Burned while waterskiing? There's a code for that...

When I see a patient in clinic or the hospital, I have to write down what problems he/she is having so that an appropriate bill can be generated for my services. It should be no surprise that there is a series of codes that one must select from, so that we can all agree that if I see a patient for 786.5, we all know that is "chest pain". The system is called the "International Statistical Classification of Diseases and Related Health Problems" and is presently in the 9th revision.We have used the 9th revision for many years now, and the federal government and insurers want to move on to the next iteration.

This older article from the Wall Street Journal just got forwarded in email to me, and helps provide some perspective about the 10th revision. As a top line overview, the system goes from 18,000 codes in ICD-9 to 140,000 codes in ICD-10. That means that not only do doctors and coders have 10 times as many choices to select when describing a patient's conditions, but all of the software for all of the electronic medical records systems, billing and coding systems, etc. have to be retooled to think in ICD-10. I am no computer programmer, but visions of the Y2K bug are flashing before me.

What do doctors and patients get out of this 10-fold expansion of codes? Well, finally, I have a code for coding "burn due to water-skis on fire". Thank goodness! For the surgeons out there, they now have not just one, measly code for saying they stitched up an artery, but 195, one for every artery they could think of and several other variables as well!

One reason why eating veggies might help you lose weight

From Graphjam.com

Hands Only CPR

At some point in your life, you may have been trained to do cardiopulmonary resuscitation (CPR). The guidelines on just how to do it have changed some over the years, but the most recent update includes some changes that could really make a big difference in life saving. Why? First, you have to think about one of the biggest barriers to CPR being done in public, on a stranger. You have to do mouth-to-mouth on someone you do not know. Now, they do make barriers and masks, some of which are small enough to carry with you, but simpler is still better. It turns out that the science has shown that mouth-to-mouth does not really add that much. Furthermore, if you can convince more people to overcome their trepidation and give CPR in the first place, you can make a bigger impact on society. Anyway, if you are interested, read more at the American Heart Association website, and check out these two YouTube videos. Hat tip to @MGKatz036 for the link!

Do you want a doctor that clowns around?

Medgadget reported last month on a study in Fertility and Sterility which randomly assigned women undergoing IVF to an encounter with a "medical clown" and showed an increase in successful births from 20.2% to 36.4%. Now, we might all be able to imagine that you could use clowns to reduce pain scores in children, or possibly to scare the living daylights out of people with coulrophobia, but improving fertility? Perhaps there is something about the hormonal environment that improves fertility when the mother is happy and laughing? The abstract is the only text of the article I can access right now, but the statistics they report suggest that the effect might be real, but it might also be a spurious finding and we will not really know until the results can be replicated. In the meantime, I will have to entertain myself with the idea of a "clown consultation service", and I will also have to refrain from any jokes about which other specialties should be first in line to staff such a service.

This is a blogpost about a news article about a scientific paper

I love dry humor, and this bit is a little old but an excellent read. Martin Robbins, writing for the Guardian in the UK, posted on Sept 27, 2010 an article titled "This is a news website article about a scientific paper". He goes on with the subtitle:

In the standfirst I will make a fairly obvious pun about the subject matter before posing an inane question I have no intention of really answering: is this an important scientific finding?

In a great lampoon of prototypical media failures when it comes to reporting on medical and scientific breakthroughs, including:

• Scare tactics
• Failing to link to the paper and not providing enough information to find it on your own
• Overstating the inadequacy of existing literature
• Oversimplification of the findings
• Failing to delve into sources beyond Google and Wikipedia
• Attaching the science to some minor celebrity's pet cause
• Meaningless figures and graphics
• False balance of competing opinions to generate controversy

I have friends in media, some of whom do an excellent job with their reporting, so I do not mean to suggest that all reporters use these tactics when reporting on science. However, the parody would not be funny if it were not (unfortunately) true so often.

A quick clinic visit with Dr. Web, M.D.

An amusing dramatization of what it is like trying to get meaningful health information from the web, which is to say that largely, online health info sucks.

http://www.collegehumor.com/video:1939123