WhiteCoat

Healthcare Update — 12-02-2010

Also see the satellite edition of this week’s update over at ER Stories.

Problems with Canadian health systems getting worse.
“We’re trying to get a Size 13 foot into a Size 8 shoe.” Emergency department overcrowding increasing due to lack of available beds. The president of the Edmonton Emergency Physicians Association described the situation as a “potential catastrophic collapse” of emergency medicine. Edmonton plans to decrease hospital emergency department crowding by moving patients out of the emergency departments sooner once the hospitals meet certain criteria such as the ED being 110% full or there are more than 35% boarding patients in the emergency department.
Five times this past year, Dr. Raj Sherman’s 73-year-old father almost died after waiting hours on a stretcher in an ambulance parked outside the hospital waiting for a bed. As a parliamentary assistant on health, he decided he had had enough and blasted the government, the Alberta Health Services chairman, the former health minister, and Premier Ed Stelmach. As a result of his statements, he has been fired from his government position.

California emergency physicians sue to keep the state from cutting reimbursement – and win.

Medicaid insurance versus Medicaid access. Yes, they have insurance, but one patient had to drive 2.5 hours to see an orthopedist that would accept her insurance. He fitted her with a brace and sent the patient for physical therapy. Now the “insurance” won’t pay for the brace. Plans that are running Medicaid managed care plans are viewed as “managing costs, not managing the care.” When patients can’t get the care they need, where will they end up? Emergency department waiting rooms.

Six California hospitals fined because employees inappropriately accessed patients’ medical information. How do we change the system to prevent this from reoccurring?

Malpractice judgments and settlements in the news:
$16.2 million Chicago settlement for neurosurgical injury after patient sustains a brainstem herniation.
$6 million Wisconsin settlement in birth injury case where patient born with cerebral palsy.
Largest verdict in Belize history for child who was delivered 2 weeks early due to miscalculation in gestational age and premature Caesarian section.

Maine preparing to repeal its universal health care plan due to funding issues. The Governor elect states that the state has paid $160 million to cover 3,400 eligible residents. The outgoing governor disagrees with the numbers.

Girlvet has another intriguing post about those warning labels on cigarettes. If cigarette packs are required to have graphic pictures on them, why aren’t beer cans required to have graphic pictures of DWI accidents? Why doesn’t McDonalds have to put graphic pictures of obese people on their bags?

A real life “Catch Me If You Can.” Fake doctor works in Fayetteville, NC emergency department for 3 weeks before getting caught.

SWAT team descends on hospital as Florida gunman fires shots in hospital cafeteria and then barricades himself inside hospital room.

Canadian man has diabetic “seizure” while visiting his wife and newborn daughter. Instead of bringing him to the emergency department, the hospital calls an ambulance and paramedics bring the man to the emergency department where he is later released. Now there’s the little matter of that $400 ambulance fee that he’s being charged – even though he never set foot in an ambulance.

One reason that some medical providers are reluctant to disclose errors: 25% of patients stated that they would file a medical malpractice lawsuit if they were told about a medical error. Many actions considered “medical errors” have no effect on patient outcomes. Giving a medication five minutes after the time it was ordered is a medical “error”. Giving ice chips to a patient who is “NPO” is a medical “error.” Giving NSAIDs without checking a creatinine may be considered a medical “error.” Giving a patient medication to which the patient has claimed an “allergy” may be considered a medical error – even if that allergy is nausea. Heck, failing to disclose a medical error may be considered a medical error. Should there be full disclosure of even inconsequential errors? If so, how many professionals are going to want to practice under ubermicromanagement every day of their careers?

Odd news story of the week:
Hey doc – be careful of those sharp points on the fork. You could poke your eye out (remember the scene at the right from Dirty Rotten Scoundrels?) Doctor Arturo Carvajal is suing a restaurant because, after Dr. Carvajal ordered a grilled artichoke and was served a grilled artichoke, no one showed him how to eat the grilled artichoke. He ate the whole artichoke and later was found to have artichoke leaves lodged in his bowel. The restaurant’s lawyer issued a statement warning restaurant patrons not to eat the bones in the barbecue ribs – which I thought was pretty damn funny.
Even though the news article was dated November 19, Walter Olsen had the story published on his “Overlawyered” blog November 5. I just can’t beat him to the scoop on these stories.

7 Responses to “Healthcare Update — 12-02-2010”

  1. ERP says:

    I can’t get over that fake doctor bit.

  2. Anonymous says:

    If an error makes no difference in the outcome, then why not report it? Kinda hard to sue for a mistake that had no adverse outcomes.

    • DrMom says:

      Because then there can be scare tactic articles published with statistics (based on extrapolations) on how many errors those of us in medicine make.

  3. k says:

    I vote for gruesome pictures of
    drug addicts and ugly OD deaths on
    bottles of OxyContin and other
    drugseeker/”mix-them-up-in-a-bowl
    pill party” favorites.

  4. tracy says:

    Annnnd the guy who ate the whole artichoke is a Physican???? Sigh. i wonder how he made it through Med School.

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