December 8th, 2011 by RyanDuBosar in News
No Comments »
The percentage of hospital outpatient department visits seen only by a physician assistant or advanced practice nurse rose from 10% to 15%, while the percentage of joint physician/nonphysician clinician visits remained at about 3%, health researchers found.
Among other findings in the Centers for Disease Control and Prevention report:
–About three-fourths of the more than 103 million hospital outpatient department visits in 2008-2009 were seen by a physician and 18% were seen by a physician assistant or advanced practice nurse;
–Among visits to a non-physician, 65% were seen by an advanced practice nurse and 35% were seen by a physician assistant;
–The percentage of outpatient department visits attended only by physicians declined from 77% in 2000-2001 to 72% in 2008-2009; and
–The percentage of visits not seen by a physician, physician assistant, or advanced practice nurse remained the same (10%).
Following previous trends, physician assistants or advanced practice nurses are the only provider for visits more often in rural areas, and with younger patients. Read more »
*This blog post was originally published at ACP Hospitalist*
December 7th, 2011 by Berci in Medical Art
No Comments »
It’s quite clear not everyone would like to read long medical reports and text as sometimes a well-designed and structured graph can say more than a hundred words. Do you remember the Wired article about the blood test makeover that described how our blood test results would be designed to show more easily understandable information to patients?
Well, this Venn diagram shows many things about hemorrhoids and related symptoms. And it’s not even a new infographics published on a blog but is from an old textbook which means the concept has been there for a long time but it always disappears in medicine.
*This blog post was originally published at ScienceRoll*
December 7th, 2011 by DrRich in Health Policy, News, Opinion, Research
No Comments »
This past summer, DrRich wrote a post on the utter arrogance of the public health experts who are urging the FDA – and international bodies of busybodies – to mandate a policy of strict sodium restriction across the globe.
DrRich attempted to show how such a broad-based salt restriction at this juncture is ill-advised for three reasons. First, the conclusion that a population-wide salt restriction would actually do any good is not based on any actual prospective studies, but on a contrived extrapolation of observational data. Second, there is some evidence that a salt restriction would be harmful to at least a substantial minority of people, even if the overall effect on the population turns out to be positive. And third, there is good reason to believe that the degree of sodium restriction which is being recommended by the public health experts is below the level which is dictated by human physiology.
Perhaps salt restriction for the entire population will turn out to be a good idea. But perhaps not. So in his previous post, DrRich was advocating a prospective, randomized controlled trial to test this proposition before just going ahead and inflicting it upon hundreds of millions of Americans.
And now, as it happens, in recent weeks new studies have been published which question the safety of salt restriction for the whole population. In fact, five studies have been published just this year suggesting that salt restriction might be unsafe.
The latest, published this week in the Journal of the American Medical Association, suggests that when you compare cardiovascular events (such as heart attack and stroke) to sodium intake, the incidence of those events follows a “J” curve. That is, cardiovascular events are lowest at an “optimal” level of sodium intake. But if sodium intake goes above that optimal level – or if it goes below it – the incidence of cardiovascular events increases. Read more »
*This blog post was originally published at The Covert Rationing Blog*
December 7th, 2011 by Bryan Vartabedian, M.D. in Opinion
No Comments »
I know this woman – a physician. She spends a lot of time on Twitter. She has a Tumblr presence but it’s sparse and not very memorable. All day long she polishes her Twitter presence. She’s everyone’s friend. And to her credit she’s a wonderful curator. We caught up recently and she wanted to know how she could bring herself to the next level. Despite her time and investment in the latest real-time social tools she felt that her ideas didn’t get the traction that they deserved.
Here’s what I suggested: Twitter works for interaction and dissemination. But ultimately you have to create the stuff that defines you. Retrievable text, video and audio is where your ideas will live.
It’s about content, not Klout. You can share and engage, but it’s what you make that lasts.
*This blog post was originally published at 33 Charts*
December 7th, 2011 by admin in Health Policy, Opinion
No Comments »
We’ve been considering FDA oversight of medical apps for a while, over at Medgadget.com. Now, the public comment period has concluded on the FDA’s draft of how this oversight might look. The story:
The FDA will scrutinize medical apps that act as an accessory to a medical device and those that transform the mobile device into a medical device. A draft guidance issued by the FDA includes an extensive list of applications that will have to undergo review. Examples of apps that fall under the regulatory oversight are:
* Applications that allow the user to view medical images, such as digital mammography or digital images of potentially cancerous lesions on a mobile platform, and those that perform a health analysis or provide a diagnosis by trained health care professionals.
* Applications that allow the user to view patient-specific lab results.
* Applications that connect to a home use diagnostic medical device to collect historical data, or to receive, transmit, store, analyze, and display measurements from connected devices.
Great, right? The apps that do heavy lifting of patient information and connect to real medical devices get regulated, but the fun and educational apps I am working on remain free and open. Still, Harvey Castro, my favorite EM-doc-and-app-developer, was worried:
“Overall, I believe safety is the most important item when it comes to providing patient care,” said Harvey Castro, MD, an app developer (www.deeppocketseries.com) and emergency physician. “Unfortunately, I believe this will hurt small businesses and entrepreneurs by making it cost-prohibitive to enter the market.”
“Applications will be dominated by a few companies capable of paying the high fees to get FDA approval. I will be saddened to see these changes in the future.”
For their part, the FDA said it’s nothing to worry about: Read more »
*This blog post was originally published at Blogborygmi*
