The Food and Drug Administration has approved a new treatment that could help millions of older adults who are nearly blinded by macular degeneration. It’s a miniature telescope implanted directly into the eye that magnifies images to more than twice their size. Findings from the clinical trials show that the telescope does improve vision for the majority of patients. Still, there are some concerns about corneal damage, since the telescope is relatively large inside the eye. And the population who might benefit from the new device is somewhat limited. The treatment doesn't work for those who have had cataract surgery. And for those who catch the disease early on, there may be better options.
Paul Cary used to examine up to 30 patients a day at his senior-focused internal medicine practice in Dallas – until he began charging them $1,500 a year to secure a spot in his schedule. The fee cut his workload significantly, but Cary isn't complaining. From his perspective, he traded quantity for quality. Now he can give the lengthier exams his aging patients often need or call pharmacists or specialists on their behalf. Cary's unconventional decision is an example of the rapidly changing nature of geriatric care – and new approaches doctors are taking to meet the bottom line. As the nation's 78 million baby boomers begin to flood the healthcare system, doctors focused on caring for the elderly find themselves in greater demand, shorter supply and searching for ways to balance costs with quality care. There are fewer than 8,000 trained geriatricians out of more than 900,000 physicians in the United States, according to the American Medical Association. In Texas, less than 1 percent of its 48,712 licensed medical doctors are geriatricians. Experts predict four times as many geriatricians will be needed by 2020 to serve the nation's aging population.
Coronary stents, which have became a multibillion-dollar medical industry, might not be as safe — or as effective — as once thought. But cardiologists are unclear about much more than simply whether stents have medical value, as evidenced by the case of Midei, who is accused of performing hundreds of unnecessary procedures yet is defended vociferously by patients and colleagues. Some doctors still argue over seemingly fundamental details, such as how to measure blockage on an X-ray, or when it is appropriate to choose surgery over stenting or medication. And now they have a new uncertainty to resolve: Will placing a stent lead to a patient's survival or the doctor's indictment?
In December, pharmacist Jim Gotta of Country Store and Pharmacy in Sartell, MN, received a letter from the state of Minnesota instructing him on the right way to dispose of hazardous waste — or else face penalties. The Minnesota Pollution Control Agency informed him that beginning Oct. 1 "all healthcare facilities will be subject to full enforcement of hazardous waste regulations, including the possibility of financial penalties for noncompliance." The MPCA letter gave healthcare providers a website to visit to understand the new regulations being placed upon them as well as to go through the required training needed to handle hazardous wastes. "This new enforcement seems appropriate," Gotta said. "Presently, I'm holding on to all the hazardous waste. I'm sitting on a bunch of stuff that I'm anxious to get rid of. I'm pretty excited about getting this stuff out of the water and landfills."
If you are one of the 133 million American grappling with a chronic illness like diabetes, asthma or heart disease, where do you turn for help managing your condition? Your employer may seem like an unlikely choice. Chronic conditions account for 25% of all medical costs, studies show, and an employee with a longstanding illness can mean higher health care expenses and lower productivity to company bean counters. Yet many firms have come to realize that it makes economic sense to help improve the health of workers who are the greatest users of medical services.
Max DeVries was sedated and awaiting a routine surgery when he rolled off the operating table and hit his head, where doctors had earlier removed part of his skull because of brain swelling following a stroke. The 61-year-old St. Paul man later died and the family contends St. Joseph's Hospital of St. Paul didn't use proper procedures and equipment to safeguard DeVries, who was 5-feet-5 and weighed about 300 pounds. According to a lawsuit filed Thursday in Ramsey County District Court, "The fall from the operating table was a direct cause of, or contributed to, the death of Max DeVries."