Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

https://www.medpagetoday.com/upload/2011/4/4/Clin%20Infect%20Dis.-2002-O'Grady-1281-307.pdf

Guidelines for the Prevention of Intravascular Catheter-related Infections

https://www.medpagetoday.com/upload/2008/3/6/CRC.pdf

Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.

Naomi P. O'Grady, M.D., Mary Alexander, R.N. Lillian A. Burns, M.T., M.P.H., C.I.C. E. Patchen Dellinger, M.D. Jeffery Garland, M.D., S.M. Stephen O. Heard, M.D. Pamela A. Lipsett, M.D. Henry Masur, M.D. Leonard A. Mermel, D.O., Sc.M. Michele L. Pearson, M.D. Issam I. Raad, M.D. Adrienne Randolph, M.D., M.Sc. Mark E. Rupp, M.D. Sanjay Saint, M.D., M.P.H. and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

/pdf/guidelines-for-the-prevention-of-intravascular-catheter-4xarsoczlz.pdf

Guidelines for the prevention of intravascular catheter-related infections, 2011

Cost Effectiveness in Health and Medicine.

New year, new codes...and all new confusion.

U.S. Preventive Services Task Force Update and Computed Tomography for Colorectal Cancer Screening Among Privately Insured Population.

With radiology practices increasingly employing nonphysician practitioners (NPPs), we aimed to characterize specific NPP clinical roles.Linking 2017 to 2019 Medicare data sets, we identified all claims-submitting nurse practitioners and physician assistants (together NPPs) employed by radiologists. NPP-billed services were identified, weighted by work relative value units, and categorized as (1) clinical evaluation and management (E&M), (2) invasive procedures, and (3) noninvasive imaging interpretation. NPP practice patterns were assessed temporally and using frequency analysis.As the number of radiologist-employed NPPs submitting claims increased 16.3% (from 523 in 2017 to 608 in 2019), their aggregate Medicare fee-for-service work relative value units increased 17.3% (+40.0% for E&M [from 79,540 to 111,337]; +5.6% for procedures [from 179,044 to 189,003]; and +74.0% for imaging [from 5,087 to 8,850]). The number performing E&M, invasive procedures, and imaging interpretation increased 7.6% (from 329 to 354), 18.3% (from 387 to 458), and 31.8% (from 85 to 112), with 58.2%, 75.3%, and 18.4% billing those services in 2019. Paracentesis and thoracentesis were the most frequently billed invasive procedures. Fluoroscopic swallowing and bone densitometry examinations were the most frequently billed imaging services. By region, NPPs practicing as majority clinical E&M providers were most common in the Midwest (33.5%) and South (33.0%), majority proceduralists in the South (53.1%), and majority image interpreters in the Midwest (50.0%).As radiology practices employ more NPPs, radiologist-employed NPPs' aggregate services have increased for E&M, invasive procedures, and imaging interpretation. Most radiologist-employed NPPs perform invasive procedures and E&M. Although performed by a small minority, imaging interpretation has shown the largest relative service growth. 

Professional Services Rendered by Nurse Practitioners and Physician Assistants Employed by Radiology Practices: Characteristics and Trends From 2017 Through 2019.

Reply to "Broadening Stakeholder Perspectives on Maintenance of Certification Research".

Seven percent of radiologists in the United States are sued each year for alleged medical malpractice [ 1 Jena A.B. Seabury S. Lakdawalla D. Chandra A. Malpractice risk according to physician specialty. N Engl J Med. 2011; 365: 629-636 Crossref PubMed Scopus (634) Google Scholar ], with radiologists on average spending 10% of their professional careers with looming malpractice claims [ 2 Seabury S.A. Chandra A. Lakdawalla D.N. Jena A.B. On average, physicians spend nearly 11 percent of their 40-year careers with an open, unresolved malpractice claim. Health Aff (Millwood). 2013; 32: 111-119 Crossref PubMed Scopus (81) Google Scholar ]. The implications are manifold. Malpractice lawsuits are strongly associated with not only physician burnout—which is now endemic—but also depression and suicide [ 3 Balch C.M. Oreskovich M.R. Dyrbye L.N. et al. Personal consequences of malpractice lawsuits on American surgeons. J Am Coll Surg. 2011; 213: 657-667 Crossref PubMed Scopus (160) Google Scholar ]. And as medical expenditures continue to soar, the costs of defensive medicine, and particularly defensive imaging [ 4 Villalobos A. Horný M. Hughes D.R. Duszak Jr., R. Associations over time between paid medical malpractice claims and imaging utilization in the United States. J Am Coll Radiol. 2021; 18: 34-41 Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar ], cannot be ignored. Despite the frequency and impact of medical malpractice litigation, the topic receives relatively little attention, partly related to associated physician shame—an elephant in the reading room, if you will. In this special issue of JACR, we dig into a variety of timely and thorny topics in this important domain. 

Richard Duszak

Papers

New year, new codes...and all new confusion.

U.S. Preventive Services Task Force Update and Computed Tomography for Colorectal Cancer Screening Among Privately Insured Population.

Professional Services Rendered by Nurse Practitioners and Physician Assistants Employed by Radiology Practices: Characteristics and Trends From 2017 Through 2019.

Reply to "Broadening Stakeholder Perspectives on Maintenance of Certification Research".

Malpractice Litigation: The Elephant in the Reading Room.