WhiteCoat

Healthcare Update Satellite — 05-21-2014

See more healthcare related stories from around the web at my other blog: DrWhiteCoat.com

19 year old Baltimore teen dies in hospital after involved in altercation where 5 security guards were unable to control him, police were called to hospital and used Taser on patient, then left once he had been subdued. Now State’s Attorney is looking into matter.

$25 million lawsuit filed against Las Vegas hospital when pregnant woman enters, has several symptoms and risk factors for tuberculosis on mandated screenings, but hospital does not evaluate or treat her for tuberculosis. She is then allowed to hold her newborn twins in the nursery without wearing a mask. All three patients ultimately die from tuberculosis.
Also of note is that there was a tuberculosis outbreak in the hospital at the time with at least 20 hospital employees contracting the disease.

Feds consider whether to spend billions of extra Medicare dollars to screen former smokers for lung cancer. Doing so could cut a high-risk patient’s chances of dying from cancer by 20%.
I remember someone in a position of leadership once saying that if we can save one life, it’s worth it. Therefore, spending this extra money should be a no-brainer.

At Queen Elizabeth II Hospital in Great Britain, you can only have emergencies between 8 AM and 12 midnight. The emergency department is closed between 12 AM and 8 AM due to staff shortages. To be fair, it seems as if most patients have already gotten the memo on this issue. Severe cases are already referred to Lister Hospital which is 20 minutes away and the QE2 emergency department only sees 5-10 patients per night.

VA Medical Center in Cheyenne, Wyoming busted for “gaming the appointments system” to make it look as if patients are being seen within 14 days of an appointment request when they really weren’t. I’m sure the VA is alleging that this is an isolated incident.
Or maybe not
And if you want a good laugh, watch Jon Stewart’s discussion of the whole debacle.
His summary:”Somehow, we as a country were able to ship 300,000 troops halfway across the world in just a few months to fight a war that cost us $2 trillion.” But it takes veterans hurt in that war longer than that to receive “needed medical care or reimbursement, all while we profess undying love for their service.”
All animals are equal, but some animals are more equal than others.

VA Chief Eric Shinseki grilled about issues in medical care in the Veteran’s system. To his credit, he did put three VA employees on leave after discovering that they may have contributed to the deaths of 40 patients. Of course if that happened in the public sector, the employees would be arrested and charged with murder by now.
All animals are equal, but some animals are more equal than others.

About a third of Australian patients waiting longer than 20 minutes in ambulances once they arrive at hospitals. In some hospitals, more than half of patients wait longer than 20 minutes.
Hopefully they’re not baking their statistics like the governments in some other countries do …

Doctor gets romantically involved with a patient who then commits suicide. Doctor removes medications and suicide note when he finds patient dead in her apartment. Pled guilty to obstruction of justice charge for removing evidence and now is being sued for medical malpractice and wrongful death.

I like this concept. Let’s expand it. If you’re unhappy with a hospital stay or an emergency department visit, do you have to pay? Heck no. If you don’t get perfect medical care, you should demand a refund. Where do these hospitals get off charging us for imperfect care?
If we’re not happy with our state or federal government, we shouldn’t have to pay taxes.
If we’re not getting good gas mileage, we should get a refund on our automobiles.
And if our bosses aren’t happy with our work, they shouldn’t have to pay us.
Others aren’t happy with the way that people on government assistance are utilizing their assistance, they get cut off.
Heck, if everyone just acts pissed at everyone else, everything could be free.

Is non-celiac gluten sensitivity all in your head? Study shows that the effects of having gluten in one’s diet may be due to FODMAPs and not duet just to gluten. Although the sample size is small, it’s an interesting concept. A diet low in FODMAPs has been shown to decrease the amount of gas and, in some cases, the symptoms of irritable bowel syndrome.

This study will give the antivax crowd fits and nightmares. Patients with terminal multiple myeloma injected with enough toxic waste — er, um — measles vaccine to inoculate 10 MILLION people. They didn’t die. They didn’t get sudden onset autism. They didn’t even get Guillian Barre Syndrome.
They got better.
One patient remained relatively disease free at 9 months, the other developed worsening disease after 6 months.
I know. I know. It must be that small doses of toxic waste — er, um — vaccines, are lethal while large doses are curative.

Issues with large medical malpractice judgments in India where the author compared them to the Code of Hammurabi in 2030 BC:
“If the doctor has treated a gentleman with a lancet of bronze and has caused the gentleman to die or has opened an abscess of the eye for a gentleman with a bronze lancet and has caused the loss of the gentleman’s eye, one shall cut off his hands”
Wonder how maiming the healers affected the provision of medical care.

5 Responses to “Healthcare Update Satellite — 05-21-2014”

  1. Don says:

    Feds consider whether to spend billions of extra Medicare dollars to screen former smokers for lung cancer. Doing so could cut a high-risk patient’s chances of dying from cancer by 20%.
    I remember someone in a position of leadership once saying that if we can save one life, it’s worth it. Therefore, spending this extra money should be a no-brainer.

    Honestly, I think we have to consider if this screening really is a good expenditure of limited health care dollars. These are Medicare patients. For the most part, they are over 65. I know there are exceptions, but most of them are over 65.

    We won’t save one life with screening for lung cancer. All we will do is move the cause of death from lung cancer to another column.

    Medical science has yet to save anyone’s life. We will all die.

    We would prefer that most of us die peacefully of old age, but we will all die.

    If you told me spend $1 billion prescreening for lung cancer and we can reduce treatment costs from $20 billion per year to $10 billion per year, then I would agree that it is a no brainer. But if we are doing it “to save lives”, it isn’t worth it. Because we won’t be saving any lives.

    • WhiteCoat says:

      Point taken about “saving lives”. It really does become a game of semantics. Perhaps “postponing death” is a better descriptor.

      The quote about “saving one life” was made in reference to school shootings. I don’t think we could use the same argument there. I was more into showing the irony about how we can take up one cause without any regard for costs or unintended consequences in order to “save” one life, but other causes that do not fit a specific agenda are cut to bare minimums regardless of the lives “lost” or the gravity of the unintended consequences.

      Determining whether the screening would be a good use of healthcare dollars could be considered a philosophical dilemma. One one hand, saving expenditures of $10 billion per year would be a wise investment. However, on the other hand, if fewer people lived longer, then there would be fewer people using those healthcare dollars. Medicare would be insanely profitable if everyone paid into the system for 40 years or so then died at age 64 before they could utilize their benefits. Medicare loses money on patients who are chronically ill and live to be nonagenarians.

      I think fairness requires that a country provide basal health care (not health *insurance*) for all of its citizens, not just the senior citizens, but that proposal would never fly.

      The latter approach of overtly or covertly rationing care would be a morally suspect and politically dangerous position to take publicly … which is why the government is hiding all of the VA Hospital policies and refusing to release them in the wake of these scandals.

      Would be a great topic for a philosophy lecture.

      • Dorothy says:

        Who’s got the government contract for lung cancer screening? I’m sure they feel it’s worth it, even if it saves only one life. Completely worth it.

  2. girlvet says:

    As someone who has been a patient at the VA, I think they do a great job.

    The VA has the same problems every other healthcare system has: trying to fits thousands of patients into a system that is not set up to cope with them.

    Part of all of this is the guilt this country feels about basically paying a professional military to fight their wars for them. Its so much easier to get behind wars when your son or daughter doesn’t have to go.

    • WhiteCoat says:

      I’m glad that you’ve had good experiences and I certainly wouldn’t contend that everyone who gets care at the VA is getting shafted.
      However, there is a culture in the VA system and in the private sector that needs a serious overhaul. Little if any competition. No incentive to do better other than intrinsic desire. Sometimes disincentive to do better if it involves spending too much money or exposing corruption. That culture isn’t going to change by creating a law forcing people to pay money to third party insurance companies who then have an incentive to deny care in order to pay multi-million dollar bonuses to their upper level management. Our current system will only make the problems worse.
      The fact that they’re keeping fraudulent records and nothing will happen to them when private sector employees would be sued and jailed for healthcare fraud under otherwise same circumstances merely breeds more distrust in the VA system and in the people who run it.

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