WhiteCoat

Healthcare Update Satellite — 07-09-2013

More updates available tomorrow on my other blog at DrWhitecoat.com

Why does an $11,596 emergency department visit cost $1,100? A spokesperson for the California Hospital Association says that it is because of government regulation. I want to know what doctor ever gets paid $4,242 for a Level 4 emergency department visit.

California attorneys are trying to raise the cap on damages under California’s Medical Injury Compensation Reform Act. Caps are currently $250,000 and haven’t been raised in more than 35 years.
The article says that many attorneys won’t take medical malpractice cases in California because they are too time-intensive and costly and attorneys don’t get a big enough payoff when they win.
So much for that whole argument about how malpractice plaintiff’s attorneys are in it only to make sure that their clients receive “justice” ….

Think you have a “spider bite”? You probably don’t. Out of 40,000 species of spiders, only about a dozen actually can cause damage to humans. Most of the others either are not toxic to humans or don’t have “fangs” big enough to pierce human flesh.
One study on the issue showed that many people with alleged spider bites actually had an infection with the “superbug” MRSA which is caused in large part by antibiotic overuse. Keep popping those amoxicillin prescriptions and Augmentin refills, though.

Speaking about antibiotics … this study in the British Journal of Dermatology shows that children who are exposed to antibiotics in their first year of life are about 40% more likely to develop eczema later in life.

Emergency physician at Logansport Memorial Hospital in Indiana sends letter to administrator seeking to terminate their group’s contract which points out the obvious: In rural areas, there aren’t a lot of emergency physicians to choose from. Getting rid of the group only changes management, but often results in either expensive locum tenens physicians or in many of the current emergency physicians being recruited by the incoming group. However, if the hospital has been through three emergency department groups in three years, maybe the hospital board needs to take a closer look at how hospital CEO Dave Ameen is running the ship.

Maybe the dogs are onto something. British researchers can detect bladder cancer with 100% sensitivity just by the smells in the urine.
Perhaps that’s why my dog shakes his head after sniffing the bases of some light posts … “Poor Shep has the Big C.”

Working out too hard too fast can cause kidney failure. One man alleged that the workout system P90X caused him to break down so much muscle that he developed rhabdomyolysis. New onset of Coca-Cola-colored urine is usually a dead giveaway that you need to seek medical attention.

Cardboard box blows out of dumpster in North Carolina hospital parking lot, police shut down roads and hospital emergency department so they can x-ray the box to make sure it isn’t harmful. Dang. I don’t know how the roads stay open on garbage pickup days.

8 Responses to “Healthcare Update Satellite — 07-09-2013”

  1. SeaSpray says:

    Then I guess it’s a good thing I didn’t listen to a coworker who thought I had a spider bite (two tiny puncture wounds in fleshy area between thumb and index finger) vs a bat bite, that I had gotten when reaching into a large dark carpet I had left folded on the line for the weekend. I did get the rabies series on the last possible day after wrestling over the decision.

    I definitely had two distinct tiny puncture wounds in which I could see blood opening although not bleeding.

    I never felt a thing either and was surprised when I removed items from my arm after coming in the house. If it hadn’t been for a patient’s bat bite I saw that came in and had to get the series, I might not have been concerned and thought spider bite myself. The patient’s bat bite looked just like mine from one fang and the other also tiny, but with a slight tear to skin. He had reached into something at work, and bat bit him on it’s flight out …hence the tear in his skin.

  2. SeaSpray says:

    Also, just a few weeks ago I assumed I had a spider bite because I woke up with swelling under my eye and on cheekbone area. Mom used to say she got a spider bite in the night if woke up with swelling and we have spiders and so I assumed. What else then?

    I don’t understand how an infection could look like a spider bite. ?

  3. Matt says:

    Who ever argued that attorneys didn’t want to make a living?

    For someone who hates it when his profession is accused of being “greedy” you are sure quick to throw that at others.

    But I’m sure you think $250,000 is fine, even if not indexed for inflation.

  4. Matt says:

    Speaking of physician pay – want to know how what they charged is determined? Here you go:

    http://www.washingtonmonthly.com/magazine/july_august_2013/features/special_deal045641.php?page=all&print=true

  5. eqvet2015 says:

    SeaSpray, a lot of people think that they have bitten by a “brown recluse” (regardless of whether brown recluse spiders actually occur in their area) or other spider when they have an open sore or necrotic lesion, not realizing how rare it is to get bitten by a spider that can actually do damage. My dad is an entomologist in a state that has no brown recluses or other spiders that cause necrosis, but still occasionally gets emails from John Q. Public enclosing pictures that he’d really rather not see, asking him to ID what spider did it.

    Not as common but still possible is secondary infection from what actually was a bite from a relatively benign spider or insect; I had this happen to me when I got a mosquito bite while on oral steroids, probably scratched it without thinking and inoculated the wound with bacteria, and developed an open sore with cellulitis a couple days later. Aren’t steroids great?

    This occasionally happens in the veterinary world, too. I saw a horse with a 10″ diameter crusty, oozing, necrotic-centered skin lesion on its neck whose owners thought it had been bitten by a spider through a full winter haircoat. ???

    • SeaSpray says:

      Interesting. Thank you for your comment. :) I do remember hearing on the news that Billy Graham was hospitalized for a spider bite ..I think brown recluse. he was bitten when putting on his shoe. he lives in NC.

      I just don’t know what else would bite me in the night that would’ve caused that swelling. It didn’t itch like a mosquito bite. I’m a Jersey girl and we have all kinds of spiders up here in northern part, although I don’t believe any are poisonous.

  6. USAF wench says:

    Re: rhabdomyolisis

    The same thing has happened to some CrossFit folks, usually guys that refuse to back off the workout of the day (WOD). The WOD can be scaled to anyone’s level of fitness; I was doing CrossFit when I weighed almost 300 lbs. For example, I rowed instead of running and stepped up to aerobics benches instead of doing box jumps.)

  7. Bethy says:

    I’m definitely interested in knowing who thinks attorneys are out there just to help people. Haha, I’d like to think most people realize that attorneys are out there to make money. Just sayin’.

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