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Mayo Clinic Medical Science Blog

meghanknoedler

@meghanknoedler

Meghan Knoedler, M.S., R.N., is part of the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery with a Policy and Practice focus. 

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Thu, Apr 20 at 8:00am CDT by @meghanknoedler · View  

Economies of scale: volume in health care

The concept is simple, if you perform the same procedure over and over; day in and day out, you tend to do it better, quicker, and safer than your counterpart who has only done it a few times, or infrequently. It’s referred to in other lines of work as “economies of scale.” The application of this concept dates back to Henry Ford and his novel use of this concept in the assembly line. However, unlike the assembly line with the ability to easily distinguish how many cars are generated, and the uniform safety of those cars and parts, health care still struggles to define these measures.

Researchers at the

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robertrobert

robertrobert responded 21 hours ago · View

Serious problems exist with the quality and cost of healthcare today. One major cause of these problems is that current systems encourage volume health care, rather than value. Physicians, hospitals, and other providers gain increased revenues and profits by Writing Help By Assignment Empire more services to more people, fueling inflation in health care costs without any corresponding improvement in outcomes.

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meghanknoedler

Tue, Mar 7 at 7:00am CDT by @meghanknoedler · View  

Choosing Wisely—At odds with Diagnostic Accuracy?

Primary Sjögren’s syndrome is a chronic autoimmune disease where your body attacks its self.  This happens because some of the white blood cells and several proteins made by these and other cells attack on normal functioning salivary glands (i.e. those in your mouth—leading to cavities, ulcers, and tooth degradation) and tear glands (i.e. your eyes).  However, the assault does not stop at just the glands; it wreaks havoc on your entire body, making you feel tired and run down. If you have Sjögren’s syndrome you also likely have painful, swollen joints that make it hard to enjoy even everyday activities. Sjögren’s can also affect the heart, lungs, brain and kidneys as well.

The diagnosis of primary [...]

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meghanknoedler

Tue, Feb 21 at 8:00am CDT by @meghanknoedler · View  

New ray of light for those who struggle with weight loss: low-level laser therapy

The struggle to lose weight is complex and full of challenges. For those who have struggled with their weight, finding hope and solutions can be difficult despite understanding the detrimental health consequences.

There is no question that losing weight is challenging.  As a result, procedures exist that aim to remove fat cells from the body.  A well-known procedure is liposuction, a surgical procedure which requires general anesthesia. In liposuction, fat cells are suctioned out through strategically-placed incisions. It carries with it a number of risks and side effects that range from cosmetic to life threatening. An emerging alternative to liposuction is Food and Drug Administration (FDA)-approved low-level laser therapy (LLLT); LLLT is more focused [...]

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meghanknoedler

Dec 27, 2016 by @meghanknoedler · View  

Using the Discovery-Translation-Application cycle to enhance recovery after surgery

old-way-new-way

Seventeen years is the average amount of time it takes for research to reach the patient bedside.  But this is not always the case, as a team of clinician researchers in gynecological surgery are showing. “It shouldn’t take 17 years for new discoveries to reach patients,” says Sean C. Dowdy, M.D., deputy director for practice in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery and chair, Division of Gynecologic Surgery, “One of our goals at the Kern Center is to not only discover new ways of delivering quality health care, but to improve the interface between discovery and translation to facilitate wide-spread dissemination. [...]

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meghanknoedler

Dec 20, 2016 by @meghanknoedler · View  

New breast cancer treatment increases chances women can save their breasts

breast-canerA very close family friend was just recently diagnosed with breast cancer. Even before all of her tests results came back she said, “Take both of my breasts, I don’t care.”  When someone you know or love is diagnosed with breast cancer, it’s terrifying.  All too commonly, our minds go to surgery.  This is what we believe will save our mom, our sister, our friend from breast cancer.  For my friend, like many others, the thought of cancer growing inside of her was scary and surgery to remove the cancer was her first thought.

Many women with early stage breast cancer have the choice between breast conserving surgery and mastectomy. Historically management of breast cancer has [...]

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meghanknoedler

Nov 29, 2016 by @meghanknoedler · View  

Rising health care costs: Are physicians Choosing Wisely?

choicesPhysicians are burned out.  The reasons for which are seemingly endless:  for one, the health care system is asking them to continually add more to their plate.  More diagnosis codes, more communication and oversight with more complex patients, more administrative duties such as charting and patient emails and portal systems, yet no more time.

Physicians are expected to stay on top of ever-changing guidelines, and provide their patients effective, compassionate, high value care.  More and more, reimbursement is tied to patient experience, but yet doctors have less time to actually spend WITH their patients ensuring the best possible experience.

It’s a nasty spiral that is difficult to control.  Then, add on the increasingly complex issue [...]

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meghanknoedler

Sep 13, 2016 by @meghanknoedler · View  

What is stopping patients from enrolling in clinical trials?

ovarian-cancerClinical trials are the mechanism through which new and promising therapies for safe, effective cancer treatment ultimately become available.  Not only do trials help identify new or best-practice therapeutic treatment options, but the act of participating in a trial has been shown to actually improve survival.

One of the most promising areas of research to fight cancer involves immunotherapy -- the use of vaccines or viruses as anti-cancer agents.  Immunotherapeutic approaches through the use of vaccines, stimulates the body’s own cells to identify and fight cancer cells, utilizing a similar mechanism of action as we do with common childhood vaccines including measles, mumps and rubella (MMR). Viral therapies introduce a virus into [...]

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meghanknoedler

Jul 5, 2016 by @meghanknoedler · View  

The July Phenomenon

july“Never go to the hospital in July,” a phrase often repeated by patients; and perpetuated by a myriad of hospital employees, casts a worrisome tone over care received in July. Thus we hear of the “July Phenomenon.”

This is because each July 1 is the start of the medical residency year. A day full of mixed emotions:  excitement, splendor, fear, stress, and accomplishment; it is the very environment that many clinicians thrive in. It also starts the period that some people fear can be very distracting for new doctors, and possibly even dangerous for their patients. [...]

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meghanknoedler

Apr 12, 2016 by @meghanknoedler · View  

A Head Start for HPV Vaccine: Better Series Completion

HPVHPV infographic

The Human Papillomavirus (HPV) is the most common sexually transmitted disease (STD), with about 14 million new cases each year.

Surprisingly, this STD is largely asymptomatic but can carry quite a punch.  HPV affects both men and women and can cause cervical cancer and other cancers of the genitals, anus, mouth, and throat, all of which can lead to severe disease, disability, infertility or death.

There are currently three different licensed vaccine options for use in girls and boys that protect against and prevent HPV, and using these vaccines routinely could potentially prevent 70% - 90% of cervical [...]

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elizabethzimmermann

Elizabeth Zimmermann Young responded Apr 26, 2016 · View

http://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html CDC has info for HPV vaccines - both routine (age 9) and catch up (teens)

thomasm2014

thomasm2014 responded May 26, 2016 · View

http://www.creative-diagnostics.com/anti-hpv18-e7-mab-176307-177.htm we can know more about that.

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meghanknoedler

Mar 15, 2016 by @meghanknoedler · View  

New Treatment-Sequencing Based on Biomarker Elevation in Pancreatic Cancer

pancreasPancreatic cancer is the fourth leading cause of death in men and women and is projected to increase to the second leading cause of death by 2020 if there are not significant treatment advances made.

Our current understanding of pancreatic cancer suggests that it is a systemic disease in most patients, meaning, that by the time of usual diagnosis metastasis or spread of the cancer has already occurred, even if imaging studies are normal.  This aggressive nature of pancreatic cancer highlights the need for innovative treatment or diagnostic options for patients to improve survival.

truty

Mark Truty, M.D., Surgical Oncologist

A study done by [...]

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rldennis59

rldennis59 responded Mon, Mar 6 at 11:16pm CDT · View

The article provides some good basic information, however, in trying to ascertain the effects, symptomology, and characteristics of pancreatic cancer in post complete pancreatectomy patient would be of value. My wife is now a Stage 4 pancreatic cancer patient, having had a complete pancreatectomy in October 2015. Even with post-surgical chemotherapy, her CA 19-9 markers have risen dramatically this year (365.5 in January 2017, 550.5 in February 2017, and this month's reading is 1140.7). She [...]

elizabethzimmermann

Elizabeth Zimmermann Young responded Tue, Mar 7 at 1:29pm CDT · View

@rldennis59, Thank you for reading the blog. I am sorry to hear about your wife's cancer. I have attached a link to our pancreatic cancer information page, which hopefully will answer your questions, or give you ideas for future areas of question. http://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/home/ovc-20268502

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meghanknoedler

Mar 3, 2016 by @meghanknoedler · View  

Changes in Medical Education: Shifting Doctors' Attitudes in Medicine

Medical school training and admissions are going through many changes.  The medical school entrance exam (Medical College Admission Test or MCAT) is one of the notable changes.   For many years, the test focused on objective knowledge based on general chemistry and stoichiometry, organic chemistry.

compassionThe test made a drastic change in 2015 decreasing the questions regarding general chemistry, physics, biology and verbal skills.  In place of the more traditional questions, the test creators added questions in the domains of psychology and sociology.

This shift in the entrance exam reflects that it is becoming more important that clinicians are able to engage patients in empathic and collaborative ways.  It advances the notion that [...]

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creativepep

Creativepep responded Jun 5, 2016 · View

How to cultivate postgraduates to find, analyze and solve problems lies at the core of higher medical education. Investigating the role and position of physics course in advanced medical education could also be helpful in medication advances, such as http://www.creative-peptides.com/product/degarelix-item-10-101-132-37.html shows.

chadwickstevenson

chadwickstevenson responded Thu, Mar 23 at 12:33pm CDT · View

Sean Phelan, Ph.D is most experienced doctor at Mayo Clinic, I have met with him when I took my friend to the hospital, and the second time he visited at my California Hill University http://www.californiahilluniversity.com/divisions/ and told us about his experienced and hard work, that was very motivational and inspiring.

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meghanknoedler

Feb 9, 2016 by @meghanknoedler · View  

Improving the State of the World: The Global Conversation on Health Care Delivery

Leaders from around the world converge annually to take part in global conversations at the World Economic Forum (WEF).  “Improving the state of the world,” lies at the heart of their mission, which they met to discuss in late January.world health

Notably, John Noseworthy, M.D., Mayo Clinic President and CEO, and, Sylvia Burwell, Department of Health and Human Services (DHHS) Secretary were both in attendance, championing health and health care delivery.  Also in attendance and contributing to the conversation were, other top private sector moguls and government officials including, Sheryl Sandberg, Chief Operating Officer of Facebook, Vice President of the United States, Joe Biden, and Canadian [...]

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meghanknoedler

Jan 26, 2016 by @meghanknoedler · View  

Resolutions for the New Year, HVHC 2.0

hvhc2It’s that time of year when we all make resolutions for the New Year.  We all strive to better ourselves: our mind, our body, our spirit.  Refocus and refresh.  Health care collaboratives seem to be no different, but rather than focusing on the individual, they are focused on bettering the lives of all patients.

Recently, the High Value Healthcare Collaborative (HVHC) repurposed the old and rang in the new HVHC 2.0. Founding member and current executive committee member Rob Nesse, M.D., says “it represents a return to our roots.”

Mayo Clinic, in conjunction with 17 other similar health care institutions across the country, including The Dartmouth Institute [...]

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