WhiteCoat

Healthcare Update — 06-18-2010

No wait emergency departments. Great business model or way to encourage more abuse of already crowded emergency departments?

Nice shackles. Memphis Med now changes policy so that prisoners wait in the waiting room like everyone else – with police escorts. Problem is that police are now paid to sit in the ED waiting rooms for six hours rather than fight crime on the streets.

Minnesota nurses strike. More than 12,000 nurses walked off the job for one day to protest working conditions and inadequate pay raises. Hospital forced to pay $1600 to $2200 to hire replacements for two days and to cut inpatient volumes.

Tweeting your doctor for advice. Nice in theory, but would you pay 50 bucks for the privilege?

Remember the chatty juror who asked the defendant doctor for medical advice? He got off with a stern warning and no jail time. Probably also got out of future jury duty.

Job security for British emergency physicians … brainiacs in Wales are trying to get drunk by pouring shots of vodka into their eyes. Talk about beer goggles.

Meet the latest member of the “you need an emergent Foley catheter” club. Intoxicated weenie gets brought to hospital emergency department then hits the doctor and nurse.

Check out the new electronic underwear that sends a text message to your nurse when you piss yourself. I’m betting that they probably cost a little bit more than a package of Depends, though. Will the new health plan cover them?

Another Canadian emergency department closing. Two doctors moved from the area leaving only one doctor capable of covering the emergency department at Wakaw Hospital in Saskatoon, Saskatchewan.

Curbing unnecessary trips to the ED. Go to the emergency department too many times for routine care in Utah and you won’t be able to get your prescriptions filled unless you see a primary care physician. Innovative idea – until someone has a bad outcome because they weren’t able to get a timely appointment with the primary care doc. Then again, probably be a little more difficult to sue the state for implementing the policy.

Don’t try this at home. Woman shoots herself in arm so that she can get treatment in the emergency department for pre-existing shoulder pain.

Fill ‘er up. Downtown New York hospitals see spike in emergency department patient visits after St. Vincent’s hospital closure. One emergency physician at Beth Israel Hospital was handling 19 patients at the same time, stating that the scenario was “like a regular day.” Juggling 19 patients at the same time is an invitation to disaster. Try remembering 19 different patient histories, physical examinations, medication lists, sets of allergies, sets of lab tests, and then coming to a rational decision about each patient – all while being interrupted a few dozen times with questions about all the other patients. I work in an ED with 40 beds plus a lot of other hall beds and managing 19 patients – even with the help of residents – is crazy. The AAEM recommends a maximum of 2.5 patients per physician per hour in a moderate acuity emergency department.

Tort reform? Nah. Let’s just charge more for auto insurance and homeowners insurance to keep the only two malpractice insurers in New York from going bankrupt. As the two-year rate freeze on malpractice premiums is set to expire later this month, New York is having difficulty figuring out how to “reduce the bonanza trial lawyers get from the system.”

Bloggers have been screaming about it for years and now all of a sudden it’s on Washington’s mind. Washington spends a whole tenth of a percent of the yearly health care budget to encourage docs to go into primary care medicine, including spending $336,000 per physician to train an additional 500 primary care physicians over the next 5 years. Forget the fact that the American Academy of Family Physicians states that to meet the need for primary care physicians in 2020, the US would have to train 3,725 family physicians and 714 osteopathic physicians per year (or more than 22,000 primary care physicians in 5 years).
Oh and by the time those 500 primary care trainees are ready to see patients (4 years of medical school plus three years of residency), the whole health system will have collapsed.
But it was a nice thought.

Off duty cop storms hospital ICU and takes hostages, then announces “You can leave now. This was just a drill!” Whiskey Tango Foxtrot? Is it OK to point a gun at someone if it is “just a drill”? Last time I checked, that was called “assault with a deadly weapon” and was a crime. Next time why don’t you go try this at the police station … or the courthouse … or the airport … or the firing range? They need to have drills, too. [via GruntDoc]

And last but not least … if you want a positive spin on what’s going on in medicine right now, check out the Positive Medical Blog. Three great bloggers – Lockup Doc, Chrysalis Angel, and SeaSpray – have gotten together to start this new blog and I know that the posts will be a combination of information, inspiration, and fun.

5 Responses to “Healthcare Update — 06-18-2010”

  1. SeaSpray says:

    Thank you WhiteCoat – for your kind words ..and the link. :)

  2. Chrysalis says:

    I second Seaspray. Thank you, WC.

  3. RedRock says:

    In my neck of the woods the off duty cop would have immediately became a patient, someone carrying heat would have plugged him. If you pull a gun out here you better mean it.

  4. k says:

    There’s a “no wait” ED near me. It’s mostly “no wait” because a) it’s out of network for some big carriers, b) most of the good physicians and specialists work at the big well-known hospital nearby and c) most of those who do end up there don’t go voluntarily – certain towns transport 911 cases or Officer Not-So-Friendly drives you.

  5. [...] insurance to keep the only two malpractice insurers in New York from going bankrupt.” [White Coat; Greg Davis, Crain's New York [...]

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