March 25th, 2010 by KevinMD in Better Health Network, News, Opinion
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It’s well known that the use of imaging scans, like CTs, MRIs and PET scans, have been growing at an alarming rate. But a recent study provides some stark numbers. According to a recent CDC report, “MRI, CT or PET scans were done or ordered in 14 percent of ER visits in 2007.” That’s four times as often as in 1996. Although a physician called that growth “astounding,” it’s really no surprise.
Emergency departments are becoming more crowded, and with patient satisfaction scores becoming more influential in financial incentives for physicians, sometimes just ordering a test is the path of least resistance. Factor in the spector of defensive medicine which, according to a survey from the Massachusetts Medical Society, accounts for up to 28 percent of tests ordered, it’s a wonder that more scans weren’t ordered.
Imaging scans are a clear cost driver in healthcare, contributing $12 billion to Medicare’s bill. But costs won’t resonate with patients requesting the tests or the doctors ordering them. One encouraging sign is the recent trend of publicizing the harms of scans, like radiation from CTs. I’m finding that patients are becoming increasingly aware of the risk, and making a more informed decision after I explain it to them. It’s a small step forward.
*This blog post was originally published at KevinMD.com*
March 22nd, 2010 by Shadowfax in Better Health Network, Health Policy
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We use a little company called Assurant to administer the employee health insurance plan for our business. We have about 50 employees, not all of whom are on our insurance (some get theirs through a spouse), so we are in a particularly undesirable segment of the small-business market. Ironically, we have had a fair amount of difficulty in getting coverage which was affordable and sustainable. A lot of insurers wouldn’t even bid on us. Funny, right? The doctors can’t get health care insurance! Hysterical! So we wound up with an unusual sort of self-funded plan administered by Assurant, which was working OK.
Recently, however, a couple of our doctors wound up taking family members to the ER for various reasons — nothing serious, but common and reasonable presentations for an ER. And Assurant denied payment for the claims. They didn’t deny it outright, actually, just imposed a $500 “penalty for non-emergent use of the Emergency Room” on top of the usual co-pays and deductibles. Read more »
*This blog post was originally published at Movin' Meat*
March 16th, 2010 by GruntDoc in Better Health Network, News, Opinion
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I have a confession: I’ve been risking my life.
Yes, still driving a Prius.
I do buy that accelerator pedals can be mechanically jammed by a floor mat (though there’s clips on my car to hold it in place), but this unintended acceleration ‘panic’ is just that. (If for no other reason that there’s now a flurry of cases of this, and none before it was the freak-out du jour). Read more »
*This blog post was originally published at GruntDoc*
March 15th, 2010 by Paul Auerbach, M.D. in Better Health Network, Health Tips
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There are rules that have been advocated for doctors to use to determine the need for x-rays (radiographs) in the setting of a possible ankle fracture (broken ankle). The purpose for using rules is to avoid unnecessary exposure to radiation. In the wilderness, there is not likely to be an x-ray machine available. Therefore, the rules might be useful to give the rescuer (or a parent) more confidence about what clinical presentation is likely to be or not be a broken bone. This would be important in terms of deciding whether or not to allow weight-bearing, such as would occur if a victim needed to walk out under his or her own power. Read more »
This post, How To Tell If A Child’s Ankle Is Broken, was originally published on
Healthine.com by Paul Auerbach, M.D..
March 12th, 2010 by Shadowfax in Better Health Network, Health Tips, Opinion
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RCentor has an interesting article on Sore Throats and Pharyngitis over at MedRants. He writes:
There is a new trend in pharyngitis that has taken hold amongst emergency physicians – the use of steroids to provide symptom relief.
I too have noticed this, and I completely agree with Dr Centor that while this is a highly effective treatment, it needs to be used with some caution. For our practice, this has been pushed by the ENTs. It has been our experience that when we see someone with a really bad sore throat or even with a peritonsillar abscess, 100% of the time the instruction from the ENTs has been to administer steroids. While the data is underwhelming (pain relief on average six hours quicker with steroids), the truth is that for a really bad case of tonsillitis, steroids work. Read more »
*This blog post was originally published at Movin' Meat*
