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Minnesotans Get More Lower-Back MRIs: Why?

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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*

Medical Devices Injure 70,000 Kids Each Year

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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*

Patient Safety: Doctors Must Report Each Other’s Incompetencies

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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*

More On The False Claims Of A Cancer Researcher At Duke

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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*

Waiting In The ER Is Okay As Long As Patients Know How Long

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Patients don’t mind waiting in the ER as long as they’re kept apprised of the time, an industry survey revealed. This is a good thing, since ER waits have risen nationally to an average of four hours and seven minutes this year.

Press Ganey Associates, Inc., has conducted the survey annually and says that ER wait times are four more minutes than last year, or a half hour more than the first survey in 2002. The company collected data on 1.5 million patients treated at 1,893 hospitals in 2009.

Despite longer wait times, patient satisfaction with U.S. hospital emergency departments stayed about the same in 2009. Communication was the key, as patients who waited more than four hours, but received “good” or “very good” information about delays were just as satisfied as patients who spent less than one hour in the emergency department.

*This blog post was originally published at ACP Hospitalist*

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