Professional Medical Interpreters are Life Saving

Proper communication is essential, particularly during emergency medical situations, but imagine how complicated it may be if you did not speak the language. More than 25 million Americans do not speak English. A patient who can’t describe symptoms or understand the doctor’s recommendations can easily become the victim of a mistake. However, in many states, interpreter services are not reimbursable. If there is no financing to support the usage of qualified translator services, many health caregivers count on household members (regularly kids) to understand during medical appointments. Untrained interpreters don’t have a medical background and can have difficulties understanding what the physician is saying causing difficulty translating. Medical mistakes including improper medication use, insufficient consent, and performing the incorrect procedure, could be a consequence of low quality translation.

Most healthcare facilities have policies in place that stop the use of bilingual personnel and household members as interpreters. However, in truth most healthcare providers ignore these rules for worries that the patient could be endangered by the delay in waiting for an interpreter. The precise impact of poor quality translator services is not known because non-English speakers aren't likely to complain about small medical mistakes, however, some new reports demonstrate a higher readmission rate among non-English speaking patients. Additional reports show that patient care improves drastically with the use of professionally qualified interpreters.

The Office of Budget and Management estimated that translator services cost over $98 million annually in the US. Those expenses often mean that the physician loses money on every interaction with a patient that requires a professional interpreter. However, the cost of not having an interpreter could be also bigger by causing a lawsuit or evoking the individual avoidable harm. The utilization of professional medical interpreters might cost less in the long run and avoid translation malpractice lawsuits.

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What “Dr. Google” Means for Patients and Practicing Physicians

Many people turn to the web for health care advice, but how much of that information is accurate? Google computed that one out of every 20 Google searches is for health related tips. Google is attempting to improve the quality of that information, by establishing "Knowledge Graph".
Some doctors are not sold, fearing that patients will be overwhelmed by this new offering with information that will not be easily understood, and could lead more people to self-diagnosis and maybe even panic. Other worries include whether Google will be able to discriminate evidence-based information from advice based on speculation or conjecture. Not all professionals are against Google's plans, however. Some think that patients having more access to information can help them find innovative treatments that may subsequently be discussed with their physician. As patients become more informed regarding their conditions, it can make their doctors appointments more productive and result in a more favorable healthcare experience. That is Google's target too, saying that the search results aren't meant to be medical advice, only for informational purposes and they encourage people to seek professional medical advice if they have a health dilemma.

What do you think?  We’d love to hear your thoughts!

Doctors Must be Cautious with Social Media

Social media is being used in a variety of occupations including medicine. Some physicians feel that social-media can be a practical and available way to share data with clients. These communications must be used with caution and professionalism. The American Medical Association adopted a social networking policy in 2010. Guidelines encourage doctors to:

• Set privacy settings to the highest degree that is possible and check their Net presence to make sure that both personal and professional information posted about them is correct and appropriate
• Maintain patient-doctor boundaries
• Consider separate online presence for personal and professional use
• Realize that online postings and material might have an adverse impact on reputation and could bring about professional consequences

A study from the University of California, Bay Area, found several activities were considered more prone to bring about inquiry by state medical boards. Quoting inaccurate data was rated as number one, followed by misrepresenting professional credibility, using patient photos without consent, and inappropriately contacting patients. Ongoing education regarding likely effects of social media is essential to ensure proper and professional use. Although social networking can be an excellent tool for doctor patient communication, it must be used responsibly.

To learn more about social-media guidelines in medicine, contact us!

The Ethics of Money in Medicine

Many doctors have patients that are not able to manage the expense of drugs prescribed to them. The sad truth is that some of these patients end up in the emergency department with an exacerbation of their illness or condition because they could not afford their medicines and therefore did not take them. Providers, having a responsibility to care for patients, cannot ignore this problem. Controversial relationships created by drug company representatives, outrageous expenses for advertisements of public policy, and outlandish executive compensation are driving healthcare costs up and providers cannot merely ignore or accept these factors. It's easy to fall into the trap of wanting to patronize someone who's buying you lunch or giving you new pencils, but this can put patients at a great disadvantage. For example, when a physician prescribes medications of questionably better efficacy (name brand drugs) that are more costly than generic drugs, just because they choose to support the drug rep who brings them breakfast once per week, this is not good for the patient.

Prices of some top-selling prescription medications have increased astronomically in a short span of time. For instance, 60 Minutes reported about the rise in the price of Gleevec, a cancer drug from Novartis, that rose to $90,000 per year from $24,000 per year. What could have caused such a leap? Bloomberg Business reports that some top-selling prescription drugs have increased as much as 841% over the past seven years. Are you aware that after the FDA approves a drug, Medicare is legally mandated to pay the drug company's asking price? Picture the lobbying that was behind that legislation!

What do you think of the increasing costs of prescription drugs? What is your alternative? Let us know!

Some Good News: Hospitals become Healthier

In 1999, The Institute of Medicine issued a study highlighting the dangers of hospitalization, particularly illness or injury caused by treatment or by medical evaluation. The report called for a comprehensive effort to lessen hospital errors that resulted in death by 50% in five years. Five years later, the goal wasn't satisfied; nonetheless awareness of the situation rallied the healthcare industry to make modifications which are finally showing results.
Measurements of patient safety have been set up to properly gauge the issue. To ensure continuing improvements, we must be able to assess the expenses of patient injury along with the reliability of existing techniques. Patient safety targets must be measured using solid data from the field.
A recent report from the Agency for Healthcare Research and Quality showed that we are improving.  Iatrogenic events (illness caused by medical evaluation or treatment) decreased 17% between 2010 and 2013.  The report revealed considerable declines in pharmacy errors including preventable allergic reactions and dosing with the incorrect medication. Pharmacy errors were reduced by 40% in the 2010-2013 time frame. Another significant section of enhancement was in a decreased likelihood of catheter infections and bedsores. Unfortunately, it remains unclear which important modifications contributed most towards the decrease in iatrogenic harm; though the cost savings are obvious. The savings to Americans were more than 12 million dollars throughout the reporting period. Closer investigation into what factors led to the most improvements in patient safety will hopefully lead to improvements and cost savings for the entire healthcare system.

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Trending: The Opioid Free Emergency Department

The epidemic of opioid abuse in the USA is undeniable. Prescriptions of opioid pain relievers have grown to approximately 207 million prescriptions in 2013 from 76 million in 1991. The United States is the biggest global consumer accounting for 81% of oxycodone prescriptions and nearly 100% of hyrocodone prescriptions internationally. The amount of deaths from prescription drug overdose has more than quadrupled since 1999 and is now one of the leading causes of death in the United States estimated at 114 deaths daily. Therefore, prevention is key to halting this alarming tendency.
Public policy reform of prescribing practices is necessary to reduce the out of control use of addictive analgesics. Physicians seem ready to face these pain management practices and explore non-opioid strategies to pain relief in the emergency department according to discussions at a recent conference of the American Academy of Emergency Medicine 21st Annual Scientific Assembly. A totally opioid ED is probably not realistic, however exploration of alternatives may supply a solution to the routine prescription of opioids in the ED and beyond.

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Recording Your Doctor Visit – Is that OK?

Anyone with a Smartphone can record their doctor's appointment with or without the physician knowledge or the physician's permission. There are lots of reasons that patients have to record a visit including to share the information with a caregiver or family member, to remember or refresh the recommendations given, and to review it in a more relaxing environment. Many doctors are opposed to being recorded for fear that the recording will be used in a lawsuit (possibly even edited to present only part of the dialogue), along with the very fact that the doctor-patient relationship is confidential. Most doctors say they'd refuse to be recorded if asked.

In most states it is legal to record an in-person conversation without getting consent from everyone present. Thus, even if your physician refuses to be recorded, you can legally still do it (check your state laws first). Some doctors feel trust is violated by these recordings and they would immediately terminate the doctor-patient relationship if they caught a patient recording an appointment. Some offices have posted warning signs or have written statements regarding the office's "no recorded visits" policy. Other physicians, however, do allow recordings and some even encourage it. These physicians believe that if you're practicing good medicine you have nothing to worry about. Patients that can review a recording later may follow recommendations and guidance more thoroughly. In some physician offices, all appointments are being recorded for the patient. In such instances, problems about partial or edited recordings being presented in court no longer apply. Having these recordings that are complete could prove useful in defense of any malpractice lawsuit as the advice to document everything will ultimately have been completely complied with.

We work at the intersection of medicine and the law.  Please don’t hesitate to contact us if you have any questions about our services!