US Troops: The Bomb was Real–maybe the Injury was, too

March 3rd, 2010. By AbiK

Ever wonder what happens to soldiers who’ve been targeted in a roadside bombing in Iraq or Afghanistan?—and by that question I’m referring to those soldiers who live. Apparently not much happens unless there is an obvious injury. Or so one would be led to believe given the news today of a new medical policy coming from the Pentagon.

As reported at cnn.com, US troops who’ve been targeted in roadside bombings will now be pulled from duty for a 24-hour period to be monitored for headaches, memory or concentration loss, ringing ears and blurred vision—the signs of a concussion. If the soldier scores low for any of these symptoms he or she will be kept out of combat until their condition improves.

So why is this new medical policy—expected to be signed into effect within two to three weeks—happening now? Well, for one thing, a traumatic brain injury (TBI) that’s been sustained due to simply being near (definition of “near” is withing 55 yards of a blast according to the cnn.com article) a roadside bomb can go undetected only to surface months or years later. (Sound familiar to anyone with PTSD? or Gulf War Syndrome?)

If you think there aren’t too many soldiers affected by roadside bombs, think again. According to NATO’s International Security Assistance Force statistics, around 80 roadside bombs have exploded EACH WEEK in Afghanistan since June, 2009. Additionally, a 2008 RAND study indicated that as many as 300,000 US troops who’ve returned home from Iraq and Afghanistan could be suffering from traumatic brain injuries.

Pentagon officials estimate the number of troops that could be removed from duty under the new policy is about two percent.

Should Hospitals have Limits in how Green they go?

March 2nd, 2010. By AbiK

Some things were just meant to be used once and one time only. Dixie® cups. Band-Aids®. Drinking straws. Envelopes you lick, to name a few. But how about laparoscopic ports, surgical scissors and pulse oximeters?

Seems some hospitals—in both an effort to be “green” as well as to introduce some cost controls—are recycling some surgical items labeled for one-time use (aka, “single-use devices” or SUDs). According to an article in the Baltimore Sun (2/25/10), the number of hospitals doing the recycling is growing; in fact, the article quotes Dr. Martin A. Makary of Johns Hopkins University School of Medicine as stating that about a “quarter of the nation’s hospitals now do some reprocessing”.

There are proponents on both sides of the hospital recycling debate. On the one hand, you’ve got those who argue that certain implements have historically been collected after use and sent back to the manufacturer where they were reprocessed—not necessarily under any regulatory watchful eye—and repackaged for re-use. The argument would then go: wouldn’t you rather reprocess them yourself and have more control over things?

And you’ve also got the January 2008 report from the US Government Accountability Office (GAO) titled Reprocessed Single-Use Medical Devices: FDA Oversight Has Increased, and Available Information Does Not Indicate That Use Presents an Elevated Health Risk. The conclusion of that report, as written about in an article at the Journal of the Association of American Medical Colleges (March, 2010), is that “although available FDA data fail to allow for rigorous in-depth comparisons, reprocessed SUDs do not present an increased health risk when compared with new nonreprocessed devices. Of the 434 adverse events reported to the FDA between 2003 and 2006 in which reprocessed SUDs were identified, only 65 actually did involve a reprocessed device, and all adverse events were similar to those reported for new devices.” 

Ok. My faith (or lack thereof) in the FDA’s oversight of all things medical notwithstanding, the obvious question is does anyone really want recycled surgical tools to be used on them without their knowledge and consent? There’s just something a little…discomforting…about lying on that chilly operating table, bright lights aglow, feeling that IV starting to flow and wondering whether that anesthesia conduction needle has been thoroughly disinfected. I’d prefer to have my thoughts on other things at that moment.

Pelvic Exams without Consent: Medical Malpractice Suit?

March 1st, 2010. By janem

Imagine you’re unconscious and several men insert objects into your vagina. Many women would consider this gang rape. At the very least, sexual assault. Guess what, it may have happened to you—without your knowledge!

How would you react if you underwent surgery such as a routine hysterectomy and found out that right after you were anesthetized, a team of medical students performed pelvic exams—without your consent? I believe that is a violation of our basic rights, to say the least. Where’s the respect? 

I know what I’d do: file a medical malpractice suit, pronto.  As a matter of fact, I’m actually scheduled for routine surgery in a few months—at a university hospital—and that rang my alarm bell. I called my gynecologist and spoke with her receptionist. “Under no circumstances do I want a student poking around my private parts,” I said, or probably yelled. She replied that I had to take that up with my gynecologist, who of course is never available for a phone call. 

So does uninformed consent qualify for a medical malpractice suit? Well, not quite, but then again, I haven’t spoken with a medical malpractice attorney…What I did discover online is that “A medical practitioner may also be legally liable if a patient does not give “informed consent” to a medical procedure that results in harm to the patient, even if the procedure is performed properly.” In my opinion, psychological harm fits the bill. 

In Canada, you aren’t even asked for consent, unlike the UK and the US—or so Americans and Brits were led to believe. Some ethical medical students have been asked to perform pelvic exams in Canada (and in British and American hospitals) without the patient’s knowledge, and they have refused. And that’s how the public knows about Read the rest of this entry »

You Don’t Look Hollister: You’re Fired

February 26th, 2010. By AbiK

What? The uber-hip, ultra-prep and ubiquitous Abercrombie & Fitch is at the center of an EEOC Complaint re: banning a Muslim employee from wearing her hijab (aka head scarf, for those of you less “hip” to all things diverse). Perish the thought!

Say it isn’t so, but oh, it’s true! Seems the Brand is the Look, and the Look is All-American-prep and so—you know, by that theory of transitivity you learned in prep school—well, the Brand is All-American-prep. Like complete mirror image. And we know brand integrity is Everything. Cap E intended.

Abercrombie & Fitch lost me a number of years ago—they used to be this quiet, reserved, quality outfitter with a store nestled in the upper recesses of Trump Tower on 5th in NYC. But then things changed. With folks like J. Crew eating up market share, well, A & F apparently found themselves in need of a re-image. Repositioning. ReBranding.

Rebrand—and expand with companies like Hollister—they did. Go into a store now and you’ll be greeted by a sea of 20-something oneness and assimiliation set to the backdrop of glaring music. Their black & white ads suggest a more “knowing” (yes, sexually) and somewhat monied and genteel crowd that I imagine the sales side of the biz only wishes it could duplicate on the sales floor. But there’s the rub. It can’t.

See, you can homogenize your ad campaign. Not so your sales staff.

So what happens when brand image isn’t playing out at the stores, or in this particular case on the stockroom floor of A&F subsidiary brand Hollister? If you’re a district manager who clearly didn’t read Read the rest of this entry »

Shopping the best Health Insurance deal? Maybe you can’t

February 26th, 2010. By AbiK

On the heels of posting about the recent WellPoint/Anthem health insurance rate hikes, an American Medical Association (AMA) report on competition in the health insurance industry came out this week.

Guess what? AMA President Dr. J. James Rohack summed it up as: “The near total collapse of competitive and dynamic health insurance markets has not helped patients. As demonstrated by proposed rate hikes in California and other states, health insurers have not shown greater efficiency and lower health care costs. Instead patient premiums, deductibles and co-payments have soared without an increase in benefits in these increasingly consolidated markets.”

The report, Competition in Health Insurance: A Comprehensive Study of US Markets, looked at data from 43 states. Interestingly, in 24 of the states, the two largest insurers had a combined market share of 70% or more. Not a consumer packaged goods company out there that wouldn’t love to be sitting in that position.

Also according to the report:

• In 54% of the metro markets, at least one insurer had a market share of 50% or more
• In 92% of metro markets, at least one insurer had a 30% or more market share

The best quote from the Rohack news release is this though—in reference to the lack of competition within the health insurance industry—it “is clearly not in the best economic interest of patients”.

No kidding.