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August 2012 Archives

Study Finds No Evidence of Heightened Risk With Surgical Residents

Going under the knife is nothing to take lightly. Knowing your surgeon is fresh out of residency only adds to the stress. But one study, however, indicates that-despite public perception-there is no higher risk of serious complications or medical errors from surgery performed by a surgeon-in-training or resident than a seasoned physician.

Prostate Cancer Survival Improved with PSA Testing

Prostate cancer survival for men with metastatic disease significantly improved with routine Prostate Specific Antigen (PSA) testing over the last 20 years, despite a current US Preventive Task Force's (USPTA) recommendation against general screening. A study in the Journal of Urology showed a significant reduction in the stage severity of the cancer in men who followed with testing. Overall survivability increased for men with metastatic disease who underwent screening, especially black American men. The study leaves no doubt that PSA testing plays a role in extending lives for such patients. It also supports the use of PSA testing for general screening in asymptomatic patients.

Medical Tests Often Not Checked When Ordered on Discharge Day

Medical tests ordered on the day of hospital discharge have a high risk of not being followed up on by the ordering physician, reports Mei-Sing Ong, PhD in a research letter in the Archives of Internal Medicine on August 13th. Of 662,858 tests ordered for 6736 patients during their hospitalization, 3.1% of test results did not get reviewed before discharge. Two months later, half of those were still not reviewed. More than one-third of patients had at least one test result that was not reviewed prior to discharge. Most of the test results that went unreviewed were ordered on the day of discharge.

Patient Picture Verification Proven to Reduce Medical Errors

Increasingly, hospitals and medical facilities are moving away from paper files to electronic medical records to promote accuracy and efficiency. Some say this has helped to reduce medical errors. Others, however, say there's room for improvement when it comes to the logistics of electronic recordkeeping.

Daily Aspirin Lowers Cancer Mortality

The Journal of the National Cancer Institute reported that the daily use of aspirin helps prevent death from cancers. Dr. Eric Jacobs  did the study to further investigate a report of an estimated 37% reduction in  deaths among people using aspirin for 5 years of more. Data from 110,139 elderly individuals participated in the study and were followed for 11 years. There was an overall mortality reduction of 16%, with a reduction in mortality of 40%  for gastrointestinal malignancies and about a 12% decrease for all others. 

Overbilling Uninsured and Self Pay Patients

Health care prices charged by hospitals and physicians for care provided to uninsured and out-of-network patients are more than 2.5 times what insurance companies pay and more than 3 times their actual costs. Unlike insurance companies, individuals are not able to negotiate a fair price.  Physicians do not obtain "informed financial consent" for their fees from self-pay patients before providing treatment. An unconscious patient or someone in need of urgent care simply is not in a situation where a meaningful discussion about the cost of care can be had. Patients do not have any information about the physicians' actual costs, and they do not have any ability to compare prices between providers. The law of implied contracts provides a fair way to price health care to people without insurance and prevent overbilling.

Sphincter Injuries During Birth Common But Often Undiagnosed

Anal sphincter injuries are detected in 25% of women after birth when they are carefully re-examined by a skilled obstetrician; however, these injuries were only found 11% of the time on a routine initial exam. Sphincter injury is the most common cause of fecal incontinence in women and can severely diminish their quality of life leading to substantial personal and financial damage. The vast majority of obstetric anal sphincter injuries can be detected clinically by a careful exam right after delivery. It is standard practice to repair a damaged anal sphincter immediately or within 24 hours of delivery. Delayed diagnosis and repair lead to life long problems with fecal incontinence.

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