Blogs
How To Operate On The Wrong Site
November 26, 2012 9:17 am | by Skeptical Scalpel | CommentsHere’s a story that illustrates how to operate on the wrong site. In a news article about some sanctions that the State of California imposed on certain hospitals for misdeeds, the following summary of one incident appeared. A six-year-old boy had to undergo a second surgery to remove a growth after a surgeon performed the wrong surgery on his tongue.
Duh? Postoperative Complications Lead To Readmissions
November 20, 2012 3:14 pm | by Skeptical Scalpel | CommentsA recent study's main findings that readmissions were due to complications and the more complications a patient had, the more likely he was to have been readmitted, are not exactly earth-shattering. The press release and articles accompanying the paper’s publication were a little over the top.
The Difference Between Complications And Negligence
November 20, 2012 9:29 am | by Michael Kirsch, M.D. | CommentsSure, complications matter, but numbers can deceive. Our most highly experienced physicians have likely had more complications than other medical colleagues, although their complication rate may be very low.
The Biggest Issues With EMR Today
November 19, 2012 9:32 am | by Kevin R. Campbell, M.D. | CommentsThe Federal government has mandated the implementation of EMR in order for providers to be paid at the highest allowable rates and receive certain incentive pay for complying with EMR. EMR has the potential to provide increased patient safety and significant cost savings if developed properly. However, current EMR systems are not really ready for “prime time.”
Hospital Shift Changes A Dangerous Time For Patients
November 16, 2012 9:58 am | by Alvin Tran | CommentsOutgoing and incoming doctors carefully exchange important information about each patient to ensure that they are properly cared for through the next shift. But many hospitals don’t follow such a process, increasing the risk of medical errors.
Decrease Burnout Through Better Understanding Of Physicians
November 14, 2012 11:23 am | by Robert Centor, M.D. | CommentsPhysician a burnout has great current interest. Many authors are worrying about burnout and therefore writing about this problem. What are the common root causes of burnout? Primarily burnout comes from loss of control and overwhelming undesirable activities. Burnout occurs when the job becomes overwhelming.
The EMR Is Trying To Serve Too Many Masters
November 13, 2012 11:24 am | by Christopher Johnson, M.D. | CommentsThe electronic medical record (EMR) is here to stay. Its adoption was initially slow, but over the past decade those hospitals that do not already have it are making plans for implementing it. On the whole this is a good thing because the EMR has the ability greatly to improve patient care.
Is It Really Fair To Penalize Hospitals For Readmissions?
November 12, 2012 11:02 am | by by Skeptical Scalpel, M.D. | CommentsAs new Medicare rules kick in, some 2,200 hospitals nationwide are facing financial penalties for high 30-day readmission rates for myocardial infarction, congestive heart failure and pneumonia. Medicare payments will be lowered by as much as 1 percent.
31 Percent Of General Surgery Residents Need Remediation. Why?
November 9, 2012 9:41 am | by Editor | CommentsA recent paper in Annals of Surgery depicts the rate of resident remediation over a decade or so at six general surgery programs in California. The authors reviewed the records of 348 categorical general surgery residents and found that 107 (31 percent) required mediation with knowledge deficits the primary reason in 74 percent.
A Window Into OR Behavior
October 26, 2012 5:57 am | by Felicity Billings, M.D. | CommentsWhen I clicked on the “View Your Exam Results” link on the American Board of Anesthesiology website, I thought something rashly exuberant would engulf me. I thought that everyone in the lunch room would turn suddenly, throw their reheated pasta and cafeteria sandwiches high aloft with glee and balloons would gush from the cracks between the fluorescent lights on the ceiling as the whole world burst into song.
Are Medical Device Companies Being Demonized?
October 24, 2012 4:45 am | by Michael Kirsch, M.D. | CommentsAll parents have heard their kids complain that but for 1 or 2 percentage points, they would have achieved a higher grade. “This is so unfair! My average is 89.9999 and he is still giving me a B+!” Every kid should receive an A, of course, since psychologists are now professing that every kid is a prodigy in some new measure of intelligence.
How Gross Anatomy Changes You Forever
October 23, 2012 5:03 am | CommentsAfter a week of medical school orientation, followed by two weeks in the classroom studying cellular organelles and biochemical pathways, our class was finally going to start the centuries-old rite of passage that is human gross anatomy. For many students, it will be first time seeing a dead body.
National Reporting Isn't The Answer To Reduce Medical Errors
October 22, 2012 7:17 am | by Kevin R. Campbell, M.D. | CommentsIn the Wall Street Journal , surgeon Dr. Marty Makary discusses the alarming costs of medical errors and offers suggestions to improve the system. In medicine, particularly during the training years of residency and fellowship, young doctors are not given the opportunity or security to report shortcomings of their superiors.
Is Normal Saline Bad For The Kidneys?
October 19, 2012 5:35 am | CommentsAnswer: Yes. This week, the two heavyweight medical journals, JAMA and the New England Journal of Medicine, featured papers describing the effect of certain intravenous fluids on the incidence of renal failure in critically ill ICU patients. The JAMA paper compared normal saline (relative to human plasma, a high chloride-containing solution) administration to more physiologic, low chloride-containing IV fluids such as Hartmann’s solution (very similar to Ringer’s lactate) or Plasma-Lyte 148.
OR Visualization
October 17, 2012 6:09 am | by Jens Ruppert | CommentsJens Ruppert, Vice President and General Manager, Surgical Business Unit NDS Surgical Imaging www.ndssi.com When considering the features of a surgical video and visualization system, it’s important to remember there are a number of critical elements that impact the overall quality of the video equipment chain.
