WhiteCoat

Healthcare Update — 06-06-2011

More news stories from around the web at this week’s Satellite Edition over at ER Stories.net.

Cell phones will really kill ya. If they don’t cause brain cancer from the radiation, those used in the hospitals are twice as likely to be full of deadly bacteria.

$7 million verdict against surgeons when patient develops sepsis and dies from bowel injury after hysterectomy.

More patients gone wild. Texas patient shouts obscenities at medical staff then kicks physician in stomach. Then he is wheeled out of emergency department on stretcher and thrown in police car.

Judge Greg Mathis – yes THAT Judge Greg Mathis – weighs in on the importance of keeping emergency departments open.

Lawn mowers are not kiddie rides. Just ask this 4 year old victim.

Insurers pay some hospitals in Massachusetts half of what they pay other hospitals for performing the same procedures. Aaaand … Massachusetts insurance premiums increased 5% to 10% per year while patients received less services, paid higher copayments and paid higher deductibles.

I’m pro-vaccination, but if you got your flu shot last year, you may not need another one this year – it’s the same vaccine. Despite this, manufacturers plan to create record numbers of vaccination doses this year.

Does your child have asthma that is difficult to treat? It could be a food allergy instead. Food allergies found in 4% of general population but in 28% of kids with poorly-controlled asthma.

Great idea. Insurance companies are currently statutorily exempt from government antitrust rules, meaning that they can legally “collude to drive up prices, limit competition, conspire to underpay doctors and hospitals, and price gouge consumers.” Rep. Peter DeFazio from Oregon aims to change that. He has introduced a bill to strip insurance companies of their antitrust exemptions.

Medicare reimbursements per enrollee actually increased after tort reform in Texas. Therefore, tort reform is the antithesis of cost control. Right?

Johns Hopkins researchers show that 71% of kids with mental health problems who visit the emergency department already have a mental health provider. So what? Most patients I see in the emergency department already have a primary care physician as well. In fact, many times the patients are actually sent to the emergency department by their primary care physician.
The researchers noted that most of the patients are African American (80%) and are on Medicaid (82%) and that most visits were for “relatively minor problems such as disruptive behavior at school, fighting with siblings or running away.” The study also showed that 11% of kids who visited the emergency department for mental health problems (338 of 2903 patients) were back in the emergency department within 6 months. The researchers concluded from their study that there were “questions about the views of families and providers about the need for emergency services.
If they had those questions, then why didn’t they interview the families and providers about their views during the study?

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12 Responses to “Healthcare Update — 06-06-2011”

  1. KT says:

    Patients who are abusive SHOULD be kicked out. I heard a rumour my workplace has done it in the past, I don’t know how much truth is in that rumour. I know I’ve told patients that their language/behaviour is unacceptable in our hospital and walked away until they’ve calmed down.

    Would you believe that mental health is the least abusive/aggressive place I’ve ever worked!

  2. ERP says:

    One day it is my hope that when I get assaulted at work (It will happen eventually I’m sure), it is from a drunk rich person and I can hire Matt to sue his ass.

  3. Pudortu says:

    Are we allowed to sue patients that hurt us? Matt, take a step back from your usual talks an educate us please.

    • WhiteCoat says:

      Anyone is absolutely permitted to sue someone for damages if that person injures them. The injured party would be entitled to damages such as medical bills, lost wages, pain and suffering, etc.
      Some violations of criminal statutes (assault/battery/false imprisonment, etc) can also be prosecuted criminally and result in jail time — if the DA will take the case.

    • Matt says:

      Why wouldn’t you be? For some reason in the back of my brain I think there are statutes that prevent law enforcement officers and the like from suing in the event of violence during an arrest or something like that, but don’t hold me to that.

  4. jamjar says:

    I once had an elderly patient (72 yo) stab me in the abdomen with a switchblade brought in by his wife. My immediate response was to slug the guy in the nose, knocking him to the floor. I then called both hospital security and the police. The patient and his spouse threatened to sue me for assault. I countered with the threat of a suit for attempted murder. The patient was discharged in the custody of the police. The hospital, a closed system HMO, terminated his membership.
    No one should have to tolerate assault of any kind. There is never an excuse for this!

  5. Shah says:

    Jamjar, I would have sued him. People like that dont need to be on the streets.

    • Ed says:

      Unfortunately most of the detritus that pull these stunts are poverty level already. One cannot get blood from a turnip.

  6. Small quibble: as far as insurance companies go, I’m pretty sure that they are subject to antitrust regulation, but at the state not federal level. Not to get into the competing merits of state vs. federal regulation of that sort of thing, but it’s not entirely accurate to say that they’re entirely exempt. Fazio’s rhetoric seems a little overblown, if understandably so.

    • WhiteCoat says:

      Many state laws parallel their federal counterparts. For example, Massachusetts’ antitrust laws exempt any activities “which are exempt from federal antitrust laws.”
      Are you aware of any states to which the exemptions do not apply?

      • Being a mere, insigificant, ignorant first year medical student, I probably shouldn’t even try to answer. Un/fortunately, there is no adult supervision around me at the moment. :)

        I would imagine that as in most states, insurance is subject to a great deal of special and heavy (relative to ”business” in general) regulation from the state department of insurance (or whatever it may be called). I would imagine that the exemption covered in (b) would be more applicable, but the thought would be that the state insurance regulator would cover antitrust issues as needed.

        Poking around some more online, it looks like McCarran-Ferguson has some carveouts for activity that continues to be regulated federally (boycott, coercion, intimidation, etc.). It also seems to provide for federal regulation where there exists none at the state level.

  7. Ben S says:

    http://www.courthousenews.com/2011/06/08/37186.htm

    “So hypothetically speaking, are there any containers currently in your house that would explode if they caught on fire?”

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