The phrase “practice makes perfect” has never been more true than in surgery. Research shows that better outcomes are associated with an increased procedure volume. While practicing and completing procedures can affect patient outcomes, the British Medical Journal (BMJ) has found that specializing in a specific procedure may be just as important as the number of times you perform it.
In January 2001, 18-month-old Josie King was rushed to the Johns Hopkins Children’s Center with second-degree burns. She had inadvertently stepped into scalding bath water. The child’s mother, Sorrel King, stayed at her child’s bedside as doctors and nurses valiantly administered to the child. A couple of weeks later Josie seemed well enough to be sent home. A celebration was planned, but then everything went downhill. The toddler became acutely sick. Her mother suspected dehydration, but nobody seemed to listen. When they did, it was too late. Josie was battling two infections—one was from a central venous line that led to sepsis. It ultimately took her life.
The Patient Protection and Affordable Care Act (ACA or “Obamacare”), signed into law March 23, 2010, requires everyone—including children—to have health insurance or pay a penalty. The law aims to have health insurance cover the services people need so that they won’t suffer financial ruin if an unexpected medical event occurs.
In its 2016 July issue Nephrology News and Issues published its annual survey of dialysis providers. Fresenius Medical Care and DaVita control the hemodialysis market with 84%, which translates to 366,000 patients out of a total of 433,000 patients.The two companies employ more than 135,000 employees. DaVita further solidified its position as one of the top players in the market with its 2015 acquisition of Renal Ventures Management, which added 2,387 patients to its roster. U.S. Renal Care, the third largest company, bought DSI Renal. Other mid-sized companies with national coverage are Dialysis Clinic Inc., American Renal Associates Inc. and Satellite Heathcare Inc. The top 10 are:
Introduced in January 2014, the Center for Medicare/Medicaid's (CMS) Star Ratings for dialysis facilities are intended to help patients know how dialysis clinics rate for quality measures. A 5-star rating for a facility indicates that its quality of care is considered “much above average” compared to other dialysis facilities. A 1- or 2-star rating indicates that measured outcomes were below average compared to those for other facilities.
John has end-stage renal disease (ESRD) and goes for hemodialysis three times a week at his local dialysis clinic. By all accounts, John seems to be handling his hemodialysis treatments well.
At the end of one of his sessions, John doesn’t feel well. He assumes it has to do with his recent treatment and figures he’ll feel better shortly. He leaves the clinic, but fails to show up for his next hemodialysis treatment.
As a surgeon, you're keenly aware of the danger of medical errors and extremely diligent to avoid making them.
Medical errors as a cause of death now rank as the third leading cause of death, behind heart disease and cancer in the United States. Researchers at Johns Hopkins University School of Medicine found that errors result in the deaths of around 250,000 patients per year.
A new challenge. A change of pace. For a profession that involves a lot of intense clinical work, these phrases might seem foreign to many cardiovascular perfusionists. But they don’t have to be.
The profession is evolving thanks to advancements in technology and medical procedures, and like other medical professionals, you can take advantage of locum tenens opportunities to expand your horizons, face new challenges or simply travel. It can be a career-shaping opportunity for many professionals.
In newly released follow-up data, Dr. Robert Michler, et al. found there was no significant benefit in patients with moderate ischemic mitral regurgitation who underwent coronary-artery bypass grafting (CABG) with combined CABG and mitral-valve repair.
According to the study, “Patients with CABG and mitral-valve repair had an early hazard of longer hospital stay post-surgery, a higher incidence of postoperative supraventricular arrhythmias and higher rate of serious neurological events than those with CABG alone. There was a threefold higher incidence of persistent mitral regurgitation in this same group without evidence of higher mortality or adverse clinical events.”
Are sleep-deprived surgical residents more likely to make serious medical errors? According to the Accreditation Council for Graduate Medical Education (ACGME) they were, and as a result, the council implemented changes in 2003 limiting the number of hours residents can work per week and increasing the amount of time off between 24-hour shifts.
However, those work restrictions may soon be a thing of the past thanks to new research published in the New England Journal of Medicine. Researchers wanted to discover if loosening the 80-hour workweek restriction and time off between 24-hour shifts had any effect on patient outcomes. What they found was surprising.