ER rotation, a white board filled with names and abbreviated medical problems next to them with little magnetic color-coded labels nearby. Room 1: Head trauma. Room 2: Abscess. Room 3: UTI, Room 4: Rash.
I got room 2. It was the biggest, bad-est infected sebaceous cyst on a guy’s back a newly minted doctor had ever seen. Can you say “softball?” “See one, do one,” they told me. And off I went.
Much in medicine has changed since then, but much remains the same. Medicine is miraculous, terrifying, then rewarding all at once. Fortunately, there’s a method within the madness that can serve to preserve and protect those who first start out. Every doctor has had the fortune to learn from those who passed before them as begin their journey to refine their title of “doctor” (literally, “teacher.”)
I thought it would be interesting to put a few of the “Rules of the Road for Medicine” down on paper (with the help of friends on Twitter) for interns and residents as they embark on their own incredible journey ahead. The list is not exhaustive, but hopefully can serve as a resource for our new doctors as they head off to meet their clinical challenges ahead.
Rule #1: Treat every patient like your mother Read more »
*This blog post was originally published at Dr. Wes*
July 1st, 2011 by Peggy Polaneczky, M.D. in Health Policy, Opinion
Tags: AMA, Big Pharma, Data Mining, Freedom Of Speech, Privacy, SCOTUS, Sorrell vs IMS Health, Supreme Court, Vermont
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The Supreme Court has sided with Big Pharma in their challenge to the Vermont Law limiting the pharmaceutical Industry’s access to physician prescribing information.
The nation’s high court handed down a verdict Thursday in the Sorrell v. IMS Health case, striking down by a 6-3 vote a 2007 Vermont law that that bans the practice of data mining — the sale and use of prescriber-identifiable information for marketing or promoting a drug, including drug detailing — unless a physician specifically gives his or her permission to use the information.
Apparently, Big Pharma’s right to “free speech” trumps my right to privacy. How getting access to my prescribing information has anything to do with free speech is beyond me. In the twisted logic of the pro-business, anti-citizen Supreme Court –
Speech in aid of pharmaceutical marketing… is a form of expression protected by the Free Speech Clause of the First Amendment. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
June 30th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
Tags: CDHP, Cigna, Consumer Directed Healthcare, Consumer-Driven Healthcare, Economic Incentives, Health Insurance, Obamacare, Rand
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The use of economic incentives to motivate behavior is neither a Democratic or Republican idea. It is human nature to be motivated by economic incentives. The concept of individual responsibility is an American idea. It has been tarnished in recent years.
There is no question in my mind that government has the responsibility to be compassionate and help the needy. It is my view that government should help individuals help themselves.
The costs associated with Medicare and traditional healthcare insurance are rising. Every stakeholder points a finger at the other stakeholders as the cause.
President Obama’s Healthcare Reform Act is raising costs higher in anticipation of cuts in the future. He is in the process of forcing individuals to be more dependent on the government rather than promoting individual responsibility.
Obamacare will fail to control costs.
All anyone has to do is look at a Rand Corp. study of 29 years ago to see what works and what doesn’t work. Read more »
*This blog post was originally published at Repairing the Healthcare System*
