New Health Policy Brief: Ambulance Diversion
A new policy brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF) discusses efforts to address ambulance diversion, a controversial strategy for temporarily relieving overcrowding in emergency departments (EDs). According to 2015 data, the national median time for a patient, from arrival to placement in an inpatient bed, was 279 minutes.
Ambulance diversion was initially viewed as a safety valve. However, the approach has yielded unintended long-term negative consequences and raises questions of equity, since it disproportionately impacts minority populations. Since many factors can impact ED overcrowdin...
Source: Health Affairs Blog - June 3, 2016 Category: Health Management Authors: Lucy Larner Tags: Elsewhere@ Health Affairs Featured ambulatory care Emergency Medicine Health Policy Brief Source Type: blogs
Ultrasound: Eye Think It’s the Retina
Part 3 in a SeriesThe Problem: Unilateral, painless vision changes and floatersOcular ultrasound is a short and sweet procedure that could change your practice and greatly benefit your patients. It can actually be used to diagnose retinal detachment, which in the past required a referral to an ophthalmologist and often led to delayed therapy. Noninvasive and simple ultrasound techniques can be used on any patient of any age presenting with visual changes. The differential for visual changes with or without complete vision loss or blurry vision encompasses a daunting list. This is for you especially if retinal deta...
Source: The Procedural Pause - May 2, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The worst reasons why people visit A & E
A&E stands for Accident & Emergencies but for some reason people seem to think it stands for “All & Everything”.
The A&E is not a polyclinic to treat all your minor ailments. Non-urgent cases do clog up the A&E services and even with triage systems (green zone for the non-urgent), patients do not understand and complain about the waiting.
Which brings us to this news item we came across about the NHS UK on The worst reasons people visit A&E when they shouldn’t.
We thought we’d ask our doctors for their experience on worst reasons for people coming to the A&E in Mal...
Source: Malaysian Medical Resources - March 29, 2016 Category: Global & Universal Authors: palmdoc Tags: - Ethics - Health tips - Nation - Offbeat news A&E Eemrgency ER Source Type: blogs
The worst reasons why people visit A&E
A&E stands for Accident & Emergencies but for some reason people seem to think it stands for “All & Everything”.
The A&E is not a polyclinic to treat all your minor ailments. Non-urgent cases do clog up the A&E services and even with triage systems (green zone for the non-urgent), patients do not understand and complain about the waiting.
Which brings us to this news item we came across about the NHS UK on The worst reasons people visit A&E when they shouldn’t.
We thought we’d ask our doctors for their experience on worst reasons for people coming to the A&E in Mal...
Source: Malaysian Medical Resources - March 29, 2016 Category: Global & Universal Authors: palmdoc Tags: - Ethics - Health tips - Nation - Offbeat news A&E Eemrgency ER Source Type: blogs
Whole Woman’s Health v. Hellerstedt: Quantifying The Case’s Potential Impact On Abortion Access And Women’s Health
Editor’s note: The post below discusses Whole Woman’s Health v. Hellerstedt, which will be argued before the Supreme Court tomorrow. The Court today decided another important health-related case, holding in Gobeille v. Liberty Mutual Insurance Co. that ERISA prevented Vermont from requiring self-insured employee health plans to report claims information and other data to the state’s all-payer claims database. Read Bill Sage’s recent Health Affairs Blog post for a discussion of the issues at stake in Gobeille.
In April 2013, there were 41 facilities providing abortion services in Texas, and now there...
Source: Health Affairs Blog - March 1, 2016 Category: Health Management Authors: Daniel Grossman Tags: Featured Health Professionals Hospitals Population Health Public Health Abortion HB2 Reproductive Health Supreme Court Texas Whole Woman’s Health v. Hellerstedt Women's Health Source Type: blogs
Stealth Public Relations and Health Advocacy, Special Pleadings and the Opposition to Guidelines Discouraging Overuse of Narcotics
As I have written before as a physician who saw too many dire results of intravenous drug abuse, I was amazed how narcotics were pushed as the treatment of choice for chronic pain in the 1990s, with the result that the US was once again engulfed in an epidemic of narcotic abuse and its effects. In mid-December, 2015, as reported in the Washington Post,The nation continues to suffer through a widespread epidemic to prescription opioids and their illegal cousin, heroin. The CDC estimated that 20 percent of patients who complain about acute or chronic pain that is not from cancer are prescribed opioids. Health-care prov...
Source: Health Care Renewal - January 4, 2016 Category: Health Management Tags: CDC Cephalon conflicts of interest deception Endo Health Solutions Johnson and Johnson narcotics public relations Purdue Pharma stealth health policy advocacy Source Type: blogs
Trouble Ahead For High Deductible Health Plans?
Benefit plans with high cost-sharing do much more than simply shift costs from employers and health plans. Conventional wisdom suggests that they help lower overall medical expenses by making patients more selective and cost-conscious consumers. However, studies are beginning to ask if high deductibles could actually result in adverse consequences in the long run due to avoidance of necessary care in the short run.
There is not much comprehensive or definitive knowledge about this potential trend yet. This post outlines a few observations based on the current state, and recommends actions that health care leaders can take ...
Source: Health Affairs Blog - October 7, 2015 Category: Health Management Authors: Ifrad Islam Tags: Costs and Spending Featured Insurance and Coverage Long-term Services and Supports Population Health Quality ACA silver plan Emergency Medicine high deductible health plans out of pocket costs Source Type: blogs
A World on Fire?
A sense of historical perspective and responsible rhetoric may be too much to ask of candidates at this stage in a presidential campaign. With fifteen contenders all looking to score points some hyperbole is to be expected. Even so the level of threat inflation and “world in flames” talk last night was troublesome given how at odds it is with fundamental trends in world affairs.
Here is just a sampling of last week’s overheated discussion of global dangers:
Donald Trump: “The world is blowing up around us. …These are extraordinarily dangerous times that we live in.”
Ben Carson: “We’re talking about global j...
Source: Cato-at-liberty - September 21, 2015 Category: American Health Authors: A. Trevor Thrall Source Type: blogs
Neuroscientists Are Also Capable of Incoherent Arguments Against Cryonics
The objective is to preserve the fine structure of neural tissue and nerve cell connections that encode the data of the mind. Provided that is stored successfully, then foreseeable forms of technology will in the future enable restoration and repair of this tissue. Early cryonics involved straight freezing, which wrecks tissue due to ice crystal formation. Modern cryonics aims for as-complete-as-possible vitrification via cryoprotectants, a process that suppresses ice crystal formation. There is ample evidence based on present theories of neural data encoding to believe that the necessary information is being preserved, al...
Source: Fight Aging! - September 16, 2015 Category: Research Authors: Reason Tags: Healthy Life Extension Community Source Type: blogs
Why Selling Oil from the Strategic Petroleum Reserve Is a Bad Idea
Some lawmakers are proposing a sell-off of oil from the Strategic Petroleum Reserve to finance highway and bridge work. This is a shortsighted strategy. (Source: The RAND Blog)
Source: The RAND Blog - September 15, 2015 Category: Health Management Authors: RAND Corporation Source Type: blogs
Driverless Money
Last week I happened to be contemplating a post having to do with driverless cars when, wouldn’t you know it, I received word that the Bank of England had just started a new blog called Bank Underground, the first substantive post on which had to do with — you guessed it — driverless cars.
As it turned out, I needn’t have worried that Bank Underground had stolen my fire. The post, you see, was written by some employees in the Bank of England’s General Insurance Supervision Division, whose concern was that driverless cars might be bad news for the insurance industry. The problem, as the Bank of England’s experts...
Source: Cato-at-liberty - June 23, 2015 Category: American Health Authors: George Selgin Source Type: blogs
Marco Rubio's Breathtaking Myopia
Sen. Marco Rubio might fancy himself as a new type of leader for a new era, but his speech yesterday to the Council on Foreign Relations was trapped in the past. Invoking John F. Kennedy’s final speech as president, more than 50 years ago, was bad enough. But Rubio’s overarching message – the Rubio Doctrine – amounts to warmed over Cold War dogma, sprinkled with the language of benevolent global hegemony favored by so many Washington elites, but disdained by most Americans beyond the Beltway. It is difficult to understand the depths of his political and strategic myopia.
Rubio misperceives the American public’s ...
Source: Cato-at-liberty - May 14, 2015 Category: American Health Authors: Christopher A. Preble Source Type: blogs
MKSAP: 21-year-old male student is evaluated for a murmur
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 21-year-old male student is evaluated for a murmur heard during an athletic preparticipation physical examination. He is asymptomatic. His medical and family history is unremarkable and he takes no medications.
On physical examination, the patient is afebrile, blood pressure is 118/76 mm Hg, pulse rate is 68/min, and respiration rate is 14/min. BMI is 18. He wears corrective lenses for myopia. Mild thoracic scoliosis is noted. He has long, thin fingers and a mild pectus excavatum deformity. His height is 188 c...
Source: Kevin, M.D. - Medical Weblog - March 8, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Heart Source Type: blogs
