physician

Defense Expenses and their role in Medical Malpractice Claims

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An interesting article titled “The Impact of Defense Expenses in Medical Malpractice Claims” written by Aaron E. Carroll, Parul Divya Parikh, and Jennifer L. Buddenbaum appears in the Spring 2012 issue of the The Journal of Law, Medicine & Ethics (vol. 40, issue 1, pages 135-142). The authors state “Multiple factors go into the determination of medical professional liability insurance premiums including return on investments, reinsurance costs, claims frequency, average amount paid out on malpractice claims, defense expenses, and administrative costs such as underwriting expense. These factors all interact with each other and, in general, evidence exists that each of these factors has played a role in the escalating cost of medical professional liability insurance.” The authors go on to describe tort reform efforts and state “These reform efforts include caps on damages, abolition of punitive damages, eliminating mandatory prejudgment interest, … Read more

Cluster Headache Features and Therapeutic Options

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A review article titled “Cluster Headache: Clinical Features and Therapeutic Options” written by Charly Gaul, Hans-Christoph Diener, and Oliver M. Muller published in Deutsches Ärzteblatt International (vol. 108, issue 33, pages 543-549, 2011) provides an interesting look on new options for those with a chronic refractory cluster headache. The article discusses how 120,000 people in Germany are affected by cluster headache. The attacks are in the periorbital area on one side and last 90 minutes on average. The attacks often posses a circadian and seasonal rhythm. The author lists the diagnostic criteria for cluster headache as from the International Classification of Headache Disorders (ICHD-II). First line drugs for treatment include verapamil and cortisione or lithium and topirmate. In addition, short term relief can be obtained by local anesthetics and steroids along the course of the greater occipital nerve. I have … Read more

Evidence Base for Oral and Maxillofacial Surgery Journals

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An interesting articled titled “The evidence base for oral and maxillofacial surgery: 10-year analysis of two journals,” appeared in the January 2012 edition of the British Journal of Oral and Maxillofacial Surgery (vol. 50, issue 1, pages 45-48) wirrten by Amandip Sandhu. The author opens by discussing an editorial in the Lancet in 1996 which discussed how there is a lack of scientific rigor in surgical research. The author states “There is a well established hierarchy of levels of evidence, and the medical community considers that meta-analyses and randomised controlled trials (RCTs) are the most scientifically stringent means of investigating the efficacy of one intervention against another. Other grades of evidence (in increasing weakness of level of evidence) are case controlled studies, comparative studies, case series, correlation studies and expert committee reports, and the clinical experiences of respected authorities.” The … Read more

Why Bother With Research

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An intriguing article recently appeared in the International Journal of Oral and Maxillofacial Surgery titled “Research – why bother?” (vol. 40, issue 12, page 1346, December 2011) written by G. Dimitroulis. The article discusses of oral and maxillofacial surgery needs research to make itself known as a professional body and not as just a technical trade. A brief mention is made that dual degree programs place time pressures on trainees at the expense of research. The author mentions how head and neck surgical oncology is shared by a number of surgical specialties with mutual interest. The author states “We cannot rely rely on the research experience of other surgical specialties if we are to secure the respect and trust of our medical and surgical colleagues from other disciplines who also have a mutual interest in head and neck oncology.” The … Read more

Perioperative Information for Third Molar (Wisdom Teeth) Removal

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A recent study titled “An Evaluation of Patients’ Knowledge About Perioperative Information for Third Molar Removal,” appears in the Journal of Oral and Maxillofacial Surgery (vol. 70, pages 12 – 18, 2012). The study attempts to look at what patients know about third molar (wisdom teeth) removal before having surgery performed. The study was conducted by authors in Brazil and Kentucky (United States). The study explains on being nervous and anxious before having wisdom teeth removed can actually cause a longer surgery, more potential swelling, and even more pain. Hence there is incentive for the surgeon and the surgical team to help produce a calming environment for patients to help reduce anxiety which can lead to potentially better outcomes. The study had 67 patients which included 43 female and 24 males who had 1 or more wisdom tooth removed. The … Read more