The Journal of the South Carolina Medical Association
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Review Comparative Study
Human papillomavirus and head and neck cancer: a growing concern.
Head and neck cancer is increasing in incidence in patients without the usual risk factors for the disease. Practitioners need to be aware that young, non-smoking patients are also at risk for certain types of head and neck cancer. ⋯ There is strong epidemiological and laboratory evidence that HPV is a cause of head and neck cancer. Therefore, any patient with persistent lesions, ulcers, swallowing difficulty, change in voice, or neck mass needs prompt referral to an otolaryngologist- head and neck surgeon.
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The pediatric hospitalists in South Carolina at all three academic centers have expanded their clinical role by acting as referral physicians during a patient's hospital stay for surgeons, subspecialists, and/or primary care providers. In addition they have taken on the challenge of improving quality of care by offering clinical services, such as palliative care and consults, and are serving as the leaders for hospital system focus on quality improvement including improved patient safety. Specific recognition of pediatric hospitalists and hospitalists in general as a subspecialty is moving forward. ⋯ It is essential that systems be voluntary and private physicians reserve the right to admit to the hospital since many office based pediatricians have the skills and desire to continue inpatient care. 2) Medicaid and private providers should recognize the safety net function of hospitalist programs and the increasing complexity and acuity of pediatric inpatients and should reimburse pediatric inpatient care at or above Medicare rates to insure that hospitalist programs are financially sustainable. 3) Hospitalists should act as leaders in safety and quality initiatives including the use of evidence-based practice. 4) Implementation of hospitalist programs should be done in collaboration with local physicians to insure success and acceptance. In summary, hospitalists programs are growing and defining new paradigms in the national healthcare system. The programs can offer numerous benefits to patients, hospitals, and payers.