… The Price of Care Can Hurt Health – Should Doctors Consider Medical Costs?

A Boston Globe article noted: “This patient could be a time bomb, Dr. Neel Shah thought. A blood test suggested that she might have an ectopic pregnancy, in which a fertilized egg remains outside the uterus. Left untreated, the condition can cause fatal hemorrhaging. But when Shah, a medical resident at the time, told the woman she needed an ultrasound to confirm the result, she refused. An earlier visit to the emergency room for a bout of stomach trouble had left her with an exorbitant bill. Until Shah could tell her how much an ultrasound would cost, she wasn’t budging.” Read more

Palliative Care Explained

A Cancer Today article noted: “Originating from the Latin word pallium, meaning ‘a cloak,’ palliative care offers relief from the symptoms and stresses of cancer. It’s not a replacement for therapies like chemotherapy, radiation or surgery that treat the illness. Instead, it’s a companion therapy.”

“For someone with a serious condition that affects quality of life, ‘if you want the best care possible and you’re getting cancer care without palliative care, then you’re not getting the best care,’ says Diane Meier, a geriatrician and palliative care specialist who directs the Center to Advance Palliative Care.” Read more

Being Your Own Health Care Advocate – How to Make the Most of Every Doctor Visit

A Everyday Health article noted: “Prevention is key to staying healthy at every age, so it’s important to get the routine health care you need. It might feel as though your doctor has less time to spend with you at office visits, but that’s precisely why you want to make the most of each one.

“Going through a health care checklist during your visit can help you make sure that healthy aging is in your future.

Maximizing Your Health Care Visits. Make a list so you don’t forget to bring up any health concerns that you want to focus on. Read more

Doctors Hesitate to Ask Heart Patients about End-of-Life Plans

An NPR story noted: “Of the 5 million Americans with failing hearts, about half of them will die within five years of getting diagnosed. Given the odds, it seems that people with heart failure should start thinking about how they want to die. But doctors don’t routinely talk to those patients about end-of-life planning.”

“When researchers asked 50 doctors and 45 nurse practitioners and physician assistants how often they discuss preparing for death with their heart failure patients. A third of the providers said they lacked confidence in talking about end-of-life care. Only 12 percent said they have routine yearly discussions about the end of life.” Read more

The Path of Least [Antibiotic] Resistance

The Brookings Institution article noted: “While antibiotics are necessary and crucial for treating bacterial infections, their misuse over time has contributed to a rather alarming rate of antibiotic resistance, including the development of multidrug-resistance bacteria or ‘super bugs.’ Misuse manifests throughout all corners of public and private life; from the doctor’s office when prescribed to treat viruses; to industrial agriculture, where they are used in abundance to prevent disease in livestock.” Read more

Hospitals Put Pharmacists in the ER to Cut Medication Errors

The NPR story noted: “In the emergency department at Children’s Medical Center in Dallas, pharmacists who specialize in emergency medicine review each medication to make sure it’s the right one in the right dose. It’s part of the hospital’s efforts to cut down on medication errors and dangerous drug interactions, which contribute to more than 7,000 deaths across the country each year.”

“Medication errors can be caused by something as simple as bad handwriting, confusion between drugs with similar names, poor packaging design or confusion between metric or other dosing units, according to the Food and Drug Administration. But they’re often due to a combination of factors, which makes them harder to prevent.” Read more

The Joint Commission New Speak up™ Infographic on Anesthesia and Sedation Safety

The Joint Commission release noted: “Nearly 40 million anesthetics are administered annually in the United States. To raise awareness of the risks of anesthesia or sedation and precautions that should be taken, The Joint Commission released a new Speak Up™ infographic today for patients and consumers titled ‘Speak Up: About Anesthesia and Sedation.’ The publication was developed in collaboration with the American Association of Nurse Anesthetists and the American Society of Anesthesiologists®.” Read more

Reduce Costs with Selective Pre-Op Testing

The Anesthesiology News article noted “Routine preanesthetic tests cost more than $60 billion every year, but far fewer than 1% reveal pertinent abnormalities relating to the anesthetic or the surgery, according to a 1989 study published in the Canadian Journal of Anesthesia (1989;36:S13-S19).”

“For that reason, national guidelines recommend minimizing preoperative testing in low-risk, stable patients undergoing non-emergent surgery. The American Society of Anesthesiologists (ASA) released a guideline in 2012 that advised against routine testing, such as labs, chest x-rays and electrocardiograms (EKG). But the ASA suggested a tailored approach for anything with a high risk.” Read more

Revolving Doors at Hospitals

The New York Times article noted: “Everyone on the ward fell hard for the patient in the room at the end of the hall. Her roommate was loud, demanding and a complete nuisance — nobody spent more time in that part of the room than was absolutely necessary. But the gently smiling, impeccably mannered little 90-year-old, admitted to the window bed with a touch of pneumonia, was a big favorite.”

“The doctors joked with her, the nurses stroked her head and brought antibiotics and nebulizers right on time, and her private-duty attendant organized her pillows and fed her little snacks. She looked like a million dollars when they sent her home.” Read more

Insurers Fill Gaps in Health-Law Plans

The Wall Street Journal article noted “Health insurers in several states are adding to the choices of doctors and hospitals in their health-law plans amid concerns among some consumers and state officials about access to care.”

“The insurers that are expanding their networks said they aren’t responding to complaints. Instead, they said, the tweaks reflect more willingness by some health-care providers to join the new networks, which often pay them less than traditional employer plans, as well as adjustments to serve the specific populations who enrolled.” Read more