Texas rural communities endangered as spiral of hospital closures continues with two more

From Healthcare Finance:

In what advocates say is a continued downward death spiral for their state, two more Texas rural hospitals closed for good earlier this week, bringing the total count of rural hospital closures in the Lonestar State to 18 in the last four and a half years alone, according to the Texas Organization of Rural and Community Hospitals or TORCH.

A hospital in Trinity, Texas closed on August 1, and another in Crockett, Texas on July 1. The closures leave those communities without immediate access to emergency and other hospital care services.

“This closure crisis, which has left many rural communities without emergency and other care, has clearly reached epidemic proportions and unless the Texas Legislature and Congress take immediate steps, it will only worsen,” said Dave Pearson, CEO of TORCH.

Should older doctors be examined, tested or forced to retire?

From Reuters:

… a new review of the literature on aging physicians questions the competency to practice of older physicians like Stockdale. The report in JAMA Surgery recommends that healthcare organizations develop protocols for testing doctors of a certain – though undetermined – age for health and competence.

“This is clearly a discriminatory policy if you pick an age to test,” said Stockdale, a professor at the Stanford University School of Medicine in Stanford, California, who was not involved in the review.

The medical community has grappled with the question of whether to test aging physicians, particularly surgeons, for two decades, if not longer. But the graying of the nation’s physicians has energized the debate over their health and competence.

During the past four decades, the number of practicing U.S. doctors who were at least 65 years old more than quadrupled. By 2015, nearly one in four physicians were 65 or older, the authors write.

Emergency docs advised to exercise caution with solo CT interpretation

From HealthImaging:

Comparing CT interpretations made by emergency physicians with those from radiologists reading the same scans, researchers in Iran found an agreement rate of 68.2 percent, leading them to urge caution among emergency doctors who feel pressured to supply their own reads for critical cases in the absence of an on-call radiologist.

A total of 170 scans were read first by attending emergency physicians, who then initiated treatment.

Within 12 hours of the first read, radiologists blinded to the first reads interpreted the scans.

For the study, the radiologists’ reports were grouped as either in agreement or disagreement with the ED doctors’ interpretations. A panel of experts evaluated the disagreement groups’ medical charts and placed them in clinically significant or insignificant group based on the follow-up for 28 days.

The researchers found that, in the clinically significant disagreement group, eight patients did not receive the required treatment, and three patients were over-treated.

Millions of Americans live nowhere near a hospital, jeopardizing their lives

From CNN:

The recent debates over the Affordable Health Care Act raised concerns that millions of Americans could lose access to health care. But already, there are many Americans who live in areas where critical-care services are lacking.

A recent study estimates that nearly 30 million Americans don’t live within an hour of trauma care. And a CNN analysis found that residents living in 16% of the mainland United States are 30 miles or more away from the nearest hospital.

Paramedics linking with ER docs could mean treatment at home

From Barrie Today:

Thanks to technology, paramedics can connect with emergency room physicians to assess, and sometimes treat, patients right where they are, he said, which will save time, enable paramedics to go to other calls and reduce demand in hospital emergency rooms.

“The Ontario Telemedicine Network is like FaceTime on steroids. You can use a device to link up to a digital stethoscope,” said Robert.

“You’re dizzy and not feeling well and you call 911. We’d do an assessment. Maybe you’d fit the protocol to be assessed at home. The doctor in emerg would hear your breath sounds and heart sounds. We even have an audioscope (to look in your ears).”