Comments on: University of Chicago’s EMTALA violation

By: University of Chicago in trouble again « The ACUTE CARE Blog: Non-Urban Emergency Medicine

Mon, 06 Apr 2009 23:57:49 +0000

[...] has a reasonable rundown on the events surrounding last month’s death in the waiting room at University of Chicago Medical Center — as well as a satisfying but spurious idea of how UCMC should respond. The news is that [...]

By: Matt

Matt — Fri, 03 Apr 2009 02:19:49 +0000

It’s also entirely possible that hospitals, like many businesses, feel that Medicare provides consistent, if not terribly profitable, operating revenue which keeps the bills paid while they look for more profitable income elsewhere.

“(This applies to general hospitals: money-skimming surgical hospitals are an obvious market distortion).”

When you refer to them as “money skimming” you seem to be denigrating those who have left the very program you yourself complain about.

By: shadowfax

shadowfax — Fri, 03 Apr 2009 01:15:10 +0000

Ever see penguins on the ice deciding whether it’s safe to go in the water? They don’t know if there’s an orca lurking, waiting to eat them. So they edge closer and closer to the edge of the ice until the jostling pushes one penguin off the ledge and into the water. Then they all watch to see if he gets eaten. If not, they all dive in. If yes, they move away from the edge and pretend nothing happened.

The moral, if there is one: don’t be the first penguin in the water.

By: V

Wed, 01 Apr 2009 20:18:27 +0000

Yeah, but in the U.S., you can still get treated for cancer somewhere. It may not be cutting edge, you may not have the best outcome, but it would still be considered standard of care. But in a lot of third world countries, if you’re dying on the street, even if the paramedics are standing right over you, if you can’t pay, I’m not sure they’ll even bother stabilizing you. I’m not sure this is where we want to go.

By: WhiteCoat

WhiteCoat — Wed, 01 Apr 2009 17:24:30 +0000

I don’t think it’s a bad thing at all. In fact, I strongly believe that is the way medical care in this country is headed.
Even if people claim a “right” to healthcare, no one has (or should have) a “right” to the best medical care in the world.

By: WhiteCoat

WhiteCoat — Wed, 01 Apr 2009 17:20:29 +0000

One might also say that the phraseology sounds like a polite way of saying “the patient was a frequent flyer (regardless of insurance status) who cried wolf about vague complaints so often and who had been worked up for his complaints so often that the medical staff believed his chronic complaints were not as serious as other patients in the emergency department at the time.”
I don’t know anything about the patient, his complaints, or what he died from.
I just don’t think the general public knows enough about the case to draw a reliable conclusion about what happened.

By: WhiteCoat

WhiteCoat — Wed, 01 Apr 2009 17:16:36 +0000

Disagree.
Because a rural hospital doesn’t give cancer treatment that patients could get at M.D. Anderson or Johns Hopkins, does that mean that all rural hospitals in the US are routinely engaging in malpractice?
Malpractice is “reasonable” care, NOT “the best care someone else can pay for (until they run out of money).”

By: WhiteCoat

WhiteCoat — Wed, 01 Apr 2009 17:12:06 +0000

This comment just illustrates the point I’m trying to make – the bully has everyone too scared to fight back.
There is no way to predict how market forces will change if a hospital eschews public funding. Perhaps a hospital will have to restructure and most likely the hospital will have to consolidate temporarily because there will be a decrease in the number of patients who seek care once it is not “free.” But …
With the consolidation, there will no longer be all the micromanagement from the government agencies. Staff will be able to focus more time on patients. Patients will get better care because the staff doesn’t spend half the day charting. Patients will be happier and will tell other patients. Staff will be happier and less stressed leading to greater staff retention. Happy staff lead to happy patients. Happy patients lead to more happy patients.
On the flip side, patients who do not want to pay or who cannot afford to pay will gravitate toward other hospitals that still accept public funding. When those other hospitals become overwhelmed with lower-paying patients, what will happen to the staff? Unhappy. Some leave. More attrition means more overwhelmed remaining staff because of less staff taking care of more patients.
Hey! I heard that everyone over at Private Pay General loves their job. Lets go apply there.
What will happen to the patients who have the ability to pay? Unhappy.
“Hey! I heard that the docs over at new Private Pay General are great and that there is no wait for care.”
If one hospital makes a successful go at privatization, news agencies will pick up on it in a heartbeat. Other hospitals will jump ship like lemmings off a cliff.
Is it possible that hospitals might be legislated into corners if they successfully wean themselves from Uncle Sam’s udders? Of course.
It’s also possible that a bully who picks on you can kick the crap out of you.
But you’ll never know until you punch him in the nose and tell him to leave you alone.

By: midwest woman

midwest woman — Wed, 01 Apr 2009 14:28:23 +0000

they must pay their er docs very well..I live in St. Louis and just heard of an er doc that commutes to this facility to work in their er…7 on 7 off. It’s not exactly like I live in a city without hospitals. Just thought you might find this interesting.

By: k

Tue, 31 Mar 2009 21:44:35 +0000

Way back at the beginning of this fiasco, WBBM 780's Steve Miller reported the elderly patient was known to the staff and had apparently been ill for some time. This particular statement has bothered me since I first heard it. Not to judge anyone involved in this matter, but the phraseology sounds like a polite way to allege "staff considered the now-deceased patient an uninsured/underinsured frequent flyer that could 'safely' be ignored for an unknown period of time".