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Sepsis Drug Pulled From The Market Due To Its Inefficacy

October 30th, 2011 by GruntDoc in News
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The irony here is that Eli Lilly has advanced sepsis care (as a prelude to using their drug), and while Xigris hasn’t panned out, aggressive sepsis resuscitation has.

Eli Lilly is withdrawing drotrecogin alfa (Xigris) from all markets worldwide after a major study failed to show a survival benefit for patients taking the drug.

…

Xigris should be discontinued immediately in patients currently receiving it and should not be started in new patients, the company said.

The trial with the bad news on Xigris was Read more »

*This blog post was originally published at GruntDoc*

The First Emergency Physician Elected To Congress

February 23rd, 2011 by GruntDoc in Health Policy, News
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I was unaware that Dr. Joe Heck of Nevada is the first emergency physician to be elected to Congress. Good for him! From the American College of Emergency Physicians (ACEP):

In one of the closest congressional races of 2010, Republican challenger and ACEP member Dr. Joe Heck upset Rep. Dina Titus in Nevada’s third Congressional District.  Dr. Heck is the first ACEP member and emergency physician to be elected to Congress.

I suppose that leaves me to be the first for the Senate…

*This blog post was originally published at GruntDoc*

Why It’s Wrong To Call Drug Seekers A “Micropopulation”

July 5th, 2010 by Shadowfax in Better Health Network, Health Policy, Opinion, True Stories
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I don’t know what’s going on with American College of Emergency Physicians (ACEP) lately, but it’s disheartening. Their abdication of responsibility and engagement during the healthcare reform debate was depressing. Then there was a rigged poll designed to elicit a predetermined result. Now I see a bizarre op-ed piece in USA Today entitled “Opposing view on drug addiction: Don’t make us ‘pain police'” and authored by ACEP President Angela Gardener. An excerpt:

The patient-physician relationship is sacrosanct, demanding candor and trust. In the emergency department, trust is built in nanoseconds because patients and doctors do not have prior relationships. Knowing that any pain prescription will be entered into a large, public database might prevent patients from being truthful, or in the worst case, from seeking needed care. … As an emergency physician, I can assure you that the drug abusers who use the emergency room simply to get a prescription drug fix represent a micropopulation of the 120 million patients who seek emergency care every year in the USA. … Put bluntly, if legislators have money to spend, they should spend it where it will do the most good for our patients, and that is not on drug databases.

I really don’t know what to say, other than to wonder whether Dr. Gardner and I practice in the same United States in which abuse of prescription drugs is growing exponentially and in which “drug-seeking” patients are a part of each and every shift worked in the ER, where deaths due to overdoses of prescription medications are on the rise, and where diversion of narcotics is a serious and growing problem. Read more »

*This blog post was originally published at Movin' Meat*

Emergency Medicine Dilemma: Risk Malpractice Or Overtesting?

July 5th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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Emergency physicians are in a dilemma. Risk missing a diagnosis and be sued, or be criticized for overtesting.

Regular readers of this blog, along with many other physicians’ blogs, are familiar with the difficult choices facing doctors in the emergency department.

The Associated Press, continuing its excellent series on overtesting, discusses how lawsuit fears is a leading driver of unnecessary tests. Consider chest pain, one of the most common presenting symptoms in the ER:

Patients with suspected heart attacks often get the range of what the ER offers, from multiple blood tests that can quickly add up in cost, to X-rays and EKGs, to costly CT scans, which are becoming routine in some hospital ERs for diagnosing heart attacks …

… and the battery of testing may be paying off: A few decades ago insurance statistics showed that about 5 percent of heart attacks were missed in the emergency room. Now it’s well under 1 percent, said Dr. Robert Bitterman, head of the American College of Emergency Physicians’ medical-legal committee.

“But you still get sued if you miss them,” Bitterman added.

The American Medical Association’s idea of providing malpractice protection if doctors follow standardized, evidence-based guidelines makes sense in these cases. Furthermore, it can also help reduce the significant practice variation that health reformers continually focus on. Read more »

*This blog post was originally published at KevinMD.com*

Health Highlights From The New Media Academic Summit

July 1st, 2010 by Nicholas Genes, M.D., Ph.D. in Better Health Network, Health Policy, Opinion
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I recently spoke at the panel on transparency at Edelman’s New Media Academic Summit. Ben Boyd was the moderator and Ellen Miller from the Sunlight Foundation was my fellow panelist.

Reviewing some of the #nmas10 tweets from the audience, I figured I should provide some links for the anecdotes I mentioned:

• Beth Israel Deaconess Medical Center CEO Paul Levy’s blog is still the starting point when talking about transparency in medicine today. I had the chance to speak with him a few years ago.
• Ed Bennett has done an extraordinary job following hospital social media adoption and highlights effective new media policies as well.
• Hospitals are using twitter and billboards to broadcast emergency department waiting room times. This is not without risk, as billboards may not clarify the triage process, where seriously-ill patients will be seen right away. 
• ACEP president Angela Gardner’s Twitter feed and ACEP’s blog. 
• A recap of Better Health bloggers’ meeting with Rep. Jack Ryan last summer during the healthcare reform debate. 
• Recent articles from NEJM and JAMA articles on medical students and social media.   
• A lot of the developments in openness in peer review and the world of grant funding are chronicled at Nature’s Peer-to-Peer blog. Bora Zivkovic has been and active an articulate defender of open publications as well.

Special thanks to Dr. Val Jones of Better Health for getting me involved with this group.

*This blog post was originally published at Blogborygmi*