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      Specialty Focus   
                                                                                    
Volume VI | Issue 49                                                                              
Dec. 5, 2017  
 
        Practice specific news, analysis and commentary 
      for Florida's Medical Specialists
                            From the publisher of FHIweekly & FloridaHealthIndustry.com

Drugmaker paid doctors with problem records to promote its pill
Blake Ellis & Melanie Hicken CNN Investigates
 
Avanir Pharmaceuticals paid nearly 500 doctors to speak or consult on its drug, Nuedexta, between 2013 and 2016, according to government data. Through a review of the top prescribers and top paid physicians in this group, CNN identified a dozen who have been disciplined by state medical boards. These offenses included the harmful treatment of nursing home residents and "grossly negligent acts" involving the inappropriate prescribing of dangerous and addictive drugs -- resulting in probation, suspension, fines and revoked licenses.
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JAMA Study: Double booked surgeries put patients at risk
Overlapping surgery, also known as double-booking, refers to a controversial practice in which a single attending surgeon supervises 2 or more operations, in different operating rooms, at the same time. Entitled Association of Overlapping Surgery With Increased Risk for Complications Following Hip Surgery, A Population-Based, Matched Cohort Study and published online December 4, 2017 by JAMA Intern Med., the authors found that for "patients undergoing overlapping procedures, there was an approximately 90% increase in the risk for surgical complications at 1 year."
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Living and aging well with HIV: New strategies and new research  
Allison Webel, Assistant Professor of Nursing, Case Western Reserve University
The Conversation

A generation ago, a list of tips for aging well with AIDS would have seemed a cruel joke. It also would have not been useful. Life expectancy immediately following the identification of the virus in 1984 was often months after diagnosis. Today < 12/1/17>, however, with World AIDS Day being commemorated for the 30th year, many people with HIV are living as long as the general population. But while people with HIV are living longer, they are also living with unique challenges regarding how to age well. New evidence suggests that there are indeed several simple but vital strategies that can help increase the likelihood of successful aging.
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Does Patient Autonomy Improve Health?
MDWhistleblower

It used to be that doctors knew best. We told you what to do and you obediently complied. The world has changed and the paternalistic system of yore has given way to the shared decision model where patient autonomy is respected.  

The Old Way:  "Well, I'll be setting you up for surgery soon."
The New & Improved Way: "Let's discuss all of the reasonable options with their respective advantages and drawbacks. Then, you make the call."
 
Has our current fidelity to patient autonomy improved medical outcomes? I have no idea. It has certainly changed patient's (and our) experience, but I do not know if it has improved patients' health. 
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