In a recent New England Journal of Medicine, a perspective piece on what to do with fatigued surgeons is generating debate. The issue of work-hour restrictions has been a controversial issue when it comes to doctors in training, something that I wrote about earlier in the year in USA Today. But once doctors graduate and practice in the real world, there are no rules.
As summarized in the WSJ’s Health Blog, the perspective piece argues for more regulation for tired surgeons:
… self-regulation is not sufficient. Instead, “we recommend that institutions implement policies to minimize the likelihood of sleep deprivation before a clinician performs elective surgery and to facilitate priority rescheduling of elective procedures when a clinician is sleep-deprived,” they write. For example, elective procedures wouldn’t be scheduled for the day after a physician is due to be on all-night call.
And the authors suggest that patients be “empowered to inquire about the amount of sleep their clinicians have had the night before such procedures.”
It’s a noble goal, and indeed, data does show that fatigued surgeons tend to make more errors. Patients, once confronted with a choice of being operated on by a tired surgeon, may choose to postpone surgery. Read more »
*This blog post was originally published at KevinMD.com*
More than 10 million Americans undergo elective cosmetic procedures each year. Dr. Jon LaPook reports on what every patient should know about anesthesia with Dr. Panchali Dhar, author of “Before the Scalpel.”
Last year — despite the recession — there were about 10 million cosmetic procedures in the United States. According to the American Society for Aesthetic Plastic Surgery, over 90 percent were in women and about 1.5 million were surgical.
The top five surgical procedures were breast augmentation (311,957), liposuction (283,735), eyelid surgery (149,943), rhinoplasty (138,258), and abdominoplasty (127.923). As you awaken on the morning of your elective surgery, there’s no way you haven’t yet met the surgeon who will be performing the procedure. But odds are you still haven’t met the person who will be most responsible for keeping you alive: the anesthesiologist. Read more »
A newly-created index of consumer healthcare confidence has fallen steadily this year, reports The Thomson Reuters Consumer Healthcare Sentiment Index. Consumers report declining confidence in their ability to access, use, and pay for healthcare. The index, set at a baseline of 100 in December 2009, is now at 97.
More consumers reported difficulty paying for services and insurance, or reported a reduction or cancellation of their insurance. More delayed or failed to fill a prescription in the past three months or canceled a diagnostic test (such as blood work, X-ray or mammogram). Further, consumers expect the situation to worsen in the next three months, including putting off elective surgery.
Thomson will report figures monthly and has published their methodology online.
*This blog post was originally published at ACP Internist*
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