By Michael Campbell, MS, APR
As winter arrives in Pennsylvania, the “destination rehabs” in Florida crank up their marketing efforts. Sometimes families find it easier to convince someone to get help for a drug or alcohol problem if treatment sounds like a nice vacation. The sales pitch can be very tempting, and the photos on the Internet include lots of palm trees and wide beaches.
Unfortunately, the stories we hear at St. Joseph Institute and at other PA rehabs paint a different picture. Here’s a common story told by a mother from Pittsburgh.
“I was searching the Internet for rehabs in Western PA and called one of the facilities listed. The program sounded great, they said they took our insurance, and we were well into the admission process before they told us they were located in Florida. We flew my daughter down — and then the problems began. Housing was in a series of townhouses in busy neighborhoods, and the residents were bused to a center for the program. Our insurance only covered four days, and we had to self-pay almost $20,000. The individual counseling was minimal, and no effort was made to create an aftercare program.”
With far less regulation than exists in most other states, Florida has a growing number of rehab facilities, representing the “good, the bad, and the ugly” of addiction treatment. The lure of sunny skies can deflect attention from the most important question, “Is this the best program for me?” The hundreds of stories heard across the state each year encouraged us to share some reasons to be wary.
A 2013 study conducted by the Mayo Clinic and Olmstead Medical Center found that 70 percent of Americans take at least one prescription drug daily. The number of people taking at least two prescriptions stands at 50 percent, while 20 percent of patients take five or more medications. The Affordable Care Act, which began enrolling new customers via insurance exchanges on October 1, is expected to provide upwards of 20 million previously uninsured people prescription drug benefits.
Needless to say, pharmaceutical-related careers will be in high demand for the foreseeable future. There are several different paths one can take to enter the pharmaceutical field.
When you go to Walgreens or CVS to pick up your prescription, the first person you will likely come into contact with is a pharmacy technician. They are the ones who count tablets, measure liquid medications, label prescription bottles, process insurance claims and perform other duties as the supervising pharmacist requests. Some pharmacy technicians learn their craft on-the-job, but the best way to get your foot in the door is by completing a training program. Community colleges and vocational schools offer certificate and degree programs that typically last five months to one year. Prospective students can start their search for the right program at http://www.collegeonline.org. Most states have regulations for pharmacy technicians, and many employers will pay for their technicians to take the required exams.
In his famous last lecture, terminally ill CMU professor Randy Pausch offered his thoughts on the really important things in life. One of the points he spoke about was knowing how to apologize. Supposedly a good apology has three parts: (i) Saying you were wrong, (ii) Saying you feel badly, and (iii) Asking how you can make it better. He added that one of the worst kinds of apologies was the “I’m sorry you felt hurt by me” kind, which seems a sort of throw away gesture because it lacks acceptance of responsibility for the hurt caused. Yet a new Pennsylvania law encourages just that.
The Benevolent Gesture Medical Professional Liability Act (the “Act”), signed into law on October 25, 2013, makes apologies by physicians to patients and their families inadmissible in medical malpractice cases. However, the Act excepts from its protection admissions of wrongdoing. Specifically, the Act makes any benevolent gesture by a health care provider, made prior to the commencement of a medical professional liability action, inadmissible as evidence of liability, so long as such gesture does not include an admission of negligence or fault. So, the physician can apologize, as long as that apology doesn’t contain an acknowledgement of responsibility – exactly the “I’m sorry you felt hurt by me” expression that Professor Pausch criticized.
Still, this new law appears to have the support of both physicians and attorneys alike. In a Press Release issued the day the Governor signed the bill, The Hospital and Healthsystem Association of Pennsylvania “hailed” the Act’s passage. HAP President and CEO Andy Carter was quoted as saying, “This is a significant win for Pennsylvanians and the hospitals that serve them…The bill does not prevent any patient from filing a medical liability lawsuit when there is an unanticipated medical outcome. Instead, it allows for the kind of open discussion that can lead to resolution without the excessive costs that result when matters are decided in the courtroom.”
Some days, Dr. Amesh Adalja finds himself in the 1930s.
That happens when a patient is infected with bacteria immune to antibiotics, the miracle drugs that transformed medical care more than 70 years ago.
“This infection is eventually going to consume you, and there isn’t anything left on the shelf to try,” Adalja, an associate at UPMC’s Center for Biosecurity, tells the person.
Overuse and misuse of antibiotics are pushing the world toward what Centers for Disease Control and Prevention Director Tom Frieden calls “a post-antibiotic era.” At least 2 million people in the United States contract antibiotic-resistant infections each year, 23,000 of whom die, the CDC estimates.
According to the Centers for Disease Control and Prevention (CDC), about 90 percent of genital warts begin with infection by the human papilloma virus (HPV) (CDC). HPV is a sexually transmitted infection (STI.) Transmission of HPV may occur even if the warts are not visible. It usually spreads by direct contact with the anus, mouth, penis, or vagina of an infected person. Intercourse is not necessary to spread the infection. It can also be transmitted by skin-to-skin contact. In general, genital warts are known to spread relatively easily among partners.
The National Institute of Allergy and Infectious Diseases (NIAID) warns that as many as two thirds of those who have had intimate contact with an infected sexual partner could develop warts within about three months of the initial contact (NIAID). Men and women with a history of anogenital warts have approximately a 30-fold increased risk of developing anal cancer, and persistent HPV infection in the anal region is thought to be responsible for up to 80% of anal cancers. HPV is now recognized as a significant health problem in the HIV(Human Immunodeficiency Virus) infected population because, although today HIV infected individuals live longer as a result of greatly improved HIV treatments, their immune systems still remains compromised.
The holiday season is an excellent opportunity to support your senior care patients and their families by preparing them to address any health changes they may notice in their aging loved ones. Holiday gatherings can provide a good backdrop for families to broach these concerns in a gentle, non-confrontational manner.
Here are five ways you can support them in this process.
Provide a Senior Safety Checklist. Remind family members of tips for general safety, such as ensuring the patient has a cane, walker or other proper support if she has difficulty walking; removing throw rugs or other potential tripping hazards; and installing grab bars and no-slip strips where needed. A Senior Safety Checklist will provide an added peace of mind.
Just how much taxes will take from what you leave your family depends upon how you structure your last will and testament. Thus for most physicians, the time to think about estate planning is when they start to think about taxes, which means when they start to make a good living after years of school and low-paid residency.
In other words, the time to start estate planning is as soon as a doctor goes into practice.
Estate planning usually comes down to a careful balance of how much someone should give to beneficiaries during his or her lifetime and how much he or she should save to bequeath in a will.
But how to strike that balance relies on a set of complicated calculations that are unique to each individual situation and the current set of laws.
Historically, there have often been wild fluctuations in federal estate and gift tax levels from year to year that have made estate planning a difficult guessing game. For example, many people faced a dilemma at the end of 2012 as many estate tax breaks were set to expire. If Congress had not acted by the end of the year, the amount of tax-free gifts that one person could give was set to drop from $5.12 million to $1 million. Furthermore, the top tax rate on amounts more than $1 million was set to rise from 35% to 55%. Thus, many people scrambled to give away portions of their wealth before the end of the year.
The Cedarville University School of Nursing is collaborating with the athletic training program to provide athletic training students with experience in the University’s High Fidelity Simulation Center.
The technology includes 22 mid-fidelity mannequins and four high-fidelity mannequins owned by the school of nursing and one high-fidelity mannequin owned by the school of pharmacy. The high-fidelity mannequins can simulate a variety of medical complications including cardiac and respiratory problems, seizures and strokes. When activated, they can blink, cry, sweat and have a pulse. From the control room, professors running the session can be the mannequin’s voice and control its medical responses to various treatments and medications.
According to Mike Weller, assistant professor of athletic training and athletic training education program director, having access to the simulation center is unique for an athletic training program. “Cedarville’s athletic training program is one of a few with access to such a high level of simulation technology,” he said.
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These are the focus areas for Issue 12 (December 30th print date):
- Undergraduate and Graduate Healthcare Programs
- Looking Ahead
- Social Media Best Practices
- Family Health
A shift is occurring in the health care industry, and it’s one that the Cedarville University School of Pharmacy has already begun to prepare students. As patients live longer, and as they need more medications, multidisciplinary health care teams are becoming more critical to patient care.
Such teams are typically made up of several medical professionals from a variety of disciplines. Teams might include nurse practitioners, physicians, physician assistants, pharmacists, dieticians and social workers. Trends in the health care industry show that multidisciplinary teams are helpful in improving patient outcomes.
“With the number of medications available today considered alongside the complexity of the human body, gone are the days when one physician could realistically care for the whole patient by themselves,” said Emily Laswell, Pharm.D., assistant professor of pharmacy practice. “Having a team with diverse sets of expertise helps to deal with this complexity.”
As more hospitals move to adopt the use of such multidisciplinary teams, the Cedarville University School of Pharmacy is already preparing for students to work in such environments. Laswell is a critical piece of this change, and her work in training students will occur both in the classroom and out.
Healthcare may mean medicine and nurses, but it may also mean a 160- pound furry creature.
Life expectancy has increased and increased over the years, but is it quantity versus quality that matters most?
It is an interesting question and one posed by Jodi McKinney, Director of Corporate Communications for Celtic Healthcare.
McKinney cited important facts in the healthcare world of today’s society:
- 75 percent of American die in a hospital or skilled nursing facility when most would have preferred to die at home;
- Medicare physician visits per enrollee for the last six months of life average 40 visits;
- 46 percent of these enrollees saw 10 or more different physicians during that time, and
- These same enrollees average 6 physician visits per month during the last 26 weeks of their life.
And perhaps most concerning of all, $60 billion is spend in Medicare funds for doctor and hospital bills in the last two months of life, but it is estimated that 20 to 30 percent of those costs have no meaningful impact, according to McKinney’s research and Dartmouth Atlas statistics.
This December, the Pittsburgh Ballet Theatre (PBT) will premiere its first-ever, autism-friendly production of “The Nutcracker.” The performance will be the first of its kind in the country to make the magic of this holiday classic accessible to children on the autism spectrum and their families. The autism-friendly ballet will take place at 2:00 p.m. Friday, December 27, 2013 at the Benedum Center in Downtown Pittsburgh.
“’The Nutcracker’ is a holiday staple in ballet companies across the country and an annual tradition for many families here in Pittsburgh, so we are particularly excited to pilot this program with a timeless story that reaches so many people year after year,” said PBT Artistic Director, Terrence S. Orr. “With this special performance, we want families to know that we are performing with them in mind and welcome them to experience this production in a comfortable and inclusive atmosphere.”
Healthcare reform is fully upon us, and unfortunately the time has come where hospitals must provide care to increasing numbers of patients with fewer resources. Corazon has witnessed the money ‘pinch’ that healthcare providers are in; as a result, cost cutting has become a common, almost essential. strategy for today.
When focusing on cost savings initiatives, the most common areas service line administrators evaluate include managing supply costs, reducing length-of-stay, and optimizing resources However, even the most well-planned strategies are frequently ineffective due to a lack of physician participation.
Thus, improving or creating hospital-physician alignment strategies, particularly service line co-management arrangements, should not be overlooked as a viable means to achieve cost savings. Although co-management agreements are often multi-faceted, there are typically two main components related to this goal: administrative functions and incentive metrics.
The symptoms of fibromyalgia (FM) can include chronic diffuse musculoskeletal pain, increased pain sensitivity at multiple tender points, fatigue, abnormal pain processing, disturbed sleep and often, psychological stress. The symptoms of post-traumatic stress disorder (PTSD) can include widespread pain and sleep disturbances such as nightmares, nighttime anxiety attacks, and difficulty falling or staying asleep.
With its many symptoms, FM has been hard to treat. Patients have reported dissatisfaction with the current standard of care, which encompasses three FDA-approved daytime medications: the analgesic LYRICA® and the antidepressants CYMBALTA® and SAVELLA®. As for opiates and prescription sleep drugs, they have proven largely unsatisfactory. For PTSD, ZOLOFT® and PAXIL® are the only FDA-approved products, but their efficacy is often modest and their use can be limited by side effects. Other anti-anxiety and sleep medicines have not been shown to improve either condition and have substantial safety concerns, particularly when used chronically.