Seeing low fees for family doctors as a weak link in the nation’s health care system, some big employers and health insurers are seeking new ways to pay doctors to reward high-quality medical care.

An influential medical standards group plans to present a new model today for helping employers and insurers to identify the best primary care doctors and to steer patients their way. Those doctors, in turn, would be paid for more services than are currently reimbursed under typical health plan payments for office visits.

The idea is to encourage doctors to meet with patients for more than a few minutes during an office visit and to also compensate them, or nurse coordinators, for communicating with patients by phone and e-mail outside office hours.

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  Judgment mistakes, teamwork problems, and insufficient technical skill contribute to the majority of medical errors that involve trainees, reports the Archives of Internal Medicine. 

Researchers examined malpractice claims (surgery, obstetrics, and internal medicine) from five U.S. insurers. Overall, 240 errors involving residents, interns, or fellows and causing adverse outcomes (death in one-third of cases) occurred from 1979 through 2001. The researchers found that: 

• errors in judgment contributed to 72% of the cases;
• breakdowns in teamwork — particularly lack of supervision by attending physicians and problematic handoffs between trainees or between trainee and attending — were involved in 70%;
• poor technical competence, most often concerning diagnostic decision-making, contributed to 58%.

Seventy percent of the errors occurred among inpatients. To improve safety in this setting, editorialists propose an approach to “translational patient care” in which teams comprising house officers, hospitalists, and nurses care for the same patient from admission to discharge.

The doctor walked into the hospital room with a discomforting mission. He was there to admit a medical mistake and apologize to his patient, a woman with breast cancer.

The staff had given her the same injection twice by accident, causing her white cell count to soar, said Dr. Divyesh Mehta, chief of oncology at the University of Illinois at Chicago Medical Center. He recommended she stay in the hospital an extra day or two.

“This is our responsibility, and we are very sorry for it,” Mehta said, recalling the conversati

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Healthcare reform and providing care for uninsured patients are the leading concerns of medical students across the nation. Students also report extensive experience with healthcare technology and believe it will have the greatest impact on improving patient care. Results of the second annual Future Physicians of America survey released today, which was conducted by Epocrates, Inc., and Gerson Lehrman Group, Inc., captures the opinions of 1,000 medical students.
These future physicians are ready to see change in the U.S. healthcare system, from insurance coverage to technology use.

Life Line Screening has screened nearly 5 million people and found carotid artery blockage, peripheral arterial disease (P.A.D.), and abdominal aortic aneurysm (AAA) in 8-10 percent of participants. The company offers affordable, hospital-quality screenings for stroke risk, vascular disease, and osteoporosis daily at community locations nationwide. Register at www.lifelinesceening.com (or toll-free at 877-237-1272).
“Carotid artery blockage is often present without symptoms, yet it is one of the leading causes of stroke; older people are particularly vulnerable,” Dr. Manganaro says. “I urge seniors and baby boomers to speak to their physician about stroke risk, vascular disease, and preventive health screenings.”
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Marcia Beaird’s life changed forever about a year and a half ago. She has to wear a pressure garment for the rest of her life. It’s basically a body suit that helps keep the swelling down.

From her breasts on down to her ankles she is covered with scars. She lost her skin because of a flesh eating bacteria infection.

Beaird says she got the infection after she had liposuction. She says her doctor used unsterile instruments in the surgery.

“I have to be able to go forward and not let this eat at me inside. It’s hard sometimes,” says Beaird who has hired an attorney and is in the early stages of taking legal action against her doctor.

Beaird says she realizes she will get little if anything in her case. Her doctor is one of the more than 2,000 doctors statewide that elect not to carry medical malpractice insurance.

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