December 19th, 2010 by DrWes in Opinion
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The consolidation of physician specialty practices into larger corporate healthcare systems in urban areas is creating a new challenge for today’s doctors when the music stops: There might not be a chair available.
There are simply many fewer hospital systems in large urban areas than there are specialy practices, so the number of specialist positions a large healthcare system is willing to absorb might be limited. As doctors and hospital systems coalesce into as-yet-to-be-clearly-defined “accountable care organizations,” the cost of too many specialists in an organization is being carefully weighed. Read more »
*This blog post was originally published at Dr. Wes*
December 16th, 2010 by DrWes in Better Health Network, News, Opinion
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In a desperate attempt to reach an even number it seems, hospital defibrillators were added to ECRI.org’s “Top 10 Health Technology Hazards” list of devices that threaten to kill or maim patients:
The Top 10 Health Technology Hazards list is updated each year based upon the prevalence and severity of incidents reported to ECRI Institute by healthcare facilities nationwide; information found in the Institute’s medical device problem reporting databases; and the judgment, analysis, and expertise of the organization’s multidisciplinary staff. Many of the items on this year’s list are well-recognized hazards with numerous reported incidents over the years.
If one honestly looks at the number of lives saved versus the number of deaths from defibrillators, I wonder how many of this highly-esteemed group of “multidisciplinary staff” of the ECRI might reconsider. Clearly, most of them have never been in a code situation.
– WesMusings of a cardiologist and cardiac electrophysiologist.
Hat tip: Wall Street Journal Health Blog
*This blog post was originally published at Dr. Wes*
December 12th, 2010 by John Mandrola, M.D. in Better Health Network, Opinion, True Stories
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The human heart resides in a lighltless 98.6-degree chest cavity. Its contracting muscles are further cushioned by the well-lubricated glistening smooth pericardial sac. One wouldn’t think that the heart could sense the time of year. The heart’s rhythm should remain independent of the holiday season. But then there is December in the EP lab. They are as busy as the malls.
Is it the depressing weather? Or the short days? Or a post-Thanksgiving hangover? It’s hard to say, but every year for as many as I can remember, the EP lab rocks in November and December. And with the advent of deductible health plans, this holiday phenomenon has only intensified.
The I-90 of the heart, the AV node, seems to give out more in the holidays. I’ll never forget the Saturday in December many years ago when I did five “urgent” pacemakers — and neither will the pacemaker rep. Read more »
*This blog post was originally published at Dr John M*
December 9th, 2010 by DrRich in Better Health Network, News, Opinion, Research
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DrRich is delighted to note that a very good and longtime friend and former colleague has been named as one of the HealthLeaders 20 for 2010 — that is, as one of 20 people, chosen by HealthLeaders Media, who are changing healthcare for the better.
DrRich has known this man for nearly two decades, and from the very beginning he has insisted his real name is Joe Smith. So let’s go with that.
Joe’s recognition by HealthLeaders is very well deserved. Joe is chief medical and science officer of the West Wireless Health Institute in San Diego, a non-profit institution whose mission is to bring wireless technologies to the patient, technologies to diagnose, monitor and treat health conditions in the patient’s own home. Joe is uniquely qualified for this role, having earned a PhD in medical engineering and medical physics, an MD from Harvard (a place DrRich has never even been allowed to see), and having spent years practicing medicine as a (particularly well-known) cardiac electrophysiologist. (Electrophysiology, as regular readers will know, is widely recognized as the geekiest of medical specialties.)
For what it’s worth, DrRich considers Joe to be one of the most honest, most ethical physicians he has ever known, one who will always place the welfare of patients ahead of his own treasure and his own career. DrRich has seen him do it. Read more »
*This blog post was originally published at The Covert Rationing Blog*
December 2nd, 2010 by John Mandrola, M.D. in Better Health Network, News, Opinion, Research
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In treating atrial fibrillation (AF), this year has witnessed some real excitement. And not all the good news has to do with new pills. Recently, there has been a flurry of encouraging and objective news on ablating AF. Here are some comments on three notable studies that address three important questions:
1. What are the “long-term” success rates of AF ablation?
On this important question comes an American Heart Association (AHA) abstract from the highly-regarded lab of Dr. Karl-Heinz Kuck in Hamburg. They report on a relatively young cohort of 161 patients who underwent AF ablation (using standard pulmonary vein isolation techniques) in 2003-2004. At an average of five years of follow up, more than 80 percent were either AF-free or “clinically improved.”
Real-world impression: Although late recurrences of AF years after successful ablation have been reported, my impression (having started with AF ablation in 2004) is that most who are AF-free off drugs after one year have remained AF-free thus far. Read more »
*This blog post was originally published at Dr John M*
