June 11th, 2011 by Shadowfax in Opinion
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It’s ever so satisfying to be proven right. Well, maybe “proven” is too strong a word to use, but there is a bit of strong evidence that, as I have said in the past, the practice of defensive medicine is driven by powerful multifactorial incentives and is very unlikely to change even if the most often-asserted motivator, liability, is controlled. Today, Aaron Carroll guest blogs at Ezra Klein’s WaPo digs:
The argument goes that doctors, afraid of being sued, order lots of extra tests and procedures to protect themselves. This is known as defensive medicine. Tort reform assumes that if we put a cap on the damages plaintiffs can win, then filing cases will be less attractive, fewer claims will be made, insurance companies will save money, malpractice premiums will come down, doctors will feel safer and will practice less defensive medicine, and health-care spending will go way down.[…]
Health Affairs in December, estimated that medical liability system costs were about $55.6 billion in 2008 dollars, or about 2.4 percent of all U.S. health-care spending. Some of that was indemnity payments, and some of it was the cost of components like lawyers, judges, etc.; most of this, however, or about $47 billion, was defensive medicine. So yes, that is real money, and it theoretically could be reduced.
The question is, will tort reform do that? Read more »
*This blog post was originally published at Movin' Meat*
June 11th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
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The appalling lack of women chief executives in today’s Health IT companies has been linked to a paucity of women in IT generally and the scarcity of female mentors and venture capitalists that could support them. Social norms regarding gender identity and child rearing also drive the disparity. In this post, I’ll briefly review these norms and some promising efforts to reduce the disparity.
Social Norms, Women and Tech
Many people believe social norms and expectations regarding women are the most important reason why there are so few female IT leaders out there today. As the father of 3 girls who are succeeding in tech, I don’t necessarily agree with this (I think the phenomenon is driven by these factors).
Still, there are some indisputable facts that have to be mentioned. Read more »
*This blog post was originally published at Pizaazz*
June 11th, 2011 by KerriSparling in Humor, True Stories
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You know when you’re skimming through the newsfeed on Facebook, and something totally grabs your face and says “LOOK AT ME I AM THE AWESOME?”
Yes, that’s precisely what happened when I stumbled upon Faye’s photo of Novolog-inspired cake pops. (You did read that correctly. Here, look:)
Photo – and cake pops – by Faye!
Faye has been living with type 1 since the age of 9, and for her 18th diaversary she wanted to make something special and bolus-worthy. Her current obsession has been cake pops (making them and feeding them to her non-d friends, even though I can safely say that some of her d-friends would happily go chompies on one), so when she saw the bright orange candy melts at her local AC Moore, a lightbulb went off – NovoLog cake pops! It was too funny (and ironic) to pass up. It’s a celebration of living with diabetes for 18 years, and it’s also a tribute to the diabetes community and a reminder to find the humor in our journey. Read more »
*This blog post was originally published at Six Until Me.*
June 10th, 2011 by Happy Hospitalist in Health Policy
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Hospital costs are out of control. We have an aging population living longer with more complicated presentation of disease. We have an insurance driven platform instead of a health driven accountability. The long term sustainability of that architecture is one of guaranteed insolvency.
One way or another hospitals are going to find their lifeline cut off. Medicaid is bankrupt. Hospital profit margins from Medicare have been negative for almost a decade. In addition, the rapid rise in private insurance premiums and industry’s gradual but accelerating exit from the health insurance benefit market all tell me that hospitals must find a way to reduce the cost of providing care.
There are many ways hospital costs can be reduced. Administrators are paid handsomely to make it happen. Either they do or they don’t succeed. Either they survive the coming Armageddon of hospital funding or they don’t. The hospitals least able to reduce their expenses in a market of decreasing payment will fold and other hospitals will become too big to fail. You want to be too big to fail. That’s the goal. If you can survive the coming tsunami, you will be saved and bailed out when you are the only one left standing. That is what history has taught us.
So, how can hospital costs be reduced? One way is to Read more »
*This blog post was originally published at The Happy Hospitalist*
June 10th, 2011 by Peggy Polaneczky, M.D. in Health Tips
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In a large multicenter study enrolling over 70,000 women, annual screening with transvaginal pelvic ultrasound and ca125 blood testing did not reduce deaths from ovarian cancer, and in fact led to an increase in complications due to screening.
Investigators in the NCI-sponsored Prostate, Lung and Ovarian Cancer (PLCO) Screening trial randomly assigned over 78,000 women age 55-64 years of age to either annual screening with transvaginal pelvic sonograms for 4 years plus CA125 testing for 6 years or usual care at 10 study sites across the US., and followed the groups for up to 13 years. Over that time period, ovarian cancer rates in the screened group were 5.7 per 10,000 person-years vs 4.7 per 10,000 persons-years in the usual care group, with 3.1 deaths vs 2.6 deaths per 10,000 person years, respectively. Over 3000 women had false positive screening results, a third of whom had surgery and 15% of those operated on had a complications from their surgery. Deaths from other causes did not differ between the groups.
The investigators concluded that annual screening for ovarian cancer does not reduce mortality, and in fact caused harms among women with fals positive abnormal results.
This is not the first study that failed to find efficacy for ultrasound and ca125 in reducing mortality from ovarian cancer, but Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
