The New York Times op-ed noted “EARLIER this month, the New York State Legislature passed a bill granting nurse practitioners the right to provide primary care without physician oversight. New York joins 16 other states and the District of Columbia in awarding such autonomy. (Most states still require nurse practitioners to work with physicians under a written practice agreement.) The bill’s authors contend that mandatory collaboration with a physician “no longer serves a clinical purpose” and reduces much-needed access to primary care.”
The New York Times reported: “The Medicare open enrollment season, which runs from Oct. 15 through Dec. 7, gives individuals a chance to rethink it all and reassess whether their plan still fits their needs.”
“Elizabeth Cooper, a 68-year-old former elementary schoolteacher, weighs her options each year. She has already tried a couple of plans, including one through Medicare Advantage, which lured her in because it had no monthly premium. But the plan required her to shoulder a significant share of her medical costs.”
The Huffington Post reported “Back in August, it only took Mount Sinai Hospital workers in New York seven minutes to isolate and start treating a man who they suspected of having Ebola. Other U.S. hospitals have also speedily screened and tested suspected Ebola patients, all without incident.
The contrast between those other hospitals’ responses and the actions of workers at Texas Health Presbyterian Hospital Dallas, who recently mistook a Liberian man’s symptoms for a common illness and didn’t properly communicate his travel history to other colleagues, can be explained with training and drills, explained Dr. Brian Koll, the executive director of infection prevention for Mount Sinai Health System.
Recently The Atlantic reported: “As doctors and nurses move through hospitals, they aren’t the only ones making rounds—hitching a ride on their hands are dangerous bacteria that can lead to infections ranging from antibiotic-resistant staph to norovirus.”
“In recent years, a number of companies have designed systems that aim to nudge doctors and nurses into washing their hands regularly. One of these devices, a badge made by Biovigil, aims to exploit a very powerful emotion: shame. When a doctor enters an exam room, the badge chirps and a light on it turns yellow—a reminder to the doctor as well as an alert to the patient that he is about to be touched by someone with unclean hands. If the doctor doesn’t wash her hands, the light flashes red and the badge makes a disapproving noise. After the doctor waves a freshly sanitized hand in front of the badge, alcohol vapors trigger a sensor that changes the light from red to green.”
The New York Times article noted “Doctors’ stethoscopes are contaminated with bacteria that can easily be transferred from one patient to another …”
“Researchers cultured bacteria from the fingertips, palms and stethoscopes of three doctors who had done standard physical examinations on 83 patients at a Swiss hospital. They tested for the presence of viable bacterial cells, looking specifically for the potentially deadly methicillin-resistant Staphylococcus aureus, or MRSA.”
The New York Times article addressed this concept by stating “That it is seldom the reality, however. Deception in the doctor-patient relationship is more common than we’d like to believe. Deception is a charged word. It encapsulates precisely what we dread most in a doctor-patient relationship, and yet it is there in medicine, and it often runs both ways.”
Then a vignette:
Recently an article in the New England Journal of Medicine “issued new guidelines to help prevent infection transmission through healthcare personnel attire outside the operating room,” while acknowledging “role of clothing in cross-transmission remains ‘poorly established.’”
Among the recommendations, published in Infection Control and Hospital Epidemiology:
We have become a society where test scores are associated with success so it is not surprising that this has become a controversy in physician education.
Recently an article in the New York Times noted: “My young friend had just finished the last months of his medical training. He had faced down many multiple-choice tests and triumphed over them all.”
The Kaiser Famly Foundation noted: “As of August 14, 2014, the Ebola virus has infected an estimated 1,975 individuals across four countries in West Africa, leading to 1,069 deaths (including three Americans). The official reported numbers, frightening as they are, likely vastly underestimate the true magnitude of the outbreak. Ebola has severely impacted the daily life of affected communities, and raised concerns across the globe about its ongoing spread. The fact that this outbreak has led to so many cases and deaths (approximately 45% of all cases of Ebola ever reported have come since March of this year) is concerning for the individuals and families struggling with the disease, and leads to questions regarding the global capacity to detect and respond to such events. It also brings up four key policy questions for the U.S. concerning its engagement with the international community’s efforts to combat Ebola and other emerging infectious disease outbreaks.”