A large study finds that it is OK to have a non-emergency procedure to open clogged heart arteries in a hospital that doesn't have surgeons ready to operate if something goes wrong. The results could help make this much more available in rural areas and at smaller community hospitals. The procedure, called balloon angioplasty, has become so safe that surgical backup is no longer needed when treating low-risk, simple cases, doctors say. Only about 20 states allow this now, and hospitals in some areas have sued so they can offer it. "The intent of this project was not to expand the number of centers doing angioplasty" but to give policymakers an idea whether it is safe, said study leader Dr. Thomas Aversano of Johns Hopkins University. He presented results Monday at an American Heart Association conference in Florida.
Personalized calls to patients are part of a new approach to primary medical care that Maryland is testing across the state. Instead of a doctor seeing patients mostly when they're sick — and the physician is getting paid for that visit or service — this program gives financial rewards to practices that use a team of doctors, nurses and other staff to treat the whole person on a continuing basis, not just for one illness. The team focuses on patients with chronic conditions, develops individual care plans, and coordinates with specialists. Emphasis is on prevention and comprehensive care. For a patient, it is like having a doctor's office that acts like mom — with nags and nudges designed to promote better health. The state initiative is among dozens of public and private experiments across the country that are trying to fundamentally change the way doctors practice medicine.
It would seem almost inevitable, yet still hard to fathom: rival gang members, angered and perhaps aggrieved over some recent disagreement, seek to continue or end the dispute the next time they meet — even if that encounter occurs at a hospital. This happened on Wednesday, in a waiting area at Bronx-Lebanon Hospital Center's emergency room. A man being treated for facial injuries bumped into a rival gang member who had also shown up at the hospital, and both of them called for backup crews who came to the hospital that evening. One of those who came to the hospital brought a gun and fired it, wounding a hospital nurse and a security guard. But even though hospital emergency rooms often sit at the intersection of mayhem and medicine, they tend to be fire-free zones to New York's criminal class.
Starting next year, health facilities and providers in Illinois that perform screening and diagnostic mammograms will receive higher Medicaid reimbursement for the procedures if they voluntarily submit data showing how well they identify small cancers and track women with abnormal mammograms, among other quality measures. The new program expands a project of the Metropolitan Chicago Breast Cancer Task Force, formed in 2008 with the aim of reducing deaths from breast cancer for all women and closing a glaring gap in death rates between black and white women.
A database of doctor discipline and malpractice records blocked by the federal government in September was made public again Wednesday with new restrictions for anyone who wants to use it. Before downloading the public file of the National Practitioner Data Bank maintained by the U.S. Health Resources and Services Administration, users must agree not to identify individual doctors and to delete or return any data at the request of the government agency. The data bank is a record of malpractice and discipline records intended for hospitals to check doctors' backgrounds. The public file of the data was stripped of doctors' names but has been used for years by reporters and researchers to analyze trends and identify problem doctors by cross-referencing with court and medical board records.
A woman's mammography results should tell her if she has dense breasts, so that she'll know the test may miss a breast cancer diagnosis, a radiologist told a federal advisory panel on mammography. Women with dense breasts are more likely to develop breast cancer, and their cancers may be more aggressive, recent research has found. Those who've already had breast cancer are more likely to have a recurrence if they have dense breasts. But tumor cells may be impossible to distinguish from normal cells on mammograms of women with dense breasts because both show up as white areas. "With dense tissue, cancers big and small are often not visible on the mammogram," Lisa Weinstock, MD, the founder of Women's Digital Imaging in Ridgewood, NJ told the FDA's National Mammography Quality Assurance Advisory Committee at their meeting on Friday in Maryland.