Ochsner Medical Center

About: Ochsner Medical Center is a healthcare organization based out in New Orleans, Louisiana, United States. It is known for research contribution in the topics: Population & Heart failure. The organization has 980 authors who have published 1159 publications receiving 49961 citations. The organization is also known as: Ochsner Hospital & Ochsner Foundation Hospital.

Culturally Competent Care of the Transgender Patient

Abstract: Despite significant strides made for the rights of lesbian, gay, bisexual, and transgender (LGBT) individuals over the past decades, discrimination and misinformation still exist in many areas of society, including health care. While the LGBT community is often thought of as a monolithic group, the transgender population faces a unique set of concerns. Transgender patients, whose gender identity differs from their birth gender, face a multitude of medical, legal, and societal disparities. A need for greater provider education and awareness contributes to a lack of access for a patient population that is already at higher risk for violence, suicide, substance abuse, and discrimination. This chapter presents a basic framework of concepts relative to the transgender community and provides strategies for effective and appropriate care.

American healthcare's dirty little secret.

Abstract: The ‘‘dirty little secret’’ of American healthcare is that fewer than 2% of acute stroke patients in the United States receive any form of reperfusion therapy and, sadly, little is being done to remedy this problem [1]. Acute ischemic stroke is a leading cause of death and disability, and it will impact three-quarters of a million Americans this year alone [2,3]. The therapeutic goal for acute stroke therapy, as with acute myocardial infarction (AMI), is early reperfusion (intravenous thrombolysis or catheter-based reperfusion) to minimize end-organ damage. The national quality mandate for 90-minute door-toballoon (D2B) time has revolutionized AMI care, and public reporting of results allows patients to compare hospitals’ treatment outcomes for AMI on Medicare’s website. Cardiologists can and should be very proud of having met this challenge to improve patient care. Over the past several years, I’ve seen roadside billboards touting hospitals’ acute stroke treatment programs, while physicians in the community know it is very unlikely that a stroke patient will actually receive reperfusion therapy. Where can patients go to see the comparative performance and outcomes for their local hospitals with regard to stroke therapy? Frustratingly, even among the select centers participating in the Get With The Guidelines-Stroke (GWTG-Stroke) registry, fewer than one-third meet the goal of ‘‘door to needle time’’ of 60 minutes [4]. Despite the fact that acute stroke patients may present too late (> 3 hrs 4.5 hrs) or are poor candidates for IV thrombolysis, many could still receive ‘‘ondemand’’ catheter-based reperfusion therapy IF an interventional stroke team were available [5–7]. Compared to the widely available access for AMI reperfusion therapies, few hospitals offer ‘‘on-demand’’ catheter-based stroke therapy. A significant barrier to conventional on-demand stroke reperfusion treatment is a shortage of interventional neuroradiologists [8]. The need for more stroke interventionalists relates to on-call coverage. An average hospital’s demand for elective neuroradiology procedures may be easily met with a single neuroradiologist, but that single individual cannot be on call every night for stroke coverage. This reality largely