WhiteCoat

Healthcare Update — 10-22-2012

We wipe our buttocks on your hospital food? Study of 100 food samples from a university hospital in Houston showed that one quarter of them were contaminated with Clostridium difficile – the organism that causes severe diarrhea and colitis in infected individuals and that causes 14,000 deaths per year.
Safest bets (at least for this hospital) included beef and pork which tested positive only 13% of the time and grains which had no positive tests. Skip dessert, though. 60% of dessert samples were C. diff positive.
Mmmmmmm. Pudding.

Who are the most influential physicians on Twitter? Here’s a ranking site and a list of 10 physicians to follow. Unfortunately, I’m not on either list. Must not twit enough. Seems as if the ones that are on the list are also the ones who tweet almost every day. They also seem to follow a lot of others. I only follow about 25 people and I can’t keep up with all of their tweets. How in the heck does someone follow 5000 people?

Who’s more to blame? Is it the paramedics who keep leaving the keys in the ignition of the ambulance or the Georgia woman who has stolen the same ambulance more than once?

Acute “incarceritis” turns into a bigger problem. California man arrested for drug possession complains of a “medical problem”. Gets taken to an emergency department for evaluation. Handcuffed to the stretcher and one of his arms is freed so that he can sign admission papers. Then grabs deputy’s gun. Shortly thereafter dies of one gunshot wound to the head.

Add this to my “[shudder] list.” When doctors look into a patient’s ear to see what is causing her ear to itch, what do they see smiling back a them?

German pediatricians warn mothers of newborns not to procure breast milk from over the internet … since you can’t trust the source of the milk. Doesn’t that apply to anything you purchase?

A comparison of health care systems under President Obama versus President Romney. Who comes out the winner?

Woman dies from overwhelming bacterial infection – possibly caused by being kissed by her dog.

Money that President Obama earmarked for research into “traditional” medical malpractice reforms has been “aimed at proving the obvious” – namely that as adverse events decline, so do the number of medical malpractice lawsuits. Oh well, at least only $23 million was wasted this time.

What hurts more — being stung by a scorpion or being stung by the $83,000 hospital bill for the treatment? Hospital charges $40,000 per dose of scorpion antivenom that can be purchased for $100 per dose in Mexican pharmacies.

Sliding further down the slippery slope of criminalizing medicine. Iowa pain clinic doctor charged with criminal acts for prescribing pain medications to patients who later died from overdoses. Iowa medical board alleges that he didn’t take enough precautions to make sure that the patients weren’t abusing the drugs.
Stock up on those pain pills now, folks. As prosecutors get more brazen with filing criminal charges, fewer and fewer doctors are going to want to take the chance of going to jail or losing their medical licence for helping patients in pain.

I’m sure that this policy will have a positive effect on the number of people willing to practice medicine in the Philippines. Any physician who practices in a field of medical specialization which is not within the scope of his or her specialization may face life imprisonment. Doctors may also be imprisoned for life if an “unqualified individual” whom the doctor is assisting causes a patient’s death.

Sad story from Nova Scotia. 23 year old woman has central line placed at hospital, but the needle was reportedly placed too deeply in the neck. Vertebral artery was punctured twice and “ruptured,” causing her to have a stroke and to develop “locked in syndrome.” Fifteen years later, lawsuit was settled.

Swedish patient dies after anesthetist and backup anesthetist both take lunch break during surgery.

Will 4 out of 5 doctors be replaced by robots as this Wired article suggests? Doubt it. Then again, I bet at least some of it will come down to free market principles. Want to see RoboDoc as part of your included benefits, want to see a physician extender in the office for X deductible payment or want to see physician in the office for Y deductible payment?

7 Responses to “Healthcare Update — 10-22-2012”

  1. Dave says:

    The swedish case wasn’t as straightforward as you portrayed it. The MD who left is definitely at fault as an MD should have been available for a given emergency. However the practice of CRNA’s (or residents) relieving one another during surgeries to take brief breaks is common at my institution (the anesthesiology department has the best coffee machine for a reason).

    With this in mind the problem seems more systemic. The CRNA’s, who was there while the patient coded, excuse was that she was an orthopedic CRNA and not used to the equipment in the abdominal surgery room. If that is the case then the hospital is at fault for not standardizing its equipement/crash carts. If this is a bunch of BS (seriously, respirators don’t differ that much and you can always just pump epi/bag ventilate) then the case is really that of an incompetent CRNA finding someone else to blame (though again there should have been an MD to step in when the shiat hits the fan).

    However this is why, when I needed surgery, I went to the hospital that only uses MD anesthesiologists and no “physician-extenders.”

  2. Dave says:

    For the robot doctors, the only use I’ve seen for tele-medicine has been psychiatrists. Most hate to do night call and in many communities you aren’t going to find one to deal with your wingbat patient hauled in by the cops in the middle of the night. If a face on a computer screen can either admit them/clear them then that’s one less patient that has to linger on till the morning.

    As for the “kissing her dog” lady, I don’t think she was in good health to begin with with the whole “3 time cancer survivor thing.”

  3. DensityDuck says:

    I’m pretty sure that there are a lot of “he ain’t look right” visits that could be handled quite well by a robodoc, or possibly just a big bright touchscreen with pictures of symptoms (lightning bolts coming out of head = headache, Pac-Man face spraying dots = cough)

  4. Tarl says:

    Off topic, but I thought of Whitecoat when I saw the verdict for this case. Criminalizing medicine, science, maybe blogging is next.

    http://www.voanews.com/content/italy-earthquake-scientists/1531344.html

    An Italian court has convicted seven scientists of manslaughter and sentenced them to six year jail terms (each) for failing to warn of an earthquake. Yes, for failing to authoritatively tell people than an earthquake was going to happen so they could sleep on the ground in bad weather outside of the buildings which eventually collapsed on them.

    It’s slightly more complicated than that – there were a series of quakes (which in 20-20 hindsight were precursors), and the scientists said they were not indicative of a major quake coming (which they aren’t, you can only tell they were precursors by looking in the rear view mirror).

    Either way, the scientists have been convicted of manslaughter for failing to predict an earthquake – something the rest of the scientific community understands and several testified is completely unpredictable. The court needed scapegoats, they found them and convicted them.

  5. LTC says:

    As for the scorpion antivenom…

    many things are cheaper in a mexican pharmacy. that doesn’t mean she was overcharged. She recieved 2 doses at 40k each. I can tell you, my hospital pays about 30k for that drug per dose. That is simply aquisition cost. That doesn’t mean her hospital’s cost isn’t a bit higher – all depends on contracts. It was big news where I am working because I know the hospital she went to.

    We already know the same drugs from mexico or canada are cheaper – but in an urgent situation, are you going to sit and wait for your mail order?

  6. deafgimp says:

    That comparison between Obama and Romney in regards to healthcare is extremely slanted. They state that Muslims won’t have to pay the healthcare tax. Why even use that as a source when it gives incredibly false information like that?

    http://www.snopes.com/politics/medical/exemptions.asp

  7. Iowa RX says:

    Why are you even using American Thinker as a source when “thinker” is clearly a misnomer? And Obamacare or not, unelected bureaucrats are already determining what health care we receive, only it’s called prior approval.

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