New York Times --Treatment Errors for Men With Prostate Cancer
- Thread starter hope12
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If this article has its facts right, the docs at the VA deserve any legal action that is headed their way...this is outrageous that it went on for so long without anyone saying a word.
On a brighter note, I love the computer simulated graphics of the procedure! Very cool, I may actually use this with patients =)
On a brighter note, I love the computer simulated graphics of the procedure! Very cool, I may actually use this with patients =)
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I was thinking the same thing on both counts. It's definitely a great thing to have when you are doing your consult. We have computers in every room where I am at and this definitely will come in handy.
Unfortunately, I don't know what can be done. Don't VA providers have immunity wrt malpractice?
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It's really so sad that our veterans get such horrendous medical care across the board. VAs are really the epitome of mismanaged medicine. Lazy staff, limited/no oversight, ridiculous bureaucracy, and a vulnerable populatin of patients. Not to mention the number of security breaches that have happened because of lack of encryption . . .
Of course some VAs are good but having worked in one for several months I can attest to the general lack of quality. Perhaps a preview of future Obama care?
Of course some VAs are good but having worked in one for several months I can attest to the general lack of quality. Perhaps a preview of future Obama care?
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Yet some important things have seem to come out of there, like the induction chemo-RT larynx trial and the staging system for SCLC.
Having also worked at a VA during internship, I have to concur with some of the negative stuff you've written though.
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Here's another link:
http://www.philly.com/inquirer/heal...eds_see_wider_woes_in_VA_s_cancer_errors.html
I found this part interesting:
The doctor who performed most of the problem cases didn't use real-time X-rays to check the placement of the seeds.
"He refused to use fluoroscopy; said he didn't need it," NRC staffer Darrel Wiedeman told the advisory committee in May, referring to an X-ray procedure that allows doctors to see internal organs.
http://www.philly.com/inquirer/heal...eds_see_wider_woes_in_VA_s_cancer_errors.html
I found this part interesting:
The doctor who performed most of the problem cases didn't use real-time X-rays to check the placement of the seeds.
"He refused to use fluoroscopy; said he didn't need it," NRC staffer Darrel Wiedeman told the advisory committee in May, referring to an X-ray procedure that allows doctors to see internal organs.
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I was rather impressed by that too.
this is why the abr/abms should develop a certification for those who claim they have the ability to 'perform brachy'. im sure this is not isolated to just the VA system; this happens at any program that performs a low-volume of prosate brachy.
patterns of care in cervix ca showed that the following:
* At institutions treating <500 new patients per year, the percentage of patients receiving a brachytherapy dose <40 Gy was significantly higher than at institutions treating > or =500 new patients per year (p < 0.0001).
*or LDR at institutions treating <500 new patients per year, the percentage of patients with treatment duration >56 days was significantly greater than at institutions > or =500 new patients per year (p = 0.002).
thats why i feel patients get better treatment at large volume hospitals that at smaller, community based hospitals...
http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
patterns of care in cervix ca showed that the following:
* At institutions treating <500 new patients per year, the percentage of patients receiving a brachytherapy dose <40 Gy was significantly higher than at institutions treating > or =500 new patients per year (p < 0.0001).
*or LDR at institutions treating <500 new patients per year, the percentage of patients with treatment duration >56 days was significantly greater than at institutions > or =500 new patients per year (p = 0.002).
thats why i feel patients get better treatment at large volume hospitals that at smaller, community based hospitals...
http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
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While I believe centers performing large volumes might have better outcomes in certain disease sites, is this really possible from a pure logistical standpoint? Additionally, in the current economic climate, I know of some academic institutions not accepting cases ultimately due to patient's financial issues.
great points. it is possible in canada, where they centralize treatment facilities by province. im not aware of the second comment...i would think that tends to happen more in private practice.
