WhiteCoat

Healthcare Update — 06-27-2012

Supreme Court prediction: Individual mandate unconstitutional. Remainder of law stands. Both parties declare victory. Then we have to put up with talking heads putting their spin on the decision for the next two weeks.

Beware what you write online … they’re watching. Study published in Emergency Medicine Journal analyzes the Twitter accounts of emergency physicians and determines that there is a “small inner network” of emergency physicians that are using Twitter to its full potential … whatever that means.

Use of electronic medical records associated with sixfold drop in medical malpractice claims? I call bullshit on that one. Electronic medical records have been around for many years and the incidence of medical malpractice claims has dropped by about half in the past 10 years. Even if we attributed all of the decrease to electronic medical record use and none to tort reform efforts, that still doesn’t bear out the numbers in this study. Does it make any difference that the study was funded by a grant from the Agency for Healthcare Research and Quality?

Dad upset because cost for four stitches in his son’s head at a specialty children’s hospital was twice as much as the cost for 12 stitches in dad’s leg. Hospital CEO attempts to justify cost by saying that is more costly to keep pediatric specialists at the hospital 24/7. Another example of why we need disclosure in costs associated with medical care. Dad may have made an informed decision to go elsewhere had he known the expense would be so much greater.

Elderly patient with arm fracture refused admission at hospital, then goes home and develops pneumonia. Patient’s family thought she should have been admitted in the first place. One writes letter to editor of newspaper … in Florida … stating that “the ER staff is a hassled, overworked lot that moves at a snail’s pace and the ER specialists seem oblivious to ailments except with the most urgent trauma.”

Washington State hospital plans to save $1 million per year by turning its 24 hour/day emergency department into a 12 hour/day walk in clinic. In other words, a lot of people who don’t have a means to pay for their care are going to soon be sent somewhere else.

Jury awards family $55 million after finding that doctors at Johns Hopkins Hospital waited too long to perform a Caesarian section on a pregnant woman. Midwife was at patient’s home trying to deliver child when baby became “stuck”. Hospital allegedly delayed C-section for 2 hours.

If you don’t like shots and have ulcers which prevent you from taking NSAID pills, soon you’ll be able to snort new and improved brand name liquid Toradol.

A new law to correct every perceived wrong. US Treasury Department plans to ban debt collection in emergency departments of non-profit hospitals. Co-pay? We don’t need no stinking co-pay. Soon it may be against the law for hospitals to ask for it.

Expert witness wins nearly $400,000 in jury verdict after American Academy of Orthopedic Surgeons published report of its disciplinary action against him for giving improper testimony in a medical negligence case. I’m scratching my head about this whole story.

If you were a Democrat running for re-election, you’d say that New Jersey trial lawyers don’t want patients to receive free medical care. New Jersey trial lawyers mount “fierce opposition” to legislation that would shield doctors from liability when the doctors provide free medical care to patients. The bill failed to pass. See how suing our way to better health care works? Now doctors who might otherwise provide free medical care to indigent patients in New Jersey have less of an incentive to do so.

$31 billion paid in medical malpractice premiums in 2011. Only $6 billion of that money went to compensate patients. The remainder went to attorney’s fees, legal costs, administrative costs, and insurance company profits. Oh, and another $650 billion is estimated to be spent on low yield testing to prevent lawsuits.

7 Responses to “Healthcare Update — 06-27-2012”

  1. midwest woman says:

    Surprised?

  2. Matt says:

    Thoughts:

    “In other words, a lot of people who don’t have a means to pay for their care are going to soon be sent somewhere else.”

    Do people truly not have the means? Cannot even make payments, however small? Is the ED supposed to be free care?

    “I call bullshit on that one.”

    It would be more interesting to know if EMRs reduce the rate of medical malpractice, rather than claims. Only insurers care about claims. Physicians should care about the actual malpractice, most of which never sees a claim files.

    ” Now doctors who might otherwise provide free medical care to indigent patients in New Jersey have less of an incentive to do so.”

    Why should people who give free care be immune for the damages caused if the care is negligent?

    Your stats on your last blurb are not actual numbers. They’re from 2009. The methodology is odd, as it ignores downward trends in payments, actually declining from 2008 to 2009, and at times ignores previous years, but then at other times takes 5 year averages.

  3. Matt says:

    Here’s some more honest information than the enjoyably named “Patients for Fair Compensation” offers. From Medical Liability Monitor:

    http://www.prweb.com/releases/2011/10/prweb8858326.htm

    “According to data from the 2011 Medical Liability Monitor Annual Rate Survey, base-rate premiums for medical professional liability insurance (MPLI) continued their downward trend for a sixth consecutive year, while the MPLI industry had one of its best years in 2010 from a financial perspective, challenging the traditional definition of a soft market.”

    We can expect a new round of calls of a crisis though, as insurers are going to be squeezed chasing ever declining premium dollars as more physicians move to larger, self insured groups or to hospital employment where the hospital has a stronger ability to negotiate premiums than the individual physician. You heard it here first – there will be a “crisis” by 2014, and the past 5 years of extreme insurer profitability will not be mentioned.

    • RSDS says:

      “more physicians move to larger, self insured groups or to hospital employment where the hospital has a stronger ability to negotiate premiums than the individual physician. ”

      The physicians of our local clinic recently sold their practice to our local hospital, for better financial management. The two are connected by a hallway.

  4. girlvet says:

    I am shocked by supreme court decision.

    • Close says:

      The supreme court opinion is very nuanced and you need to read it carefully to understand how the individual mandate was unconstitutional under certain clauses but saved by being construed as a tax.

  5. eqvet2015 says:

    Is there any evidence that ketorolac by any route is less ulcerogenic than other non-selective NSAID’s? I thought NSAID’s primarily cause GI ulceration through absorption and systemic inhibition of COX-1, decrease of prostaglandin production, etc., not local irritation – am I wrong?

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