August 7, 2013
Comment Posted on
Epidural Corticosteroid Injection article in Annals of Internal
Dr. Laxmaiah Manchikanti,
Dr. Frank JE Falco and Dr. Joshua Hirsh submitted a comment regarding a
manuscript titled "Epidural Corticosteroid Injections in the Management of
Sciatica Epidural corticosteroid injections in the management of sciatica" by
Pinto et al (Ann Intern Med 2012;157:865-877).
The comment has been posted
along with the manuscript in the Annals of Internal Medicine journal.
Click HERE to read
Click HERE to read manuscript
on the Rise: 4 Best Practices for Hospitals Facing the Last Resort
Large layoffs and workforce
reductions have become more common at hospitals and health systems across the
country, regardless of size or for- or nonprofit status.
Through July this year,
several organizations have laid off dozens and cut hundreds more jobs through
attrition. For example, St. Vincent Health in
Indianapolis cut roughly 865 jobs, Denver Health plans to eliminate 300 jobs through layoffs, attrition and reduction in new
hires, and Vanderbilt University Medical Center in Nashville, Tenn., cut more than 300 members from its staff. In one of the
biggest layoffs so far, Baton Rouge-based Louisiana State
University Health Care Services Division laid off 2,340 employees in
its 2012-13 fiscal year, which ended June 30.
Most hospitals turn to
layoffs as a last resort, so the rash of layoffs signifies the dire financial
situation provider organizations are in across the country. "Hospitals don't
like to lay people off," says Ken Perez, a healthcare policy expert. "It's not a
preferred strategy. Evidently, the leadership of these organizations felt that
they had to make a move now in order to financially make it through
Overtreatment, Costs Takes 'Courage'
The former acting head of
the Centers for Medicare & Medicaid Services lauds efforts such as the
Choosing Wisely campaign, which aim to reduce medical interventions "for which
the risks outweigh the benefits."
At the American Hospital
Association's Leadership Summit last week, Don Berwick, MD, called out the
"11 scary monsters" lurking under
the healthcare industry's bed. Can you guess which one he says is the worst one
of all, the Godzilla thwarting improvements to quality care?
Pat yourself on the back if
you said "excess," or "overtreatment." These are drugs, tests, or procedures
that "don't help, but subject people to risk." Berwick, former acting
administrator of the Centers for Medicare & Medicaid Services, says spending
on American healthcare is 40% more than it needs to be.
One Year In,
Landmark Prescription Drug Bill Shows Huge Impact
Ky. - One year after landmark legislation aimed at curbing
prescription drug abuse took effect, Governor Steve Beshear credited the bill
with closing non-compliant pain management clinics and reducing the number of
prescriptions for heavily-abused controlled substances.
Plus, for the first time in
a decade, the number of deaths blamed on prescription overdoses has declined.
House Bill 1 (HB1), signed
into law by Gov. Beshear last spring, included multiple elements to prevent the
abuse and diversion of prescription drugs and to enhance law enforcement's tools
to investigate illegal prescribing practices.
Declines in Some States
The problem of childhood
obesity, long among the country's most intractable and vexing health issues, is
at last showing signs of turning the corner.
The obesity rate for
low-income preschool-age children declined between 2008 and 2011 in 19 of 43
states and territories measured, federal data showed on Tuesday.
This followed a leveling
off of childhood obesity rates in recent years, a generation after they began a
climb to levels that alarmed pediatricians and public-health experts and
prompted national campaigns to bring the rate down.
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Premiums Will Soar
Get ready to shell out more
money for individual health insurance under Obamacare ... in some states, that
While many residents in New York and California may see sizable decreases in their
premiums, Americans in many places could face significant increases if they buy
insurance through state-based exchanges next year.
That's because these people
live in states where insurers were allowed to sell bare-bones plans and exclude
the sick, which has kept costs down. Under Obamacare, insurers must offer a
package of essential benefits -- including maternity, mental health and
medications -- and must cover all who apply. But more comprehensive coverage may
lead to more expensive insurance plans.
How to Get Tax
Breaks for Your Medical Practice
Constructing a new medical
facility or hiring new employees might seem like a daunting and expensive
undertaking for many physicians. But those tasks could become a little more
feasible if they take advantage of the many federal, state and local incentives
available to help developers, including physicians, substantially reduce taxes
and slash their building, equipment and hiring costs.
In some cases, getting
financial help can be as easy as filling out a form and building in the right
location. Obtaining other financial incentives, such as tax abatements from
local communities, can be complicated and time-consuming, often requiring a
lawyer or other adviser to help wade through the political and bureaucratic
The trick is to know where
to look, whom to talk to and when to act. Some programs have specific deadlines.
Others have limited funding.
Grants Priority Review to Mallinckrodt's New Pain Drug
Mallinckrodt announced that the FDA has granted
priority review to its new pain drug MNK-795.
MNK-795 is a
controlled-release oral formulation of oxycodone and acetaminophen that has been
studied for the management of moderate to severe acute pain.
The FDA grants priority
review to drugs that offer significant improvements in the safety or
effectiveness of a treatment when compared to standard applications.
spending slows: But why?
The apparent slowdown of
the growth of healthcare spending has been noted by many in the healthcare
industry, the policy world and economists. But what is causing it and how long
it will last is unknown.
The White House
weighed in late in July with a blog by Alan Krueger, chairman of the Council
of Economic Advisers. In his post, he highlighted the evidence indicating
healthcare cost growth has slowed and the ACA's role in that slow
Among the evidence he
- Recent prices for personal consumption expenditures (PCE) on
healthcare goods and services rose at its slowest rate in nearly 50 years, at
1.1 percent over the 12 months ending in May.
- The Congressional Budget Office (CBO) expects combined Medicare and
Medicaid spending to be about $200 billion lower in 2020 than what it forecast
three years ago.
- From 2009 to 2011, nationwide real per capita health expenditures grew
at the slowest pace since reporting began in 1960.
- In 2012, premium growth for employer-sponsored insurance was at its
lowest rate - 3 percent - since the Medical Expenditure Panel Survey started in
For Some Post-Op
Care, a Phone Call May Be All That's Needed
New research is posing the
question of whether the most productive visit after certain surgeries or
procedures is one in which the patient, by design, doesn't show up at the
A study posted online July
10 in JAMA Surgery found that open hernia repair or laparoscopic
cholecystectomy patients who followed up their surgery with a phone call instead
of a doctor's visit had the same rate of complications of those who showed up at
the office - none for the hernia patients and a small rate for the
Almost all patients who did
their follow-ups by phone said they were very satisfied with the experience.
Most of them, given the option, asked for phone calls over personal visits, with
71% of 115 hernia patients and 90% of 26 cholecystectomy patients electing to
get a phone call.
FDA issues warning
about acetaminophen and skin reactions
(CNN) -- The
Food and Drug Administration warned consumers on Thursday that popular pain
reliever acetaminophen may cause serious skin reactions in some
The FDA will now require a
warning about the skin conditions to be added to the labels of prescription drug
containing acetaminophen and will ask manufacturers of acetaminophen products to
add warnings to their over-the-counter medications.
Acetaminophen is found in
numerous prescription and over-the-counter products designed to treat pain and
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