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Healthcare Update — 12-31-2015

How well are patients in one Norwegian emergency department having their pain managed? According to this study in the Scandinavian Journal of Trauma, Resuscitation & Emergency Medicine, not very well. Of patients with moderate to severe pain (58% of all study participants), only 14% received pain medications. The authors note that
“Pain management is accepted as a quality indicator of care, and additional focus on strategies to improve pain management in the ED is necessary to ensure that all patients receive optimal pain assessment and treatment.”
First of all, not all patients come to the emergency department with pain complaints. It gets idiotic when asking patients with a rash, a runny nose, or a cough about their level of pain.
Second, the study required that anyone with a pain rating more than 3 of 10 be treated for pain. Demanding medication be given for 4 of 10 pain? Give me a break.
Third if you want “strategies” to improve compliance, just take a page from the US playbook. Call pain the “fifth vital sign,” create some silly agency that monitors compliance and documentation of irrelevant metrics (you can call it NJCAHO), and create another agency to send out patient satisfaction surveys having little or nothing to do with assessing proper medical care. You’ll get 90+ percentile compliance guaranteed. Of course, then you’ll also create an incentive to prescribe an order of magnitude greater number of pain medication prescriptions, the number of deaths from drug overdoses will skyrocket, you’ll have to create a whole different system to monitor and track patients who become addicted to the pain medications and try to con doctors into writing prescriptions for more medications, other countries will make fun of your citizens for all the pain medications they use, the morale of the healthcare providers in your country will take a hit, and eventually fewer people will want to go into the healthcare profession.
But the pain will be better controlled.

Want to see what you’ll look like when you stick to that diet you’re beginning tomorrow for a New Year’s resolution? This web site will give you simulated before and after pictures. Unfortunately, it only has simulated females and it appears to be less accurate as the weight increases. But you can print up a picture to tape to your bathroom mirror to remind you of your goal each morning.

Want some motivational quotes to paste under the before and after pictures? This Inc. article gives you 101 of them. Here are a couple of good exercise-related ones:
The secret to getting ahead is getting started.
No matter how slow you go, you’re still lapping everyone sitting on the couch.

I’ve tweeted about this site before, but for those of you who missed it, if you need to get a full copy of a scientific article, but can’t afford the $30+ fee to download it, the site Sci-Hub will allow you to download full copies of research papers. Just paste the URL of the article into the site and it will provide you with a full copy of the article. It has 47 million articles in its library.

Study in Gut magazine shows that taking proton pump inhibitors (“PPIs”) such as Protonix, Aciphex, Prevacid, Nexium, Prilosec, and Dexilant is associated with unfavorable changes the bacteria in the intestinal microbiome. These changes may explain increases in the rate of Clostridium difficile (“C. diff”) infections in PPI users. The study also notes that the changes in gut flora associated with PPI use are “more prominent than the effects of antibiotics.”

Attack of the Glasshole 2.0 nears. Newest iteration of Google Glass appears to rest on one ear and has a prism without the eyeglasses – which will make it easier to slap off of someone’s face when they use it to film you.


One comment

  1. I have resisted taking a daily PPI until recently. It’s been three months. Are there other alternatives? I tried diet modification and frankly, it does not help. I can eat nothing, eat blandly or eat crappy and it is still the same. So I broke down and started taking Nexium. Since I understand the C. diff problems, I don’t want that to happen to me. Boo. Not happy about that read.

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