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 ...
Posts tagged Malpractice
Op-ed: Health reform is missing malpractice and primary care fixes
The following op-ed was published on March 22nd, 2010 in CNN.com.With health reform passing the House, a comprehensive overhaul of our health care system draws another step closer.Coverage will expand to cover nearly 95 percent of legal U.S. residents. With a recent study showing that patients without health insurance have a shorter life span, coupled with the number of uninsured approaching 50 million in 2010, that is perhaps the ...
Checklists help reduce hospital deaths
by Michael SmithThe use of treatment checklists for 13 common diagnoses was associated with a dramatic reduction in patient deaths at three London hospitals, researchers said.The year the checklists were introduced, the three facilities in the North West London Hospitals NHS Trust registered 255 fewer deaths than the previous year, according to Brian Jarman, PhD, of Imperial College London, and colleagues.The targeted diagnoses accounted for 174 fewer deaths than the ...
iPhone medical apps may be medical malpractice targets
by Satish MisraMedical practice is a big business. Conservative estimates put the total cost of medical malpractice at nearly $35 billion annually and, according to a Kaiser Family Foundation report, nearly $5 billion is paid in claims each year. With an average claims payment of about $300,000 and up to 50% of that going to the lawyers representing the patient, its not surprising that practically every show on cable ...
Teaching patient safety starts in medical school
Ten years after the release of the IOM report To Err is Human, which documented the toll taken by medical errors in this country, the question remains: What can be done to reverse the trend of ever-increasing morbidity and mortality due to medical errors?Last December, a look back over the decade since the release of To Err is Human -- and a steady medical error death rate of about ...
Never events in hospitals depend on patient risk
Originally published in MedPage Todayby John Gever, MedPage Today Senior EditorOccurrence of some so-called "never events" in hospitals may depend partly on unmodifiable risk factors such as patient characteristics, undermining the rationale for denying Medicare payment for their treatment, researchers said.
Analysis of some 890,000 surgeries performed in 1,368 hospitals showed that patient age and pre-existing conditions such as weight ...
Why is President Obama ignoring the doctors when it comes to health reform?
by Ernesto Gutierrez, MDThere is a lot of discussion about what Obama did right and wrong in managing the politics of passing health insurance reform. What strikes me as the most obvious is the failure to engage physicians. Sure there was support from the AMA, ACP, and AAFP, but the support was lukewarm at best. The position letters sent out to society members outlining their support seemed forced ...
Doctors are responsible for a minority of medical mistakes in radiation therapy
The New York Times recently featured a disturbing expose of serious medical errors associated with the newest forms of high tech radiation treatment, entitled, Radiation Offers New Cures, and Ways to Do Harm. The piece is an example of excellent medical journalism, compelling stories of two individuals who sustained truly horrifying injuries as the result of treatment errors framed a detailed investigation of similar errors that have occurred in New ...
When doctors are at greatest risk of making a mistake
Early in my training as a glider pilot my instructor showed me an excellent but simple analogy for ensuring my safe performance as a pilot. I have always remembered this lesson, which he called the ‘accident slope’, and have tried to apply it to my method of practicing medicine, as well as the other ‘dangerous’ activities for which I have an affinity.“Accidents and mistakes are seldom the result of one ...
Why health IT won’t help with medical risk management
by Satish Misra and Iltifat HusainThe march is on across the American healthcare landscape to implement electronic health records that also function as decision-support systems.These “advanced” electronic health records will both provide centralized records and assist providers in making care decisions such as implementing therapy and utilizing evidence-based practice on the individual patient level. And anyone that has had the opportunity to work with some of the systems out ...
The difference between regret and apologies in health care
I've written recently that "I'm sorry" are the hardest words for doctors to say.Good piece in The New York Times, observing that the health care industry, in general, has a hard time apologizing. In many cases, hospitals and drug companies simply state they "regret" the situation.Is there a difference? Of course there is: "The difference between apologizing and simply offering a 'regret' may seem semantic. Yet ...
Were hospitals responsible for patient deaths during Hurricane Katrina?
A jury is about to decide how far hospitals have to go to protect themselves against natural disasters.It all starts in New Orleans, during the Hurricane Katrina disaster. Hospital generators were not protected against floods, and predictably, that contributed to the loss of power during the category 5 hurricane. If all hospitals were to protect their generators appropriately, it's estimated that it would cost millions to do ...
How doctors suffer during medical malpractice litigation
There are no winners in medical malpractice cases.Patients, of course, suffer the most. But doctors aren't spared either. It's been written previously that doctors suffer significant emotional turmoil after being sued, and in fact, a good percentage even contemplate suicide.In a recent New York Times essay, physician Joan Savitsky talks about her own ordeal. She discusses how being sued affected not only her, but other ...
How root cause analysis can improve patient safety
Hospitals face so many urgent tasks in safety – computerize, promote teamwork, implement evidence-based safety practices, discover unsafe conditions – that it’s hard to know where to start. If you’re struggling, I recommend that you put your Root Cause Analysis enterprise on steroids. This is what we did at UCSF Medical Center, and it was the most important change we’ve made in our safety journey. Here’s the story, ...
Why are so many patients referred to specialists?
Do generalist doctors refer to specialists too much?Jeffrey Parks, otherwise known as the Buckeye Surgeon, has written numerous times on the issue, and his feeling is, yes, they do.And he's right. There are many physicians, along with mid-level providers like nurse practitioners and physician assistants, that refer to a spectrum specialists for routine conditions, especially in the hospital setting.Dr. Parks asks, "shall we continue with the status quo ...
Good doctors sometimes may make patients unhappy
Most of us went into medicine because, in addition to being good students, we wanted to help people. How many oceans of ink and forests of paper have been used explaining that point to admissions committees we’ll never know. Suffice it to say, it felt very good when our professors wrote us glowing letters of recommendation. Of course, we were also saying, “I want to feel good about helping people. ...
Don’t use kitchen spoons to measure drug dosages
Originally published in MedPage Todayby Todd Neale, MedPage Today Staff WriterIndividuals using standard spoons from their home kitchen to dispense liquid medications may be pouring too little or too much of the drugs, researchers found. Among volunteers trying to pour a teaspoonful of cold and cough medicine, using a slightly larger spoon resulted in underdosing and using a much larger ...
Will physician and hospital penalties improve patient care?
Originally published in HCPLive.com by Alan Berkenwald, MDIn 1904, the Scottish author Sir James Matthew Barrie sent Peter Pan off to Never-Never Land to escape growing up and to enjoy many-many adventures. As children, we all hoped it really existed. In truth, many of us fantasized, one day, to make the trip ourselves.Well, good news for physicians - that day has arrived! Thank you all for making 2009 the most successful year ever on KevinMD.com, with over 1.3 million visits, and 2.2 million pageviews.Here are the most popular blog posts of 2009. Enjoy, and I wish everyone a Happy New Year.Regular blogging will resume on January 4th, 2010.1. How did Michael Jackson die, and the medicine behind sudden cardiac death2. How long are you ...
The most popular medical and health blog posts of 2009
A cockpit checklist to improve patient safety
Originally published in MedPage Todayby Chris Emery, MedPage Today Contributing WriterMedical teams should take a lesson from airplane crews, a new study concludes. Medical personnel who used procedural checklists modeled after preflight checklists used by airplane crews were more likely to report safety-related incidents and feel empowered to address safety issues, according to an online report in the Dec. 21 ...
