At the Doctor’s

• Prepare for your visit to the doctor’s office.
  • Make a list of questions before your visit. Bring your questions or checklist to your appointment so you can remember what you want to ask.
  • Bring an updated listing of all the prescription and over-the-counter medicines you take, including herbal supplements.
• If your doctor prescribed medicine for you, confirm the name of the drug and the dose. Be sure you understand how, when, and for how long you should take it. Read your notes back to the doctor to be sure they’re correct.
• Ask the doctor or nurse to explain what the drug will do. Ask if any lab tests will be needed to check how the drug is working in your body. Ask about side-effects. If cost is a concern, ask if there is a generic or lower cost brand-name medication that works just as well. Write down the information you receive.

At the Pharmacy

• When you take the prescription to the drug store, include a copy of your list of medicines and over-the-counter drugs that you take. Some pharmacies may keep a list of the drugs you get from them on their computer. Ask for a copy so you can make sure the information is up to date.
• You will probably be told to sign an electronic log or clipboard when you hand in your prescription or when you receive it. By signing, this means you know your “HIPAA” (federal privacy law) rights and, in many pharmacies, that you have received an offer to be counseled by the pharmacist. By signing it, they assume you do not want to talk to the pharmacist. If you would like to talk to a pharmacist, let the clerk or the pharmacist know that you have questions and want counseling.
• When you get your medicine, check that the drug’s name and directions are the same as what your doctor told you. Check your notes.
• Confirm the medicine directions with the pharmacist. Double check with the pharmacist about how you should take the drug. Ask about food-drug interactions, alcohol-drug interactions, and necessary monitoring tests. Make sure the pharmacist has your updated list of medications so the pharmacy can check for possible interactions, too.

At Home

• Keep your personal medication record (the list of prescription drugs, over-the-counter drugs, and herbal supplements) updated. Give a copy to loved ones, keep a copy with you, and consider posting a copy on your refrigerator.
• Use a pill organizer so you can easily see if you need to take your pill or if you already took it. You can fill it once a week. This takes the guesswork out of taking the pills. It reduces missed doses, reminds us that we took our medicine, and avoids double dosing. It can be really handy if you’re helping someone take care of their medicines.
• Read carefully the written information that comes with your medicine. It has important information about, side effects, warnings, precautions, how to store it, and how and when to take your medicine.

Insurance companies have said for years that they’re paying more and more in medical malpractice claims as they push for caps on lawsuits, like the cap approved in Idaho. But a new study shows claims have been decreasing for seven years while the insurance premiums continued to rise. Report author Jay Angoff with the American Association of Justice says it looks like the insurance companies are overcharging doctors.

“The amount they project that they’re going to be paying out in the future has decreased by 48 percent over the last four years, yet rates have been going way up,” Angoff told SVO. “This makes no sense.”

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Wrong-site surgery data received by the Patient Safety Authority shows that every other day in Pennsylvania healthcare facilities an actual adverse event or near miss of a wrong-site surgery occurs. The Authority released its 2007 June Patient Safety Advisory containing the data in a press conference held in Harrisburg today.
“To be frank, wrong-site surgeries in Pennsylvania should never occur. However, every other day in Pennsylvania we have a report of a wrong-site surgery being caught either before or after the start of an operation,” said Dr. Stan Smullens, chief medical officer of the Jefferson Health System and vice-president of the Patient Safety Authority Board of Directors. “However, we are not alone. Wrong-site surgeries are no more common in Pennsylvania than they are in other states. We also have in common with other states the problem of trying to fix them.”
In a 30-month time period (June 2004 – December 2006) the Authority received 427 near misses and serious events of wrong-site surgeries. Of those, 253 were near misses or did not reach the patient.
“Of those events that reached the patient in the operating room, sixty- nine percent were wrong side surgeries, fourteen percent were wrong body part surgeries, nine percent were wrong procedure and eight percent were wrong patient,” added Smullens. “The most common sites where the wrong-site occurred were extremities, eyes and spine. Orthopedic and ophthalmologic procedures were the most common for wrong-site surgeries.”

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The Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS), today announced a milestone addition to the Hospital Compare consumer Web site http://www.hospitalcompare.hhs.gov/. The revised comparison tool will now give consumers even better insight into the quality of care provided by their local hospitals.

In vetoing, for the second time, the bill for federal funding of crucial stem-cell research–President Bush stated, “I appreciate the fact that we’re joined by a lot of folks who share the deep desire to advance science, and at the same time, uphold our moral values. I appreciate the fact that Mike Leavitt is here, Secretary of the Department of Health and Human Services. I want to thank the members of the United States Congress and Senate who have joined us. I thank you for taking your time to be here on this important announcement today.
I’m joined on stage by two good docs, really smart, capable people: Dr. Bill Hurlbut, Professor of Stanford University Medical Center; Dr. Don Landry, Professor at Columbia University Department of Medicine — actually, he’s the Chairman of the Department. The reason they’re here is these are brilliant biologists who are seeking new ways to develop stem cell lines without violating human life. And these are smart folks, and I cannot thank them enough for coming to the Oval Office to share with me their wisdom and their vision.”

Despite the proclamation of the worth of a life, Bush will continue to call for limiting the rights of victims of medical malpractice, when their lives are destroyed or ended.
 

Robert N. Butler M.D., a New York physician and nationally known expert in gerontology at Mount Sinai Medical Center, has added his name to the long list of leading doctors and health consumer groups who are endorsing passage of Rx gift disclosure legislation, S.2971 (Maziarz)/A.7468(Gottfried). In the meantime, drug companies are trying to halt the legislation, claiming it is not necessary.
“AARP welcomes the support of this critical issue from a national leader here in our state,” said Lois Aronstein, AARP New York State Director. “With just one week left in the New York State Legislative session, we have an important and timely opportunity to adopt a statewide policy to require disclosure of certain marketing activities. Unfortunately, drug companies and their army of lobbyists have come to Albany to kill this bill when so many New Yorkers could benefit from its passage,” she said.
The bill requires drug companies to annually report to the New York State Department of Health for disclosure to the public, all gifts (excluding free samples) to health care practitioners who prescribe drugs when such gifts have a value of $75 or more.
Dr. Robert N. Butler, President and CEO of the International Longevity Center and Professor of Geriatrics and Adult Development at the Brookdale Department of Geriatrics and Adult Development at Mount Sinai Medical Center, wrote a letter to members of the New York Legislature calling on them to support “legislation that will, in my view, take a major step towards strengthening patient confidence and limiting industry influence on the medical profession.”

The Tampa Tribune, on medical professionals trying to delay the implementation of an amendment that would give patients access to records of hospitals’ and doctors’ medical mistakes:

When Florida voters went to the polls three years ago and passed Amendment 7 – the Patient’s Right-to-Know initiative – they chose patients’ rights over physicians’ confidentiality.

Floridians want patients to have access to records about medical mistakes in hospitals and doctors’ offices.

But in consolidated cases now before the Florida Supreme Court, the medical profession seeks to delay implementation of the amendment by limiting it to records created after passage of the initiative, a position adopted by the Legislature at the behest of the medical lobby. The move defies common sense and the people’s will.

for full story, click here

Patient safety requires commitment from all levels of an organization. While executives foster a safety culture and establish clear goals and metrics for the organization, the day-to-day execution is the responsibility of frontline managers who direct resources at the “sharp end” of care. 

Getting frontline managers to fully commit to implementing the organization’s safety plan is one of the most important elements in building a culture of safety. These individuals help contribute to an atmosphere of mutual trust in which all staff members can talk freely about safety problems and seek solutions without fear of blame or punishment. In order to ensure that quality and safety are a top priority, these managers need the tools and understanding of patient safety to lead the work at their institutions.

The Institute for Healthcare Improvement can help. IHI has developed Leading and Implementing Safety Strategies: Role of Managers, a two-day seminar that provides front-line managers the tools and resources needed to lead the quality and safety projects in their individual departments and throughout their organizations.

for information on this seminar, click here

From 2003 to 2004, the most recent data available, personal health care costs increased 7 percent, from $98.7 billion to $105.5 billion, the third-largest year-over-year increase since tracking began in 1980. The largest growth in spending occurred between 2000 and 2002.Personal health care spending jumped from 10.6 percent of the state’s gross domestic product in 2000 to 11.7 percent in 2004, according to the bureau.

Bernard Black, the UT professor, was not surprised by the lack of savings for patients. The promise of lower prices was a red herring from the start, he said. Medical malpractice costs – both in defense and in payouts – account for at most 2 cents of the health care dollar, he said.

for full article in Dallas Morning News, click here 

Filmmaker Michael Moore is making headlines again. His new documentary, “Sicko,” promotes a national healthcare program like Canada’s. The film, due to open in theaters June 29, got a big boost when the US Treasury Department sent Mr. Moore a letter acknowledging a probe into his trip to Cuba to obtain medical treatment for three 9/11 rescue workers – and film a segment for his movie.

An “appalling” form of harassment, declared Moore, saying his work as a journalist is protected by the United States Constitution.

Advocates of a single-payer national healthcare system welcome Moore’s movie. With millions of viewers likely to see the film, it’s “unquestionably” helpful, says a spokesman for Physicians for a National Health Program. PNHP, with a membership of 14,000 physicians, has been campaigning for a national system for 20 years. But the prospects of success for PNHP are not great yet, figures Henry Aaron, an economist at the Brookings Institution in Washington.

One reason is the power of various medical industry lobbies. Americans spend as much on healthcare today as the entire gross domestic product of France and Spain combined, notes one economist. If health-related costs continue to rise rapidly, spending could soon equal the entire GDP (that is, the output of goods and services) of Germany.

The $2.1 trillion the US spends per year on healthcare creates “strong interest groups,” notes Mr. Aaron. These include a host of politically powerful private health insurance companies and for-profit hospitals.

But a cofounder of PNHP, Steffie Woolhandler, a Harvard Medical School associate professor, is more hopeful for radical reform – though not under the Bush administration. That’s because she sees a slow-motion collapse of the present employer-based health insurance system.

Faced with globalization and severe competition from abroad, American companies are moving to reduce their health insurance costs. They are raising deductibles, requiring bigger copayments, and trimming the medical services covered. As these trends hit the middle class, the political result will be a “big storm,” Dr. Woolhandler predicts.

As it is, the US devotes about twice as much to healthcare as a proportion of GDP than do other rich nations with nationalized health systems.

for full story, click here