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	<title>Comments on: Healthcare Update &#8212; 06-27-2012</title>
	<atom:link href="http://www.epmonthly.com/whitecoat/2012/06/healthcare-update-06-27-2012/feed/" rel="self" type="application/rss+xml" />
	<link>http://www.epmonthly.com/whitecoat/2012/06/healthcare-update-06-27-2012/</link>
	<description>A blog from inside the emergency department</description>
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		<title>By: eqvet2015</title>
		<link>http://www.epmonthly.com/whitecoat/2012/06/healthcare-update-06-27-2012/#comment-92697</link>
		<dc:creator>eqvet2015</dc:creator>
		<pubDate>Mon, 02 Jul 2012 08:01:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=8222#comment-92697</guid>
		<description><![CDATA[Is there any evidence that ketorolac by any route is less ulcerogenic than other non-selective NSAID&#039;s?  I thought NSAID&#039;s primarily cause GI ulceration through absorption and systemic inhibition of COX-1, decrease of prostaglandin production, etc., not local irritation - am I wrong?]]></description>
		<content:encoded><![CDATA[<p>Is there any evidence that ketorolac by any route is less ulcerogenic than other non-selective NSAID&#8217;s?  I thought NSAID&#8217;s primarily cause GI ulceration through absorption and systemic inhibition of COX-1, decrease of prostaglandin production, etc., not local irritation &#8211; am I wrong?</p>
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	<item>
		<title>By: Close</title>
		<link>http://www.epmonthly.com/whitecoat/2012/06/healthcare-update-06-27-2012/#comment-92658</link>
		<dc:creator>Close</dc:creator>
		<pubDate>Sun, 01 Jul 2012 07:24:27 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=8222#comment-92658</guid>
		<description><![CDATA[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.]]></description>
		<content:encoded><![CDATA[<p>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.</p>
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		<title>By: RSDS</title>
		<link>http://www.epmonthly.com/whitecoat/2012/06/healthcare-update-06-27-2012/#comment-92533</link>
		<dc:creator>RSDS</dc:creator>
		<pubDate>Thu, 28 Jun 2012 21:04:16 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=8222#comment-92533</guid>
		<description><![CDATA[&quot;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. &quot;

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.]]></description>
		<content:encoded><![CDATA[<p>&#8220;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. &#8221;</p>
<p>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.</p>
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		<title>By: girlvet</title>
		<link>http://www.epmonthly.com/whitecoat/2012/06/healthcare-update-06-27-2012/#comment-92522</link>
		<dc:creator>girlvet</dc:creator>
		<pubDate>Thu, 28 Jun 2012 18:44:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=8222#comment-92522</guid>
		<description><![CDATA[I am shocked by supreme court decision.]]></description>
		<content:encoded><![CDATA[<p>I am shocked by supreme court decision.</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2012/06/healthcare-update-06-27-2012/#comment-92516</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Thu, 28 Jun 2012 17:06:15 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=8222#comment-92516</guid>
		<description><![CDATA[Here&#039;s some more honest information than the enjoyably named &quot;Patients for Fair Compensation&quot; offers.  From Medical Liability Monitor:

http://www.prweb.com/releases/2011/10/prweb8858326.htm

&quot;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.&quot;

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 &quot;crisis&quot; by 2014, and the past 5 years of extreme insurer profitability will not be mentioned.]]></description>
		<content:encoded><![CDATA[<p>Here&#8217;s some more honest information than the enjoyably named &#8220;Patients for Fair Compensation&#8221; offers.  From Medical Liability Monitor:</p>
<p><a href="http://www.prweb.com/releases/2011/10/prweb8858326.htm" rel="nofollow">http://www.prweb.com/releases/2011/10/prweb8858326.htm</a></p>
<p>&#8220;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.&#8221;</p>
<p>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 &#8211; there will be a &#8220;crisis&#8221; by 2014, and the past 5 years of extreme insurer profitability will not be mentioned.</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2012/06/healthcare-update-06-27-2012/#comment-92512</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Thu, 28 Jun 2012 16:53:10 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=8222#comment-92512</guid>
		<description><![CDATA[Thoughts:

&quot;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.&quot;

Do people truly not have the means?  Cannot even make payments, however small?  Is the ED supposed to be free care?

&quot;I call bullshit on that one.&quot;

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.

&quot; Now doctors who might otherwise provide free medical care to indigent patients in New Jersey have less of an incentive to do so.&quot;

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&#039;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.]]></description>
		<content:encoded><![CDATA[<p>Thoughts:</p>
<p>&#8220;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.&#8221;</p>
<p>Do people truly not have the means?  Cannot even make payments, however small?  Is the ED supposed to be free care?</p>
<p>&#8220;I call bullshit on that one.&#8221;</p>
<p>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.</p>
<p>&#8221; Now doctors who might otherwise provide free medical care to indigent patients in New Jersey have less of an incentive to do so.&#8221;</p>
<p>Why should people who give free care be immune  for the damages caused if the care is negligent?</p>
<p>Your stats on your last blurb are not actual numbers.  They&#8217;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.</p>
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	<item>
		<title>By: midwest woman</title>
		<link>http://www.epmonthly.com/whitecoat/2012/06/healthcare-update-06-27-2012/#comment-92507</link>
		<dc:creator>midwest woman</dc:creator>
		<pubDate>Thu, 28 Jun 2012 16:19:51 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=8222#comment-92507</guid>
		<description><![CDATA[Surprised?]]></description>
		<content:encoded><![CDATA[<p>Surprised?</p>
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