WhiteCoat

Healthcare Update — 05-02-2011

First year medical student writes about what it is like to dissect cadavers in the anatomy lab.

Abuse-resistant form of oxycodone on the horizon? I give it a month before someone has figured out how to abuse it.

Emergency department access not the same as health care access. Here’s why. I disagree with some of the statements made, such as asthmatics can’t get prescription refills, but many of the other statements are true.

“No wrong should be without a remedy.” That is, unless you are a judge who plagiarizes 321 of 368 paragraphs of an opinion from an attorney’s brief in a medical malpractice case. The judicial misconduct caused a reversal of a plaintiff’s $5 million medical malpractice judgment.

Arizona gets federal approval to cut funding for catastrophically ill or injured patients. Up next for Arizona: Hospital stays capped at 25 days, limitations on emergency department visits, eliminating non-emergency transportation, mandatory co-pays for care and additional fees on patients who smoke, who are overweight, or who don’t comply with physician treatment plans.

Government considering “enormous” cuts in Medicare and Medicaid to save money. Good thing that health care reform plans to give millions of more patients “insurance” under those plans, isn’t it?

As Medicaid costs increase from $9 billion to $21 billion, Florida plans to funnel patients into HMOs. Now patients with serious illness no longer have access to specialists who refuse to participate in the program due to poor reimbursements. On the other hand, HMOs rely upon financial penalties to guide care. If you go out of network, you have to pay more. How exactly will Florida penalize indigent patients if the find an out of network physician to care for them or if the patients make inappropriate emergency department visits?

Got appendicitis? Meh. Take some antibiotics and see me in the morning. According to this study, in some cases it works.

Now Winnie the Pooh will be fighting off the dogs to see who gets to lick wounds first. Manuka honey helps to prevent many resistant bacterial infections by interfering with the bacteria’s ability to attach to tissues and by preventing bacteria from creating a protective biofilm.

Non-medical post of the week: Walter Olson at Overlawyered.com catches an article about how one lawyer worked 11 hours a day, 365 days per year for 4 straight years charging $925/hour so that he could bill more than $25 million in a class action settlement. I never appreciated how hard some lawyers work.

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20 Responses to “Healthcare Update — 05-02-2011”

  1. Gene says:

    I’m not sure about a new way to abuse the oxycodone, but I would bet that the number of people “allergic” to it skyrockets.

    • Dave says:

      So they made it hard to chew/taste bad. Couldn’t you just dissolve it in something? Even if they make it hard to dissolve in water crushing it up and throwing in some water/alcohol would probably do it.

      • RSDS says:

        And what are people unable to swallow pills supposed to do when they are in extreme pain?

    • Hueydoc says:

      They’ll smoke it, boil it out in their meth lab, etc….

    • DefendUSA says:

      Gee, Matt you never cease to amaze! I think the point was completely missed by you.

      I think WC meant that as a humorous look at something and you come back with some sort of “defense” and google search to show docs commit fraud?
      Good grief, I never would have guessed!! But, hey, I’ll play.

      Methinks when someone like you comes around and constantly berates and uses chest puffing to defend the profession for which you practice, then there must be some truth to the overall idea that a lawyer’s shi* doesn’t stink and therefore his services “worth” what is charged, even if it’s dishonest at times.

      Fraud is fraud No matter who commits it. I don’t believe I have ever seen WC not agree that the docs who are committing fraud shouldn’t be called out.

      Are all lawyers as child-like as you in your need to constantly prove that you are “right?” This seems to be a pattern with you.

    • Ed says:

      I expect that a “link off” battle looking a falsified billable hours and other crimes will not look good for lawyers.

      Nor does it pertain to the post.

      Que arrogant response in 3, 2, 1….

    • Matt says:

      Gotcha. Smart ass posts are only welcome when they’re directed at OTHER professions. Then they’re just lighthearted humor. If they’re about docs they’re unwarranted attacks.

      And no Ed, I don’t see that much good comes from the “no you’ve got more bad apples” argument. I think it engenders enmity where there should be unity. However you guys seem bent on it.

      • Ed says:

        don’t know which “guys” you are refering to. I am not a doctor, nor am I even remotely associated with the medical field.

        However, two doctors (maybe more) have saved my life, on two separate occasions.

        My dealings with lawyers cost me more per hour, and I netted much less in return. (never in a legal defense mode, either.)

      • doc99 says:

        Seriously, Matt and WC could take this act on the road. Think about it.

      • Hueydoc says:

        Only if it was a Death Match- and my money’s on WC !

    • WhiteCoat says:

      Gee. All the doctors got prosecuted and sent to prison for their fraud.
      The lawyer will get slapped on the wrist and only allowed to bill $15 million. Oh, the aaaaa-go-ny.

      See if you can rustle up some links about lawyers who have been sent to prison for overbilling, won’t you, Matt? I can find one case. The rest of the cases seem to be “bar probes” or clients suing to get their money back.

      Add the 0.2 hours for research time to my bill … unless you’re Dennis Gingold [the lawyer from the article]. Then you can add 4 days and six hours to my bill.

      • Matt says:

        The lawyer got his clients a $3.4 billion settlement. He’s now (apparently, because there’s no link to his affidavit) arguing with the defendants over the fees for a case he started 15 years ago against the most powerful defendant there is – the US govt.

        The doctors defrauded taxpayers only to their own benefit. Get the difference? Do you really think they’re comparable?

      • Matt says:

        “My dealings with lawyers cost me more per hour, and I netted much less in return. (never in a legal defense mode, either.)”

        So don’t hire them. Nothing prevents you from representing yourself.

      • Matt says:

        “See if you can rustle up some links about lawyers who have been sent to prison for overbilling, won’t you, Matt.”

        There won’t be many – I’m surprised you found one. Overbilling a client is generally not a criminal act, unless you’re overbilling the government. It’s typically a private civil action for fraud or breach of contract, and thus not punishable with jail time. As the government pays approximately 1/2 of all medical costs, it’s not surprising there are far, far more cases of physicians being prosecuted criminally.

        You continually fail to understand the difference between criminal and civil law.

      • Ed says:

        Represent yourself.
        Right.

        It would be feasible if the courts were not a lawyers fraternity.

        Tell you what. Next time you are sick. Heal yourself.

  2. Anonymous says:

    “Got appendicitis? Meh. Take some antibiotics and see me in the morning.”

    I thought I read here or somewhere else a couple months ago that dragging in sleep deprived surgeons increases the risk of an adverse outcome vs. waiting until morning to do the surgery.

    Re: Cadaver cutting
    Interesting though that it was written by a female. As a male, I know that I can separate emotions from what I’m doing…it’s just a job and it has to get done…fine by me.

  3. Hueydoc says:

    Thus the old joke about the lawyer that dies and actually goes to heaven. When he gets there, there is a huge crowd waiting for him. When he asks why, Saint Peter tells him “Not only do we rarely see a lawyer here, but never have we seen one that was 180 years old !”.
    The lawyer replies ” What ? I was only 68 years old when I died!”
    Saint Peters holds his chin and thinks , then says ” I guess we must have gone by the hours you billed for !”

  4. Pattie, RN says:

    WC…appreciate the medical news updates. I would never see most of these medico-legal updates due to my very full plate.

    Is there ANY way to get Matt to STFU??? Not because I disagree (which I do, frankly) but because he is bboooorrrrringggggggg, redundant, and contributes nothing to the conversation~no matter what the conversation is about!!!

  5. DensityDuck says:

    If you don’t want Matt around you could try not replying to him.

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