Medical practice

How do your surgeons get trained to work with new medical implants? Once they're out of residency, they may depend on professional societies or vendor training programs that aren't consistently regulated for quality and effectiveness. And vendor-sponsored programs may create a conflict of interest by tying free training to purchase of their implants. The federal government has started collecting data on cardiac implants, comparing implant specialists with general cardiac surgeons who …

Twenty years ago, there were four vaccines for kids. The cost was $100 or less for all of them, and the schedule was straightforward. Now there are 12--soon to be 13 with the newly recommended HPV vaccine for girls--and the costs have skyrocketed to $1,250. While insurance generally covers vaccines, the poor and uninsured are worrying disease-control experts, who fear that government coverage can't keep up. And diseases like mumps and whooping cough have been breaking out even among the …

Reusable medical devices were largely displaced by disposables when advances in plastic technology met the age of AIDS. But now, hospitals are re-using single-use items multiple times, aided by industrial reprocessing companies. The practice slashes supply costs. Usually the devices work fine, but sometimes they don't, with disastrous results. This story in The New York Times describes a heartbreaking case where a breathing tube tip damaged by reprocessing has permanently …

California hospitals try to be earthquake-proof, while Gulf Coast hospitals worry about withstanding hurricanes. They think they've got problems. At Western Galilee Hospital in Israel, about five miles from the Lebanon border, patients are kept safe in a maze of underground bomb shelters set up to be a complete 200-bed hospital. Tunnels are wide enough to ferry patients by ambulance from the helicopter pad outside, and operating rooms sit above the facility in bomb-proof bunkers. Deputy …

One of the more desperate forms of "medical tourism"--going abroad for a black-market kidney transplant--can result in souvenirs that include surgical complications, systemic fungal infections and compromised grafts that in some cases require nephrectomy, leaving the patients back at square one or even dead, say a group of investigators presenting at the World Transplant Congress in Boston this week. They reported the outcomes of 22 Canadians who purchased a kidney abroad, in the Middle …

The American College of Physicians is offering a new set of online quality measurement tools to its 120,000 members. They're designed to help physicians figure out and hopefully comply with 26 "starter set" measurements developed by the Ambulatory Care Quality Alliance, a joint effort of the ACP, the American Academy of Family Physicians (AAFP), America's Health Insurance Plans (AHIP) and the Agency for Healthcare Research and Quality (AHRQ). The starter measurements cover many of the top …