Male docs are more often involved in medicolegal actions than female docs

"Male doctors are more likely to have experienced medico-legal actions compared to female doctors. This finding is robust internationally, across outcomes of varying severity, and over time," concluded a recent meta-analysis.

The study, published online in BMC Medicine, said men were 2.45 (95 % CI, 2.05–2.93) times more likely to have been the subject of legal proceedings.

Legal action was defined as disciplinary action by a medical regulatory body, malpractice experience, complaints received by a medical regulatory or healthcare complaints body, a criminal case, or when a paper on the topic did not specify one of the above.

Data from 32 published papers were pooled and analyzed. At first glance, the methods seem reasonable, and the conclusion may even be correct.

But to their credit, the authors mention that the paper has some limitations which, in my opinion, probably invalidate the results.

In the study, medicolegal encounters could not be broken down by specialty because of the 13 studies included in the meta-analysis, "the specialties most and least likely to face medicolegal action varied greatly."

Five of the included studies controlled for the effect of specialty, and four of them showed that specialty did not matter. However, that represents only 12.5% of the papers in the meta-analysis.

The paper also was unable to examine the effect of the number of hours worked or number of patients seen by doctors of each sex.

Heres why these limitations are important. A 2011 study done by a group from the American Board of Surgery looked at data submitted by over 5000 general surgeons applying for recertification and found the average yearly workload for men was 506 ± 370 cases vs. 375 ± 261 for women. More cases performed means more opportunities to be sued.

Obviously the types of surgery done also could have an impact on the number of malpractice suits filed. Men performed significantly more abdominal, gastrointestinal, and laparoscopic procedures than women, who performed significantly more breast surgery. The table below shows the data.

A financial blog called NerdWallet looked at Medicare payments to physicians of all specialties per year and found that male physicians see 60% more patients—women doctors treat an average of 320 Medicare patients a year; men treat 513.

This difference was true for nearly every specialty. Here are just a few examples:

Again, more patients seen equals more risk.

Male and female doctors may not have different legal problems after all, but a paper which found that surgeons are taller and better looking that non-surgeons is certainly true.
Read More..

Maria Sharapova pictured wearing Nike sportswear after losing 50m deal due to drug scandal

Tennis star Maria Sharapova was pictured leaving the gym yesterday wearing Nike sportswear despite being suspended by the Sportswear giant after admitting to failing a drug test in the last Australian Open. Her deal with Nike, worth $50m was suspended by the company yesterday and her other sponsors Tag Heuer and Porsche have ditched her too, pending judgement from the World Tennis Association.

She said she had used the banned drug since 2006 due to a family history of diabetes but it was banned for athletes in January 1 this year. Other companies that have sponsorship deals with the athlete such as American Express, Evian and Avon, were said to be considering their positions last night.
Read More..

Proctoring supervising and coaching

Any surgeon who acts as a proctor for another surgeon or supervises residents or mid-level providers should be aware of the potential legal pitfalls.

An informative discussion of proctoring and supervision called "Is There a Proctor in the House?" appeared in 2012 on a website called Law Journal Newsletters.

Proctoring has always been an issue. For many years, surgeons have been assigned to proctor newly appointed staff in order to confirm that they were properly trained. Proctoring has been extended to those learning new techniques in minimally invasive and robotic surgery.

The usual scenario is that a proctor is assigned by a hospitals department chair or credentials committee with the expectation that the proctor will observe and report on the new individuals skills.

According to the article, "a surgical proctor who acts only as an observer should not have any medical malpractice liability if a procedure is performed below the standard of care." This holds true as long as the proctor has no physician-patient relationship and does not participate in any medical decision-making or scrub in on the procedure.

In order to avoid malpractice liability, a proctor should not preoperatively meet or examine the patient nor should he scrub in or actively participate in the surgery. A proctor should also not receive any compensation.

This differs from acting as a preceptor or supervisor, which involves training another surgeon and assuming hands-on responsibility if something goes wrong.

From the article: "one can presume that the existence of the following elements would be more likely to result in a finding that a observing surgeon was more than a proctor and owed a duty to intervene if improper care was occurring: 1) A contractual duty to supervise or respond to a call; 2) A clear agreement by the observing physician to supervise and guide the treatment of another physician; 3) A voluntary substantial interjection in the decision-making surrounding a patient’s care; 4) The signing of medical records; and 5) Involvement in the patient’s post-surgical care."

Even if they are not physically present, attending surgeons are usually found responsible for the acts of residents they are supervising. One exception that I am aware of [but do not have a reference] may be if a trainee does not give the attending an accurate description of the situation with a patient.

The concept of a surgical "coach" was not addressed. However, as described in his New Yorker piece, Gawande introduced his coach to the patient, which would theoretically expose the coach to liability issues if a problem arose. Note that I had mentioned this possibility in my 2011 critique of the coach concept.

While any rational person would prefer to avoid potential litigation at all costs, I fail to see how a proctor or coach could not intervene if she saw that a surgeon being observed was about to cut a common bile duct or remove the wrong organ.

Not explored in the article about proctoring is what happens if a proctor reports that the surgeon being observed is incompetent. Id say there would be a 100% chance that the observed surgeon would sue.

I supervised residents and physician assistants for my entire career and survived, but Im not sure that I would want to be a proctor or a coach, both of which would seem to put one in an awkward position.

What do you think?

Read More..

On the shoulders of giants

The following was sent to me by a professor who sits on the admissions committee of a medical school in the United States. Here’s what he asks prospective students during interviews.

Sir Isaac Newton said, “If I have seen further, it is by standing on the shoulders of giants.”

If you want to become an astronaut, I’ll bet you know who Neil Armstrong is. If you want to become a rock-star, you likely know who the Beatles were or who the Rolling Stones are. If you want to become President of the United States, you know who Barack Obama is. But you want to become a doctor, right? That’s why you’re here.

So, who are those giants of medicine? What famous scientists or doctors who have advanced the science of medicine can you name?

The following would not be acceptable:

Mehmet Oz, MD
Sanjay Gupta, MD (Medical reporter)
Phillip McGraw (“Dr. Phil”)

Here are some names that would count: Drs. Watson, Crick, and Franklin

You wouldnt believe the answers I get. For example:

Me (after an applicant couldn’t think of any names): "What do we do to milk to make it safe to drink?"

Applicant: "Put antibiotics in it."

Me: "What was your major in college?"

Applicant: "Microbiology."

Me: "OK, what is the PROCESS we use to make milk safe called?"

Applicant: Crickets...Crickets...

Me: "Ill give you a hint. It is named after a French scientist."

Applicant: Crickets… “I wasnt a history major.”

Me: “No, worse—you were a microbiology major. Let me give you another hint: His first name was ‘Luis’ (Loo-ee, pronouncing it best I can).”

Applicant: Crickets...

Me: “Okay, what is the process of heating milk at a high temperature, under pressure, to kill bacteria called?”

Applicant: “WAIT!!!! Pasteurization!!!!”

Me: “Great. So what is the guys name?”

Applicant: “Dr. Pasteurization!!!! Dr. Franco (after Id already told him the first name was Luis) Pasteurization.”

Me: Crickets...

Here are a few choice responses from other applicants: Patch Adams, David Perlmutter, anesthesia, the one who created penicillin, Bill Nye, Ben Carson, and [my favorite]—Jonah Salt (sic).
Read More..

Pazino Buiness Network presents 2016 Business Opportunity Exposure



This is a sponsored post. 

Become a Real Estate Business Owner this 2016 with just N2000 & earn over N250,000 weekly. Benefits:
1. Enjoy 10 direct commission.
2. 5%, 3%, 2% indirect commission on your 1st, 2nd & 3rd generation respectively if active.

3. Free Online Portal to manage your business from anywhere in the world.
4. Qualify to win incentives ranging from Household items, all-expense paid trip aboard, Brand New Car, Apartments and Duplex.


5. Business Center Facilitation Cash Rewards.
6. Product promo reward. Here, you can win free plots of land.
7. Free and highly subsidized advance professional trainings.
8. Free office/work space for members.
9. Access to genuine garden schemes.
10. Free inspection tour for members and their clients.
11. And so much more
What are you waiting for, jump on board and let ride together to success (Limited space available)
We are proud to say that, we are the best Real Estate Network Marketing in Africa.
Send your name, phone number and email to 09080423881 and you will be invited for a BOT (Business Opportunity Training) or simply request for our registration account details.
It can only get better

DO KNOW ANY OF THE FOLLOWING CLASS OF INDIVIDUALS?
1. Full Time Housewife.
2. Young, Vibrant & Unemployed Youth.
3. Working Class That Is Fed up of His or Her Job.
4. Good Income Earner That Wants Extra Stream of Income.
5. Undergraduate That Needs A Part or Full Time Job.
THEN THIS IS FOR YOU!
Earn so much working with us as an independent Real Estate Consultant weekly.
PAZINO ECC LTD, a major real estate marketing and development company specially invites you to our FREE Business Opportunity Exposure @ Km 25, Puri Mall, LASU Bus Stop, Oko-Ado, Along Sangotedo-Ajah Road, Lekki, Lagos
On Tuesday and Thursday by 10:30am.

Kindly send your name, phone number and email to 09080423881 for a seat reservation.

Contact or Call - Nike: 08179407253 | Nneka: 08185802285 | Soji: 08034699002
Read More..

Obama the dog of Rome well slaughter your soldiers and kill your people ISIS threatens America in new video

Terrorist group ISIS has released a new video warning Americans to expect a Paris-style terrorist attack soon. In the video, the ISIS terrorist with British accent issued a chilling threat to the US and President Barack Obama.
“Paris isn’t far from you - we will by Allah’s permission do to your country what we did to Paris. We will kill, slaughter and burn your people. “Inshallah [God willing], we will attack you very soon with anything we lay our hands on.”
“To Obama, the dog of Rome, today we are slaughtering the soldiers of Pasha, tomorrow, we will be slaughtering your soldiers. We will soon, like your puppet David Cameron said, begin to slaughter your people, on your streets.”
He then drops his hostage onto his front, pulls his hair back and cuts off his head as bloods spatters all around, before looking up at the camera menacingly. “No matter how many times you delete our accounts or chase our places and no matter how you fight us, we are still here and we will support the Islamic caliphate state.”

See the video after below...
Read More..

Problem with my blog I need your help


I have a big problem.

For the last 10 days, Twitter has been blocking me from tweeting any links to my blog.

This is the message I get whenever I try to send a tweet with "skepticalscalpel.blogspot.com" in it.



I have tried to contact Twitter through @twitter and @support four times and have received no reply, nor have they replied to numerous ticket requests through the Twitter Help Center.

I discovered a site called virustotal.com which compiles reports from 63 different programs that detect viruses, worms, trojans, and malware.

Originally a site called BitDefender claimed my site was malicious. The next day, BitDefender declared my site was clean, but AutoShun, which previously had no problem with my site, said it was malicious. The following day, AutoShun said my site was unrated and Clean MX said "malicious." But the day after, AutoShun went back to calling it malicious and Clean MX said my blog was clean. At no time, did more than one of the 63 detection programs identify my blogsite is being malicious.

You would think that if my blog contained any suspicious programs, more than one of the 63 virus detection organizations would have come up with a positive result on the same day.

None of the programs saying my blog was malicious gave me any clue as to what part of my site was supposedly creating the problem.

I attempted to get some help from Blogger, which hosts my blog. Although one person on a forum responded with some advice, it wasnt enough for me to solve the problem.

My blog is averaging 1600 page views per day. Not one person has contacted me to complain that I am harboring viruses or any other malicious software. That is because, to the best of my knowledge, no such malicious software exists on my blog.

Maybe it would help if you would go to the results section of the virustotal website and cast your vote in favor of my site as not being malicious. In the upper right-hand corner of the site you will see this cartoon.



 Please click on the green face to support my blog.

Meanwhile, I have discovered an interesting workaround which enables me to tweet links to my blog, but visitors to the site will still be blocked by Twitter from tweeting links.

If you consider yourself computer-savvy, maybe you can figure out how I did it. If you think you know the answer, please submit a comment.

I also would welcome any comments or suggestions that could help to resolve my problem. If anyone knows a way to contact a human at Twitter, please let me know.

Thanks.




Read More..

Kylie Jenner shares loving photo with Tyga

Kylie Jenner shared this loving photo with boyfriend, Tyga at the Universal Studio in Orlando, Florida where she is hosting the Grand Opening of a new restaurant.
Read More..

Is Starting a Business for 1 Actually Possible by Marc Charles

12:22 PM


Greetings:

Is it possible to start a business for $1 in the real world?

My friend and client thinks so.....

Heres his pitch:



Start Your Own Internet Business Today For Just $1!

http://bit.ly/test-drive-jb


Marc Charles
Read More..

What Does 500 Words Look Like

stickman shows his 500 word post to a friend
The writing on this page will be about 500 words - the point being to demonstrate what it looks like.

It doesnt matter a great deal what it is about - it will wander along in a reasonably simple and quick fashion, depending on your reading pace of course.

The purpose, and all writing has to have a purpose, except the best sort, which is writing that doesnt - the purpose being to give a rough idea of words on a page, and how much space 500 of them take up.

I guess that most people would be horrified to talk about words being used as filler, but the truth is, that is all writers do.  Sure, they can dress it up as great meaningful prose, or important news or even poetry - but it is all just letters, arranged to lesser or greater effect.

For my part, I love words and playing with them, shifting them around in my head and then laying them out - attempting to make a coherent point about something.  The fun of the surprise gives me great pleasure.

On this occasion I am working within a narrow remit.  It is to show you what 500 of these beauties look like when laid end to end.

Obviously, unless you have a very wide screen, they will not appear in a single line but in a series of mini paragraphs - the two sentence rule being the internet standard at present.  Eventually we will end up with a single word being sufficient for the average reader with at least two lines of space and a video to alleviate the extreme stress of reading.

I might point out at this stage that the word count is a disappointingly slim three hundred or so.  That means more work for the both of us to get to the end.  I would say "Ill keep it short" but there is a target here that I intend to hit.

Sometimes, when the subject matter is a little more, how shall we say... interesting, then 500 words is nowhere near enough.  On a title like this though Im almost pushing it to get there.  Still, the average paragraph is fifty or so, and it doesnt take a whole lot of waffle to put a few together.

I wonder what it is you are going to be writing?  A school essay, a job application, maybe a love letter?  Five hundred words of endearment should go a long way I should think, although I am no expert.  There was a time once, I can tell you, although sadly - fifty words would probably cover it.

Whatever it is you are aiming for, I wish you good luck and as we reach the finish point I hope you find it easy enough.  I will say that practice makes writing very easy, and its more fun than it probably looks.

Well, I enjoy it.

Thats it by the way - five hundred words, including these.  Good luck!

Heres a guy who knows all about writing...
Read More..

Earn Money Online Without Investment

Everyone loves to Make Money Online with Zero Investment, 0 Skills, No Risk, No Experience and with Less Consumption of Time
  .                 "I will teach you Various suitable ways to Make Money Online without any Investment." 
Use my strategy which works on a common factor on all the different ways provided and will boost your     income 100 times more through these sites. no wonder it’s true that your initial money income would be so less but that’s the truth, you might have heard about the people clamming to make 5 figure ($$$$$) online income per day or week by working online with zero or without any investment and zero skills, but just ask yourself a question, is that possible with no money and no skills? you will surely get your answer as "no" , if that is possible then everyone around the world would purchase a computer and a internet connection and will beat the bill gates or lakshimi mittal within a year or two, so forget your dream of making a huge amount of money online with no investment. I will teach you the most legitimate way to Make Money Online With Zero Investment and not a way to "get rich soon", because there is no way for that if you have No Investment or No Cash to Invest. .
1) "Never purchase any money making scheme or eBooks online, why to purchase them when all the information they have is available for free of cost on internet? Also this internet is moving very fast, so no one can guarantee anything perfectly or exactly. Think Yourself."  
2) "There is no shortcut to become rich, but there are so many tricks which you can apply to boost your earning. I explained them on "the strategy" page which works on the common factor for all the different ways."  
3) "Keep in mind to reach the HEIGHT you must start from BASE and the different ways to make money shown below are the BASE." 


Read More..

Graphic photos Woman and her 6 months old baby among the 18 people killed in Lagos building collapse

18 persons including a woman and her 6 months old baby have been confirmed dead in the 5- storey building collapse that happened at Chisco bus stop, opposite Oando Gas Station in the Lekki area of Lagos yesterday March 8th. According to the National Emergency Management Agency NEMA, 13 people have been rescued alive. Continue to see more photos from the unfortunate incident..



Read More..

It is uncharitable for a political party to play politics with the security in the state Wike

Rivers State Governor, Nyesom Ezenwo Wike has stated that the state government is supporting the police and the Department of State Services, DSS, to tackle the cult-related violence in some communities in the state.

He said it is uncharitable for a political party to play politics with the security in the state by claiming that victims of cult-related violence as their members, simply because they want to gain political mileage.
 
Speaking at the Government House, Port Harcourt on Wednesday, March 9 when he received the new Managing Director of Total E and P Nigerian Limited, Mr Nicholas Terraz, Governor Wike said : "We are doing everything in partnership with the security agencies to resolve the cult related security challenges in some communities in the state.
"Kidnapping is a national issue, but the reportage on the situation in Rivers State is over-blown. What we have in Rivers State is cult -related violence which the government and security agencies are resolving. Those who beheaded members of a family in Omoku have been arrested and they are cultists,"
"If any casualties occur during the cult-related violence, a particular political party claims the victim as their member. I wonder why a political party because of politics will claim cultists as their members? "
He assured business concerns in the state that his administration will continue to create a secure environment for the development of the state.
"We are committed to protecting lives and property across the state. We are building a friendly environment for investors to come and invest in the state " he added
 
 
Read More..

oNormal"

self,storage,real,estate,by,marc,charles
Read More..

Heroes Alliance Pennsylvania Members Talk Costuming for Charity

It takes a special type of person to suit up on the weekends and dedicate their day off to visiting a childrens charity. Not everyone is willing to do it but the members of the Heroes Alliance are here to answer that call. The Heroes Alliance believes in using our passion and skills in costuming to give back to the community through fundraising and supporting charity and community events. It is a nationwide non-profit costuming organization whose mission is to bring a "real life" superhero experience to sick, disabled and medically fragile children. Some members of the Pennsylvania branch, which was established in November 2013,  took time out to talk to the Confessions of a Cosplay Girl Blog about why superhero charity work means so much to them.









Philip Parke- Fully activated member. Costumes Hawkeye: "Ive always wanted to give back to the community I live in and sometimes love. I was sick and fighting cancer at one time. I was lucky enough to survive and tell my story. These kids dont always have that chance. So I figured running into burning buildings and pumping on peoples chests wasnt enough. I had to start learning to sew and do silly poses. I love the Heroes Alliance. I love the people we help. We dont ask for money and we all give our best effort to make children feel special even if for a moment. This is why Im here. To make a stand with my sisters and brothers of the Heroes Alliance, and make the world a better place. One smile at a time." 












Greg Walraven- Fully activated member. Costumes Captain America and Green Lantern. "I joined Heroes Alliance so I could help make people feel better, happy, maybe smile for a moment. Then I found that we also have the awesome benefit of inspiring children. I learned this at my second event when a little girl came sprinting and nearly tackling Victoria dressed as Wonder Woman. This little girl (4-6) I believe was so happy to see WW, but what struck me the most was how focused she was while Victoria was talking to her. She was not going to miss a word she said. That little girl was clearly inspired. What better way to inspire people than with a group of superheroes?"















Alexandra and Mark Wolsiefer - Fully activated members. Costumes include Scarlet Witch, Star-Lord and Quick Silver. "My husband and I both joined the Heroes Alliance for similar reasons. We both understand what its like to be young and have something unexpected happen. For him it was the loss of a family member and for me it having to deal with chronic illnesses. We both shared a passion for fandom though, and know just how much these Superheroes can help make even the darkest times feel better. So when I saw the opportunity to join the Heroes Alliance and give back to the community, we jumped at it. Seeing the smiles on the faces of children is worth every moment of being hot in a wig. And we are both so honored to be a part of this organization." 






 Kevin Diplacido- Fully activated member. Costumes Batman and Captain America.  "I’m a veteran at costuming for birthday parties and charity events. Since 1992, when I did my first costuming at a comic con in NYC. Loving costuming, I started working for a party entertainment company as Tommy, The White Power Ranger. Wanting to do more events, I added to the heroes and characters I did, and I started my own party and event entertainment business. Over the years many charities have reached out to me to be at their events, and I have donated my time to them. I have had family and friends who have battled different diseases. Some have lost the battle to these diseases. Cancer, Alzheimer’s, and MS just to name a few. Many of my events are for adult, and children’s charities. The Heroes Alliance has helped me expand on that, and has allowed me to get out there more often to children’s charity events, and make more people smile. HA is dedicated to making children in need happy, and I support that very much. I look forward to our events, and hope there are many more to do, with my friends at The Heroes Alliance." 




Kim Cicconi- Fully activated member. Costumes The Invisible Woman and Black Widow. "Ive got a history of unconventional philanthropy to continue, having participated in Penn States Dance Marathon (THON) for three years. When the opportunity arose to join Heroes Alliance and give back to the community again, I signed up in a hot second--and to be honest, I cant tell you why. Deep down, I suspect its because costuming can be a very self-gratifying hobby for me at times, satisfying needs for attention and self-expression and creativity. I have the privilege to turn those needs outward, and give something of my self-expression and creativity to people who deserve my attention. Im massively grateful every time I have the opportunity to attend an event as a Heroes Alliance member, because its a chance to offer kids a smile and a hug and a moment of joy. Even the ones who dont know who Im dressed as. Or dont want to come close. Or just want to talk to Batman. Its all great."




Victoria Lee- Leader/Coordinator for the Pennsylvania branch of the Heroes Alliance and Council Member. Costumes Supergirl and Wonder Woman (has also costumed Black Widow, Shadow Cat and Catwoman).  "I know from personal experience what it is like for your life to change in a blink of an eye. In 1999 I was injured in an auto accident and suffered 17 fractures. I was given 2 blood transfusions and required two emergency surgeries where doctors put two titanium rods in my right arm and one in my right leg. I was told I may never be able to walk again. I spent several months in the hospital and when I was released, I was bound to a wheel chair. It took me 9 months to learn how to walk again. When you experience trauma, you go through stages of shock, anger and depression. In addition to your physical injuries you also suffer emotionally and psychologically. The smallest act of kindest can impact you greatly and helps with the healing process. I am blessed. I got my life back. I am in the position now where I can use costuming/cosplay to give happiness to those who are suffering. They need as much positive energy as possible. They truly need it. I know that from personal experience."






Heroes Alliance Official Facebook Page

Heroes Alliance Official Website







Read More..

Hot mug shot guy leaves prison starts modeling career

Remember the guy whose mug shot threw the internet into a frenzy in June of last year, Jeremy Meeks, well hes served his prison term and is out.
According to his agent and manager, Jim Jordan, Meeks was released on Tuesday morning from the Mendota Federal Correctional Institution in Northern California and was greeted by his wife Melissa and their three children.
“He’s in great spirits,” Jordan told TheWrap. “He’s delighted to be reunited with his family.

According to Jordan, a modeling agent at White Cross Management in Los Angeles, his phone has been ringing off the hook with offers from the world’s “top five designers,” as well as TV producers, for Jeremy Meeks.
“We were bombarded by every news media outlet and production company out there,” Jordan said, adding that Meeks has been getting ready for his close up, doing 500 sit-ups and 500 push-ups in his cell every day.
“We have a huge plans for him,” Jordan said. “A lot is about to happen. We don’t want to announce it at the moment, but we have some incredible stuff coming that will blow everyone away.”
Meeks is not allowed to talk to the press as of yet, according to Jordan. He’ll be spending the next month in a transition house. But once he does, Jordan says he expects Meeks to take over the modeling world.
“The world responds to beautiful things. Jeremy is a beautiful thing. His striking looks are the first thing we noticed. His appeal got the attention of the world,” Jordan said.
Read More..