|
|
|
|
| Report Explores What Surgeons Don't Like |
|
Guess which MDs are least satisfied with the physician-administration relationship, according to a new report. You got it: surgeons. Independent anesthesiologists aren't far behind, the report finds.
So says Press Ganey Associates' 2008 Hospital Check-Up Report: Physician Perspectives on American Hospitals, which examines the experiences of 27,671 physicians practicing at more than 300 hospitals and surgical facilities across the country
Surgeons are least satisfied with disorganized and inefficient operating rooms along with complications in scheduling patients' surgery (whether inpatient or outpatient) and their outpatient tests and therapies. The report finds this response "troubling because [surgeons] are the highest revenue producers." Press Ganey research also shows that the most satisfied physicians refer the greatest number of patients.
Specifically, here's what really ticks surgeons off:
Not being able to schedule patients for times conducive to their schedules. "Scheduling cases in the OR is a chore and not surgeon-friendly," one surgeon told Press Ganey.
Mismanaged block time and add-on scheduling. "We should have an 8 a.m. 'cut time.' We do not. Since complaining has fallen on deaf ears, perhaps the competition of a local surgery center will wake up the OR," said another surgeon.
"Surgeons who are not employed by hospitals have the lowest satisfaction scores, which parallels the national database," says the report. "Hospitals would benefit from working with these physicians to decrease the likelihood that they will establish their own competitive surgical centers." Physicians practicing between six and 20 years are the least satisfied and are the most likely to launch physician-owned facilities, says the report.
Overall, physicians report a need for administrators to be more responsive to the ideas and needs of medical staff.
"A true partnership between administrators and physicians advances the quality of patient care, improves the hospital's financial performance, and retains talented physicians in an increasingly competitive environment," says Debbie Paller, vice president of physician and employee services for Press Ganey. "Acknowledging and respecting physicians' needs is the first step in building an open, mutually beneficial relationship."
Dan O'Connor |
|
 |
^ Back to Top |
|
|
|
|
| Surgeon Suspended for Operating While Impaired |
|
It's been a downward spiral for Harvard-trained plastic surgeon Loren Borud, MD. On June 27, he allegedly performed two procedures while impaired. This led to his firing from the staff of Boston's Beth Israel Deaconess Medical Center and the suspension of his medical license by the Massachusetts Board of Registration in Medicine. Then a lawsuit was filed.
Over the weekend, a patient who underwent one of the two procedures in question sued Dr. Borud, the medical center and five doctors and two nurses at the hospital, according to a published report. The patient claims he suffered post-operative complications and accuses the hospital's staff of letting Dr. Borud continue to operate after they realized he was impaired, says the report.
The state's medical license suspension order details Dr. Borud's actions on June 27. During the first case of the day, it says, OR staff assisting Dr. Borud noticed he looked sluggish and had bloodshot eyes. He cut a stitch during closure, but failed to correct the mistake, they recall.
Later that day, OR staff noticed that Dr. Borud's eyes were closed while he performed a liposuction. When roused, he claimed he was tired and continued the procedure. After staff watched his eyes close a second time, he was asked to step away from the table by an operating room nurse. Following a brief conversation, he returned to the procedure appearing more alert.
A resident who attended a portion of the second procedure voiced his concern about Dr. Borud's behavior to the hospital's associate chief of surgery. That afternoon the chief asked Dr. Borud to undergo a drug test. Dr. Borud allegedly asked the resident to borrow a urine sample in order to pass the screening, says the suspension order, a request that the resident refused.
A few days later, Dr. Borud entered an inpatient rehabilitation program, according to the order. The document notes the Dr. Borud has battled addiction to alcohol and prescription medications in the past, prompting his entry into voluntary monitoring contracts with the Massachusetts Medical Society's physician health services.
Daniel Cook |
|
|
^ Back to Top |
|
|
|
|
| ASGE Issues Endoscopy Guidelines for Bariatric Patients |
|
The growing popularity of weight-loss surgery has spurred the American Society for Gastrointestinal Endoscopy to create guidelines for endoscopy performed before and after bariatric surgery.
The society published these guidelines in the July issue of its journal, Gastrointestinal Endoscopy.
Upper endoscopy can be used for pre-operative evaluation to detect and treat GI tract lesions that may affect which type of bariatric surgery will be performed, the guidelines state. "In addition, endoscopy is used to diagnose and treat many of the post-operative symptoms or conditions the patient may develop," said Jason A. Dominitz, MD, MHS, chair of ASGE's Standards of Practice Committee, in a press release.
The guidelines recommend upper endoscopy for:
patients with nausea, vomiting and abdominal pain;
patients considered for Roux-en-Y gastrojejunal bypass or gastric banding, in order to detect hiatal hernia, esophagitis or gastric ulcers that may change the surgical approach;
diagnosis and management of post-operative bariatric surgical symptoms and complications; and
monitoring with endoscopic retrograde cholangiopancreatography in selected difficult cases where non-invasive magnetic resonance cholangiopancreatography has delivered inconclusive results.
The guidelines also call for direct communication between the bariatric surgeon and endoscopist so the endoscopist is aware of the procedure to be undertaken as well as any pre-procedural imaging that has been done.
Kent Steinriede |
|
|
^ Back to Top |
|
|
|
|
| News & Notes |
|
Implant on hold Orthopedic instrument manufacturer Zimmer has announced plans to suspend the sale of its Durom Cup artificial hip component due to surgeons' complaints of its failure in patients, who then had to undergo additional replacement surgeries. Zimmer's investigation determined that while the Durom Cup is not defective, it has challenged even experienced surgeons, and will be shelved until further training can be offered. More than 12,000 patients have had the socket implanted.
Aquavan denied A new sedative that promises minimal sedation for diagnostic procedures without the need for anesthesia providers' supervision has failed to sway the FDA. In a letter to drug manufacturer Eisai, the FDA denied approval of Aquavan (fospropofol disodium), but did outline a pathway to potential sanction, according to the company. On May 7, an FDA advisory committee voted in favor of approving Aquavan for use only by properly trained anesthesia providers. "We are confident that our continued discussions with the FDA will lead to the timely approval of this important new therapy," says Mary Lynne Hedley, PhD, executive vice president of the Eisai Corporation of North America.
On-time antibiotics For pediatric patients undergoing spinal surgery, the best time to administer antibiotics is within one hour before surgery, according to a study conducted at the Johns Hopkins Children's Center and scheduled for publication in the August issue of the Pediatric Infectious Disease Journal. The review of 1,000 spinal fusion surgeries over a six-year period shows that children who received antibiotics more than an hour before surgery were 3.5 times more likely to develop serious surgical site infections. The results suggest the timing of antibiotics "may matter just as much as the type and dosage of the medication," concludes infectious disease specialist and lead researcher Aaron Milstone, MD. |
|
|
^ Back to Top |
|
|
|
|
|
|
