To increase access to medical for our nation’s veterans, the Veteran’s Choice Act authorized the VA to pay for more medical provided to veterans from community health providers. How did the VA save money in that scenario? It either “lost” claims in which providers had proof of submission or it just delayed paying the claims so that veterans would be billed for the treatment. Now providers are refusing to contract with the VA due to all of the hassles. The VA said that it was making interest payments to providers who received delayed payments, but none of the people testifying to a Senate subcommittee had received such payments.
And this is the type of system that we’re all hoping to adopt for our nation’s healthcare?
Thought provoking article in American Thinker where a physician compares defensive medicine to defensive policing. Both professions can involve life-or-death decisions in which not all information is always available. Physicians may respond by ordering more tests “just to be sure.” Police may respond by ignoring criminal activity or by delaying a response to a crime to avoid any conflicts.
“The natural response is to avoid the high-risk situations. Stop accepting new patients, particularly sick patients with a greater chance of complications. Order extra tests to avoid missing a diagnosis, however unlikely. For police, just look the other way. Take your time responding to a distress call. Don’t make the arrest. And watch the crime rate climb.”
How grubby are children’s hands? This mom put her 8 year old’s hand on an agar plate after he had been playing outside. What grew on the plate appears remarkable on its face, but many microbiologists who commented on the project said the agar would probably have grown out the same material even if the kid had washed his hands before putting it on the agar plate. Still a pretty cool picture.
Speaking about bacteria, a recent study from the University of Iowa shows that chronic exposure to Staph aureus superantigens in rabbits causes type 2 diabetes. According to this article in Science Daily, the researchers are now working on a vaccine to the superantigens and also doing studies to determine whether topical antibiotic gels may affect glucose levels.
Stay off of the internet while you’re working in the hospital … unless you’re trying to game the system to improve the hospital’s ratings on Yelp, HealthGrades, ZocDoc, and other web sites. Hospitals are now hiring “reputation managers” whose job it is to improve the hospitals’ online reputations.
Wait. Patients can die from Z-Paks? Who would have imagined? NY Times Wellness Blog tells story of a patient who underwent surgery to fix a broken arm, got postoperative antibiotics to prevent a wound infection, then developed a recurrent Clostridium difficile infection and died. As the article notes, C. difficile causes almost 500,000 infections per year and more than 29,000 deaths per year.
The expert interviewed for the article noted that “most antibiotics ‘are being used inappropriately, for things like upper respiratory infections that are caused by viruses.’ And eating yogurt or taking commercially available probiotics while on an antibiotic have not proved protective, he said. However, in England, where a program of more judicious use of antibiotics was put into effect, C. diff. infections have declined.
Doing genetic testing for diseases? Be careful about relying upon the results. Not all genetic testing is created equal.
Nonurgent cases account for 80 percent of all emergency department visits in Jeddah, Saudi Arabia. Private health department director notes that “this rush also adds to patients waiting a long time to get treatment and their negative effects on doctors and on other patients whose health conditions are critical.”
Is nitrofurantoin effective for use in patients with reduced kidney function? The simple answer is “yes”, but other antibiotics such as Cipro and Bactrim had half as many treatment failures (6.5% versus 13.8%) in women with a low estimated GFR (average 38 ml/min/1.73m2).
OK, this isn’t medicine, but it is science. And dammit, I wish I knew about it a couple of years ago. How do you get the smell of skunk out of a dog’s fur? Tomato juice? Peanut butter? Nope. Mix a quarter cup of baking soda and a couple of teaspoons of liquid soap into a quart of 3% hydrogen peroxide and wash your dog down with it. The dog might turn blonde, but the smell will disappear.