“This is it!”
This was my thought as I am aboard the plane from Phnom Penh, Cambodia on my way back home to Dallas, Texas. I had just spent 2 weeks in Cambodia – my first time after having been lucky to survive the Khmer Rouge. I was both exhausted and emotionally charged after a week of providing anesthesia on the medical mission trip and another travelling through Cambodia.[Read more…] about What’s Your Mission: Part 2
Revolution in Healthcare
As we all know, we are in the middle of a Revolution of sorts in Health Care. The practice of medicine is becoming less about the art of medicine and more about the business of medicine. Patient Satisfaction is a major concern, and satisfaction ratings along with Quality measures, such as MIPS, are going to play a large role in how we are reimbursed by insurance payors. And when you look at the MIPS guidelines, one of the first questions that comes to mind is ‘How do I satisfy these requirements while keeping my patients happy’? Well, we are going to go over a few of the common MIPS standards here and how you can meet those standards while providing the care that patients want or expect.
The purpose of this post is to explain the concept of sensitivity, specificity, predictive values, and likelihood ratios.
Screening tests (surveillance tests) are tools use to assess the likelihood that a patient may have a certain disease. They are not definitive, but if positive, will heighten suspicion that would warrant use of a gold standard diagnostic test to rule in or rule out a certain diagnosis. The goal of screening tests is to reduce the morbidity and mortality in a population group (Maxim, Niebo, & Utell, 2014). Examples of screening tests include routine EKGs, PSA, PAP smears, and mammograms. For example, a male with an elevated PSA may have prostate cancer, BPH, or prostatitis. Positive results of screening tests need to be compared to the established gold standard test that is regarded as definitive. In this case, a prostate biopsy is considered a definitive test, as it will reveal the etiology of the elevated PSA. Screening tests are less invasive and less costly, whereas the gold standard test may be more invasive, expensive, or too late (discovered during an autopsy). Ideally, gold standard tests, such as coronary angiography, breast biopsy, or colposcopy should have 100% sensitivity and specificity. However, in reality, this may not be the case, as it may be the best test given the clinical picture at the time (Maxim, Niebo, & Utell, 2014).[Read more…] about Sensitivity, Specificity, Predictive Values, Pre/Post-test Probability, and Likelihood Ratios explained
DKA and SGLT-2 inhibitors
One of the greatest aspects of medicine that I enjoy is a continual process of learning. We must continue to grow in our profession, seeking knowledge and experience as much as possible. One such incident occurred recently while on shift… and talk about being a little late to the party! In 2015, the US food and drug administration issued a drug safety communication that warned of an increased risk of DKA with uncharacteristically mild to moderate to glucose elevations (euglycemic DKA). This warning was based on diabetic medications involving SGLT-2 inhibitors. In fact this was based on 20 clinical cases requiring hospitalization captured between March 2013 and June 2014 in the FDA adverse event reporting system database. SGLT-2 inhibitors first came into market in 2013. What are SGLT-2 inhibitor medications?
During a recent weekend shift in the Emergency Department, four patients presented with the same chief complaint: “I just want to know if I have the flu.”
In honor of the Reverend Dr. Martin Luther King, Jr
An Immigrants Story
Please allow me to share my perspective on why I chose to travel across the world to provide medical care to people I do not know. But first, I am going to provide you with a little background on me.