It’s commonly thought that health care in the United States is heavily dependent on diagnostic testing.
But how do we compare with the rest of the world? Perhaps these graphs, courtesy of the New York Times can provide a stark illustration.
Here’s the data regarding CT scans, showing the number of tests per 1,000 people. Guess which country’s on top:
Why doctors in the United States order so many CT scans and MRI tests
Originally published in MedPage Today
by Peggy Peck, MedPage Today Executive Editor
“What we did for patients with acute MI was place them in a cool, dark place. Give them morphine for pain and lidocaine to prevent arrhythmias and hope for the best.”
The speaker is Steven Nissen, MD, director of Cardiovascular Medicine at the Cleveland Clinic. He is describing standard care 25 …
Cardiologists discuss how far myocardial infarction management has come
by Mark E. Klein, MD
“I think anytime you use science to kind of fundamentally change what people are used to, I think it’s a difficult thing to grapple with.” So spoke Ned Calonge, chair of the United States Preventive Services Task Force (USPSTF) in explaining the reaction to that group’s recommendation to radically alter their previous guidelines for breast cancer screening. Regrettably the incorrect application of science, as in …
Linking the USPSTF mammogram guidelines to their virtual colonoscopy recommendations
After the LA County + USC Medical Center closed my Pain and Palliative Care Service because of budget cuts in 1995, I spoke out publicly about the dysfunctional financial reimbursement system funding charity care in LA County.
For example, when my consultation service controlled the pain and distressing symptoms of over 400 terminally ill cancer and AIDS patients per year and discharged them to home hospice programs, the hospital lost about …
The story behind a whistleblower doctor license reinstatement hearing
Public hospitals have a bad rap. They’re viewed by many as hospitals of last resort, and most patients with private insurance do anything to avoid them.
As a long-time physician in a public hospital, I’m sensitive to this reputation. I wouldn’t work in my hospital if I didn’t feel that it delivered excellent health care. I’m certainly aware that private hospitals have amenities that public hospitals can’t afford, but many of …
Public hospitals are the unsung jewels of our healthcare system
Originally published in HCPLive.com
by Alan Berkenwald, MD
In 1904, the Scottish author Sir James Matthew Barrie sent Peter Pan off to Never-Never Land to escape growing up and to enjoy many-many adventures. As children, we all hoped it really existed. In truth, many of us fantasized, one day, to make the trip ourselves.
Well, good news for physicians – that day has arrived!
Will physician and hospital penalties improve patient care?
Originally published in MedPage Today
by Michael Smith, MedPage Today North American Correspondent
Brazilian researchers have found three distinct patterns of lung damage in patients who died of the H1N1 pandemic flu.
They also found evidence of a so-called “cytokine storm,” a runaway immune response associated with the lung damage, according to Thais Mauad, MD, PhD, of Sao Paulo University Medical School, …
How patients are dying from H1N1 infection
Originally published in MedPage Today
by Chris Emery, MedPage Today Contributing Writer
Emergency physicians and radiologists overwhelmingly choose computed tomography (CT) imaging to diagnose pulmonary embolism, a potentially deadly blockage of lung arteries, a new study found.
Ninety percent of radiologists and 96% of emergency physicians use CT as their first-line choice for the diagnosis of pulmonary embolism, according to a report …
What’s the most popular way to diagnose a pulmonary embolism?
by Tim Noonan
When a team misses out on an opportunity to go to the Super Bowl, World Series, Final Four, or something similarly trivial, these words may be appropriate. When the person, who has been the center of your life dies, what is more insensitive than, We’re sorry for your loss?
What kind of language is that to use when providing some of the worst news we could imagine? True, we …
How to tell a family that their loved one has died
Originally published in MedPage Today
by Chris Emery, MedPage Today Contributing Writer
Medical teams should take a lesson from airplane crews, a new study concludes.
Medical personnel who used procedural checklists modeled after preflight checklists used by airplane crews were more likely to report safety-related incidents and feel empowered to address safety issues, according to an online report in the Dec. 21 …
A cockpit checklist to improve patient safety
The rapid advance in digital video and still camera technology has found its way into the operating room.
There is the potential to capture and record just about every minute of every surgical procedure in some way. The newest endoscopic camera systems and operating microscopes have integrated systems to record video footage. Storing all that data is just the press of a button away.
The advantages for surgeons are obvious, like the …
Issues surrounding videotaping surgeries in the operating room
Originally published in HCPLive.com
by Victor G. Dostrow, MD
There are some recent developments in the world of stroke, which are interesting:
The first manuscript is an evaluation of stroke risk and the “stroke belt” (North Carolina, South Carolina, Georgia, Tennessee, Arkansas, Mississippi, or Alabama).
The authors evaluated stroke risk measured over three decade census intervals for persons aged 30 to 80, based on …
A review of the latest stroke studies
Originally published in MedPage Today
by Katrina Woznicki, MedPage Today Contributing Writer
Hospitalized patients were often clueless when asked about their medications, with almost all of them unable to name all their medications and many leaving out as many as a half-dozen drugs they have been prescribed, according to a small survey of patients in a Colorado hospital.
Ninety-six percent of the …
How medication mistakes happen in the hospital
ADVERTISEMENT
Originally published in HCPLive.com
MDNG interviews Phil Baumann about the future of Twitter and social media in health care.
Way back in January, Phil Baumann, RN, provided an empathic answer to the question/concern that was on everyone’s mind then: “Yeah, Twitter seems great and all, but can you use it for anything useful in healthcare?”
Taking things to the extreme, Baumann, …
How Twitter will impact health care in 2010
Originally published in MedPage Today
by Emily P. Walker, MedPage Today Washington Correspondent
The notion of a public health insurance plan appears to be evaporating from the Senate’s healthcare reform bill, replaced in part with an expansion of Medicare — an idea that’s meeting resistance from doctor and hospital associations.
A proposal to scrap the public plan to allow people as young …
Why doctors and hospitals oppose expanding Medicare
by Michael Kirsch, MD
Who says one person can’t make a difference? This past week, I personally set back health care reform. No, I wasn’t attending a ‘tea party’ or decrying Obamacare in a venomous letter to the editor. I single-handedly bent the health care cost curve in the wrong direction. I performed an unnecessary medical test on a hospitalized patient, which exposed her to risk and cost the system money. …
Some patients won’t accept a conservative approach to medical treatment
Two years ago, I wrote about the case of Julie Thao, the Wisconsin nurse sent to prison for a medication error. I argued then that – although Julie bypassed some safety rules – she most certainly did not deserve jail time.
Along comes another case involving jail time for a medical mistake, this one featuring an Ohio pharmacist named Eric Cropp. I became aware of Eric’s case through the efforts of …
Should health care workers go to jail for medical errors?
Originally published in HCPLive.com
by Alberto Borges, MD
For those interested in health information technology, there is now an excellent, new, powerful article about this topic entitled, “Can Cleveland Clinic Be a Model for Digital Medicine?” where they discuss how this hospital system has failed to recoup their $100 million investment to date.
Here is my take on the Cleveland Clinic story, beyond the …
How health IT can bankrupt healthcare
As the health reform debates continue, I am struck by the lack of attention to what seems to be a critical issue in poor health care delivery.
With the technologizing of medicine (and more recently the hospitalist “movement”), delivery of health care has come to be centralized around acute care hospitals. Over time, patient care has been divided into acute inpatient care and ‘ambulatory’ outpatient care. While transitions of care, hospital-at-home, …
The inpatient, outpatient divide in patient care today
Originally published in MedPage Today
by Kristina Fiore, MedPage Today Staff Writer
For years, the pager and cell phone have summoned on-call radiologists to the emergency room. Now this leap in technology: an iPhone App that lets radiologists diagnose a patient remotely, wherever they may be.
Using a $20 iPhone application called OsiriX, radiologists made correct diagnoses of appendicitis in 124 of …
iPhone radiology app to diagnose appendicitis
Get free updates delivered free to your inbox.
