Coming soon to a hospital near you? Overcrowding and physician shortages at Royal Columbian Hospital in British Columbia having adverse effects on patient care. Volumes are up by 20% from a few years ago and the physician groups estimate they need about 25% more physicians to handle the patients. The result is significant overcrowding. A recent report showed 34 “near misses” where wait times could have affected a patient’s safety or medical outcome – including a man who waited five hours with an intracerebral bleed.
Fire marshals visited the emergency department due to a complaint about overcrowding and issued a notice of fire safety violation. As a result, ambulances are being instructed to hold patients in vehicles in the ambulance bay until there is a bed available. Apparently if you can’t see them, they’re not your problem.
The docs even created a web site to notify the public about how inadequate staffing and overcrowding are limiting their ability to provide “safe and effective care to all patients in a timely and respectful manner.”
In other news, hospital officials are now chastising the emergency personnel for their lower than average Press Ganey scores for the previous quarter.

Should I pack lunch … or lunch and dinner? As emergency department use has increased 32% and wait times have increased 50% over the past 10 years, more emergency departments are posting wait times online. Now if we could only get someone to post wait times for specialist appointments, the Department of Motor Vehicles, and tax refunds.

More on Bret Michael’s experiences in the emergency department. “Am I dying? If I’m dying, I want to see my kids, but if I have a chance, I don’t want them to see me in this condition.”

Former Miami Dolphins receiver O.J. McDuffie wins $11.5 million medical malpractice award after team doctor allegedly misdiagnoses big toe injury.

Parkland Memorial Hospital in Dallas is repeatedly investigated by the Centers for Medicare and Medicaid Services, yet according to this article, CMS found few violations and may have even downplayed or covered up some mistakes.
Another one of those “too big to fail” scenarios?

Obtaining an MRI often requires that the patient remain still for extended periods of time. Kids often don’t want to fit into that category. Pediatric emergency physicians are frequently using propofol – the same drug that allegedly killed Michael Jackson – to sedate children prior to MRIs. In a study of more than 25,000 patients, complication rates with using the drug averaged about 6 percent, with 1.4% of patients needing ventilatory support. No deaths from the drug occurred.

Opting out of Medicare. “Why would you sign up for something that would guarantee to pay you less over time when you’re expected to work harder? We want to be able to spend our time caring for patients instead of assigning codes to them and filling out paperwork.”
Another cardiologist whose practice is comprised of 70% Medicare is considering “opt[ing] out of America,” by moving to and practicing in another country, or retiring early.
Other physicians and patients are considering the “opt out” as well, affecting patients’ access to care.
This is precisely what the government wants – a slow attrition of medical providers so that patients have increasing difficulty accessing care. Those providers that stay with the system will be paid less and less for the services they perform. A win-win situation for government insurance. Pay providers less so you save money on care. Then providers drop out of the system. Patients have to wait longer and longer to access care. When patients can’t access care or have to wait in long lines to do so, then they can’t run up as many charges and the system saves money. Funerals are a lot less expensive than cardiac catheterizations and hemodialysis.
Wasn’t the health care bill supposed to prevent insurers from pulling this type of stuff? Oh. Forgot. That’s only for private insurers.

Statewide narcotic databases going national? Databases that list patient prescriptions only go so far if a patient jumps from state to state. Will a national database improve a provider’s ability to shut down drug seekers or will it intrude even more into a patient’s privacy?

Like something out of a TV sitcom … mistrial called in medical malpractice lawsuit after doctor faints when listening to testimony. Floor throwing in a courtroom? Puh-leese. Are they going to strap him in his chair for the next trial or what?

Ripple effects from St. Vincent’s Hospital closure:
When the hospital goes bankrupt, it doesn’t pay for tail insurance on the medical malpractice insurance policies. Now the doctors have to pay $40,000 per year out of pocket or risk being fully liable for a malpractice lawsuit.
Beth Israel Medical Center is absorbing a lot of the patients that would have gone to St. Vincents. Ambulance runs doubled in the first week after St. Vincent’s closure, walk in patient volumes increased 25% and admissions are at an all time high.
Now the clipboard brigade from New York City is monitoring how quickly the overworked staff is moving at Beth Israel. Go ahead. Shut them down, too. I dare ya.