Most doctors and nurses don’t know what ER care costs

From Reuters:

Less than half of doctors and nurses working in emergency rooms know what some of the conditions they see most often cost to treat, a recent U.S. study suggests.

Researchers asked 441 emergency medicine clinicians to estimate the cost of care for three common scenarios: a 35-year old woman with abdominal pain, a 57-year old man with labored breathing and a 7-year old boy with a sore throat. Each case included a medical history, results from physical exams and lab tests as well as a rundown of any treatments provided.

Then, researchers asked participants to choose one of four price ranges for each scenario: less than $2,000; $2,001 to $4,000; $4,001 to $6,000 or $6,001 to $8,000.

Just 32 percent of respondents got the right price range for the scenario of the man with labored breathing, which cost $2,423. Only 40 percent of clinicians picked the correct price range for the kid with a sore throat, whose cost was $596, while 43 percent of participants chose the right price range for the case of the woman with abdominal pain that had charges of $4,713.

Telepsychiatry helps with mental health burdens in rural Missouri

From the Post-Dispatch:

Missouri has seen a rapid growth in “telepsychiatry” services. Health providers see the technology as a powerful solution to the severe shortage of specialists able to diagnose and prescribe medications for mental disorders — a dangerous scenario that has contributed to higher rates of hospitalizations, emergency room visits, drug addiction and suicide in rural areas.

Compass Health Network, whose health care facilities serve rural residents across the state, provided more than 36,000 telepsychiatry sessions last year at its Pathways and Crider Health clinics in 26 cities. That is more than triple the 11,000 sessions provided just five years ago, officials say.

Mercy Health’s primary care clinic in Rolla began providing pediatric telepsychiatry to its patients five years ago and now reaches 650 children a year. Mercy is working to integrate the technology into more of its rural primary care clinics.

Female physicians called ‘doctor’ less than male counterparts, study finds

From Becker’s:

A recent study sought to quantify anecdotal evidence that men in academic medicine use gender-subordinating language when addressing their female peers by not using professional titles.

Researchers analyzed archived video of same and mixed-gender speaker introductions at Internal Medicine Grand Rounds held at two locations of an academic medical center. They found female introducers almost always used professional titles when introducing speakers, male or female (97.8 percent for female speakers and 95 percent for male speakers). Male introducers were less formal — they were less likely to use formal titles when introducing speakers of either gender. However, male introducers were significantly less likely to acknowledge a speaker’s credentials if she was a woman, the researchers observed. Men introducing other men used professional titles such as “doctor” 72.4 percent of the time. Men introducing women used professional titles just 49.2 percent, according to the study.

‘I knew they were sugar pills but I felt fantastic’ – the rise of open-label placebos

From the Guardian:

Dr Jeremy Howick first began asking about placebos when a herbal doctor suggested he drink ginger tea to combat cat allergy symptoms. He was highly sceptical, but three days later his runny noses, sneezing and insomnia stopped. Twenty years later, Howick is a clinical epidemiologist at the University of Oxford. Last month, his group published a review of previous research that has compared the effects of giving patients open-label placebos with no treatment.

The first was led by Professor Ted Kaptchuk, of Harvard Medical School, who gave 80 IBS patients, including Buonanno either no treatment or open-label placebo pills. He found those who took placebos for three weeks experienced greater improvements in symptoms, including less severe pain. Sadly for Buonanno, when the study ended she was unable to obtain further effective placebos and her symptoms returned.

In another of the studies in Howick’s review, chronic lower back pain patients openly given dummy pills to add to their existing treatments reported an average 30% pain reduction. In the three other review studies, people given open-label pills reported reduced symptoms for depression, lower back pain, and attention deficit hyperactivity disorder.

Likelihood of having current CPR training declines with age

From Reuters:

Older people are the group most likely to need cardiopulmonary resuscitation (CPR), but they are the least likely to have training in the life-saving technique, according to new findings.

“This mismatch may translate into lives lost, because if someone collapses at home who is 65 years old and their 62-year-old spouse does not know CPR, they have to wait for the ambulance to arrive and it may be too late,” said Dr. Benjamin S. Abella, who directs the Center for Resuscitation Science at the University of Pennsylvania in Philadelphia. “We need to be more creative about our approach to CPR training in this population.”

Kidney Stones Fly Out Of People On Roller Coasters, Surgeon Discovers

From All That Is Interesting:

Using a 3D printer, Wartinger made a silicone replica of the three-stone-Thunder-Mountain-man’s kidney and filled it with fake stones and his own very real urine.

Then, like a championship-winning quarterback, he went to Disney World.

Wartinger and his colleague, Marc Mitchell, packed their fake kidney in a backpack with a plan to hold it between them on the ride.


Wisconsin proposal would help keep chronically ill out of emergency rooms

From the Journal-Sentinel:

Last year in Wisconsin, thousands of people visited an emergency room more than seven times each — a stream of bad outcomes for taxpayers, the health care industry and the patients themselves.

To respond, lawmakers voted last week to give hospitals a powerful financial incentive to reduce emergency room costs within the state’s Medicaid health programs for the needy.  The pilot proposal: Work with diabetics and patients with asthma and heart disease to control the health conditions that are landing them in the emergency room. If successful, the proposal could mitigate millions of dollars in unnecessary costs for taxpayers and give patients better lives to boot.

The approach: Pay health care providers to prevent bad outcomes and emergency room visits for patients rather than paying them even more to provide emergency room care after a patient has had a bout with asthma, or worse yet, a heart attack.

Medical implants and hospital systems are vulnerable to hackers

From Boing Boing:

Medical devices have long been the locus of information security’s scariest failures: from the testing and life-support equipment in hospitals to the implants that go in your body: these systems are often designed to harvest titanic amounts of data about you, data you’re not allowed to see that’s processed by code you’re not allowed to audit, with potential felony prosecutions for security researchers who report defects in these systems (only partially mitigated by a limited exemption that expires next year). What’s more, it can get much worse.

A pair of new studies from independent security researchers show that things are as bad or worse as they’ve ever been in the domain of implants and hospital systems.

See Also: There Are ‘Thousands’ of Bugs Making Pacemakers Vulnerable to Hackers

Direct Relief and Pfizer donate 1 million doses of naloxone to health providers

From Modern Healthcare:

A leading humanitarian organization known for providing medical aid to impoverished countries and disaster zones is now setting its sights on helping U.S. healthcare providers combat the opioid epidemic.

California-based charitable medicine program Direct Relief has partnered with pharmaceutical giant Pfizer to donate up to 1 million doses of the drug overdose-reversal drug naloxone to free health clinics, community health centers, public health departments and other not-for-profit providers nationwide.

Implementing Telemedicine in a Skilled Nursing Facility To Reduce Emergency Department Visits

From the Arizona Telemedicine Program:

Telemedicine offers great promise as a strategy to reduce the skilled nursing/emergency department loop.  Telemedicine can be powered by a specialized telemedicine cart or a computer with a camera that facilities a live video connection between a patient and nursing assistant at the facility and the off-site resource (physician or nurse).  When deployed and used, it reduced unnecessary patient transportation to the emergency department for non-emergent situations.

For most facilities, the barriers to telemedicine adoption are the perceived expense of the equipment or software.  In fact, an iPad at the bedside loaded with Zoom or VSee could suffice. Important factors for success tend to be operational ones.  The facility must have physicians or nurses available for consultations.  Documentation of the visit must occur.  One strategy is to have the after-hours coverage physician or nurse staff the telemedicine platform and chart in the existing Electronic Medical Record.  Telemedicine allows the physician to assess the situation from his or her home and drive to the facility only if “hands on” treatment is required.  In short, telemedicine can be an inexpensive and effective tool to reduce transportations and increase patient access to physicians.