The goal is to deliver “parsimonious care,” says the American College of Physicians’ updated ethics manual. The college also offers guidance for online behavior.

My latest. Read the whole shebang.

The Laser Spine Institute, a Tampa, Fla.-based endoscopic spine ambulatory surgery center with locations in seven cities, has a sophisticated approach to getting out the word about its treatments for back and neck pain. The institute’s website features videos of its physicians talking about the minimally invasive procedures and includes links to their frequent appearances in news media and the institute’s active social media accounts.

Now the institute, like many other health care organizations, is expanding its marketing beyond the public and aiming at physicians in the community who might send them new patients. To help in the effort, the 25-doctor group is looking to hire four new representatives — called physician liaisons or physician relations associates — who have at least five years’ experience as drug or device-company detailers. The new hires will visit doctors in their offices and discuss how the institute’s services could benefit their patients.

My latest. Read the whole shebang.

The Joint Commission has issued a sentinel-event alert saying drowsy health professionals are likelier to be involved in adverse events than their well-rested counterparts. The commission advised the more than 6,500 hospitals and other health care organizations it accredits to take steps to mitigate the risks of such fatigue.

The December 2011 action comes amid more pushback against the Accreditation Council for Graduate Medical Education’s resident work-hour restrictions, with research published in December 2011 linking the limitations with more complications among neurosurgery patients.

My latest. Read the whole shebang.

The past decade saw high-profile private and publicly funded initiatives targeted at the patient safety hazards affecting inpatients, including hospital-associated infections and wrong-site surgeries. Now experts are calling for a similar effort focused on the dangers that afflict outpatients.

In 2000, the Agency for Healthcare Research and Quality set an ambulatory care research agenda to help fill the gap. But the subsequent 10 years amounted to a “lost decade” as outpatient safety research and initiatives took a back seat to problems in hospitals, say the patient safety experts who produced a December 2011 report reviewing about 100 outpatient safety studies from 2000 to 2010.

My latest. Read the whole shebang.

Most hospitals say the Centers for Medicare & Medicaid Services’ no-pay policy for hospital-acquired conditions has pushed them to make greater efforts to prevent health care-associated infections. But a study says preventing one item on the no-pay policy has gotten less of a push: catheter-associated urinary tract infections.

My latest. Read the whole shebang.

Kansas City, Mo. — Thirty years after the disaster, Joseph F. Waeckerle, MD, still prays that he made the right calls.

The 1981 collapse of the interior skywalk system in the Hyatt Regency in Kansas City killed 114 people and injured 216 under the crushing weight of concrete and steel. Dr. Waeckerle directed the rescue effort and decided with just a few moments’ review who could be rescued and who could be offered only a morphine drip and advised to make peace with God.

Dr. Waeckerle and others at the scene had to determine how to save the most lives and limbs with little assurance that their judgments would be well-regarded in the aftermath.

A medical disaster is when the need for care outstrips the available resources — medicines, equipment, personnel. Such a chasm between demand and supply stretches far beyond a hectic day in the emergency department and requires a shift in ethical thinking because not every patient can get the care he or she would be entitled to under normal circumstances.

Which patients get the highest priority? What obligation do physicians have to respond to patient need in disasters? What should physicians do to prepare?

My latest. Read the whole shebang.

Physicians are accustomed to dealing with interruptions of all kinds — nurses with questions, phone calls from the pharmacy, incoming test results. With recent surveys showing that more than 80% of doctors carry smartphones and about a third use iPads or other tablet computers, some doctors are raising concerns about the capacity of these always-with-you devices to cause new distractions that could hurt patients.

My latest. Read the whole shebang.

Even as physicians face increasing pressure to perform well on measures of patient satisfaction, they may take some comfort in knowing that most patients rate their own doctors very highly.

The average physician rating is 9.3 out of 10, according to a study based on nearly 15,000 patient online ratings between 2004 to 2010. The analysis is based on data from DrScore.com, an online rating site started by a physician. Sites such as Yelp.com may highlight venomous comments from some unhappy patients and paint a misleading portrait of overall patient satisfaction, said Rajesh Balkrishnan, PhD, lead author of the study.

My latest. Read the whole shebang.

Offering financial incentives to encourage people to donate bone marrow cells using a method similar to regular blood donation is legal, a three-judge federal appeals court panel unanimously ruled in December.

The 9th U.S. Circuit Court of Appeals ruled that donations made using a technique called peripheral blood stem cell apheresis are not covered by the 1984 National Organ Transplant Act. The act outlaws payment or any compensation for organs such as kidneys, lungs or eyes.

My latest. Read the whole sheabang.

Functional magnetic resonance imaging of doctors’ brains could help physicians learn to avoid diagnostic and treatment mistakes. Doctors who pay as much attention when they make the wrong call as when they get it right are likelier to deliver better care, say the authors of a new study.

My latest. Read the whole shebang.

Proposed federal rules that would override laws in 20 states and require laboratories to send test results directly to patients upon request drew an array of objections from physician organizations, labs and hospitals.

The Dept. of Health and Human Services proposal, filed in September, does not require labs to ensure that physicians get test results before patients so they can help them understand the results. The proposal also does not distinguish between routine test results and those that deliver news of a potentially life-altering diagnosis, saying patients should have direct access to all test results.

My latest. Read the whole shebang.