|
Scott Serota, CEO of the BCBS Association. |
|
Blues Create A Healthcare Bank
The big push to spread acceptance of consumer-directed health plans is spurring the Blue Cross Blue Shield Association to start a unique new bank for members of the Blues.
Dubbed Blue Healthcare Bank, the institution is designed to provide the kind of financial support consumers will need when they sign up with a consumer-directed health plan, a health savings account, a health reimbursement arrangement or a flexible spending account from any of the BCBS companies scattered throughout the country.
Increasingly, consumers are expected to put up a larger share of their own funds to pay for their insurance. And the Blue Healthcare Bank gives them a way to manage their health funds to maximum advantage. Consumers and companies can deposit money into the accounts. A checkbook or debit card will be available to pay for specific health expenses, which will also make it easier to handle tax-sheltered funds and budget their share of deductibles.
By John Carroll - Posted: Friday, January 6, 2006 4:07 pm |
Healthcare Providers Can Help Reduce Alabama Waistlines
According to officials with the Centers for Disease Control, an estimated 365,000 people die each year from health problems related to obesity, a public health issue that is growing rapidly in the U.S. But while obesity is a national concern, nowhere are waistlines expanding as rapidly as they are in the state of Alabama.
In the 2005 report "F as in Fat: How Obesity Policies are Failing in America" by Trust for America's Health (TFAH), Alabama is rated the second most obese state, with Mississippi ranking number one. While Mississippians took the top spot away from Alabama this year, Alabama still exhibited the largest overall increase in obesity. Obese Alabamians increased 1.5 percentage points to 27.7 percent.
Obesity is defined by a body mass index (BMI) of 30 or above. Overweight is a BMI of 25 to 29.9. When you combine both groups, 63 percent of Alabama adults need to lose weight. So why is Alabama so fat? TFAH says obesity is primarily the result of poor nutrition and lack of physical exercise. Jose Fernandez, PhD, assistant professor at UAB's Department of Nutrition Sciences, said genetics also play a role, with African American women and Mexican American men having the greatest propensity for obesity.
By Ann B. DeBellis - Posted: Friday, January 6, 2006 4:04 pm |
Declining Reimbursements Present Challenges as Practice Costs Rise
In an environment where rising operating costs collide with declining reimbursements, practice managers face significant challenges. The endless struggle to maintain revenue while managing overhead and providing quality care requires effort and imagination.
The difficulty is compounded by the fact that fixed costs comprise the bulk of most practices' overhead. One of the larger components of fixed costs is real estate. Increasingly, medical practices are choosing to sell office buildings in order to reduce real estate costs. "We've acquired quite a few properties from large physician groups," say Rance Sanders of The Sanders Trust. "Usually, equity has built up in the property. By selling the building and leasing it back, they can increase cash on the balance sheet, reduce debt, and lower their monthly operating costs."
By Steve Spencer - Posted: Friday, January 6, 2006 4:01 pm |
Wanda Hooper |
|
Avian Flu Fears Leave Local Providers With Few Options
In the small Gulf Coast community where Dr. Ralph Kahler practices, questions about avian flu are a regular part of the job. As a local infectious disease expert, he has a lot of people turning to him for answers.
And he doesn't have a lot of reassuring answers to offer."I really don't see anything that we could do on the local level," says Dr. Kahler. "We're really dependent on the federal government and the Centers for Disease Control, vaccine and drug makers."
Local doctors would do everything they could, he adds, disseminating any vaccines that could be available and providing supportive care for anyone affected, but that's "about all we can do. Tamiflu has been used. But if a true pandemic comes, it will disappear in short order."
By John Carroll - Posted: Tuesday, December 13, 2005 5:04 pm |
P4P Plan Delivers Only Small Gains In Quality Metrics
A group of researchers tested the theory that paying doctors for performance would improve healthcare quality and discovered that in one of the most ambitious projects, most of the pay-for-performance money already goes to the best doctors, with only marginal gains in quality to show for the money.
The number of health plans that have adopted P4P plans has been growing rapidly, notes Harvard School of Public Health Assistant Professor of Health Economics and Policy Meredith B. Rosenthal, the lead author of the study that appeared in the October 12 issue of the Journal of the American Medical Association. But they're making the adoption of the plans a leap of faith, believing they will spur quality improvements without any data to back up their assumptions.
BY TRACY STATON - Posted: Tuesday, December 13, 2005 5:02 pm |
Dr. William F. Jessee, FACMPE, president and CEO of MGMA |
|
MGMA CEO Outlines Strategic Plan at Annual Meeting
At the end of October, practice managers from around the country gathered in Nashville for the annual meeting of the Medical Group Management Association. Dr. William F. Jessee, FACMPE, president and CEO of MGMA and its certification body, the American College of Medical Practice Executives, delivered his annual report highlighting accomplishments and concerns impacting the membership.
Additionally, the physician outlined the six components of the recently completed strategic plan and unveiled the new, unified mission statement for MGMA and ACMPE, which simply states the association will be driven to continually improve the performance of medical group practice professionals and the organizations they represent. Straightforward in content, Jessee said the short mission statement had become the launching pad for all other efforts.
"That mission drives our every effort to make a better future than we have today," he said. "It is the beacon from which we built the strategic plan."
By Cindy Sanders - Posted: Tuesday, December 13, 2005 4:59 pm |
Patients Are People, Too
Despite the increasing specialization in medicine, some doctors are advocating an approach to care that focuses on the entire patient rather than on a single section of the body or biological process that needs to be fixed. While this concept may not technically meet the criteria of alternative or complementary medicine, viewing a patient as an entire person can still require a shift in the traditional approach taught in medical school.
"If you go back to the history of medicine, René Descartes established this dualism between mind and body, and it brought into our time a mechanistic approach to the body, where doctors would treat the body like a mechanical object," explains Dr. Mark Stafford, associate professor in the department of medicine at UAB. "What we've learned in recent years is that there's an intimate connection between the brain and the body."
By Marti Webb Slay - Posted: Tuesday, December 13, 2005 4:56 pm |
Vicki Briggs, Montclair Baptist Medical Center CEO |
|
Joint Venture Established to Build New Montclair Baptist Hospital
A joint venture agreement between Triad and Baptist Health Systems has given the two companies co-ownership of Montclair Baptist Medical Center in Birmingham. The new venture, owned 65 percent by Triad and 35 percent by Baptist Health System, was finalized on October 1 for the purpose of building a replacement hospital for the Montclair facility. The site of the new hospital has not been confirmed, but Montclair CEO Vicki Briggs hopes to build the facility on the Interstate 459 corridor between Liberty Park and Grants Mill Road.
Interest in Montclair will transfer to Triad on January 1, 2006, and the venture will receive $11.5 million for capital improvements at the current facility, Briggs said. "We will do basic maintenance at the current facility and add new equipment, the majority of which should be able to be moved to the new location," she said.
By Ann B. DeBellis - Posted: Tuesday, December 13, 2005 4:54 pm |
Dr. Paula Stewart, medical director at Lakeshore Rehabilitation Hospital |
|
75% Rule Denies Medicare Patients Inpatient Rehabilitation Services
Unless The Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005 is passed, approximately 40,000 Medicare patients will be denied care at inpatient rehabilitation facilities (IRFs) in 2005 as a result of the "75 Percent Rule" which was implemented in July 2005 by the Centers for Medicare & Medicaid Services (CMS). First established in 1983, the 75 Percent Rule requires IRFs to focus treatment on patients with specific types of medical needs, and, in effect, 75 percent of patients must be diagnosed with one or more qualifying medical conditions.
The 75 Percent Rule, which CMS is phasing in over three years, requires that a facility seeking classification as an inpatient rehabilitation hospital demonstrate that 75 percent of its admissions are cases that fall into one of 13 qualifying conditions, most of which were first established 20 years ago. Hospitals and patient groups believe that the conditions are too narrowly drawn and omit many vital and newer rehabilitation services, such as cardiac, transplant and cancer care.
By Ann B. DeBellis - Posted: Tuesday, December 13, 2005 4:50 pm |
Dr. Kenneth Varley |
|
New Law Helps States Monitor Prescription Drug Abuse
Alabama is one of 19 states that currently have operating prescription drug monitoring programs In August 2005, the federal government joined the fight against prescription drug abuse when Congress passed the National All Schedules Prescription Electronic Reporting Act (NASPER), which was sponsored by Alabama Sen. Jeff Sessions. Sessions said the ultimate aim of his bill is to make it possible to share the information across all state lines while maintaining the privacy of individual patients' medical records. The law authorizes $60 million through 2011 for state drug monitoring programs.
The legislation creates a federal grant program to help establish or improve state-run drug monitoring programs, and according to the National Alliance for Model State Drug Laws, an additional 24 states are actively working to establish such a program.
By Ann B. DeBellis - Posted: Tuesday, December 13, 2005 4:48 pm |
Dr. Edward Hill, AMA President |
|
Medicare�s Reimbursement Cut Tops List of Legislative Priorities
While healthcare industry advocacy groups nationwide each have their own set of priorities in Washington, D.C., federal reimbursements to providers — and proposed payment cuts — are where these groups find common ground.
Unless Congress acts before the end of the year, Medicare reimbursement to physicians will be slashed by 4.4 percent in 2006 and 26 percent by the end of six years. "So, at the end of six years, physicians would be paid the same thing they were paid in 1991 by Medicare," says Dr. Edward Hill, president of the American Medical Association. And that's while the cost of running a medical office goes up 15 percent.
By Sharon H. Fitzgerald - Posted: Tuesday, December 13, 2005 4:45 pm |
Paperless Advocates Put New Technology on Display in Reopened Medical Clinic
Doug McVey and his partner, Jack Weir, have plotted an unusual course in their quest to market the merits of a paperless office to physicians: they have started their own paperless medical clinic in part to show how it works in the real world.
Early this year, Central Arkansas Hospital closed its clinic in Austin, Arkansas as part of a consolidation move, even though it was seeing about 60 patients a day and drawing in 50 to 60 new patients a month. That's when McVey and Weir decided that the shuttered site would make a perfect showcase for the paperless medical office.
On August 17, they reopened the facility as the Northside Healthcare Center. And everything following the initial visit — from medical records to lab reports and X-rays — has gone digital. A physician's assistant, a nurse with X-ray capabilities and a front-end person are in charge of day-to-day operations. A part-time medical director comes in every two weeks. And McVey and Weir have just bought two more clinics that are being converted over to paperless as well.
By John Carroll - Posted: Tuesday, December 13, 2005 4:43 pm |
Health Law 2005 Top Ten List
The past twelve months have seen new laws and new deals for Birmingham area healthcare providers. Some of these changes have already had an impact on the market, while the significance and effect of others will be felt in years to come. At the risk of being accused of a lack of originality (isn't imitation the sincerest form of flattery?) following is our Health Law 2005 Ten List for Birmingham providers.
Posted: Tuesday, December 13, 2005 4:41 pm |
Laurie Gautney, R.N., M.S.N. at Brookwood, works with the ECIN system. |
|
Local Hospitals Shift to Electronic Discharge Placement
Several local hospitals now use digital networks to streamline the discharge placement process. This summer, Baptist Montclair and Princeton hospitals installed a Web-based program from Patient Placement Systems (PPS) of Alpharetta, Georgia.
"PPS has been quite a time saver," says Toni Uffinger, Princeton Social Work Coordinator. "Under our old system, when a patient needed to be discharged to a nursing facility, for instance, we might call four or five acceptable facilities and, of course, we'd often end up playing phone tag. Once we reached the admissions coordinator and found bed space, we'd usually need to follow up with more information either by phone or fax. Then we'd wait to hear back from them."
"Now, I can run down the list of facilities on my computer, check the ones acceptable to the patient, and then I fax the documents one time to PPS, where it goes into their server. The server sends the information to selected facilities and within minutes, we can have a response. We might get replies from several facilities that say they have bed space and believe they can meet the patient's needs. They might ask us to call to discuss further."
By Steve Spencer - Posted: Tuesday, December 13, 2005 4:39 pm |
Physician Spotlight: Dr. Sandra Ford
Talk to Dr. Sandra Ford and she will tell you that God called and she answered And the mission she accepted is a big one. In 2003, Ford and her husband, Henry, founded a ministry called A Promise to Help (APTH), a healthcare initiative directed to Alabama's Black Belt counties. Its goal is to eliminate the healthcare disparities in the underserved, underprivileged and underinsured populations of the region.
For Ford, the project is the fulfillment of an early promise to help she made while growing up in the Black Belt's Barbour County. Back then, there were only two physicians in the county, far too few to meet the healthcare needs of the people. The results were inferior care and in some cases, early death.
Ford prayed, "Lord, if you will enable me to become a physician, I will come back and help."
By June Mathews - Posted: Tuesday, December 13, 2005 3:42 pm |
Larry Glasscock, Wellpoint CEO |
|
New Health Plan Mergers Spark Fears Among Providers
In the world of managed care organizations, mega-mergers have become trendy.
When WellPoint announced its deal to buy WellChoice -- the parent company for Empire Blue Cross and Blue Shield — earlier this year, its executives were constructing a giant health plan that would cover more than one in 10 Americans. WellPoint had already swollen in size from its merger last year with Anthem Blue Cross and Blue Shield, and now is set to grow to 33 million Blue Cross and Blue Shield members.
But there was another recent merger that figured into this power play as well.
BY TRACY STATON - Posted: Tuesday, December 13, 2005 3:35 pm |
How Are Medicare Changes Affecting Alabama?
The Medicare Modernization Act of 2003 is best known for establishing a controversial and confusing prescription drug benefit for seniors. But the bill also modified payment to virtually every type of Medicare provider -- changes that bode both good and ill for the Alabama medical community.
The act did provide some relief for rural hospitals. In Alabama, about 40 percent of hospital patients are Medicare patients, a number that is typically higher in rural areas.
Medicare payments are calculated based on more than 400 diagnostic related groups, or DRGs. There is a DRG payment rate for hip replacement, a DRG for pneumonia, etc. Certain factors are used to adjust the payment, based on various geographic locations.
By Deborah Lockridge - Posted: Tuesday, December 13, 2005 3:25 pm |
MDs Find that Acupuncture Works when Other Pain Treatments Don't
For two physicians in the Birmingham area, personal pain opened the door to considering acupuncture for relief. And for both, the successful treatment of pain that didn't respond to traditional biomedical approaches led them to start practicing acupuncture in order to provide similar relief to their patients.
For Dr. Melanie Miller, a family physician in Trussville, it was a car accident when she was an undergrad that led her to acupuncture. After suffering whiplash, she had neck pain for a year. "I did everything I could to get it better with physical therapy and with manipulation from a D.O.," she says. "I was taking the things they asked me to take. It just wasn't getting better."
By Marti Webb Slay - Posted: Tuesday, December 13, 2005 3:23 pm |
Nurse Practitioners Lead Big Jump In House Calls
The number of house calls in the United States has been rising steadily since 2000, but it's not doctors who are leading the charge.
An analysis of Medicare data by the American Academy of Home Care Physicians shows that the number of doctors' visits made to the homes of the elderly surged from 1.5 million in 2000 to two million in all of last year. But even as there was a modest rise in the number of physicians willing to see a patient at home, it's been nurse practitioners who have been signing on to satisfy at least a portion of the enormous need to see the elderly where they live.
BY TRACY STATON - Posted: Monday, November 7, 2005 3:01 pm |
Dr. Dennis Occhipinti views a patients X-ray with a nurse. |
|
Friends Indeed: New Orleans ENT Practices Medicine in Birmingham
As Katrina rushed toward New Orleans, Dr. Dennis Occhipinti drove to Destin with an overnight bag and a change of clothes. "I figured we'd be back in New Orleans in a couple of days," he says.
After the levee broke and the city flooded, leaving Occhipinti, like so many others, stranded, he was fortunate enough to hear from an old friend and classmate, Dr. Bill Cornay, here in Birmingham. "He and his wife Elizabeth invited us here," Occhipinti says. "They put us up in their home. Bill and his partner, Dr. Marc Routman, have let me practice with them, part time. They've all been really generous."
By Steve Spencer - Posted: Monday, November 7, 2005 2:58 pm |
Anti-Psychotic Drug Study Questions New Drugs' Performance Compared to Generics
In a recent study involving more than 1,400 people, researchers funded by the National Institute of Mental Health concluded that a mix of four new medications used to treat schizophrenia had a comparable effect to a generic medication that has been a mainstay treatment for decades. Only one of the newer medications appeared to be modestly better than the others, but was also linked to weight gain and unwelcome metabolic changes.
Those results have triggered a renewed debate over the value of comparative drug research studies and fueled anticipation among some patient advocates that state Medicaid programs are likely to cut beneficiaries off from branded anti-psychotics.
by Tracy Staton - Posted: Monday, November 7, 2005 2:56 pm |
Health Officials Hopeful That Sufficient Flu Vaccine Will Be Available
Flu season is upon us, and health officials are keeping their fingers crossed that this year will play out without any of the sudden vaccination snafus that have roiled the healthcare system in years past.
This year, health officials believe the United States will need about 90 million doses of flu vaccine to satisfy demand. And vaccine manufacturers have assured the Centers for Disease Control in Atlanta that 89 million to 97 million doses are on their way, says Ray Strickas, M.D., assistant director for adult immunization activities for the CDC.
BY JOHN CARROLL - Posted: Monday, November 7, 2005 2:54 pm |
New Medical Technologies' Price Tag Will Challenge Society
A new report from the influential Rand Corporation underscores the dilemma posed by new and better healthcare therapies: They work.
New drugs in the pipeline for chronic ailments like Alzheimer's will likely extend seniors' lives, says Dana Goldman, director of health economics at Rand Health and leader of the research project. But in the process, the elderly will live longer, adding more to the already soaring cost of Medicare and presenting major societal debates over how these technologies will be paid for.
"An array of new medical technology on the horizon could greatly inflate elderly healthcare spending," says Goldman. "This technology is valuable because it will improve health and extend lives. But we need to begin thinking about how to pay for it."
By Tracy Staton - Posted: Monday, November 7, 2005 2:51 pm |
David Archer, M.D. Eastern Virginia Medical School. |
|
After Lengthy Delay, New Hormone Therapy Gets FDA's OK
Beginning in the middle of next year, women will have a new hormone replacement therapy available called Angeliq. Developed by Germany's Schering AG, the FDA sanctioned the drug at the end of September after a lengthy delay to carefully review potential safety issues.
The agency's approval marked a sharp reversal of fortune for the HRT therapy. The FDA originally decided in 2002 that it couldn't approve the treatment, shortly after a new study indicated that Wyeth's hormone replacement therapy increased risks of stroke, cancer and heart disease. A year ago, when Angeliq was approved in Europe, U.S. regulators said that they needed more trial data before they could approve it here.
By John Carroll - Posted: Monday, November 7, 2005 2:48 pm |
John Wilson |
|
Area Firms Are Meeting Unique Healthcare Accounting Needs
Realizing the importance of the healthcare industry here, many Birmingham area accounting firms have identified ways to provide their clients with highly specialized services. In some firms, a few individuals dedicate most of their time to medical clients. Other firms have established separate divisions dedicated to the field.
As in any professional arrangement, being able to communicate comfortably with a chosen accounting firm can be as important as the services provided. The firms listed below reflect some of the range of dedicated healthcare accounting services available locally.
By Ann Halpern - Posted: Monday, November 7, 2005 2:45 pm |
Noel Falls |
|
Healthcare Consultants Offer Clients
When physicians, hospitals or other healthcare entities want a little advice, there are consultants available to offer objective advice and opinions. Although consultants usually are well versed in many aspects of healthcare, they often concentrate their services in an area of specialization.
By Ann Halpern - Posted: Monday, November 7, 2005 2:42 pm |
Pulmonary Physician Passionate about Smoking Prevention and Cessation
Dr. Allan Goldstein, pulmonary physician with Pulmonary Associates of the Southeast, is passionate about smoking cessation, and he wants other physicians to be passionate about it as well.
And he doesn't stop there…he wants insurance companies to pay for smoking cessation counseling, and he is a proponent of efforts to stop people from smoking before they start.
"The people who are paying for healthcare need to tell the insurers that they want [smoking cessation] paid for, and they need to put money into prevention," Goldstein says. "We talk a lot about prevention, but I can tell you that there aren't a lot of people that want to pay for prevention, which doesn't make sense to me. It costs a whole lot more to remove somebody's lung cancer than it does to get them off cigarettes.
By Marti Webb Slay - Posted: Monday, November 7, 2005 2:39 pm |
Dr. William Rodman Shankle |
|
MCI Screen May Improve Alzheimer's Detection, Treatment
Dr. William Rodman "Rod" Shankle is a board-certified neurologist and statistician whose entire career has been focused on Alzheimer's disease and related disorders, or ADRD.
Almost two decades ago, he co-founded the Alzheimer's Research Center at the University of California, Irvine. Currently, he manages about 1,000 patients through his community-based private clinic in Orange County and is the chief medical officer for the Medical Care Corporation (MCC), a private company he founded that specializes in management and detection tools for ADRD.
BY CINDY SANDERS - Posted: Monday, November 7, 2005 2:36 pm |
Dr. Alan Percy, one of the country's leading experts on Rett Syndrome, talks with one of his young patients. |
|
Medical Alert: Recognizing Rett Syndrome
Correctly diagnosing the little known neurodevelopment disorder Rett Syndrome is not easy. In fact, the disease often is misdiagnosed as autism, cerebral palsy or mental retardation. Such misdiagnoses generally come from a lack of understanding of the disorder, according to UAB pediatric neurologist Dr. Alan Percy. Percy directs the Rett Syndrome Clinic at UAB, which is one of only three such facilities in the United States and the only comprehensive Rett Syndrome clinic in the Southeast.
"We in the Rett Syndrome community are asking physicians to be on the alert for this disorder," Percy said, "because it is generally unrecognized in the medical community. Unless you put all the symptoms together, you don't recognize it."
By Ann B. DeBellis - Posted: Monday, November 7, 2005 2:33 pm |
Southwest façade of the John E. Porter National Neuroscience Research Center. |
|
Integrating Research
In the late spring of 2004, research scientists began moving into the new state-of-the-art John E. Porter National Neuroscience Research Center.
Three years earlier, more than 150 investigators representing nine institutes of the NIH gathered to hear Dr. Gerald Fischbach, then director of the National Institute for Neurological Disorders and Stroke (NINDS), and Dr. Steven Hyman, then director of the National Institute for Mental Health (NIMH), outline their idea of creating an integrated framework to further research efforts in the neurosciences.
The two leaders, who are no longer with the NIH, envisioned a facility where investigators from different disciplines could work together sharing space, equipment and ideas to build upon basic research in five key areas — neurogentics, neuroplasticity, neurodevelopment, neural circuits and mood incognition.
Today, their dream is rapidly becoming a reality. Already, scientists from different institutes work in clusters depending on their lines of research.
The idea of creating a central research facility on the Bethesda, Md. campus was to "augment the amount of collaborative work researchers could do," explains Dr. Eugene Major, acting director of the basic neuroscience program with the Division of Intramural Research for NINDS.
"I think we'll see exactly how productive that approach is several years down the road, but it's off to a good start," Major says.
BY CINDY SANDERS - Posted: Monday, November 7, 2005 2:31 pm |
Dr. Thomas Swift |
|
An Exciting Time for the Neurosciences
The American Academy of Neurology has gone public.
Established in 1948, the international association of 19,000 neurologists and neurosciences professionals has just wrapped up its inaugural public expo.
Held in Atlanta, this first public forum was designed to increase visibility of neurological diseases, disseminate information, to raise awareness of the impact of neurological disorders on American society and to try to connect patients with support services.
BY CINDY SANDERS - Posted: Monday, November 7, 2005 2:27 pm |
Dr. Camilo Gomez, director of the Alabama Neurological Institute, uses innovative methods to treat stroke victims. |
|
Time is Major Factor in Successful Stroke Treatment
A stroke can affect anyone at any time, and about 750,000 people are victims of strokes every year. Because brain damage often results from a stroke, researchers continually look for ways to increase survival rates and decrease the risk of disability. Treatments currently in use include intravenous drugs, arterial stents and hypothermia, among others.
Dr. Fazal Rahim, a neurologist at Citizen's Baptist Medical Center in Talladega, said, "My job as a physician is to clearly identify a patient's risk factors for a stroke and treat them accordingly."
Those factors include high blood pressure, diabetes and smoking. He added that the patient plays a role in successful survival of a stroke by seeking medical help as soon as possible so physicians can begin treatment.
By Ann B. DeBellis - Posted: Monday, November 7, 2005 2:25 pm |
Dr. Paul Obert at Namche Bazaar, Nepal, at the beginning of his trek to Everest Base Camp. The Namche area is considered the gateway to the Everest region. |
|
Physician Spotlight: Dr. Paul Obert
Sometime in his life, Dr. Paul Obert must have heard the challenge "climb every mountain" and taken it seriously. Maybe not to the point of trying to climb every mountain, but at least to the point of conquering the Seven Summits, the highest peaks on each of the seven continents.
Obert accomplished that goal with a trek up the world's tallest peak, Mount Everest (Asia), in May 2003. He had previously climbed Mount Aconcagua (South America), Mount Elbrus (Europe), Mount Kilimanjaro (Africa), Mount Vinson (Antarctica), Mount McKinley/Denali (North America) and Mount Kosciusko (Australia), all in less than two years' time.
"For me, it was an excuse to travel around the world, and after having climbed several of the mountains already, I simply decided to finish them off for fun and adventure," says Obert. "For everyone it is a huge challenge which demands determination, commitment, fitness and a tolerance for risk."
by June Mathews - Posted: Monday, November 7, 2005 2:20 pm |
Roger Gates, DSS Research |
|
Managed Care Plans Roll Out Their Part D Drug Programs
For months a group of managed care companies has been carefully crafting drug programs to be subsidized for seniors under Medicare Part D. Kept under wraps and waiting for federal approval, the MCOs were clearly straining at the legal leash that was used to prevent any marketing activities until October.
"Were excited about the growth potential," said Mike Seltzer, CEO of Humana's Florida senior products division. "What I'm seeing is that there are a lot of marketing plans. CMS has millions of marketing dollars ready and assigned for various areas around the country. They're going to be talking a lot about the new drug benefit."
BY TRACY STATON - Posted: Monday, November 7, 2005 2:17 pm |
Wesley Brown, CPA and Margaret Cook, CMP of Kassouf & Co. discuss a new business venture with Tomeka Roberts, MD. |
|
Can Joint Venture Projects Enhance Physician-Hospital Relationships?
Relationships between doctors and hospitals can be amiable or antagonistic. Many experts believe an era of increased cooperation is becoming more likely. One of the closest relationships is shared ownership in a business entity - a joint venture.
There is little question that roles of doctors and hospitals are shifting and changing. Not too many years ago, joint ventures would have been unlikely if not impossible. Today they are becoming common.
What will the future hold? Thalia Baker, CMPE, healthcare adviser for the accounting firm L. Paul Kassouf & Co, P.C., believes a serious look at the long-term roles of doctors and hospitals may offer a key to the answer. "Right now everybody's fighting over the most profitable services. If physicians owned or had ownership in hospitals, we wouldn't be fighting over where the MRI sits." She says physicians are trying to move the services they use all the time to someplace where they have ownership.
By Ann Halpern - Posted: Monday, November 7, 2005 2:13 pm |
UAB Alzheimer's disease specialist Dr. Edward Zamrini examines a patient. |
|
Searching for the Critical Marker
With any disease, early detection generally increases a patient's chances of recovery or survival. In the treatment of Alzheimer's disease (AD), finding the most sensitive marker for change in its victims has become a concentrated quest for researchers.
"The earlier we can detect changes, the more brain that is left for us to preserve and the more time we have to use new agents to treat the disease," said UAB neurologist Dr. Edward Zamrini. 'If we are to really enhance the speed with which we discover drugs, we need to identify the marker."
That discovery is becoming even more important as experts predict the current number of people with AD - 4.5 million - will triple in the next 50 years unless new and effective treatments become available. A national study currently under way at the National Institutes of Aging (NIA) may be another step toward achieving that goal. The five-year study will test whether serial magnetic resonance imaging (MRI), positron emission tomography (PET), and biological markers can be combined with clinical and neuropsychological assessment to measure the progression of mild cognitive impairment and early AD.
By Ann B. DeBellis - Posted: Monday, November 7, 2005 2:10 pm |
FDA Approves Xeloda® Oral Chemotherapy for Colon Cancer Treatment
After a two-year long international clinical trial involving 2000 patients, the FDA approved the first oral chemotherapy drug for the adjuvant treatment of Dukes' C colon cancer. The innovative new drug, Xeloda® (capecitabine) by Roche Pharmaceuticals in New Jersey, was given to half of the patients while the others received intravenous fluorouracil plus leucovorin or 5-FU/LV, the foundation for chemotherapy for the last 40 years. The X-ACT trial, which stands for "Xeloda® in Adjuvant Colon Cancer Therapy" showed that Xeloda® not only met its primary endpoint of non-inferiority to 5-FU/LV but surpassed it by 15 percent according to Dr. Howard A. Burris III, FACP, Director of Drug Development at the Sarah Cannon Research Institute in Nashville, Tenn., one of the lead American accruers in the study.
BY NICK CHARLES - Posted: Monday, October 10, 2005 2:59 pm |
Dr. Ted Chan |
|
Study Finds new ER Procedures Reduces Numbers Who Leave Without Being Seen
In emergency departments around the country, many of the patients who show up needing help never get it — and leave before ever seeing a doctor. According to the General Accounting Office, leave-without-being-seen rates may be as high as 7 percent nationally, and some experts say individual hospitals may have an unexplained departure rate as high as 15 percent.
For many patients, crowded ED departments have made the wait for a doctor simply too long to be endured.
"There were increasingly long stays for a number of reasons," says Dr. Ted Chan, who works in the ED at the University of California, San Diego, Medical Center, where the average wait times for emergency patients hits two hours during peak demand periods. And it wasn't possible just to expand the amount of space given to the department, either.
BY JOHN CARROLL - Posted: Monday, October 10, 2005 2:58 pm |
Companies Getting Aggressive in Putting Lid on Insurance Hikes
Largely by assessing steadily rising co-pays for employees, companies have been able to ratchet down next year's increases in healthcare premiums to the lowest level in five years, says employee benefits consultant Hewitt Associates. But with average premiums still shooting up an average of 12.4 percent, the march of double-digit rate hikes continues and greatly outpaces inflation.
In addition, a new survey by the nonprofit Kaiser Family Foundation found that rising premiums are forcing a growing number of small businesses out of the market altogether, with the percentage of such companies offering group coverage sliding from 69 percent in 2000 to 60 percent this year.
BY TRACY STATON - Posted: Monday, October 10, 2005 2:56 pm |
How Can Relationships Between Physicians and Hospitals Improve?
Though strained relationships between physicians and hospitals get the most attention, many are finding ways to work to their mutual benefit. There is no one solution, but everyone can benefit from good communications and creative thinking.
"Hospitals and physicians can improve their relationships if they do nothing more than just communicate more effectively with one another," says Jay Weatherly, principal and co-founder of Cullman-based Salient Health Ventures. He admits this is not always easy.
"You have two very busy parties who know they need one another and have great intentions of communicating with one another," says Weatherly. He says one way to open lines of communication is finding important and tangible things to do together. "That's why we encourage hospitals to develop proactive strategies for working with their doctors."
BY ANN HALPERN - Posted: Monday, October 10, 2005 2:53 pm |
CytoViva 150 adaptor and light source installed on a microscope. |
|
New Microscope Technology Offers Real-Time Nano View
A new adapter to traditional microscopes is expected to take light microscopy to a new level. Developed by a professor at Auburn University, the CytoViva allows resolutions below 100 nanometers and detection capability below 10 nanometers. The resolution of traditional microscopy is limited to only about 240 nanometers.
"What this really does is provide a very focused and a very directed beam of light to a very, very tiny target," explains Charles T. Ludwig, president and chief executive officer of Aetos Technologies Inc., a privately held technology development company in partnership with Auburn. The CytoViva "fills the gap," he says, between a conventional light microscope and an electron microscope.
BY SHARON H. FITZGERALD - Posted: Monday, October 10, 2005 2:50 pm |
St. Vincent's Neurosurgical Center operating rooms feature all-digital, state-of-the-art equipment. |
|
Joint Venture Results in New Outpatient Neurosurgical Center at St. Vincent's
A collaboration between two different neurosurgery groups and St. Vincent's has led to the opening of a new neurosurgical outpatient center which is housed in the hospital's new North Tower.
"St. Vincent's Neurosurgical Center is a first for Alabama and one of few such facilities throughout the country, dedicated to the provision of outpatient neurosurgical and interventional pain procedures," says Scott Goggins of St. Vincent's. "This unique focus, coupled with the compassion and competency of the professional staff in the Center, should lead to an outstanding patient experience."
Several local neurosurgeons began discussing the idea a couple of years ago when they heard of a similar venture in Nashville. Benjamin B. Fulmer, MD, a neurosurgeon with Birmingham Neurosurgery and Spine Group, says they were impressed with the efficiency of the Nashville center, and they felt it would take two different groups working together to have enough cases to make the project work. Colleagues with Neurosurgical Associates were interested, and they began to search for a hospital that would work with them.
BY MARTI WEBB SLAY - Posted: Monday, October 10, 2005 2:48 pm |
Jerry Stone |
|
ReDoc Simplifies the Lives of Therapists
Who better to help design a software package for physical therapists than a physical therapist? That's the logic Jerry Stone applied 10 years ago when he founded ReDoc, his Nashville-based medical software company. After two decades as a physical therapist and frustrated by the overwhelming documentation requirements of the job, Stone decided to tackle the problem himself.
"I saw there was a need to alleviate the paperwork involved," he recalls. "Having a lot of experience in that field, I was able to work with some software developers and develop a tool that automates all of this paperwork and decreases the paperwork time by about 50 to 60 percent for the treating therapist." The ReDoc Suite of software modules answers the needs of physical therapists, occupational therapists and speech language pathology therapists.
BY SHARON H. FITZGERALD - Posted: Monday, October 10, 2005 2:45 pm |
Lakeshore Foundation's many group exercise classes are adapted for individuals who may be either seated or standing throughout the class. |
|
Lakeshore Foundation: Healthy Living After Rehab
Chances are, you know about Lakeshore Foundation for its sports programs for the disabled. After all, much of the critically acclaimed movie "Murderball," about the 2004 U.S. Paralympic quadriplegic wheelchair rugby team, was shot at Lakeshore's renowned facilities. The U.S. Olympic Committee chose Lakeshore as the first combined training site for Olympic and Paralympic sports.
What you may not know is that the non-profit organization offers exercise and recreational opportunities for people with a wide variety of disabilities and chronic conditions. One of the most comprehensive fitness facilities for the disabled in the country, Lakeshore can benefit patients with severe arthritis, chronic back pain, diabetes, cardiac conditions, spinal cord injury, stroke, spina bifida, cerebral palsy, amputation, MS, MD, visual impairment, Parkinson's Disease, cancer, fibromyalgia and more.
BY DEBORAH LOCKRIDGE - Posted: Monday, October 10, 2005 2:43 pm |
Dave Mason, American Physical Therapy Association |
|
Medicare Beneficiaries May Face Therapy Reimbursement Cap
Have you ever really wanted to do something and just didn't have the money? According to Dave Mason with the American Physical Therapy Association, that's the position Congress is in when it comes to the reimbursement cap on physical therapy benefits for Medicare beneficiaries. Of course, that may not help those elder Americans who depend on Medicare benefits to receive the therapy they need.
"It's just a very problematic policy — one of those that for the best of intentions just kind of runs into the budget rules, and Congress has been struggling to figure out a good way out of the situation," says Mason, vice president of government affairs for the American Physical Therapy Association. Should Congress fail to act by the end of the year, Medicare therapy benefits will be capped at about $1,750 per calendar year for all Medicare recipients, no matter the nature of their malady, the nature of their therapy or where they receive that therapy.
BY SHARON H. FITZGERALD - Posted: Monday, October 10, 2005 2:39 pm |
Jay Segal, PT, agrees that patients benefit when physicians and therapists work together. |
|
Physicians, Therapists Can Work Together to Benefit Patients
,C,*?y that's home to some of the nation's top sports orthopedists and one of the nation's largest providers of rehabilitative healthcare services, physical therapy and rehabilitation probably enjoy a higher profile than in Birmingham than in many cities. But at the same time, those factors could obscure the fact that therapy offers benefits for many different patients and conditions, not just athletes and joint replacement patients. We spoke to several local therapists for some thoughts on how patients could benefit from a visit to a physical therapist.
Emmett Parker, PT, ATC, owner of Accelerated Physical Therapy in Trussville, explains how therapy differs from the practice of medicine. "If someone breaks their arm, we don't treat a fractured humerus," he says. "We treat the loss of motion, the loss of strength, the loss of function [that results from that fracture]."
BY DEBORAH LOCKRIDGE - Posted: Monday, October 10, 2005 2:36 pm |
New Cycle Activates Paralyzed Muscles
Even after his death, paralyzed actor Christopher Reeve is still contributing to rehabilitation advances. That's according to Dr. John McDonald, who directs the International Center for Spinal Cord Injury at Kennedy Krieger Institute in Baltimore. The latest advance taking advantage of work done with Reeve and others is a breakthrough medical device to help restore motor functions to previously paralyzed muscles.
"Part of that concept really bore through with the work that we did with Christopher Reeve, demonstrating that he could recover major function many years out from his injury. That kind of shattered the old myth that most of the recovery is in the first year, and then after that it's finished. It's just not true," says McDonald, who was Reeve's lead neurologist.
BY SHARON H. FITZGERALD - Posted: Monday, October 10, 2005 2:31 pm |
Alice H. Martin, U.S. Attorney for the Northern District of Alabama |
|
Healthcare Crime Doesn't Pay
Every U.S. president's administration focuses on certain initiatives. Under the Bush Administration, the Department of Justice has cracked down on healthcare fraud, in particular the physicians who commit fraudulent crimes.
"I think [the Bush] administration is appropriate in its aggressive stance against healthcare fraud," said Alice H. Martin, U.S. Attorney for the Northern District of Alabama. "Sometimes people do things without knowing they've crossed legal boundaries. Others willfully violate the law. We're taking aggressive action against the willful offenders."
Over the past several years, the case load in Alabama's Northern District has increase 250 percent, Martin said. Of the 93 districts in the United States, her district is eighth in the nation based on the number of civil healthcare cases filed. Some of the areas that have filed more cases include Manhattan, Philadelphia, New York City and Dallas. "We're high on the list for the size of our city, but we do have a large medical community here so these crimes are a considerable focus in our office," Martin added.
BY ANN B. DEBELLIS - Posted: Monday, October 10, 2005 2:28 pm |
Aaron Krupp, MGMA Senior Counsel for Government Affairs |
|
A Year After Stark, The Bright Line Test Has Dimmed
Healthcare is scrutinized by the government like no other industry, and medical professionals rely on their contingent relationship with attorneys to keep them informed and well within regulations. The federal physician self-referral law, referred to as the Stark law, dictates much of what legal professionals consider in their daily workings with medical clients. Now, over a year after Stark II, Phase II, a look into the medical-legal world paints the picture of an ever increasing rift between hospitals and physician practices and the realities of structuring business deals in the healthcare industry. In addition, new stipulations are making the law more convoluted. Since early last year, the designated health services (DHS) had become finalized, with CMS ensuring that physicians could not benefit from self-referring Medicare or Medicaid beneficiaries to an entity in which they or an immediate family member hold a financial interest, from employment contracts to lease agreements. The law also laid some important exceptions, namely the in-office ancillary exception and one excluding nuclear medicine from the DHS list.
BY HOLLI W. HAYNIE - Posted: Monday, October 10, 2005 2:26 pm |
Richard Brockman |
|
Balancing Cost Control and Patient Care
The need to control healthcare costs is an ongoing issue and one that every state works diligently to balance with quality patient care. To help facilitate this need, many U.S. states, including Alabama, are governed by Certificate of Need (CON) laws, which are designed to help control healthcare costs by regulating supply and by requiring advance approval by state agencies for most hospital expansions and major equipment purchases.
"In Alabama, we have measured healthcare because of the CON process," said Birmingham attorney Richard Brockman of the law firm of Johnston, Barton, Proctor and Powell LLP. "CON has been a mandatory program in our state since 1972. When used properly, it ensures that the right amount of healthcare services are used in local communities and that licensed providers provide services correctly. Those states without CON end up with a lot of empty hospital beds and services that are not being provided."
BY ANN B. DEBELLIS - Posted: Monday, October 10, 2005 2:24 pm |
Physician Spotlight: Dr. David DeAtkine
Growing up in coastal Texas, Dr. David DeAtkine skimmed the waves as a surfer and skimmed the pavement as a skateboarder, but he refused to apply the same technique to his medical practice.
"In the summer of 2003, I had 4,300 active patients," he says. "I was seeing 150 new cases each month and adding on the order of 1,500 patients a year. I felt like I was still doing a good job but if it went further, I would be 'skimming the surface' of thousands of patients rather than doing a really good job with a smaller number. I was thinking there had to be a different way."
BY JUNE MATHEWS - Posted: Monday, October 10, 2005 2:21 pm |
UAB Critical Care Transport Team evacuated seven babies from the gulf region. |
|
Hospitals Aid Katrina Victims
Hospitals across Alabama have been generous in aiding Katrina victims. In Birmingham, the Baptist Health System provided medical assistance to evacuees sheltered at the Birmingham-Jefferson convention center, while doctors and nurses from Princeton, Walker, Citizens, Shelby and Montclair Baptist Medical Centers volunteered at the airport to triage patients brought in by plane. The Baptist Health Foundation established a Hurricane Katrina relief fund designed as a donation vehicle for Baptist employees, as well as the general public.
In addition to admitting a large number of evacuees and existing patients from Mississippi and Louisiana, Brookwood Medical Center is assisting displaced Tenet employees with community placement. Brookwood has also collected food and clothing, while helping people find temporary housing.
BY STEVE SPENCER - Posted: Monday, October 10, 2005 2:16 pm |
After patients have been discharged from therapy, they can continue their recovery with a |
|
Local Hospitals Offer Innovative Therapy Facilities
Whether it's inpatient or outpatient care, some local hospitals offer innovative treatment facilities for therapy and rehabilitation.
The new Regional Care Center at Medical Center East helps patients take the next step after their therapy with an exercise/fitness program.
"It's given us the opportunity to have a larger, nicer facility with better equipment," says Bill Huber, administrative director for MCE rehab. At one end of the facility is outpatient rehab, with physical therapy and occupational therapy. At the other end there's a cardiac rehab area. And in the center is an exercise area, where exercise trainers can help patients progress after they're discharged from therapy in what Huber calls a "step-down" program.
BY DEBORAH LOCKRIDGE - Posted: Monday, October 10, 2005 2:12 pm |
Jay Weatherly of Salient Health Ventures, (far right) confers with his business partner Steve Nyquist (left) and Dr. Bob Nesbith (center). |
|
Doctors Become Businessmen to Control Costs and Quality of Care
We all remember the 19th Century image of the physician who based all of his recommendations strictly on medical science and the needs of the patient, but today's economic reality of high-cost healthcare resources has forced many doctors to find ways to cut costs without compromising the quality of patient care. Many are taking on the additional role of businessmen and investing in entrepreneurial ventures.
Cost containment is one reason for the doctor-turned-investor, but according to Jay Weatherly of Salient Health Ventures in Cullman, it's not the only reason. Some physicians are simply taking advantage of good investment opportunities while others are seeking more control over their practice and their income, he said.
BY ANN B. DEBELLIS - Posted: Monday, October 10, 2005 2:10 pm |
New Procedures Help Alleviate Common Urology Problems for Men
As men age, there are two common problems that can send them to a urologist: erectile dysfunction and benign prostate disease. Brian Christine, MD, with Urology Centers of Alabama says recent developments with both conditions make treatment easier and more effective.
BY MARTI WEBB SLAY - Posted: Tuesday, September 13, 2005 2:50 pm |
Cecil Long, MD |
|
Advancements in Male Factor Infertility Make Conception More Successful
When a couple seeks help for infertility issues (between 15 and 20 percent of U.S. couples do), it's important to test both the man and woman, according to Cecil Long, MD, physician with the ART Program of Alabama. "Of the couples who seek help, about 40 percent of the problems are related to a severe or significant male factor," he says. And if infertility is bad news, those couples can consider it good news if the problem is discovered to be on the side of the male. "There are several developments in recent years that have all but eliminated male factor infertility," says Long. "Most of the time our treatments will overcome most factors."
If sperm counts are low, inseminations may be required. "If we see less than two million mobile sperm on a semen analysis, then the most practical way to proceed is in vitro fertilization and ICSI, or intracytoplasmic sperm injection."
BY MARTI WEBB SLAY - Posted: Tuesday, September 13, 2005 2:49 pm |
A variety of masks are available for use in sleep therapy. |
|
Sleep Apnea Treated More Effectively with Newer, Improved Machines
It's not uncommon to find that a spouse or girlfriend is behind a man's visit to a doctor to address specific health concerns, and that is especially true when it comes to sleep apnea. "About 75 percent of the time we hear, 'My wife says I snore and stop breathing, but I don't think I have a problem,'" says Patricia Patterson, MD, FCCP, medical director of the St. Vincent's Sleep Center.
"The wives are usually right," she adds.
Apnea occurs when air doesn't adequately exchange into the lungs due to a mechanical obstruction in the airway. The brain senses an elevation of carbon dioxide and reduction of oxygen, sends a signal and tightens up the airway, causing breathing to stop. Multiple sleep disruptions result, leaving a patient fatigued, even if he thinks he's had ample sleep. Many people with sleep apnea snore, which is one reason that spouses urge medical intervention.
BY MARTI WEBB SLAY - Posted: Tuesday, September 13, 2005 2:44 pm |
Redefining the "Men" in Menopause
Although it's a complete misnomer, the term "male menopause" has begun gaining ground in popular culture over the last few years.
Since menopause comes from the Latin "mensis" referring to month and is tied to the ending of the menstrual cycle, men cannot physiologically go through male menopause.
However, the term instantly connotes a physical change of life that is something more than the typical "midlife crisis" often associated with men.
BY CINDY SANDERS - Posted: Tuesday, September 13, 2005 2:42 pm |
Surgeons at the University of Alabama Birmingham Hospital use a video conferencing system for real-time consults with physicians in other operating rooms or the pathology lab. |
|
Operating Rooms Combine Information, Clinical Technology
Today's operating room is blending information technology and clinical technology for safer, more efficient procedures.
"The gap between information technology and clinical technology has been getting smaller," says Tim Stettheimer, vice president/chief information officer, St. Vincent's Hospital, and in fact they overlap. For instance, he says, x-rays and MRIs are historically a clinical technology — but now they're being captured digitally and used in electronic medical records and for image-guided surgery, bringing them into the realm of information technology.
Nowhere is that more true than in the operating room. The University of Alabama-Birmingham last month opened its new endo suite, which has x-ray capabilities right in the operating room for use in endovascular procedures.
BY DEBORAH LOCKRIDGE - Posted: Tuesday, September 13, 2005 2:39 pm |
Wireless electronic health record systems, like this one from Source Medical Solutions, allow medical practitioners easy access to a patient's medical records. |
|
Electronic Health Records: The Future is Here
Last year, President Bush outlined a plan aimed to ensure that most Americans have electronic health records within the next 10 years.
Electronic health records, also called electronic medical records, can eliminate problems such as dangerous drug interactions, patient information being filed in the wrong chart, large amounts of time and money spent on recording and transcribing doctor's notes, staff time pulling paper charts, lack of easy access to a patient's prior medical history and storage issues.
The accumulation of paper had gotten so bad at one practice, "it was just about to get the entire floor reinforced to handle all the paper charts," says Ralph Riccardi, executive vice president and COO of Birmingham-based Source Medical Solutions, which offers an electronic health records system called SourcePlus EHR.
BY DEBORAH LOCKRIDGE - Posted: Tuesday, September 13, 2005 2:37 pm |
One-Time Health Plan Credentialing Streamlines Cumbersome Process
Say the words "health plan credentialing" to physicians or their office managers and watch them cringe. Completing the applications to be a provider for multiple health plans is a time-consuming administrative burden, fraught with mind-numbing detail and redundancy.
True to its name and mission, the national Council for Affordable Quality Healthcare (CAQH), based in Washington, D.C., has tackled this hassle using a secure, state-of-the-art data center and the Internet. The organization's Universal Credentialing DataSource, launched in 2002, received earlier this summer a statement of support from the American Medical Association and was already endorsed by the American College of Physicians and the American Academy of Family Physicians.
BY SHARON H. FITZGERALD - Posted: Tuesday, September 13, 2005 2:34 pm |
Researchers Find Doctors Turning to Handhelds for Bigger Load of E-Prescribing
If you want to find the physicians most likely to use the latest handheld technologies for writing prescriptions, you need to start by looking for the doctors with the most to gain.
"It's really the busy physicians that are writing a lot of prescriptions that are most likely to embrace technology," says Erika Fishman, an analyst for Manhattan Research. A new survey by Manhattan Research concluded that the doctors who tap electronic prescribing software on their PDAs blaze through an average of 42 more prescriptions per week than those who stick with their desktop software.
BY TRACY STATON - Posted: Tuesday, September 13, 2005 2:33 pm |
How Have Relationships Between Hospitals and Physicians Changed?
Editor's note: This article is the first in a series of articles about the relationship between hospitals and physicians.
The relationship between doctors and hospitals has always been dynamic with opportunities for both collaboration and conflict. "They need each other, but they don't always realize they need each other," says Jay Weatherly of Cullman-based Salient Health Ventures.
Years ago, hospitals didn't provide the beds, physicians did. "Hospitals started out on the first or second floor of physician offices," says Gary Griffin, advisor with Gary Griffin & Associates in Gadsden. He recalls a Pell City hospital facility above a pharmacy.
BY ANN HALPERN - Posted: Tuesday, September 13, 2005 2:30 pm |
Physician Spotlight: Dr. Gregory D. Chapman
Dr. Gregory D. Chapman is a man who practices what he preaches. The 50-year-old Birmingham cardiologist naturally encourages his patients to exercise — after all, cardiologists are supposed to do that. But he recently demonstrated to his patients, and indeed the world, his own willingness to exercise by running in a 26.2-mile race.
And he not only survived, but he thrived on the effort it took to do it.
On July 31, Chapman was one of 5,000 runners — out of nearly three times as many starters — to finish the 2005 San Francisco Marathon. Long an advocate of a healthy diet, a healthy lifestyle and exercise, he can now serve as a personal example to his patients as to the benefits that training for a marathon can bring.
BY JUNE MATHEWS - Posted: Tuesday, September 13, 2005 2:27 pm |
Government Tracks Soaring Demand for Bariatric Surgery
For a growing number of morbidly obese Americans, the most effective tool for fast weight loss is a scalpel.
As bariatric surgery becomes increasingly safer, a growing number of obese Americans are turning to surgeons for a quick victory in the fight against fat. And in a new report, analysts say that demand for weight-loss surgery has the potential to increase at an even faster pace in the years to come.
After examining the available data from 1998 to 2002, researchers at Health and Human Service's Agency for Healthcare Research and Quality determined that the number of bariatric surgeries in the United States soared from 13,386 a year to 71,733. A big part of that increase resulted from a 900 percent rise in operations for patients 55 to 64.
BY JOHN CARROLL - Posted: Tuesday, September 13, 2005 2:25 pm |
Dr. John Parker, assistant professor in the department of ophthalmology at UAB, is implanting an artificial cornea, a process called permanent keratoprosthesis. |
|
UAB Eye Surgeons Offer Alternatives to Corneal Transplants
Recent medical advancements in the field of ophthalmic surgery are making life better for patients who once would have required cornea transplants to treat Fuch's dystrophy or other corneal diseases. Three less invasive procedures currently being performed at UAB are proving to reduce recovery times significantly and give these patients greater quality of life.
For years, corneal transplant has been the procedure used to treat diseased corneas. The procedure requires the removal of diseased tissue, which is then surgically replaced with donor tissue and sutured in place. The surgery takes one to two hours and requires multiple follow-up visits to check the healing process and remove the sutures. Overall recovery generally takes more than a year.
BY ANN B. DEBELLIS - Posted: Tuesday, September 13, 2005 2:23 pm |
Tim Stettheimer, St. Vincent's Vice President and CIO. |
|
St. Vincent's is Digital Flagship
St. Vincent's Hospital is a nationwide leader when it comes to using information technology. It has repeatedly been honored as one of the "100 Most Wired" hospitals in the country by Hospitals & Health Networks magazine. Publications and TV shows such as the Wall Street Journal, Forbes magazine, ComputerWorld, ABC News Tonight and Inside Edition have singled out St. Vincent's for its high-tech advances. St. Vincent's is the flagship digital hospital for Ascension Health, the nation's largest nonprofit health system.
Just a few of St. Vincent's accomplishments:
o One of the largest wireless networks in the nation;
o Electronic medical records going back as far as eight years for all patients;
o Digital diagnostics, such as X-rays, CTs, MRIs;
BY DEBORAH LOCKRIDGE - Posted: Tuesday, September 13, 2005 2:21 pm |
The first nurses in the pilot program in 2002 were (L-R): Debbie Duke, Lucy Willis, Dorothy McConis, Dedra Arledge, and Cindy Calvert . |
|
Parish Nursing Grows in Popularity
A special group of nurses is finding that there are benefits to screening for certain conditions and providing training in good health practices at churches, rather than waiting for people to go to their doctors.
They are parish nurses, and the concept of providing counseling and support at places of worship is gaining in popularity. "Parish nursing is a nurse who works for the church or a faith community," explains Gretchen S. McDaniel, DSN, professor and director of NurCE at the Samford University Ida V. Moffett School of Nursing. "It's not a hands-on practice or clinical practice, but is more focused on health education, health screening, health counseling, and being a referral agent. They coordinate support groups and volunteers. A parish nurse is someone who helps others work their way through the maze of healthcare."
Samford offered the first parish nursing course in the Birmingham area in 1999, and classes are usually overbooked, with a waiting list. The continuing education course is for registered nurses and takes place in two weekend sessions at a retreat setting.
BY MARTI WEBB SLAY - Posted: Monday, August 8, 2005 5:13 pm |
Joe Bryant (far right) Happy Home Heath Care in Alabaster loads up a delivery for a home care patient. |
|
Home Care 101: The Basics of Providing Patients With All the Comforts of Home
Caring for people in their own homes plays a significant role in the delivery of healthcare. Studies show that providing care at home as opposed to in a clinical setting enhances a patient's quality of life and independence. It is also much more cost effective than long hospital or nursing home stays.
The variety and scope of services now available makes home care not only more possible than before, but more practical and comfortable as well. As a result of all that is now being offered, home care has become the fastest-growing service industry in the United States in recent years.
According to the National Association for Home Care & Hospice, approximately 20,000 providers currently deliver home care services to 7.6 million individuals. In 2003 alone, the annual expenditures for home healthcare services amounted to around $38.3 billion.
BY JUNE MATHEWS - Posted: Monday, August 8, 2005 5:08 pm |
Paul J. Williams |
|
Sink or Swim … America's Age Wave on the Horizon
Those demanding Baby Boomers … they impact, change and challenge the system at every lifestage.
In the 60s they were outspoken in their criticism of the government. By the 90s, they'd elected the first president from their own generation. In 2020, they are fully capable of again raising their voices, in a loud protest if the system isn't prepared to offer the array of senior services and lifestyle options, they are sure to demand.
In truth, the industry is already getting a taste of what Boomers will expect for themselves as members of the nation's largest generation are now reviewing housing and service options on behalf of their parents.
Nursing homes … or skilled nursing facilities … have been around a long time for those with the highest level of needs. However, assisted living and continuing care retirement communities (CCRCs) are relatively new options that have evolved over the last couple of decades as a growing number of seniors have hit a mid-point between wanting or being able to maintain their own home and requiring around-the-clock care.
"The major difference is the type of care and the frailty of the elder," says Paul J. Williams, director of state affiliate relations for the Assisted Living Federation of America (ALFA).
BY CINDY SANDERS - Posted: Monday, August 8, 2005 5:05 pm |
Mount Royal Towres offers, among many levels of senior care, assisted living and ActivCare® Residential Alzheimer's Care. |
|
Assisted Living & Other Senior Care Options
The demand for long-term healthcare services is reaching an all-time high, thanks in part to extended life expectancy and the overall graying of America. According to statistics compiled by the National Center for Assisted Living (NCAL), in the year 2000 approximately one in eight Americans reached the age of 65 or older; and by the year 2030, that figure is estimated to rise to one in five. As the population ages, the senior housing market continues to expand to meet the growing demand. From independent living to assistance with daily activities to full-scale monitored care, today's choices are driven by healthcare needs as well as lifestyle demands. This month Medical News will explore design options bridging the continuing care spectrum as well as health, safety, and legislative issues impacting senior living.
BY DANA C. CRISSON - Posted: Monday, August 8, 2005 5:02 pm |
Hospital-Based Palliative Care: Has the Time Come?
The scenario is painfully familiar: A 93-year-old woman in breathing distress is rushed by ambulance from her nursing home to a hospital emergency room in the middle of the night. She's later admitted into the intensive care unit, where her family can't see her, and she's hooked up to a ventilator.
"I'm not a clinical person, but you would be amazed how many stories I hear about people who had advance directives that were ignored and how difficult it is, once someone is on the conveyor belt into the hospital," says Lynn Spragens, a national expert in palliative care and an independent consultant with the New York-based Center to Advance Palliative Care. Spragens contends that hospital-based palliative care programs help prevent such agonizing situations — and save hospitals money at the same time.
Palliative care is an emerging medical specialty with its definition still in flux. While originally linked with hospice, palliative care is now forging its own way. "Palliative care programs should always work very collaboratively with hospice, but this takes it upstream," Spragens explains. Palliative care looks at medicine more broadly "because it's also about the beliefs and wishes. It's not just, 'What's your blood pressure?' That's where it shares some of its philosophy with hospice," she says.
BY SHARON H. FITZGERALD - Posted: Monday, August 8, 2005 5:00 pm |
Dr. Russell K. Portenoy, Beth Israel Medical Center |
|
Hospice and Palliative Care Board Certifies While Pushing for Formal Recognition
What does it mean to be a specialist in hospice and palliative medicine? To help answer that question, the American Board of Hospice and Palliative Medicine was founded in 1995 and since 1996 has administered a certification process to ensure physicians have the necessary knowledge and competency to do the job.
"What we're doing is certifying physicians both through their training and experience and then through the exam process. Those physicians must prove specialty level knowledge in the care of people at the end of life and in the care of people with life-threatening illness," explains Dr. Russell K. Portenoy, chairman of the ABHPM Board of Trustees and chairman of the Department of Pain Medicine and Palliative Care at Beth Israel Medical Center. An expert in the field of pain management, Portenoy champions the cause that hospice and palliative medicine should be a legitimate subspecialty recognized by the American Board of Medical Specialties, and the ABHPM is working toward that goal.
In fact, Portenoy says several milestones have been already reached on the path toward formal recognition, including an application in May to the Accreditation Council of Graduate Medical Education. The application asks the council to initiate an accreditation process for fellowship training programs in hospice and palliative medicine.
BY SHARON H. FITZGERALD - Posted: Monday, August 8, 2005 4:59 pm |
Healthcare Cost Inflation Levels Off at High Rate
Hopes that healthcare spending was beginning to slow to a more affordable pace have been dashed by a new study showing industry inflation steaming ahead of overall economic growth.
Healthcare costs surged 8.2 percent last year, according to the Center for Studying Health System Change. That is at the same pace as 2003 and well ahead of a brisk 5.6 percent surge in the economy as a whole. Analysts fear that after peaking at 11.3 percent in 2001, healthcare spending growth may have settled in at a high level. And that's bad news for groups hoping to see the trend that has left a growing number of Americans without health insurance coverage go into reverse.
"If healthcare spending continues to grow at a significantly faster rate than workers' incomes — and there's every sign that it will — health insurance will become unaffordable to more and more people," said Paul B. Ginsburg, Ph.D., coauthor of the Health Affairs study and president of HSC, a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation. Those higher costs are increasingly being passed on to workers, he adds.
The Center noted that this year will mark the fourth straight annual increase in the amount of health costs being passed on to rank-and-file employees through ever-higher co-pays, deductibles and co-insurance.
BY TRACY STATON - Posted: Monday, August 8, 2005 4:57 pm |
Dr. Mauro Moscucci, University of Michigan |
|
Doctors Say New Report Cards Force Them to Turn Away Sickest Patients
Throughout the country, new report cards grading how effectively physicians are taking care of their patients are becoming increasingly popular. In theory, giving doctors grades will help the public choose better doctors and encourage physicians to practice better medicine.
But a new study suggests that the trend may have just the opposite effect than what was intended, with more and more docs deciding to steer clear of the sickest patients who may contribute to a bad grade.
Researchers at the University of Michigan took several years of data from New York's ambitious reporting system on two major heart procedures and found that doctors in their home state were more likely than surgeons in New York to perform angioplasties on very sick patients. Their conclusion: reporting outcomes is persuading physicians to turn away the patients in most need of an operation. And that follows a survey done by the Archives of Internal Medicine earlier this year that eight out of 10 New York cardiologists said that public reporting made them less likely that they would accept the most seriously ill patients.
BY JOHN CARROLL - Posted: Monday, August 8, 2005 4:56 pm |
Physician Spotlight: Dr. Alton Baker
Alton Baker, MD, has a mission: to make Princeton Baptist Medical Center "the best hospital in the state."
Princeton may not be as well known in Birmingham as, say, UAB or St. Vincent's, says Baker, who's vice chairman of the radiology department, but the hospital has a lot going for it, and he'd like area residents to know.
"We're doing a lot of things here," he says. "For instance, the hospital does more open heart surgery and more catheterizations of the heart than anyplace else in the city. The emergency room is one of the busiest in the city."
The radiology department, he says, is all-digital and features very advanced light-speed CT scanning, as well as the state's first three-Tesla MRI. "It's twice as strong and has twice the resolution of the more typical 1.5 Tesla MR, so it's one of the foremost machines in the country."
The newest technology in the department is a volume CT scanner, which Baker says is the first one in Birmingham. "It scans very quickly with very small cuts at very high resolution," he says, enabling a CT scan of the chest or abdomen/pelvis in only two seconds.
BY DEBORAH LOCKRIDGE - Posted: Monday, August 8, 2005 4:54 pm |
AMA Plots Ambitious Legislative Agenda at Annual Policy Summit
When members of the American Medical Association's House of Delegates gathered in Chicago in June for their annual policy meeting, image was much on their mind.
Delegates were treated to a new set of television ads starring physicians as "everyday heroes" in an upcoming $60 million marketing campaign. And there was a new logo featuring a stylishly modern staff-and-snake design.
For the AMA, it is all part of a carefully crafted effort to put physicians in the best light possible at a time when the organization is grappling with some contentious issues. And many of those issues were framed in 200 proposed initiatives that were intended to create a legislative agenda for the 244,530-doctor group to pursue in Washington and 50 state capitols.
BY TRACY STATON - Posted: Monday, August 8, 2005 4:52 pm |
Hospice: Easing Life, Easing Death
For most physicians, from the moment they take the Hippocratic Oath, the unwavering focus is on caring for patients to the best of their ability by bringing forth all the knowledge, science and technology available to effect a cure. The attention has been so intensely focused on battling disease, little room is left to discuss what happens when the fight ends. Somehow, with all our modern science, death seems like the ultimate defeat.
However, for some patients there comes a point after which aggressive treatment for incurable diseases is no longer desirable. Palliative and hospice care are excellent options.
BY MELINDA DICKINSON - Posted: Monday, August 8, 2005 4:51 pm |
What Does the Future Hold for HealthSouth's Digital Hospital?
Early on, HealthSouth's facility on U.S. 280 got tagged a digital hospital while still in the planning stages because of all the proposed innovations. Today every new hospital facility fits that high-tech description and existing hospitals are catching up fast.
While area hospitals are moving with the trend by adding digital technology, only the HealthSouth facility was designed from the ground up with a wired future in mind. Financial and management troubles halted construction. The new management team has elected to sell the facility and focus its efforts elsewhere.
This digital hospital facility should prove a decided asset for the eventual buyer and for people in our area. Digital hospitals nationwide claim drops in patient mortality and increases in quality of care. Investing in technology is also improving productivity.
Another reason hospitals keep investing in technology is that government and private insurers are tending to pay more for higher quality care. The key to measuring — and improving — quality is more information technology.
BY ANN HALPERN - Posted: Monday, August 8, 2005 4:48 pm |
July 2005
Posted: Monday, August 8, 2005 4:24 pm |
UAB Program Works to Prevent Shaken Baby Syndrome
A program at the University of Alabama at Birmingham is teaching parents of newborns how to protect their children from shaken baby syndrome, one of the most severe forms of child abuse.
Shaken baby syndrome happens when parents or caregivers shake the baby out of frustration or stress when the child is crying inconsolably. It can cause brain trauma and death, and occurs most often in infants two years old and younger.
According to the National Center on Shaken Baby Syndrome, treatment was sought for approximately 1,200-1,400 children who were shaken last year. Of those, 25 to 30 percent died as a result of their injuries, and the rest will have lifelong complications. In reality, many more babies probably suffered from the effects of SBS, because SBS victims rarely have any external evidence of trauma.
Now nearing the end of its second year, UAB's Shaken Baby Prevention Program recruits volunteers to visit new parents in the hospital, show them a video, review printed materials with them and give them a toll-free number to call. For parents who want more information, The Birmingham Exchange Club Family Skills Center is partnering with UAB to provide free parenting support. New parents can also sign up for a free childcare newsletter.
BY DEBORAH LOCKRIDGE - Posted: Friday, July 8, 2005 4:22 pm |
Dr. John E. Lewy |
|
Children's Access to Care Tops AAP Priority List
"Access is at the top of everyone's agenda," stated Dr. John E. Lewy, FAAP, chair of the American Academy of Pediatrics' Committee on Federal Government Affairs.
With more than nine million uninsured children in America, many kids go without the necessary preventative medicine … and even acute care … that they need. In the 109th Congress, the AAP supports several solid pieces of legislation that would significantly chip away or totally eliminate the number of uninsured minors in the nation.
While advocating for broad-based access to healthcare, the AAP is simultaneously trying to minimize damaging cuts to the nation's Medicaid program.
With $10 billion in cuts slated over the next five years, the AAP fears that both enrollment and benefits will be impacted further elevating the number of children who don't get appropriate medical care in the United States.
BY CINDY SANDERS - Posted: Friday, July 8, 2005 4:21 pm |
Early Intervention Key to Dealing with Childhood Obesity
"To me, the hardest part of our clinical program is seeing a child who's 12 years old who weighs 300 pounds and is 5 foot 2. That child didn't get to be 300 pounds overnight. Why was that child not recognized when they were five, six or seven and starting to pull away from the curve?"
That's the lament of Frank Franklin, MD, PhD, medical director of the Children's Center for Weight Management at Children's Hospital and professor of pediatrics and nutrition science at the University of Alabama at Birmingham. The center treats childhood obesity through a multi-disciplinary approach, treating medical problems and psychological issues, revamping diets, devising appropriate exercise programs, offering peer group support programs, even doing bariatric surgery.
Childhood obesity demonstrates how the job of pediatricians has changed, says Lillian Israel, MD, senior partner at Shades Crest Pediatrics in Brookwood Medical Plaza.
"Twenty-five years ago, we were seeing a lot more worrisome infectious diseases," she says. "With the advent of several vaccines, we're seeing fewer and fewer of those more serious infections. We're much more concerned with lifestyle issues," such as ADD, depression, social problems relating to higher divorce rates — and obesity.
"It's a gigantic problem, both literally and figuratively," Israel says. "I didn't used to see fat kids, and now I see some that are morbidly obese. It's really scary."
BY DEBORAH LOCKRIDGE - Posted: Friday, July 8, 2005 4:18 pm |
National Organizations Take on Childhood Obesity
While access to healthcare tops most pediatrician's list of legislative priorities, reversing the trend of overweight children is quickly climbing to the top of clinical concerns.
Dr. Bob Holmberg, a board certified pediatrician for Eastern Maine Medical Center's Norumbega Pediatrics group, sits on the American Academy of Pediatrics Obesity Task Force, which was created two years ago.
"It is increasingly recognized that the acceleration of the prevalence of obesity is one of the major epidemics we're dealing with," Holmberg said.
He added the task force is focused on developing practical, evidenced-based guidelines for what pediatricians can do to combat the problem in their offices. A second, equally important mandate is to find a way to collaborate and coordinate with other groups from urban planners to school lunch directors to fast food providers on what is clearly a multifactorial problem.
BY CINDY SANDERS - Posted: Friday, July 8, 2005 4:16 pm |
Dr. Steven Harms is pictured here with his RODEO MRI behind him. |
|
The Answer in Black and White
Any woman who's ever had a mammography will cheer the work of Dr. Steven Harms at the University of Arkansas for Medical Sciences. His new magnetic resonance imaging (MRI) technique to detect breast cancer does not require the tissue compression necessary for traditional mammography. No more squashing the breast with an unforgiving plate of Plexiglass.
Developed by Massachusetts-based Aurora Imaging Technology Inc., the dedicated MRI machine is designed specifically for breast imaging and is contoured for the patient to lie face down. The breasts are suspended away from the chest wall — without compression — in a cushioned device which contains the signal transmitters and receivers for the radio frequencies. Harms' RODEO MRI method is at use in nine medical facilities across the country with an onslaught of additional sites expected in the next year. The first site was in Knoxville, Tenn.
RODEO, which stands for ROtating Delivery of Excitation Off-resonance, produces hundreds of three-dimensional, cross-sectional images of the breast. What makes the process superior to mammography is its clear image of cancer when a contrast agent has been injected into the patient.
"It's so clear in terms of what you need to do," says Harms. "Medicine is mostly shades of gray. Everything's not black and white. But with MRI, it's more black and white."
Once malignant breast tumors reach a certain size, they begin to grow their own blood supply; thus high blood vessel density is a characteristic of cancer. Harms explains that, because of the increase in blood-carrying vessels, tumors appear "very bright" thanks to a contrast agent such as Gadolinium, which is slightly magnetic and accumulates in the abnormal tissue. It then is rapidly eliminated from the body by the kidneys.
BY SHARON H. FITZGERALD - Posted: Friday, July 8, 2005 4:12 pm |
New Jet Means Speed, Comfort and Efficient Care for Critically-Ill Patients
In its quest to bring an ever-higher level of medical care to the people of Alabama, the University of Alabama at Birmingham (UAB) has upgraded its medical transport air service with a new jet.
Dedicated on June 7 during ceremonies at the Birmingham International Airport, the $4 million 2000 Cessna Citation Bravo has been specially outfitted with a wide cargo door, the world's first modification of this kind on a Bravo. The plane can accommodate two adult stretchers or two newborn isolettes and has room for parents to fly with their children. UAB's Critical Care Transport (CCT) service transports approximately 400 babies a year.
"The Critical Care Transport program is a valuable community service and gives UAB the capability of literally delivering 'medicine that touches the world'," says Marlon Priest, M.D., medical director of CCT. "With this new aircraft, we are now able to fly someone nonstop from Boston to Birmingham, for example, getting our patients where they need to go and shaving more than two hours off the total flying time of our (previous) jet.
"The new aircraft has advanced avionics that will allow us to fly at higher altitudes, giving us even more efficiency and patient comfort," he said.
The previous airplane was a Cessna Citiation 500 that served the program for well over 20 years, according to Robert Cofield, associate vice president of UAB Hospital. Increasing maintenance costs and the expense of technological upgrades required to keep the plane competitive were factored into the decision to retire it.
The CCT program, says Cofield, was begun in 1983. He estimates that since its inception, the size and usage of CCT has more than doubled.
BY JUNE MATHEWS - Posted: Friday, July 8, 2005 4:10 pm |
Dr. Rebecka Peebles, Stanford University adolescent medicine specialist (left) and Jenny Wilson, Stanford medical student. |
|
Dying to Be Thin
Physicians who treat patients with anorexia or bulimia face a sinister obstacle in the form of Web sites that promote eating disorders as a lifestyle choice. These painfully thin patients, mostly young women, look to these sites for validation — and they get it, according to a California doctor who has studied their impact.
"These Web sites are founded on the mistaken belief that eating disorders are not a disease, but a way of life," says Dr. Rebecka Peebles, a Stanford University adolescent medicine specialist. Peebles and Jenny Wilson, a Stanford medical student, presented their research on the subject at the annual meeting of the Pediatric Academic Societies in Washington, D.C., in May.
What they found in their preliminary study, which they say is the first to examine the health effects of frequenting pro-eating disorder sites, is that these teens spend more time in the hospital and less time on their schoolwork than their peers who don't visit the sites. Peebles says there wasn't much difference when it came to length of their eating disorder, the number of their missed menses, presence or absence of osteoporosis, and their percentage of ideal body weight.
Of the anorexics and bulimics studied, 40 percent said they had visited Web sites promoting eating disorders, while 34 percent said they had visited sites dedicated to recovery from the condition. About 50 percent of those studied hadn't visited either type of site.
Peebles says that the overlap between those who had visited pro-disorder sites and those who had visited recovery sites was "surprising," but whether that's a positive or a negative is still up for interpretation. "Clearly, a lot of our patients are looking for information," she adds.
BY SHARON H. FITZGERALD - Posted: Friday, July 8, 2005 4:07 pm |
Mark DeGuenther, MD |
|
Obturator Tension-Free Tape Offers Fix for Women with Urinary Incontinence
In the not-so-distant past, women suffering from stress urinary incontinence were treated with a bladder tack, a procedure which was a "big deal," explains Mark DeGuenther, MD, urologist with Urology Centers of Alabama. Now with an obturator tension-free vaginal tape, treatment is improved and the recovery is much easier. "It's a very minor outpatient surgical procedure. I've been more excited about the results with this procedure and the easy recovery than anything I've learned to do any time recently," he says. "The patients have very little recovery period, very little post-operative urinary symptoms, and about 90 percent of the people are either dramatically improved or cured. That is on par with anything else we can do. It's a fantastic procedure."
The old vaginal sling required an incision in the belly, a cut through the fascia, and a big incision in the vagina. "You had to place it in the proper spot and make sure you tacked it down properly. Then you had to fool with getting the tension just right … too much tension and they couldn't void, not enough tension and they still leaked. There was an awful lot of educated guesswork involved," says DeGuenther.
That procedure had evolved to a tension-free vaginal tape that was placed around the urethra. It also required an incision in the vagina, with two stab wounds in the lower abdomen. "It also creates some potential risk because you are passing through an area in front of the bladder where there's an awful lot of big blood vessels," he says.
Now, however, there's the obturator tension-free tape. "It's the same type of approach, but we don't go behind the bladder. We go out to the side and through the obturator foramen. We pass the tape through there and avoid the potential for bleeding in the retropubic veins. It's a significant improvement," he explains.
BY MARTI WEBB SLAY - Posted: Friday, July 8, 2005 4:02 pm |
Freda Centor RN, MS, clinical nurse specialist, explains postpartum care to a patient, Edith Ramirez, in UAB Women's and Infant's Services. Translator Fiorella Potestoy bridges the language barrier. |
|
UAB Nurses Cross the Language Barrier with Hispanic New Mothers
It's a daily challenge for healthcare professionals: communicating with patients about their condition without the overuse of medical terms that can confuse them rather than enlighten. But when a patient doesn't even speak English, it adds another language barrier that can impede quality care. For new mothers, that language barrier can make the difference between a positive birth experience and a frustrating one.
That's why Freda Centor, RN, MS, clinical nurse specialist in the UAB Women's and Infant's Services proposed a course for ob/gyn nurses that would help them talk to Hispanic mothers and provide them with the information they needed to care for their babies. "I have not heard of anyone else doing a program like this," she says.
When Centor arrived at UAB about five years ago, she wrote a discharge class for the postpartum unit that the nurses taught to new mothers before they left for home with their babies. "Patients really seemed to like it," she says, "but a whole group was falling out because they didn't speak English. Those mothers were primarily Hispanic and spoke Spanish."
She wanted to translate her postpartum class into Spanish, but she also wanted nurses to be able to communicate better with their patients, so she set out to find funding for a Spanish class for healthcare professionals. It was more difficult than she expected, but finally she discovered that the March of Dimes would provide funds. "They have been fabulous to work with," she says.
BY MARTI WEBB SLAY - Posted: Friday, July 8, 2005 3:58 pm |
Pill Cam Gives Physicians a Close-Up of the Human Body
The PillCam has been revved up to speed diagnostics and broaden its uses among gastroenterologists.
Introduced by Israel-based Given Imaging, the pill-sized device includes a miniature video camera that is swallowed by a patient and then returned to a physician after it passes through their gastrointestinal system. During its journey through the small bowel, the device takes 15 to 25 picture frames a second — about 55,000 altogether — which can be downloaded later and reviewed by the physician to diagnose abnormalities like Crohn's disease, Celiac disease and tumors. The PillCam was approved for use in the U.S. by the Food and Drug Administration as an "adjunctive" tool in 2001 and OK'd for primary diagnosis use in 2003.
And it's been catching on around the country. In May, Given Imaging reported that record PillCam sales helped push revenue up 73 percent in the first quarter of this year, to $22 million.
In a recent clinical trial involving 24 patients, the PillCam's wireless capsule endoscopy was compared with barium contrasts to find polyps in the small intestines. In barium contrasts, a doctor orders X-rays after a reflecting liquid is inserted into the small intestine.
Researchers found that the barium contrasts were able to locate polyps in three of the patients, while the pill camera was used to find polyps in seven.
"Our study confirms previous study findings that established the accuracy of innovative wireless capsule technology in identifying intestinal polyps," said Josep Llach, MD, lead study author from the Endoscopy Unit of the University of Barcelona in Spain. "This non-invasive procedure is legitimately setting a new standard for small bowel assessment."
BY TRACY STATON - Posted: Friday, July 8, 2005 3:56 pm |
University Cuts Drug Firms Out of its Pharmacy Program
Like most employers, the University of Michigan has been stung by soaring drug prices. But unlike most employers, the university was able to do something about it.
Convinced that something needed to be done to rein in the stiff, double-digit price hikes that hit their budget with each passing year, the university called on a staff full of medical experts and a group of outside consultants to create a working group that could come up with a solution. In the end, says Keith Bruhnsen, who was hired on to the university's benefits division specifically to focus on drug costs, Michigan found that some of the biggest culprits for higher drug prices were the pharmacy benefit managers (PBMs) who had been brought in to help manage costs.
Instead of dividing drug administration among the five different health plans and pharmacy benefit managers engaged to work with each, the university acted to centralize drug administration under one vendor. The remaining PBM, AdvancePCS — later bought by Nashville-based Caremark — was ordered to turn the work of the pharmaceutical and therapeutics committee over to the university's experts; a panel of pharmacists and physicians who were charged to determine which drugs needed to be covered for the 80,000 lives covered by the university and which could be safely excluded.
BY JOHN CARROLL - Posted: Friday, July 8, 2005 3:54 pm |
Physician Spotlight: Brad Goodman
A number of Birmingham radio listeners have Brad Goodman, MD, to thank for better knowledge about their health issues — and the good doctor has learned a lot along the way, too.
Goodman, a physiatrist at Alabama Orthopedic and Spine Center at Medical Center East, is the host of "Doc Talk," an hour-long radio call-in program each Saturday at 10 a.m. on WAPI 1070 AM.
It all started 10 years ago, when Goodman was in a meeting where radio advertising was suggested to promote orthopedics at Medical Center East. "I suggested to them that we should do a radio show," Goodman recalls. He thought it would be very easy to do, simply answering questions that listeners called in.
"I was very naive at the time," he says. "It was a lot harder and a lot scarier than I imagined it to be. Generating phone calls was a lot more challenging than I had thought. The first day, I had a lot of people 'planted' to call, but I soon realized I couldn't spend my time finding people to call in every week."
The solution was to bring guests on the show so Goodman would have someone to talk to, and a topic to talk about, while he waited for callers. "I'm not talented in the way of some radio people who can sit there and talk to a microphone," he says.
BY DEBORAH LOCKRIDGE - Posted: Friday, July 8, 2005 3:51 pm |
Dr. Theodore Addai, the chief of cardiology at Nashville General Hospital and Meharry Medical College. |
|
BiDil Receives FDA Approval as First Racially Targeted Drug
The Food and Drug Administration on June 23 approved BiDil, a drug treatment for cardiovascular disease that specifically targets blacks. In a statement, the FDA says the drug represents "a step toward the promise of personalized medicine."
"Today's approval of a drug to treat severe heart failure in the self-identified black population is a striking example of how a treatment can benefit some patients even if it does not help all patients," says Dr. Robert Temple, FDA associate director of medical policy. "The information presented to the FDA clearly showed that blacks suffering from heart failure will now have an additional safe and effective option for treating their condition. In the future, we hope to discover characteristics that identify people of any race who might be helped by BiDil." A Food and Drug Administration advisory committee endorsed the drug on June 16.
Dr. Theodore Addai, the chief of cardiology at Nashville General Hospital and Meharry Medical College, calls approval "a great step forward in the management of heart failure." Addai headed one of the 170 sites across the nation where BiDil was studied as a therapy for blacks diagnosed with heart failure. The Phase III clinical trial, launched in May 2001, was abruptly halted in 2004 because the findings so far had been overwhelmingly positive — an astounding 43 percent reduction in death rates. Cessation allowed the study participants who were taking the placebo to benefit from BiDil as well.
BY SHARON H. FITZGERALD - Posted: Friday, July 8, 2005 3:48 pm |
Dr. Judith Favor holds a Novasure System, the latest generation of devices that treat the entire inside of the uterus at once. |
|
Endometrial Ablation Now Faster, Safer, More Effective
Endometrial ablation isn't the newest treatment on the block for heavy bleeding, but because of recent innovations, the procedure is faster, safer and more effective than ever, say local OB/GYNs.
"Ablation means burning down the lining of the uterus," explains Kathleen Ingram, MD, an OB/GYN with Henderson and Walton Women's Center. "You're trying to burn it down all the way to the muscle wall, where you're hoping it's never going to grow again. You're trying to get to where you're never going to have a cycle again."
At one time, a roller ball was used to heat the uterine lining. "It took a little talent, and it took a lot of time because you have to cover the entire surface," says Ingram. Since fluid was put into the uterus to distend the cavity, fluid overload was also possible. "It wasn't real popular surgery even though it worked pretty well," she says.
Several years ago, Francois Blaudeau, MD, OB/GYN at the Center For Advanced Gynecological Surgery, helped introduce the Novasure system to this area. Blaudeau, who is a Surgical Preceptor for Novasure, says that, "because this is such a simple outpatient procedure, it has really helped expand interest in endometrial ablation."
BY MARTI WEBB SLAY - Posted: Friday, July 8, 2005 3:46 pm |
| |
|
| Google Ad Blocks |
|
| Add our RSS Feed |
|
| |
|
