Also see the satellite edition of this week’s update over at ER Stories. While ERP is on vacation, I’ll try to do double duty and post on both blogs this week.
They’re already starting to itch. Drug seeking patients will soon have a new medication to add to their list of allergies … and/or medications that “don’t work on me”: Intravenous Tylenol.
US Supreme Court to decide whether California will be allowed to cut access to care, er, um, cut payments to providers and still remain in compliance with federal Medicaid laws. Twenty two other states have joined California in its appeal, meaning that about half of the people with government health “insurance” – and those about to be forced to purchase insurance under the new health care plan – will have one heck of a hard time finding access to medical care.
In another story on the topic, Arizona is looking to drop more than a quarter million patients from its Medicaid “insurance” plan. Twenty nine state governors have signed a letter to President Obama requesting a change in the law to permit the states to tighten Medicaid requirements. Arizona is pushing the envelope by making the formal request directly to Kathleen Sebelius and “daring” her to refuse it.
You’ll get faster attention all right – from men with bigger guns than yours. Twenty four year old patient walks into hospital emergency department and demands faster treatment for his condition or else he’ll start shooting up the place. Instead, he gets a free trip to the Greybar Motel.
Disincentive to seeking help for psych problems in North Carolina emergency departments – you’ll have to spend an average of 3-4 days in the emergency department before you find placement. You read that right – three to four days. Biggest problem: Few states want to pay for funding for psychiatric care. Next biggest problem: Mentally ill patients are less likely to vote.
Then again, if you go to an emergency department seeking psych care and say you want to kill your pastor, you can always sue the hospital and psychiatrists when they involuntarily commit you. In this case, the plaintiff’s psychiatric patient’s expert stated that the patient should just have been given anti anxiety medications instead of being committed because she didn’t have a “plan” to kill the pastor.
Another example of how physicians are damned if they do and damned if they don’t. If you don’t commit a patient who threatens homicide, then you’re sued if the patient goes out and kills someone. If you do commit the patient, you’re sued for unlawfully committing the patient. No matter what happens, plaintiff attorneys will always be able to find some purported expert to testify that what you did was wrong.
Two interesting factiods from Physician’s Practice Magazine
First is commentary about the “Twinkie Diet” – which I hadn’t heard about before reading the article. See more here. A professor of nutrition at Kansas State University ate mostly “convenience store food” for two months – in addition to vitamins, a protein shake, and a can of vegetables per day. At the end of the month, he had lost 27 pounds. Not only did his weight go down, but, his LDL (bad cholesterol) dropped, his HDL (good cholesterol) increased and his triglycerides dropped by 39%. On Twinkies and Doritos! Once he started eating meat, his cholesterol went back up. I think that’s pretty compelling evidence in favor of the intake/output argument for weight control.
Next is the study showing that the screen on that iPhone of yours has 18 times as many bacteria than the handle of a toilet in a men’s restroom. Wonder how it compares to the toilet seat. Maybe we all should start putting toilet paper over the iPhones before we touch them.
Speaking about germs … stay off of public transportation during flu season. You’re six times as likely to get a respiratory infection that requires a doctor visit.
Which emergency department has the longest wait? Pennsylvania hospitals are starting to compare waiting times for hospitals. For example, Tenet Healthcare Corporation is posting wait times for 40 of its 49 hospitals. Can anyone guess what will happen when hospitals compete to see who has the shortest wait times? Remember the engineer’s triangle: Fast care, free care, quality care: Pick any two. Plaintiff’s attorneys are going to love this …
Harbor-UCLA Medical Center settles case for $1.175 million after catheter inserted into trauma patient “accidentally punctures a vessel wall.” Details of the case aren’t provided except for the fact that the patient left the hospital after a few days. If this case revolves around accidental arterial puncture when inserting a central venous catheter, depending on the location site, arterial punctures are a known complication of catheter insertions.
It’s not enough that some patients assault staff in the emergency department. Now patients are planting fake bombs in emergency department bathrooms.