WhiteCoat

Healthcare Updates — 12-31-2010

See more health care news at the satellite edition of this update over at ER Stories.net.

Providing free medical care when a mistake occurs. The hospital doesn’t just compensate the patient for his injuries – it writes off the entire hospitalization. I think we ought to do this for every industry. Restaurant screws up my order, I want the whole meal free – including drinks and dessert. And the restaurant owner pays for the waiter’s tip. Grocery store misprices an item, I want my whole order free. Worker comes to work late, employer doesn’t have to pay them for the entire day. Lawyer screws up a motion, the whole case should be free. This is how business ought to be.

Just because the sign says “urgent care center” doesn’t mean that you won’t get billed like you went to the emergency department.

I’ll be back …. Ticked off patient leaves British Columbia emergency department after waiting for 45 minutes then returns and drives his Chevy Blazer through the front door.

Jury awards couple $2 million for delay in cancer diagnosis.

$7 million judgment against hospital and surgeons after delay in diagnosis of postoperative cardiac tamponade.

Note to dimwit would-be robbers: If you beat one of your victims while trying to steal her purse and dislocate your shoulder in the process, it would probably be a good idea NOT to go to the closest emergency department for treatment. The victim just might just go there for treatment and recognize you from the waiting room.

Survival by deception. Parents get their kids labeled with psychiatric disorders and then medicate them so that the parents can make $700 per month in SSI payments. Nice. Parents should have their kids taken away from them and should be permanently banned from public assistance if this happens. And the doctors that create these bogus diagnoses or prescribe medications when the children don’t meet criteria for the diseases should have their licenses stripped.

Government insurance isn’t working so well for West Virginia hospitals. Appalachian Regional Healthcare system is suing the WV Department of Health because Medicaid payments are less than the cost of providing care. Without the added payments, the hospital says that it may not be able to provide services to all its patients.

Should a law requiring that everyone purchase health “insurance” be considered “necessary and proper” for Congress to carry out its responsibilities? That appears to be the $64,000 question in the mounting legal challenge to Obamacare.

Child of star from “16 and Pregnant” ends up in emergency department after hitting her head on fireplace and sustaining a “gash.” Doctors glued her scalp back together. Wait a minute. There’s a TV show that makes “stars” out of 16 year olds who get pregnant? What has our society become?

Remember my post in July (also featured over at Kevin MD) about how Medicare patients are getting stuck with huge bills because they’re being admitted for “observation” status rather than a full admission? Welcome to the newest method by which the feds are pushing hospitals to classify more and more people as “observation” patients. The feds just settled for $3.2 million dollars with a hospital in Pennsylvania after the hospital discovered that it “billed Medicare for more expensive one-day hospital admissions on an unspecified number of occasions when it should have billed for observations or outpatient visits.” From experience, the determination of “observation” versus “inpatient” status is often arbitrary. Now hospitals will be more likely to err on the “observation” status — which means that Medicare patients will get even more of the shaft.

13 Responses to “Healthcare Updates — 12-31-2010”

  1. hannah says:

    Yeah, but if the restaurant screws up your order or you get mis-charged at the grocery store, it won’t cause you to go into cardiac arrest.

  2. Steve says:

    Re: the urgent care article

    So the article suggests that a receptionist should give advice over the phone as to whether the patient should come to urgent care vs. the ED? What happens when this same receptionist mis-triages a patient and a bad outcome happens?

    I don’t know why people would think to expect a lower charge from an urgent care center- you a getting what you pay for- an unscheduled visit during regular/off hours (or 24/7) to see a doctor/midlevel provider at a place with more resources than your average outpatient doctor’s office. Whether that happens at an ED or “urgent care” the actual service is still the same. Get over it.

    • MV says:

      I would expect a lower charge from an urgent care center because in my experience they charge less than a typical doctor visit (total charge). And they may or may not have more services than my regular doctor office. They don’t provide ongoing care and they certainly don’t provide the level of services of an ED.

      While I consider my local hospital (level 4 trauma center) to be not much greater than a glorified urgent care center in practice, they can at least justify the additional charges. But if you are going to charge ED prices at urgent care, people are going to go to the hospital for “better” but unneeded care. And we know how emergency physicians whine when patients do that.

  3. Steve says:

    From one of the malpractice articles. It made me want to vomit…

    “About Pegalis and Erickson: Pegalis & Erickson, LLC is a Long Island based firm dedicated to representing individuals or their families that have been seriously injured as a result of medical malpractice, negligence and failure to diagnose. A voice and advocate for medical patient safety our core philosophy is to represent injured patients while helping to suppress the actions of careless medical practices by way of instituting accountability to parties responsible in the blatant disregard of medical safety procedures that have impacted lives.”

    Awesome…

  4. jillian says:

    Have you ever -seen- “16 and pregnant”? It’s basically about how much it sucks to be 16 and pregnant. Not a glorification at all.

  5. DefendUSA says:

    Society has begun to accept behaviors that used to be considered taboo. Not only has teen pregnancy being tolerated, no one blinks at the mention of it. Things that were once considered immoral are now being accepted without question and it’s a sad commentary. I could make a long list, no doubt. And it is a shame.

  6. Joe says:

    If a restaurant screws up my order to the point of almost killing me, they damn well better comp my drinks and dessert. I think you chose your analogy poorly.

    • WhiteCoat says:

      First of all, if a restaurant “almost kills you” then you either will be taken away by ambulance and won’t be finishing your meal or you won’t be able to prove it because you have the reaction a day or so later. Don’t plan on creme brulee and a Grand Mariner on the house.

      But let’s say that the potential for a near-death experience is sufficient to require overpayment for damages.

      The blown tire in my car “almost killed me.” I want a new car.

      The employee at work didn’t put the box on the shelf correctly and it injured my foot and just missed my head. It almost killed me. He shouldn’t be paid for the whole week. I should be paid double time for my injuries.

      That moron driver hit my car and almost killed me. He should have to pay for an entire new car, all my time dealing with the insurance companies, and even the fear that I felt, plus a few months of my car payments – just for my troubles.

      I could go on and on.

      Injured parties should be compensated fairly, not overcompensated. Overcompensation will invariably lead to an increase in claims.

      If that’s the way that society is going, so be it. But if we’re going to establish a precedent of overcompensating those who receive medical services, we damn well better be overcompensating everyone else as well.

      • WarmSocks says:

        That moron driver hit my car and almost killed me. He should have to pay for an entire new car, all my time dealing with the insurance companies, and even the fear that I felt, plus a few months of my car payments – just for my troubles.

        That already happens. New car, all medical bills paid, counseling if needed, and a hefty settlement, too.

      • Joe says:

        “…will be taken away by ambulance and won’t be finishing your meal…”

        Hey, it was your bad analogy, not mine.

        But I hope we can both agree that the waiter shouldn’t be showing up at your hospital bed with your bill.

        I agree with your broader point that we shouldn’t require overcompensation for injuries. If the cost of the surgery was in fact substantially greater than the harm the patient suffered, then I too would question the hospital’s action. But it seems likely that the opposite was the case. And in that case, I would commend both the hospital and the patient for responding to the situation in a humane and mature fashion.

        And for keeping the lawyers out of it.

  7. joe2 says:

    Re: Med mal 2 million verdict.

    But St. Vincent Hospital did not immediately send the biopsy slides and blocks to Massachusetts General Hospital, delaying his treatment, according to Jeffrey S. Raphaelson, the couple’s lawyer.

    Mr. Ginisi was transferred to the Boston hospital on March 2, 2004. The hospital received the slides and blocks on March 5. His treatment began on March 8, court records said.

    Wow, now that is just plain scary. Expecting chemotherapy (or radiotherapy) to have an immediate effect in this setting shows:
    a: the lack of knowledge here as to the time of action of these modalities
    b: the expectation that results will be immeidate and if it is not, it is a malpractice suit.

    But hey, I am just an oncologist. I am sure a lawyer knows more about my field than I do.

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