December 15th, 2010 by Michael Sevilla, M.D. in Better Health Network, News, Opinion, True Stories
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My professional organization recently asked me to participate in an interesting meeting at the state capitol talking about healthcare payment reform and how to improve the healthcare delivery system. This was sponsored by the state of Ohio and their Health Care Coverage and Quality Council.
It was the first meeting that I’ve been to where there were physicians, hospitals, insurance companies, and patients — all trying to put our heads together — present our points of view and try to come to consensus. Did we come to consensus on solutions? Not really, only that we will continue the conversation. There is no perfect solution that will make everyone happy, but we will strive to try to get to that best imperfect solution.
When is comes to healthcare delivery and healthcare payment, there was a lot of discussion on physicians and hospitals — meaning healthcare providers. The motivating factor in these cases uses terms like payment, lack of payment, incentives, bonuses, and penalties. Read more »
*This blog post was originally published at Doctor Anonymous*
December 15th, 2010 by admin in Health Tips
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This is a guest post from Dr. Mary Lynn McPherson.
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Rescuing Patients On Darvon Or Darvocet With Zero Tolerance For Pain
On November 19, 2010 the Food and Drug Administration (FDA) called for a halt in the use of the popular opioid pain relievers Darvocet and Darvon. These products contain the opioid propoxyphene, and it has been used to treat mild to moderate pain for over 50 years. However, concerns have long been raised about the effectiveness of this drug, and the risk of death (accidental and suicide). Darvon and Darvocet were banned in Britain in 2005, followed by the European Union in 2009. Over the past 30 years, the FDA has received numerous petitions to take these drugs off the U.S. market.
Research has shown that Darvon and Darvocet are no more effective for treating moderate pain than over the counter drugs like acetaminophen, aspirin or ibuprofen. Unfortunately, Darvon and Darvocet cause a lot more side effects such as dizziness, drowsiness, nausea and vomiting, hallucinations and constipation (all pretty typical of opioids used to treat pain). But, the side effects don’t stop there. The data is in, and it’s not a pretty picture. A recent study requested by the FDA showed that when used at the recommended doses, Darvon and Darvocet cause significant changes in the electrical activity of the heart, which can lead to a fatal irregularity in your heartbeat, even after only short-term use.
Among those advocating for the removal of these drugs from the market were pharmacists. The American Society of Health-System Pharmacists approved a policy in 2007 advocating for the withdrawal of Darvon and Darvocet from the U.S. market, and recently testified at the FDA Advisory Committee to this effect. As an often overlooked member of the medical team, pharmacists have a vital role to play in providing safe and effective treatments. We serve as the last line of defense against improper or unwise prescribing of drugs — especially those for pain. We are drug experts, and we can help patients and doctors switch from Darvon or Darvocet to safer and more effective treatments. Read more »
October 27th, 2010 by RamonaBatesMD in Better Health Network, Opinion, Research
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There’s an article in the Oct 20, 2010 issue of the Journal of the American Medical Association (JAMA) which discusses surgical team training and teamwork in the operating room.
Most surgeons have crews or individuals in the operating rooms they prefer to work along side. Things just go smoother. We work more as a team, more as one.
Why? Personalities. Communication styles that work well together. Skills that compliment. Each person knows and does their job, not trying to do someone else’s. Each knowing that even the smallest task is important to the whole.
Ideally, we could create teams like this at all times in the operating room. In reality, its not so easy. Change in personnel happens. Team members get sick, so there is great need for crosstraining and flexibility. Personnel (including surgeons) need to be able to work with these changes.
I know currently the comparison is to racecar teams that change the tires, etc. with great efficiency or the aviation industry with their checklists. While we should learn from these industries, we must not forget that medicine is far more diverse. Surgeries are not all the same. The cars are. Read more »
*This blog post was originally published at Suture for a Living*
October 15th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Opinion, True Stories
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I read this article about a young child with heterotaxy syndrome with great interest. Not because I find heterotaxy syndrome something of great fascination, but because of the lack of communication — on both ends of the spectrum:
Even though 5 other Dr. all came in and listened to his lungs and said that he didn’t sound like he was wheezing and that his lungs sounded really good. But because this hospital is overly political, process driven, bureaucratic, and in a constant state of litigious fear they are unable to make any conclusions based on actual medicine and patient care. Common sense is blown out the window when you have a system were a hospitalist one year out of medical school has an opinion that is as valuable as a cardiologist with 25+ years experience.
But in fairness, they all had to “really consider her opinion.”
So they went and got a pulmonologist to evaluate him, which Scott and I were very happy about because there was nothing in the world that would’ve made me more happy in that moment than to have her proven wrong. Which she was.
The whole article is a case study in stress, distrust, and legalism. Read more »
*This blog post was originally published at The Happy Hospitalist*
September 10th, 2010 by BarbaraFicarraRN in Better Health Network, Health Policy, Health Tips, Opinion
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Some patients struggle to communicate effectively with their doctors and some doctors and nurses find it difficult to communicate and collaborate with each other.
Historically, the dynamic symbiotic relationship between doctors and nurses has been a little shaky, evidenced by the lack of engagement and respect for one another.
Hospitals are chaotic and stressful. Working in such an environment can lead to frustration and it can take a toll on the staff. Instead of a good working relationship (which may never have been fostered to its full potential from the start), doctors and nurses become a fractured team. As a result, the fractured team will not effectively communicate and patient care may suffer devastating consequences. Read more »
*This blog post was originally published at Health in 30*
