August 12th, 2011 by RyanDuBosar in Research
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Prescriptions for antidepressants given by nonpsychiatrists to patients without a specific psychiatric disorder increased more than 12% in 12 years, leading to the drug class becoming the third most commonly prescribed, a study found.
A study in the August issue of Health Affairs reported that antidepressant prescriptions by doctors who didn’t record a specific psychiatric disorder increased from 59.5% of all prescriptions by nonpsychiatrists in 1996 to 72.7% in 2007.
Researchers reviewed data on patients age eighteen or older from the 1996-2007 Centers for Disease Control and Prevention’s National Ambulatory Medical Care Surveys, a national sample of more than 233,000 office-based visits. The proportion of antidepressants prescribed for patients without a psychiatric diagnosis increased from 2.5% of all visits to nonpsychiatrist providers to 6.4% between 1996 and 2007. For visits to primary care providers, antidepressant prescribing grew from 3.1% to 7.1%. For other nonpsychiatric providers, visits without a psychiatric diagnosis grew from 1.9% to 5.8%. In contrast, antidepressants prescribed with a psychiatric diagnosis increased from 1.7% to 2.4%.
Patients who received antidepressants without a psychiatric diagnosis by nonpsychiatrist providers were more likely to be Read more »
*This blog post was originally published at ACP Internist*
August 12th, 2011 by Emergiblog in Opinion
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You want to be a registered nurse?
Let’s cut through the B.S. and get real about it.
Put a hold on all this soft-focus “I live to care!” or “It gives my life meaning…”
Here’s the reality.
***
You will study your butt off.
Nursing science is based on biology, chemistry, microbiology, anatomy, physiology, psychology, sociology and philosophy. Yeah, every single one of them. You will incorporate those into every decision you make in your practice. It’s called critical thinking. You master it and become a professional, or you don’t and you become a robotic technician.
Bottom line.
Your choice.
Oh, and the studying doesn’t stop after you graduate. Nursing school is just the warm-up.
***
The work is physically exhausting and emotionally demanding. Read more »
*This blog post was originally published at Emergiblog*
August 11th, 2011 by Linda Burke-Galloway, M.D. in Health Tips, News
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Could breastfeeding kill a newborn? That is the question a California district attorney will ask a jury at the trial of a breastfeeding mother. Most women do not intend to harm their children but substance abuse and addiction comes with a heavy price. Such was the case of Maggie Jean Wortman, who has been charged with second degree murder after medical tests revealed that her newborn son died from methamphetamine intoxication obtained through her breast milk. Wortman’s 19-month-old daughter also tested positive for methamphetamine and was placed in protective custody. How could this happen?
The transfer of drugs from the mother’s blood to human milk depends on the chemical composition of the drug. Antibiotics such as penicillin will remain in the mother’s blood for long periods of time whereas certain types of blood pressure and heart medications will remain in the milk. During the first three days after birth, higher concentrations of medicine remain in breast milk. Wortman’s attorney is attempting to argue that methamphetamine in breast milk could not kill a baby but here’s why he’s wrong: Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
August 11th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
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The American College of Graduate Medical Education has enacted further restrictions on resident work hours. No more than 80 hours per week of work for resident physicians, averaged over one month. And no more than 16 hours of continuous work for first year residents (24 after that), which includes patient care, academic lectures, etc.
Whenever they do this sort of thing, everyone seems excited that it will make everyone safer. After all, residents won’t be working as much, so they’ll be more rested and make much better decisions. It’s all ‘win-win,’ as physicians in training and patients alike are safer.
I guess. The problem of course is that after training, work hours aren’t restricted. There is no set limit on the amount of work a physician can be expected to do, especially in small solo practices, or practices in busy community hospitals.
I understand the imperative to let them rest. I understand that fatigue leads to mistakes. I get it! But does the ACGME get it? Read more »
*This blog post was originally published at edwinleap.com*
August 11th, 2011 by Bryan Vartabedian, M.D. in Opinion
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I never thought I’d change the way I practice medicine. But I recently enrolled as a provider in the Improved Care Now (ICN) collaborative network and I’m already working differently.
ICN is an alliance of gastroenterologists and patients working in a new model of pediatric inflammatory bowel disease care based on the analysis of thousands of doctor–patient visits as well as the latest studies and treatments. Doctors and patients apply this information, experiences are tracked in an open registry, the results are then shared and refined to improve care. I can see what I’m doing well and where I’m falling short relative to other clinics and pediatric gastroenterologists.
ICN is under the direction of Dr. Richard Colletti of the University of Vermont. ICN is supported by the Chronic Collaborative Care Network (C3N), the brainchild of Cincinnati Children’s qualitymeisters, Peter Margolis and Michael Seid. I flew to Cincinnati earlier this week to catch up on C3N and what appears to be a first step into medicine’s future. More on the specifics later. But suffice it to say that I’m stoked about where this is all headed.
A couple of thoughts after enrolling my first few patients: Read more »
*This blog post was originally published at 33 Charts*
