Questions such as this from proactive, increasingly knowledgeable patients place a physician on the horns of an ethical dilemma. Although fellows are closely supervised and trained under a gradually increasing responsibility principle (based upon subjective evaluation), a time will come when there is no one available to back you up in the catheterization lab.
Monday is the start of the federal fiscal year, and with it begins Medicare’s biggest effort yet at paying for performance. Starting Oct. 1, Medicare is withholding 1 percent of its regular hospital reimbursements in the new Value-Based Purchasing Program, which was created by the 2010 health care law.
There is nothing more powerful than an idea whose time has come. There is nothing less powerful than an idea whose time has come and gone. In 1846, and for more than 100 years after that, the American Medical Association as a nationwide organization for all physicians was a powerful idea whose time had come.
Several recent articles should dispel any remaining notion that care provided under the so-called Affordable Care Act will in fact be affordable. Just the opposite is true. The Wall Street Journal reported that when physicians sell their practice to hospitals and become hospital employees, services they provide to patients become significantly more expensive.
Having taken an extended break from writing about the problems associated with robotic surgery, I think it’s time to explore an area not previously discussed. What is the effect of the robot on surgical resident education? Let’s review a few points about robot-assisted surgery. The surgeon actually doing the case is not scrubbed.
“What we have here is a failure to communicate.” A famous quote from the movie Cool Hand Luke. As many know poor communication is common in healthcare. Consider the following examples. According to Charles Duhigg in his newly released book, The Power of Habit , Rhode Island Hospital was one of the nation’s leading medical institutions.
In 2006, an otherwise healthy 53-year-old Ezekiel C. Mobley Jr. underwent routine surgery to remove an infected appendix. A Los Angeles native, he was planning to get back to hosting Pittsburgh's first Spanish-speaking television show. But he died before leaving the hospital. "I was really shocked -- very, very shocked," said Ora Mobley Sweeting, a human rights activist and Mobley's mother.
While our dad was in the hospital last winter, my brother shared with me his strategy for talking to the doctors we encountered – an approach honed over ten years of marriage to an internist and dozens of pediatrician visits for his two little boys. He asked smart questions that used medical terms to earn their respect, he told me.
Sepetmeber 18, 2012 What does it mean to be a professional? And how do we maintain our professionalism at a time when things such as stress, burnout, and caregiver fatigue threaten our motivation? As an anesthesiologist, the ability to remain professional in many scenarios is something I constantly strive for.
Dr. Anthony Youn, a plastic surgeon practicing in Detroit places most of the blame for long office waiting times at the feet of the patients themselves. He comes up with three general categories; patients who arrive late for their appointments, emergencies that require the physician to leave the office, and “oh by-the-way” scenarios: “Here is a typical scenario: It’s the end of a 10-minute office visit, scheduled as a follow-up for high blood pressure.
Here’s another reason health care inflation is down: The slowing growth in MRI scans, CT sessions and other diagnostic imaging that began in the mid-2000s has continued, paired with sharply lower Medicare reimbursements The end of the MRI boom may not rank with the poor economy, high-deductible health plans and expiring blockbuster drug patents as a factor in slowing cost trends — scans make up about 5 percent of total medical spending, according to the American College of Radiology — but it should please insurers and government officials who were complaining about it a few years ago.
“Yes,” says a large review of a single institution’s experience with appendectomy for acute appendicitis. The study looked at over 4500 patients who underwent appendectomies over the 8-year period between 2003 and 2011. The main findings of the study were that patients who developed surgical site infection (SSI) had a significantly longer delay in going to the operating room.
While policymakers debate complex changes to reduce health spending, promoting patients’ involvement in treatment decisions could have an immediate effect. A new Health Affairs report about decision aids — materials given to patients to help educate them about treatment options — shows they can help hold down costs by reducing demand for medical procedures.
People blame anesthesia personnel for everything. You name it, they blame us for it. They call us by the umbrella name “Anesthesia” and if there’s a problem, it’s always “Anesthesia’s” fault. Got into the room late? Blame Anesthesia. (Even though the anesthetist’s been sitting at the bedside for twenty minutes waiting for the surgeon or the nurses to be ready.
I distinctly remember that in first grade I had an idea of breathtaking wisdom and profundity. Candy should be free. You may have had a similar thought at the same age. This idea was supported by an incontrovertible rationale, namely that I really liked candy. Tragically, it only took a moment for my parents to expose a flaw in my otherwise revolutionary scheme.