This da Vinci’s code: Less pain, fewer scars for women having robotic hysterectomy procedure

More robotics - great news for women!  BD

The little bit of down time that Stacy Siracki experienced after a robotic-based hysterectomy is a far cry from the years of persistent problems she endured.

“I was a little sore but I was walking around Home Depot on Monday,” she said.

Just the Friday before, on May 25, the 43-year-old was the first patient at the hospital to undergo a hysterectomy where her surgeons used a robotic-surgical system, called da Vinci.

The NCH Healthcare System bought the da Vinci system in 2005 for prostate cancer treatment and is now expanding its use for other minimally invasive surgeries.

The da Vinci is advantageous to surgeons because it provides better range of motion with the robotic instruments for more accurate incisions, and that spares healthy tissue.

So far, he and McLean have performed da Vinci hysterectomies on five local patients, all of whom stayed in the hospital for 24 hours afterward, just because use of the da Vinci for hysterectomies is new to NCH and to the operating room team. The patients came to the hospital the day of the surgery.

“It can be performed as an outpatient procedure,” he said.

McLean likewise said the advantages with the da Vinci system compared to other laparoscopic systems is the greater depth of field and better wrist movement ability.

This da Vinci’s code: Less pain, fewer scars for women having surgery

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Staph infection - physicians found negligent in missing diagnosis

 

 Two Kenmore Mercy Hospital emergency room doctors were found liable Friday for $1.5 million that will be awarded to the widow of a Texas man who died nine years ago of a staph infection.

A State Supreme Court jury determined that Drs. William Dice and Mark Fennema were negligent in the care of the late Peter Pflanz, 47, an art teacher from Sugar Land, Texas, and father of two.

Though the jury also found Kenmore Mercy Hospital liable in the case, the hospital will not share in the payment of the jury award to Pflanz’s widow, Sherryl, a Buffalo-area native who teaches school in Sugar Land.

Pflanz attorneys John M. Dempsey and Patrick J. Maloney said malpractice insurance carriers for Dice and Fennema and Great Lakes Emergency Physicians, the Michigan business that supplies emergency room physicians to Kenmore Mercy and other hospitals, will pay for the settlement.

Pflanz, visiting his wife’s relatives in the Buffalo area, went to Kenmore Mercy July 31, 1998, for treatment of vomiting and a headache. However, he was misdiagnosed and prescribed medication for a jaw ailment — not the staph infection that was causing his symptoms.

The Buffalo News: Northern Suburbs

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Chaudhuri buys stake in IHHI Hospital Group

 

Dr. Kali Chaudhuri, who two years ago was forced to withdraw a bid to be majority owner of a group of four central Orange County hospitals, has exercised a warrant to buy a minority stake in the same company, Integrated Healthcare Holdings Inc.

According to a filing with the Securities and Exchange Commission on Thursday, Chaudhuri, a physician and entrepreneur based in Riverside, has acquired 39.7 million shares of IHHI, which makes him the company's second-largest shareholder  Chaudhuri sparked opposition from doctors and regulators in 2005 because of his financial past. In 2000, a chain of clinics that he owned, KPC Medical Management, went bankrupt, stranding 300,000 patients without medical records and owing $400 million to creditors.

A group of Orange County doctors led by Dr. Anil Shah, a Santa Ana cardiologist, is the largest shareholder in IHHI with 59.1 million shares.

Larry Anderson, president of IHHI, said the company plans to disclose further details about Chaudhuri's shareholding in a filing with the SEC on Monday.

Article - News - Chaudhuri buys stake in O.C. hospital group

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Huntington Beach Hospital Installs Dynamic Imaging's IntegradWeb(R) PACS

 

HUNTINGTON BEACH, Calif., July 6 /PRNewswire/ -- Huntington Beach Hospital announced today that it has installed Dynamic Imaging's IntegradWeb PACS, a leading Web-based Picture Archiving and Communications System (PACS). The new PACS will help Huntington Beach Hospital provide improved service to its patients and referring physicians by eliminating the need for traditional x-ray film, while quickly transitioning to an all digital workflow. "The new PACS at Huntington Beach Hospital is an example of Prime Healthcare Services' commitment to the hospital and the community it serves to improve the infrastructure and update the equipment with State-of-the-Art technology that helps in proving high quality patient care," said Prem Reddy, MD, FACC, FCCP, Chairman of the Board. "Prime Healthcare Services (PHS) is investing millions of dollars in Huntington Beach Hospital to improve operational efficiencies," continued Dr. Prem Reddy.

Huntington Beach Hospital Installs Dynamic Imaging's IntegradWeb(R) PACS

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Exodus likely at Stroger hospital in Chicago

Looks like hospitals still need doctors more than doctors need hospitals.  BD

Large numbers of demoralized physicians are planning to leave Stroger Hospital as Cook County cuts services in its beleaguered health system, according to a new survey conducted by Stroger's medical staff leadership.
If it materializes, the exodus could threaten clinical care at Stroger, the county's flagship medical institution, and undermine its once-sterling reputation.
The survey was conducted last month; 178 of about 350 physicians at the hospital responded.

Physicians are also finding it difficult to obtain services patients need at overstretched clinics. Orris said this last week he tried to schedule a surgery for a patient with a "large kidney cancer" but was told the renal clinic is prioritizing care for cancer patients because of a backlog.
In the new survey, only 22.8 percent of the respondents said the quality of care they were able to deliver was excellent or very good. Some 68.2 percent said the quality of care had worsened a little or a lot over the last year. A second round of survey responses is being solicited.
County administrators have a different perspective. Rashid cited a number of accomplishments, including a doubling in the number of patient exam rooms at the busy Fantus Clinic across from Stroger, a decline in wait times for phone calls to Fantus, and the addition of several new pharmacies.
Officials will be launching a new effort to "inform doctors of all the changes we are implementing," Rashid said.

Exodus likely at Stroger | Chicago Tribune

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Hospital group rejects system and cashes in - the story of Prime Healthcare and Dr. Prem Reddy

From cardiologist to hospital and healthcare mogul.  BD

At a public hearing in Anaheim last month to determine whether Prime Healthcare can acquire Anaheim Memorial Medical Center, dozens of residents, community activists and other critics spoke out against the pending sale.
One speaker cited a federal report from early June that detailed how, days after the company took over Paradise Valley Hospital near San Diego, hospital administrators allegedly changed patient care directives — including canceling chemotherapy services and requiring doctors to get prior authorization for cardiac treatment without alerting the medical staff beforehand.

When Reddy and his company's billing and patient care practices were described to him in an interview, Dr. David Goldstein, director of the USC Pacific Center for Health Policy and Ethics, said he worried that the company's business model ignored the medical profession's responsibility to care for all patients equally.

Reddy said his decision to wage battle against private health insurers was triggered by a mix of confidence and necessity.

"Somewhere along the line, the insurance industry has gone bad," Reddy said. "They want to pay $1,100 a day for patients that cost $1,700 to treat. They are bilking the system and getting rich at everyone else's expense."
While in his office one night, Reddy had an idea about how to make Desert Valley profitable. If his company canceled the hospital's private insurance contracts, it might be able to make up for the loss in patients by increasing traffic through the emergency rooms and admitting those who needed more care into his hospitals for longer stays.

This month, Reddy said, the company is expected to announce "a major acquisition" that could include a large hospital in Los Angeles, and Reddy recently expressed interest in two large hospitals in Orange County.

However, insurers, who have been criticized in recent years for raising patient premiums while restricting care, say they have found a tenacious adversary in Reddy.
"His policies will equate to higher premiums and higher cost of care for everyone," said Josh Valdez, senior vice president of Blue Cross of California, which reluctantly pays Prime Healthcare's bills. "People of California are not going to stand for it."

Hospital group rejects system and cashes in - Los Angeles Times

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Polygarol

Another amusing Pharma spoof...BD

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Not your basic barebones HMO Commercial

Definitely not your usual dry commercial.  BD

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HMO Whistleblower interview at Sicko Premiere

 

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Heart Replacement - video on how the unit functions

 

The AbioCor is the world's first completely self-contained replacement heart. A product of three decades of research, development and testing, the AbioCor is central to ABIOMED's mission to make real the day when heart failure need not mean the end of life or the ability to enjoy life. Designed to fully sustain the body's circulatory system, the AbioCor is intended for end-stage heart failure patients whose other treatment options have been exhausted.

 In 2001, ABIOMED made history when Mr. Robert Tools, a 58-year-old telephone company employee and teacher suffering from end stage heart failure was successfully implanted with the first AbioCor. The FDA approved the Abiocor for commercial approval under a Humanitarian Device Exemption in September, 2006.

ABIOMED is also working on the next generation implantable replacement heart, the AbioCor II. Incorporating technology both from ABIOMED and Penn State, the AbioCor II is smaller and is being designed with a goal of five year reliability.

Heart Replacement

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At the Pearly Gates....

Two doctors and an HMO manager died and lined up at the pearly gates for admission to heaven. St. Peter asked them to identify themselves. One doctor stepped forward and said: "I was a pediatric spine surgeon and helped kids overcome their deformities." St. Peter said, "You can enter."

The second doctor said "I was a psychiatrist. I helped people rehabilitate themselves." St. Peter also invited him in.

The third applicant stepped forward and said, "I was an HMO manager. I helped people get cost-effective health care." St. Peter said, "You can come in too."

But as the HMO manager walked by, St. Peter added, "You can stay three days. After that you can go to hell.

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Hospital and Blue Cross at odds on contract negotiations with patients and physicians caught in the middle

 

Thousands of Lake County patients could face the harsh reality of having to change their health coverage provider due to stalled contract negotiations between Blue Cross and Blue Shield of Illinois and Condell Medical Center in Libertyville.

According to Condell Vice President of Business Development Jodi Levine, the hospital has being trying to renegotiate its contract with Blue Cross since January, but Blue Cross representatives have not been willing to bargain.

Neither party is sure when a resolution will be reached. In the meantime, Blue Cross and Condell are urging patients to contact their primary physician to explore their options.

"We have been working with them the last 60 years, and the hospital can't understand why they won't sit down and have discussions with us," Levine said. "We are just a phone call away."

One of the reasons Blue Cross might not be in a bargaining mood is the hospital's decision to terminate its contract with HMO Illinois and Blue Advantage HMO, effective Aug. 31. Blue Cross learned that Condell might terminate its PPO and MRC plan contracts Dec. 31.

Blue Cross also claims that Condell hired a public relations firm to pressure them into meeting their demands.

Condell officials have denied that claim.

Condell terminating Blue Cross contract :: News Sun :: News ::

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The Citizens Voice - Don't Cut Medicare

A Pennsylvania citizen voices their opinion.  BD

It would cause pain immediately,
Well, that’s what the federal government is proposing for doctors.
It wants to cut their payments for Medicare services by 9.9 percent, starting next year.
Anticipating such a cutback, 60 percent of Pennsylvania doctors say they will stop taking new Medicare patients if the cuts go through.
Likewise, half the doctors said they would reduce staff, two-thirds said they would put off upgrading essential information technology and 14 percent said they would “completely get out of patient care.”
The last item, withdrawal from providing patient care is of special concern because Pennsylvania is in need of more doctors, not fewer.
Pennsylvania is the third largest state using Medicare, behind only West Virginia and Florida.
Locally, in Luzerne and Lackawanna counties more than 110,000 people were enrolled in Medicare as of 2006.
The problem is, the age of doctors in Pennsylvania is increasing as well. More than 40 percent of the doctors in Pennsylvania are beyond age 50 and many are approaching retirement.
It will be hard to attract new young doctors to practice in Pennsylvania if the number of Medicare patients is huge and the compensation for those patients is small.
And although Pennsylvania is one of the highest states in educating doctors, they will go to other states when it comes time to practice medicine.
Part of the issue is perception. People imagine doctors making bundles of money. But for those treating Medicare patients, that is not the case.
Additionally, doctors have overhead to pay staff, rent electricity and all the other services attached to a business.

Some balance is needed here.
Medicare should not be a bonanza for doctors, with payments that put millions into their accounts. But it should be a fair compensation for medical services provided.
Cutting it by 9.9 percent would not be fair.

The Citizens Voice - Don’t cut Doc’s Medicare

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How to find a good doctor - #1 check for use of electronic medical records

Great article on how to select a physician.  Most of the time it is pretty easy to detect once you walk in to a lobby of a practice, those still using paper seem to possess an atmosphere of chaos to some degree, and the entire staff appears rushed and somewhat stressed, whereby those offices using electronic records have much of this information at their fingertips on the computers, thus less physical movement in pulling charts, looking for faxes, etc. and this in itself allows the office to focus better on patient care and not chasing information.  You still need the patient-doctor relationship as well, but if you can find both at one office, chances are you will end up being a winner the search for a good doctor.  BD

Odd as it may seem, simply calling prospective doctors and asking whether their office is computerized may turn out to be the best advice for finding a physician committed to patient care over the long term.

"The average consumer takes it as a given that doctors have these systems in place," says Peter Lee, chief executive of the Pacific Business Group on Health, an employer coalition based in San Francisco. "They don't know how much medical care today is not 20th century, let alone 21st century, in terms of how much doctors rely on paper instead of computers."

Nationally, only about 20% of physician offices are computerized; the rest still rely on notoriously inefficient paper charts. But computers are an easy benchmark for quality. They can help a doctor not just keep track of files, but also send out prescriptions accurately and quickly, get lab results inserted into the record automatically and be reminded what the scientific evidence suggests is the next best step with a patient.

At the same time, for doctors to get the most value out of computers, experts say they need to use them as more than word processors; physicians should use features such as electronic reminders to prescribe a test or a medication, and change the way they practice as a result. "I believe it really does translate to better care," says Robert Eidus, a New Jersey physician with a background in business and medical quality improvement. "But it's not just that I have an electronic medical record, it's how do you use it and how does it impact caring for patients."

"I've always loved them, they treat you like family," says patient Josh Dryman, a 33-year-old who lives in Laguna Niguel. "But I had to wait an hour in the lobby and wait in the exam room another half-hour. Now when you go in, they get you in right away and the staff seems a heck of a lot friendlier."

 

How to find a good doctor - Los Angeles Times

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CMA Statement On Public Policy Institute Survey Saying Changes Are Needed In Health Care System, California

 

The California Medical Association said that findings of a Public Policy Institute of California survey released recently saying patients are largely dissatisfied with the state of health care are consistent with CMA findings in a similar survey.
"The Public Policy Institute is telling us what doctors have known for years - there is a growing concern among patients that health care is in real trouble, and the Governor and the Legislature must act now," said CMA President Anmol S. Mahal, M.D.
Similarly, the CMA released a survey earlier this month that found that 91% of physicians in the state believe health care is in trouble.
The CMA survey also found that although doctors are frustrated with the health system, they still love treating their patients and report that is their favorite part of their job.

CMA Statement On Public Policy Institute Survey Saying Changes Are Needed In Health Care System, California

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One-Fifth of Hospitals Give Bad ER Stroke Advice - Heart Disease and other cardiovascular conditions

 

THURSDAY, July 5 (HealthDay News) -- Americans who think they're having a stroke face better than a one-in-five chance of getting the wrong -- and potentially fatal -- advice when they call local hospital personnel, a new study shows.

Although experts say the best thing to do when suspected stroke symptoms appear is to immediately call emergency 911, in 22 percent of cases, hospital personnel who answered the phone advised that patients call their family doctor.

One-Fifth of Hospitals Give Bad ER Stroke Advice - Heart Disease and other cardiovascular conditions on MedicineNet.com

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LEAKED INTERNAL MEMO; 'SiCKO' Has Capital BlueCross Exec Scrambling to Respond

Who knows how "confidential" information gets out there, but it does.  This might put an end to confidential emails and correspondence as we know it today.  BD

Capital BlueCross VP of Corporate Communications Barclay Fitzpatrick recently went to see Moore’s film SiCKO. In an internal memo, he writes, “You would have to be dead to be unaffected by Moore’s movie.” He worries that if “popular, the movie will have a negative impact on our image in this community,” and suggests “talking points” to discount the film.

MichaelMoore.com : SiCKO : 'SiCKO' News : LEAKED INTERNAL MEMO; 'SiCKO' Has Capital BlueCross Exec Scrambling to Respond

Related story and comments:  http://thinkprogress.org/2007/07/06/michael-moore-releases-secret-hmo-memo-on-sicko/

Wait until Cheney makes his Hulliburton & Oil movie…called ‘ Sucko…”

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NHS Direct Smashes All Performance Targets, UK

Performance records in the UK show the NHS goals and performance of physicians are getting better, but only the doctors I think know for sure.  BD 

NHS Direct has recorded its best ever performance in June 07, exceeding all the stringent targets set by the Department of Health. The targets1 cover access, response times, and clinical sorting (appropriate advice and signposting). The performance figures for June also incorporate those set for GP out of hours services.
'These figures show that we are providing an exceptional level of service to callers, enabling them to receive rapid and appropriate health advice at the end of a telephone, 24 hours a day. The public has consistently demonstrated its appreciation of our service, but we are looking to continually improve the way in which we meet the needs of all our users', said Dr Mike Sadler, Chief Operating Officer.

NHS Direct Smashes All Performance Targets, UK

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Patient Sues Chiropractor over not diagnosing cancer from X-rays

This is indeed a strange case as I don't think anyone could expect this type of diagnosis from a Chiropractor.  BD

At trial, a chiropractic expert for the plaintiff testified that the defendants departed from good and accepted chiropractic practices by attempting to diagnose cancer, and by failing to refer the plaintiff to an internist or general surgeon. A chiropractic expert for the defendants characterized the idea that the defendants were attempting to diagnose cancer as "absurd," and testified that they did not depart from accepted practices. In addition, an oncologist who testified as an expert for the plaintiffs, admitted that there was no evidence of cancer on the X-ray films, but also testified that X-rays are not used to diagnose cancer.

A jury returned a verdict for the defendant chiropractors. The Second Department affirmed the jury's verdict stating there was a valid line of reasoning by which the jury could have concluded that the defendants did not depart from good and accepted chiropractic practice, and that the jury was entitled to credit the testimony of the defendants' expert over that of the plaintiffs' expert.

New York Legal Update: Chiropractors, Cancer, And Medical Malpractice

Hat Tip:  Kevin, MD

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Pharmalot Pool - Drug Reps would prefer fewer speaker programs

 

Speaker programs are sales reps these days. Novartis, for instance, is considering cutting back and many of its reps are thrilled. AstraZeneca reps would like nothing less, according to the latest chatter on CafePharma, where detailers dish. So one rep began a poll to quantify the sentiment.

Now, keep in mind that Cafe Pharma polls aren’t scientific - anyone who visits the site can vote, and they can vote more than once. So this doesn’t necessarily prove anything. And for those who question what they read on the site, well, we understand. Then again, one can glean useful info by being persistent. This is our usual disclaimer, by the way. So far, there are 39 votes; the poll closes July 31.

Pharmalot » AstraZeneca Reps Hate Speaker Programs

Hat Tip:  Kevin, MD

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Potential Personal Heart Monitor - The Smart Shirt, I have email on my shirt and my heart is doing OK!

Let me see, I think I'll download some music to my shirt today, load some RSS news feeds and maybe it can hold all my email too!  I could be reading email on the sleeve of my shirt someday.  Nice that the shirt can re-charge itself too.  By using a blue tooth device or cell phone the information can easily be sent to a medical office, and on top of that it will tell me when it needs to be cleaned.  According to the article, there is a potential selection of colors available.  BD

Imagine wearing a smart T-shirt or a suit embedded with tiny electronics that can monitor your heart or respiratory function wirelessly. When dirty, you take it off and throw it in the wash or have it dry-cleaned.
Researchers from the University of South Australia have been using garment integrated electronic technology to develop smart garments that, when placed on electronic hangers, enable monitored data to be downloaded in a heartbeat to a computer in your wardrobe, and then be recharged ready for wearing.
And there's no need to worry about your heart skipping a beat while your garment is being cleaned, according to researcher and Director of UniSA's Wearable Computer Laboratory, Professor Bruce Thomas.
"For continuous monitoring, you can take off one garment and put on another smart garment so, instead of having just one heart monitor, you can have a wardrobe of them," Prof Thomas said.

Prof Thomas points out that his researchers were not the first to think of this technology, but "we're the first worldwide to develop smart garment management technology that works," he said.
"The wardrobe has a touch screen on the outside and conductive metal bands spanning the hanging rail inside, with wires connecting it to a computer in the base of the wardrobe. When we place electronic hangers, each with their own ID and metal connection, on the rail, it detects the hangers and smart garments incorporating the conductive material and integrated electronics," Prof Thomas said.

Garments with communication technology only and a wireless connection enable users to access heart monitoring through a simple blue tooth or zigbee network, eliminating the need for expensive heart monitoring equipment to be placed in each garment.

The smart wardrobe can also be adapted for other uses including the self diagnosis of faulty monitoring equipment; scheduling cleaning and dry-cleaning; a fashion butler to help people accessorize, color match and select appropriate clothing for special occasions; and for pre-loading news, music and daily schedules into smart garments.

Potential Personal Heart Monitor Using Garment Integrated Electronic Technology

Also see:  Sensatex

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Kidneys Could Be Damaged By Angioplasty Procedure

 

The most common procedure for clearing blocked kidney arteries can also release thousands of tiny particles into the bloodstream that can impair kidney function, according to researchers from Wake Forest University Baptist Medical Center and colleagues.
"This is the first data in humans to show that debris released during angioplasty and stenting of the kidney arteries can be harmful to kidney function," said Matthew Edwards, M.D., M.S., lead researcher and an assistant professor of surgery. "It raises important questions about how to most safely perform this very common procedure."
Edwards said that understanding more about potential complications from the procedure can lead to improved treatments. The study, reported in the current issue of the Journal for Vascular Surgery, suggests that having patients stop aspirin use before the procedure may lead to worse results. It also shows that stent size is important and raises questions about whether blocking or filtering out the debris, known as emboli, may be effective in improving results.
"New devices exist that may prevent the passage of this debris into the kidney and may lead to better patient outcomes," said Edwards. "We are currently conducting a clinical trial to explore this question."

Kidneys Could Be Damaged By Angioplasty Procedure

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Business Owners Challenge San Francisco Health Plan

 

Restaurant owners in San Francisco say the city's new health care program for uninsured residents puts a heavy financial burden on businesses, which make contributions to help fund the initiative, NPR's "All Things Considered" reports.
The Golden Gate Restaurant Association has filed a lawsuit seeking to stop the Healthy San Francisco program. Patients at two clinics in San Francisco's Chinatown on Monday began enrolling in Healthy San Francisco.

Business Owners Challenge San Francisco Health Plan - California Healthline

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Beware Windows Hactivation Threat

Something new to be aware of - don't fall victim to this new threat.  Once your pc has been activated, there's never a reason to do this. BD 

 

Symantec reported recently on a Trojan horse that mimics the Microsoft Windows activation interface. Called Trojan.Kardphisher, it doesn't do most of the technical things that Trojans usually do: It's purely a social-engineering attack, aimed at stealing credit card information. In a sense, it's a standalone phishing program.

Once you reboot, Kardphisher asks you to reactivate your copy of Windows, citing piracy issues and telling you that another user has activated your copy. Though it assures you that you will not actually be charged, it asks for credit card information. If you don't enter the credit card information, Kardphisher shuts down the PC. The Trojan also disables the Windows Task Manager, which makes it more difficult to shut the malware down.

Running on the first reboot is clever. It makes the process look more like a legitimate message coming from Microsoft, and it won't seem to occur as a result of the user clicking on a new file. The program even runs on versions of Windows that were made prior to XP and do not require activation. That's a bit of a red flag, although I bet there's a strong correlation between people running pre-XP versions of Windows and people who aren't as well educated about malware as they could be .

Beware Windows Hactivation Threat - Expert Help by PC Magazine

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New Diet Pill - Wear dark pants and bring a change of clothes when using Alli

 

GlaxoSmithKline has also not been shy about informing the public about the side effects of the pill. Alli comes with a warning label listing possible gastrointestinal side effects, including "the caution to wear dark pants and bring a change of clothes with you to work until you have a sense of any treatment effects."
"You have to remember that manufacturers have been slammed recently for not being upfront about the possible side effects of their drugs," said Dr. Trombetta. "You have to hand it to GlaxoSmithKline for putting things on its sleeve."
These side effects are providing great fodder for popular late-night comedians. Most recently, Jay Leno, of The Tonight Show, and Conan O'Brien, of Late Night with Conan O'Brien captured viewers' attention with jokes using Alli's side effects as the punch line.

GlaxoSmithKline's new diet drug, Alli, hit shelves nationwide last month. As the first FDA-approved over-the-counter weight loss pill, Alli is receiving a lot of attention. "We have an obesity epidemic with people screaming for a solution," stated Bill Trombettta, Ph.D., professor of pharmaceutical marketing at Saint Joseph's University. "Alli is on everyone's lips because it's the only new diet drug available to address this unmet need."

New Diet Pill You Can't Buy This Publicity

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Blood Protein Offers Clues To Heart Attack In Healthy People

 

We've all wondered how a seemingly healthy person can actually be at high risk for heart disease or a heart attack. Now researchers have uncovered a new clue to this mystery. The culprit: myeloperoxidase (MPO), a protein secreted by white blood cells that both signals inflammation and releases a bleach-like substance that damages the cardiovascular system.

Although MPO is intended to kill harmful bacteria, it may instead inflame the body's arteries and cripple protective substances in the blood, according to a study published in the July 10, 2007, issue of the Journal of the American College of Cardiology (JACC). As a result, long before conventional risk factors set off alarms, elevated MPO levels signal that harmful plaque has been building up.

"Another interesting aspect of MPO is that it may be a marker for unstable plaque. Even more than the number or severity of coronary plaques, we want to know the risk of plaque rupture, and this evolving new marker may help in that regard. More study is needed, but among the hundreds of markers tested to date, MPO looks like a "keeper" that will one day become part of clinical care," Dr. Cannon said.

Blood Protein Offers Clues To Heart Attack In Healthy People

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Quarantined TB Patient Said CDC Should Apologize

 

Andrew Speaker, the TB patient who was quarantined in the US because he was misdiagnosed as having an extreme drug resistant form of the disease known as XDR-TB said the Centers for Disease Control and Prevention (CDC) who ordered the quarantine and alerted worldwide authorities about him when he went abroad should apologize, he said in an interview with CNN on Tuesday night.
The case roused international public interest because in May this year, the CDC in Atlanta issued a rarely used order under the Public Health Act (the last one was in 1967) to put Speaker in quarantine because they said a test revealed he had XDR-TB. Speaker was traveling in Europe when the announcement was made.
However, a more recent test shows that the 31 year old lawyer from Atlanta does not have XDR-TB but MDR-TB, a multi-drug resistant strain of the disease. It is still a serious disease to have, but not as dangerous as the extreme drug resistant form, according to the physician who is treating Speaker, Dr Charles Daley at the National Jewish Medical and Research Center in Denver, Colorado, in a press conference earlier the same day

Quarantined TB Patient Said CDC Should Apologize

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Surgery Is More Effective Than Other Treatments For Common Back Problem, Study Finds

 

When it comes to low back pain, physicians generally advise exhausting nonsurgical options before resorting to surgery. But a new study shows that for degenerative spondylolisthesis with spinal stenosis, surgery provides significantly better results than nonsurgical alternatives. The study, published in a recent issue of the New England Journal of Medicine, is the second in a series reporting findings of the Spine Patients Outcomes Research Trial (SPORT), a five-year, multicenter study supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the National Institutes of Health.

Surgery Is More Effective Than Other Treatments For Common Back Problem, Study Finds

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Medical Students Mobilize In Support Of Single-Payer Healthcare Reform

 

Members of the American Medical Student Association (AMSA) joined nurses, survivors of the private health insurance industry, Michael Moore, and members of Congress in a historic hearing on the negative health impacts of the for-profit private insurance industry.
The hearing, organized by Congressman John Conyers, featured clips from Mr. Moore's new film, Sicko, and testimony from industry survivors, Michael Moore, health policy experts, and Flávio Casoy, AMSA's Jack Rutledge Fellow for Universal Healthcare. The hearing was preceded by a press conference where numerous members of Congress denounced the profiteering in the healthcare systems, called for national public financing of healthcare, and lauded Mr. Moore for shedding light into the corrupting influence of private insurance. In his testimony, Casoy explained how medical students often have to negotiate between recommending the best, scientifically-proven care for patients and recommending secondary treatments that are covered by patients' insurance. For Jennifer Jackson, a fourth-year medical student at George Washington University, the "hearing was inspiring because so many leaders in Congress and in health policy testified about practical solutions to reform a system that is not working for Americans."

Medical Students Mobilize In Support Of Single-Payer Healthcare Reform

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Landmark Discovery In Manipulating Fat Could Revolutionize Plastic Surgery, ASPS Says

 

This week, physicians and researchers at Georgetown University Medical Center revealed they may have discovered a natural way to fill-in pesky crow's feet and get rid of unwanted fat in the thigh and abdominal areas. According to a study published online in the July 1 issue of Nature Medicine, physicians have been able to selectively add fat in targeted areas of the body in laboratory animals by injecting a natural chemical (neuropeptide Y) found in the body. Likewise, they have found blocking this chemical (neuropeptide Y2R blocker) can prevent the development of fat.
The study, partially funded by the American Society of Plastic Surgeons (ASPS) National Endowment for Plastic Surgery, could revolutionize aspects of cosmetic and reconstructive plastic surgery, says the ASPS.

Patients tired of staring at marionette lines or deflated lips could also see significant benefits. This natural chemical could be used to induce cells into making fat in a specific area. The patient's own body would naturally fill in wrinkles or augment lips without the high re-absorption rate found with current fat injection techniques

Landmark Discovery In Manipulating Fat Could Revolutionize Plastic Surgery, ASPS Says

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Chavez Threatens to Take Over Private Hospitals in Venezuela

President Hugo Chavez said Tuesday his government will nationalize
Venezuela's privately owned hospitals and clinics if they fail to
reduce health care costs.

"If the owners of the private clinics don't want to obey the laws,
then the private clinics will be nationalized," Chavez said in a
nationally televised speech. "They will become part of the public
health service."

Venezuela has a two-tiered health system in which wealthier, insured
patients often can afford prompter, better treatment at private
hospitals.

"This is the evil of capitalism," Chavez said of the
health care costs at private clinics. "We have to regulate this
progressively, transforming the savage capitalist market into a market
of solidarity."

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F.D.A. Approves a Hip Resurfacing Implant

Nice to see this alternative coming to the US.  BD

Hip resurfacing, a popular alternative implant to total hip replacement for younger patients disabled by hip failure, is about to become competitive.

The Corin Group of Britain and Stryker said yesterday that the Food and Drug Administration had approved the Cormet hip resurfacing implant by Corin, thus giving American consumers an alternative to Smith & Nephew’s Birmingham hip resurfacing system for the first time since the F.D.A. approved that device in May 2006.

Although total hip replacement has become a common and exceedingly successful operation for patients whose natural hip has been irreparably damaged by illness or injury, resurfacing has attracted surgeons and many patients because it preserves more of a patient’s thigh bone. That makes it easier to replace the original implant with a total hip in the future if necessary, which is often the case for active patients who have their artificial hips for 15 or 20 years.

F.D.A. Approves a Hip Resurfacing Implant - New York Times

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'Harry and Louise,' the Sequel? The Universal Health Care Debate Is Back

Interesting article on one person's opinion on what has changed since Universal care was proposed in the 90's.  BD

In 1993, two unlikely public policy leaders took to the airwaves and in less than one minute helped to scuttle a health care reform bill that had been at the center of national debate. Broadcasting from their kitchen table, "Harry and Louise" leafed warily through a stack of documents representing the Clinton administration's universal health care proposal, commenting on its lack of individual choice and seemingly endless bureaucratic complications. "They choose, we lose," the two concluded.

What's Different Now?

The public, employers and the provider community are increasingly disillusioned by rising costs and increasingly complex plans. Employers, especially, are at a tipping point, and that might make a difference this time around. "As the cost of insurance rises, employers are shifting the increase to employees, and employees are getting angry.  Although employers are generally reluctant to cede power to government, they might be willing at this juncture to put the monkey on someone else's back."

The health care landscape is changing, too, with the recent introduction of a universal health care plan in Massachusetts and a highly publicized debate on the subject in California.  If health care reform does come in the U.S., it might be through a series of state-based initiatives, "Massachusetts is not an easy model to replicate; it's a state with adequate resources and a liberal outlook. A plan that works in Massachusetts wouldn't necessarily play in Kansas." Still, the fact that key states are moving in the direction of universal health care shows that there is substantial support for the ideal of reform -- and that will likely affect national as well as state-level politics.

"We have a very complicated health care delivery and payment system that has evolved over a long period of time. There are a lot of powerful vested interests, so change won't come easy.  Incremental change is far more likely. "It's probably the only way to get there from here. Given our history, politics and national character, sweeping health care reform would be too big a pill to swallow. But change in some form certainly seems inevitable; there's just too much dissatisfaction with the current situation." Try as they might, Harry and Louise -- or their current counterparts -- won't be able to hold on to the status quo indefinitely.

'Harry and Louise,' the Sequel? The Universal Health Care Debate Is Back - Knowledge@Wharton

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Children's, Blue Cross reach deal for 30 days while working on contract, patients receive notification to seek non emergency care elsewhere if new contract is not negotiated for HMO coverage

 

Blue Cross and the hospital sent letters out to patients this month informing them they would have to seek nonemergency hospital care elsewhere if a new contract wasn't reached.

The Madera County hospital -- the only children's hospital between the Bay Area and Los Angeles -- mailed 5,000 letters June 22 to families.

Officials with Children's Hospital Central California and Blue Cross of California agreed to a 30-day contract extension Friday that allows the hospital to continue treating thousands of poor children covered by the HMO while the two sides try to work out a long-term agreement.

FresnoBee.com: Business: Children's, Blue Cross reach deal

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Hospital quits Medicare heart program

If a health facility does not perform enough heart transplants by Medicare standards, then the funding may not be available, such as this example who is declining transplants for Medicare patients only, although their normal transplant procedures will continue for other patients.  BD

University of Kentucky Chandler Medical Center has stopped performing Medicare-funded heart transplants after failing to meet requirements for reimbursement for the procedure.

The hospital has been unable to perform the 12 heart transplants annually required by Medicare. Over the past decade, the hospital has performed 14 heart transplants annually but recently began to see a decline in numbers.

The U.S. Centers for Medicare and Medicaid Services sent letters Friday telling hospitals in Texas, Minnesota and Indiana that they have 30 days to overhaul their heart transplant programs. Over the past two years, the hospitals have performed too few transplants to maintain the proficiency required by Medicare.

The need for heart transplants has declined because of advances in medication and other surgical procedures, UK doctors said. UK's heart transplant program will continue, but not with Medicare recipients.

Kentucky.com | 07/04/2007 | UK hospital quits Medicare heart program

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Potential Organ Donors Fear Losing Insurance

I truly hope this is not becoming a reality.  BD

According to a new review in American Journal of Transplantation, people who donate their kidney or part of their liver to help someone else may themselves encounter difficulty with life and health insurance, despite insurance companies saying otherwise.

"Insurance companies, when surveyed, stated they would insure living kidney donors, and would usually not charge higher premiums," says review author Robert Yang, a research fellow in the Kidney Clinical Research Unit at the London Health Sciences Centre. "Despite that, 3-11 percent of donors still experienced insurance problems."

Potential live donors worry about possible insurance problems in the future. As many as 14 percent of potential donors, from various countries with different social support and health care systems, expressed concern with their insurability if they were to donate an organ. Some research indicates that these concerns may lead a potential donor to reconsider donating.
Yang suggests that physicians should provide all information to patients before they make the important and life-altering decision to donate. "Even if donors are willing to accept the risks of non-insurability and/or higher insurance premiums, transplant professionals still have an ethical obligation to protect donor freedom of choice while ensuring that donors do not suffer unnecessary stress or financial penalty," says Yang.

Potential Organ Donors Fear Losing Insurance - 1 In 7 Organ Donors Concerned About Life & Health Insurance

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First Baby Is Born And 3 More Women Are Pregnant After Oocytes Were Matured In The Lab And Frozen

 

The first baby to be created from an egg that had been matured in the laboratory, frozen, thawed and then fertilised, has been born in Canada. Three other women are pregnant by the same process. The research was presented to the 23rd annual meeting of the European Society of Human Reproduction and Embryology.
The baby girl was born to one of 20 patients with polycystic ovarian syndrome (PCOS) or with ovaries that had been detected to be polycystic by ultrasound (U/S), who took part in the trial at McGill Reproductive Center, Montreal, Canada. The baby is progressing well.
Dr Hananel Holzer, who led the team, is an assistant professor at the Center and coordinates the fertility preservation programme there [1]. He said: "Freezing a woman's eggs (or oocytes) has become an important and integral part of fertility treatment, and the introduction of new freezing techniques such as oocyte vitrification has increased significantly both oocyte survival and resulting pregnancy rates. However, to date, the pregnancies reported have been the result of fertilisation of frozen or vitrified and then thawed oocytes that had been collected after ovarian stimulation. Unfortunately, some patients seeking fertility preservation may not have enough time to undergo ovarian simulation, or may suffer from a medical condition deemed by some oncologists as a relative contraindication to hormonal stimulation, such as oestrogen-receptor-positive breast cancer.

First Baby Is Born And 3 More Women Are Pregnant After Oocytes Were Matured In The Lab And Frozen

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Company to Charge 'Unhealthy' Workers More for Insurance

 

INDIANAPOLIS —  Unhealthy habits could cost Clarian Health employees a healthy chunk of money as the company tries to rein in rising health care costs.

Starting in 2009, Clarian will begin charging workers extra for insurance if they let health risks such as smoking, obesity or high cholesterol go unchecked.

Questionnaires and screenings will be used to detect health risks. Workers who fail to measure up in five areas — including body mass and blood pressure, will have up to $30 deducted from each biweekly paycheck if they can't prove they're working to improve their health. Workers who smoke will pay $5 extra every two weeks starting in 2008.

The law allows employers to use financial incentives in wellness programs to motivate workers to adopt more healthy lifestyles, said Mike MacLean, a partner at Indianapolis law firm Baker & Daniels.

FOXNews.com - Company to Charge 'Unhealthy' Workers More for Insurance - Health News | Current Health News | Medical News

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Health insurer cited in policy cancellations -Los Angeles

 

BC Life & Health revoked 1,880 individual health insurance policies in California in 2004 and 2005, and a state agency that examined a sampling says it found that more than half the cases it reviewed were improperly handled.
The Department of Insurance said it studied 83 sample cases and issued citations in 49 of them, alleging 67 violations of fair-claims handling laws.

When coverage is rescinded, it is as if the policy never existed, leaving the policyholder and healthcare providers to settle outstanding charges.

"A rescission can be a financial death sentence when you're ill," Poizner said in an e-mail. "In my view, even one improper rescission is one too many. When it comes to rescissions, we are acutely aware that these are people's lives. They're not just numbers to us."

A spokesman said that the department was looking at rescissions industrywide and that BC Life was one of several companies under the microscope. The others include Blue Shield, HealthNet, Cigna and Aetna. 

"We've got verification from another department doing its own investigation that this is happening consistently," Liang said. "Clearly, the system is broken…. Patients are getting harmed left and right, and nothing is getting done."

Health insurer cited in policy cancellations - Los Angeles Times

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Chicago Police Probe High Insulin Levels

 

University of Chicago Medical Center and police are investigating whether three patients, including two who died, were somehow given insulin overdoses, officials said.

Suspicions were raised after insulin levels hundreds of times too high were found in a comatose hospital patient less than three weeks after a similar case.

"We haven't necessarily tied it to anyone. We don't know if it's medical error or product integrity or defective test results," hospital spokesman John Easton said Tuesday. "We just don't know yet

Chicago Police Probe High Insulin Levels - Forbes.com

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As Costs of Drugs Shift to Consumers, Spending Drops

As pay for performance expands, this is not necessarily good news either as this seems to be one of the top reasons for patient non-compliance with treatment plans.  BD

TUESDAY, July 3 (HealthDay News) -- As employers and insurance companies shift more of the cost of prescription drugs onto consumers, actual spending on these medications declines, new research finds.  For each 10 percent increase in cost-sharing, prescription drug spending went down by 2 percent to 6 percent.

For people with certain chronic medical conditions, this means more money is probably spent on expensive medical services and health outcomes worsen down the line, the researchers add.  But increases in pharmacy spending have caused insurers and employers to try to move some of that cost onto the consumer.

For patients with congestive heart failure, lipid disorders, diabetes and schizophrenia, higher cost-sharing meant more use of medical services.

"There is some evidence that cost-sharing costs insurers more down the road, suggesting that the best strategy is to give people their medicine for free," Goldman continued. "Some insurers are actually moving toward that for certain chronic diseases."  Once the consumer knows what the cost is, she can have a conversation with her physician about costs versus benefits. This gets her more invested in her own course of treatment, which will promote greater compliance with the entire gamut of treatment."

As Costs of Drugs Shift to Consumers, Spending Drops - Forbes.com

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Doctors have reattached one of injured girl's feet

 

Doctors were able to reattach one of the feet of the 13-year-old Louisville girl who had both feet severed on a ride at Six Flags Kentucky Kingdom on June 21, according to a statement from the family released late this afternoon.
Kaitlyn Lasitter, known as Katie to her friends and family, remains in stable condition at Vanderbilt University Medical Center in Nashville, Tenn.

Doctors have reattached one of injured girl's feet

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City scales back employee benefits, blames tax reform - more join the ranks of HMO insurance

 

PUNTA GORDA: Punta Gorda city employees could be paying more for health insurance if a new plan goes into effect. The city claims tax reform has forced them to make major cuts in their budget.

One man who spoke with us didn’t want to be identified for fear of being reprimanded for speaking to the media.

Up until now, city employees had the option of choosing either a PPO or an HMO plan and the city paid the entire bill for the average employee with no dependents.

As the city plans to slash costs, the city will only pay for the HMO plan. Those workers who want to keep the PPO, will have to pay the difference, which could be as much as $70 a month. Those who want to stay with the HMO won’t have to pay anything.

"We would pay for the employees HMO as the primary coverage," said Punta Gorda City Manager Howard Kunick.

The health care change will save the city almost $300,000 a year.

NBC2 News Online - City scales back employee benefits, blames tax reform

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Financial Health of California Hospitals

 

The health of California's hospitals is better than it was in the 1990s, although there is a wide gap between those that are doing well and those that are not. Over one-third of California general acute hospitals have very strong operating margins and good bond ratings.

But the financial health of almost half of the facilities qualifies them for junk bond status at best. This affects their ability to borrow funds to modernize, which can impact the quality of care they provide.

This graphic snapshot focuses on the financial health of California's 355 general acute care hospitals, including data on how they are owned, how they are used, who pays for hospital care, and their relative financial strength. The snapshot provides an overview of the major findings of the full report Financial Health of California Hospitals, produced by PricewaterhouseCoopers, which is available under Document Downloads below. (This study is an update of a 2001 Shattuck Hammond Partners report that looked at hospital performance for 1995 to 1999, which is also available below.)

Some key findings of this study include:

• Over 60% of California hospitals are affiliated with multi-hospital systems.
• Most California hospitals are nonprofit entities, representing 67% of all hospital beds in the state.
• California's hospital resources are used more efficiently, with fewer emergency department visits, hospital admissions, and days of hospital care per 1,000 population than the U.S. average.
• Large numbers of Medicare and Medi-Cal patients served generally have a negative impact on a hospital's performance because these payments don't cover the cost of providing care. Private insurance generally pays more than the cost of care to offset the loss.

Financial Health of California Hospitals - CHCF.org

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You can't call San Francisco 'Sicko' / City's universal health care initiative signs up its first applicants

 

The first group of participants must earn less than 100 percent of the federal poverty level.

The program is slated to expand in September, opening to low-income patients who are already seen by the public health department or at other city-supported nonprofit community clinics. In January, the city plans to open it up to everybody who lives in San Francisco, is uninsured and doesn't qualify for other government health care programs, such as Medi-Cal. Only adults qualify because children are covered under a separate San Francisco program.

So have the city's elected leaders, who in a rare display of unanimity agreed last summer to begin providing health care to all San Franciscans. At a time when the broken state of the health care system is at center stage -- in the race for president in 2008 and at movie theaters where Michael Moore's documentary "Sicko" is filling a lot of seats -- San Francisco is the first city in the country to try to tackle the problem itself.

Healthy San Francisco is estimated to cost $200 million a year and will be paid for through a mix of public funds, participants' premiums and co-payments and employer contributions.

The city is mandating that employers who don't currently offer health insurance to their employees contribute to Healthy San Francisco starting Jan. 1. The Golden Gate Restaurant Association has sued to block this component of the program, saying small business owners simply cannot afford it. Both sides are due in federal court Aug. 31.

You can't call San Francisco 'sicko' / City's universal health care initiative signs up its first applicants in Chinatown

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Who is paying for uninsured medical patients?

Interesting analysis...BD

STANFORD GRADUATE SCHOOL OF BUSINESS — California Gov. Arnold Schwarzenegger has proposed setting up a universal health coverage system, arguing that caring for the uninsured has prompted health care providers to shift the burden to private payers as a type of “hidden tax.”
Citing a study by the New America Foundation, Schwarzenegger argues that private payers are handing over 6 to 11 percent more in order to cover the cost of caring for those without health insurance.

Not so, counters economist Daniel Kessler. The higher premiums are being driven by the decreased funding for public insurance programs such as MediCal and Medicare, not by the cost of caring for the uninsured.
In a recent paper, titled “Cost Shifting in California Hospitals: What Is the Effect on Private Payers?” Kessler, a professor of economics, law, and policy, concludes that the impact on private insurance premiums is much less significant than critics are arguing.

Health care costs for those without insurance led to a 1.4 percent increase in private premiums, compared to a whopping 10.8 percent escalation due to uncovered costs of MediCal and Medicare, Kessler writes.

www.exduco.net - Graduate schools and programs guide

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Hike in NY medical malpractice insurance rates approved

 

ALBANY, N.Y. (AP) _ Regulators in New York approved a 14 percent increase in medical malpractice insurance rates on Monday and Gov. Eliot Spitzer formed a task force to find ways to rein in the high cost of the coverage.
The state Insurance Department said the latest rate hike was lower than insurance companies wanted and "is necessary to avoid further financial deterioration of the companies and perhaps an irreversible crisis in an already severely distressed market."

Hike in NY medical malpractice insurance rates approved - Newsday.com

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Sicko file sharing relentless - removed and then returned to Google Video as the movie premiered

This is an article about file sharing, but makes a point about the popularity of the movie and the number of people viewing, and after it was removed once, it appeared again on Google Video.  BD

It is believed that tens of thousands of copies of Moore's documentary about the health care industry were downloaded without authorization during the past two weeks. The movie has also gone up on YouTube and Google Video, and was viewed by thousands before being removed. As the movie played on theater screens across the country this weekend, the film returned to Google Video and was watched more than 2,000 times.

If Moore's film has been harmed by file sharing, the damage is hard to find.

Hollywood hates pirates, but can it use them? | Tech News on ZDNet

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Why Physicians don't email - Free care makes no money

Very good points in this thread on physicians and email, little or no reimbursement.  BD

Patients who consult with their physicians via e-mail are less likely to visit their physician and less likely to call their doctor’s office, according to data from the Kaiser Permanente Center for Health Research, the Portland Business Journal reports.

You have to understand that I am a very tech-savvy physician.  We have been on EMR for over 10 years.  I am at home today, but just spent an hour logged in at work answering questions and finishing documentation.  I give talks around the country about the adoption of technology in medical practice and have personally succeeded where many have failed: increasing income while improving quality using an EMR in a small-office setting.  Yet we do not use e-mail with our patients.

Margins are already very tight.  Doctors are not much use to their patients if they have to close their offices.

There are ways around this problem, such as having physicians charge for e-visits or charge a global fee for access via e-mail.  But Medicare won’t allow physicians to charge above and beyond what they pay for, so to implement this a physician needs to either exclude Medicare patients, or stop seeing them altogether.

The main issue in this case is not physicians’ slowness in accepting technology, nor is it simple greed.  For there to be real change in this area, there must be a change in the way physicians are reimbursed.  Until that happens, expect the low adoptions rate to persist.

Musings of a Distractible Mind » Blog Archive » News Flash: Free care makes no money

Hat Tip:  Kevin, MD

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Minnesota To Require Insurers, Providers To File Claims Electronically by 2009

 

Minnesota Department of Health officials on Wednesday announced that all health care providers and insurers in the state will be required to file their claims electronically in a standard format beginning in 2009, the Minneapolis Star Tribune reports. State Health Commissioner Diane Mandernach cited a study by America's Health Insurance Plans that showed electronic claims cost 85 cents each, compared to $1.58 for claims submitted on paper. Mandernach, said, "We anticipate many positive results including more efficient care and lower costs."

Minnesota To Require Insurers, Providers To File Claims Electronically

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Pot update - New Mexico says grow your own

 

 As of yesterday, New Mexico law not only permits the medical use of marijuana, but provides state oversight of medicinal pot's growth and distribution.

Officials in New Mexico -- the eleventh state to legalize medical marijuana, but the first to regulate its production -- are still trying to figure out whether health department employees could potentially face federal prosecution, as users do.

Among the conditions for which pot use is permitted are cancer, glaucoma, multiple sclerosis, epilepsy and HIV-AIDS. Patients in hospice care are also covered.

Wired Science - Wired Blogs

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Two Doctors Arrested In UK Terror Investigation

 

Among the seven suspects arrested for terrorist attempts in London and Glasgow last week, two are doctors who work in the UK: 1. Dr. Bilal Abdulla, from Iraq, was arrested in Glasgow at the scene of the attempt on Saturday. 2. Dr. Mohammad Asha, from Jordan, was arrested while driving with his wife on the M6 motorway. Dr. Asha's father has told the UK media he is sure his son is innocent - he has called on the King of Jordan to intervene. He described his son as pious, but not extremist.
Dr. Asha works at North Staffordshire hospital, Hartshill, Stoke-on-Trent, England, in the neurology department. He is registered to work in the UK until 2008.

Two Doctors Arrested In UK Terror Investigation

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Physician Fee Schedule may include elimination of the E-prescribing exemption for 2008

In short, it appears no E-prescribing, no pay is proposed on the agenda if the exemption is eliminated.  There is a link on this page to sign up for free e-prescribing at no cost to the physicians.  BD

Medicare Program; Proposed Revisions to Payment Policies Under the Physician Fee Schedule, and Other Part B Payment Policies for CY 2008; Proposed Revisions to the Payment Policies of Ambulance Services Under the Ambulance Fee Schedule for CY 2008; and the Proposed Elimination of the E-Prescribing Exemption for Computer-Generated Facsimile Transmissions.

Physician Fee Schedule

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Fake CPR certificates spark new UCI inquiry

 

Campus police are investigating how 22 health care workers at UCI Medical Center got bogus certificates in cardiopulmonary resuscitation, hospital officials said Wednesday.

The discovery of a phony certificate at a training class in May sparked an internal review, completed Friday, of all 2,000 employees with CPR certification.

Hospital officials would not detail how the employees were disciplined, other than to say they were removed from directly caring for patients.

Article - News - Fake CPR certificates spark new UCI inquiry

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Heart defibrillators now required in gyms by law in Orange County, CA

 

The response in Orange County has been mostly disappointing, said Rhea Jones, vice president of HeartCharger, a Santa Ana company that sells and maintains defibrillators. Jones says many gym owners are either ignorant of the law, or opposed to it.

While every health club is required to register their defibrillators with the county, only 12 out of about 200 have done so, said Dr. Sam Stratton, medical director of Orange County Emergency Medical Services. Stratton said he's supportive of the law, but concerned it doesn't go far enough.

"There's not a lot of authority that we have over compliance," Stratton said. "There's no funding to go out and survey the clubs to make sure they have them."

Even without laws requiring them, hundreds of defibrillators are scattered throughout the county at stadiums, airports, courthouses, golf courses and beaches.

Gil Yurly, who owns BodyWise Fitness in Newport Beach and Holy Spirit Gym in Costa Mesa, said he hasn't yet bought defibrillators, which cost about $1,500. He gives the law a thumbs-down "from a gym owner's standpoint who's still looking to get over the top."

Article - News - Heart defibrillators now required in gyms by law

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Thinking about out of state college and you have HMO coverage - be sure to check the policy first for coverage or select another alternative

 

Different arrangements may need to be made if the family is enrolled in a health maintenance organization (HMO) -- which typically covers emergency treatment, but not other care, outside of the service area.

"If their parents are in a tightly controlled HMO, the students may not be able to get the care they need unless they come home to get it," says Sandy Praeger, the Kansas insurance commissioner and president-elect of the National Association of Insurance Commissioners.

Tom Richards, senior vice president of products at Cigna HealthCare, recommends that families enrolled in such an HMO find out whether their students can get "guesting privileges," which would enable them to use a different doctor near their college.

Depending on the HMO's policy and on the school location, some families may want to switch from an HMO to a PPO during the next benefits-enrollment period.

Another option, especially if the student is likely to need medical care not available at the college infirmary, is to get a student health-insurance policy.

College Medical Coverage - WSJ.com

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HEAL Program seeks health care for area poor

Bring in the attorneys from the Legal Aid Society....sad it has evolved to this point of legal aid just to get medical care when needed.  The education process portion sounds like a good idea as part of the program, but there are so many areas for one to research these days, it gets a little confusing.  BD

Doctors and lawyers are teaming up in a new effort to improve health care for poor Central Virginians.

White said that the program uses the legal system to make sure low-income residents and their children receive public benefits including food stamps and Medicaid, to identify mental health issues and to achieve family stability.

Called the HEAL Project, the program is a partnership between the Lynchburg-based Virginia Legal Aid Society and the Lynchburg Family Practice Residency Center - both groups that serve low-income populations free of charge.

“Low-income people have lots of obstacles to living healthy lives,” said David Neumeyer, executive director of the Legal Aid Society.

A similar program began about 10 years ago at a Boston hospital and is now used in about 50 localities across the country. In Virginia, a partnership between the University of Virginia Hospital, UVa. Law School and Charlottesville’s legal aid branch began only about 18 month ago.

Neumeyer said the program is just beginning to take off in the United States, and Canada is not lagging far behind.

NewsAdvance.com | HEAL Program seeks health care for area poor

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Aetna is First National Health Plan to Contract with the Department of Veterans Affairs

One big question - how do the recognized in-network providers handle referrals, claims, etc.  How does this work with the in-house VA system?  It appears the VA physicians might now get some exposure to some additional administrative functions with claims and encounter information, which has all been handled in house by the VA for years.  BD

HARTFORD, Conn.--(BUSINESS WIRE)--Aetna (NYSE:AET) announced today that it is the first national health plan to sign a participating provider agreement with the Department of Veterans Affairs (VA) for Aetna members who are also enrolled and receiving health care services from the VA. Health care providers participating with the VA now are recognized as in-network participating providers for all health plans administered by Aetna.

VA has 153 hospitals, 881 outpatient clinics, and 135 Nursing Home Care units and is the largest integrated health care system in the United States. The agreement also includes employed and contracted physicians, including dental and behavioral health providers, in the United States and Puerto Rico.

“Aetna is committed to helping our members achieve optimal health and access cost-effective, quality care,” said Allen Karp, Aetna’s vice president of Health Care Delivery. “We are pleased that through this agreement with VA, we can offer members greater choice of health care options and in particular, services that are relevant to veterans.”

Aetna is First National Health Plan to Contract with the Department of Veterans Affairs

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Medicare to clamp down on fraudulent suppliers

 

(07-02) 04:00 PDT Washington -- Fraudulent Medicare billings submitted by medical equipment suppliers in the Los Angeles area and south Florida are the target of a pilot program to be announced today by the Department of Health and Human Services.

The two-year program, which was developed by the Centers for Medicare and Medicaid Services, will concentrate on fake bills or overcharges sent by suppliers of prosthetic limbs, orthotics, diabetic supplies and durable medical equipment, which includes such items as wheelchairs and nebulizers.

"In the Los Angeles area, there are over 4,800 durable medical equipment suppliers. Because there are so many suppliers and such a high number of beneficiaries, it creates an opportunity for this kind of fraud," said Kimberly Brandt, Medicare's director of program integrity.

The U.S. attorney in Los Angeles has a special unit of four prosecutors devoted to filing criminal cases, and the office uses civil lawsuits to seek reimbursements for improper billing.

Medicare to clamp down on fraudulent suppliers

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Ultra Mobile Device: Tablet Kiosk eo TufTab v7112XT

Nice short presentation on the EO Tuf Tab.  The Tuf Tab is a heavy duty version of the EO UMPC.  The small size and semi rugged design makes the unit a perfect solution for those wanting a UMPC for portability, but need the extra support in the case design.  The unit also has a couple new features that are not on the standard unit as well, worth checking out.  Great companion for electronic medical records.  BD

Ultra Mobile: TabletKiosk eo TufTab v7112XT

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Content and Face Validity of a Cost-Effective Personal Laparoscopic Trainer Designed for At Home Use

 

ANAHEIM, CA (UroToday.com) - The groups from UC Irvine and Columbia presented their experience with a new affordable, portable laparoscopic training device, the EZ Trainer System, which is suited for use at home. This system utilizes a webcam to provide the optical signal in combination with the trainees own laptop computer to act as a viewing monitor. The face and content validity of this device was documented, with 96% of the participants indicated that the EZ Trainer provides a realistic training format. The EZ trainer was easy to use and could provide a good training system for laparoscopic surgery.

UroToday - AUA 2007 - Content and Face Validity of a Cost-Effective Personal Laparoscopic Trainer Designed for At Home Use

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Study Finds 5 Types Of Alcoholics, Research Also Shows More Than Half Of U.S. Alcoholics Are Young Adults

 

New research on alcoholism shows that there are five types of alcoholics in the U.S., and more than half of alcholics are young adults. (CBS/AP)

"When most people think of alcoholics, they think of middle-aged men with a profile similar to our chronic severe subtype. Our data shows that alcoholism is more a disorder of youth than previously suspected."

(WebMD) New alcoholism research identifies five types of alcoholics and shows that young adults account for more than half of U.S. alcoholics.
The high percentage of young adults among alcoholics was unexpected, notes researcher Howard Moss, M.D., the associate director for clinical and translational research at the National Institute on Alcohol Abuse and Alcoholism (NIAAA

Study Finds 5 Types Of Alcoholics, Research Also Shows More Than Half Of U.S. Alcoholics Are Young Adults - CBS News

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State intervenes in PacifiCare coverage dispute

This is the second story this week about patients being forced to change physicians based on HMO contracts.  Hope this is not a trend, especially when the government has to get involved such as the story below.  BD

The California Department of Managed Health Care has reached a settlement with PacifiCare that ends, for now, a months-long saga for hundreds of Peninsula residents to find medical care after the insurer dropped physicians from its network.

And it's patients who get caught in the middle when the relationship ends between insurers and providers.

"It was almost like I didn't have any insurance," said Irene Meyer, a receptionist in a Belmont physicians' practice who had to visit the emergency department for crippling pain after her family's doctor of 17 years was cut from the network.  The May 17 cease-and-desist order found that more than 500 people enrolled with a small physicians' group associated with Sequoia Hospital in Redwood City were "deceived, or otherwise misled" into believing their primary care doctor was still part of PacifiCare's network when they enrolled or re-enrolled with the insurer last fall.

The order requires that PacifiCare allow the patients to immediately return to their original physician until the next open enrollment period in the fall. At that point, they'll still need to find either a new health plan or a new primary care physician.

A PacifiCare representative, Cheryl Randolph (no relation to the state spokeswoman), said the insurer adamantly disagrees with the state agency's finding of fraudulent marketing actions.

PacifiCare's Randolph also said the doctors were offered an option to switch to other PacifiCare plans, enabling them to keep working with their patients. Only two doctors, she said, elected not to move to other groups.

"Nonsense," responded Dr. Sidney Marchasin, a primary care physician in Belmont who was dropped by PacifiCare.

Inside Bay Area - State intervenes in PacifiCare coverage dispute

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VeriChip Corporation Announces American Medical Association Recommends Implantable RFID Chips

I guess like it or not, we may all have a chip someday, just like Fido our dog has, but wit a lot more information.  This is truly a busy year for the AMA compared to years past.  BD

 

VeriChip Corporation, provider of RFID systems for healthcare and patient-related needs, announced recently the American Medical Association’s (AMA) Council on Ethical and Judicial Affairs has adopted a policy stating that Implantable radio frequency identification (RFID) devices may help to identify patients, thereby improving the safety and efficiency of patient care, and may be used to enable secure access to patient clinical information. VeriChip has the only FDA-cleared RFID implantable microchip for patient identification and health information purposes. VeriChip anticipates that the AMA’s recommendation will enhance the Company’s marketing efforts by accelerating the adoption by hospitals of the VeriMed Patient Identification System and increasing the profile of the VeriChip among the medical community.

RFID Healthcare: VeriChip Corporation Announces American Medical

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Hospitals flummoxed by patients too big for MRI machines

Hospitals are not purchasing larger MRI machines for obese patients, but rather choosing for machines with better diagnostic features.  Want an MRI, be sure you are less than 350# is the obvious answer here.  BD

When Dr. Susannah Cornes' patient came in with paralysis and numbness, she wanted an MRI to look at the spinal cord. But the machine couldn't handle someone of her patient's size -- more than 350 pounds.

Absent that option, Cornes, a UCSF resident in neurology, recommended exploratory surgery. The patient declined, choosing instead to live with the numbness and limited movement.

When the opportunity to buy a new machine comes up, hospitals opt for machines that give better images rather than systems that handle larger patients. And that rankles some people.

The average CT is of no use for people who weigh more than 450 pounds, and most MRIs can't handle people who weigh more than 350 pounds. With both machines, the table that carries the patient into a small tunnel, or bore, where the images are taken can't support the weight. In some cases, the bore is too small.

BAY AREA / Hospitals flummoxed by patients too big for MRI machines

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Ontario chided over health records

The first line of this story tells all, something we face here too in the US.  BD 

The bigger you are as a jurisdiction, the tougher it is,” said Alvarez.

Still, if Ontario makes electronic health records a priority they could “overtake the rest of the country,” he said.  Ontario isn't making enough progress and is falling behind, said Ms. Cavoukian.

Without immediate access, doctors and their staff have to get on the phone seeking the information and test results they need, said Dr. Willett, who adds she spends about 15 per cent of her time tracking down patient information.

globeandmail.com: Ontario chided over health records

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Proposed IRS form revision irking nonprofit hospitals with additional bookkeeping

 

The proposed form would ask nonprofit hospitals to detail how much money they spent on a number of specific areas, such as charity care, unreimbursed Medicaid costs and health professions education.

Schedule H also asks nonprofit hospitals to describe their collection and billing practices and seeks details as to their joint ventures, such as specifying the ownership interests of doctors in any for-profit activities.

The form comes as more attention has focused on whether nonprofit hospitals are carrying out effectively their charitable missions, as well as how they bill uninsured patients.

AMNews: July 9, 2007. Proposed IRS form revision irking nonprofit hospitals ... American Medical News

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MinuteClinic seeks waivers of Massachusetts public health rules

 

Three medical associations and two other health care organizations in Massachusetts have asked the state's Dept. of Public Health to exercise careful consideration and hold a public hearing before waiving certain clinic requirements in favor of MinuteClinic, the Minneapolis-based operator of retail-based health clinics.

MinuteClinic asked the state for exemptions from several requirements, such as providing receptacles for soiled linens and having examination rooms of a certain size, in preparation for its plans to open clinics in Boston-area CVS pharmacies.

AMNews: July 9, 2007. MinuteClinic seeks waivers of Massachusetts public health rules ... American Medical News

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Wired Doctors Bringing Technology to Treatment

Good article about physicians using mobility not only with patient consultations and office visits, but also to keep on top of medical journal events and reading material.  Just like newspapers, printed journals also are facing a short life in the future as online information is current.  BD

One way the Internet is influencing medicine is at the point of care. About 25% of physicians are accessing the Internet during patient consultations, while use of the Internet between patient consultations is up 11% since last year, Abreu said.
Physicians who go online during patient consultations are more likely to:

• Be in a group practice;
• Have an electronic health record in the practice; and
• Spend more than 10 hours online per week.

Also, the use of offline medical journals has dropped 14%, while the use of online journals has jumped 27%. Replacing print journals, online journals "almost becoming the new norm for physicians," Abreu said.

Mobile, M.D.: Wired Doctors Bringing Technology to Treatment - iHealthBeat

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