$6 million hospital wing, ER to be built in Cairo (IL)

From KFVS:

CAIRO, IL (KFVS) – Plans for a new hosptial wing and emergency room in cairo have folks around Cairo buzzing with anticipation.

It’s been more than 22 years since the old hospital in Cairo shut down, leaving thousands without emergency healthcare close by.

“(The) hospital mainly we need it,” said Christine Covington of Cairo. “Help our elderly and our children, sick and afflicted and down. We need it.”

But a $6 million expansion at the Cairo MegaClinic promises to restore emergency services.

Fred Bernstein, CEO of Community Health and Emergency Services, Inc. has worked 12 years with state and federal lawmakers for an expansion at the MegaClinic in Cairo.

“One is to be able to provide emergency care on a 24/7 basis and two to be able to take care of those kinds of urgent care needs,” Bernstein said.

CHESI serves seven counties, including four of the poorest in the state.

The clinic provides basic doctor and dental, and outpatient surgeries, with a lab and radiology department on site, but the expansion will create a 16 bed wing with 24/7 emergency services.

“We also have the greatest need for care that’s more immediately accessible because we’re farther away from existing hospitals here,” Bernstein said.

The Efficacy of Pediatric Advanced Life Support Training in Emergency Medical Service Providers

From Pediatric Emergency Care:

Pediatric advanced life support (PALS) teaches skills unique to pediatric resuscitation. The purpose of this study was to assess the effect of PALS training among emergency medical service (EMS) providers in out-of-hospital trauma and medical resuscitations. A physician panel evaluated all EMS run sheets of pediatric traumas and medical resuscitations brought to a tertiary children’s hospital/regional trauma center over a 3-year period. In 183 responses, EMS personnel were the sole providers of medical stabilization. Evaluation included the ability to secure an airway, establish vascular access, shock recognition, and appropriate cardiac rhythm assessment and resuscitation. The panel was blinded to the PALS training status of the responding EMS squad until completion of the review. Pediatric advanced life support-trained EMS personnel responded to 36% of the resuscitations reviewed. A significant difference in successful intubations was noted in PALS-trained squads compared with squads with no PALS training (85% vs 48%; P < 0.001). A significant difference was also noted in the ability to obtain vascular access in shock/arrest cases (100% vs 70%; P < 0.001). Similarly, PALS-trained squads were more successful in intraosseous line placement than non-PALS-trained squads (100% vs 55%; P < 0.01). However, despite better procedural skills, there was no difference in mortality rates between the groups (37% PALS vs 32% non-PALS). We conclude that PALS training improves procedural skills among EMS personnel and should be strongly considered as part of EMS training.

Doctor shortage looms as primary care loses its pull

From USA Today:

Longer days, lower pay, less prestige and more administrative headaches have turned doctors away in droves from family medicine, presumed to be the frontline for wellness and preventive-care programs that can help reduce health care costs.

The number of U.S. medical school students going into primary care has dropped 51.8% since 1997, according to the American Academy of Family Physicians (AAFP).

Considering it takes 10 to 11 years to educate a doctor, the drying up of the pipeline is a big concern to health-care experts. The AAFP is predicting a shortage of 40,000 family physicians in 2020, when the demand is expected to spike. The U.S. health care system has about 100,000 family physicians and will need 139,531 in 10 years. The current environment is attracting only half the number needed to meet the demand.

At the heart of the rising demands on primary-care physicians will be the 78 million Baby Boomers born from 1946 to 1964, who begin to turn 65 in 2011 and will require increasing medical care, and the current group of underserved patients.

First, Make No Mistakes

Op Ed piece in the NY Times from a former head of the NTSB:

In the health care debate, there is one thing we can all agree on: the importance of reducing unnecessary deaths in medicine. Medical error causes tens of thousands of deaths each year that could be prevented by known techniques and technologies. And all errors, even those that are not fatal, are costly: 10 years ago, the Institute of Medicine estimated that the effects of medical error accounted for $17 billion to $29 billion in domestic health care spending, and the error rate has not declined since then.

What makes the problem all the more frustrating is that we could address it with little cost to the American taxpayer. Because American medicine accepts error as an inevitable consequence of treatment, our hospitals, insurers and government do little to respond to unnecessary deaths. If we are to address the problem in a serious manner, we must first change this culture.

As a former chairman of the National Transportation Safety Board, I am familiar with the deadly consequences of human error. However, because that agency views every transportation death as a preventable occurrence, our roads, rails and skies enjoy an unparalleled level of safety. After any significant accident, the board undertakes an extensive investigation, and makes recommendations to the parties involved to ensure that such an accident never recurs. While the transportation safety board has no regulatory authority, its recommendations are viewed by the industry and the public as unbiased and therefore credible, and federal regulators usually act with haste to address them.

Such an investigative body could substantially improve the safety of medicine in the United States. While it surely could not investigate every individual instance of error, it could address many well-known maladies. Hospital-acquired infections, for instance, affect millions of Americans each year. A National Medical Safety Board would collect regional data on the problem, paying particular attention to hospitals with high incidences of infection. It would then determine preventive measures and make recommendations to state and federal regulators, hospitals and health care officials.

House of God

From the NY Times:

18house-190It was a raunchy, troubling and hilarious novel that turned into a cult phenomenon devoured by a legion of medical students, interns, residents and doctors. It introduced characters like “Fat Man” — the all-knowing but crude senior resident — and medical slang like Gomer, for Get Out of My Emergency Room.

Called “The House of God,” the book was drawn from real life, and 30 years after its initial publication, it is still part of the medical conversation.

Written by a psychiatrist, Stephen Bergman, under the pseudonym Samuel Shem, M.D., the novel is based on his grueling, often dehumanizing experiences as an intern at Harvard Medical School’s Beth Israel Hospital in 1974. More than two million copies have been sold, and the book has been continuously in print since its 1978 publication. A recent edition (Delta Trade Paperbacks, 2003) features an introduction by John Updike, who ranks the book alongside Joseph Heller’s famed military satire, “Catch-22.”

Over the years, it has served as a required guidebook for medical neophytes and a clarion call for the old guard to make striking changes in the way we train young physicians.