Articles Posted in Training

algorithmwoes2-300x200High-tech wizards may be pushing medicine into a brave new world where important medical decisions rely on supposedly data-driven findings that also may be rooted in an old malignancy: discrimination against black patients.

A new study published in the New England Journal of Medicine warns that race-based tools and formulas, algorithms aimed to assist doctors in speeding up their diagnosis and treatment in such areas as heart disease, cancer, and kidney and maternity care, improperly steer blacks away from therapies commonly given to whites without sound reasons, the New York Times reported:

“The tools are often digital calculators on web sites of medical organizations or — in the case of assessing kidney function — actually built into the tools commercial labs use to calculate normal values of blood tests. They assess risk and potential outcomes based on formulas derived from population studies and modeling that looked for variables associated with different outcomes. ‘These tests are woven into the fabric of medicine,’ said Dr. David Jones, the paper’s senior author, a Harvard historian who also teaches ethics to medical students. ‘Despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice,’ he wrote.”

chartGAOnursinghomeinfection-300x300Is the coronavirus’s staggering toll on patients in nursing homes something to be written off as a force of nature for which humans bear little fault? Or are there lessons to be learned about shortcomings that could help preserve lives the next time?

News media reports keep unearthing institutional misery and a blindness to the suffering of the aged, chronically ill, and seriously injured. Bad luck, shrug facility owners and operators, seemingly joined in by regulators and some politicians. Couldn’t be helped. Did the best we could.

In fact, investigations — by journalists and watchdogs — have shown the toll taken by nursing homes’ sloppy disregard for infection control, press for profits, and unacceptable paralysis as situations headed south.

howardnewhospital-300x169Even as the Covid-19 pandemic shows the terrible toll inflicted on African Americans in the District of Columbia by health care disparities, city officials have announced they are advancing with a pricey plan to plug a giant hole in area medical services by helping to fund not one but two new hospitals that will serve impoverished communities of color.

The facilities will be in Wards 1 and 8 and will replace the Howard University Hospital and the United Medical Center (UMC) in Southeast D.C., Mayor Muriel Bowser has proposed.

The City Council in the days ahead will consider her latest $700 million or so plan to try to improve medical services for some of the poorest residents in the city by working with Howard, its medical school — one of the main training institutions for black doctors — George Washington University Hospital and two big health systems, Adventist and Universal Health Systems.

ctracing-300x218As state and local officials struggle with constituents restless with measures designed to deal with the Covid-19 pandemic, the next key phases in the battle with the novel coronavirus may prove yet more contentious. How ready are we to accept not just testing but also tracing and isolating infections?

The White House is bolting to a cut-and-run approach to fighting Covid-19, deflecting, denying and downplaying its staggering toll — more than 1 million infections and tens of thousands of deaths.

This already has led to a debacle with what needed to be an effective, widespread regimen of testing, testing, testing — not only to see who is infected now but also who may have been exposed to the disease and potentially have some immunity against it.

GovMikePence-300x200The viral outbreak that exploded out of central China suddenly has captured the rapt attention of Wall Street, the White House, and Americans from coast to coast. The rising pitch and politicization of the important conversation about Covid-19 — a respiratory virus that already has posed a growing global health threat — can only be described as worrying.

For ordinary folks, the guidance emerging from all this: It may be time for smart preparation — definitely not panic.

The Trump Administration apparently has gotten the message that viral concerns are high, and the president and his men have conducted two news conferences in almost as many days, including announcing the first coronavirus death of an American in the continental U.S. and travel restrictions affecting Iran, Italy, and South Korea.

ambcenterleapfrograting-300x109They may be more appealing and convenient because they’re located in the neighborhood with better hours and more parking. They also may be less costly because they lack the high overheard of big hospitals. But those booming same-day surgery centers have patient safety issues of their own.

Their doctors and nurses may not be as well-trained as patients might find at big hospitals or academic medical centers, with 1 in 3 centers not having staff who were all board-certified, according to the Leapfrog Group, a consortium of big companies and other major health care users focused on patient concerns.

Leapfrog has issued — to its considerable credit — its first safety and quality study of the facilities, also finding that, “not all ambulatory surgery centers and hospital outpatient departments provide surgery consent materials before the day of surgery. Just 14% of ambulatory surgery centers provided the information one to three days before the surgery, while just 20.7% of hospital outpatient departments do so,” Modern Healthcare, an industry news source, reported.

carteslasummon-300x225Technology advocates may be ignoring due cautions as they put software ahead of safety in the push to make the vehicles of today and tomorrow more self-driving (aka autonomous).

Car and truck owners, safety advocates warn, should proceed with care before relying on automatic emergency braking systems, especially as they purport to safeguard pedestrians. Restraint also may be the watchword for a new feature that allows a luxe electric car to be “summoned” to its driver, shifting out of a parked position and navigating short distances on its own.

The American Automobile Association reported that it sought to get ahead of the curve by subjecting the new automatic emergency braking systems to track tests in mid-sized sedans of their safety applications under “real world” conditions. The outcomes were worrisome, AAA found:

voxsnip-300x134Americans are confronting a care-giving calamity with the elderly at home, and the alarms are sounding loudly about it. But are experts and politicians grasping the severity of this crushing health care shortfall?

The New York Times, Vox, Washington Post, and Forbes all published detailed and solid news articles about the nation’s quiet nightmare with the workforce needed to deal with the booming population of aging baby boomers.

Just a reminder: This is a huge group that is graying rapidly, with 10,000 boomers each day turning 65 and this startling reality continuing for the next  decade or so. Seniors long have said they prefer to age at home, that they dread and may not be able to afford nursing home care, and they are panicked about who will help them in their daily lives as they become debilitated, especially with dementia or Alzheimer’s — conditions predicted to explode in prevalence and cost as the nation’s elderly population increases.

beaumonthospital-300x115When doctors become medical outliers, shouldn’t hospitals, colleagues, insurers, and the rest of us ask how and why an individual practitioner diverges so much from the way others provide care?

Olga Khazan details for the Atlantic magazine the disturbing charges involving Yasser Awaad, a pediatric neurologist at a hospital in Dearborn, Mich. As she describes him, for a decade he racked up hundreds of cases in which he is accused by patients of “intentionally misreading their EEGs and misdiagnosing them with epilepsy in childhood, all to increase his pay.” Khazan says his case “shines a light on the grim world of health-care fraud—specifically, the growing number of doctors who are accused of performing unnecessary procedures, sometimes for their own personal gain.”

In the malpractice cases that are unfolding against him, Awaad’s pay has become a central issue, with evidence showing his hospital contract rewarded him for boosting the number of screenings he ordered and diagnoses he made. Jurors have been told that Awaad, whose salary increased from 1997 to 2007 from $185,000 annually to $300,000, “turned that EEG machine into an ATM.” He earned bonuses exceeding $200,000, if he hit billing targets.

doctired-300x169Will the medical educators finally get that it makes no sense to force residents to toil like field animals? Yet another study, this latest from Harvard experts, finds that keeping residency training hours at more humane levels does not significantly affect quality of patient care, including inpatient mortality.

Let’s be clear: The grueling preparation for MDs is only relatively better than before, capping their training time to 80 hours a week.

Medical educators, hospitals, and doctors themselves have criticized that limit since it was imposed after long study and much argument in the profession by the Accreditation Council for Graduate Medical Education (ACGME), the group that accredits MD training programs.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
Washingtonian Top Lawyer 2011
Avvo Rating 10.0 Superb Top Attorney Best Lawyers Firm
Contact Information