See also the Satellite Edition of this week’s update over at ER Stories.
Hey … she had great Press Ganey scores, so who cares? Spanish woman with no medical training masquerades as emergency department physician for 5 months before being caught. See also a Google Translation of the Spanish newspaper article covering the story.
Drug seeking patients are getting trickier. Patient calls EMS and states that he was beaten with a bat. While in the ambulance, he grabs a syringe “containing a controlled substance” and sticks it in his pocket. When he gets to the hospital, a nurse finds the syringe and calls the po-lice. After an investigation, police determined that the whole call was a “ruse” to gain access to controlled substances in the in the ambulance. Never fear, though. The federal government is cracking down on fraudulent ambulance calls.
Obstetrician ordered to pay $3 million to patient born with cerebral palsy … 18 years ago.
Speaking about obstetrician/gynecologists, the $204,000 malpractice premium they have to pay every year on Long Island is driving many of them out of the baby delivering business. Now some New York counties have no obstetricians to deliver babies. Another example of the dilemma between perfect care and available care. Trying to sue your way to better health care may just leave you with no health care at all.
When you decrease reimbursements and have a bad reputation with malpractice reform, what happens? Just like the story above … doctors leave. New Jersey is expecting an increasing shortage of physicians in the next 9 years due to the poor reimbursement, high tax rates, and its “judicial hellhole” atmosphere.
Should every patient needing a gallbladder removal be required to have an intraoperative cholangiogram just to make sure which one is the hepatic duct and which one is the cystic duct? Doing so would add tremendous costs to every patient’s surgery, but would prevent malpractice lawsuits such as this one in which there was a $250,000 judgment against a surgeon. Issues like these are how defensive medicine is perpetuated. The complication may be quite uncommon (occurring in about 1 in 1000 cases), but if your patient suffers it, you will be sued, you will be made to look like a moron in front of a jury, and you will likely lose the case. What does everyone think? Is an intraoperative cholangiogram one of those “unnecessary” tests that doctors are just performing so that they can make more money?
Medicaid “ripe for slashing” in many states. Governors look to cut Medicaid services and decrease payments to providers in order to shore up state budget gaps. All those patients who are about to get Medicaid “insurance” are soon going to see first hand how Bernie Madoff made all his money.
It doesn’t just happen in the United States and Canada. Woman dies after waiting in an Italian emergency department for eight hours.
Ham on rye, hold the Mayo. Remember that interview President Obama did with Diane Sawyer on how the Mayo Clinic was an example of good care at a lower price? “[At] Mayo Clinic, … people … spend about 20-30 percent less than some other parts of the country, and yet have better outcomes.” Ask the insurers who actually pay for the care and you’ll find out that isn’t always the case. Routine obstetric care costs almost twice as much at Mayo than the median statewide payments in Minnesota. A colonoscopy costs more than double the state median at Mayo. Now insurers are making visits to the Mayo Clinic “out of network” so that the patients have to pay more money to go there.
I think that it is good that consumers must now become more educated about pricing and quality. Do you want to go out of network and pay more for “better quality” care at Mayo or would you rather pay less and go to a hospital that doesn’t have as good “quality” measures?
The problem is that we are spending a heck of a lot more money to purchase insurance policies, will soon be forced to do so, and the policies are likely to cover less and less care – or to make that care “out of network” so that consumers get a “double whammy” of higher insurance premiums and then increased “out of network” charges.
He gets an “A” for effort … and innovation. Insect flies into man’s ear and is flapping around next to his eardrum. First the man tries to get the insect out with a toothpick. Then he puts a vacuum cleaner up to his ear to see if he can suck the critter out. Eventually, he has to go to the emergency department.
Not that you should try to extract insects from your ear at home, but if the buzzing in your ear from the insect’s wings is driving you crazy (and it will), first you have to exterminate the insect. Stabbing it with a toothpick isn’t the way to go, either. When faced with attack, all the insect will do is lay larvae – which will eat their way into the skin in your inner ear and hatch.
Pour water into your ear canal and let the insect drown, first. Then go to your doctor to get it out.
By the way, I was kidding about the “larvae” thing. How many of you freaked when you read that one?
What a great post. Let’s call it “Exhibit A” to why we’re going to have single payer!
I especially love – NEW JERSEY EXPECTING A SHORTAGE OF PHYSICIANS IN 9 YEARS!! You’d think their lobbyists could have come up with a slightly more immediate scare tactic.
“but if your patient suffers it, you will be sued, you will be made to look like a moron in front of a jury, and you will likely lose the case. ”
This is an odd claim. Is any of it true? Is every physician whose patient suffers this sued? How often do they lose the case? I’ll be shocked if it turns out you have no clue about your claims, WC. Just shocked! But by all means, let’s second guess the jury because we read a press release.
With that 18 years later line, though, I realize you’ve become quite the lobbyist yourself. It sounds so shocking, UNTIL you realize that the statute of limitations for most minors is tolled until they reach the age of majority. What’s next – you going to object because contracts signed with minors aren’t always enforceable? Oh, the humanity!
Really, very funny post, WC. Exciting, light on facts, and inciting anger about things that are of minimal relevance to healthcare today, but maximum relevance to liability carriers. Keep up the good work.
“You’d think their lobbyists could have come up with a slightly more immediate scare tactic.”
Kind of like the feds predicting a “$10 billion savings over 10 years”?
“Let’s second guess the jury because we read a press release.”
One would think that attorneys fishing for more clients would publish facts that put their case in the best light. Besides, what did the jury have to decide? If you took the time to read the article instead of going into automatic “Mattuendo” mode, you’d see that the the surgeon admitted he made a mistake. It was the plaintiff attorneys who suggested that, to avoid the complication, doctors should perform an intraoperative cholangiogram. So you’re saying we should doubt the assertions of a plaintiff’s attorney? Blasphemy!
Decreasing availability of medical care, increasing defensive medicine, increasing costs of insurance. Sure sounds like “minimal relevance” to healthcare today to me. Your comments just show how little you know about the subject matter.
Reminds me of an old Frasier quote in a “Cheers” episode. “Hello in there … how are things in *your* little world?
The “feds”? Which ones? Yes, if only we could save $10 billion in 10 years. Healthcare spending for 2009 was $2.5 TRILLION. In one year alone. We can probably save $1 billion a year by cutting physician payments by the government 5% across the board, and we don’t have to impact constitutional rights!
“One would think that attorneys fishing for more clients would publish facts that put their case in the best light.”
One would think a physician wouldn’t make diagnoses based on the press releases of anyone, much less a law firm’s PR dept. But to be fair you’re not much of one for the facts when you reach conclusions.
“Decreasing availability of medical care, increasing defensive medicine, increasing costs of insurance. Sure sounds like “minimal relevance” to healthcare today to me.”
Everything physicians don’t like allegedly decreases availability. When we give you what you do like, it doesn’t change that fact. Poor rural areas are still underserved and rich urban areas aren’t. That’s been the case for decades. I’d say you are the one who doesn’t know much if you think otherwise.
And really with the defensive medicine? Still? Are you really trying to sell the “we need tort reform to lower defensive medicine” line? How many decades of evidence does it take for you to quit pushing that?
I’ll say this, in *your* little world, there’s a real fact deficit. But hey, at least you’re consistent. You got that going for you, which is nice.
“One would think a physician wouldn’t make diagnoses based on the press releases of anyone, much less a law firm’s PR dept.”
What’s the take home point, Matt? Who made diagnoses in the case? Fault was admitted. Did you even read the article? When is it OK to make any conclusions based on something that is published? Or do you just advocate putting everything to a vote of 12 jurors to come to a conclusion?
“Everything physicians don’t like allegedly decreases availability. When we give you what you do like, it doesn’t change that fact.”
As usual for you, short on facts, long on exaggeration and inflammatory language.
“Are you really trying to sell the “we need tort reform to lower defensive medicine” line?”
Nope. This whole shotgun lawsuit, hospital closing, doctors leaving judicial hellhole states is just a bunch of propaganda. We should just make everyone legally liable for everything because our system is working so well right now and all these other countries around the world are emulating it.
You did. You’ve concluded everything about this case and assume it’s wrong based on that article. What’s more, you followed it up with a ridiculously broad statement about how in every situation you will get sued. You just make stuff up.
When it is ok to reach a conclusion on a medical issue? I would think after you’ve seen the records. You know, the evidence. I realize that letting the facts drive the opinions as opposed to the other way around is out of favor these days, but I still think it’s the way to go. Don’t you?
“This whole shotgun lawsuit, hospital closing, doctors leaving judicial hellhole states is just a bunch of propaganda”
Except for hospitals closing, it is propaganda, at least on the level you claim. Just like it’s propaganda that physicians are paid way too much or that they’re all out there committing malpractice left and right and covering it up. I don’t buy it on either side. You only buy it on one, apparently. Do hospitals close? Yes. They do. They’re businesses, and businesses fail all the time. But they close in states with your “reform” and without it. They close for myriad reasons.
” We should just make everyone legally liable for everything because our system is working so well right now and all these other countries around the world are emulating it.”
That’s a cute tactic, but frankly, a little high schoolish. And really, you illustrate the problem. We don’t have a healthcare “system”, or if you’re a physician you shouldn’t want us to. Because a system means we only replace it with new “systems”, and systems are run by government for the most part.
You are an independent professional. You have a skill people will pay money to access. That’s what you should be starting with. Stop trying to fix “the system”. If it’s the legal system, you don’t understand it enough to do so. If it’s the healthcare system, you can’t fix it as one guy because there’s too much money at the top being made well over your head. If each of you front line physicians will take control of YOUR position, by remembering that you are a PROFESSIONAL service provider, we’ll be better off. You’re not a cog in the wheel. You’re someone with a valuable skill who many will pay for. Stop putting all these other people in between you and the person who wants your services. And stop trying to insulate your insurance carrier from your mistakes.
I also noted you didn’t get to the factual basis of this quote, which is typical of your hysterical, but fact light, claims:
“but if your patient suffers it, you will be sued, you will be made to look like a moron in front of a jury, and you will likely lose the case.”
Don’t forget, only 9 years to NEW JERSEY ARMAGEDDON!!!!* WE MEAN IT!!!**
*Potentially, maybe. If you accept all of our assumptions. And stop asking questions about what we mean by “shortage”.
**No, we don’t promise ARMAGEDDON!! will be averted if you give us liability protection. We want more money too. But that’s for later. We don’t want to overplay ARMAGEDDON!! now. Move along, Captain Inquisitive, this ain’t about the facts.
And seven counties in NY State still have no Obstetrician.
And? Are you arguing they are entitled to one? Vast parts of the rural west don’t have one either.
Are you guaranteeing us physicians if we give you something? Who is vowing to leave Manhattan for rural upstate New York if we give you what you want?
You want something – so what are you PROMISING in return? I look forward to your response.
NOT COOL with the insect joke!
Remember the episode of House that had the patient with the bug in his ear and he freaked out in the clinic lobby when it started biting his eardrum? That was the same time we had an earwig outbreak in our area. That year I learned that some earwigs HAVE WINGS AND CAN FLY.
I’m a smarter than average person and I sleep with a blanket over my head. Thanks for adding to my “bug eating your eardrum” nightmares.
How big was this guy’s ear canal that a *moth* could fly in there? I can envision a no-see-um making it in, but even mosquitoes find my ear canal a tad narrow for aerobatics. They love biting the ear, but I’ve never had one bite inside.
My recollection is that for a home remedy, mineral oil was preferred over water. Lie down on your side and have someone take a (needle-less) syringe and squirt a few cc of mineral oil into the canal. As long as you don’t have a perforated eardrum (and you probably know if you do), that oil isn’t going anywhere but back out, usually carrying the bug with it. In a pinch, olive oil will work too.
WC…yes, I admit it…I freaked. A totally ew! moment…and I should know better…
I got scabies from my sister at age 13 in the summer… and those little mites made me crazy with itching. To this day, I can feel when any bug is on me or near me. If a flea jumps onto my sock when I am outside…I. KNOW. IT. *CAN’T* STAND. IT.