Re: Prophy ABX for Elective C/S was Re: No Posts!
From: R. Daniel Braun (rd.braun@gmail.com)
Sun Dec 2 10:10:14 2007
Henry and everybody else, check out Placebo Journal Television. Follow this
link: http://placebojournal.com/shopcontent.asp?type=placebotv If it
doesn't show as a link just copy it to your web browser. I think you will
all like it.
Dan
On Dec 2, 2007 3:36 AM, Henry Gregor <henrygregor@yahoo.com> wrote:
> Couldn't agree more with you Dan...awhile back the OBGYN News had an
> article of P4P which noted something like sixty performance criteria used
> among and by numerous 3rd party organizations, with the observation not not
> more than three criteria were shared among ten organizations...great
> correlation... really convinced me of the insightful relevance of the
> criteria and their ability to help the average patient and his/her family
> find affordable care.
>
> It's definitely a new growth industry for managed care and government
> overseers (not to say oversight is not desirable and important, but lets
> make it releavant, intelligent and beneficial), asnd hospital administrative
> staff...who will only want a little of medical practitioner input and
> committee work to allow the hospital to comply to requirements.
>
> Nationally and locally I keep hearing so many of our peers puffing off re
> the importance of getting in sync with P4P....while the government and
> insurance companies dole out millions, (yup millions already) to consulting
> firms who get their bucks up front for their work, the working massses of
> providers are expected to build up the IT and other beauracratic structures
> to collect these mountans of data inputs....and I suspect when the
> conversion for "bonuses" for performance trickle down, they will be pennies
> for the dollars of overhead costs, lost patient revenue generating encounter
> opportunities...not to mention no proven correlation to health benefits for
> patients, and IMHO ultimately more barriers to affordable basic medical
> services. We as MD's will look like dogs chasing their tails. (BTW, how many
> of us on this list can remember our professional leaders of the eighties
> counseling us to sign on with HMO's and gate keeper managed care, otherwise
> the teams will pass us by, the games will be on, and we will have "lost' our
> opportunities to control the rules and applications of the games we'd all
> have to play under eventually?)
>
> Hank
>
> *"R. Daniel Braun" <rd.braun@gmail.com>* wrote:
>
> Because some bean counter selected them as a way to cheat MD's out of
> appropriate payment and increase his bonus and the CEO's bonus.
> BTW, that is all that P4P is good for. (And I am retired and it doesn't
> affect me other than the way in which it will negatively affect health care
> for all PATIENTS)
>
> Dan
>
> On Dec 1, 2007 1:32 AM, Henry Gregor <henrygregor@yahoo.com> wrote:
>
> > Wow, that's intiguing to me...how'd they get selected?...thinking off
> > the top of my head, (which might be a bit more addled than usual, since I've
> > been taking some APAP/500 - acetominophen/hydrocodone - post surgically) if
> > I were looking for more bang for a buck spent in assessing care, how'd STD,
> > Pap, Rubella, Varicella, HIV screens, breastfeeding counseling,
> > and antenatal childcare and parenting info, etc. get behind these two? I
> > wonder what other listers would suggest for criteria?
> >
> > Hank
> >
> > *Myer Bornstein <mborn@massmed.org>* wrote:
> >
> > the 2 OB criteria are Testing for GBS and treating according to
> > protocol and pre-op antibiotics for C/Sections
> > Myer
> >
> > ------------------------------
> > *From:* ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] *On Behalf Of *R.
> > ------------------------------
> > Daniel Braun
> > ------------------------------
> > *Sent:* Wednesday, November 28, 2007 8:06 PM
> > *To:* Multiple recipients of list OB-GYN-L
> > *Subject:* Prophy ABX for Elective C/S was Re: No Posts!
> >
> > What is your infection rate on elective sections who don't get
> > antibiotics? If it is less than 5%, giving prophylactic antibiotics is
> > probably not justified.
> > In a healthy upper S-E population, and with a surgeon who handles tissue
> > gently and hardly ever takes more than 25 minutes, less than 5% puerperal
> > morbidity should be expected without antibiotics.
> >
> > Dan
> >
> > On Nov 28, 2007 5:10 PM, Andrew Folley <agfolley@hotmail.com > wrote:
> > No we do not. My understanding is it is not necessary. However we are
> > doing surgical antibiotic prophylaxis on all c-sections elective and
> > emergency. agf
> >
> > <http://www.windowslive.com/connect.html?ocid=TXT_TAGLM_Wave2_newways_112007>
> >
> > --
> > R. Daniel Braun, MD FACOG(L) CMT
> > Professor Emeritus
> > Dept. of Obstetrics and Gynecology
> > Indiana U. School of Medicine
> >
> > R. Daniel Braun
> >
> > "Science without Religion is LAME; Religion without Science is
> > BLIND"
> > Einstein 1941
> >
> > it now.<http://us.rd.yahoo.com/evtQ731/*http://mobile.yahoo.com/sports;_ylt=At9_qDKvtAbMuh1G1SQtBI7ntAcJ%0A>
> >
>
> --
> R. Daniel Braun, MD FACOG(L) CMT
> Professor Emeritus
> Dept. of Obstetrics and Gynecology
> Indiana U. School of Medicine
>
> R. Daniel Braun
>
> "Science without Religion is LAME; Religion without Science is
> BLIND"
> Einstein 1941
>
--
R. Daniel Braun, MD FACOG(L) CMT
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
R. Daniel Braun
"Science without Religion is LAME; Religion without Science is BLIND"
Einstein 1941
