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Healthcare Update — 07-22-2013

What are the 10 most useless exercise machines? Prevention Magazine lists them for you. Interesting that many of the alternative recommended exercises involve nothing more than body weight and some dumbbells.

One in five US residents makes a visit to an emergency department each year.

West Virginia hospital goes on offensive against drug seekers by limiting the amount of prescriptions for pain pills. Now they’re only going to prescribe enough medications to cover the patient until the patient can see a pain specialist. Only problem is that there is a month or more waiting list to get into the pain clinic. Maybe we’ll just make that a day’s worth of pills, instead.

The Unaffordable Insurance Act is causing many doctors to accelerate their exit plan from medicine. Sixty percent of physicians will retire earlier than planned in the next three years. In addition, many doctors won’t take patients with government insurance because of low reimbursement rates, leading to a “disaster for patients.”
Think about this from a government standpoint, though. To save money on medical care, the payors either need to decrease utilization of medical services or decrease payments to providers. By cutting payments and decreasing the number of providers, they hit both goals. In the end, patients have a harder time making appointments, they are therefore less able to utilize the system, and the government continues taking money from everyone’s paycheck to pay for less utilization. Pret-ty sneaky.

Threat to care of patients with mental health emergencies becomes even more dire. More than one in eleven North Carolina emergency department visits are for acute psychiatric problems or for injuries related to a mental health condition. Those numbers are increasing.
The safety net for Buffalo’s psychiatric patients is being stretched to its breaking point as one hospital closed its behavioral health unit and other hospitals shrink their available beds.Jails have now become de facto holding rooms for some psychiatric patients and the crisis is only getting worse.

What makes mosquitos bite some people more than others? If you go out for a beer after working out in a red shirt, be prepared for the itch.

You know all those recommendations from the CDC about keeping your salt intake low? Now another study of the studies on the subject states that they can’t make any conclusions about whether lowering salt intake increases the risk of heart disease, stroke, or mortality in the US.

From the “Daily Fail” as some people call it, but still an interesting story. Women in Zimbabwe hospital are charged a $5 fee every time they scream during childbirth. Supposedly, the fine is for “raising a false alarm” and amounts to more than a third of the average monthly income.
Wonder how much they charge for breaking wind …

One way that we know the world population is getting older … in seven years, adult diapers are predicted to be outselling baby diapers in Japan. Companies are loving it because adult diapers sell for double the price of baby diapers.

4 year old Washington State child with heart transplant goes into cardiac arrest and suffers permanent brain damage after mother gets phone advice to use Afrin to treat the child’s cold. Jury awards family $15.2 million.
Sad case. But if you ever wanted a reason why you shouldn’t give medical advice over the telephone, this is it.
Another story on the case is here and raises an interesting issue of “causation”. Would the recommended dose of a children’s topical decongestant cause such profound changes on a child’s blood pressure that the child would go into cardiac arrest? That seems like it would be a tough one to prove. Wonder what studies the expert witness in the case relied upon.

St. Louis-area couple wins $6.4 million malpractice verdict after doctor fails to consider bacterial endocarditis as cause of fatigue, loss of appetite, and abdominal pain. Patient develops stroke from septic emboli two months later and unable to work since stroke occurred. Verdict is one of largest in the state.

What’s the incidence of ED visits for priapism in the US? According to estimates in the Journal of Sexual Medicine, there are 8 cases per 100,000 ED visits and fewer patients than you might think had a concurrent diagnosis of sickle cell disease.

As long as we’re on the topic, men out there can review another article in the same journal to see exactly how they “measure” up against the competition. This study compares the self-reported length and circumferences of male genitalia.
The researchers apparently told the study participants that they needed accurate readings so they could get a proper fitting condom. The results are self-reported, though, so the data may not be quite accurate.

3 comments

  1. JAMA got the 1-in-5 number slightly wrong.

    The actual visit data is one American in 15 goes to the ER annually, but half of them go twice.
    That last metric invariably after not following up with a specialist, nor getting any of the Rx meds prescribed in the ED, and therefore perplexed as to why their original condition is still unimproved.

    But kudos to that St. Louis jury who determined a stroke was caused by a doctor’s failure to diagnose from two months prior.
    Evidently Missouri has dropped the bar preventing the mentally retarded from serving on juries, which is clearly a boon to lawsuit-mongering ambulance chasers.

    Do us a favor, Doc, and let us know what the wait is next year to find a GP/IM doctor in MO to see you for fatigue, appetite loss, and abdominal pain, when another 5,000 docs there retire, quit, or move out of state, okay? I’m ballparking that it’s going to be over two months.

  2. The thing about diapers in Japan: lots of people don’t diaper their kids and they toilet train earlier than we do. Look for “Natural Infant Hygiene.” I don’t know much about the reliability of this source, but here’s some info: http://kk.org/cooltools/archives/1050.

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