German Shepherd Dog’s X-Ray Nets Offer of Narcs from Pain Doc

From AZ Central:

Investigators say a Southern California doctor saw enough from an X-ray to prescribe pain killers to an undercover cop but missed the tail showing it was an image of a dog.

The Los Angeles Times reports Atiga examined the X-ray and asked if she wanted Vicodin, oxycodone, Valium or Xanax.

Drug-Related ER Visits

From the Daily Rx:

Emergency Rooms (ER) report all drug-related information to a special government public health watchdog. Drug overdoses and adverse reactions are through the roof, compared to a few years ago.

The 2010 U.S. drug-related emergency room report was just released. Nearly half of all drug-related ER visits are related to abuse or overdose, while the other half are from bad side-affects to drugs.

Emergency Medicine and Hospital Medicine: A Call for Collaboration

From the American Journal of Medicine, via PubMed:

BACKGROUND: In the United States, emergency physicians and hospitalists are increasingly responsible for managing hospitalized patients. These specialists share a common practice space and similar shift work schedules. Together they govern decisions about use of the most expensive care setting in medicine-the hospital.

DISCUSSION: Unfortunately, in most institutions there is little collaboration between emergency physicians and hospitalists, resulting in missed opportunities to improve the quality of care and reduce its cost. In this call to action, we challenge emergency physicians and hospitalists to work together to develop protocols for consistent, evidence-based, and expeditious care of patients admitted from the ED; to collaborate in the care of ED patients who can safely be discharged home; to pursue joint quality, hospital leadership, and cost-effectiveness projects; to work in partnership to assure adequate staffing of hospital-based specialists; and to cooperate in the professional, front-line assessment of clinically and fiscally driven policies aimed at assessing the appropriateness of hospital admissions and readmissions.

SUMMARY: Hospital care is increasingly driven by emergency physicians and hospitalists. We envision a vital role for ongoing collaboration between them in achieving the goals of patient care, education, and quality and safety outcomes.

ACEP Corrects Statistic Used by Texas Medicaid Director about Emergency Care

From PRNewswire (press release):

A statement by the Texas state Medicaid Director incorrectly attributed a statistic that applies to all of hospital care by Texas Medicaid patients to emergency care, according to the American College of Emergency Physicians (ACEP). A state health facts report from the Kaiser Family Foundation say that emergency care represents about 6.5 percent of Texas Medicaid spending in 2010 ( http://tinyurl.com/7hkytj4 ). The state Medicaid Director inappropriately added inpatient care with emergency care in his percentage.

“Emergency physicians are committed to delivering the highest quality care in the most cost-effective and efficient way for the millions of emergency patients who visit ERs each year,” said Dr David Seaberg, president of ACEP. “As we target solutions to the nation’s growing health care costs, we need to examine these issues carefully, base the solutions on evidence-based research and make sure we are using accurate data.”

Dr. Seaberg said the focus on non-urgent emergency visits has distracted policymakers from the potential savings that do exist in the area of hospital admissions, pointing to a recent study in Annals of Emergency Medicine. According to the study, reducing lower urgency visits to emergency departments is unlikely to generate significant cost savings (“A Novel Approach to Identifying Targets for Cost Reduction in the Emergency Department”) http://bit.ly/LSncb9 . However, since 50 percent of hospital admissions come through the emergency department, even a small reduction of those admissions potentially could result in significant savings.

Another report released earlier this week from the Centers for Studying Health Systems Change (HSC) found the majority of Medicaid patients ages 21 to 64 have symptoms of urgent or serious medical conditions when they seek emergency care, dispelling conventional wisdom. According to the HSC, many assessments of “unnecessary” use of emergency care incorrectly look at patients’ diagnoses, instead of patients’ symptoms and why they are choosing to seek emergency care, leading to wrong conclusions.

“Unfortunately, our current system does not support the standby costs mandated by federal law for 24-hour-a-day readiness to handle car crashes, heart attacks and pandemics,” said Dr. Seaberg. “True payment reform must adequately reimburse the emergency medical care system so it is ready for anything at any time.”

ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

SOURCE American College of Emergency Physicians (ACEP)