12/27/2023 0 Comments Stefan kaiser occupational medAfter securing the blessings from senior leadership, the doctor recruited two medical toxicologists to launch the service in 2010. He studied the data and found that a large, integrated health care organization like TPMG that provides care for more than 4 million patients had a demonstrated need for a dedicated service. Offerman believed there had to be a better way. “The latter is a great service for the outpatient, but once patients are hospitalized, they really should be assessed by a medical toxicologist who has electronic access to their medical records.” First 24/7 virtual serviceĭr. “This shortage leaves physicians nearly everywhere with just two options – treat the patient if they are familiar with the protocol for a certain toxin, or consult the nearest poison control center,” says Dr. Because the specialty is relatively new, with limited opportunities to practice toxicology full time, there are fewer than 500 board-certified medical toxicologists in the United States today. Recognized as a specialty by the American Board of Medical Specialties since 1992, toxicology focuses on the diagnosis, management, and prevention of poison and other adverse health effects from medications, occupational and environmental toxins, and biological agents. “But about a year later, after attending one of our toxicology meetings, I came away thinking we really needed our own regional, dedicated service.” “When I first arrived, I was thrilled to be practicing emergency medicine and nothing else,” Dr. The toxicology service is the brainchild of Steve Offerman, MD, a medical toxicologist and emergency physician who came to TPMG in 2005 after leading the toxicology program at University of California, Davis. “It also increases the consistency of toxicologic care across our 21 medical centers in Northern California.” Steve Offerman, MD “Having a dedicated and integrated toxicology service in which medical toxicologists are immediately aware of patients’ information, such as their weight, medical conditions, and allergies, makes all the difference in terms of arriving at the right diagnosis and treatment,” says Stephen Parodi, MD, TPMG associate executive director. Daubert is one of five board-certified toxicologists with The Permanente Medical Group (TPMG) in Northern California who make up the TPMG Regional Toxicology Service, which leverages telemedicine and Kaiser Permanente’s integrated electronic health record so that any TPMG physician can access a toxicologist 24/7 for a virtual consultation. Daubert’s diagnosis, the teenager made a full recovery. “These types of creams can be quite effective, but they also can contain very high levels of mercury,” says Patrick Daubert, MD, a medical toxicologist and emergency medicine physician at Kaiser Permanente South Sacramento who had been brought in to consult on the case when the teenager was in pediatric critical care. He was transferred to Kaiser Permanente’s Santa Clara Medical Center and spent more than 3 weeks in pediatric intensive care before the mystery was solved – mercury poisoning from a face cream purchased in Mexico.ĭespite an overall decline in mercury toxicity in the United States, mercury poisoning from foreign-produced cosmetics is more common that we might think. The boy, a junior in high school and captain of his soccer team, eventually ended up at the Emergency Department in a wheelchair with severe back pain, leg tremors, face and upper extremity twitching, sleep disturbances, hypertension, and persistent tachycardia. For the next several weeks, his symptoms progressed – a tingling sensation in his chest, arms, and legs, and lower back pain – but tests, exams, an MRI, therapy, pain medication, and several consultations didn’t yield any answers. He had no injuries, and his lab work was normal. Regional toxicology service uses telemedicine to connect doctors with medical toxicologistsĪ previously healthy 17-year-old boy visited his primary care physician in California’s Central Valley, complaining of lower extremity weakness.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |