Air Medical Crash

From AOL:

WASHINGTON (May 31) – A medical helicopter crashed on its way to Washington Hospital Center, killing the patient and injuring three crew members.

The patient, Steven Gaston, was being transported from another hospital about 10 miles away and died in emergency surgery late Tuesday after the crash, Washington Hospital Center spokesman LeRoy Tillman said.

The pilot, nurse and paramedic were listed in serious but stable condition with broken bones and tissue injuries, said Dr. Janis Orlowski, the hospital’s chief medical officer.

The chopper crashed in clear conditions less than a mile from the hospital on a hilly area of a golf course at the U.S. Soldiers and Airmen’s Home.

One witness said he saw the low-flying helicopter and heard it hit a tree about 500 yards from the golf course clubhouse.

“It was lumbering,” said Billy Bartlett, who works at the golf course’s pro shop. “You knew something wasn’t right.”

The National Transportation Safety Board and Federal Aviation Administration were investigating.

Top 10 Drugs Prescribed by Emergency Physicians in 2005

From “Vital Signs” in ACEP News
Source: Verispan

Zithromax Z-Pak: 961 million
Levaquin: 662 million
Zithromax suspension: 354 million
Zithromax: 310 million
Lipitor: 308 million
Norvasc: 197 million
Ambien: 191 million
Skelaxin: 189 million
Prevacid: 186 million
Toprol XL: 183 million

Physicians’ on-call system may have to go through changes or die

From Columbus (OH) Business First, via Symtym:

The Ohio Hospital Association says shrinking reimbursements from insurers, Medicare and Medicaid, increasing malpractice insurance premiums and other factors are combining to discourage physicians from taking on-call assignments.

Physicians serving on-call at hospitals generally don’t earn income unless they are actually called into service and the patient or their insurance carrier pays.

An ever-growing number of patients without health insurance showing up in emergency rooms, as well, means physicians treating those patients most likely will not be paid.

Consequently, physicians are increasingly either declining to serve on call at hospitals or attempting to find compensation for being on call, a service traditionally rendered as a courtesy to hospitals at which they hold privileges.

As a result, some in the health-care industry fear that patients will soon face sharp increases in already skyrocketing costs for care – or may end up with limited access to critical specialist care in emergency rooms around the country.

“Doctors are saying, ‘if I spend 12 or 24 hours on call, I’d like a certain amount of money because that’s impinging on other things – my life, my ability to generate other revenues in practice,’ ” says Reed Fraley, senior vice president of the Ohio Hospitals Association.

Iowa governor signs malpractice bill

From the Des Moines Register:

Legislation offering a solution to the problem of costly medical malpractice insurance was signed into law Wednesday by (Iowa) Gov. Tom Vilsack.

Under House File 2716, approved by the Legislature late last month, doctors and other licensed professionals will be allowed to apologize for botched procedures and not face those admissions as proof of wrongdoing in court.

Supporters of the legislation say it will permit some patients to get closure from their doctor without having to go to court. They hope that will cut down on medical malpractice lawsuits and help hold down malpractice insurance premiums.

Standards, costs keep docs from digital age


Dr. Brian Zell was an early adopter of electronic health records when he switched his suburban Philadelphia practice to a computerized system five years ago — but he still uses reams of paper.

Most experts agree that electronic records reduce medical mistakes and cut costs by avoiding duplication, but there is no standardized way to share digital information with other doctors, hospitals or insurers.

At Zell’s office in Marlton, New Jersey, doctors and office staff use 13 computers to manage notes on patient care as well as keep insurance and payment records. But they still use paper for referrals, faxing forms and other tasks.

“Until there’s a standard technology … it makes it very difficult for my practice to leap forward,” said Zell, an orthopedic surgeon who shares a 10,000-patient practice.

A group of companies hopes to have a prototype of a national health network ready later this year, but there is still a debate over whether doctors need incentives to digitize their practices.

Doc gives patient blood during surgery


A heart surgeon had to take a break from a mercy-mission operation in El Salvador so he could donate his own rare-type blood for his 8-year-old patient.

Dr. Samuel Weinstein said he had his blood drawn, ate a Pop-Tart, returned to the operating table and watched as his blood helped the boy survive the complex surgery.

“It was a little bit surreal,” Weinstein said by phone from the Children’s Hospital at Montefiore Medical Center in New York, where he is chief of pediatric cardio-thoracic surgery

"Doctors’ Lingo That Leaves You Speechless"

From the Hartford Courant:

It’s impolite to speak in a foreign language in front of people who don’t know it. For many of us in the medical profession, though, the switch to medicalese just happens, the way French comes back when two Parisian expatriates meet. At lunch with friends, another of whom is a doctor:

Guest: What’s with bleeding people? Do you guys ever bleed anyone anymore?

Doctor: Yes. There’s a condition called hemochromatosis where bleeding is actually the treatment.

Me: Or CHF. [Congestive heart failure – a type of fluid overload.]

Doc: Ah, just give ’em Lasix. [A “water pill” in IV form.]

Me: What if they’re in renal failure? [What if their kidneys aren’t working, and they can’t make urine?]

Doc: Just dialyze ’em. [Hemodialysis, that is.]

Me: What if the renal fellow doesn’t show? Phlebotomize! (Looking around at other guests) Um…Never mind.

At a patient’s bedside (as when the expat is back in France, talking to a puzzled tourist): “Your EKG was negative, and your clinical picture and elevated BNP really suggest that your dyspnea was due to CHF – we’re diuresing you and giving you antihypertensives.”

At least we’re not phlebotomizing.

New ACEP CME: Treatment of TASER Injuries

An article associated with Continuing Medical Education (CME)on the American College of Emergency Physician’s (ACEP) website:

Focus On: Management of TASER Injuries

Specialists Paid to Aid the Uninsured

From the Palm Beach (FL) Post:

In an effort to alleviate the shortage of medical specialists handling emergency cases, JFK Medical Center in Atlantis has started paying doctors for treating uninsured emergency patients.

JFK is setting aside at least $800,000 a year to pay physicians under the program that started last month, said Dr. Ross Stone, an orthopedic surgeon and president of the JFK medical staff.

This gives us an incentive to cover the ER where otherwise we would lose money on indigent patients,” he said.

While many South Florida hospitals have recently started paying hard-to-find specialists such as neurosurgeons and hand surgeons a daily stipend for being on call for emergencies, JFK is believed to be the first to directly reimburse doctors for treating uninsured emergency patients. JFK is owned by HCA Inc. (NYSE: HCA; $43.44), the largest hospital chain in the country.

JFK doctors are paid only if uninsured patients don’t qualify for Medicaid, the Health Care District of Palm Beach County’s Coordinated Care program or other government insurance programs. The doctors are paid a rate based on how much the federal Medicare program pays for the service.

Some doctors say the JFK reimbursement program is fairer than paying physicians a daily stipend for being on call. That’s because a doctor who treats a patient with health insurance under that system gets to “double dip” — receive a payment from both the hospital and the patient.

QuickStats: Most Common Diagnoses in Patients Transported by Ambulance to Emergency Departments, by Primary Diagnosis Group

From the CDC, via GruntDoc

During 2003, approximately 16 million ambulance transports were made to emergency departments (30 per minute); 37% of patients transported were admitted to hospitals.

Chest pain
Contusion with intact skin
Nonischemic heart disease
Sprains and strains of the neck and back
Syncope and collapse
Abdominal pain
Drug dependence and non-dependent abuse of drugs
Fractures, excluding lower limb