Archive for October, 2009
Posted on October 31, 2009 01:00:00 PM
What Shari Welch Said.
Ultrasound is a neat toy, and I’m all about toys. I found two opportunities to play with enhance patient care with our ultrasound today on my shift. But it doesn’t have the bang for the buck that the enthusiasts think it does. It has very narrow, but real, utility, and does nothing to generate revenue. It does in some cases enhance patient turnaround, and it certainly enhances patient satisfaction (they love cool toys as much as we do — and extra face time with the doctor to boot!). But that’s a small return on a machine costing tens of thousands of dollars.
But what Dr Welch is griping about is not just the cost of the machine (after all, the hospital pays for that), but about the hassle and time required to generate a professional bill for ED ultrasounds. The rules are fairly clear — you need to archive the images, you need to generate a report comparable to that which a radiologist would have done (which is not to say that you need to perform a complete exam; the “limited” disclaimer will exempt you from the requirements for a complete exam, though you will bill out at a lower code as a result), and you need to perform regular Quality Assurance. It’s a big commitment, and if you are really going to comply with these rules it will take a lot of administrative time, and will certainly slow down a busy ER doc trying to, um, move the meat. As an entrepreneur, I’m all about trying to maximize the income stream. Is there potential revenue in ultrsound? Yeah, sure, some. Not a lot, and definitely less than the opportunity lost in the time required to realize that revenue.
I kinda hate to be a wet blanket on this point. I mean, it’s a gadget! How can I *not* be insanely enthusiastic about it? Turns out it’s kinda like my old Palm Pilot (yes, I am old enough to remember when it was called the Pilot). I was the early adopter, got one as soon as they hit the market. Showed everyone how cool it was and evangelized about how it was going to change the way doctors interacted with patient data. Slowly it started to get used less and less till it ended up in my desk drawer. The ultrasound’s not relegated to that ignominious fate and I doubt it will be. But neither will it ever be one of those “I don’t know how I ever got by without it” things.
*This blog post was originally published at Movin' Meat*
Posted on October 31, 2009 07:00:00 AM
… they can get creative with “pump-kin” decorating:
*This blog post was originally published at Dr. Wes*
Posted on October 30, 2009 04:03:00 PM
Ben Goldacre, Saturday 31 October 2009, The Guardian.
Every now and then it’s fun to dip into the world of politics and find out what our lords and masters are saying about science. First we find Brooks Newmark, Conservative MP for Braintree, introducing a bill to reduce the age for cervical cancer screening to 20. The [...]
Posted on October 30, 2009 04:00:11 PM
I never knew that newspapers use to hire nurses. This nurse is working in a big city at the news desk. I wonder if she had to have a journalism degree as well as a nursing license in order to write copy for a media outlet back when nurses wore their cap. There was a time when only journalists wrote the news. Now anyone with a computer, a video camera, and a website can out scoop CNN. Kim from Emergiblog told me that some bloggers and a member of the press got into a debate at BlogWorld09. I wasn’t surprised to hear this because mainstream media thinks that its the only legitimate source for news. Come on mainstream media, we both know what’s really going on here. You have blogger envy.
I’m sorry if I sound cranky, mainstream media, but I’m really tired of all your whining. I know you don’t think that citizen journalists check their facts and that we lack reliable news sources. Some of you have even said that our stories aren’t fair and balanced. Do you really want to go there, mainstream media? I’m talking to you Fox News and MSNBC. You’ve got your nerve to criticize anyone about their scruples.
And let’s talk about your content, mainstream media. Really guys, Balloon Boy? There is no way that Walter Cronkite would have been caught flatfooted on that story. Everyone believed Walter when he said, “And that’s the way it is,” because reporters like Walter worked their fannies off to get the story right. Mainstream media, you blew it. Your game is off. You need to get your gumshoe reporters back on their beats. I hate to break it to you mainstream media, but you’re boring. It wouldn’t hurt you to let your hair down and go a little Gonzo with your reporting. Start channeling Hunter S. Thompson. He was a hell of a writer.
I think what really makes you angry, mainstream media, is that a lot of citizen journalists are the sources that YOU turn to for your news. My blogger buddies and I get contacted all the time by the media when reporters need reliable health information for their stories. I give great quotes. Now I hear that the Annenberg School for Communication and Journalism at USC has invited bloggers to come to talk their students. Take a deep breath, mainstream media. Embrace bloggers. We aren’t going away.
*This blog post was originally published at Nurse Ratched's Place*
Posted on October 30, 2009 01:00:47 PM
Health on the Net Foundation has been evaluating and rating medical websites for years and it’s sad when we find out there might be some problems and concerns around this highly-respected system.The Bradfield Resident blog published an interesting entry:
…from a review the HONcode guidelines on the Health On the Net Foundation website, it appears that the Australian Dental Association’s site, which currently displays a HONcode seal, does not respect the HONcode principles.
Details of the water fluoridation argument (and safety of mercury in fillings, etc) aside, it is apparent that the current ADA website does not respect a number of the HONcode principles – to an obvious and significant extent – and I imagine this to have been the case for a number of years, if not from the original review in January 2004. This example does not instill confidence in the credibility of the Health On the Net Foundation seal used for medical and health websites. I seek your explanation as to how a site reviewed numerous times with such glaring inconsistencies could be certified. I have not particularly listed examples of the inconsistencies since they appear on almost every page of the ADA website – if you cannot see them, I hold little hope for the HONcode’s reputation at all.
*This blog post was originally published at ScienceRoll*