Physician credentialing needs better standardization

From Kevin MD:

One issue that really, really needs better standardization is physician credentialing. Each healthcare entity, be it a hospital or a payer, has its own way and standards of reviewing the credentials of physicians. And believe me, it’s a mess that just gets worse and worse. I have practice privileges at several hospitals and medical licenses in several states. Each one of these has its own, often idiosyncratic, standards for credentialing physicians, and these credentials need to be redone every couple of years. The process takes many hours and causes many headaches. There are national databases that keep relevant information about physicians — medical school and residency information, medical license information, information on disciplinary actions. You might think this would have made the process faster, but it just added another layer to the mess. Hospitals spend millions of dollars duplicating work that has already been done. It’s crazy.

In the new year, be a first responder

From CNN:

Each December, each person makes his or her own pledges. This December there has been a phrase that has been much in the news: First responders.

It is a relatively new description. In earlier generations, the people to whom it applied were referred to simply as police officers or firefighters or emergency squads. The people who, in times of great trouble, run toward the peril and not away from it.

Every day, in every part of the country, they humble us with their courage and commitment. The first responders we have been reporting on and reading about as the old year nears its end have given new meaning to “above and beyond the call of duty”:

Baby boomer nuns help revolutionize health care

From CNN:

The baby boomer generation’s efforts at creating social justice dramatically transformed history — from the Vietnam War to gay rights.

Even institutions that kept tradition at their very core — institutions such as the Roman Catholic Church — were radically changed by this generation.

Within the church, perhaps the biggest agents of this change were its nuns. A wave of new thought during the 1960s opened cloister doors.

While modernization of the church did leave fewer nuns in the pipeline to carry out work in the health care and education fields, the ones who stayed — this baby boomer generation of religious sisters — undertook a kind of grass-roots, social justice-oriented health care.

Even today, their work continues to fill in the gaps left by our general health care system.

ERs Have Become Central Staging Area for Acutely Ill Patients

From Health News Digest:

Lack of stable medical homes and reduced inpatient capacity are key factors that could be responsible for a shift toward higher billing levels over the past decade in U.S. emergency departments, according to a new report from the New England Journal of Medicine ( Changing standards of care and the implementation of electronic medical records are additional potential factors in this shift that is accompanied by increases in higher-complexity, higher paid visits for Medicare emergency patients.

U.S. mentally ill and their families face barriers to care

From Reuters:

… families trying to get help for a loved one with mental illness confront a confusing, dysfunctional system that lacks the capacity to help everyone who needs it – and that shunts many of the mentally ill into the criminal justice system instead of the healthcare system.

“Public mental health services have eroded everywhere, and in some places don’t exist at all,” said Richard Bonnie, professor of law and medicine at the University of Virginia. “Improving access to mental health services would reduce the distress and social costs of serious mental illness, including violent behavior.”

Analysis Supports Limiting Spinal Immobilization in Car Crash Patients

From JEMS:

This is a retrospective cohort analysis from a U.S. National Highway Traffic Safety Administration database (National Automotive Sampling System Crashworthiness Data System) that examined crashes from 1998 to 2008. Investigators were interested in vehicle window integrity and the relationship to restrained, front seat (driver and passenger) occupants in motor vehicle crashes (MVCs) that required vehicles to be towed from the scene. Using only objective data, investigators hypothesized that if patients met certain criteria: age 16-60, no damage to the vehicle’s windows occurred, no airbags were deployed, and front seat occupants were restrained—that a patient isn’t likely to have a cervical spine (C-spine) fracture. Investigators included more than 14,000 patients in the analysis, and using a 2×2 contingency table for analysis, concluded the test had a specificity (the probability of a positive test actually being positive) of 99%, a sensitivity (the probability of a negative test actually being negative) of 54%, and a predictive value negative (proportion of true negative tests) of 99.9%. This means that patients who met all the criteria were almost 100% not likely to have C-spine injury.

What Happens When You Get Alcohol Poisoning?

From Gizmodo:

First of all, “‘Alcohol poisoning’ is a layman’s term,” says Doctor L, our ER doc-friend who asked to remain anonymous due to her university affiliation. “Alcohol intoxication is a spectrum and there isn’t a specific threshold that one crosses and suddenly becomes ‘poisoned.'” Makes sense. After all, alcohol is a toxin and our body treats it as such, regardless of quantity. Even a single glass of champagne (or wine, or beer, or whatever) will result in some ‘poisoning,’ it just won’t be very severe for most people. On the other hand, some people have a very tiny threshold for alcohol, and even half a glass can send them running to the bathroom. Food intake, sleep, and a person’s physiology are just a few of the variables (you can read about that here).