If you want to know one reason why our health care system is so screwed up, please read this article. It explains how hospitals often make more money when complications arise during surgery.
Patients who suffer complications after surgery are lucrative for hospitals, which get paid more when they treat infections and other problems, according to a study published in the Journal of the American Medical Association today.
In 2010, an unnamed, nonprofit 12-hospital chain in the southern U.S. was paid an average of $49,400 per person for treating surgery patients who have complications — more than double the $18,900 paid for patients who underwent only the initial surgery, according to an analysis by researchers from Harvard Medical School and elsewhere.
Read the entire article for details on this problem. We need to alter these incentives and pay for health care that actually works. Incompetence and mistakes should not be rewarded.
Certainly, the rationale behind screening seems obvious. The earlier cancers are diagnosed, the more often lives will be saved, right? With enough screening, we might even stop cancer.
If only. Finding cancer early isn’t enough. To reduce cancer deaths, treatment must work, yet it doesn’t always. Second, it must work better when started earlier. But for some cancers, later treatment works as well. (That’s why there is no big push for testicular cancer screening — it is usually curable at any stage.)
And some of the worst cancers aren’t detected by screening. They appear suddenly, between regular screenings, and are difficult to treat because they are so aggressive.
Biopsy, exploratory surgery , radiation and chemotherapy as the result of positive or abnormal results from screening, pose dangers and have side affects of their own to be seriously considered.
When you consider that the majority of insurance dollars are spent in the last 6 months of a patient’s life we have to consider if this is money well spent.
This goes for testing, as well.
The Choosing Wisely project was launched last year by the foundation of the American Board of Internal Medicine. It recruited nine medical specialty societies representing more than 376,000 physicians to come up with five common tests or procedures “whose necessity … should be questioned and discussed.”
The groups represent family physicians, cardiologists, radiologists, gastroenterologists, oncologists, kidney specialists and specialists in allergy, asthma and immunology and nuclear cardiology.
Lack of access in rural areas, and little or no emphasis on preventive care have contributed to a gross misuse of medical resources.
Too few dentist participating in Medicaid has also contributed to the problem.
Using emergency rooms for dental treatment “is incredibly expensive and incredibly inefficient,” said Dr. Frank Catalanotto, a professor at the University of Florida’s College of Dentistry who reviewed the report.
Preventive dental care such as routine teeth cleaning can cost $50 to $100, versus $1,000 for emergency room treatment that may include painkillers for aching cavities and antibiotics from resulting infections, Catalanotto said.
Dr. Otis Webb Brawley, the chief medical officer of the American Cancer Society wrote, “How We Do Harm: A Doctor Beaks Ranks About Being Sick In America”.
He describes the ways in which the whole medical system is broken and who is responsible.
Spoiler: We all are.
It is amazing the number of health care professionals who seemingly reject the scientific method. They prescribe treatments they believe to be appropriate as opposed to therapies that are known to be appropriate based on objective scientific evidence. This form of ignorance is a root cause of much of the overuse of medical therapy.
Too often, doctors fail to distinguish what is scientifically known from what is unknown, from what is believed. This is beyond mere disagreement about interpretation of the science. There is often selective reading of the science, especially by those trained in a specialty wanting to advocate for it.
Shannon Brownlee’s book, “Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer”, Bloomsbury USA; First Edition edition (September 18, 2007) sheds light on what physicians know about extraordinary measures used in the ER and in intensive care units and why many physicians opt out of such care.
Dying in a hospital bed attached to tubes is not how many in the medical field would choose to die.
Why would doctors be so anxious to avoid the very procedures they deliver to their patients every day? For one thing, they know firsthand that these procedures are most often futile when performed on a frail, elderly, chronically ill person. Only about 8% of people who go into cardiac arrest outside of the hospital are revived by CPR. Even when your heart stops in the hospital, you have only a 19% chance of surviving. That’s a far cry from the way these procedures are portrayed on TV, where practically everybody survives having his heart shocked and undergoing CPR.
Following the lead of the Cleveland Clinic in 2007 to create a smoke free campus the Geisinger Health System, a facility located in the eastern town of Danville, PA., will institute its no-nicotine policy on February 1, 2012.
Gary Burtless, a senior fellow at the Washington-based Brookings Institution, said the measures are commonly adopted to reduce future health-care costs.
He said “there is no denying” the subsequent drop in cost, pointing to a 2003 study that revealed a range of between $500-$2,200 in additional annual medical expenses for smokers when compared to non-smokers.
Dr. Steven Bernstein, a professor at Yale University, added that smokers are also likely to take breaks more often, reducing hours worked.
A few simple changes could drastically reduce infection and death:
Keep the surgery ward absolutely sterile
Fumigate the operation theater after every surgery
Autoclave or sterilize all the equipment after every surgery
Use disposal equipment whenever possible
Recovery ward should be kept clean and hygienic
Maintain the hygiene of diabetics and low immunity patients
Keep the necessary emergency drugs at hand to combat the infection effectively and promptly
Train the hospital staff in hygiene maintenance during and after surgeries
Switching from stainless steel to copper fittings could reduce spread of infection by as much as 40% according to recent reports
To tackle this serious menace, the federal government has introduced a new reporting system that will be available to the general public for evaluation. In addition, from 2013, those hospitals that have improper records and fail to follow the norms will face a 2% loss of Medicare funding. Surgery records have to be compulsorily updated and reported till the case is closed. An estimated two million contract hospitals acquired infections and spend about $6.5 billion extra to treat such affected patients.
The hospitals will now have stringent norms to follow and it has been made compulsory that they report all the cases of nosocomial infections or hospital related infections and the number of deaths thereafter. This will give an idea as to which areas and hospitals are more prone tro these types of infections and steps can be taken to curb these. Using faulty catheters, improper sterilization of tracheostomy tubes, and other methods of intervention are the major causes of hospital related infections.
This blog is for consumers of health care and medical services. Basically, it’s for everyone. For health issues you should always see a doctor or qualified medical professional - we are not dispensing medical advice. You should, however, be an educated consumer, so we offer information to help you start the process to become educated and to ask important questions. There are many excellent resources on the web, along with all sorts of conflicting opinions and advice. The key is to use a wide variety of resources to learn and access information, so you can ask the important questions when you are with your doctor or health professional.