D’oh!
March 30, 2005
Advertising by Academic Medical Centers | Archives of Internal Medicine | 3.28.05
Conclusions Advertising to attract patients is common among top academic medical centers but is not subjected to the oversight standard for clinical research. Many of the ads seemed to place the interests of the medical center before the interests of the patients.
The Effect of Physician Disclosure of Financial Incentives on Trust | Archives of Internal Medicine | 3.28.05
Conclusions The public wants information about physician financial incentives. Specific communication styles enhance how this information is conveyed to patients, increasing trust and supporting the physician-patient relationship.
D’oh!
National Health Interview Survey
March 30, 2005
January-September 2004 National Health Interview Survey (PDF) | CDC | 3.23.05
In this release, the National Center for Health Statistics (NCHS) updates estimates for 15 selected health measures based on data from the January-September 2004 National Health Interview Survey (NHIS) and presents estimates from 1997 through 2003 for comparison. …
The 15 measures included are:
- lack of health insurance coverage and type of coverage,
- usual place to go for medical care,
- obtaining needed medical care,
- influenza shot,
- pneumococcal vaccination,
- obesity,
- leisure-time physical activity,
- current smoking prevalence,
- alcohol consumption,
- human immunodeficiency virus (HIV) testing,
- general health status,
- personal care needs,
- serious psychological distress,
- diagnosed diabetes, and
- asthma episodes and current asthma.
Figure 1.1. Percent of persons of all ages without health insurance
coverage: United States, 1997-2004Table 1.1. Number and percent of persons without health insurance
coverage,
by age group: United States, 1997-2004 (modified)
Year All < 65 yrs 18-64 yrs < 18 yrs 1997 41.0 40.7 30.8 9.9 1998 39.3 39.0 30.0 9.1 1999 38.7 38.3 29.8 8.5 2000 41.3 40.8 32.0 8.9 2001 40.2 39.8 31.9 7.9 2002 41.5 41.1 33.5 7.6 2003 43.6 43.2 35.9 7.3 Jan.-Sept. 2004 (Method 1) 42.1 41.6 34.7 7.0 Jan.-Sept. 2004 (Method 2) 41.6 41.2 34.5 6.7
{Modified from Table 1.1}
Ratio Fallout
March 30, 2005
Hospitals scramble to find nurses | AP | 3.27.05
Court order requires compliance with staffing-ratio law
LOS ANGELES - California hospitals are scrambling to meet a new court order to have one nurse for every five patients around the clock - and officials say most are failing to reach the goal.
Some hospitals have tried to close the gap by hiring nurses from registry services and having staffers work more hours.
“Our Band-Aid, if you will, or solution today is contract labor and overtime,” said Carol Bradley, chief nursing officer for the Tenet California chain. …
“Closures of beds and increased diversions and increased wait times are becoming common again,” said Jan Emerson, a spokeswoman for the California Hospital Association.
“Even if money came down from heaven and paid for all of the extra costs, you still can’t find the nurses,” she said. …
At Methodist Hospital of Sacramento, more patients are being held in the ER - but not just because of the latest court order, said Holly Worley, an emergency room nurse.
“There just aren’t enough RNs, period, and that was happening way before we had nursing ratios,” she said.
The 60,000-member California Nurses Association said the ratio will make hospitals safer. But hospitals complain that it’s virtually impossible to obey the law throughout the day because the ratio must be met every time new patients swell wards and even when a nurse takes a coffee break.
“Eighty-five percent of the hospitals are out of compliance at any given time with the old ratios. The new ratios only make them more out of compliance,” said Jim Lott of the Hospital Council of Southern California, which represents about 190 public, private and nonprofit hospitals. …
Well said Holly!
Easter
March 28, 2005
Chili Con Digiti
March 26, 2005
Search continues in Wendy’s finger case | Sacramento Bee | 3.25.05
A woman bit into a partial finger served in a bowl of chili at a Wendy’s restaurant, leading authorities to a fingerprint database Thursday to determine who lost the digit. …
In this black and white photo released by the
Santa Clara County Department of Environmental
Health in San Jose, Calif., Thursday, March 24, 2005
shows a portion of a human finger that a woman says
she found while eating a bowl of chili at Wendys Restaurant
in San Jose, Calif., on Tuesday. Photo was taken on Wednesday,
March 23, 2005.
Don’t know about the chili, but I’d check the salad—usually nothing to sew back on.
Skynet’s HKs
March 23, 2005
Drone Will Get More Weapons for ‘Hunter-Killer’ Missions | WP | 3.22.05
The newest version of the Air Force’s Predator unpiloted aircraft will perform primarily “hunter-killer” missions, according to newly available Pentagon documents. …
The Predator B will be armed with as many as 3,000 pounds of precision-guided bombs or missiles and carry sensors that will allow it to automatically find, track and hit moving targets on the ground. …
The strategy calls for denying sanctuary to enemies such as terrorist groups in ungoverned territories within otherwise sovereign countries anywhere in the world. …
…”The aircraft is being designed primarily to prosecute critical emerging time-sensitive targets as a radar-based attack asset with on-board hard-kill capability.” The Predator B will fly at 50,000 feet, twice the altitude capable by its predecessor, and will carry seven times the munitions load. It will be able to stay aloft for more than 30 hours, covering targets hundreds of miles from its land base. …
It is reminiscent of Skynet’s HKs—but a necessary evolving capability considering the new types of enemies and not risking American lives.
Predator B
Predator
WAMP & CMS
March 23, 2005
Caveat lector a real geek post…you may wish to blog-on…
Tonight I took a 30 minute break from studying and decided to finally install a desktop server. I’ve been toying with the idea for about a year—just a tad chicken to muck around with a desktop that works just fine.
EasyPHP was just that easy—about 5 minutes from downloading to up and running! Next came the installations of TikiWiki and WordPress. About 10 minutes and 5 minutes respectfully. WordPress is always so easy to install, even more so on a desktop server (and a truly private blog). The reason for the TikiWiki installation was to explore the CMS features of a Wiki application. It was going to be either MediaWiki or TikiWiki and I had some difficulty previously getting MediaWiki and DokuWiki running on my Dreamhost account.
I see a natural evolution from weblogs and forums to wikis to true all encompassing CMS systems. Its all coming together in application like Drupal, TikiWiki, and the still beta JotSpot. Interesting post at Lessig on Code v2.0 and the CC-Wiki license.
My predictions are that CMS will go big time—someone’s going to snap up Jotspot or take some other wiki project and make it like TypePad is to MovableType. For that matter, what is SixApart going to do with LiveJournal—I see alot of potential morphing of MovableType and LiveJournal into SA’s entry in the CMS arena. And, then there is the imminent release of Yahoo 360° coming on the 31st. Blogger is looking mighty long in the tooth—Google has to be looking for their CMS entré.
For me, I’m sitting with my ExpressionEngine for now—the forum module is coming, they’ve added a gallery module (just my dog for now). They’ll have to ramp it up to keep up with the potential of Jotspot. I’ve toyed with my vBulletin installation and even got it skinned to match the blog—but to run a forum well is too high a maintenance in terms of time and commitment.
I have test sites for WordPress, MovableType, vBulletin and Drupal (just added this week) on my Dreamhost account. Drupal is a fantastic CMS contender—blogs, pages and forums. I have my Blogger sites saving to Dreamhost. And, now I’ve finally added WAMP—Windows running Apache, MySQL and PHP as a sandbox on my Dell box. Sometime ago I saw a nice article (and didn’t save it) where AMP was installed on a USB fob “drive”—anyone seen one of those or heard of them, please let me know…OK, enough procrastination…
EmergiBlog.com
March 20, 2005
EmegiBlog.com | EP Monthly | 3.05
When Allen Roberts sat down to create an online medical journal three years ago, he didn’t think of himself as a “blogger.” He was just an Emergency Physician in Texas sharing his thoughts with whoever happened upon his website. Sometimes he wrote about trivial things, like a funny gift from his nursing staff. But he also posted his thoughts about real ED issues, like tort reform and ambulance diversion, and pretty soon he had created an online dialogue. Roberts’ website became a place for EPs to swap stories, complaints and medical advice in a casual and exceedingly convenient environment. Thus Gruntdoc.com was born, and much to Roberts’ surprise, became a gold standard among medical web journals. But don’t take our word for it; Gruntdoc.com was recently voted Best Medical Weblog of 2004. …
For instance, Chris Rangel, a hospitalist in Texas with the weblog “rangelmd.com”, recently posted an entry discussing the extent of doctors’ responsibility in the recent Vioxx disaster. …
Others mentioned in the article:
- RangelMD
- symtym
- richard[WINTERS]md
- Medpundit (albeit a typo “webpundit.com”)
Congratulations to Gruntdoc on his hosting of ER “Talk” Blog (announcement, blog):
This is an open discussion about anthing. Share your funniest situations in the ER, ask your fellow ERPs a question. Jump in and start a debate! Now Dr. Roberts will be moderating the EPmonthly.com BLOG!
NKA
March 20, 2005
EMT brings patient in from SNF and gives report. States the nurse at the SNF, when asked about drug alleries, said, “yes, patient is allergic to NKA.” Too funny and too sad a reflection of some nursing care in some SNFs.
My favorite from doing EMS ride-alongs when in residency was a cardiac arrest call at a SNF. Patient is in the bed on a backboard having chest compressions being performed very well. The staff are using a BVM and bagging the patient well. I’m thinking this is absolutely amazing—they’ve got it right. Then I follow the oxygen tubing from the BVM, looking for the cylinder or the wall connector—there is none. I see the end of the oxygen tubing lying on the floor. I ask the charge nurse about this, she says, “it’s okay doctor, patient is a retainer.” {of course the appropriate accent is missing in this rendition so is the emphasis doc[tor]—but those that have BTDT can hear the exact same voice and are smiling}
Common Good on Two Fronts
March 18, 2005
The Doctor’s Court? | Legal Affairs | 3.14.05
George W. Bush is pushing an aggressive agenda for reforming medical malpractice law, with a focus on capping the amount of damages patients can be awarded if their doctors harm them. But some advocates suggest a completely different reform: “health courts.” These jury-less courts would deal only with medical claims and be administered by trained healthcare professionals. This, supporters argue, might improve healthcare by providing quicker resolution to malpractice suits and limiting frivolous claims.
Are health courts a good idea?
Philip K. Howard is Founder and Chair of Common Good and the author of The Death of Common Sense: How Law is Suffocating America. Stephanie Mencimer is a contributing editor of The Washington Monthly and is writing a book on tort reform. …
Charity Case | WSJ | 3.17.05
Sooner or later, Americans will realize that sue-for-anything justice erodes their freedom. First it was diving boards that disappeared, then seesaws. Businesses stopped giving references, and doctors started quitting. …
Like a lake receding from its shores, the area of our freedom continues to diminish with each new theory of liability. The latest casualty is volunteerism. Last month, a jury in Milwaukee found the Catholic Archdiocese liable because a volunteer for a Catholic lay organization, driving her own car, ran a red light and caused an accident while delivering a statue of the Virgin Mary to an invalid. Although the church does not direct the activities of this group, called the Legion of Mary, its meetings are held on church property. The jury decided the Archdiocese should pay $17 million to the paralyzed victim, an 82-year-old semi-retired barber. …
via Common Good’s MedWatch