December 9th, 2011 by DrWes in Health Policy, Opinion
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With the announcement that the Center for Medicare and Medicaid Services (CMS) will begin auditing 100% of expensive cardiovascular and orthopedic procedures in certain states earlier this week, we see their final transformation from the beneficent health care funding bosom for seniors to health care rationer:
The Center for Medicare and Medicaid Services will require pre-payment audits on hospital stays for cardiac care, joint replacements and spinal fusion procedures, according to the American College of Cardiology in a letter to members. Shares in both industries fell with Tenet Healthcare Corp., the Dallas- based hospital operator, plunging 11 percent to $4.18, the most among Standard & Poor’s 500 stocks. Medtronic Inc., the largest U.S. maker of heart devices, dropped 6 percent to $34.61.
The program means hospitals won’t receive payment for stays that involve cardiac care or orthopedic treatment until auditors have examined the patient records and confirmed that the care was appropriate, Jerold Saef, the reimbursement chair for the Florida chapter of the American College of Cardiology, wrote in a Nov. 21 letter to members. The review process is expected to take 30 days to 60 days, beginning January 1, Saef said.
This is not at all unexpected. In fact, Read more »
*This blog post was originally published at Dr. Wes*
December 9th, 2011 by Dr. Val Jones in News, Patient Interviews
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There aren’t too many grandmothers developing mobile health apps these days, but I met a charming one (Jill Campbell) at the mHealth Summit yesterday. Jill is a 60 year-old woman from Texas who has been actively concerned for the safety of herself and her daughter over the years.
“My daughter took a self-defense class,” Jill explained, “And she was taught the ‘fight or flight’ response to escape harm. I’m 60 years old. I’m not good at fighting and not very fast at fleeing. So what’s my third option?” Jill created the WatchMe 911 app to provide the solution.
“I first started thinking about a personal alarm system before smart phones even existed. I saw that there were car alarms and house alarms, and wondered why there weren’t personal alarms. At the time I imagined that the personal alarm would go through an answering service system, but since smart phones were created, it can all be tied together in an app format.”
Jill demonstrated the WatchMe 911 app to me during our interview. It contains features such as a panic button that can be armed in advance. Two taps on the smart phone screen and a circle of friends and 9-1-1 are contacted immediately with your GPS location and an alert message. The panic button is a favorite for women who are concerned for their safety when walking late at night or in dimly lit parking lots or alleys. Read more »
December 8th, 2011 by John Di Saia, M.D. in Research
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“According to that study, nearly half of the 500 most popular sunscreens may actually increase the speed at which malignant cells develop and spread skin cancer such as melanoma.
Why? Because they contain Vitamin A, an ingredient that was added to sunscreen formulations because it’s an antioxidant that slows skin aging.
This isn’t necessarily new information….as some studies suggest “that vitamin A might have some phototoxicity.”
Source: health.msn.com/health-topics/skin-and-hair/articlepage.aspx?cp-documentid=100260739
Take it easy folks. One study on the effects of Vitamin A on skin cancers in animals does not invalidate sunscreen use. We don’t really need Vitamin A in sunscreens though. We need good blockers of UVA and UVB at an SPF of at least 30.
*This blog post was originally published at Truth in Cosmetic Surgery*
December 8th, 2011 by admin in Health Policy, Opinion, Quackery Exposed
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In November, the journal Pediatrics published an entire supplement devoted to Pediatric Use of Complementary and Alternative Medicine: Legal, Ethical and Clinical Issues in Decision-Making. The authors purport to have “examined current legal, ethical, and clinical issues that arise when considering CAM use for children and identified where gaps remain in law and policy.” (S150) Their aim is to “illustrate the relevance and impact of identified [ethical, legal and clinical] guidelines and principles,” to recommend responses, identify issues needing further consideration, and thus “assist decision makers and act as a catalyst for policy development.” (S153)
Unfortunately, as we saw in Pediatrics & “CAM” I: the wrong solution, the authors’ solution for the “issues that arise when considering CAM use for children” consist, in the main, of placing a huge burden on the practicing physician to be knowledgeable about CAM, keep up with CAM research, educate patients about CAM, warn patients about CAM dangers, refer to CAM practitioners, ensure that CAM practitioners are properly educated, trained and credentialed, and so on.
Limit CAM? Not happening
Curiously absent are recommendations placing responsibility on those who profit from the sale of CAM products Read more »
*This blog post was originally published at Science-Based Medicine*
December 8th, 2011 by SteveSimmonsMD in Expert Interviews, Opinion, Video
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Today, most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago, President Obama signed his executive order, directing the FDA to take steps to reduce drug shortages as the White House stated that drug shortages have nearly tripled over the past five years reaching the stunning number of 178 in 2010. These shortages make regular news: Cancer patients without the chemotherapy needed to keep them alive, antibiotics unavailable to treat life-threatening infections, or intravenous nutrition to support the critically ill fighting to live while medical teams and families search for elusive remedies.
As this new reality plays out in hospitals and homes the media is provided a steady stream of drama for our morning paper or evening news. Meanwhile, time and focus is repeatedly stolen from physicians, patients, and parents in a myriad of ways. Currently, my medical practice- in primary care Internal Medicine- has been negatively affected by the shortage of Adderall, a medication used to treat Attention Deficit Hyperactivity Disorder (ADHD). What this medical condition may lack in dramatic news-worthiness it more than makes up for in sheer numbers with an estimated 4.5 million Americans living with this condition today.
I had my first inkling several months ago of the affect the Adderall shortage would have on my practice after one of my patients called frustrated that their pharmacy did not have their Adderall at the prescribed dosage. By calling several pharmacies I was able to find their medication at a smaller dose. Advising my patient to “double-up” I wrote another prescription and had to direct my patient to return to my office to pick up the rewritten prescription- a time-consuming process that doctors and patients can ill afford to repeat on a regular basis.
Unfortunately, this scenario -initially thought an exception- has now become the rule monopolizing my own time while draining the daily resources of my staff, nurse, and medical partner. Most ironically though, Read more »
