Originally posted in MedPage Today
by Kristina Fiore, MedPage Today Staff Writer
Medical students are frequently stuck by needles, and few report their accidents, researchers say.
In a survey, about 60% of surgery residents reported being stuck with a needle while they were in medical school, Martin A. Makary, MD, MPH, of Johns Hopkins, and colleagues reported in the December issue of …
Medical student needlestick injuries
Barack Obama is certain that electronic health records (EHRs) can improve the quality of care and the efficiency with which it is delivered. How certain? Certain enough to have bet billions on a program that pays providers to adopt and meaningfully use EHRs.
Of course there are many ways to improve quality and efficiency. The Pennsylvania Health Care Cost Containment Council (PHC4) for example, publishes outcomes data for the states’ 172 …
I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some …
The joys of practicing rural emergency medicine
Originally published in MedPage Today
by Michael Smith, MedPage Today North American Correspondent
In the first six months of the H1N1 flu pandemic, 22 million Americans fell ill from the virus, the CDC now estimates.
Of those, about 98,000 needed inpatient care, and 3,900 died, according to Anne Schuchat, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases.
The estimates …
What is the death toll for the H1N1 flu pandemic?
We found out that her real name was Cindy Chapman, and that she died alone and afraid.
Cindy was a paralegal, an activist and a fighter of lost causes who lived in Worcester, Massachusetts. She was part of an online community called RATEMDs, where she had many soul mates. Her posts on health care were funny and cynical and wise. Her screen name was Jane Q. Patient.
My wife, Pam, was especially …
Discharged from the hospital without answers; the death of Jane Q. Patient
Originally published in HCPLive.com
by Colleen O’Leary, RN, MSN, AOCNS
Last time I talked about how I had never really experienced the concept of nurses eating their young in action.
However, I have seen the opposite begin to evolve. I see this as a bigger issue in nursing these days. The “putting out to pasture” of seasoned, experienced nurses is happening more often …
Are older nurses being forced out of the profession?
Originally published in MedPage Today
by Chris Emery, MedPage Today Contributing Writer
Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found.
Among more than 2,500 abortions performed by family physicians, abortion was successful without complications in 96.5% of patients using medications (95% CI 95.5% …
Can family doctors do safe first trimester abortions?
The Wall Street Journal and other sources reported on a study from the Annals of Internal Medicine that showed that most US doctors don’t know the guidelines of how often women should get a pap smear. More importantly, doctors were doing a lot of pap smears on women who didn’t need them. In all the talk about health care reform, reducing costs by eliminating unnecessary testing has been mentioned multiple …
Why doctors are doing so many unnecessary Pap smears
On my last day of ward attending, I handed out an EKG that resembled the Dow Jones industrial average over the last 10 years (not pictured). The normal pattern of an EKG was completely disrupted: ST segments were markedly elevated, P waves were hidden, and beats were grouped in odd patterns. My medical team laughed and shook their heads.
I asked why.
A brave intern responded that he was completely at a …
Learn how to conduct a family meeting by using a structured approach
There is plenty to criticize in our bungling trek toward health reform. Leaders on the right, left and at 1600 Pennsylvania Avenue have sidestepped the crucial conversation of controlling the cost of care, in favor of partisan rhetoric about “death panels” and “rationing care.” Worse, the entire focus of reform has centered on spending billions of dollars on technology solutions that will only make marginal changes in the cost and …
Medicine needs to get back to hands-on basics, rather than focusing on technology
by Crystal Phend, MedPage Today Senior Staff Writer
Limiting surgical residents’ work hours has compromised both surgical education and patient safety, according to an analysis concluding that an 80-hour work week isn’t enough.
The maximum 80-work week imposed in the U.S. for residents is too little to provide mastery in surgery, Gretchen Purcell Jackson, MD, PhD, and John L. Tarpley, MD, …
Surgeons don’t receive enough training when resident work-hours are capped
I recently cared for a patient who raised my heart-rate a bit. Of course, any emergency physician will tell you, the potentially difficult and complicated cases often come at the end of the shift, as you’re trying to clean up all of the paperwork and ‘head for the house.’ Nurse Ginger came to me and said, ‘we need a doctor in room 11.’ I snarled, snatched the paper, grumped and …
How teamwork is essential in the emergency department
Originally published in Insidermedicine
Nearly half of women who undergo surgery and other treatments for breast cancer report having persistent pain in and around the treatment area a year or more later, probably because of nerve damage, according to research published in the November 10 issue of the Journal of the American Medical Association.
Here is some information about neuropathic, or nerve, pain:
• It is a type of pain that occurs when …
Many women report nerve-related persistent pain after breast surgery
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by Kristina Fiore, MedPage Today Staff Writer
Rhode Island Hospital, located in Providence, will pay $150,000 and install video cameras in all of its operating rooms after performing its fifth wrong-site surgery since 2007, according to the state’s Department of Health.
The hospital will also have to open its ORs to an inspector who will observe surgical procedures and protocols for at …
Will video cameras in the OR decrease the rate of wrong-site surgery?
Originally published in HCPLive.com
by Victor G. Dostrow, MD
Dementia is a terminal illness. However, people with advanced dementias often languish in skilled nursing facilities, far from the ministrations of specialists. And, with reasonable luck, they have directives that specify that they are not to be taken to the hospital in the event of a respiratory arrest. Consequently, most of us are not privy to the mechanisms of demise in such situations.
How do people with dementia die?
Originally published in MedPage Today
by Kristina Fiore, MedPage Today Staff Writer
Expectant mothers may enjoy listening to their unborn babies’ heartbeats, but they shouldn’t rely on home fetal heart monitors to provide an accurate picture of fetal health, researchers say.
The devices may provide false reassurance in some situations, according to Abhijoy Chakladar, MD, of Princess Royal Hospital in West Sussex, …
Do home fetal heart monitors give mothers false reassurance?
Originally published in MedPage Today
by Charles Bankhead, MedPage Today Staff Writer
Clostridium difficile infection has spread from the hospital to the community but has proved manageable thus far.
From 1991 to 2005, the incidence of community-acquired C. difficile in Olmsted County, Minn., quadrupled but still remained less common than the hospital-acquired gastrointestinal infection, Sahil Khanna, MD, of the Mayo Clinic in …
Clostridium difficile infection is spreading from the hospital to the community
Originally published in MedPage Today
by Michael Smith, MedPage Today North American Correspondent
Good hand hygiene among healthcare workers is an important factor in preventing the spread of disease, but exactly how important depends on an individual’s job, researchers said.
In a mathematical model, so-called “peripatetic” workers — such as therapists or radiologists — were most likely to spread pathogens if they …
Who’s most likely to spread infection in the hospital?
Originally published in MedPage Today
by Charles Bankhead, MedPage Today Staff Writer
The physician workforce in the U.S. is growing smaller and younger, according to data from the Census Bureau, but conflicting estimates make it difficult to determine just how many doctors are out there — and how many the nation will need.
The census survey showed 67,000 fewer physicians than estimates based …
Is the impending physician shortage worse than we thought?
I think by now there is not a person in the US who cannot quote at least approximately how much we spend annually on healthcare. Fewer people appreciate that nearly 1/3 of this $2.2 trillion bill is eaten by hospitalizations, amounting to about $680 billion. Although the data in the diagram below represent a single year, the overall distribution of expenses is remarkably constant over time.
Discussing end-of-life care in the ICU and saving Medicare money
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