My mom doesn’t take any diabetes medicine. She keeps her blood sugars normal through a combination of common sense and careful carbohydrate consumption.
A few months ago, she had to be hospitalized for what she calls a “minor procedure.” The procedure went fine, but not the food. The first meal they brought her consisted of breaded fish (frozen), mashed potatoes (instant), corn (canned), a dinner roll (frozen), and tea (2 sugar …
Last year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients’ lives.
And it has been estimated that 20 to 30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked. This statistic is from a 60 Minutes story on “The Cost of Dying” and …
I got the call from the ER because I was the “no-doc” surgeon, meaning I was the guy to call when a patient showed up needing a surgeon, and who had no primary care doc to direct the referral. Usually it meant trouble. A drunk who smashed his car and himself, possibly others. Stab-wound, gun-shot. People who don’t have their own doctors include more than those down on their luck; …
It had been a high-speed motor-vehicle accident. One car. A twenty-something male driver without passengers. No seat belt. And now, this same driver had no movement from his waist down and no sensations below his mid-abdomen.
According to bystanders, he had been driving his sedan dangerously fast, some estimates of nearly 100 m.p.h., before losing control. The car veered off the roadway to the right, flipping mid-air before smacking head-on into …
by Lyle Denniston
Hospitals know that medical care decisions often have legal consequences, which makes it all the more important to know what the law requires. But when judges can’t agree, and there also is some ambiguity in the way government officials see a legal issue affecting care decisions, hospitals may need to go to the ultimate authority – the U.S. Supreme Court – for an …
by Winston F. Mitchell
I’m a 53 year-old male with no history of hypertension, no cholesterol problems and glucose count normal.
I was overweight but still in great physical shape. But over a period of weeks, walking to work, I started experiencing a shortness of breath. Finally I went to my doctor, he informed me he was going to admit me to the hospital immediately because a …
Interesting article recently from Health Affairs about the clinical equivalence between the care provided by anesthesiologists and CRNAs. The article concludes by advocating that CRNAs be given permission to practice anesthesiology without physician supervision. It’s more cost effective. And there is no compromise to the quality of care delivered to patients.
We recommend CMS return to its original intention of allowing nurse anesthetists to work independently of surgeon or …
Being a hospitalist, I often see patients sitting in the hospital for days at length for no reason other than poor planning.
Sometimes I feel that physicians who are involved in patient care are oblivious of each other. Everyone is in their own domain rather than working as a team. An increased length of stay in the hospital not only increases the cost of health care but also adds to the …
by Dennis Grace
So, you have to go to the hospital. You’ve had an accident and the doctor wants to keep an eye on you for a few days. Maybe you need major surgery. Whatever the reason for the stay, a lot a people think you should have an advocate with you.
Why? In my life, I’ve had lots of hospital stays. Why is this suddenly a big …
At the recent AAMC meeting on how to integrate quality into teaching hospitals, the question that kept popping up from speaker after speaker was how to address the fact that doctors in teaching hospitals don’t get along.
Unfortunately, all the specialty bashing that takes place prevents the adoption of a team based culture necessary to advance quality and safety. As one speaker highlighted, how can we really start to address this …
A couple of months before my son was born 2 1/2 years ago, we were notified that my husband, an active duty member of the Navy, was getting deployed to Iraq.
His date of departure was exactly one week after my due date. To any wife or family member of a service member, this would be difficult news — a loved one going into a war zone. But, to me, 8-months …
by Felasfa Wodajo, MD
Recently, we had the chance to check in with Dr. Henry Feldman. He had posted a detailed summary of his experiences using the iPad as his main interface while rotating on service for a week as a hospitalist at Beth Israel Deaconess hospital (BIDMC) in Boston. Dr. Feldman is also Chief Information Architect for the Harvard Medical Faculty Physicians.
The summary of the …
Gordon Gekko is wrong. Greed is not good. Not when it comes to health care providers.
The socioeconomic study of what motivates people is a fascinating field of study, not the least of which is because of how counter-intuitive it is. For example, it seems normal to assume that the more someone is rewarded for their efforts, the more effort they will put forth toward those rewards.
These rewards (increasing salary, bonuses, …
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At a recent meeting I attended, a vigorous discussion broke out about what medical students, residents and attendings should wear, and more importantly what they should not wear.
Interestingly, patients have been asked to weigh in on this discussion. What to wear is also on the mind of many current second year medical students who may find themselves trying to take study breaks from USMLE 1 to go buy …
One in every 10 patients admitted to six Massachusetts community hospitals suffered serious and avoidable medication mistakes. This has created a new urgency for all hospitals in the state to install computerized physician order entry (CPOE).
At BIDMC, we implemented CPOE in 2001 and have not had a handwritten order in most areas, except for the 2 days of our network outage in 2002. Implementing CPOE is challenging and requires …
I have given anesthesia for a lot of breast surgery. I don’t think I’ll ever get used to the fog of pain and sorrow surrounding a double mastectomy.
All surgery is invasive in some way. Amputations, in particular, have a horror all their own; the idea that destroying someone – cutting off a body part, violating a coherent whole – should be necessary in order to save a life is almost …
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As a typical guy, there are several painful illnesses that can hit our brotherhood in an instant. No warning was given. No “Get out of jail free” pass, either. Just cruising along, having another fine, healthy day, and bam! — suddenly, you are lying on the floor in severe distress.
The most feared? A testicular torsion. It can happen spontaneously. It can …
by John Gever
Emergency department patients with chest pain may safely be evaluated in the waiting room when necessary, researchers said.
Among 303 patients triaged to waiting-room evaluation in a prospective study, no acute coronary syndromes were missed and adverse event rates overall were lower than among 804 patients who were assessed in conventional monitored beds, reported Frank Scheuermeyer, MD, of St. Paul’s Hospital in Vancouver, British Columbia, and colleagues online in …
I walked into Room 35 to find a three year-old lying on the hospital cot. Her father sat alongside her bed, whispering softly to her. The patient appeared quite tired, wiped-out even, and if it weren’t for her complacent eyes tracking my every move, I would have thought she might be sleeping.
She was visiting our ER because, after a few days of cough and congestion, she had developed a fever. …
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by Todd Neale
The recent stroke suffered by Delaware’s attorney general Beau Biden, who is 41, has highlighted the fact that people of all ages are vulnerable, despite seemingly good health.
A statement from Timothy Gardner, MD, medical director of the Center for Heart and Vascular Surgery at Christiana Care Health System in Newark, Del., where Biden was initially treated, said he had suffered a “mild stroke,” although it remains unknown whether …
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