Treating the patients we cannot reach
I had never met the man, but from a brief reading of the notes in his medical record, I knew that this was not going to be easy. Thirty years old with stage III kidney cancer, the notes showed a long history of missed appointments and late arrivals. I had been asked to talk to him about sperm banking and so started a 3-month journey of contact numbers not in service, relatives who hadn’t seen him for months, and oncology colleagues who were running out of patience.
He had seemed to form a bond with one of the nurses who cared for him before and after his nephrectomy. She offered herself as the liaison between the patient...
Source: Kevin, M.D. - Medical Weblog - July 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/anne-katz" rel="tag" > Anne Katz, RN, PhD < /a > Tags: Physician Cancer Source Type: blogs
Intuitive ’s New Budget Friendly da Vinci X Robotic Surgical System Cleared in U.S.
Intuitive Surgical is following up on the European clearance from a month ago for its da Vinci X robotic surgical system with a similar clearance from the FDA. The da Vinci X is a budget friendly cousin of existing offerings from Intuitive, yet offers many of the same capabilities and is upgradeable to include various others. All of the tools, such as staplers, firefly, and vessel sealers are available on the da Vinci X, as is the same training and support that is included with the more expensive devices.
The interface console that the surgeon uses to control the robot is the same as on other da Vincis and the robotic ar...
Source: Medgadget - May 31, 2017 Category: Medical Devices Authors: Editors Tags: Ob/Gyn Surgery Thoracic Surgery Urology Source Type: blogs
Intuitive Cleared in EU for Its New, More Budget Friendly da Vinci X Robotic Surgical System
Intuitive Surgical, makers of the famous da Vinci line of robotic-assisted surgical platforms, just announced receiving European regulatory approval to introduce its new da Vinci X surgical system. The system is designed for customers that can’t afford the hefty price tag of more expensive da Vinci robots while offering many of the same capabilities as those products. The console that the surgeon uses to manipulate the robot stays the same, as well as the display cart which nearby clinicians use to monitor the procedure.
Similar to the da Vinci Si system, the da Vinci X has its robotic arms mounted on a side cart, w...
Source: Medgadget - April 28, 2017 Category: Medical Equipment Authors: Editors Tags: Ob/Gyn Surgery Thoracic Surgery Urology Source Type: blogs
Fovia Utopia
I ' ve found over the years that the PACS field is rather mobile. A friend that worked for company A might now be found at company C having arrived there after doing time at firm B. You might remember back when Merge first bought out Amicas...there were some discussions about whom to keep and whom to let go, and I was rather vocal in urging (begging?) Merge to keep the folks who madeAmicasMerge PACS what it is. That didn ' t work out, but one of my friends from that realm is now with an amazing little company called Fovia. I sought him out at RSNA, as I usually do, and he showed me some cool stuff. Due to some personal thi...
Source: Dalai's PACS Blog - January 18, 2017 Category: Radiology Source Type: blogs
There is something wrong with a system that punishes legitimate patients in pain
Overwhelmed by the insanity of the bureaucratic bungle surrounding the dispensing of narcotic pain medication, I’m not sure where to begin. So I will begin with my experience.
I am a licensed physician in the state of Nevada. I retired from full-time practice in California and moved to Las Vegas, where I work part time. I have a friend who recently underwent a nephrectomy. She was discharged with a prescription phoned in for oxycodone, which was filled at her local pharmacy.
I accompanied her to an urgent care facility today because of a cough. She took her last oxycodone this morning. I asked the doctor seei...
Source: Kevin, M.D. - Medical Weblog - November 13, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/judy-salz" rel="tag" > Judy Salz, MD < /a > Tags: Physician Pain management Source Type: blogs
Integrating Care At Every Point Along A Patient’s Surgical Journey
In the United States, the full continuum of care before, during, and after surgery is expensive, fragmented, and associated with a high number of complications. We believe the current segmented care model must become an integrated care model based on excellent coordination throughout the entire perioperative system, from the minute the surgeon and the patient decide a procedure is needed until the patient is discharged and transferred to his or her primary care provider or medical home.
This new model, which was originally proposed by the Perioperative Surgical Home (PSH) of the American Society of Anesthesiologists, is bu...
Source: Health Affairs Blog - April 7, 2015 Category: Health Management Authors: Zeev Kain and Jason Hwang Tags: All Categories Chronic Care Innovations in Care Delivery Nurses Physicians Policy Quality Source Type: blogs
Health Affairs’ February Issue: Biomedical Innovation
The February issue of Health Affairs includes a number of studies examining issues pertaining to biomedical innovation. Some of the subjects covered: how declining economic returns for new drugs may affect future investments, the changing landscape of Medicare coverage determinations for medical interventions, the slowly emerging US biosimilar market, and more.
With declining economic returns, can manufacturers afford to continue investing?
Ernst Berndt of Massachusetts Institute of Technology’s Alfred P. Sloan School of Management and coauthors compared present values of average lifetime pharmaceutical revenues to prese...
Source: Health Affairs Blog - February 2, 2015 Category: Health Management Authors: Chris Fleming Tags: All Categories Biotech Innovation Medicare Pharma Policy Research Science and Health Technology HA_BiomedInnovation Source Type: blogs
MKSAP: 66-year-old man with vague abdominal pain
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 66-year-old man is evaluated for vague abdominal pain of several months’ duration and a 10-kg (22-lb) weight loss. He drinks alcohol socially but does not smoke. The patient is otherwise well, has good performance status, and takes no medications.
On physical examination, vital signs are normal. No lymphadenopathy is noted. Cardiopulmonary examination is normal. He has a slightly distended abdomen with vague left-sided upper abdominal fullness but without tenderness, rebound, or guarding. The rectal exam...
Source: Kevin, M.D. - Medical Weblog - January 3, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Cancer Source Type: blogs
Best Post of August 2012: A case of renal cell carcinoma metastatic to a meningioma
The next in our "Best of the Month" series is from August 9, 2012:A 74-year-old woman with a history of a seizure disorder had been followed for several years with a stable and unsymptomatic left parasagittal dural-based brain tumor presumed to be a benign meningioma. Recently, though, the lesion increased in size and hemorrhaged, leaving her significantly paretic on the right side. Neurosurgery thereupon performed a craniotomy for tumor removal. Intraoperative frozen section diagnosis was meningioma. But, upon receipt of the permanent sections, I was impressed by the staghorn vessels at low power and hemangioperic...
Source: neuropathology blog - January 25, 2013 Category: Pathologists Tags: neoplasms Best of the Month series Source Type: blogs
