Archive for December 2010

How Not to Respond To a NEJM Letters To the Editor:

In todays NEJM, three surgeons from the American College of Surgery (ACS) reply to a commentary on sleep deprivation and elective surgery. The letter is instructive. Read it, and you will note several things: (more…)

Lower Salary Equals Higher Pay… Really?

Last month, we dug through a sample set of Hospitalist Compensation and Productivity data.  That column excited two people, maybe three, to get out a slide rule and some actuarial tables for the sheer joy of the experience!  Meanwhile, my partners insist that everyone else had to grab a drink and find something better to do with their time. OK, point taken!  But, I’d like to hit on some information that even non-numbers nerds found intriguing in the SHM-MGMA Survey this year.  That information is the correlation between lower base salary and higher overall productivity for hospitalists.  See the graph below. (more…)

Rapid influenza tests

The CDC has updated it's recommendations for use of rapid tests for influenza. Although they are easy to perform, with turnaround times of 15 minutes, most have limited sensitivity and therefore high false negative rates. This should be factored in when using these rapid tests, and patients with a high clinical suspicion for influenza should be treated as such, even if the rapid test is negative (CDC site).

Apixaban for VTE prophylaxis after THA

In this large industry sponsored randomized trial of apixaban (an oral Xa inhibitor) versus enoxaparin in patients post-hip THA, patients were treated for 35 days, and followed up at an additional 60 days for the primary outcome (DVT/PE/Death). Patients in the apixaban group had significantly fewer events than the enoxaparin group (1% versus 4%). Apixaban, similar to rivaroxaban, are both oral Xa inhibitors that are effective in preventing VTE after orthopedic surgeries. However, neither are yet FDA approved in the US, and cost remains to be seen (abstract)

Influenza is here

Circulating influenza virus has been isolated in most states. Fortunately the vaccine well matches the circulating strains, so we can hope for a mild influenza season (CDC site)