Why do doctors call it “practice variation” instead of poor care?

Did you know that your medical treatment may depend on where you live?  It even has a name: doctors call it “practice variation”. A new U.S. study suggests, for example, that a person living in St. Cloud, Minnesota is twice as likely to undergo invasive back surgery as a patient with a virtually identical diagnosis living in Rochester.  There are a number of reasons for this strange disparity, but one might be that Rochester is the home of the non-profit Mayo Clinic, where surgeons are paid a salary. No matter how many surgeries they do, they earn the same paycheque.  But other physicians elsewhere who are paid per surgery may be inclined to do more surgeries.

Such “practice variation” is not just seen at Mayo. Medicare patients in Fort Myers, Florida, are more than twice as likely to receive hip replacement surgeries compared to their counterparts across the Everglades in Miami, according to Dartmouth Health Atlas researchers.

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Why some people should avoid social media completely

In February, the American Red Cross social media specialist Gloria Huang sent the following tweet out on the organization’s Twitter feed:

But the party girl’s rogue tweet stayed up only about an hour on the site, before a flurry of complaints prompted the organization to remove it. Huang later blamed the mistake on her “inability to use Hootsuite(a service that enables users to manage multiple Twitter accounts).  Continue reading

Researchers: “Osteoarthritis treated with drugs/surgery instead of recommended guidelines”

When I had arthroscopic surgery on my right knee to repair a torn cartilage, my orthopedic surgeon also found evidence of osteoarthritis in that knee.  Not surprising, really, given my age and family history, but new research says many docs would now be recommending drugs or surgery that they shouldn’t for that new diagnosis.

This month’s issue of the journal Arthritis Care & Research suggests that doctors are disregarding standard medical guidelines to manage the joint inflammation condition of osteoarthritis (OA) through lifestyle improvements (like exercise or weight loss) – and instead relying on drugs and surgery.   Continue reading