Cancer. #Screening. #overdiagnosis. When Evidence Says No, but Doctors Say Yes - The Atlantic. First, listen to the story with the happy ending: At 61, the executive was in excellent health.
His blood pressure was a bit high, but everything else looked good, and he exercised regularly. Then he had a scare. He went for a brisk post-lunch walk on a cool winter day, and his chest began to hurt. Back inside his office, he sat down, and the pain disappeared as quickly as it had come. That night, he thought more about it: middle-aged man, high blood pressure, stressful job, chest discomfort. Listen to the audio version of this article: Download the Audm app for your iPhone to listen to more titles.
A cardiologist recommended that the man immediately have a coronary angiogram, in which a catheter is threaded into an artery to the heart and injects a dye that then shows up on special x-rays that look for blockages. While he was waiting in the emergency department, the executive took out his phone and searched “treatment of coronary artery disease.” So, what do surgeons do? NHS patients could have to show passport for treatment. Patients could soon have to take their passport to hospital to prove they are eligible for free treatment, under new rules to stop so-called health tourism.
The Department of Health's top civil servant, permanent secretary Chris Wormald, told MPs that he was looking at making hospitals check whether patients should be paying. Mr Wormald admitted the proposal was controversial, but it would mean anyone, including British citizens, might have to prove their identity before tests or an operation. He told MPs on the Public Accounts Committee that passport checks were already taking place at one hospital in Peterborough which serves a high immigrant population. "On the general question of are we looking at whether trusts should proactively ask people to prove their identity - yes we are looking at that," Mr Wormald said. "Individual trusts like Peterborough are doing that and it is making a big difference. Other parts of the NHS have been experimenting with tougher identity checks. Controlling Waste: What's in it for Us? Heterogeneity in Treatment Effects and Choosing Wisely.
Tackling Wasteful Spending on Health - en. Cardiopulmonary Resuscitation for older people: the mirage of numbers. In June of the same year, the NEJM itself published a couple of letters to the director stressing that the data presented by American Heart Association researchers, whilst true, were also misleading.
In another "icon-box", GeriPal summarized the same results but viewed from a global perspective, which could be explained as follows: out of 100 people aged 64 and over who received CPR during hospitalization, 49 did not survive the resuscitation attempts and 34 died during the subsequent stay. This means that 83 of the patients (49 + 34) showed as discharged dead and therefore only 17 were discharged alive. Of the latter, 7 died before the end of the year, while 10 were still alive, some of them with moderate to severe neurological injuries. Note that 59% of the survival rate shown in the first “icon-box” appears to relate the 10 people who survived the first year of discharge with the 17 who were discharged alive.
Jordi Varela Editor. Why do surgeons continue to perform unnecessary surgery? Patient Safety in Surgery201711:1 DOI: 10.1186/s13037-016-0117-6 © The Author(s). 2017 Received: 14 December 2016 Accepted: 14 December 2016 Published: 13 January 2017 Patient safety in surgery has historically suffered from a lack of physician-driven initiatives aimed at recognizing, preventing and mitigating medical errors and surgical complications .
What do we mean by unnecessary surgery? In 2016, the existence of unnecessary surgery remains a daunting reality that continues to expose our patients to an unjustified surgical risk . Consider this provocative analogy: If surgery were a pharmaceutical drug, the procedure would be required to undergo scrutiny of testing its safety and feasibility in phase 1 and 2 trials. The title of this editorial asks, “Why do surgeons continue to perform unnecessary surgery?” As representatives of the most privileged and rewarding profession on Earth, it is our duty as surgeons to be unwavering patient safety advocates. Authors’ contributions. Man evicted from hospital for blocking bed for two years. A hospital applied for a court order to remove a patient who had occupied a bed "unnecessarily" for more than two years.
The man, who has not been named by the hospital, had refused to leave the James Paget University Hospital in Norfolk. The hospital said he had been "fit for discharge" and had been offered appropriate accommodation. It said the decision to go to court was a last resort and "not taken lightly". The man, from Suffolk, had been at the hospital in Gorleston, near Great Yarmouth, since August 2014. 'Using a hospital as a hotel' A patient who had been in the same ward said it had been an "open secret" at the hospital that he had been there for more than two years.