Archive | March, 2013

Examining Hospitalization for the Removal of Wisdom Teeth in Australia

A recent study titled “Hospitalisation for the surgical removal of impacted teeth: Has Australia followed the international trends?” by George RP, Kruger E, Tennant M., appears in the Australasian Medical Journal (AMJ) vol. 4, issue 8, pp. 425-430, 2011. The study looks at a period of six years between 1999 and 2005 in which patients had impacted teeth removed under general anesthesia in a hospital in Australia. The authors state that the vast majority of teeth that are impacted are wisdom teeth (third molars). A total of 37.6% of all oral health hospitalizations over the six years were for hospitalizations. Most of the patients were females with an average age of 21.6. The majority of patients were hospitalized at a private hospital and privately insured. A total of 47,411 patients were hospitalized in Western Australia for the oral condition ‘Impacted/embedded teeth’ during the six-year study period. A total of 60.8% of the patients admitted were between age 15 and 24. A figure in the paper shows the full age distribution. A total of 86.6% of the patients were hospitalized at a metropolitan private hospital and a total of 74.9% of the patients were insured and were treated at a metropolitan […]

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Dental Patients Warned of Possible HIV and Hepatitis Exposure Due to Oral Surgeon’s Practices

Previously in this post Oral Surgeon Investigated for Reusing Needles and Syringes it was discussed how last summer in 2012 an oral surgeon in Colorado was investigated for re-using syringes and needles while performing various oral and facial surgery procedures. Around 8,000 patients were told to be tested for potential HIV, hepatitis B, and hepatitis C. Recently, in Oklahoma around 7,000 patients were told to be tested for potential HIV, hepatitis B, and hepatitis C who were treated by an oral surgeon due to his potentially rusty instruments and lax sterilization procedures. A complaint by the Oklahoma  Board of  Dentistry was filed against the oral surgeon on March 26, 2013. It is located over at The complaint says that an unidentified patient who was treated by the oral surgeon tested positive for HIV and hepatitis C shortly after being treated for dental procedures. The complaint says that during the Dental Board’s investigation there were multiple sterilization issues, multiple cross contamination issues, the drug cabinet was often unlocked, and some of the dental assistants were routinely providing the IV sedation for some procedures. In addition, it was found that no written infection prevention policies and procedures were available or used. […]

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Justice and Fairness in the U.S. Healthcare System

An interesting article appears in the Fall 2012 issue of the “The Journal of Law, Medicine & Ethics” titled “Justice and Fairness: A Critical Element in U.S. Health System Reform,” written by Paul T. Menzel. In the article Paul discusses how unfettered competitive markets in health insurance generate market failure. The market failure of course is the fact that in an unfettered competitive market, health insurance will inevitably be out of reach for many (even most) of those who desire and need it most. In the article Paul discusses a term he coins the Just Sharing principle “The financial burdens of medical misfortunes ought to be shared equally by well and ill alike, unless individuals can be reasonably expected to control those misfortunes by their own choices.” Paul goes on to say “Just Sharing is incompatible with pre-existing condition exclusions, high degree of premium variation by subscriber risk, rescission of insurance when a subscriber becomes high-cost, and other market segmentation devices that inevitably arise in an unfettered competitive insurance market, creating market failure. If one only bars insurers from using these devices, however, then the “death spiral” for insurance begins: community-rated premiums lead even more of the likely well to […]

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Medical Responsibility

An interesting article by  Ronald Hamowy titled “Medical Responsibility” appears in the Fall 2012 issue of the The Journal of Law, Medicine & Ethics. While I don’t agree with the all the points addressed in the article some of the points are worth mentioning.  Ronald says “That we are part of some organic body and that we are interconnected so that we “belong” to and are responsible for each other is basically antithetical to our notion of the sovereignty of the individual. Nothing is more elemental to the nature of man than that he be in control over the decisions that affect him. And no decisions are more central to his existence than the medical care he receives. This extends to being able to determine the type and degree of medical care he opts for and to choose among those who might provide these services. Self-responsibility is not a burden — or at least not just a burden — but a method of insuring that the each of us has plenary control over our lives. And the only economic system compatible with individual autonomy is one of free markets, which also serves as the most efficient system for the production […]

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Unnecessary Medical Care and Over Used Tests: The Choosing Wisely Campaign

The Choosing Wisely Campaign is an initiative which I believe I first heard about in late 2010 launched by the ACR (American College of Radiation as the Imaging Wisely Campaign) The Imagely Wisely Campaign was designed to have people aware of the fact that certain medical imaging tests such as CT exams were sometimes over used and did not always have to be used in some instances. It seems that the Choosing Wisely Campaign was launched by the ABIM Foundation which is an organization designed to advance medical professionalism to improve patient care. In April 2012 the Choosing Wisely Campaign released some lists of tests and procedures commonly done in 9 medical professions that should be questioned.  In February 2013 an additional 18 lists of tests or procedures were released. The press release is located at On the website of the Choosing Wisely Campaign it states “An initiative of the ABIM Foundation, Choosing Wisely is focused on encouraging physicians, patients and other health care stakeholders to think and talk about medical tests and procedures that may be unnecessary, and in some instances can cause harm.” Consumer Reports is involved in helping to disseminate information to patients in a more […]

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