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Sensing Savvy

Thomas Gole, DO, FAAFP

Thomas has been a physician for more than 25 years. He is board certified in family medicine, completing his family medicine residency and earning the honorary degree of fellow, granted by the American Board of Family Medicine (AAFP). Thomas has been a teacher and mentor of medical students and residents for more than a quarter century and served as an assistant family medicine residency director for more than a decade.

Recent Posts

How Working Locum Tenens can Reduce Surgeon Burnout

Posted by Thomas Gole, DO, FAAFP on Aug 10, 2016

You struggle to get yourself to the hospital for your shift. You’re not as engaged with patients and your peers as you once were. You might even find yourself dealing with feelings of anxiety and depression. You’re likely suffering from burnout, and like over half of your colleagues, you’re not alone.

Over 50 percent of surgeons report feelings of burnout. Researchers also found that rates of burnout among surgeons increased between 2013 and 2016, with female surgeons experiencing burnout more often than their male colleagues.

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Topics: Cardiothoracic

Ways to Reduce Dialysis Nurse Burnout

Posted by Thomas Gole, DO, FAAFP on Aug 4, 2016

Twelve-hour shifts, sleep deprivation, skeleton staffing, and difficult patients. For nurses, these working conditions come with the profession. However, being on the front lines of patient care can have deleterious effects for those providing care.

Nurse retention and burnout plague many hospitals and health systems, but nowhere is the issue more prevalent than among dialysis nurses. One in three dialysis nurses in the United States experiences burnout. That’s because these nurses are usually more overworked, underpaid and, at times, undervalued than their peers in different specialties, says Francyne N. Rosenstock, vice president of Business Development and Marketing for Renal Reserve. 

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Topics: Hemodialysis

The Latest on Obamacare Funding and Healthcare Policies

Posted by Thomas Gole, DO, FAAFP on Jul 25, 2016

Many low-income Affordable Care Act patients will be seeing higher co-pays and deductibles at hospitals and doctor’s offices if the May 2016 decision by federal Judge Rosemary Collyer stands.

But the ruling doesn’t just affect the finances of patients: Your hospital could take a hit, too. Here’s what you need to know about the latest happenings with Obamacare funding and other healthcare policies:

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Topics: Hospital Administration

Medical Errors as a Cause of Death: 4 Things to Know

Posted by Thomas Gole, DO, FAAFP on Jul 20, 2016

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.

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Topics: Clinical Trends, CABG Surgery

How to Increase Efficiency in the Operating Room

Posted by Thomas Gole, DO, FAAFP on Jul 18, 2016

One of the costliest areas in a hospital is the operating room. Despite its high costs, the OR is also one of the top revenue generators, bringing in between $15 - $20 per minute, and that’s just for a basic surgical procedure.

But as budgets become tighter and patients and insurance companies seek a greater value for their money, hospitals are examining ways to increase efficiency in the operating room. Imagine the money and time wasted each time a case is delayed by a search for a piece of missing equipment.

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Topics: Hospital Administration, Cardiothoracic, CABG Surgery

Are Transonic Access Flow Measurements the Standard of Care?

Posted by Thomas Gole, DO, FAAFP on Jun 29, 2016

After reviewing and comparing various methods of surveillance of AV grafts and fistulas, a London, Ontario group of physicians concluded that Transonic’s ultrasound indicator dilution methodology (Kriviski Method) is the gold standard for measurement of vascular access recirculation and access flow. It is the method of choice for monthly surveillance of vascular access grafts in adherence to NKF-KDOQI guidelines.

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Topics: Hemodialysis

Study: AV Graft Flow Measurements Important for Proactive Surveillance

Posted by Thomas Gole, DO, FAAFP on Jun 20, 2016

Indiana University clinicians studied 71 patients with PTFE grafts with venous pressure and flow measurements and evaluated the grafts after one year. They found the average initial graft flow was 900 mL/min, graft flows differed significantly between failed and patent grafts, and that venous pressures did not indicate access failure.

Of particular significance and interest was their finding that a single graft flow measurement was not useful in clinical decision-making. Investigators had tried to predict graft thrombosis for a 12-month period based on one access flow measurement at the onset of the study knowing that grafts without maintenance will generally clot within six to 12 months.

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Topics: Hemodialysis

Top Children’s Hospital Assesses AV Access Flow Monitoring

Posted by Thomas Gole, DO, FAAFP on Jun 13, 2016

Although ultrasound dilution (UD) monitoring of AV access flow is widely used in adult HD units for early stenosis detection, its experience in pediatric units is limited. Therefore, a group at Boston Children’s Hospital conducted a study to evaluate the impact of UD monitoring on AV access-related morbidity, especially access thrombosis.

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Topics: Hemodialysis

A Nephrologist's Role in Vascular Access Management

Posted by Thomas Gole, DO, FAAFP on Jun 10, 2016

In an article in Nephrology, Dialysis and Transplantation, leading Italian nephrologists Drs. Carlo Lomonte and Carlo Basile address the often undefined role of the nephrologist in the management of the vascular access in hemodialysis patients.

They call for a more active role of the nephrologist in leading a team of experts to efficiently address the multi-faceted issues of the ever-increasing number of dialysis patients with multiple comorbidities. In preparation for such a role, they advise that nephrologists undergo a comprehensive vascular access management training program that would include education on techniques for thorough examination of patients, proficiency in using and correlating Doppler ultrasound with clinical surveillance and access blood flow screening, vascular access planning, vascular mapping and intervention.

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Topics: Hemodialysis

How Medicaid's Final Rule Changes Affect Hospitals

Posted by Thomas Gole, DO, FAAFP on Jun 6, 2016

The Centers for Medicare and Medicaid Services (CMS) recently announced an update to Medicaid and the Children’s Health Insurance Program (CHIP). Medicaid's final rule is an attempt to modernize and strengthen the quality of care of its low-income healthcare program.

Thanks to the Affordable Care Act, Medicaid has seen substantial growth, and now 80 percent of enrollees are served through managed care delivery services.

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Topics: Hospital Administration

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