MA surgical errors

From the Boston Globe article:

During the past three years, doctors at Massachusetts hospitals mistakenly removed a patient's kidney when they were supposed to take out her gallbladder and performed an unscheduled cervical biopsy on a woman who had the same first name as the patient scheduled for the procedure.
...
In most cases examined by the Globe, patients did not appear to suffer long-term physical harm, but many had to undergo second surgeries to correct problems while others experienced pain before objects were removed.

Click here to read the entire article.

ACCME posts clarification

The ACCME has posted clarification regarding joint sponsorship as it relates to the August 2007 definition of a commercial interest.

Click here to access.

Medical errors and residents

Check out the Archives of Internal Medicine article "Medical Errors Involving Trainees":

Results Among 240 cases, errors in judgment (173 of 240 [72%]), teamwork breakdowns (167 of 240 [70%]), and lack of technical competence (139 of 240 [58%]) were the most prevalent contributing factors. Lack of supervision and handoff problems were most prevalent types of teamwork problems, and both were disproportionately more common among errors that involved trainees than those that did not (respectively, 54% vs 7% [P < .001] and 20% vs 12% [P = .009]). The most common task during which failures of technical competence occurred were diagnostic decision making and monitoring of the patient or situation. Trainee errors appeared more complex than nontrainee errors (mean of 3.8 contributing factors vs 2.5 [P < .001]).

Conclusions In addition to problems with handoffs, house staff are particularly vulnerable to medical errors owing to teamwork failures, especially lack of supervision. Graduate medical education reform should focus on strengthening these aspects of training.

Click here to access the article (sub. req.).

Smoky Southern California Sunset

Will health care reform work this time?

Probably not...check out the article by Jonathan Oberlander, Ph.D., "Learning from Failure in Health Care Reform" just published in the New England Journal of Medicine:

...it is easy to forget that Bill Clinton was not the first president to fail at health care reform: he was following in the footsteps of Franklin Roosevelt, Harry Truman, and Richard Nixon. Ultimately, the demise of the Clinton plan says less about the administration’s mistakes than it does about the extraordinary difficulty of adopting comprehensive health care reform in the United States.

Click here to access this free full-text article.

Cultural competency and diabetes

From the Wall Street Journal article:

With minorities accounting for nearly a third of the U.S. population, medical professionals are beginning to bone up on so-called cultural competency, part of an effort to ensure that patients from disparate backgrounds get proper care. Nowhere is the challenge more acute than for those treating diabetics, given the rising incidence of the disease, its prevalence among minority groups and the changes in diet and lifestyle that treatment often entails.

Click here to read the entire article (sub. req.).

Resources for coping with disasters

Click here to access the CDC's resources on coping with disasters.

More on anemia drugs

From the L.A. Times article:

The largest group of U.S. cancer doctors said Monday that Medicare has gone too far in restricting the use of anemia drugs made by Amgen Inc. and Johnson & Johnson and released its own guidelines.

The doctors' recommendations add new warnings about heart risks while saying patients can safely use higher doses than Medicare allows. The guidelines, based on a three-year review of clinical trials, are being published by the American Society of Clinical Oncology, an association of cancer doctors, and the American Society of Hematology, a group of blood experts.

Click here to access the article.

San Diego County Ablaze

John Gastaldo/The San Diego Union-Tribune/Zuma Press

Click here to see additional photos.

Christopher Gist

History fascinates me, especially when it involves one of my ancestors, such is the case with Christopher Gist. From the Ohio History Central website:

Christopher Gist was an explorer, surveyor and accomplished frontiersman. He was born about 1706 in Maryland to Richard and Zipporah Gist.
...
Gist returned to the Ohio Country, this time with George Washington, in the winter of 1753-1754. The Ohio Company sent the two men to the region to negotiate with French military forces. The French had constructed Fort Duquesne near Shannopin's Town to prevent English settlement of the Ohio Country. Negotiations failed, but during the trip Gist saved the young Washington's life on two separate occasions.
...
Gist provided England and its colonists with the first detailed description of southern Ohio and northeastern Kentucky. While Daniel Boone is generally given credit for opening Kentucky to white settlement, Gist preceded the frontiersman by more than fifteen years.

Click here to access the website.

Murphy's law?

From the Pittsburgh Post-Gazette article:

In response to a national report on an increase in staph infections, Pennsylvania's Rep. Tim Murphy, R-Upper St. Clair, yesterday touted a bill that would create a public database showing how many infections are acquired by patients in each of the nation's hospitals.

"A hospital is a place where people go to get better. No one should have to worry about getting sick while they're there," he said.

Click here to access the article.

Health advocates

From the San Francisco Chronicle article:

Margalit Mathan and Peter August found themselves caught in a maze of medical appointments and conflicting professional opinions when their 7-year-old daughter developed serious eye problems related to her juvenile rheumatoid arthritis.

The Berkeley family decided to consult yet another professional. They turned to a health care advocate, an adviser who specializes in helping patients and their families cut through the health care bureaucracy to find the help they need..

Click here to access the article; be certain to read the tips for choosing a health advocate.

HealthGrades 10th Annual Report

Click here to check out the latest information on hospital quality courtesy of HealthGrades.

Forget insurance coverage, will there be enough physicians?

From the HealthLeaders cover story:

Americans alive today have never experienced a real physician shortage. Sure, there have been occasional dips every few years in certain specialties, like when we worried that we may not have enough obstetricians to go around. And after the need for HMO gatekeepers went away, a shortage of primary-care physicians developed and is worsening. But a widespread, sustained doctor drought is American healthcare’s disaster without a preparedness plan.

Click here to access the entire article. It's a good read!

Pfizer and Sermo?

From the Boston.com article:

A year-old online forum where 30,000 doctors swap medical observations has lined up a partnership with Pfizer, Inc. - an alliance that runs counter to the site's founding ideal to give doctors a place to communicate without the drug industry listening in.

Under a collaboration to be announced today with Cambridge-based Sermo Inc., Pfizer will work with the fast-growing Web venture and its participating doctors to agree on terms allowing Pfizer's hundreds of staff doctors to view postings and reply.

Click here to access the entire article.

Sink your teeth into this

From the New York Times article:

For American dentists, times have never been better.

The same cannot be said for Americans’ teeth.

With dentists’ fees rising far faster than inflation and more than 100 million people lacking dental insurance, the percentage of Americans with untreated cavities began rising this decade, reversing a half-century trend of improvement in dental health.

Click here to read the entire article.

ACCME posts new FAQs

Click here to access.

Impact of Minnesota limit on industry gifts

From the New York Times article:

Michael Clements, the owner of a food-catering business in St. Paul, said the new rules had been disastrous for him. His business of taking lunches, paid for by drug makers, to doctors’ offices all but disappeared after the rule change, cutting his overall sales by two-thirds, Mr. Clements said.

...

Food has not entirely disappeared from the marketing efforts of drug makers in Minnesota. The companies still rent out private dining rooms in restaurants and still hire influential doctors to deliver educational talks about drugs during dinner. But instead of doctors, the companies now invite nurses and secretaries to dine, drink and listen.

Click here to read the entire article.

The Clooney incident

From the EOnlineNews article:

More than two dozen employees at Palisades Medical Center have been suspended pending an investigation into whether they leaked details about Clooney's condition to the press when the actor and his girlfriend were treated Sept. 21 after a motorcycle crash, New Jersey's WCBS-TV reported Tuesday.

News of Clooney's accident was speedily followed by reports of the injuries he and Sarah Larson suffered—a fractured rib and road rash for him, a broken foot for her. The couple only spent a few hours at the hospital.

Click here to access the article.

Medtronic in the news again

From the Bloomberg.com article:

Medtronic Inc. was warned by the U.S. Food and Drug Administration that a manual for the company's Satellite spinal device encouraged its use in unapproved ways.

The device is intended to be fused with a bone graft to stabilize and hold together parts of the vertebrae while they heal, the FDA said in a warning letter posted today on the agency's Web site. Medtronic's surgical technique manual described a non-fusion procedure without implantation of a bone graft, according to the letter, dated Oct. 1.

Click here to access.

Early treatment key

From the Bloomberg.com article:

Patients who get treatment within a day of having a minor stroke cut their risk of a second stroke by 80 percent, researchers reported.

Aspirin, blood thinners and other common therapies given within 24 hours may prevent almost 10,000 major attacks a year in the U.K., scientists said today in the medical journal The Lancet. Sending patients to a specialized clinic also reduced the risk of a stroke, a separate study in The Lancet Neurology found.

Click here to access.

Facing the serpent

I just found out that Flower, the alpha female on the TV show Meerkat Manor died! I've only watched the show a couple of times, and not recently, but this news certainly moved me.

Flower bravely entered the burrow to protect her pups from a cobra (she kept them safe) but she lost her life in the process. My father always said that animals are a gift from God and could teach us more than we could ever teach them -- a little rodent from the Kalahari Desert proved him right. Click here to check out Meerkat Manor.

"Talking Leaves"

From the Sequoyah Birthplace Museum website:

They called him Sequoyah. And, this great Cherokee Indian gave his people an enduring gift. He gave them a writing system - so that the greatness of the Cherokee Nation will live forever.
...
Although Sequoyah was exposed to the concept of writing early in his life, he never learned the English alphabet. He began to toy with the idea of literacy for the Cherokee people. Unlike the white soldiers, he and the other Cherokees were not able to write letters home, read military orders, or record events as they occurred. After the war, he began in earnest to create a writing system for the Cherokees.
...
In 1821, after 12 years working on the new language, he and his daughter introduced his syllabary to the Cherokee people. Within a few months thousands of Cherokees became literate.

Sequoyah's white name? -- George Gist. Click here to access the museum website.

Surprising smoking prevalence info from the CDC

Smoking prevalence among people with disabilities is nearly 50 percent higher than among people without disabilities (29.9 percent vs. 19.8 percent), according to a new study from the Centers for Disease Control and Prevention (CDC) in Preventing Chronic Disease. The study found that in 2004, smoking prevalence for people with disabilities is highest in Delaware (39.4 percent) and lowest in Puerto Rico (16.5 percent).

The study found that about 70 percent of people with disabilities who smoke and had visited a doctor in the last year had been advised to quit smoking. However, more than 40 percent of those advised to quit reported not being told about the types of tobacco-cessation treatment available.

Click here to access the CDC press release.

Planned behavior theory

From the psychservices.psychiatryonline.org article "The Theory of Planned Behavior Applied to Continuing Education for Mental Health Professionals":

OBJECTIVE: This study evaluated the effects of a continuing education class that applied the theory of planned behavior to the intentions and behavior of mental health practitioners.
METHODS: In 2006 a total of 94 mental health practitioners were randomly assigned to either a standard continuing education class or one that applied principles of the theory of planned behavior. The class topic was a brief, self-report tool that assesses felt need for employment among people with serious mental illnesses. Participants' intentions to apply the tool were evaluated before and after each class. Participants' implementation of the tool was measured three months after the class.
RESULTS: The class guided by the theory of planned behavior significantly and substantially increased the participants' intentions to use the tool in comparison with the standard class. Significantly more participants in the theory-guided class than in the standard class (74% versus 42%) had applied the tool by the three-month follow-up. Among those who implemented the assessment tool, the participants in the theory of planned behavior class also assessed significantly more of their caseload.
CONCLUSION: The theory of planned behavior can improve and may be well suited to continuing education in psychiatry.

Click here to access this article (sub. req.).

If they were psychic, shouldn't they have known this would happen?

From the Skeptical Inquirer Magazine article:

A continuing-education workshop titled “Coming to Our Senses: Psychic Events in the Lives of Clinicians and Clients” was touted in North Carolina this year by Beth Wechsler, MSW. According to the brochure, the topics to be covered included an account of the nature of ESP (with perspectives from parapsychology and quantum physics, as well as material from Einstein, Edison, and Jung), ESP and medicine, psychics and mediums (and how to detect fakes!), telepathy, precognition, and apparitions.
...
An e-mail addressing the content of the workshop was sent to the associations and boards that had designated PESI as an approved provider. Karen Kanefield, the director of the Continuing Education Sponsor Approval System of the American Psychological Association, responded immediately. She said that the content of the psychic-events workshop does not meet the curriculum-content requirements of the APA and that PESI would be informed that the workshop “is not suitable as continuing education for psychologists.”

Please note the new label. Click here to read the entire article.

BMS to pay $515 million

From the AP article:

Bristol-Myers Squibb Co. and a former subsidiary have agreed to pay more than $515 million to settle federal and state investigations into their drug marketing and pricing practices.

The civil settlement announced Friday resolves a broad array of allegations against Bristol-Myers Squibb, dating from 1994 through 2005.

Among them were a charge that the New York-based pharmaceutical company illegally promoted the sale of Abilify, an anti-psychotic drug, for pediatric use and to treat dementia-related psychoses. Neither use is approved by the U.S. Food and Drug Administration.

Click here to access the article.