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By Dr. Paul Kivela

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Month: April 2016

Medically Sound

With Dr. Paul Kivela

A solution for that double chin-Kybella

  April 26, 2016  |    drk  |    1 Comment

“Double chin”, “turkey neck”, “neck waddle” or “baggy neck” and otherwise known as submental fullness is one of the most common anesthetic complaints. It doesn’t matter if you a guy or a gal, this solution is effective.pproximately two thirds of people said they are bothered by submental fullness. This can be enforced by multiple factors… Read More


Accountable Care Organization Update 2016: 

  April 26, 2016  |    drk

It is always interesting to follow the successes and failures of healthcare reform.  The touted solution of Obamacare revolves around the formation of the Accountable Care Organization (ACO).  Recently, there has been quite a bit of press about the failure of ACO’s and more recently United Healthcare has publicly reported that they will be dropping out… Read More


Solar Airplane crosses the Pacific Ocean

  April 24, 2016  |    drk

Solar Impulse 2, the plane trying to fly around the world without fuel, has landed in California after a two-and-a-half day flight across the Pacific. It is awesome how fast and far alternative fuel technologies are taking us in a relatively short period of time.  Piloted by Swiss explorer and psychiatrist Bertrand Piccard and Swiss… Read More


Chief Complaint is not helpful to determine acuity

  April 23, 2016  |    drk

It is impossible to determine from a discharge diagnosis or a chief complaint who has an emergency medical condition and who can be seen later in another setting.  We can all recount stories of someone triaged as at a low level and was determined by the physician to have require emergency surgery or have a… Read More


CMS delays new hospital quality ratings 

  April 20, 2016  |    drk

An article in the April 20. 2016 issue  of Modern Healthcare reports that CMS will delay release of the their hospital quality star ratings.   Excerpts of the article go through the rationale and role out. The federal government has been promoting the ratings for hospitals, nursing homes, dialysis facilities and other providers as a… Read More


Hospitals want to be like Kaiser Report confirms...

  April 15, 2016  |    drk

Everyone wants to be like Kaiser. Many people saw this as a potential issue that I think will increasingly become the norm.  The consolidation of the healthcare industry will move to more and more entities controlling all aspects of the healthcare delivery financing model.  A report y McKinsey and Company as reported in Modern Healthcare… Read More


Overdose epidemic

  April 12, 2016  |    drk

As the number of overdoses linked to the potent painkiller fentanyl has grown over the past two days to 48, nearly two weeks after the first reports of such overdoses began popping up in the Sacramento region, the Sacramento County Department of Health and Human Services reported Wednesday. No additional deaths have been reported, leaving… Read More


Retail Clinic Visits For Low-Acuity Conditions Increase Utilization...

  April 12, 2016  |    drk

Once touted as a way to save money for the healthcare system, a study published in Health Affairs by the RAND Corporation indicates that these clinics may actually increase costs without providing any additional value to the system.   In the last decade these clinics have proliferated across United States and their estimates there are approximately… Read More


Big California Firms Take On Health Care Giant...

  April 10, 2016  |    drk

Sutter Health is taking an interesting approach and utilizing its market share to possibly force employers into arbitration clauses and protect its market strength. Sutter Health has hospitals in more than 100 communities in Northern California; it reported $11 billion in revenue last year, with an operating profit of $287 million. Sutter Health, a large… Read More


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