August 16th, 2011 by Elaine Schattner, M.D. in News, Opinion
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Last Sunday’s New York Times featured an op-ed by Dr. Ezekiel Emanuel, on the oncology drug shortage. It’s a serious problem that’s had too-little attention in the press:
Of the 34 generic cancer drugs on the market, as of this month, 14 were in short supply. They include drugs that are the mainstay of treatment regimens used to cure leukemia, lymphoma and testicular cancer.
Emanuel considers that these cancer drug shortages have led to what amounts to an accidental rationing of cancer meds. Some desperate and/or influential patients (or doctors or hospitals) get their planned chemo and the rest, well, don’t.
Unfortunately, Read more »
*This blog post was originally published at Medical Lessons*
August 13th, 2011 by MotherJonesRN in Opinion
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Meet Nurse Prudence Perfect. She is the unit’s refrigerator nurse. It’s her job to make sure that everything is perfect and meets Joint Commission standards because you never know when the old JC will drop by for an unannounced visit. Insulin vials labeled and dated? Check. Refrigerator thermometer easily accessible and log up to date? Check. Hey, who put their lunch in here? There is to be no food in medication refrigerator! Prudence is gearing up. Stand by for one of her Joint Commission inservices.
For you nursing history buffs, the term “refrigerator nurse” goes way back to a time when Prudence was a graduate nurse. The term was coined back when it only took one paycheck to support a family, and when nurses, typically women, quit working once they got married. A nurse who went back to work after she was married in order to buy luxury items for her family, such as a refrigerator, was known as a refrigerator nurse. Some have suggested that these nurses were less dedicated to their patients and to the nursing profession, but this is simply not true. It was a different time back then. Women who went back to work after they got married broke with convention. They were rebels and some of the best nurses I’ve known.
This week, I also became a refrigerator nurse, but not in the classic sense. Read more »
*This blog post was originally published at Nurse Ratched's Place*
August 7th, 2011 by Happy Hospitalist in Opinion, Research
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I’ve been telling my smoking patients for years that nothing I do for them is going to make an ounce of difference until they quit smoking for good. And the Italians are out to prove me right. The American Journal of Cardiology reported July 11th, 2011 on the Effect of Smoking Relapse On Outcome After Acute Coronary Syndrome.
In a study of just under 1,300 patients, Reuters reports that just over 1/2 the patients started smoking within 20 days of hospital discharge, despite in-hospital smoking cessation consultation for all patients. Researchers also found that resuming smoking increased death 3-fold compared with those that did not relapse and quitting smoking had a similar lifesaving effect as taking cholesterol and blood pressure medications. And I’m sure these folks all landed themselves back into the hospitals for a very expensive dying process.
That’s why billing the patient or their insurance for smoking cessation (CPT® 99406 and 99407) is so important. And that’s why I give many of my smoking patients my smoking lecture. You know how much Medicare pays for a ten minute consultation to help cardiac patients quit smoking right now? Read more »
*This blog post was originally published at The Happy Hospitalist*
July 6th, 2011 by DavidHarlow in Health Policy
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Massachusetts Attorney General Martha Coakley released her office’s second annual report, An Examination of Health Care Cost Trends and Drivers (PDF; see also press release), which contains a wealth of critical data analysis — and also highlights how little we know about certain things — providing some important context for the discussion of the proposed Part III of Massachusetts health reform, a bill filed by Governor Patrick which would create all-payor ACOs and a system of global payments.
At this late date, few would argue against a move a way from fee-for-service reimbursement for health care, or adding quality metrics to the mix, and tying financial rewards to providers to their performance measured against these metrics. (Consider the Massachusetts Blue Cross Blue Shield ACQ (alternative quality contract) experience.) The AG’s report, however, highlights the wide disparities in payments to providers based on negotiating strength, rather than quality or cost of care (as noted in last year’s AG report; check out the 2009 special commission report, too). Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
July 4th, 2011 by DrRich in Health Policy, Opinion
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Everyone agrees that national spending on healthcare is on a trajectory to bankrupt America during the lifetimes of even Old Farts like DrRich. And therefore, most folks* agree that we ought to do something to reduce our national spending on healthcare.
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*The reason it’s only “most folks” who agree is that, apparently, some folks are still partial to the Cloward-Piven strategy, and continuing to spend on healthcare as we are doing today is the quickest and surest way to get there.
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Unfortunately, our national “discussion” on how to achieve this reduction in healthcare spending has devolved into a spectacle of accusations and counter-accusations, vituperation, abuse, and scurrility. Accordingly, not much useful has so far been achieved. Worse, the back-and-forth contumelies lobbed by the various interest groups in this national discussion have created a general sense among the public that the problem is so confused and chaotic, so rifled by conflicts of interest, and so very complex, as to be fundamentally unsolvable.
This general sense of despair is entirely unnecessary. Read more »
*This blog post was originally published at The Covert Rationing Blog*
