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By Dr. Paul Kivela

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WELLNESS

HEALTH CARE POLICY

INSIDE XC

ECOCOMMUTER

LIFE HACKS

MEDICAL ADVANCES

Month: March 2016

Medically Sound

With Dr. Paul Kivela

Tulare Hospital Discharges Medical Staff

  March 27, 2016

TULARE HOSPITAL BOARD DISCHARGES ENTIRE MEDICAL STAFF OF 135: UPDATE Dave Adalian Following the publication of the article “Tulare Hospital Board Discharges Entire Medical Staff of 135,” the Valley Voice was contacted by a publicity firm and attorneys representing Tulare Local Health Care District (TLHCD) and Health Care Conglomerate Associates to raise objections to facts… Read More


Value Based Payment lottery: an unfair result

  March 13, 2016

The results are out: 3% winners and 97% losers in the first go around on Medicare bonuses for the Value-Based Payment Modifier (VBM) program in 2014. No one knew what exactly to expect when the instituted the VBM program but no one expected these lopsided results and clearly now it appears these results are like a… Read More


Data on CHF repeat hospitalizations

  March 13, 2016

5.8 Million people in the U.S. suffer from CHF and this accounts for over 1 million hospitalizations a year.  Rehospitalization rates approach 30% at 90 days. The costs to treat heart failure are over $37 Billion a year.     The majority of the costs of heart failure come from hospitalizations and repeat hospitalizations.  Hospitalizations account for… Read More


United flies SFO to LAX on biofuel –...

  March 13, 2016

Whereas not many years ago, it was thought impossible to fly an airplane on biofuels, United flew a jet light from SFO to LAX using biofuels.  This March 11,2016 San Francisco Chronicle article talks about how biofuels are a way the airlines can deal with climate change and are a potential hedge against high oil… Read More


ESI may correlate with E & M Codes

  March 7, 2016

  In order to simplify and make more uniform  emergency department triage, the ESI acuity scale was developed. ESI has become very popular because it has been validated for interrater and inter-institution reliability and is even endorsed as a best practice by AHRQ ( the Agency for Healthcare Research and Quality).  Dr. Wiler and others… Read More


Insurer cuts physician pay for ACA Plans

  March 4, 2016

It was just a matter of time  before insurance companies passed on their ACA losses to physicians.   I mark is just the first  insurance company to announce that they will cut physician pay by 4.5% to help mitigate their losses from the Obamacare plans.   As multiple insurance companies have announced that they suffered significant losses… Read More


Lose weight by cold exposure or stool tranplant

  March 3, 2016

There is an interesting article in the March 3, 2016 issue of NEJM that discusses obesity and that there are two new areas of research including the manipulation of brown adipose tissue and the role played by the gut microbiome in energy balance.   With the tremendous epidemic of obesity, type II diabetes and dyslipidemia, it… Read More


Stool transplant a cure for IBD, C. difficile...

  March 3, 2016

Chrohn’s disease, Ulcerative Collitis, inflammatory bowel disease and C. difficile infections plague millions of Americans every year.  Chrohn’s disease alone affects approximately 700,000 Americans.  Many of these diseases are considered autoimmune disorders and are thought to occur when the immune system attacks healthy tissue. Typical treatments are toxic and have variable efficacy.  However, a relatively… Read More


Dragon for Mac – speech recognition software

  March 3, 2016

I am back to using Dragon dictation software at home as much as I possibly can.   Whereas certainly I can type relatively fast I find that Dragon can dramatically improve my typing speed and I think it can recognize my speech better than I can type with typos.  I also use speech recognition on my… Read More


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