Health

Study: Many Medicare Cataract Patients Given Needless Tests

Published

9 years ago

April 16, 2015

MARILYNN MARCHIONE, AP Chief Medical Writer

Millions of older people are getting tests they don’t need to prove they are healthy enough to have cataracts removed, a new study finds. The excess testing before this quick, ultra-safe eye procedure is costing them and Medicare a bundle, and many patients don’t know they can question it, doctors say.

“They should ask, ‘Is it really necessary?'” and how much it will cost them in co-insurance — usually 20 percent under Medicare, said one study leader, Dr. R. Adams Dudley of the University of California, San Francisco.

It’s amazing “how much harm a doctor can do with the wiggle of their pen or a check in a box” to order these tests, he said. “In just seconds they can spend tons of people’s time and money.”

Removing cataracts that cloud vision is the most common elective operation for older adults, done 1.7 million times each year in the United States. It’s an outpatient procedure that takes about 18 minutes and requires only numbing eye drops, not general anesthesia.

“This is one of the lowest-risk surgery procedures you can have,” with less than a 1 percent risk of major heart problems or death, said Dr. Catherine Lee Chen, a UCSF anesthesiologist who led the study.

Yet many doctors order preoperative tests such as blood work, chest X-rays, electrocardiograms and even advanced heart and lung tests to ensure a patient can withstand the procedure.

Major studies found that about half of Medicare recipients were getting such tests before cataract removal, and that routine testing did not improve outcomes or safety. In 2002, several medical groups issued guidelines advising against it.

Chen did the study to see if the situation had improved since then, and found it had not. Looking at Medicare records on more than 440,000 patients who had cataracts removed in 2011, researchers found that 53 percent had at least one test in the month before surgery.

About 13 percent of patients were given one test; 11 percent had two, 10 percent had three, 7 percent had four, and a whopping 13 percent had five or more tests.

The biggest factor in whether tests were ordered was the eye doctor, not characteristics of the patients or their health risks. About 36 percent of eye doctors ordered tests on three-fourths or more of their patients, and 8 percent did so for every patient.

“It could be the policy at their surgery center,” Chen said, yet researchers found that whether the procedure was done at a hospital outpatient center versus somewhere else made little difference in testing rates.

The study is in Thursday’s New England Journal of Medicine.

The results are surprising, said Ellen Meara, a professor at the Dartmouth Institute for Health Policy and Clinical Practice.

“It suggests a lot of unnecessary testing,” and that patients should be questioning it, she said.

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Calif. Dept. of Public Health: Got Milk Allergies? Don’t Eat Dave’s Bakery Cornbread

The California Department of Public Health (CDPH) issued a warning on Jan. 26, instructing consumers with milk allergies or “severe sensitivity to milk” in the state to not eat Dave’s Bakery Corn Bread due to “risk of illness.” The CDPH warns that consumption of the corn bread manufactured by a Gardena-based company — with expiration dates up to June 18, 2024 — may lead to “life threatening” reactions.

Published

1 week ago

May 4, 2024

Oakland Post

Dave's Bakery Corn Bread, 9 pack/net wt. 21 oz (595g) (Courtesy of CDPH)

By California Black Media

The California Department of Public Health (CDPH) issued a warning on Jan. 26, instructing consumers with milk allergies or “severe sensitivity to milk” in the state to not eat Dave’s Bakery Corn Bread due to “risk of illness.”

The CDPH warns that consumption of the corn bread manufactured by a Gardena-based company — with expiration dates up to June 18, 2024 — may lead to “life threatening” reactions.

“This warning applies only to the Corn Bread produced by Bake R Us, DBA Dave’s Baking Company and distributed to schools, retail facilities and in vending machines primarily in southern California,” the DCPH statement reads.

“This product should not be confused with other similarly named companies with national distribution,” it continues.

According to the CDPH, although the corn bread product contains whey, which is a milk allergen, there is no allergy warning label on the packaging, though it is required by state law.

So far, authorities say, no illnesses have been reported in the state, but if anyone finds the products on sale anywhere in the state, they should call the CDPH complaint hotline at (800) 495-3232 or file a report online at CDPH.ca.gov

The CDPH is also recommending that people who have eaten the product and are experiencing any reaction or ill effects should consult their health care provider.

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Bay Area

East Bay Regional Park District Issues Rattlesnake Advisory

The East Bay Regional Park District released an advisory today on rattlesnakes, which emerge from winter hibernation in early spring and become more active. Warm weather can bring more potential for rattlesnake encounters with humans and dogs, particularly along trails and roads.

Published

1 week ago

May 4, 2024

Oakland Post

The Northern Pacific rattlesnake is the species found in East Bay Regional Parks. Courtesy photo.

The Richmond Standard

The East Bay Regional Park District released an advisory today on rattlesnakes, which emerge from winter hibernation in early spring and become more active.

Warm weather can bring more potential for rattlesnake encounters with humans and dogs, particularly along trails and roads.

Visitors are encouraged to avoid hiking alone in case of an emergency, to scan the ground ahead as they walk, jog or ride, stay on trails avoiding tall grass, and to look carefully around and under logs and rocks before sitting down. Keep your dog on your leash to be extra safe, park officials said.

If you encounter a rattlesnake, leave it alone – it is unlawful to capture or harm one. Move carefully and slowly away or around it and give it plenty of space, park officials said.

Those who are bitten by a rattlesnake are instructed to stay calm by lying down with the affected limb lower than the heart, then having someone call 911.

Getting medical attention is critical.

Those bitten should not use tourniquets, “sucking,” or snake bite kits. If you are by yourself, walk calmly to the nearest source of help to dial 911, do not run.

If bitten by any other type of snake, wash the wound with soap and water or an antiseptic and seek medical attention.

Not sure what bit you? Check the bite for two puncture marks (in rare cases one) associated with intense, burning pain, which is typical of a rattlesnake bite. Other snakebites can leave marks without associated burning pain.

The Northern Pacific rattlesnake is the species found in East Bay Regional Parks. Snakes are important to the natural environment, helping to control rodents and other reptile populations. But enjoy them from afar.

For more information, download the Park District’s Common Snakes brochure or watch our Gopher Snake or Rattlesnake video to learn how to tell the difference between rattlesnakes and gopher snakes. Additional information is available at ebparks.org/safety/wildlife-encounters.

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Alameda County

A Safe Place, Bay Area Domestic Violence Community Organization, Opens New Service Center in Oakland

Oakland-Bay Area non-profit, A Safe Place, announces the grand opening of its newly purchased building in Oakland that will be a service center for families that have suffered from domestic violence. The new, two-story building has over six new service rooms for counseling, mental health support groups, legal services, children’s treatment, safe space for community engagement, and partnership activities.

Published

1 week ago

May 4, 2024

Oakland Post

Façade of the new community center for A Safe Place opening on May 10 in Oakland. Courtesy photo.

By Courtney Slocum Riley

Special to The Post

Oakland-Bay Area non-profit, A Safe Place, announces the grand opening of its newly purchased building in Oakland that will be a service center for families that have suffered from domestic violence.

The new, two-story building has over six new service rooms for counseling, mental health support groups, legal services, children’s treatment, safe space for community engagement, and partnership activities.

Domestic violence occurrences and offenses account for a considerable amount of all violent crimes in Alameda County. A Safe Place is attempting to provide a safe place for families to heal. A Safe Place is the only comprehensive domestic violence assistance program including a safehouse, in Oakland.

The grand opening celebration will also serve as a fundraiser to build out healing, therapeutic spaces for children and adult victims and survivors and survivors of domestic violence (male and female).

The new service center will expand the work of the organization, founded in 1976 when a group of women working in San Francisco came together to address the urgent need for a shelter in the East Bay. A year later, they founded A Safe Place (ASP) in Oakland. Run solely by volunteers, they set up a crisis line to offer crisis counseling and information to battered women and their children.

The organization serves over 500 adults and children annually through a host of services including crisis counseling via 24-hour crisis line, emergency motel and safehouse sheltering, mental health services (counseling and support groups).

Under the leadership of Executive Director, Carolyn Russell, the organization has grown from a single program into the comprehensive domestic violence and assistance program. ASP strives to meet the growing and diverse needs of our growing community.

The organization hopes to complete all the upgrades and therapeutic room improvements by August 2024. The public is invited to donate to the effort by using the website at www.asafeplace.org/donate. The organization also accepts in-kind gifts as well as items from the organization’s Amazon Wishlist.