Want to know where your doctors earned their degrees? Or how about which physicians are — or aren't — certified by specialty boards for a medical expertise? In Missouri that information has been, literally, a state secret. But a law that took effect last week puts it in the public domain. That information, and more, is available from the agency that regulates doctors, the state Board of Professional Registration for the Healing Arts. Because of the data release, Missouri patients are empowered to make more informed decisions about their health care, said Suzanne Henry, policy analyst at Consumers Union. "By requiring the state to put this stuff up, it gives the patient a much better idea than if you just know this doctor is licensed," Henry said. John M. Huff, director of the Missouri Department of Insurance, Financial Institutions and Professional Registration, called the law "a significant step toward better transparency for patients in Missouri."
It's 7 a.m. and attending physicians from seven of the 10 intensive-care units at Montefiore Medical Center in Bronx, N.Y., gather for their first daily triage session of the hospital's sickest patients. Residents, fellows, nurses and other specialists ring the conference table. More join in via video feed from ICUs at Montefiore's two remote campuses. Bed by bed, unit by unit, they rapidly run through the multiple complex conditions each patient faces, each word telegraphing just how critical the patients are and how long they are likely to need ICU care. Some patients are improving and heading for a less-intensive step-down unit, opening up some beds. Anywhere in the 1,491-bed hospital, a patient could suddenly suffer respiratory, heart or other organ failure and need critical care. And anything from gunshot wounds to auto accidents to a building collapse could bring more critically ill patients into Montefiore's emergency department. As the triage sessions illustrate, handling the flow of patients in and out of the hospital's 78 adult medical and surgical ICU beds, and anticipating who else might need such high-level care on any given day, requires precision management. Many hospitals struggle to do it effectively, but Montefiore doesn't?thanks to several innovations spearheaded by Vladimir Kvetan, director of critical-care medicine, over the past decade.
A new study has a message for doctors and nurses who fail to wash their hands: Don't think about yourself. Think about your patients. Getting healthcare professionals to comply with notices to wash their hands before and after dealing with patients has been something of a thorn in the side of many hospitals. Although this simple measure limits the spread of sickness -- and could potentially reduce the nation's hospital healthcare bill by billions of dollars -- many doctors and nurses simply ignore it. Compliance rates for hand washing in American hospitals are only around 40%, and years of awareness programs urging doctors to wash up or use disinfectant gels have had little effect. Part of the problem, according to a forthcoming study in the journal Psychological Science, are the actual signs posted in hospital washrooms urging health care workers to wash up. Changing the message from "Wash Your Hands to Protect Yourself" to "Wash Your Hands to Protect Your Patients," the study found, could motivate some doctors and nurses to wash their hands more frequently.
A Suffolk County Superior Court jury awarded a South Hamilton couple a judgment of $7 million yesterday in the 2004 death of their newborn daughter at Beth Israel Deaconess Medical Center, according to their attorney. Jurors found Dr. Janet Lloyd and nurse practitioner Michele Ambrosino negligent in the care of Katherine Bellerose, who was born about two months early at the hospital on June 13, 2004, and developed a condition that caused her intestinal tissue to die. The baby's parents, Danielle and John, alleged in their lawsuit that those caring for her in the neonatal intensive care unit failed to recognize that their daughter's health was deteriorating and then took too long to call surgeons after her bowels had become perforated. A lawyer representing the defendants said they provided appropriate care that met medical standards. Premature infants are at higher risk for developing the condition, called necrotizing enterocolitis. William Thompson, the family's attorney, said the intensive care unit staff should have been watching for it in Katherine, who was a twin.
A Hollywood pharmacy has been identified as the source of injection drugs that caused blindness and vision damage in a dozen South Florida patients, federal health officials said. The 12 patients in Miami-Dade and Broward counties developed infections that seriously marred their vision after getting shots of the drug Avastin in their eyes for the disease macular degeneration, said officials and attorneys for some patients. The Food and Drug Administration issued a warning to doctors late Tuesday saying the 12 cases had been linked to one lot of Avastin that was unsealed and repackaged into smaller, individual-dose injections by the Hollywood pharmacy. The government did not name the pharmacy Wednesday, but attorneys who filed lawsuits on behalf of seven patients said federal and state investigators linked all the cases to Avastin from Infupharma, a company that prepares special dosages of drugs. All of the suits named Infupharma as the source of the injections. An Infupharma spokeswoman said the company would not comment because it has been sued. Infupharma is headed by pharmacists Mike and Judith Rizo, corporate records show. The infections appeared in July in patients at three Miami-area physician offices that were treating the eye disease with Avastin from Infupharma, said attorney Philip Gold, who filed suit for a Miami man who went blind in his right eye.
When kids get respiratory infections like bronchitis or the common cold, most times they don't need antibiotics to get better. Many still receive the drugs, however, even after public-health campaigns warning against overuse. Unnecessarily administering the drugs does patients no good and can lead to antibiotic resistance -- potentially rendering the drugs useless against serious infections. New stats out today from the CDC show that antibiotic prescribing rates for kids 14 and under have improved since the early 1990s. But the prescribing rate "remains inappropriately high," the report says. Overall prescribing rates fell 24% to 229 antibiotic prescriptions per 1,000 office visits in 2007-2008 from 300 in 1993-1994. Looking specifically at acute respiratory infections, prescription rates fell 11%; specifically, rates fell 26% for sore throat (pharyngitis) and 19% for the common cold. That's good news, the CDC says. And changes in prescribing behavior are likely at least partly responsible. Fueling the drop in sore throat prescriptions may be a rapid test for strep throat that helps doctors rule out or diagnose that condition -- which can be treated with antibiotics -- on the spot. But the CDC says there's plenty of bad news in the report, too. A full 58% of the antibiotics prescribed for kids in 2007-2008 were for acute respiratory infections and therefore mostly unnecessary.