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[Editor's note: This is Part 2 of an article that appeared in the April 1, 2009, issue of Medical Ethics Advisor.]
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Boutique; concierge; retainer. These are all words used to describe physician practices that charge patients an annual fee for access. And while there don't appear to be firm numbers on such practices, some say they are meeting an important need in a broken health care system.
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Feelings of abandonment on the part of patients and their caregivers are not uncommon as they transition from treatment to end-of-life care, according to a recent study completed by a team at the University of Washington.
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A study published in the March 9, 2009, issue of Archives of Internal Medicine, which revealed that patients with advanced cancer who reported talking to their physicians about their end-of-life care wishes had significantly lower health care costs in the last week of life.
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While psychiatric advance directives are not new in concept, patients tend not to take advantage of these tools.
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[Editor's note: Dr. Banja is a Professor in the Department of Rehabilitation Medicine; a Medical Ethicist at the Center for Ethics; and the Director of the Section on Ethics in Research at Emory University in Atlanta. E-mail:
[email protected].]
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Health care-associated infections cause direct medical costs as high as $45 billion annually in U.S. hospitals, the Centers for Disease Control and Prevention reports in a new analysis.
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Beyond the immediate threat to frail, hospitalized patients posed by emerging carbapenem-resistant Klebsiella pneumoniae (CRKP) is a larger concern: its mechanism of resistance is transferable to other bacterial species.
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Trying to keep the genie in the bottle, the Centers for Disease Control and Prevention has issued new guidelines to halt the emergence of a highly drug-resistant, gram-negative pathogen that can cause a variety of infections with a strikingly high mortality rate.
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Having been in infection prevention in one capacity or another since 1981, Denise Murphy, RN, MPH, CIC has seen the field affected by everything from the AIDS epidemic, the rise of drug-resistant pathogens, and the increasing influence of consumer advocates and lawmakers. She has seen it all and seen enough.