Tuesday, July 17, 2007

Hospitalists - Wall Street Journal Finally Catches Up with Medinnovationblog.blogspot.com with News on Proceduralists

A Tongue-in-Cheek Commentary

Proceduralists--This is a more recent but rapidly emerging specialty. It is a spin-off of the hospitalist’s movement. Proceduralists are hospital-based and are trained to do procedures common in hospitals--tracheostomies, cut-downs to create venous and arterial access, parancenteses and thorancenteses, spinal taps and diagnostic procedures such as ultrasound. Proceduralists are in demand, not only because of their skills gained and safety provided for patients from repeatedly performing procedures, but because they can train incoming residents to perform them.”

www.medinnovationsblog.blogspot.com, "Six Innovations – Innovation Number Two: Introducing New, More Focused, and More Productive Specialties," July 1, 2007

“With a steady decline in the number of doctors trained to perform intensive procedures in recent years, Cedars and other large academic centers are looking for ways to fill the gap. They are creating special procedure services and new procedure training programs for medical residents. Teams of doctors known as proceduralists are now available at some centers with special expertise in tunneling a catheter into a vein , slicing an incision into the neck for an airway, or plunging a needle into a patient’s back for a spinal tap.

Laura Landro, “To Reduce Risks, Hospitals English ‘Proceduralists’”, Wall Street Journal, July 11, 2007

Ordinarily I’m not one to brag about scooping a major publication like the Wall Street Journal, but I will anyway. My blog was one of the first publications to bring proceduralists to the attention of a wider world. This minor scoop is probably of no lasting significance. The important thing is that patients are safer with proceduralists. That’s what counts, not who did what first.

I admire the WSJ reporter’s use of verbs – “tunneling” a catheter into a vein, “slicing” an incision into the neck for an airway, and “plunging” a needle into a patients’ back for a spinal tap.

And she has a nifty list showing risk of procedures.

Procedures and Risks

•Thorancentesis, collapse of lung, bleeding, infection, respiratory disease

•Parancentesis, puncture of bladder, lower or blood vessel in the abdomen; spread of cancer cells in abdominal cavity; shock

•Lumbar puncture/spinal tap. Leak of cerebrospinal fluid nerve injury; infection

•Central -line insertion, injury to nearby arteries lung, infection

•Arterial –line insertion, infection, bleeding, damage to surrounding tissues, blockage of artery

And I freely admit the WSJ reaches a much bigger audience.

But it gives me a small cheer when I realize minds of small blog creators and great newspaper reporters travel in similar channels when it comes to spotting significant news and trends. To sum up, it’s three cheers for the procedualists, two cheers of www.medinnovationblog.blogspot.com, and one cheer for the Wall Street Journal.

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