Speaking about JCAHO, they’re now telling patients that they better “speak up” about falls. Are they branching out into the home safety business, too? Do things like keeping lights on in your house all the time. Put non-slip decals on steps so you can catch your foot and trip over them. Avoid getting old so you won’t lose your balance. If you’re in the hospital, make sure you use the call bell every time you want to get out of bed – don’t do that and your fall is your own fault. If you’re at home and you don’t have a call bell … looks like you’re out of luck.
Better watch it or they’ll decredential you as a patient.

We don’t care if you are an emergency department – we’re not stopping. Ambulance service refuses to bring patients to newly-established free standing emergency department because it isn’t attached to a hospital.

Hospital guarantees fast and comprehensive care. Using the “pick any two” theorem, what do you think the cost will be?
With these “see a physician in 5 minutes or less guarantees” – does the public realize what they often involve? I haven’t worked at a hospital with such a guarantee, but one of my friends formerly worked in one (before leaving due to issues that the whole department was having with hospital administration). She told me that they were required to “pop their head in the room” as soon as any patient showed up and say “Glad to meet you. I’m Dr. QuickSee. I’ll be with you as soon as I can.” There. You’ve officially seen a physician. If Dr. QuickSee can’t make it there within five minutes, the patient gets two free discount movie tickets. Other people have different experiences?

Medical devices injure more than 70,000 kids each year. Common problems included puncture wounds from hypodermic needles breaking off in the skin while injecting medicine or illegal drugs; infections in young children with ear tubes; and skin tears from pelvic devices used during gynecological exams in teen girls. You’ll never guess what the most frequent offending medical device is. Hint: Kids frequently put it in their mouth before using it – something that thoroughly grosses me out.

That videotaping patients thing I keep talking about … it’s coming. The report may be biased because the information is coming from the CEO of a company that manufactures such video cameras, but allegedly some insurance companies are considering whether to refuse malpractice coverage for certain high-risk surgical procedures unless doctors videotape the procedure. Alternatively, surgeons who document their surgeries on video may get lower insurance premiums. I found one article in which the Rhode Island Health Department required a hospital to audio and video record all surgeries for one year after several wrong site surgeries occurred. Also see this discussion over at Kevin’s blog about whether surgeons would be willing to operate under these “Big Brotheresque” conditions.
If malpractice insurance companies won’t cover certain high-risk surgical procedures, guess how many physicians will perform these high-risk procedures. All of you that said “none” – pat yourself on the backs. For all of you that think – “I’ll just go to the emergency department and they’ll have to do the procedure,” think again. If the surgical procedures aren’t emergencies, you’ll get sent home with a list of surgeons to contact. If the surgeries are emergencies and the surgeons don’t want to perform those types of procedures, they’ll just drop their hospital privileges for performing those procedures. Like a lot of neurosurgeons drop privileges for performing brain surgery because of increased liability. Then you get to enjoy the ever-increasing waits to get transferred to a hospital that does perform the procedure you need.

I got your package for ya. Man gets vacation in detention center after yelling obscenities at emergency department staff, then partially disrobing and “performing a lewd act“. I can only imagine what that involved.

Also see more news tidbits from around the web on the Satellite Edition over at ER Stories.

Rome, GA woman is arrested after police find her on top of another patient in a dark emergency department room … throwing punches. After being seen yelling profanities at the patient, the perpetrator told law enforcement that she passed out and didn’t know what she was doing. Good answer.

You can only go to the doctor whose next appointment is in six months and the hospital that has a reputation for maiming patients. Otherwise you pay full price. Insurance companies are testing out programs that limit what hospitals and doctors a patient may see. If patients go outside the network, they pay full price for the care. One insurance executive was quoted as saying “We think it’s going to grow to be quite a hit over the next few years.” Just like HMOs were a hit in the 90′s, huh?

The insurance mandate IS NOT a tax … OK, we lied. Last September, Obama was quoted as saying that “For us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase.” In recent court briefs defending the health care law against lawsuits from 20 states, the Obama administration now admits that “the requirement for people to carry insurance or pay the penalty is “a valid exercise” of Congress’s power to impose taxes.” Change you can believe in, baby.

Charity medical care in Utah hospitals drops by 40% in 2008. I’m sure that the numbers are worse in 2009 and 2010.

The Mike Royko approach. Don’t want to pay the overpaid sawbones? “Just have the kid the old-fashioned way. Squat and do it. And if it survives, you can go to the library and find a book on how to give it its shots.” Some people are actually doing that. Only they’re going to YouTube and not to the library to learn how to drain abscesses, remove warts, and … have home births. Only problem is that things don’t always turn out as planned. The article highlights this case in which a 14-year-old girl in Texas was charged in relation to the death of her newborn boy after she and her 11 year old sister learned how to deliver babies on YouTube.

Here’s a news release to slip under the hospital CEO’s door … After several injuries to hospital staff, OSHA fines Danbury Hospital for failing to provide adequate workplace violence safeguards. Does this mean that our 75 year old security guard with the bad back can finally get a TASER? Hat tip to the ageless GruntDoc.

Blacks, Hispanics, and Asians all tend to think that doctors of their same race or ethnicity provide better medical care. Unfortunately if they go to the emergency departments, they have a 4 in 5 chance of being disappointed. 80% of the emergency physicians in the US are white.

It’s a trust fund, not a piggy bank. Wisconsin Supreme Court rules that state has to pay back $200 million it “borrowed” from the trust fund physicians created to compensate medical malpractice victims. With only $45 million left in state budget reserves, the state budget just became a much deeper shade of red.
Here’s an idea. Why don’t Wisconsin residents force the state to sell off its assets to balance the budget? State parks and other state land. State office buildings. State vehicles. If you owe taxes, the state and federal government will force a sale of your assets to pay your debts.
Wisconsin has a projected budget shortfall of $2.5 billion for next fiscal year. I’m sure that the state has more than $2.5 billion in assets. Fork ‘em over.
Anyone want to go in halfsies on a Wisconsin State Police cruiser for those vacations in the Dells?

Dengue … Dengue very much. Dengue Fever getting a foothold in the Florida Keys. One of the first patients to be diagnosed with the disease (after multiple doctor visits) describes her symptoms. “My head hurt so bad that I wouldn’t wish it on my worst enemy.” “Your bones just hurt. That’s why it’s called breakbone disease. It’s indescribable. I can’t even articulate the crazy pain that you’re in. You feel like you’re heavy and out of your body.” Twenty eight cases of Dengue Fever have been confirmed in Key West and about 5 percent of the local population may have been exposed to the disease.

Tennessee emergency department closing after being projected to lose $1 million this year. Urgent care center taking its place. Now patients with emergency conditions will have to add 40 minutes to the trips they take to see a doctor. The local EMS director estimates that each emergency call will now take a total of 2 hours. A major accident in that town will have disastrous consequences.

Press Ganey survey data from them shows that the average time a patient spends in an emergency department visit across the United States was more than 4 hours. Utah patients spent an average of eight hours and 17 minutes per visit while only Iowa and South Dakota were able to break the three hour wait mark.
By the way, did you know that some hospitals/systems pay Press Ganey well more than $100,000 per year to perform these surveys and compile the data? Or that Press Ganey partners with more than 40% of the hospitals in the US?

Some people are starting to get the whole insurance/access disconnect. Arkansas Surgeon General is concerned that adding another 400,000 patients to the ranks of Arkansas’ Medicaid program will worsen the state’s doctor shortage. “We’re going to have to better organize our system so we have access and availability. Otherwise, we’ll have financial coverage but no accessibility.” Exactamundo. Unfortunately, organizing a system won’t do much if you don’t have enough medical personnel providing care.