Specialty boards set time limits for certification

From Modern Physician:

In an effort to prevent physicians’ indefinite use of the term “board-eligible,” all member boards of the American Board of Medical Specialties will limit the time that physicians have to undergo board certification after completing their residencies. Some of the ABMS’ 24 member boards already have certification time limits in place; the rest will complete a transition to time limits by Jan. 1, 2019.

According to an ABMS news release, the organization has never recognized the term “board eligible”—a term some physicians use to signal to patients and prospective employers that they intend to seek certification, the release notes. Establishing time limits, according to the release, “makes it legitimate” for physicians to claim eligibility while preventing the term from being abused.

Most of the time limits (PDF) for the 24 boards range between five and seven years. The boards of surgery and thoracic surgery have not yet established time limits. The American Board of Obstetrics and Gynecology has not yet established a starting date for its seven-year limit.

For emergency room regulars, a promising lifeline out

From the Star Tribune:

An innovative pilot program, Hospital to Home, is helping them do just that. It partners Westgard and other Regions doctors with Hearth Connection, a nonprofit dedicated to ending homelessness; Guild Inc., whose mission is to help people with mental illness lead quality lives, and the Minnesota Department of Human Services.

The pilot program was small — seven individuals with tremendously challenging personal stories — but so promising that HUD has awarded Hospital to Home nearly $258,000 to expand by another 18 to 20 individuals this summer.

As Psychiatric Wards Close, Patients Languish In Emergency Rooms

From NPR:

Many hospitals don’t even have psychiatric wards anymore. “The reimbursement for mental health care within the country is among the lowest across the different disease states,” he says, “and so it’s not, in some cases, economically viable to support these types of units.”

One hospital chain is going against the trend. Denver’s HealthOne hospital chain is opening a new psychiatric ward with 40 beds. It’ll be one of the first Colorado has seen in years.

San Carlos Hospital ER says ‘we never turn down patients”

From the Arizona Silver Belt:

She explained that all patients that enter the ER are served, something the hospital is bound to by federal law. It is also not uncommon, for any hospital, to have some long waits depending on the number of patients that are seeking service at a given time. Patients are also seen based on the severity of the patient’s condition. Acute conditions such as chest pain, child birth, and severe injuries will be treated first, while others may have to wait.

Update on ACEP and the Choosing Wisely Campaign

From ACEP’s The Central Line (Dr. David Seaburg, President):

Although ACEP has previously reviewed the Choosing Wisely Campaign and agreed not to participate, due to continued questions and comments from our members, I convened a workgroup to re-review the campaign and ACEP’s participation.  The workgroup consisted of a wide and diverse representation of ACEP members and Committees.

The group was overwhelming in support of not joining the Choosing Wisely Campaign.  Although the issue of cost control is crucial for emergency medicine’s future, the Choosing Wisely Campaign is not the vehicle for ACEP’s participation.

Iowa hospital to close labor and delivery unit

From the Sioux City Journal:

Horn Memorial Hospital in Ida Grove, Iowa, is getting out of the baby business.

The hospital will close its obstetrical unit on June 1. Women with due dates after June 1 will be given a list of facilities that deliver babies.

Firework Removed from Minnesota Man’s Chest

From JEMS:

A man is in critical condition after the St. Paul Bomb Squad removed an unexploded firework from his chest over the holiday weekend.

The 31-year-old apparently was shooting off illegal fireworks when a firework intended for the sky penetrated his chest, according to Cmdr. Paul Sommer.

Tool Predicts Outcome After Cardiac Arrest

From MedPage Today:

A simple tool administered at the bedside can accurately predict the likelihood of survival without serious neurologic sequelae after cardiac arrest in the hospital, researchers reported.

Patients whose scores on the prediction tool were below 10 had a 70.7% probability of surviving with favorable neurologic status, while those with scores at or above 28 had a probability of only 2.8%, according to Paul S. Chan, MD, of the University of Missouri–Kansas City, and colleagues.

Number of ED visits attributed to walking and texting injuries doubled every year since 2006

From the Baltimore Sun:

Though researchers and lawmakers have spent considerable time and energy worrying about distracted driving, distracted walking is low on the radar, but possibly beginning to get a little bit of attention as both an annoying menace and possible danger.

What’s apparently the only serious study on the topic came out of Ohio State in 2008. Researchers found the number of emergency room visits attributed to walking and texting injuries doubled every year since 2006. The professor who led the study, Jack Nasar, told The Sun that unpublished follow-up data showed that the numbers continued to double through 2010.

Narcotic Painkiller Use Booming Among Elderly

From MedPage Today:

Opioids were prescribed primarily for cancer pain and short-term relief immediately after surgery or an accident.

But increasingly, the drugs have been prescribed for chronic pain, an area where their safety and effectiveness is unproven, especially for older patients, a Journal Sentinel/MedPage Todayinvestigation found.

This increased use of opioids for non-cancer pain prompted the FDA to convene a two-day public hearing today and tomorrow to investigate “available data on the efficacy of analgesics in the treatment of chronic non-cancer pain.”