Friday, December 31, 2010

Interesting Points

http://www.thehindu.com/opinion/editorial/article1021283.ece
  • Researchers at Harvard have made the point that illness or medical bills were behind 62 per cent of personal bankruptcies in the United States in 2007. In India, high spending on health is a major reason for people sliding into poverty.
  • In India, there has been an increase in the share of private insurance to meet private health expenditure, up from 1.1 per cent in 1995 to 2.2 per cent in 2008

Tuesday, December 28, 2010

Universal health care(India): media push needed

http://www.thehindu.com/opinion/Readers-Editor/article981134.ece

S. Vishwanathan makes the following points


  1. Hardly five years ago, when multi-discipline hospitals started mushrooming in cities across the country, thanks to liberal support from the governments under the policy of privatisation and liberalisation, rising India celebrated their arrival. Many believed their arrival was a landmark in the history of health care in India. There was, further, the aspect of medical tourism. In sum, this was seen as the end of the search for a cost-effective and modern private medical service, with particular significance for the secondary and tertiary sectors.
  2. the Annual Report to the People on Health, which was published in September 2010, begins, understandably, with listing the achievements of the Indian government in the health sector. In terms of life expectancy, child survival, and reducing maternal mortality, the report notes, India's performance has improved steadily. Life expectancy at birth now is 63.5 years; the infant mortality rate is 53 per 1000 live births; and the maternal mortality rate is 254 per 100,000 live births. The report, however, calls attention to the wide variations across States in the improvement of these key human development indicators, and to the “inequities based on urban divides, gender imbalances, and caste patterns.”
  3. Now, the private sector is providing healthcare to about 80 precent of Outpatient population and 60 percent of Inpatient Volume.
  4. Further, “the private sector in India has a dominant presence in all the sub-markets such as medical education and training, medical technology and drugs and pharmaceutical manufacture and sale, hospital construction and ancillary services and finally, the provisioning of medical care.” In fact, more than 75 per cent of the human resources and advanced medical technology, 68 per cent of an estimated 15,097 hospitals and 37 per cent of 6,23,819 total beds in the country are in the private sector, most of which is located in urban areas.
  5. As a result, Govt hospitals are losing key skilled staff to private sector and conditons are get worse there.
  6. Author is requesting India Press to highlight this issue.

Monday, December 20, 2010

Figuring out Hospital Hierarchy

http://answers.yahoo.com/question/index?qid=1006041302580

1.Board of Directors(President,CEO and Chief of Medical Staff are members)
2.President and CEO
3.Vice President(like of HR,Planning and Corporate Affairs)
4.Chief of Medical Staff
5. Chief of Medical Specialities( OB/GYN, Emergency Medicine, Medicine, Anesthesiology)

3.1 Staff Members


For Academic Hospital
5.1 Residents

Suggestions for Becoming a Positive Deviant Surgeon

Atul gave five principles/habbits/suggestions for Surgeon to become better.
I think that it apply to all professionals

Suggestions for Becoming a Positive Deviant
1. Have people skill
Ask an unscripted question
2. Don’t Complain
3. Count Something
Atul Counted Hospital Acquired Conditions
If you count something you find interesting , you will learn something interesting
4. Write Something

5. Change

Soruce:
Better, A Surgeon's Notes on Performance -- Atul Gawande

HealthCare: Some Numbers

819,000: Number of Physicians and Surgeons
2.4 million: Nurses
388,000: medical assistants
232,000: pharmacists
121,000: paramedics
94,000: respiratory therapists
85,000 : nutrionists

Soruce: Better, A Surgeon’s Notes on Performance – Atul Gawande

Thursday, December 16, 2010

Outsourcing Your Heart

http://www.time.com/time/magazine/article/0,9171,1196429-1,00.html



The bottom line: If more private payers sent patients abroad for uncomplicated elective surgeries, the savings could be enormous. "This has the potential of doing to the U.S. health-care system what the Japanese auto industry did to American carmakers," says Princeton University healthcare economist Uwe Reinhardt.
U.S. hospitals could certainly do with a little global competition. For years, their share of the national heath-care bill has grown at a rate far faster than inflation, and today they gobble up a third of all medical expenditures. At current rates, the U.S. will be spending $1 of every $5 of its GDP on health care by 2015, yet more than 1 in 4 workers will be uninsured. The ingrained inefficiency of most hospitals doesn't help. "A lot of them still don't know how to schedule their operating rooms efficiently," says Reinhardt. "They've never had to. They always get paid, no matter how sloppy they are."

Read more: http://www.time.com/time/magazine/article/0,9171,1196429-2,00.html#ixzz18KbnqwBb

Wednesday, December 15, 2010

Medical Tourism

http://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1371&context=refereed

The U.S. healthcare system is not
only the most expensive in the world but estimated 50 million people have no health coverage and 130 million have
no dental insurance.

The BlueShield of
California’s Access Baja Plan offers people living near the border an opportunity to receive medical care in Mexico.
According to the MTA (2009c) reports, Surgical Tip has joined with USNow to offer medical tourism to all its
members and Healthbase has collaborated with WellPoint Blue Cross Blue Shield to handle their pilot program of
offering medical tourism for Americans traveling to India. According to the International Federation of Health Plans
reports, almost 11 percent of U.S. employers are currently offering medical tourism and about 73 percent of U.S.
companies might offer CDHP (Consumer Driven Health Plan) that can help people to seek healthcare overseas and
can save them the deductibles and coinsurance payments (MTA, 2009c).

Wednesday, December 8, 2010

Wednesday, December 1, 2010

Surgery Checklist

Surgery Checklist Lowers Death Rate
http://www.washingtonpost.com/wp-dyn/content/story/2009/01/14/ST2009011402914.html
Surgeons, it seems, are discovering what airline pilots learned decades ago: The human brain can't remember everything, so it's best to focus on the com


If every operating room in the United States adopted the surgical checklist, the nation could save between $15 billion and $25 billion a year on the costs of treating avoidable complications, according to calculations by the authors.


If every operating room in the United States adopted the surgical checklist, the nation could save between $15 billion and $25 billion a year on the costs of treating avoidable complications, according to calculations by the authors.

Sunday, November 28, 2010

Atul Gawande: Wiki Page

http://en.wikipedia.org/wiki/Atul_Gawande

A June 2009 New Yorker essay by Gawande, "The Cost Conundrum", which used as an example the town of McAllen, Texas to argue that unnecessary medical tests and procedures were a primary factor in driving up the cost of health care in the U.S.,[3] was cited by President Barack Obama during Obama's attempt to get health care reform legislation passed by the United States Congress. According to Senator Ron Wyden, the article "affected [Obama's] thinking dramatically", and soon after its publication, Obama showed the article to a group of senators including Wyden and said, "This is what we’ve got to fix."[4] Gawande, in turn, later expressed approval for Obama's health care proposals on the New Yorker "News Desk" blog.[5] After reading the New Yorker article, Warren Buffett's long-time business partner Charlie Munger mailed a check to Gawande in the amount of $20,000 as a thank you to Dr. Gawande for providing something so socially useful.[6] Gawande reportedly donated the $20,000 to the Brigham and Women's Hospital Center for Surgery and Public Health.[7]

Atul Gawande's Complication: A Surgeon's Note on Imperfect Science

I went to Border last weekend and was browsing general Medical bookshelf. One book that caught mine attention was complication. Front and back page contained very glowing reviews about the book.
So, I decided to read the book. This book is very easy to read, crisp and informative.
I was holding my breath and my heart was pumping very hard while reading some chapters.

Surgeons become proficient by performing same procedures over and over. They don't bored considering their repetitive jobs. They take pride in their perfection.

If you compare a Surgeon to Machine, it is the best compliment that they can get.

Every Surgeon commits mistake.

Lessons for Software Professional
Technology changes very fast. We cann't master technology and cannot be perfect. We should follow some good practices that protect us from disasters.
Document, Document and Document.
Measure, Measeure and Measure.

Monday, November 22, 2010

Medicare Doctors Once Again Face Big Pay Cuts

http://www.aarp.org/health/medicare-insurance/info-11-2010/medicare_doctors_face_pay_cuts.html

Saturday, November 13, 2010