January 3rd, 2012 by DrWes in Opinion, True Stories
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The call never should have been made.
It broke every proscribed rule.
After all, I was not on call. Thanks to the wonders of computer technology, it was very clear that I was being covered by my colleague. And yet, despite this, it came.
“Dr. Fisher, I’m so sorry for calling you at home, but I received a call from Ms. X, the wife of your patient Mr. Y. who said she really needed to speak to you about her husband… she seemed quite concerned and insisted I call you…. I told her I’d see if I could reach you at home… I’m so sorry, but it sounded urgent… I have her number, could I connect you?” Read more »
*This blog post was originally published at Dr. Wes*
November 27th, 2011 by DrWes in News, Opinion
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It was an interesting tweet that referenced a soon-to-be-published case report from the Annals of Emergency Medicine (via @EmergencyDocs) that piqued my interest:
Thrilling case study: emergency doc cracked chest to save 42 y/o woman in cardiac tamponade after ablation therapy. http://bit.ly/umnydc
Details about the case are quite specific and the case report heralds from a town in Minnesota. It describes, in very specific detail, the management of a patient who presented to the emergency room in shock from cardiac tamponade after a catheter ablation procedure for right ventricular outflow tract tachycardia.
Is this unique case report HIPAA compliant?
I would say, according to our current definition of HIPAA’s “personal health information,” such a case report is Read more »
*This blog post was originally published at Dr. Wes*
October 3rd, 2011 by DrWes in Health Policy, Opinion
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I had a patient with non-valvular atrial flutter denied dabigatran (Pradaxa®) by their insurer recently. The patient had diabetes, hypertension and has had a heck of a time maintaining therapeutic blood thinning levels (prothrombin times).
But those are the rules, you see. Only patients with non-rheumatic atrial fibrillation can get dabigatran, I was told. Dabigatran was never approved for atrial flutter, only atrial fibrillation. Never mind the stroke risk in non-rheumatic atrial flutter, like atrial fibrillation, has been found to be significant.
For my patient, dabigatran would have been the perfect solution.
But increasingly I’m finding the patient is not mine, they’re Read more »
*This blog post was originally published at Dr. Wes*
April 25th, 2011 by DrWes in Health Policy, Opinion
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The above graph from the Cato Institute demonstrates the growing complexity of the U.S. tax code over the years. After doing my taxes recently and trying to track the ins and outs of the law for my wife’s private practice, I can attest to the graph’s accuracy.
But then I was reading an interesting editorial in Circulation: Arrhythmia and Electrophysiology by N.A. Mark Estes III, MD and Jonathan Weinstock, MD that reviewed an article by Roos, et al in the same journal that found only 27 of 698 guideline recommendations from the European Society of Cardiology (median 1.2% per guideline [IQR 0.95% to 3.7%]) were correctly referenced as Class I or III Level of Evidence A recommendations, calling into question the accuracy of guideline recommendations. In their editorial, Estes and Weinstock defended the guideline process but also mentioned the following shocking statistic: Read more »
*This blog post was originally published at Dr. Wes*
April 10th, 2011 by PeterWehrwein in Health Policy, Health Tips
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Opening Day, the first day of the 2011 major league baseball season, was March 31st. The first pitch was thrown a little after 1 p.m., and sometime after that baseball fans heard the first crack of the bat of a brand-new season.
Even nonfans can rejoice at this sign of spring, and a promise that summer days are ahead.
But you won’t hear the crack of the bat very much these days from other diamonds—Little League, high school, and college. It has been replaced by pings and thunks as most players at those levels now use metal bats or composite ones, which that are made with a mixture of materials, including graphite.
Players started using metal (usually aluminum) bats about 30 years ago. They last longer than wooden bats and send the ball farther. The composite models have come on strong more recently.
But there’s growing concern that nonwood bats may pose a safety hazard to fielders—especially pitchers— because they make a hit baseball go faster. The added speed gives fielders less time to react and, if they are hit, increases their risk of injury. Read more »
*This blog post was originally published at Harvard Health Blog*
