Also see the satellite edition of this week’s update over at ER Stories.

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Work in a health care facility? Get a flu shot or lose your job. That’s the policy that a couple of national health organizations are pushing. We already do it for tuberculosis, measles, mumps, and rubella. Why should influenza be any different? New York is currently creating a permanent regulation for yearly flu vaccination.

The University of Texas Medical Board is losing money. The medical school is getting less funding from the “Legislature” (which I am assuming is the State legislature). How does UTMB make up the shortfall? By cutting charity care. The amount of charity care that the hospital system provides went from 20.6 percent of total patient services in 1999 to 2.6 percent last year. Now the clinics that still care for indigent patients are “busting at the seams” with new patients and patients aren’t getting necessary care for serious medical problems.
Local leaders are claiming that UTMB has a “responsibility” to provide services for those that are economically disadvantaged and that the hospital needs to “do right” for the people of Texas. I disagree. The State of Texas has a responsibility to provide health care to its residents. That “responsibility” can’t be imposed upon private institutions any more than the responsibility to feed the indigent can be imposed on private grocery stores. Since the University of Texas is a state institution, though, the State of Texas also has a responsibility to make sure that its institutions have sufficient funding to provide proper medical care. You can’t cut funding to the institutions and then turn around and blast the institutions for failing to provide care. If the UTMB Board is cracking down on UTMB to be profitable, what is UTMB supposed to do?
Interesting twist to the story is that UTMB is going to have difficulty crying “poverty.” It is reportedly undergoing a $1 billion expansion.

Would you trade a quick ED visit for seeing a nurse practitioner instead of a physician? Journal of Bioethics survey shows that 80% of patients “fully expect to see a physician regardless of acuity or potential for cost savings by seeing another provider.” Patients are more willing to see medical residents than nonphysicians. A little more than half of patients surveyed would agree to see a nurse practitioner or a physician assistant in the emergency department. Additional story from AM News.

Now the citizens get to cast their vote on you. After voting to overturn medical malpractice reform, Illinois Supreme Court Justice is getting a little squeamish about his tenure. Sixty percent of the voters in November have to vote to retain him. More than one group is campaigning against him. The state trial lawyers endorse him. And he gave a speech stating “I didn’t unilaterally make this ruling.” That’s true. Illinois citizens won’t unilaterally vote you out of office, either. Another story on the topic is here.

Patient doesn’t like the only doctor available to treat him, so he calls her a derogatory name … then stabs her in the chest.

39 year old male goes into hospital to visit a patient, takes a dislike to the patient’s 78 year old roommate, then stabs her. Of course, the hospital is going to be held liable since this is considered a never event. How could any responsible hospital not have purchased the technologies available in the Minority Report so that they could prevent crimes before they happen?

Can a football team be sued for medical malpractice? We might find out after the Bengals waived Rashad Jeanty.

Will one physician bankrupt Indiana’s medical malpractice patient compensation fund? With 357 lawsuits pending against him, he might not bankrupt the fund, but he could take a serious chunk out of its reserves.

Nursing assistant gets 2 years in prison for squeezing Fentanyl from 92 year old woman’s pain patches then licking his fingers to get a buzz.

Should hero who saves someone from drowning have to pay his own medical bills after being taken to hospital by ambulance? People on the scene thought he should be “checked out” – which ended up costing him almost $2000. Hero’s family claims “unfairness” for charges. Eventually hospital writes off the bill.

See the satellite edition with more news briefs from around the web over at ERP’s blog – ER Stories.

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When states cut funding for mental health, where do all the patients go? You guessed it. Sacramento emergency departments are getting “swamped” by mental health patients. Visits for mental health illnesses are up 30% in the past year. Inpatient psych treatment centers close inpatient beds, then tell the community to call 911 or go to the nearest emergency room. About one patient every 30 minutes are taking that advice. Yet the county wants to cut more services – requiring a federal court to block them from doing so last month.

You take away our malpractice reform, we take away your database of doctors. Illinois removes online database listing physician crime convictions, physicians who were fired by a hospital and physicians who were forced to make medical malpractice payments. The database was required as part of Illinois’ medical malpractice reform bill, but since the Illinois Supreme Court overturned malpractice reform, it also got rid of the requirement for the database. Now only disciplinary actions are listed.
The president of the Illinois Trial Lawyers Association got into the act, too, being quoted as saying “That anyone would want to keep that information from the citizens of Illinois is appalling to me. Patients deserve to know whether their doctor poses any dangers to them.” Guess you should have thought about that before striking down tort reform. By the way, does the Illinois State Bar Association have the same database? Don’t clients deserve to know whether their lawyer poses any dangers to them? Yeah. Didn’t think so.

Does the admission of guilt and early offer of compensation reduce the costs of medical malpractice? The University of Michigan believes so. Ted Frank at Point of Law has his doubts, but does note that such a policy would decrease the amount of money going into the lawyer’s hands.

5′5″ 300 lb patient falls off of operating room table because velcro straps won’t hold him. Now the hospital is getting sued.
In other news, hospital names velcro strap manufacturer and McDonalds as codefendant in case.

“Florida has the highest rate of malpractice premiums in the U.S., and Miami is the highest in the state,” says Florida Attorney General Bill McCollum during a campaign speech. “As a result, the percentage of doctors practicing is among the lowest in the nation.” Nope. No connection there.

Savings you can believe in. Health care reform expected to increase Nebraska Medicaid costs by $526 million to $766 million over the next ten years.

Do seniors come to the hospital for warm meals and companionship? Researchers enrolled 118 seniors to get coaching visits plus deliveries of food for a month after they had been discharged from the hospital. Nurses visited homes two days, seven days, 14 days and 30 days after discharge to ask patients if they’d scheduled appointments with their doctors and to make sure they were taking medications as prescribed. The number of patients readmitted within 30 days dropped from 23.3 percent to 2.7 percent. Providing hot meals alone dropped the readmit rate by almost half.

Was the closure of St. Vincent’s Hospital due to financial mismanagement? Lawsuit will find out. While heading toward more than a billion dollar budget shortfall, hospital execs paid for a $278,000 golf outing, took home salaries of $1 million, spent $17 million on management consultants and had more than $100 million in “unspecified spending” for just one year.

Here we go again. Radiologists berating clinicians for ordering too many x-ray studies.
In other news, look soon for the American College of Radiology to publish whitepapers on how to judge the amount of coronary artery occlusion by palpation of pulsations in the patient’s chest, how to interpret a radiologic study without recommending further radiologic studies, and how to get out of lawsuits alleging that not enough radiologic testing is ordered.

Kudos to ACEP President Angela Gardner who was just elected as one of the 100 Most Powerful People in Healthcare (free registration required). Barack Obama was #1, Kethleen Sebelius was #2, and Nancy Pelosi was #3.
I admit being a partisan toward ACEP, but awards like this are the reason. I don’t agree with all ACEP policies or actions, but I also think that ACEP does a great job advocating for both emergency physicians and emergency patients. As I scrolled through the Top 100 list, the only other medical society members present were people from the AMA and the American Board of Internal Medicine. No other medical specialty societies were represented.