New research suggests that sedating patients before a nerve block needed to diagnose or treat chronic pain increases costs, risks and unnecessary surgeries, and sedation does nothing to increase patient satisfaction or long-term pain control.
‘Sedation doesn

Patients with bladder cancer are two times more likely to have complications after a radical cystectomy procedure if they have a biomarker for poor nutritional status before the operation, according to study findings presented last week at the 2013 Clinical Congress of the American College of Surgeons. Surgeons from the University of North Carolina at Chapel Hill School of Medicine and UNC Lineberger Comprehensive Cancer Center identified a potentially modifiable risk factor for such post-surgical problems: a low preoperative level of albumin, a marker of the protein level in the blood.

David C. Johnson, MD, MPH, lead author of the study and a senior urology resident at UNC School of Medicine, and colleagues evaluated the impact that patients

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Being able to provide high-quality health care is a primary driver of job satisfaction among physicians, and obstacles to quality patient care are a source of stress for doctors, according to a new RAND Corporation study.

While physicians note some advantages of electronic health records, physicians complain that the systems in use today are cumbersome to operate and are an important contributor to their dissatisfaction, the study found.

The findings suggest that the factors contributing to physician dissatisfaction could serve as early warnings of deeper quality problems developing in the health care system.

‘Many things affect physician professional satisfaction, but a common theme is that physicians describe feeling stressed and unhappy when they see barriers preventing them from providing quality care,’ said Dr. Mark Friedberg, the study’s lead author and a natural scientist at RAND, a non-profit research organisation. ‘If their perceptions about quality are correct, then solving these problems will be good for both patients and physicians.’

The findings are from a project, sponsored by the American Medical Association (AMA), designed to identify the factors that influence physicians’ professional satisfaction. The issue is of increasing importance as health reform and other forces in the U.S. health care system alter contemporary delivery and payment models.

‘Overcoming modern medicine’s greatest obstacles to first-rate medical care can simultaneously enhance the quality of care and improve professional satisfaction among physicians,’ said AMA President Dr. Ardis Dee Hoven. ‘The AMA is committed to leading a national dialog regarding the major factors driving many physicians to feel increasingly disconnected from what really matters