Do doctors spend too much time with computers?

From Reuters:

For every hour that some doctors devote to direct patient care they may spend about five hours on other tasks, often because they’re tied up with computer work, a Swiss study suggests.

The results are based on observations of just 36 doctors-in-training at one hospital in Switzerland. But research dating back more than half a century has documented physicians dedicating a similar amount of their workdays to direct patient care, said Dr. Nathalie Wenger, lead author of the current study.

Mylan says being investigated over EpiPen practices

From Reuters:

Mylan NV said on Monday U.S. antitrust authorities had launched an investigation into its EpiPen emergency allergy treatment.

The Federal Trade Commission had asked the company for information months ago as part of a preliminary investigation, a company spokesperson said in an email.

The company did not provide any further details on the investigation but said suggestions it took any inappropriate or unlawful actions to prevent generic competition was “without merit.”

Five physicians affected by Trump’s immigration executive order

From Becker’s:

President Donald Trump signed an executive order on Jan. 27, which bans nationals from Iran, Iraq, Libya, Somalia, Sudan, and Yemen from traveling into the United States for 90 days, bans Syrian refugees indefinitely and suspends the U.S. refugee program for 120 days, according to The Wall Street Journal and New York Times.

Several physicians who are citizens of one of the countries included in the travel ban who were traveling overseas attempted to return this past weekend and were affected by the executive order. A few were detained for hours before returning home while others were unable to board their flights back to the U.S.

On Jan. 28, a federal judge issued a temporary injunction that blocked travelers held at airports from being detained.

Here are five physicians who were affected by President Trump’s travel ban.

Banner Health reduces patient admissions by 50% through telehealth initiatives, study finds

From Becker’s:

Phoenix-based Banner Health, through a collaboration with healthcare IT firm Royal Philips, utilized telehealth initiatives to reduce patient healthcare costs and hospitalization rates by roughly 50 percent in one year, an in-house study found.

The Intensive Ambulatory Care pilot program, developed in conjunction with Royal Philips, treats patients with complex medical conditions through telemedicine solutions. To study the IAC’s effects on patient care, researchers examined 128 patients who had at least one year of pre-IAC follow up and one year of post-IAC follow up.

Clinicians found the program reduced overcall costs of care for patients participating in the program by 34.5 percent, the number of hospitalizations by 49.5 percent, the number of days patients spent in the hospital by 50 percent and patients’ 30-day readmission rate by 75 percent.

Rule could take one-third of chest pain patients off emergency department heart monitors

From EurekAlert:

Ottawa researchers have validated a rule that could safely take a third of chest pain patients in the emergency department off of heart monitors, according to a study published in the Canadian Medical Association Journal. Implementing this made-in-Ottawa rule could free up these monitored beds for sicker patients and reduce wait times.

“Chest pain is one of the most common reasons people visit Canadian emergency departments, with around 800,000 visits a year,” said Dr. Venkatesh Thiruganasambandamoorthy, lead author of the study and a scientist and emergency physician at The Ottawa Hospital and an assistant professor at the University of Ottawa. “Between the two emergency departments at The Ottawa Hospital we see around 35 chest pain patients every day, and usually 25 are assigned to monitored beds. This rule would let us safely remove eight patients from these beds, freeing up the monitors for other patients.”

Leaders in Emergency Medicine Promote Diversity

Press Release:

An editorial published online Friday in Annals of Emergency Medicine launched the official kick-off of a campaign to promote diversity within the specialty of emergency medicine (“Why Diversity and Inclusion Are Critical to ACEP’s Future Success“).  Written by two American College of Emergency Medicine (ACEP) presidents (one current, one former) and the immediate past president of the American Medical Association (AMA), the editorial announces the inclusion of diversity as an integral part of ACEP’s Strategic Plan.

The United States is culturally and racially varied, which is reflected in our nation’s emergency departments,” said the president of ACEP, and one of the paper’s authors, Rebecca Parker, MD, FACEP. “As a specialty, emergency medicine is in a unique position to serve this diverse group of patients. As ACEP’s president, I am committed to promoting diversity and inclusion within our specialty for the well-being and resiliency of our members as well as the improvement in patient care.”

The paper is the result of a diversity summit held in April 2016 at ACEP’s headquarters in Dallas, Texas. ACEP has a diversity and inclusion task force led by Aisha Liferidge, MD, FACEP, examining how ACEP can promote diversity and inclusion within emergency medicine by engaging colleagues, identifying and breaking down barriers, and highlighting the effects of diversity and inclusion on patient outcomes as a path to improving these outcomes.

“Embracing diversity and inclusion in the workplace and our professional societies can improve patient care,” said Dr. Parker. “The Institute of Medicine identified the under-representation of minority clinicians as a contributing factor to health care disparities in our country. Increasing the number of women and minority physicians in the emergency department can increase cultural sensitivity to the patients we treat.”

The medical workforce remains predominantly white and disproportionately male, though in recent years the ranks of women in medical schools and residency programs have grown: In 1970, women comprised 7.6 percent of physicians, but in the past year just over 45 percent of all medical school students were women. Approximately 44 percent were from a racial minority. The percentage of women in emergency medicine residency programs has grown from 27 percent to 38.5 percent over the last 20 years. During the same period, the growth in the percentage of non-white physicians in emergency medicine residency programs has grown from 23 percent to 34 percent.

The paper recommends a strategic focus on diversity as good for business, good for ACEP’s reputation internally and externally, good for clinical quality improvement in emergency medicine and good for legislative advocacy.

The third author of the paper, Steven Stack, MD, FACEP, the immediate past-president of the AMA, concluded: “Diversity is a strength and asset to our specialty and to our patients. Together we are stronger. Though there have been efforts by numerous medical and health-related associations, it is fair to say that most medical societies have failed to achieve the desired outcome of a membership and leadership reflective of the society we serve. Actively understanding and embracing diversity will transform the practice of emergency medicine. The journey will be challenging and the rewards will be great.”

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical 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. For more information, visit

Expanding the Emergency Room Model: ‘Central Care System’ Could Help Americans Gain Universal Health Care Access

From the Huffington Post:

It may sound counter-intuitive, but sending more people to the emergency room is what I would propose. Instead of offering only emergency services, however, the ER needs to evolve to encompass mental health and primary care clinics to create a “central care system,” allowing more people to be seen. Emergency rooms already provide 24-hour care to people who need urgent medical attention, but also to those whose work schedules or other issues make it impossible to be seen during regular clinic hours. In the ER, the infrastructure already exists to see anyone with a common cold to mental health issues to heart attacks and strokes 24 hours a day, 7 days a week; obtain labs, x-rays and the aforementioned CT scans (computed tomography scans — CT or “CAT” scans). It is logical to use what already works.

Adolescent Admissions to Emergency Departments for Self-Injurious Thoughts and Behaviors

From PLoS:

The objective of the present study was to describe the incidence and the characteristics of Self-Injurious Thoughts and Behaviors (SITBs), among adolescents aged 11–18 admitted, over a two year period, to all the Emergency Departments of a Region of North-eastern Italy through a comprehensive analysis of medical records. A two-step search was performed in the regional ED electronic database. First, we identified the cases that had been clearly diagnosed as SITBs by an Emergency Department physician. Secondly, suspect cases were detected through a keyword search of the database, and the medical records of these cases were hand screened to identify SITBs. The mean annual incidence rate of SITBs was 90 per 100,000 adolescents aged 11–18 years. Events were more frequent in females. Drug poisoning was the most frequently adopted method (54%). In 42% of cases a diagnosis of SITB was not explicitly reported by the physician. In 65% of cases adolescents were discharged within hours of admission. Only 9% of patients started a psychiatric assessment and treatment program during hospital stay. This research confirms the high incidence of SITBs among adolescents and highlights the difficulty in their proper diagnosis and management. Such difficulty is confirmed by the fact that only a few patients, even among those with a clear diagnosis, were sent for psychiatric assessment. Correct identification and management of SITB patients needs to be improved, since SITBs are an important public health problem in adolescence and one of the main risk factors for suicide.

Artificial intelligence can spot skin cancer as well as a trained doctor

From The Verge:

Researchers at Stanford University have created an AI algorithm that can identify skin cancer as well as a professional doctor. The program was trained on nearly 130,000 images of moles, rashes, and lesions using a technique known as deep learning. It was then tested head-to-head against 21 human dermatologists, where its creators say it performed with an accuracy on par with humans (“at least” 91 percent as good). In the future, they suggest it could be used to create a mobile app for spotting skin cancer at home.

Already troubled, rural hospitals brace for effects of Obamacare repeal

From CNN:

The Affordable Care Act, which President-elect Donald Trump has vowed to repeal, threw a number of life-savers to these vital but financially troubled centers. And its full repeal, without a comparable and viable replacement, could signal their death knell.

The health care law expanded Medicaid to tens of thousands of previously uninsured patients, providing new revenue streams for rural hospitals, which often serve a poorer, sicker patient population. The law also created a program that allowed some of these facilities to buy prescription drugs at a discount, though Highlands qualified for that program independently of Obamacare.
“All these rural hospitals are operating on thin margins. The removal of any income source or coverage, or expansion of bad debt, is going to create significant financial hardship,” said Alan Morgan, CEO of the National Rural Health Association.