Physician

A speeding ambulance may not benefit patients

How fast should an ambulance go?

The stereotypical speeding ambulance with sirens blaring is the image that most conjure up.

But recent data suggests that transport speed may be overstated.

In a fascinating piece from Slate, emergency physicians Zachary F. Meisel and Jesse M. Pines examine that very question. They cite a recent study from the Annals of Emergency Medicine, which concluded that a fast transport speed didn’t necessarily save lives:

The …

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Patient handoffs increase medical malpractice risk

Patient handoffs increases the risk of medical errors.

It’s a phenomenon during residency, as doctors are mandated to leave the hospital after a defined number of hours.  But it’s also prevalent outside of an academic setting, as more institutions use hospitalists for their inpatients.

This increases malpractice risk.

Perhaps the biggest problem with hospitalists is the transition during discharge, when the patient is handed back to the primary care physician’s care.

Various questions …

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Are da Vinci surgical complications the fault of the robot?

The daVinci surgical robot is a multi-million dollar device that more hospitals are using for urologic and gynecological surgery.

I wrote previously on the topic, saying that robotic surgery is, in part, driven by patient demand.

The Wall Street Journal had a scathing piece on the robot a few weeks ago, exposing the relatively high complication rates at a small New Hampshire hospital.

The issue comes down the training, or lack thereof, …

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Some doctors may resist the primary care team approach

What if some physicians actually like the way primary care is currently practiced?

It’s hard to believe, considering the majority of studies suggest marked dissatisfaction among primary care doctors, and an increasing prevalence of physician burnout.

The ACP’s Bob Doherty recently summarized an epic Health Affairs article devoted to fixing primary care. The bottom line was that better paying primary care doctors isn’t enough. The whole field needs to …

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Patient grief and the safety of doctors and nurses

A patient’s grief can threaten the safety of health care providers when it crosses into rage.

Emergency physician Edwin Leap illustrates some concerning instances:

In one instance, family members became angry because we did not leave the body in the ER for eight hours so that everyone could come and pay their respects. (Which I always thought was the purpose of a funeral home.) In another, a family was …

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Patient wants an apology, not money, after medical malpractice

by Tricia Pil, MD

This is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and third, the version put forth by the hospital.

FRIDAY

Patient:
It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of …

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Endocrinologists may improve surgical care in diabetic patients

by Kristina Fiore

Shorter hospital stays and lower costs were the result when surgical patients with diabetes and dysglycemia received endocrinology consults, researchers said.

Adding endocrinologists to surgical care teams for patients with abnormal blood glucose readings cut total length of stay among patients in a single center by 1,342 days and saved the hospital $1.15 million, according to Arthur Chernoff, MD, of Albert Einstein Medical Center in Philadelphia.

Chernoff presented his findings …

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Medical students who choose primary care lose millions in income

Will medical school loan forgiveness be enough to convince prospective doctors to forsake specialty practice as a career?

I’ve argued previously that it may help a little, but it’s unlikely to change the overall trend away from primary care.

A recent article from Health Affairs compares lifetime earnings from a cardiologist versus a primary care physician. The difference is stark:

Their calculations showed that cardiologists earn a career average of more …

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Calls and e-mails to patients are a big part of primary care

There’s been a lot of commentary on a recent article from the New England Journal of Medicine, detailing the undocumented tasks that a typical primary care physician performs.

For those who haven’t read the piece, entitled, What’s Keeping Us So Busy in Primary Care? A Snapshot from One Practice, it’s available free at the NEJM website. I highly recommend it.

To summarize, primary care doctors are responsible for much more …

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Children with fever may not receive antibiotics in the ER

by John Gever

Up to one-third of children with febrile bacterial infections failed to receive antibiotics in a large emergency department, while 20% of youngsters without such infections received antibiotics unnecessarily, Australian researchers said.

A computer algorithm based on standard test results could do a better job of assigning feverish children to the correct treatment sooner, Jonathan C. Craig, MBChB, PhD, of the University of Sydney, and colleagues reported online in BMJ.

Although …

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False patient contact information worsens emergency care

One of the biggest emergency room problems is contacting patients after they leave.

Patients sometimes leave false contact information — which makes it difficult for the emergency room staff should problems arise after the visit.

The issue was illustrated in a piece from msnbc.com. Many times, results like blood cultures or x-ray findings take time to return. And if there’s something that needs to be acted upon, contacting the …

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