Dr Peter Carter, RCN chief executive and general secretary, said: ‘Nurses spend more time with patients than any other health professional, so it makes sense for them to be a key part of the decisions which impact on the care that patients receive.

‘Nurses are often the first to identify where things are going wrong. By failing to give them proper representation at the board table, these trusts are missing out on valuable expertise that could help nip any problems in the bud.’

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Patients and health and social care professionals will be able to access quality information through NHS Choices which currently details 13 long-term conditions (asthma, bowel cancer, CKD, COPD, coronary heart disease, depression, dementia, diabetes, heart failure, osteoarthritis, prostate cancer, rheumatoid arthritis and stroke). Detail on schizophrenia, bipolar disorder, lung cancer, cervical cancer and epilepsy will be added this month.

Health minister Ann Keen said: ‘People have always been able to have information but both the quality and quantity can vary greatly. These measures are designed to ensure that people have consistent and reliable information that allows them to be in control of their care and manage their condition better.’

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MedPage Today reports on a study where researchers looked at the 1980 Super Bowl, where the (then) Los Angeles Rams lost to the Pittsburgh Steelers. The game was “high-intensity, [where] the lead changed hands seven times. The game was played in nearby Pasadena, and the Rams had been in Los Angeles for many years. They were also underdogs and went into the fourth quarter with the lead before ultimately losing.”

After the game, there was an increase in both all-cause and cardiovascular mortality in the Los Angeles area two weeks following the game.

They also looked at the Super Bowl four years later, where another Los Angeles team won the game. Soon after, there was a slight decrease in mortality.

The effect is similar to major sporting events in Europe, where the outcome of big soccer matches can influence mortality.

Patients love their sport teams. And when it comes to NFL football, sometimes to the detriment of their health.

kevinmd.com

Heidi Wright, head of practice at the RPSGB, said: ‘The majority of safe sex messages are targeted at teenagers, but as more adults begin new relationships later in life, they quite clearly need advice too.’

Almost one in five 45-54 year-olds surveyed said they had unprotected sex with someone other than a long-term partner in the past five years.

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However, that leaves a significant 40 percent who were not.

According to a recent study, patients who were not connected were less likely to received recommended preventive care and other screening tests.

Which all comes as no surprise. Not only is it increasingly difficult to find a new primary care doctor in the first place, but those who accept new patients are part of larger groups, work part time, or are mid-level providers who work in concert with physicians.

Furthermore, with the proliferation of retail clinics and the worsening crowding in emergency departments, more patients are obtaining primary care from multiple providers.

Which means that as we move forward, it is less likely that patients can identify with a single person they can call their primary care provider.

And, if this study is to be believed, that means that more preventive care measures will fall by the wayside.

kevinmd.com

My kids love to play Monopoly. They delight in acquiring properties, making money and crushing their siblings. They play with passion and savagery. That is, until recently. A couple of weeks ago I walked past the Monopoly board, spread on the floor between my children and their dear friend Tyler.

‘How’s it going guys?’

‘Great game, but we all ran out of money. So, we just put some more money on the table.’

‘Don’t tell me you…’ I stammered, nervously.

‘Yep. We gave ourselves a stimulus package!’

I must admit, I was both amused and bumfuzzled. Then, I heard one of them say, ‘I can’t pay the rent here!’ The answer I heard made me laugh out loud, and cry inside. ‘Oh, don’t worry about it. Just pay part of it.’

The young, the future in which we must invest, have learned the lesson loud and clear. ‘Throw out some money and ignore the debts you incur.’ OK, granted, they’re kids and they’re mostly just joking. But Americans have lost all sense of proportion when it comes to responsibility and money.

Someone has to clear this up. Someone, ultimately, will have to pay. But who? I know the simple answer. ‘Greed on Wall Street did all of this! Let’s send some bankers and brokers to jail; let’s tax the living stuffing out of them!’ Well, some in the financial industry need to get in big trouble. But the fact is, greed operates in all spheres of human endeavor. Even the most socialist volunteer is greedy for the appearance of virtue and the subsequent power and influence that follow. Financial greed, being tied to cash and other items, is just easier to track and easier to demonize. Still, I’ll grant that some people in the financial world have contributed to our current uncomfortable situation.

But our leaders also had their hand in the mess; leaders past as well as leaders present. A huge part of the problem lies with legislators, the executive, with non-elected functionaries and even with political activists, whose decisions have economic impact across the country. It lies with politicians who could not pause and wait; who lived by the principle, ‘Don’t just stand there, do something.’

The problem is, sometimes ‘doing something’ is worse. (Just ask a good surgeon. Occasionally, hesitation is best.) The greater problem is that politicians love to call their disasters ‘honest mistakes.’ Heck, even when they conveniently forget to pay their taxes they call it ‘an honest mistake.’

I know a thing or two about honest mistakes. In my field, they call them ‘malpractice.’ I pay for insurance to protect me from the results of ‘honest mistakes.’ If I commit an ‘honest mistake,’ I may just lose a whole bunch of money and respect. Even if I win, I’ll have to endure depositions and the hard benches of the court-room, waiting for my turn at the whipping post, where a plaintiff’s attorney will scour charts and scourge my soul, looking for weakness and cash.

In fact, almost anyone with a business or profession, from doctors to lawyers, plumbers to truck-drivers, knows that, in our culture, mistakes equal lawsuits. So, we’re right careful not to make them.

Not so in the hallowed halls of government. So I want to make a suggestion. My children have seen the government bailouts and learned. I think, therefore, that government has failed them. Thus, that government and government personnel have committed a kind of malpractice.

Can I take them to court? Can I drag their names through the mud? Can I expect a large cash sum (scratch that; everyone’s getting large cash sums), or even a court-mandated apology from those enlightened Washington minds? Would it be possible for someone from Washington to sit down with my kids and explain, with a straight face, why bailouts that couldn’t work on Monopoly will work beautifully in real life?

Can they expect to defend their actions before a ‘jury of their peers?’ That is, folks with almost no knowledge of the complexity of the job? Will they, mostly attorneys, allow themselves to be berated by attorneys? Will they ever, just once, say ‘we messed up, sorry…honest mistake,’ and then pay back the money it cost the rest of us? Unlikely. And what a shame. That would be something I’d like my kids to see. That would be some ‘change I could count on.’ Legislative malpractice… the settlements might just replenish the budget!

But it won’t ever undo the great Monopoly bailout of 2009!

Edwin Leap is an emergency physician and blogs at edwinleap.com.

kevinmd.com

1. NHS trust directors’ pay up 6.4%
NHS trust directors in England received an average pay increase of 6.4% last year, according to new research.

2. DoH ‘may regret’ regulating advanced nurses on the cheap
The government may scrap plans for statutory regulation of advanced nursing roles in favour of a low-cost ‘buyer beware’ scheme, a DoH adviser has said.

3. GMC consults on fitness-to-practise changes
Changes to fitness-to-practise rules including the filtering out of vexatious complaints at the point of initial consideration are out for consultation.

4. DoH considers allowing practices to sell over-the-counter medicines
GP practices could be able to sell over-the-counter (OTC) medicines to their patients for profit under plans being considered by the DoH, reports the Daily Telegraph.

5. NHS fails people with learning disabilities
The NHS is failing to meet the needs of people with learning disabilities, according the Health Service and Local Government Ombudsmen. Julie Griffiths reports.

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When you think about it, how much care does the average patient really need? Over at Better Health, Val Jones writes that 75 percent of patients require an average of 3.5 office visits annually for all the medical care they need. That works out to about 1 hour of a physician’s time per year.

How much is that worth? Well, the going rate is about $300. For a year.

And when you consider that, also think about the typical health care premium, which is often much higher than $300. Per month.

The reason why people aren’t going to cash-only practices is a matter of mindset, says physician Alan Dappen.

“People have been conditioned to believe that if they pay their insurance premiums, then healthcare is ‘free,’” writes Dr. Dappen. “In reality, their employers are taking out $3600 or more per year from their paychecks for this ‘free’ care. But since employees don’t see that money, they don’t miss it as much.”

Right now, the penetration of cash-only practices is relatively low. For instance, in southern New Hampshire where I live, there are none that I know of.

Perhaps if patients knew that a majority of them can actually save money by seeking cash-only care, the demand, and subsequently the proliferation, of such practices can increase.

kevinmd.com

Due to the cervical cancer immunisation for teenage girls and the government push to have a specialist school nurse for every secondary school and its cluster of primary schools by 2010, there is also concern about the increasing workload.

Ros Godson, Unite’s professional officer for school-aged children, said: ‘We have repeatedly called for the immediate employment of 2,000 more qualified school nurses in England to give advice on issues, such as teenage pregnancy, and alcohol and drug misuse.’

healthcarerepublic.com

In fact, more medical schools are resorting to so-called “virtual” gross anatomy, using sophisticated imaging and computer programs.

This is a mistake, says psychiatry resident Christine Montross, in a NY Times op-ed. And she has a point.

“Someday, [doctors] need to keep their cool when a baby is lodged wrong in a mother’s birth canal; when a bone breaks through a patient’s skin; when someone’s face is burned beyond recognition,” writes Dr. Montross. “Doctors do have normal reactions to these situations; the composure that we strive to keep under stressful circumstances is not innate. It has to be learned.”

Such talk about replacing real bodies with virtual ones continues the depersonalization trend in medicine. Already, today’s doctors rarely do thorough physical exams, instead relying on diagnostic tests and imaging studies. After all, why spend the time listening to a patient’s heart for a murmur, when an echocardiogram can simply be ordered?

Using computerized body replicas distances medical students from the human element in medicine, and indeed, “the dissection of cadavers . . . gives young doctors an appreciation for the wonders of the human body in a way that no virtual image can match.”

kevinmd.com