Working in the hospital this month, my team has been caring for Mr. M. He was here when we started on service at the beginning of the month, and unless his planned transfer to another facility goes through, he’ll be here when we sign off to the next team at the end of the month. Mr. M is in his fifties. He speaks Spanish. He is an undocumented immigrant from Central ...

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Let's face it. Health care is an odd field. Costs are unknown or indecipherable. Prices for the services offered are hidden from consumers. Likewise, the value (efficacy, quality, safety) of the services received is hidden from consumers. In no sense does it represent other markets, in which transparency of these elements reigns and which therefore have a better chance of reaching the "efficient market" described by economists. In such an environment, ...

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The National Center for Health Statistics recently released a new report, Recent Trends in Cesarean Delivery in the United States. The report is most notable for a startling statistic; the C-section rate has reached the astronomical level of 32%, an increase of more than 50% since 1996. This is disturbing news. Why is the C-section rate sky high? The pervasive nature of the increase may hold some clues. The increase has ...

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by Marie Cooper St. Vincent’s Medical Center in Greenwich Village was founded in 1849, making it the third oldest hospital in New York City. It has been an occasional scene of notoriety but mostly it has witnessed countless episodes of anonymous compassion and care. My two sons were born there. As a major teaching hospital, it has over 1000 affiliated physicians. It is where generations of ...

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by John Gever Surgeons in Barcelona announced on Friday that they had performed the most extensive face transplant yet reported, including skin, muscles, teeth, and some bone. The procedure was performed March 20 by a team of 30 surgeons at Vall D'Hebron Hospital in Barcelona. classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="356" height="294" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0"> Doctors led by Joan Pere Barret, MD, took 24 ...

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Not long ago, I attended the Shining Knight Gala, a fundraising dinner that benefited the trauma surgery and injury prevention programs at Virginia Commonwealth University Medical Center. The highlight of the evening was the dramatic presentation of the story of a young man who had suffered severe, life-threatening injuries in a car accident and, through the skill and dedication of first responders and the VCU trauma and rehabilitation professionals, was stabilized ...

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Our state of South Carolina is a delight. From wonderful people to beautiful landscapes, from a vibrant Southern culture to excellent food like shrimp and grits, it’s a place I’m thrilled to live. But we do lack a few things. And one of the most striking is adequate mental health care. The state budget, like so many state budgets, has been trimming anything and everything. And of course, mental health coverage ...

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Patient satisfaction, as I wrote previously, is being increasingly focused upon. Doctors are often pressed for time, and appear rushed -- which can potentially lead to unhappy patients. I saw this small study showing that the simple act of sitting down while talking to patients can have a profound effect. Many doctors I know already do this, but now there's some data to support sitting. According to the study, performed ...

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I was consulted recently about an elderly woman who refused surgery for a large bowel obstruction from a colonic mass, likely cancer. The inpatient team asked me to help with the transition to hospice and to help make her comfortable. I went to see her. She had a nasogastric tube sucking up brown material from her stomach. Her abdomen was swollen and uncomfortable. Her primary goal was to return to walking ...

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by Michael Smith It's possible to reduce the burden of drug-resistant pathogens in hard-hit hospitals -- all it takes is consistent effort over time, French researchers say. That's the conclusion after a 15-year, intensive program aimed at reducing the impact of methicillin-resistant Staphylococcus aureus (MRSA) on Parisian hospitals reported in the March 22 Archives of Internal Medicine. The program started in 1993 in the 38-hospital, 23,000-bed Assistance Publique-Hôpitaux de Paris, the largest ...

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