“Do You Moonlight?”

A post from the Student Doctor Network EM Section:

I moonlight in a single coverage rural (critical access) hospital. 4 beds, one nurse, 8 inpatient beds.

I also moonlight at a suburban 40,000 volume ED as triple coverage.

so, far at has been the single most invaluable experience of residency. The first time going to a rural area and having a code come in or a sick kid and talk about pucker factor. It’s a real test.

You definately learn to deal with autonomy and making your own calls. It can be a little scary at time, but good learning experience that I can’t simulate at my residency with oversight constantly.

I also understand the problem with allowing non-boarded people to work in ER’s, but on the other hand I’m getting check out from ortho residents and optho guys are covering an ER by themselves.

So, yes, I feel that EM residents are serving these communities in a good way because their other option is the 65 y/o FP guy who still uses keflex for abscesses or the ortho resident who hasn’t read an EKG since medical school.

Do you need to moonlight to be competent………absolutely NOT, but I haven’t regretted one moment of it and thoroughly enjoy the cash as well.

Calling Into Question Whether “Apology Works”

From Kevin MD:

Apologizing after medical errors is the moral and ethical thing to do, but this attorney says otherwise.

Saying sorry can deny malpractice coverage, says attorney Steven Kern, and from a legal perspective, “saying I’m sorry is an admission. An admission is an exception to the hearsay rule, so anyone who hears it can be called to testify against you, should legal action ensue.”

What about the 35 states that have enacted apology laws? Not good enough says Kern, who adds that “while some of these laws may provide sufficient protection to a physician who wants to apologize, others do not.”

Rite Aid Settles With Feds Over Handling of Abuse-Prone Drugs

From the Wall Street Journal Health Blog:

Rite Aid has entered a $5 million civil settlement with the Justice Department over the way pharmacies in eight states handled controlled substances, drugs like pain pills that are prone to abuse. Rite Aid has agreed to set up a compliance plan meant to help “prevent diversion of controlled substances” and keep them away from people who shouldn’t get their hands on them, DOJ said. It includes audits and regular counting of the drugs. The plan also requires Rite Aid to get a tracking system going for pseudoephedrine and ephedrine, over-the-counter drugs that are used by some bad guys to make methamphetamine.

NY Settlement

From the NY Times:

In a settlement with one of the nation’s biggest insurers, New York’s attorney general, Andrew M. Cuomo, has ordered an overhaul of the databases the industry uses to determine how much of a medical bill is paid when a patient uses an out-of-network doctor.

A statement from Mr. Cuomo’s office said the industry had engaged in “a scheme to defraud consumers” by systematically underpaying the nation’s patients by hundreds of millions of dollars over the last decade.

Hospital Scrubs Are a Germy, Deadly Mess

From the Wall Street Journal:

You see them everywhere — nurses, doctors and medical technicians in scrubs or lab coats. They shop in them, take buses and trains in them, go to restaurants in them, and wear them home. What you can’t see on these garments are the bacteria that could kill you.

Dirty scrubs spread bacteria to patients in the hospital and allow hospital superbugs to escape into public places such as restaurants. Some hospitals now prohibit wearing scrubs outside the building, partly in response to the rapid increase in an infection called “C. diff.” A national hospital survey released last November warns that Clostridium difficile (C. diff) infections are sickening nearly half a million people a year in the U.S., more than six times previous estimates.

The problem is that some medical personnel wear the same unlaundered uniforms to work day after day. They start their shift already carrying germs such as C.diff, drug-resistant enterococcus or staphylococcus. Doctors’ lab coats are probably the dirtiest. At the University of Maryland, 65% of medical personnel confess they change their lab coat less than once a week, though they know it’s contaminated. Fifteen percent admit they change it less than once a month. Superbugs such as staph can live on these polyester coats for up to 56 days