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| Colonoscopy Risks Seen in Advanced Age |
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Researchers claim that older patients are at increased risk of adverse events following outpatient colonoscopy, findings they say could influence cancer-screening recommendations to individuals with limited life expectancies.
A review of 53,220 elderly patients who underwent colonoscopy between July 2001 and October 2005 revealed that the overall risk of adverse events following colonoscopy is low, but that patients between 80 and 84 years of age were at a 75% greater risk of such serious gastrointestinal complications as bleeding and bowel perforation than patients aged 66 to 69 years were.
Additionally, patients having polyps removed were at a higher risk of complications than patients undergoing screening or diagnostic colonoscopy were. Those presenting with history of co-morbidities such as diabetes, stroke, chronic obstructive pulmonary disease, atrial fibrillation or congestive heart failure demonstrated a significantly higher risk of adverse GI events, according to the study.
The researchers believe their findings, which appear in the June 16 issue of the journal Annals of Internal Medicine, support the U.S. Preventative Services Task Force's recent conclusion that the potential benefits of colorectal screening decrease with a patient's advancing age due to competing causes of mortality.
"Our (research) should aid clinicians in making age- and health status-appropriate recommendations to elderly patients for colorectal cancer screening, especially given the availability of Medicare coverage for alternative colorectal cancer screening tests that are less risky than colonoscopy," conclude the authors.
Daniel Cook |
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| Report Shows Bariatric Surgery's Safety |
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When compared to national statistics, bariatric surgeries are "significantly safer than common operations like hip replacement and gallbladder removal," according to researchers.
Studying data on nearly 58,000 obese patients, they found that the weight-loss procedures have a complication rate of only about 11% and a mortality rate of 0.135%, making them as safe as many routine surgeries. The most commonly reported post-discharge complication was post-operative nausea and vomiting.
For the study, presented at the annual meeting of the American Society for Metabolic and Bariatric Surgery last week, Eric J. DeMaria, MD, vice chair of the surgery department at Duke Medical Center in Durham, N.C., and colleagues mined data from the Bariatric Outcomes Longitudinal Database.
The database compiles information from 650 surgeons and 350 surgical facilities participating in the non-profit Surgical Review Corporation's Bariatric Surgery Centers of Excellence program.
Kent Steinriede |
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| Docs' Salaries Not Keeping Pace with Inflation |
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Physician compensation did not rise above inflation between 2007 and 2008, says a survey that shows salaries for both primary care docs and specialists rising only slightly more than 2 percent during that time.
When those figures are adjusted to reflect the 3.8% increase in the U.S. Consumer Price Index for 2008, the compensation actually decreased 1.73% for primary care physicians and 1.59% for specialists, according to the Medical Group Management Association's Physician Compensation and Production Survey: 2009 Report Based on 2008 Data. The report, based on data voluntarily submitted by nearly 50,000 providers, breaks down the numbers for several specialists:
Urologists, ophthalmologists and pain management docs were among the hardest hit, with compensation dropping 4.97%, 4.28% and 9.36% respectively after inflation.
Anesthesiologists, OB/GYNs, orthopedists and general surgeons registered slight gains before inflation, but their salaries dipped 0.87%, 1.92%, 0.35% and 2.72% respectively after adjustment.
Gastroenterologists were one of the few specialists to fare relatively well, with compensation rising 7.38% before and 3.41% after inflation.
MGMA's report also shows the median collections for specialists' professional service fees between 2007 and 2008 declining 6.53% overall and nearly 10% when adjusted for inflation. The drop "may signal the leading edge of the economic downturn in 2008, demonstrating the trend of patients electing to postpone care," says the group.
A sampling of the survey's results are available on MGMA's Web site.
Irene Tsikitas |
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| InstaPoll: Are You Facing Job Burnout? |
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Regardless of how much you like your job, there will come a time when you just don't feel like doing it anymore. The pressure of managing a surgical facility, of dealing with surgeons, staff and patients, of dueling with vendors, insurers and regulatory agencies will simply become too much. This week we want to know how long it takes before a surgical facility manager experiences career burnout. After 1 or 2 years, 2 to 4 years or never?
Go to our home page to register your opinion and see real-time results.
Dan O'Connor |
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| News & Notes |
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Tip of the week At the Harbor Hospital in Baltimore, an electronic patient tracking system aids administrators in benchmarking, keeps track of doctors and lets housekeeping know when rooms are ready for turnover. It also saves the nurses all the time that they'd otherwise spend answering patients' families' questions about the status of cases, says MaryAnn Earl, RN, BSN, CNOR. Each patient is assigned a number upon admission, and that number is displayed on a monitor screen posted in the waiting area along with the physician's name and the patient's location.
Licorice licks post-op sore throat Patients who gargled with a licorice solution before surgery were less likely to suffer post-op sore throats than patients who didn't, says a study published in the July issue of the journal Anesthesia & Analgesia. Researchers at Sanjay Gandhi Post Graduate Institute of Medical Sciences in Lucknow, India, observed 40 elective lumbar laminectomy patients who were intubated for general anesthesia, 20 of whom gargled with 30mL of diluted licorice solution (0.5g licorice in water) and 20 who gargled with 30mL of water for 30 seconds 5 minutes before induction. Two hours after surgery, only 25% of the licorice patients reported having a sore throat, while 75% of the water patients did. Soreness was also reportedly less severe among the licorice patients. The researchers note that licorice includes compounds that have been employed in anti-inflammatory, anti-irritant and anti-cough remedies.
Knee replacement cost-effective When performed in high-volume surgical facilities, total knee replacement is consistently successful and cost-effective across all surgical risk groups, according to a study appearing in the June 22 issue of the journal Archives of Internal Medicine. Researchers discovered that individuals who undergo the procedure gained 1 additional quality-adjusted year of life for every $18,300 in costs associated with the surgery. "Because healthcare expenditures related to TKR are substantial, it is critical to understand the value obtained for the money spent on [the procedure]," explains the study's lead author, Elena Losina, PhD. While TKR patients won't live longer, she says, they will experience improvement in the quality of each year lived. |
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