Remember the good ol' days when taking a single board certification examination from the American Board of Internal Medicine (ABIM) was good enough to call yourself "board certified" in a medical specialty? Those were the days.
Attention technologists, CEO’s, and health care consultants: your decisions can be as dangerous as a nurse with a syringe of over-concentrated heparin. When EMRs are implemented that take physicians eyes and minds away from the patient without demonstrable improvement in quality of care (and cause excess spending), patients can die.
A recent paper's finding as that hospitals in Pennsylvania that had 10% more nurses with BSN degrees were found to have 2.12 fewer deaths per 1000 postop patients than those that did not. The authors extrapolated this, saying that if all the hospitals they surveyed had the same percentage of BSN nurses as the best performers, 500 deaths may have been avoided.
You can’t keep asking these young doctors to do more and more work in less time without affecting patient care. Until we address the problem of overwork, we’re just playing a shell game. Something more substantial needs to be done to deal with the problem of overwork for young doctors.
As we continue to carry out the Affordable Care Act and enter a new era of tremendous change, we must confront our natural tendencies to favor patients we find pleasant — especially when it comes at the expense of those we find less so.
There will always be controversy when it comes to using diagnostic tests for routine screening of asymptomatic patients. Ultimately, we must continue to take a reasonable and academic approach to testing. We are still going to discover the “incidentaloma."
The hospitals, many of which specialize in heart or orthopedic surgeries, have long drawn the ire of federal lawmakers and competitors. They say physicians often direct the best-insured and more lucrative cases to their own facilities, while leaving the most severely ill patients to others.
The doctor shortage will have a profound effect on every community attempting to receive adequate medical care. Using existing resources like NPs will bridge the healthcare gap, but this must be done wisely and carefully to assure patient care is not compromised.
Media coverage of this issue has resulted in the medical community proactively addressing and researching methods to prevent, identify, and treat intraoperative awareness. In fact, mindfulness about intraoperative awareness is a good thing, especially when it is discussed factually and is not sensationalized. Here are some facts every patient undergoing general anesthesia should know.
I really had no choice of hospitals. If I wanted my trusted doctor to do the operation, I would have to go where he recommended. However, my patient experience made me aware of how many places in the chain of care where mistakes can occur.
Transparent pricing is necessary for any concept of value to have meaning, and to send appropriate signals concerning scarcity or abundance. Non-transparent pricing is a hallmark of command economies. There can simply be no meaningful competition when the prices aren’t transparent and known up front.
Healthcare policy is a moving target; and the most effective measures endure as “best practices” only until new research points the way to even better approaches.
Simply stated, there is one significant drawback: patients can't predict the urgency of their diagnosis based on initial symptoms alone.
Some groups, particularly nursing organizations, are calling for the placement of smoke evacuators in all operating rooms. As you might suspect, these efforts are being vigorously supported by the manufacturers of smoke evacuators. I attempted to find some real evidence about all this, but it is hard to come by.
No choice is without risk for the high-risk surgical patient with significant aortic stenosis.