Road rage in the operation room

In a recent article at the Boston Globe, they report on a serious matter when it comes to doctors in operation rooms. In some hospitals, there are frequent outbursts from doctors that include fits of swearing, yelling and throwing objects in the emergency room. The Globe paralleled this behavior to road rage. According to a study done at Vanderbilt, 4 to 6% of doctors have frequent outbursts in the operation room. The study found that the more outbursts doctors have, the more likely the hospital is to be sued due to the fact that bad behavior in the surgery room is often connected to medical errors.

So some hospitals are stepping up and solving the problem. The Joint Commission is mandating that all hospitals and nursing homes adopt a zero tolerance policy by January 1 that will include rules and processes on: including codes of conduct, ways to encourage staff to report bad behavior, and a process for helping and, if necessary, disciplining offenders.

Intel Health Guide

According to this article on eWeek, a small touch screen PC that includes a new online interface released by Intel that allows patients to connect with their doctors has won approval by the FDA.

The Intel Health Guide will be able to handle a series of patient care services. The system will take the burden away from insurance companies, since the monitoring of patients with chronic and outgoing patients will be done at home instead of the hospital.

Louis Burns, VP and general manager of Intel's Digital Health Group mentions:

"With more people living with chronic diseases, we believe care can be increasingly moved outside of the hospital to the home. Through our research, we've learned that a home-based model of care becomes more than just delivering care to patients at home—it is about creating connections to family, friends, caregivers, and the care team."

Glucose monitors, blood pressure monitors, and other medical devices can be attached to the Intel Health System, and the information gathered can be shared with doctors on the Internet through a secure host server. We can expect the Intel Health System to reach the US market by end of 2008 or by the first quarter of 2009.

What’s the Real Cost of Healthcare?

Trisha Torrey brings up a good point in her latest post on the Patient Empowerment Blog, the true cost of healthcare remains a mystery still to many patients.

First is the copay, then the insurance takes the rest of the doctors charges if the patient is insured. If there is a balance after the insurance has paid their stated amount, the patient is responsible for remainder of the payment. Costs are sometimes negotiated between insurance companies and doctors, but for those who don’t have insurance, negotiations are made between the patient and the doctor. So here’s a solution that can possibly help patients make wiser decisions when it comes to costs.

Change Healthcare is an online service that finds average costs of doctor visits, services, and what insurance companies typically negotiate with doctors. You can upload information about your own costs to the website. By sharing information, it is possible to help people in your area discover the true costs of healthcare.

New Chiropractic Laws in Florida

According to a recent post at the Health Care Fraud Blog, as of July 1, 2008, a health clinic must have a director that is a MD or DO (Doctor of Osteopathy) before employing a chiropractor. This new law is being put into place so that Doctors of Chiropractics aren’t running these clinics.

Florida Lawmakers cite this as the reason for this new law:

The purpose of this section is to prevent a person other than a licensed chiropractic physician from influencing or otherwise interfering with the exercise of a chiropractic physician's independent professional judgment.

Disciplinary Doctors

According to a recent blog post at the NY Times, Alaska reports the most disciplinary actions at 8 per 1,000 doctors, making it the state with the most disciplined doctors. The others at the bottom of the list are Kentucky, Arizona, Ohio and Nebraska. At the top of the list with less than two actions per 1,000 doctors are South Dakota, Mississippi, Wisconsin and South Carolina.

An interesting point brought up in the article was that often, the better funded state boards proved to have fewer disciplinary actions. The NY Times pointed out that maybe this was because since they were better funded and well staffed, they took action and prevented the disciplinary action before it had to happen.

Baby Boomers May Face Deficit in Doctors

In a recent article at Medical News Today, it considers the number of doctors available to aging Baby Boomers. At this time, the medical workforce is too small to support the growing needs of the generation as it turns 65. Adjustments need to be made in order for more doctors to go into geriatrics. Instead, the current portion of doctors specialized in geriatrics is barely growing.

According to this article at AMNews, there are 7,100 geriatricians today. Most startling is:

By 2030, there will be an estimated 8,000 geriatricians, but the nation will need 36,000, according to the Assn. of Directors of Geriatric Academic Programs.

This lack of growth appears to be the result of doctors working in a poorly compensated specialty; geriatric doctors are reimbursed far less than doctors who specialize in other areas. In turn, this seems to contribute to the long term stagnation of medical school graduates specializing in internal and family medicine.

Can you email the doctor?

A new article at ABC News ponders this question: Should doctors use email to communicate with their patients?

As in many industries, the medical profession has not been very fast to adapt the new practices utilizing the latest technologies of Web 2.0. Many patients believe it would be easier to simply email their doctors with their questions that are not truly life threatening and avoid the time and expense of an office visit. However, less than 1/3 of doctors today use email.

Some doctors’ concerns include the worry that they won’t be reimbursed for their time, while others worry about privacy and the possibility that the emails could be intercepted by hackers, putting patient information at risk. Nevertheless, there are some patients who think emailing may be a useful means to receive help. So, should the health care field begin to look at this as a new way to help patients? For minor questions and or non-severe medical advice, it could save both time and costs for the doctor and the patient in avoiding unnecessary office visits. However, there is still the effort spent as doctors sit and answer emails, when they could be working on other critical tasks. It appears there may not be one easy solution any time in the near future.

Do gifts influence prescriptions?

In a recent blog at A Healthy Blog, they shed light on doctors receiving gifts from biopharma companies. Senator Patty Murray of Massachusetts is trying to pass a law where biopharma companies couldn’t present gifts to doctors in order to alter the doctor’s prescribing behavior.

In some cases, doctors are given luxury trips and expensive sports tickets in order to influence the prescription of drugs. With this new bill, doctors would still be allowed informative sessions about the new drugs, but would instead learn about them in an environment neutral to the prescription process, such as a lunch and learn.

While such legislative steps seeks to ensure that doctors are focused on patients' primary care, minimzing access can also create difficulties in properly educating doctors on new advances in pharmacology. A balance has to be created where doctors have access to the latest information while ensuring they are not unduly influenced.