shutterstock_213583006 In the world of health care, we face a lot of questions and challenges. Hospital administrations across the country are grappling with these and always on the lookout for solutions. As far as raising the standard of health care quality, there’s been great progress over the last several years in the areas of patient safety, adhering to best practices, and trying ...

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In many communities around the country, hospitals are one of -- if not the -- largest employers. Consequently, there are undoubtedly economic issues that would befall an area if its hospital were to close. But this post isn’t about that. It’s about the health care consequences, and by extension, the health consequences that might arise in a community when a hospital closes its doors. The logic is fairly straightforward: If a ...

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shutterstock_167475845 Imagine you were seeking major surgery, and the hospital's consent form contained this surprise statement, which you were asked to initial: "I understand that this surgeon and hospital have not performed this procedure in the last 12 months. As such, I accept the greater risk of complications and even death." It's hard to believe that you would sign the form and move ...

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shutterstock_99727790 It could be the title of a new prime time show (maybe it should be): The Great Discharge Paperwork Makeover. Assemble a group of bright and creative minds from across the country and put them together in an exotic location for a week to talk about something that will affect all of us one day -- either ourselves or a relative. ...

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Co-management agreements are growing in popularity as health care shifts to outcomes-based reimbursement models.  Physicians and hospitals contract with one another in quality-oriented pay-for-performance arrangements, in which physicians oversee and manage service lines (most commonly orthopedics, oncology, and cardiology). The overarching goal of these agreements is quality improvement, which benefits all parties involved -- especially the patient.  The hospital benefits financially in part from reducing costs and physicians receive a base ...

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shutterstock_173620244 This is one of those columns that will risk the respect and friendship of some of my closest colleagues in the health care world.  In addition to disagreeing with me, they may argue that I am giving aid and ammunition to "the enemy," where the enemy might be viewed as those forces in the health care world who really don't want ...

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Recently a neighbor of mine was in our local hospital for several weeks undergoing treatment for MRSA and dehydration. Polly is a woman in her late seventies who is completely alert and oriented. She lives an active and independent lifestyle and is fully capable of understanding and communicating clearly with others. I asked her adult daughter how her mother’s experience had been so far. Given that this is a hospital that ...

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“Dr. Vashist, I’m sorry to bother but you really need to look at this medication being taken by our patient.” My hospital pharmacist gently prodded me as he handed over the patient’s medication list along with cost information and side-effects of the offending medication. The issue with the list was a subcutaneous injectable form of calcitonin, Miacalcin, costing approximately $11,300 per day of treatment. The patient had been admitted about 11 days back ...

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shutterstock_48561808 The medical world has made terrific scientific and technological progress over the last century. Previously incurable diseases can now be treated as day cases, and patients no longer have to accept a paternalistic, one-sided relationship with their doctors. Hospitals too, have a come a long way if you look at pictures of what they used to look like in those old ...

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shutterstock_178086407 He sat there holding his wife’s hands and hugging her as tightly as he possibly could.  Tears were streaming down her face, and she was vulnerable to the diagnosis I had just bestowed upon her. Cancer, the “C” letter word nobody wanted to hear, suddenly invaded the lives of this newly married couple. Multiple thoughts were running through my mind before bestowing ...

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