Entries in Doctors (40)


ER Docs See Patients with Unimaginable Items in Unlikely Places

Medioimages/Photodisc/Thinkstock(NEW YORK) -- One winter night, Dr. Melissa Barton was the attending physician in the emergency department of the Detroit Medical Center.  Making her rounds, she picked up a chart for a new patient and read the woman's chief complaint: "eye in the vagina."

The patient told Barton she had been expecting a fight with some neighbors outside her house.  Wearing only a sweatshirt and spandex pants, she needed somewhere to stow her prosthetic eye for safe-keeping.

"Those things are pretty expensive and hard to replace," Barton said.  "So that's where it went, along with her driver's license."

Unfortunately, it got stuck.

Dr. Gary Vilke, a professor of clinical emergency medicine at the University of California San Diego Medical Center, saw a patient who had four Barbie doll heads stuck in his rectum.

"When you looked at his x-ray, they were looking at you, like a totem pole," Vilke said.

Ask a handful of emergency medicine specialists about cases like these, and you'll get a cascade of stories about patients with strange objects ingested or inserted in unlikely places. Vegetables, light bulbs, tools, even cellphones and reading glasses have wound up illuminated on x-rays or described on medical charts in U.S. emergency departments.

For many unlucky patients, an inserted or ingested foreign object is the result of a one-in-a-million accident or a single bout of bad judgment or curiosity.  While there is little data detailing just how many patients wind up in U.S. emergency departments with objects stuck in their orifices, doctors say they see these patients more often than you might think.

"There's usually a good story every week or two, everything from the unique to the bizarre to the gross," said Vilke, who has practiced emergency medicine for 20 years.

Copyright 2011 ABC News Radio


Few Docs Follow Heart Attack Guidelines for Student Athletes

Jupiterimages/Thinsktock(SEATTLE) -- Sudden cardiac arrest deaths in otherwise healthy teens are usually triggered by an unknown heart condition.  While doctors have created screening guidelines for student athletes in an attempt to avoid such tragedies, perhaps the real tragedy is that few doctors actually follow these screening guidelines.

The new research, presented at the American Heart Association's Scientific Sessions 2011, found that fewer than 6 percent of doctors fully follow national guidelines for assessing sudden cardiac death risk during high school sports physical exams.

"Despite national guidelines that have existed unaltered for 15 years, those recommendations still have not reached the bedside for sudden cardiac arrest during sports physical screenings," said Dr. Nicolas Madsen, lead researcher and pediatric cardiology fellow at Seattle Children's Hospital and the University of Washington School of Medicine.

More than 1,100 family doctors and pediatricians were surveyed in the study.  Less than half of physicians and only 6 percent of the 317 athletic directors questioned were aware of the national guidelines, which were published in 1996 by the American Heart Association. The guidelines consist of physical exam elements, including listening to the heart and checking blood pressure, along with eight medical history questions.

"We should really begin to implement policies such that sports physical recommendations is freely available to the public," said Madsen.  "It's clear that physicians are interested in figuring out how to get to a screening approach in the best way, that maximizes the potential for maximizing each patient visit and streamlines financing."

Copyright 2011 ABC News Radio


Economy Has Patients Asking Docs for Freebies

Comstock/Jupiterimages/Thinkstock(NEW YORK) -- The economy is forcing some patients with pricey prescriptions to skip doses, cut pills in half or even stop taking potentially life-saving medications. But many are asking their doctors for help in the form of handouts -- free samples of expensive drugs from the pharmaceutical companies that make them.

"They show up with their hands out," said Dr. Howard Weintraub, clinical director for the Center for the Prevention of Cardiovascular Disease at NYU Langone Medical Center, describing patients who confess they "just can't afford" to take their medications. "Certainly you can see the frustration in their faces."

Like samples of cheese at the grocery store, free drug samples are intended to encourage patients to try, and ultimately buy certain drugs. But some patients say they need the freebies to bridge gaps in insurance coverage and offset healthcare costs through tough financial times.

Copyright 2011 ABC News Radio


New Device Tests How Well Doctors, Nurses Wash Hands

Medioimages/Photodisc(ELMWOOD PARK, N.J.) -- Just how well do you wash your hands?  If you're a health care worker you may soon find out.

A new system that monitors how thoroughly doctors and nurses lather up is being tested in hospitals across the Midwest.

The VSS Vision Safety Solutions, created by Sealed Air Corporation, detects and records "when hand hygiene occurs; the duration of each hand washing event; and confirmation that each individual uses soap and/or sanitizer," the company said in a statement.

The system activates when a health care worker wearing a radio-frequency ID tag approaches a sink or sanitizing station.  A device then records if soap was used and the duration of the hand washing.

The new technology is being tested to help fight against the number of healthcare-associated infections that occur each year.  The U.S. Centers for Disease Control and Prevention says about 100,000 people die annually from illnesses they acquire while staying at health care facilities.  These infections also cost the health care industry over $30 billion each year, according to the CDC.

Copyright 2011 ABC News Radio


Conjoined Twins: Doctors Debate Ethics of Separation Surgery

Jupiterimages/Thinkstock(CLEVELAND) -- The decision to separate conjoined twins would be easy if it guaranteed a better life for both babies.  But the possibility of one or both twins dying or becoming severely disabled because of the surgery or the separation's effects weighs heavily on parents and doctors, according to a new report.

Two-year-old twins joined at the head were the focus of the report on the bioethics of separation surgery.  The girls, who were unnamed, shared kidneys and veins that drain blood from their brains, making separation surgery a risky undertaking unlikely to benefit both of them equally.  But leaving them joined could also threaten their health, not to mention their independence.

"In this case, every ethical principle is sort of turned on its head," said Dr. Devra Becker, a plastic surgeon at UH Case Medical Center in Cleveland and senior author of the report published Monday in the Plastic and Reconstructive Surgery journal.  Those principles, including informed consent, the duty of doctors to heal and avoid harm, and the tenet that health care resources should be distributed fairly, form the framework of Becker's report.

The girls traveled with their parents to Rainbow Babies and Children's Hospital in Cleveland from Italy for separation surgery.  They are craniopagus twins -- the rarest form of conjunction affecting one in 2.5 million births.  Based on published cases, the odds of both twins surviving separation surgery are 33 percent -- the same odds for both twins dying.

"Few will debate the benefit of separation if the surgical risk is [zero].  Similarly, few will advocate for separation if the procedure guarantees the deaths of the twins," Becker and colleagues wrote in the report.  "The ethics of separation becomes more complex when the morbidity of separation lies between [zero] and 100 percent or if one twin will benefit more from the separation than the other."

Following the risky, not to mention expensive procedure, the larger twin would need a kidney transplant or lifelong dialysis to live.  The smaller twin would be at risk for brain damage.  But left together, the girls were at risk for kidney failure and cardiovascular disease.

The procedure could also give both twins the chance for a normal life.

After thoroughly weighing the risks and benefits, the Italian twins' parents and the medical team decided to move forward with the procedure.  The larger twin, who would be left without kidneys, would go on dialysis until she was strong enough for a transplant.  And the risk of brain damage in the smaller twin would be minimized by doing the procedure in stages.  The benefits of separation for both twins, both medical and otherwise, outweighed the risks.

But during the procedure, the surgeons noticed the layer of tissue covering the twins' brains was dangerously tight -- a twist that tipped the risk-benefit scale.  The surgery was aborted, and both twins recovered.

Copyright 2011 ABC News Radio


Buyer Beware: Uncertified Doc Botches Surgery

ABC News(NEW YORK) -- After going into surgery for a simple repair of her breast implants, Dinora Rodriguez, 40, awoke from the procedure to find that her plastic surgeon had left her with conjoined breasts. Without her knowledge or permission, the surgeon had also nip/tucked her eyelids, leaving Rodriguez with eyes that to this day cannot close all the way.

Rodriguez learned the hard way -- you always have to vet your plastic surgeon.

"A friend had recommended the doctor to me. My biggest mistake is that I didn't check any of her credentials. I found out later that she had done really bad surgeries on some other people too," Rodriguez told ABC News.

The doctor in question was licensed to practice as a plastic surgeon in California, where Rodriguez lives, but she was not board certified by the American Board of Plastic Surgery.

After a year of pain and disfigurement, Rodriguez sued her doctor for malpractice and says she found out that the corrective surgery on her breasts was not even necessary in the first place.

"She told me that she needed to replace the implants because they were leaking and I believed her. She gave me a good price on the surgery and I said yes," she said.

Now Rodriguez has become the poster child for a new safety campaign spearheaded by the new president of the American Society of Plastic Surgeons (ASPS), Dr. Malcolm Roth. The campaign, announced Monday at the annual ASPS conference, warns against "white coat deception" – basically, just because a doctor has a white coat, and even an M.D., doesn't mean they are qualified to perform plastic surgery.

In 48 states it is currently legal in the United States for doctors who are not certified by the board of plastic surgeons to practice cosmetic and plastic surgery.

"This means that we have other physicians creeping in who have taken a course and think they can do plastic surgery," said Roth. "It's not the same as going through six years in training specifically in plastic surgery, plus the continual training and code of ethics that are required for those who are board certified," he said.

"People spend months or years making a decision on which care they're going to purchase – it's no different when having a procedure performed. Plastic surgery is elective, there's plenty of time to do your homework and that's really all we're asking: do your homework," Roth said.

Rodriguez ended up settling her malpractice suit out of court. She says the compensation she received barely covered her reconstructive surgery she needed. Because the surgeon had cut across the two separate "pockets" that normally hold breast tissue, the implants were able to touch in the middle, said Dr. Steven Teitelbaum, a plastic surgeon in Los Angeles who did Rodriguez's reconstructive surgery.

Unfortunately, because the first surgeon had removed too much skin from Rodriguez's eyelids during the procedure she says she had never asked to have done, there is nothing that can be done to reconstruct her lids -- she will never again be able to fully close her lids and must take medication for the rest of her life to moisten her eyes. Because the first surgeon cut through nerves and muscle, she also has shooting pains in her ribs surrounding her breasts.

The number of non-board certified plastic surgeons practicing is on the rise, Teitelbaum said, because the public is demanding more plastic surgery and with insurance reimbursements so low, many non-plastic surgeons are offering cosmetic procedures in an attempt to maintain their income.

And with the rising number of unqualified plastic surgeons practicing, he says the number of patients suffering from less-than-ideal surgeries is also increasing.

So what can a patient do to check out their doctors before going under the knife?

First and foremost, make sure the doctor is board certified in plastic surgery specifically, which you can do by searching the doctor's name on the ASPS website, Roth said.

In order to be board certified, doctors who do their residency in plastic surgery must pass a rigorous set of written and oral examinations. While they can legally practice plastic surgery even if they don't pass these tests, they will not get board certification.

Another important question to ask of your surgeon is whether they have hospital privileges if needed to perform their procedures, Roth says.

"If the nearby hospital won't let them practice under their roof, then something might be up," he says. "Probably, the physicians at the hospitals don't believe that this physician has adequate training."

Copyright 2011 ABC News Radio


Benefactor Gives U. of Chicago $42 Million to Work on Bedside Manner

Hemera Technologies./Thinkstock(CHICAGO) -- A benefactor who believes doctors need to work on their bedside manner is giving $42 million to the University of Chicago Medical Center to train physicians to be good communicators.

The donation from Carolyn "Kay" Bucksbaum and her husband, Matthew, will create the Bucksbaum Institute for Clinical Excellence, the medical center announced Thursday.

Kay Bucksbaum, whose husband made his fortune developing shopping centers, said she was inspired by Dr. Mark Siegler, a leading medical ethicist at the University of Chicago who became the couple's internist when they moved to Chicago from Iowa about 10 years ago.

"He keeps front and center getting to know his patient," she said.

In contrast, she recalled a doctor years ago who didn't listen to her when she told him what she thought was wrong with her -- and didn't apologize when she turned out to be right.

When her husband needed surgery, she said, Siegler "took my husband by the hand to meet the surgeon, introduced him, and told the surgeon something about my husband."

He even scrubs up and watches his patients' surgeries when he can, she said. And he encourages patients to call him "Mark."

That kind of emphasis on bedside manner and developing a relationship with the patient is being eroded in modern medicine, said Dr. Matthew Sorrentino, a cardiologist who is co-director of the new center.

"The way I was taught, you sit down and look directly at the patient," he said.

That communication is crucial for good diagnosis, Sorrentino said. "If you listen carefully to the patient, 95 percent of the time people will tell you what's wrong."

Preliminary data show that good doctor-patient relationships can improve patients' health and well-being, he said.

Nowadays, he added, doctors are doing less looking at and listening to their patients.

"Medicine has become much more technology driven," he said. "Everything's become electronic these days. We start looking at computer screens and less at the patient."

Even the little things matter, Sorrentino said, such as avoiding using a patient's first name while they call you "doctor."

The new center has designated three second-year students as the first Bucksbaum fellows and anticipates supporting up to 15 such fellows by its third year of operation. It will recruit "master clinicians" to be role models for developing top-notch patient communication skills.

Kay Bucksbaum believes many students entering medical school today are altruistic and motivated by idealism.

"By the time they're into practice, that feeling seems to have gotten beaten out of them," she said. "It's not just the education beating it out of them, it's the red tape, the bookkeeping."

But in spite of those pressures, she said, some doctors manage to retain their humanity and rapport with patients. If the Bucksbaum Institute can teach young doctors how to achieve that balance, she added, then the $42 million will be "money well spent."

Copyright 2011 ABC News Radio


Medicare Fraud Bust Nets 91 People, Including Doctors and Nurses

PhotoAlto/Frederic Cirou/Thinkstock(WASHINGTON) -- The Justice Department announced on Wednesday that 91 people allegedly scammed $295 million from Medicare by falsely billing the entitlement program.

To make matters worse, some of the suspected crooks are doctors, nurses and other medical professionals, according to Attorney General Eric Holder.

In announcing the charges, Holder said they were "based on a variety of alleged fraud schemes involving various treatments and services that were not medically necessary -- and, oftentimes, were never even provided."

The crackdown netted 11 doctors, three nurses and 10 licensed health professionals.  The charges were filed in Baton Rouge, Louisiana; Brooklyn, New York; Chicago; Dallas; Detroit; Houston; Los Angeles and Miami.

Half of the defendants came from South Florida, the reputed national leader in Medicare fraud.

Copyright 2011 ABC News Radio


Study Finds Hospital Uniforms Teeming with Germs 

George Doyle/Thinkstock(JERUSALEM) -- We like to think of hospitals as sterile environments. But even there -- it turns out dangerous bacteria are where you may least expect them.
Disease-causing bacteria are lurking in the folds of hospital uniforms, according to a study in the American Journal of Infection Control.

The study found that 63 percent of doctors' coats and nurses' uniforms at Hebrew University's Medical Center in Jerusalem tested positive for pathogenic bacteria.  
These findings proved true even though most participants said they changed their uniforms every day.  
The authors caution they don't know how often germs may have been transferred from the tainted clothing to patients. Even so, they call for daily uniform changes, proper laundering, plastic aprons when bodily fluids may be spread and strict hygiene for hands.
They also suggest wearing short-sleeve coats and even having doctors dispense entirely with their white coats to reduce the risk of spreading disease.
Copyright 2011 ABC News Radio


Doctors Prescribing Fewer Antibiotics after Warnings of Overuse

Comstock Images/Thinkstock(WASHINGTON) -- Antibiotics are no longer the cure-all that physicians and parents once thought they were.

For years, doctors prescribed these drugs to children for everything from the common cold to earaches to respiratory infections.  In many cases, the antibiotics produced no healing and in fact, often led to a bacterial and viral resistance that made them powerless against the infections they're intended to cure.

This led health officials to warn against prescribing antibiotics for every illness that befalls kids.

The Centers for Disease Control and Prevention says the message was heard, though not as loud and clear as the agency would have liked.

The prescribing rates have fallen from a generation ago when they were 300 per 1,000 office visits in 1993-1994.  The last count was 229 prescriptions per 1,000 visits in 2007-2008, a decrease of 24 percent.

According to the CDC, new tests to immediately diagnose strep throat, which can be treated with antibiotics, were partly responsible for the drop.  However, a majority of antibiotic prescriptions for children are still for acute respiratory infections that don't respond to these drugs.

Copyright 2011 ABC News Radio

ABC News Radio