Pinoy.MD Blog

Interesting news for Filipino doctors (and medical students!) who want to go abroad.

(via AAMC: Physician specialist shortage to reach 63,000 by 2015)

Between now and 2015, the shortage of U.S. doctors across all specialties will quadruple to nearly 63,000, according to a report from the Association of American Medical Colleges (AAMC) Center for Workforce Studies.

While previous projections showed a baseline shortage of 39,600 doctors in 2015, AAMC estimated 62,900, with a worsening shortage of 130,600 by 2025. Partially driving the shortage, the U.S. Census Bureau projected a 36 percent growth in the number of Americans over age 65, and nearly one-third of all physicians are expected to retire in the next decade, the report found.

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There also will be a substantial shortage of non-primary care specialists, according to the report. In 2015, the U.S. will face a shortage of 33,100 physicians in specialties such as cardiology, oncology and emergency medicine. In 2025, AAMC estimated that number to rise to 64,800.

I do think this situation is not unique to the US. Other countries, including the Philippines, are feeling a shortage of doctors.

Wrong-patient, wrong site procedures still happen even among Joint Commission accredited hospitals.

(via amednews: Wrong-patient, wrong-site procedures persist despite safety protocol – American Medical News.)

Patient safety experts said the problem is not with the safety protocol, but with failure to follow it every time. Sometimes physicians and other health professionals rush through the checks, and in some places, the surgeon may not even be in the operating room when the timeout discussion is done.

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Analyses of wrong-procedure cases find that failure to comply with protocols is the No. 1 reason they occur, with poor communication and lack of physician leadership also frequently contributing, said LaMar McGinnis, MD, immediate past president of the American College of Surgeons. He also serves as the colleges representative on the Joint Commission.

How common, do you think, is this here in RP? Although I’ve yet to hear of a sensational case about this, I’m sure this happens.

This piece of news didn’t really surprise me. It’s just good to know there is documented evidence for a common suspicion.

For-profit hospitals across the state are performing cesarean sections at higher rates than nonprofit hospitals, a California Watch analysis has found.

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In addition, some hospitals appear to be performing more C-sections for nonmedical reasons — including an individual doctor’s level of patience and the staffing schedules in maternity wards, according to interviews with health professionals.

via Cesareans more likely for women at for-profit hospitals, study finds – San Jose Mercury News.

The article says there’s at least 17% more C-sections in for-profit hospitals as compared to non-profit or public hospitals.

How high do you think is it here in the Philippines?

This would make a good study.

With the looming threat of a superbug, we need to find ways to help curb drug resistance and the diminishing power of antibiotics.

An article has an interesting idea: why not pay only for antibiotics that work?

Their big idea is to reward both hospitals and drug companies for what they do to keep antibiotics effective.

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Radical? I think so. But it makes some sense. We would be paying for antibiotics to work and keep on working – not for more and more drugs that quickly become useless. I can imagine this being a nightmare to negotiate between the interested parties. But at least it’s a new idea. Like new antibiotics, we are short of those.

via A radical plan to save antibiotics | Society | guardian.co.uk.

What do you think?

I tried to avoid a controversial headline for this blog post. But the article I am sharing didn’t mince words.

Surgeons lack professionalism: Lancet medical journal – Telegraph.

A recent independent report found concerns over inadequately equipped operating theatres and a lack of anaesthetists and emergency care.

There was a statutory obligation to participate in the audit yet only half of centres actually did.

“That such revelations must come from outside the surgical community implies a lack of professionalism and leadership among the surgeons involved,” the editorial said.

It continued: “Surgeons, as patients’ advocates, should be active and united in drawing attention to inadequacies as part of an agenda of reform that promotes professionalism and leadership. But surgeons are largely absent from the debate.”

Read through the article to get a better handle of the topic.

Doctors everywhere might find this article useful: 5 Tips for Avoiding Diagnostic Errors – HealthLeaders Media.

Wachter suggests five ways to start addressing this system of neglect:

1. Improve board certification standards by requiring more frequent reviews and perhaps annual maintenance of certification documentation, with hospitals making that a requirement for staff privileges for certain specialties. Already, he says, efforts are underway to make this process more rigorous and remove some of the grandfather privileges that exempt doctors trained decades ago if they are still practicing.
2. Encourage research on diagnostic errors to better understand how and when they happen, and whether computerized decision support tools reduce them. The AHRQ has provided some seed funding for such research.
3. See what sorts of training are associated with improved diagnostic performance, and hospitals should be required to offer them or ensure that their medical staffs participate in them.
4. Use technology, perhaps some of the $20 billion in federal support from the stimulus bill, to find health information technology strategies that reduce diagnostic errors.
5. Improve medical teaching by having the Accreditation Council for Graduate Medical Education ensure that residencies and medical schools train students in diagnostic reasoning, including more creative use of simulations and model patients.

Do you have anything to add? What tips or advice can you give to fellow doctors to avoid diagnostic errors here in the Philippines?

Medscape has an interesting study on the Association Between Time of Admission to the ICU and Mortality.

Conclusions: Whereas patients admitted to an ICU over the weekend appear to be at an increased risk of death, nighttime admissions were not associated with an increased mortality. The lower level of staffing and intensity of care provided by many hospitals over the weekend may account for this finding. The heterogeneity noted between studies evaluating nighttime admissions likely reflects the diverse organizational structure of the hospitals and ICUs where these studies were carried out.

(Bold emphasis mine.)

You will need to login to read the whole article.

I’m sure doctors who are also gamers will find this bit of news ‘rewarding’.

From WebMD: Action Video Games Help Decision-Making.

In the new study of 18- to 25-year-old non-gamers, one group played 50 hours of action-packed video games, while the other played a slow-moving strategy game for the same amount of time. Participants were then asked to perform two specific decision-making tasks in the lab. The first task involved determining whether a bunch of moving white dots were going right or left. The second task measured their ability to tell if a single pitched tone was heard in their right or left ear while wearing a pair of headphones that emitted white noise.

“Action video games help you make faster decisions across the board because you are learning to translate what you are seeing or hearing into correct probability,” Green says.

“Action gamers are not trigger happy or impulsive,” he says. “They press the button faster, and are just as accurate,” he says.

This quality is beneficial for people in the military or police officers who must think quickly on their feet with little margin for error, he says.

This gives us more reasons to spend on game consoles.

From WebMD: CDC Study Shows No Vaccine, Autism Link.

Exposure to thimerosal-containing vaccines in infancy or in the womb is not associated with an increased risk for developing autism, according to a new study from the CDC.

Children in the study who developed autism spectrum disorder (ASD) actually had less exposure to vaccines with the mercury-containing preservative than children who developed normally.

The study is the latest of almost 20 studies to find no link between childhood vaccinations and autism.

A fellow Filipino Doctor has shared her slide presentation on Gestational Diabetes.

It’s on slideshare.net:

Philippine CPG on Diagnosis & Screening for Gestational Diabetes

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Do you have CPG’s you’d like to share? Send us the link and we’ll post them here.