WhiteCoat

Healthcare Update — 12-17-2010

See more medical news stories on the Satellite Edition over at ERP’s blog – ER Stories.

More violence against emergency department staff. Illinois nurse gets punched in the gut by an intoxicated patient. At least the police and hospital are prosecuting the schmuck. Because health care employees are a protected class of individuals, the criminal is now facing a felony charge.

Second Illinois schmuck is arrested for pushing police officers in emergency department, then trying to bite them, then kicking one of them several times, then trying to kick the windows out of a police cruiser.

Third Illinois schmuck arrested after “lunging” at physician treating his child then grabbing police officer who tried to restrain him.

More medical violence. California psychiatric hospital workers strangled. Another sustains four skull fractures from a patient who had just attacked a custodian. One psychiatrist at the hospital calls it a “culture of violence,” yet hospital police officers are prohibited from carrying firearms or Tasers. Wouldn’t it be interesting if judges and police forces had to live with the same rules imposed upon health care workers? Instead of JCAHO, ENTER JCALEO – the Joint Commission on Accreditation of Law Enforcement Organizations. Sorry, you can’t carry guns. Much too dangerous. First you have to try verbal de-escalation of the whackball who’s running at you with a machete. If milk and cookies don’t calm him down, then – and ONLY then – can you institute the LEAST RESTRICTIVE form of restraint possible. And you have to fill out 17 pieces of paper in triplicate and check on him every 15 minutes to make sure he isn’t hungry, doesn’t need to use the bathroom, and all his other creature comforts are met.

$20 million liposuction medical malpractice judgment upheld in Pennsylvania.

The University of Chicago is back in the news after having the highest rate of going on ambulance bypass in the state of Illinois. The article states that University of Chicago diverted ambulances for 1,764 hours between Jan 1 and Nov 30 this year, adding up to being on ambulance bypass 22% of all available hours. The runner up was Christ Hospital in the South Chicago suburbs that was on bypass for 706 hours or about 9% of the time. Most of the other Illinois hospitals had bypass rates of less than one percent. The article describes how many patients – even those with insurance – wait 24 hours or more to get a hospital bed.
Only two hospitals in NorthWest Illinois went on diversion at all and those hospitals were on diversion for 12 and 17 hours respectively.

Excellent article in the Flagler College newspaper about how the health care plan will affect access to care. According to proponents of the Obama plan, such as US Senators Tom Coburn, MD (a family practitioner) and John Barrasso, MD (an orthopedist), patients only go to the ED because federal law requires that they receive treatment there. Insurance expansion will allegedly decrease waiting times and tame overflow.” If these forward-thinking representatives of ours took some time out of their day to actually talk to patients who already have the insurance they’re pushing, they would see that expanding insurance will only increase the strains on the emergency departments because there are few if any community physicians willing to put up with the byzantine rules and low reimbursement from government insurance. The article gives a couple of examples about how the current system has already played out with a couple of patients.
Get ready for a ride, folks. Then again, Dr. Barrasso was a rodeo doctor, so he’s had some practice already.

Patient pens letter of complaint to newspaper because some “barely understandable … foreign doctor” comes to take care of his wife after a knee operation rather than their own family physician. Medical care is becoming “too impersonal,” he writes.
Sorry to burst your bubble, sir, but the Marcus Welby days are long gone. Patients now drop their physicians like they drop garbage in the trash any time their insurance changes. If you go to a university hospital, the doctor that spends the most time with you will probably be a resident. Once that resident graduates, you’ll get a different doctor. And the insurance that you have pays a pittance for providing care to patients in hospitals and it doesn’t compensate your doctor for time away from his practice or for all the phone calls he gets in the middle of the night. Office-based physicians have less and less incentive to take care of their patients in the hospital.
We reap what we sow.

Let the patient die or you will no longer be considered a Catholic hospital. A pregnant woman at St. Joseph’s Hospital in Phoenix was diagnosed with pulmonary hypertension. Pregnancy makes the condition worse, and may cause maternal death. Physicians consulted a member of the hospital’s ethics committee and then terminated the pregnancy. Bishop Thomas Olmstead demanded that the hospital repent for this “grave scandal to the Christian faithful,” and if it did not meet his many other demands, threatened to suspend his endorsement of the hospital and warn the members of the diocese that the hospital no longer qualifies as a “Catholic” hospital.

6 Responses to “Healthcare Update — 12-17-2010”

  1. Tracy2 says:

    I’ve been to University of Chicago’s ER. Huge medical center – small ED. I’m not surprised. I don’t think emergency care is really what they want to do. I’d have hated to have been waiting in that teeny tiny waiting room – my family member had an emergency in one of their physicians office, was brought straight back. They have this little waiting room, with two desks right there by the door for triage – no screen or anything. Very hospitable – not.

    The rest of what they do – the specialists – wasn’t our best experience. Surprised me, they have a great rep. Perhaps we just had bad luck.

  2. k says:

    UCMC has been in the news regarding diversions, but IMHO, you shouldn’t pick on Christ Hospital much, they get a lot of GSW and similar from the South Side.

    As for the incidents reported against ED personnel -i would attribute that to the outflow of population from this high-unemployment state, along aka “no idiots left behind”.

    Just sayin’.

  3. throckmorton says:

    Hmm. I seem to recal that there was a VP of the U of C hospital systems that helped set up a program where they could decrease their ED size, encourage patients to go instead to “community health centers” that did not exist. Seems to me, the VP had a publicist to help with the whole thing. I think, yeah, Axelrod was his name. Oh, her husband had something to do with the government. Anyway, if let the U of C not have to see so many poor, underserved patients of the great city for which it shared its name.

    • throckmorton says:

      Oh, I forgot to mention. She got a huge raise and a bonus becuase she cut the losses of the ED department. They would put people in cabs and send them accross town to Cook County so that they would not have to see them. When the “patient dumping investigation came” the Federal Attorney who now has a high place in the Presidents Administration dropped the case.

  4. maureen says:

    Yikes, Illinois got a lot of coverage today on your blog today! I have been in the ER at Hinsdale Hospital a few times. It’s never been really overcrowded and it’s clean and orderly. They seem to run a top-notch ship there. The few times I was there I was brought by ambulance, which most of the time means you usually get right into a room in the ER. I was headed into an Addision crisis, but I came very prepared with all my medical info/meds/doctors names etc. It was as if they breathed a sigh of relief to have a patient that wasn’t using them in place of going to their own doctor. Univ of Chicago hospital is HUGE and like Tracey2 said they aren’t interested in ER nightmares. I used to get lost when I went there to see my endocrinologist….it is a speciality hospital, not an ER in my opinion. High ER waits are because of the knucklheads that bring their kids there because of an earache, or who fell down and hurt their ankle last week. I often feel that I don’t even belong in an ER during a crisis. I increase my meds, give myself a good shot of Solu-Medrol and wait it out. Then if I finally do decide to go, the ER staff is bogged down by people who don’t even belong there. My son is a Firefighter in a town that brings their wounded to Christ Hospital. It is like an inner-city hospital and they are often on by-pass. I wouldn’t take my Addisonian Butt there ever….let them care for the GSW, burn victims, car crashes and all that gory stuff.
    I enjoy your blog.
    mo

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