Diagnostic errors in pediatrics

From the abstract of the Pediatrics journal article "Errors of Diagnosis in Pediatric Practice: A Multisite Survey":

The overall response rate was 53% (N = 726). More than one-half (54%) of respondents reported that RESULTS The overall response rate was 53% (N = 726). More than one-half (54%) of respondents reported that they made a diagnostic error at least once or twice per month; this frequency was markedly higher (77%) among trainees. Almost one-half (45%) of respondents reported diagnostic errors that harmed patients at least once or twice per year. Failure to gather information through history, physical examination, or chart review was the most-commonly reported process breakdown, whereas inadequate care coordination and teamwork was the most-commonly reported system factor. Viral illnesses being diagnosed as bacterial illnesses was the most-commonly reported diagnostic error, followed by misdiagnosis of medication side effects, psychiatric disorders, and appendicitis. Physicians ranked access to electronic health records and close follow-up of patients as strategies most likely to be effective in preventing diagnostic errors.

CONCLUSION Pediatricians reported making diagnostic errors relatively frequently, and patient harm from these errors was not uncommon.

Click here to access the abstract. 

Are docs out of touch with the whole physician-industry relationship media thing?

The results of a survey on physician attitudes about the marketing practices of industry has just been published in the Archives of Surgery and might provide some insight.  Click here to access the article (free full text!).  Hat tip to FierceHealthcare.

Suntelligence

From the American Academy of Dermatology:

At first glance, Hartford, Salt Lake City and Denver might not seem to have much in common. But a new survey by the American Academy of Dermatology (Academy) found these three cities outshine other U.S. cities in heeding dermatologists' advice on preventing and detecting skin cancer.

The “Suntelligence: How Sun Smart is Your City?” online survey polled more than 7,000 adults nationwide to determine their knowledge, attitudes and behaviors toward tanning, sun protection and skin cancer detection. Twenty-six cities were ranked based on respondents’ answers to several questions in each category.

 Click here to read more on this important topic.

U.S. physicians on the defensive?

Interesting data from the latest on the series of national physician surveys conducted by Jackson Healthcare on the impact of defensive medicine; some key findings:

• 76 percent of respondents reported that defensive medicine decreases patients’ access to healthcare.
• 72 percent of respondents reported that the practice of defensive medicine negatively impacts patient care.
• 71 percent of respondents reported that defensive medicine has had a negative effect on the way they view patients.
• 67 percent of respondents reported that defensive medicine comes between the doctor and patient.
• 57 percent of respondents reported that defensive medicine hampers their decisionmaking ability. 
• Patients most likely affected by defensive medicine are 1) those requiring surgery, 2) women and 3) those visiting emergency rooms.
• Defensive medicine is now being taught as standard medical practice. The survey found that 87 percent of current residents and fellows reported being taught to avoid lawsuits, compared with 48 percent of total respondents.

Click here to access add'l information on this survey as well as other surveys conducted by Jackson Healthcare.

America’s Health Insurance Plans survey on health care pricing

From the New York Times article "Survey Finds High Fees Common in Medical Care":

“A patient in Illinois was charged $12,712 for cataract surgery. Medicare pays $675 for the same procedure. In California, a patient was charged $20,120 for a knee operation that Medicare pays $584 for.
...
It’s the wild, wild West when it comes to prices of anything in the U.S. health care system, whether for a doctor visit or for hospital charges,” said Jonathan S. Skinner, a health economist at Dartmouth.
...
But Dr. Robert M. Wah, a spokesman for the American Medical Association, said there was another side to the story: insurers’ low payments to doctors who enter into contracts with them and the doctors’ difficulties, in many cases, in getting paid at all.
...
Karen M. Ignagni, president and chief executive of America’s Health Insurance Plans, had a different view, saying: “As we think about the health care debate, what’s been talked about is, What are the cost-sharing levels? What are the premium levels? How much do health plans pay? No politician has asked how much is being charged.”

Click here to access the NYT article.

Medical Meetings Magazine's Annual Physicians' CME Preferences Survey

Click here to access the MM article on the survey results.

Doctor Who?

From the New York Times article:

Researchers at the University of Chicago interviewed 2,807 adults admitted to the school’s hospital over a 15-month period. The patients were asked about the roles of the various physicians attending to them and to name the doctors on those teams. Medical teams consisted of three to four people, including medical students, residents and attending physicians.

Some 75 percent of the patients were unable to name a single doctor assigned to their care. Of the 25 percent who responded with a name, only 40 percent were correct. Those patients who claimed to understand the roles of their doctors were more likely to correctly identify at least one of their physicians.

Click here to access the article.

Big Bad Pharma?

About 74% of Americans think so, according to a recent Harris Interactive Poll. Click here to access the survey results.

Survey results on patient use of physician rating websites

From the amednews.com article:

A Harris Interactive poll commissioned by the California HealthCare Foundation found that although more than 80% of the state's adults turn to the Internet for health-related information, less than one-quarter have looked at physician ratings sites. Only 2% of those surveyed made a change in physicians based on information posted on a rating site.

Click here to access the article.

Survey results regarding "CME Linkages"

Thanks to those of you who completed the survey! Here are the top-rated areas y'all would like to see addressed in CME Linkages:

CME Best Practices
CME Collaboration
Legislation/Regulatory Issues
Professional Development
Professional Practice Gaps
Physician Survey Results

Respondents included accredited and non-accredited providers and "neither." If you'd like to add your two cents to this survey:

Click Here to take survey

Please complete a brief survey regarding my blog!

Click Here to take survey

Just say...Yes!

From the CNN.com news article:

One in five respondents to a new survey in the journal Nature say they've used drugs to boost their brain power.

"We were putting our finger in the air to see what our reader response would be. And it was tremendous," said Brendan Maher, an editor with the widely read scientific publication. "What it's suggesting is there are a high percentage of adults using these drugs."

The informal, nonscientific survey, conducted online, polled 1,400 people in 60 countries. Most of the responders, the majority of whom said they worked in biology, physics, medicine or education, reported taking the drugs to improve their concentration.

Click here to access the article.

Patient safety survey stats

From the Washington Post article:

From 2004 through 2006, patient safety errors resulted in 238,337 potentially preventable deaths of U.S. Medicare patients and cost the Medicare program $8.8 billion, according to the fifth annual Patient Safety in American Hospitals Study.

Click here to access.

National survey of hospital patients

From the New York Times article:

Many hospital patients are dissatisfied with some aspects of their care and might not recommend their hospitals to friends and relatives, the federal government said Friday as it issued ratings for most of the nation’s hospitals, based on the first uniform national survey of patients.
...
The new data, part of a survey of patient experiences and perceptions of hospital care, is posted at a government Web site, www.hospitalcompare.hhs.gov.

Richard J. Umbdenstock, president of the American Hospital Association, which helped develop the measures, said they allowed “an apples-to-apples comparison” of hospitals at the state, local and national levels.

Click here to access the NYT article.

Survey shows heath care is a ministry priority in the U.S.

From the news release:

A groundbreaking survey of more than 6,000 American congregations reveals that churches spend a significant amount of time, energy and money in the ministries of health care.

The Congregational Health Ministry Survey, conducted by the National Council of Churches USA (NCC) with support from the Robert Wood Johnson Foundation, shows that a majority of churches are serving their communities by providing health care ministries. As the number of uninsured Americans reaches 47 million people, congregations are supplying health education and direct health care services. Many are advocating on behalf of public policy issues related to health care.

Click here to access.

Injuries and surgeons in training

From the New York Times article:

Nearly all surgeons accidentally stick themselves with needles and sharp instruments while in training. But most fail to report the injuries, risking their health and that of their families and patients to the threat of diseases including AIDS, hepatitis and many other blood-borne illnesses, according to a survey being published today.

Their being rushed was the chief reason the surgical residents cited for the injuries, which were mostly self-inflicted. Among the reasons they cited for not reporting the potentially fatal injuries was that doing so would take too much time, could jeopardize career opportunities and might cause a loss of face among peers.

In addition, there was a false belief that getting even timely medical attention would not prevent infection. In fact, immediate treatment with antiviral drugs can prevent infection among those stuck with needles while caring for patients with the viruses that cause AIDS and hepatitis B. Immediate treatment can also prevent chronic infection among those infected with hepatitis C virus.

Click here to access the article. Click here to access the New England Journal of Medicine source article.

Do physicians consider your out-of-pocket costs?

A study conducted by the Center for Studying Health System Change (HSC) and the University of Chicago Hospitals indicates that:

While almost 80 percent of physicians consider patient costs when prescribing a generic over a brand-name drug, far fewer consider patient costs when deciding what diagnostic tests to recommend (40.2%) or deciding whether to hospitalize a patient when outpatient treatment is an option (51.2%), the study found.

Click here to read the news release.

Why physicians leave a practice...

In a nutsell, it's the ole "not-a-good-fit" reason. According to a survey conducted by Cejka Search and published in STLToday:

More than half of the practices surveyed said "poor cultural fit" was No. 1 among the top three reasons given by departing doctors before they left. Cultural fit could include differences in clinical approach, bedside manner or management style. The other two top reasons for leaving were relocating closer to family and seeking higher compensation.
...
Statistically, most doctors leave a practice between years one and three.
...
Turnover rates were about the same among men and women. Among female physicians, however, the rates declined by about a percentage point versus the previous year. The rates among male physicians rose by about a point.

Click here to read the entire article.

Do physicians need spiritual CME?

Tracy Balboni, a radiation oncologist, conducted a survey of terminally ill cancer patients about their spiritual needs:

...Balboni found that 88% of terminal cancer patients said religion was at least somewhat important to them. And about half had been visited by clergy. Yet Balboni's research also suggests that hospitals, doctors and even religious communities fail to support the spiritual needs of their cancer patients at the end of life.

In her survey of 230 people with less than a year to live, nearly half say they received little to no support for their spiritual needs from religious communities. More than 70% say their spiritual needs weren't met by hospital chaplains or others in the health care system, says the study, published Saturday in the Journal of Clinical Oncology.

Click here to read the USA Today article.

"When the moon is in the Seventh House..."

Interesting survey conducted of hospital visits by Peter Austin and colleagues at the Institute for Clinical Evaluative Sciences in Toronto. They found that "Virgos have an increased risk of vomiting during pregnancy, Pisces have an increased risk of heart failure, and Libras have an increased risk of fracturing their pelvises." Looks like the real purpose of the survey was to make this important point:

Austin said he found that even though each astrological sign had its own unique disorders, his initial results were not reproduced when they were explicitly tested in a second population.

"Scientists take pains to make sure their clinical studies are conducted accurately," said Austin. "But sometimes erroneous conclusions will be obtained solely due to chance."

Statistical chance means that 5 percent of the time, scientists will incorrectly conclude that an association exists, when in reality no such association exists in the population that the scientists are studying.

One way to reduce the chances of drawing a wrong conclusion is to try and reproduce unexpected results in further studies.

Click here to read the entire news article.