WhiteCoat

Healthcare Update — 10-29-2012

Electronic medical records causing significant delays in medical care and less face time with patients.

In the “that’s why they call it dope” department: Man high on PCP undresses at intersection, runs street naked, randomly pounding on hoods of cars. Tries to pull driver out of car and is arrested by police. Taken to ED where he was medically cleared for jail. Once in jail, he eats his medical bracelet, then gnaws at his wrists. Initially reported to have bitten his finger off and swallowed it, but later story changed to just gnawing at his finger, too.

I’ve commented on this before, and the stories just keep coming. More on the “Liverpool Pathway” from Great Britain. Almost a third of the deaths in Britain each year are patients on the Pathway. “It is a roach-motel for patients deemed to have a terminal condition. They check in but they don’t check out.” But the care is free …

Another medical theory goes up in smoke. Large federal study shows that weight loss has no effect on rate of heart attacks and strokes in overweight patients with Type 2 diabetes. Interesting. I would feel comfortable extrapolating that obesity is not a risk for heart attacks and strokes in the non-diabetic patient as well. This was a huge study and it was stopped early because there was no benefit in weight loss over a decade.
My bigger question is what about diabetes is so damaging to blood vessels?

This policy will go over like a lead balloon. Asking too many questions during a doctor’s office visit can trigger a “split visit” charge where patients are charged for two appointments. When people pay by the visit, there is no incentive to get in and out of the office quickly. This is one topic where I agree with Matt – medical care should be charged on an hourly basis like most other service professions, not a “complexity” basis. Would instantly resolve a lot of billing issues.

Wisconsin man charged with disorderly conduct and faces 90 days in jail plus $1000 in fines for repeatedly stabbing himself in the thigh, arms, and neck with a box cutter while in an emergency department.

Why are kids showing up in the emergency department after eating Flamin’ Hot Cheetos? Because there’s too much red dye in them and when kids eat a lot of them, their stool may look like blood. Wondering how long it will take before someone demands regulation of these things. It’s for our own safety, you know …

Maine emergency department closes, towns have to pay more for ambulances to take patients to other facilities – sometimes a lot more. Can telemedicine fill in the gaps?

How hospital administrators can ruin a hospital. In Pennsylvania’s Carlisle Regional Medical Center, 90% of the emergency physicians and PAs resigned within 1.5 years. Management allegedly putting pressure on staff to “commit some sort of fraud” or “get fired.” Watch all about it on an upcoming episode of 60 Minutes.

Anyone can get confused. This is the defense statement of a nursing student who accidentally injected coffee into a woman’s IV line. The 80 year old woman later died.
Aaaand … the student another student, and two nurses have all been indicted for involuntary manslaughter based on the incident.
Hat tip to @skepticscalpel

Drunk patient sets hospital bed on fire while trying to light imaginary cigarette. In other news, the Joint Commission will soon declare hospital beds a patient safety hazard.

Senate Majority Leader Harry Reid injured in motorcade accident and taken to emergency department. Diagnosed with rib and hip contusions.
Fortunately for him, he has good health care insurance.

11 Responses to “Healthcare Update — 10-29-2012”

  1. steve says:

    Re “Liverpool Pathway”, as I’ve said before linking to the Daily Mail is like linking to the National Enquirer , it might be true but probably isn’t.

    Doing it second hand still has the same problem.

    • stephen says:

      on reading this had the same thought as steve-but he beat me to the punchline. The dailymail is for right wing fascist racists and everything about it is one dimensional and abhorent

    • WhiteCoat says:

      I’m not saying that anyone should take what they read as 100% true – regardless of the source. The New York Times has quite a few mess-ups itself. I just summarize articles I find interesting from my newsfeeds.
      Admittedly, I don’t know the reputation of the newspapers overseas, so I appreciate you both helping to clue me and the US readers in a little more.
      However, bigger issues are whether the Liverpool Pathway really does end up in premature death of people entered into it and whether it will be used as a model for other health care systems.

  2. DefendUSA says:

    I read that diabetes study. It gave me pause to think about the cholesterol studies, too. Could it be that some people just have a genetic tendency to have a high total cholesterol, despite doing all the right things according to the medical community?

    • JJ says:

      Anecdotally to your point. I had a friend (female) who was 25 years old, 5’7, about 125. Vegetarian. Worked out almost everyday, running, yoga, weights etc… No FH of familial hypercholesterolemia. Normotensive. Total cholesterol was around 230. Yes her HDL was elevated, but not enough to justify the high total.

  3. DensityDuck says:

    EMR: QQ by old farts who just can’t understand why Their Way isn’t Good Enough.

    My mom goes through hell with clinical research because of doctors who can’t be arsed to check the units on the box they’re filling in, giving us such miracles as a woman three feet tall weighing 400 pounds who had a 22-pound baby in 9 weeks.

  4. Good luck says:

    I hope any epmonthly people who are affected by Storm Sandy are okay and safe and provided for. I wish good luck.

  5. If you are obese and have unhealthy eating or activity habits, you have a higher risk for gallstones, type 2 diabetes, high blood pressure, high cholesterol and triglycerides, coronary artery disease (CAD), a stroke, and sleep apnea, among other conditions.

    Physicians in Dallas Texas

  6. GrumpyRN says:

    Please do me a favour, when commenting on things in the NHS please stop adding on the statement “But the care is free …” It is wrong and misleading.

    The NHS is not, never has been and never will be free. I and every other worker pays through National Insurance at a set percentage of our wages/salaries. It is also funded through general taxation. It is free at the point of use and patients are not presented with a bill at the end of their stay.

    Yes, if you are unemployed it is free as you do not contribute. The rest of us see this as part of looking after our citizens, as being unemployed is something that can happen to anyone.

    • DensityDuck says:

      grumpyRN: dat’s da joke.

      People here point to nationalized healthcare systems as some shining example of what modern life ought to be. You go to the doctor and it’s free! You don’t have to pay!

      It’s because to modern Americans, taxes are invisible. Your parents handle it. Or it’s a line-item deduction from your paycheck so you don’t actually see the money, and you get a refund every April.

    • WhiteCoat says:

      DensityDuck is exactly right. I’m using the phrase as a double entendre.

      I realize that NHS isn’t free. I realize that it is paid for through higher taxes and that Britain has higher income taxes than the US. I also realize that every government should have a system in place to provide health care to its less fortunate citizens. The US fails miserably at that right now and largely pushes the costs of caring for indigent patients onto the private sector.

      The perception of many people in the US is that because no money exchanges hands during visits or at the end of a stay, the care in socialized systems is “free” and that such a system would be better for the US.

      I’m merely trying to contrast some examples of outcomes in a “free” socialized system, with those in a heavily regulated non-socialized system that we have in the US. Each one has its advantages and disadvantages, but if people are pining for socialized medicine because they think it’s “free” and provides perfect medical care, they’re wrong.

      In fact, if you or anyone else who has experience with the NHS would like to write a post about how the system works, I would love to put it up on this blog so people in the US can see how the system operates.

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