Typing this week’s update hurts. My fingernails are chewed down to nubs after last night’s football game. More news over at my blog on EP Monthly.
Elderly patients with tight finances skimp on medical care. One in five skips a doctor’s appointment or cuts back on medications.
The newest medication to treat chronic pain patients: Zohydro. All the hydrocodone, none of the Tylenol. It’s time-released, so people only have to take it twice a day. And as the blood levels build up when people take extra doses for their pain, we’ll see more overdoses like we do with patients taking methadone.
Do patients with dizziness require a CT scan of the brain? Henry Ford Health Center study showed that 810 out of 1681 patients received a CT scan when complaining of dizziness, but only 6 patients had “clinically significant results that required intervention.” The cost of the testing totaled almost $1 million. So the study is great if the hospital is looking to save some money, but it sucks if you happen to be one of the 6 people needing intervention or if you happen to be the doctor that doesn’t order the scan on those 6 people.
Where do we draw the line on testing?
Louisiana refuses to pay for dental care for indigent patients. As a result, it pays more than $1.7 million per year to emergency departments to treat dental emergencies. The golden rule: He who has the gold makes the rules. Keep that in mind with universal health care.
What to do with patients who are “frequent flyers” in the emergency department? Some of them won’t check their blood sugars and won’t take their medications. Oregon hospitals have hired a social worker that some have called a “babysitter” for adults. She checks in on patient after emergency department visits, finds them subsidized housing, provides them with bus tokens and takes them food.
It may be encouraging “learned helplessness” in the patients, but it is also saving the system hundreds of thousands of dollars per year and dramatically cutting down on unnecessary emergency department visits.
The big question in my mind is whether there will be an increase in “frequent flyers” in the emergency department once homeless patients learn that they can get extra perks for the frequent visits.