September 5th, 2011 by Happy Hospitalist in Health Policy
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One of the worst parts of my job over the years has been to tell patients I was going to bring them into the hospital as an observation status because they did not have any criteria for full inpatient status. There is a huge difference in how CMS pays for hospital care (excluding critical access hospitals) between inpatient versus observation.
Observation is considered outpatient. Medicare will pay for observation hospital services for up to 48 hours to allow physicians a chance to observe the patient and determine if they need to have an inpatient hospital admission. Observation was never intended to be used as a holding pit to help social workers arrange for a nursing home transfer during normal business working hours because it can’t be arranged, on either end, at 10 pm on a Friday night.
What used to be a moral family obligation to care for loved ones too weak to care for themselves has now been relinquished to the role of hospitals and hospitalists. And we all pay for it. Families have abandoned their loved ones for good. It’s really quite sad. Bringing patients into the hospital for the purpose of arranging a nursing home transfer is, in my opinion, a form of Medicare fraud, since these patients have no intention of being fully admitted.
But it’s paid for and will always be paid for, except when Read more »
*This blog post was originally published at The Happy Hospitalist*
September 5th, 2011 by AndrewSchorr in Opinion
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Steve Jobs in 2010
It was a bombshell that shouldn’t have been unexpected. Steve Jobs resigning. Anyone who saw him knew he was sick and, just watching him on television, it was obvious to me he was getting sicker. When you get so thin, when your color is not good, when you are probably taking heavy duty drugs that have side effects, you certainly don’t feel good. And when you don’t feel good, it is tough to think clearly, and make decisions with certainty. That is not a good thing for the CEO of one of the most successful corporations. It is actually a tribute to his will that he carried on so long. Many of the rest of us would be on a beach, taking it easy and celebrating every day. Steve Jobs celebrated every day by running Apple.
But at some point, given life is a terminal condition anyway, you have to accept that “the beast,” whatever it is in your case, is winning. I know that for myself. I have had a long remission with leukemia. But I know it could come back and even newer drugs might not “win.” I am thankful for the success treatment has had for so long. And I am sure Steve Jobs is thankful his diagnosis several years ago didn’t lead to his demise right then. We thank him, too, for iPhones and iPads and several other wonderful gizmos he has in the works that will blossom in the future.
Knowing when to call it quits – not accepting death – but accepting disability or a need to spend time differently – is a hard part of being a patient, it stinks. But it is reality. Read more »
*This blog post was originally published at Andrew's Blog*
September 4th, 2011 by Berci in Opinion
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I’ve recently come across Medikidz, a fantastic initiative with a mission to help children understand medical information, especially diseases. I cannot imagine a better way to promote such important messages to children.
Millions of children worldwide are diagnosed every day with conditions that even their parents may find difficult to comprehend. Most children don’t understand their medical conditions, or associated investigations, procedures and treatments, and are often scared by what is going on around them.
That is where the Medikidz come into action!
The Medikidz are Read more »
*This blog post was originally published at ScienceRoll*
September 4th, 2011 by Medgadget in News, Research
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Though mastectomies are often a necessary and even welcome intervention to save the lives of women suffering from breast cancer, they also may contribute to the overall physical and emotional trauma facing the patients. In order to alleviate some of these problems, surgeons have developed breast reconstruction procedures that usually entail restoring the mound by implanting a silicone sac filled with salt solution (saline) or gel under the skin and pectoral muscles. The traditional process to prepare for implantation of the sac may be long and sometimes painful because it involves weekly bolus saline injections (sometimes up to 22 weeks) in order to create a pocket of sufficient size.
A potential alternative solution is being developed by AirXpanders, a med tech start-up in Palo Alto that focuses on tissue expansion for breast reconstruction following cancer. Their system, known as AeroForm, just recently Read more »
*This blog post was originally published at Medgadget*
September 4th, 2011 by Iltifat Husain, M.D. in News
1 Comment »
Add Yale’s School of Medicine to the growing list of medical schools that are embracing the iPad as the primary source of medical teaching.
This upcoming year Yale will be giving their medical students, all 520 of them, an iPad 2 with an external wireless keyboard. We’ve covered with great depth the growing list of medical schools using iPads as the main tool for learning — such as Stanford, UC-Irvine, and many more.
“Yale School of Medicine this year will outfit all students with iPads and no longer provide printed course materials. The initiative, born out of a going-green effort, could Read more »
*This blog post was originally published at iMedicalApps*
