Forks In the Road
By NORTIN HADLER, MD
On Saturday, Dr. Hadler delivered the commencement address at the University of Michigan Medical School. THCB is pleased to feature his remarks.
Thank you, Class of 2015, for the privilege of sharing this special occasion with you, your families and the community that has come together to celebrate with you. This is a rare day of pure self-indulgence. Our professional life allows little room for self-indulgence and seldom applauds when one of us makes the room. For those of you who are drawn to a career anchored at the bedside, the trade-off is the quiet, internalized quest to become the best phy...
Source: The Health Care Blog - May 18, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
Go Slow On Reference Pricing: Not Ready For Prime Time
Editor’s note: This post is part one of two on reference pricing.
The use of reference pricing by health insurers and employee health benefit plans stands high on the policy and regulatory agenda because it is gaining popularity, particularly now that federal agencies have blessed its use by large group insurers and self-insured plans, while imposing only relatively lax requirements. The purpose of reference pricing is to enable patients to “shop” for care and to spur provider competition by creating a group of “designated” in-network providers that agree to abide by the reference price while others do not...
Source: Health Affairs Blog - March 9, 2015 Category: Health Management Authors: David Frankford and Sara Rosenbaum Tags: All Categories Business of Health Care Competition Consumers Employer-Sponsored Insurance Health Care Costs Health Reform Hospitals Payment Pharma Spending Source Type: blogs
Lightning goes to ground
I respect and admire Lucien Engelen, the spirit behind the REshape Center for Innovation at Radboud University Medical Center in the Netherlands, so when he recently posted an article entitled, "10 TED talks that change(d) healthcare," I was intrigued. Who doesn't love TED talks, after all?But then I concluded that he was off base.Not because the talks aren't great. They are great. They are stimulating, well presented, thoughtful, and challenging.But they have not changed health care. Look through the talks and see what's imagined in them. Now, compare them to what's happening on the ground in most...
Source: Running a hospital - January 10, 2015 Category: Health Managers Source Type: blogs
Another Example of Defensive Medicine
The ultrasound images above show a circular clot in the superficial femoral vein. The image on the left is without compression and the image on the right is with compression. Normally blood vessels flatten out when compressed. Since the vessel did not flatten with compression it confirmed the presence of a blood clot.
While discussing a case with one of the nurses with whom I work, I saw how once again defensive medicine had affected my medical practice.
I gave a few examples of defensive medicine in a post several years ago and I also mentioned how sometimes doctors have to prove a negative when dealing with patients. Bot...
Source: WhiteCoat's Call Room - September 18, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Defensive Medicine Patient Encounters Source Type: blogs
Top stories in health and medicine, August 28, 2014
From MedPage Today:
I, Intern: Common Problems, Elusive Answers. Rebecca Karb, MD, crosses paths with patients in the Rhode Island Hospital emergency department who have ailments that she rarely saw as a medical student.
Results Mixed With Home BP Monitoring. A hypertension self-management program reduced systolic blood pressure in high-risk patients, including those with cardiovascular disease, diabetes, or chronic kidney disease.
Surgery No Help for Mild Knee OA. Arthroscopic surgery for degenerative meniscal tears in patients with mild knee osteoarthritis had no benefit for function or pain.
Study Flags ECG Change as ...
Source: Kevin, M.D. - Medical Weblog - August 28, 2014 Category: Journals (General) Authors: MedPage Today Tags: News Heart Orthopedics Source Type: blogs
The “Failure” Of Bundled Payment: The Importance Of Consumer Incentives
TweetBundled payment for orthopedic and spine surgery and other major acute interventions has many attractive features, in principle. But implementation has been difficult in practice. The recent Health Affairs paper by Susan Ridgley and colleagues, and the Health Affairs Blog commentary by Tom Williams and Jill Yegian, list quite a few practical implementation problems, and the points raised in both these pieces are well taken.
As leaders in the Integrated Health Association (IHA) bundled payment initiative, we shared the same hopes, devoted the same energies, and share the same frustrations with the modest results. W...
Source: Health Affairs Blog - August 21, 2014 Category: Health Management Authors: James Caillouette and James C. Robinson Tags: All Categories Consumers Employer-Sponsored Insurance Health Care Costs Hospitals Payment Policy Quality States Source Type: blogs
Healthcare Update Satellite — 12-04-2013
What are the busiest hospital emergency departments? An American Hospital Association survey from 2011 published earlier this year is surprising (link to .pdf file). The 25 busiest hospitals in the US see more than 5 million patients per year. Florida Hospital in Orlando is the busiest in the US and sees 407,000 patients per year – an average of 1,100 per day.
Georgia Supreme Court rules that emergency physician’s to diagnose a pulmonary embolism in 15 year old football player who had arthroscopic knee surgery a week prior to ED visit can constitute gross negligence. The patient had pleuritic chest pain, a norm...
Source: WhiteCoat's Call Room - December 4, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Real Time MRI Guidance and Visualization for Brain Surgery Using Clearpoint System: Interview with CEO of MRI Interventions
Ever since the 1950s neurosurgeons have been using static images, taken prior to the procedure, to guide them through an operation. Brain surgeries performed in this manner are based a great deal on trial and error, and require the patient to stay awake as the surgeon painstakingly works for hours to determine if the therapy reached the correct location in the brain. Now, MRI Interventions, an Irvine, CA company, is developing a novel technology called Clearpoint that uses real time, intra-procedural magnetic resonance imaging to guide neurological procedures. The Clearpoint system is intended to be used for treatment ...
Source: Medgadget - November 19, 2013 Category: Technology Consultants Authors: Gaurav Krishnamurthy Tags: Medgadget Exclusive Neurological Surgery Radiology Source Type: blogs
Smith & Nephew Launches HEALICOIL REGENESORB Suture Anchor (VIDEO)
Smith & Nephew has launched the HEALICOIL REGENESORB suture anchor made out of advanced biocomposite material for use in arthroscopic surgery. HEALICOIL REGENESORB not only uses the osteoconductive properties of beta tricalcium phosphate (β-TCP) to provide 18 months of sustained bone formation like other biocomposite implants but also utilizes a second osteoconductive component, calcium sulfate, that comes into play early in the bone healing process and helps to increase the levels of local growth factors.
Unlike solid core implants, the HEALICOIL suture anchor has an open-architecture that eliminates the mater...
Source: Medgadget - November 12, 2013 Category: Technology Consultants Authors: Gaurav Krishnamurthy Tags: Orthopedic Surgery Source Type: blogs
Ceterix NovoStitch Arthroscopic Suture Passer Gets Under Otherwise Inaccessible Soft Tissues (VIDEO)
Meniscal tears are excellent candidates for repair via arthroscopic surgical procedures. Football players are often back on the field within a few weeks following an injury, but there’s still room for improvement in the way the procedures are performed. Specifically, because of the limitations of current technology, meniscectomies are often performed because of the difficulty of sewing tears in very tight spaces.
Enter the Novostitch from Ceterix Orthopaedics, a Menlo Park, CA firm, that is unveiling its NovoStitch arthroscopic device capable of passing a compression suture from the lower to the upper part of its ja...
Source: Medgadget - July 18, 2013 Category: Technology Consultants Authors: Editors Tags: Orthopedic Surgery Source Type: blogs
Demand drives supply which drives cost
A recent report from the Bureau of Labor Statistics showed the trends in employment by sector in the US. I don't have the reference here, but if you look at the period from 2007 to present, the major sector that has shown growth was health care. For example, look at this BLS article from 2011. The current job report, as I recall, will likely mark well over 110 consecutive month of job growth for the health sector.In a related story over at Modern Healthcare, CMS provided detail of the pioneer accountable care organizations that realize the business proposition for the program doesn't work. "Seven Me...
Source: Running a hospital - July 16, 2013 Category: Health Managers Source Type: blogs
Mitek Sports Unveils HEALIX ADVANCE KNOTLESS Anchor for Rotator Cuff Operations
Mitek Sports Medicine, part of DePuy, itself part of J&J, is releasing the HEALIX ADVANCE KNOTLESS Anchor for arthroscopic rotator cuff repairs. Here are some details about the device from Mitek:
The HEALIX ADVANCE KNOTLESS Anchor features dual-thread technology to maximize fixation and pull-out strength in both cancellous and cortical bone, and a multi-thread design that enables fast insertion into bone. Additionally, the device eliminates the need for arthroscopic knot tying.
The HEALIX ADVANCE KNOTLESS Anchors are offered in three sizes, 4.75mm, 5.5mm and 6.5mm and are made of either BIOCRYL® RAPIDE™, a biocompo...
Source: Medgadget - July 15, 2013 Category: Technology Consultants Authors: Editors Tags: Orthopedic Surgery Source Type: blogs
Healthcare Update Satellite — 06-26-2013
See more HealthCare Updates at my other blog at http://drwhitecoat.com.
UK Accident and Emergency Department criticized for multiple failures after going into “crisis” mode from January through March due to a surge in patient volumes. Of course, all the investigators go and pick through the hospital’s policies four times in April after things have calmed down, rather than going and trying to address the problems in real time while they’re happening.
Want to see me faint? Give me a story about an inspector going to a hospital during a crisis, and making a specific real-time recommendation on how to improve the ...
Source: WhiteCoat's Call Room - June 27, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
What do you do if you’ve got osteoarthritis of the knee?
Film director Baz Luhrmann made a spoof graduation speech famous with his hit “Everybody’s Free (To Wear Sunscreen)” back in 1999. At the time, I wasn’t particularly worried about the line in that track: “Be kind to your knees, you’ll miss them when they’re gone.” But, you get older, knees become more of a focus, so what are you to do if you suffer from osteoarthritis of the knee (thankfully, I don’t…yet).
According to SBM, here’s what a massive scientific review of the various possible treatments has to say:
Exercise – strong evidence for effectiveness
Weight los...
Source: Sciencebase Science Blog - June 11, 2013 Category: Medical Scientists Authors: David Bradley Tags: Science Source Type: blogs
