WhiteCoat

Healthcare Update Satellite – 06-04-2014

See more medical news from around the web at my other blog … DrWhiteCoat.com

Car crashes into VA Hospital emergency department in Boston. Elderly driver taken to emergency department … then put on a secret waiting list and will be seen within 2 weeks … if he’s lucky.

What happens when someone calls an ambulance in South L.A.? Same thing that happens in most other places in the country. The stories are the same, only the faces change.
Patient evaluated by EMS for dizziness, hard time breathing, chest pain. Paramedics arrive within 4 minutes. Symptoms resolve. Likely a panic attack. Patient wants ride to hospital anyway. Sits in the hospital with paramedics for up to 3 hours waiting for a bed to open up.
“In many cases people who live in low-to-middle-income neighborhoods like those served by Martin Luther King Jr. Community Hospital choose to take ambulance rides even when deemed unnecessary, all with the public picking up the tab.”
When ambulances are transporting patients with fevers instead of strokes, however, these varying states of crisis weaken the entire system. “They’re not going to a clinic and pay; they’re going to go wherever they can go the fastest, and they use ambulances to get there.”
“The number of people using EMS as a taxi is, not only way to high, it’s alarming,” said Weiss who sees the effects of this first hand as he works in Emergency Departments at various facilities around Los Angeles each day. “We’re using precious resources for a process that isn’t valid.”

Florida Supreme Court decision to invalidate medical malpractice caps may have a ripple effect throughout the nation. Five of seven justices held that there was no malpractice crisis and that the caps don’t hold medical costs down. Of course, when the caps were created, the legislature held differently, but who cares about that.
And if the justices think that there is no malpractice crisis, then why don’t they also rule that the state must provide malpractice insurance to all Florida physicians? Shouldn’t be much of an expense since there isn’t a crisis, right?
Don’t practice medicine in Florida.

Study from Detroit’s Henry Ford Hospital presented at SAEM’s annual meeting shows that 77% of emergency department “super users” have some type of addiction disorder and half were seeking narcotic pain medications. And they still get satisfaction surveys.

Another hospital emergency department closing. Latest victim is Long Island College Hospital in Brooklyn. It is losing about $13 million per month. May get converted into condos. Housing apparently pays better than medical care.

Half of all medical school deans say that their students aren’t competent to treat patients with disabilities. Enlightening article describes how our ignorance about patients with disabilities affects our ability to provide emergency department care. We need to do a better job at this.

ProPublica report shows that even though Medicare is able to export its data for the public to review, Medicare officials are still too dumb to actually look at the data themselves. Average “Level 5″ visit billing by physicians is about 4% of patient volume. 1800 health professionals across the country bill that level in 90% of their patients … yet Medicare keeps paying them. Idiots.
Medicare is just as guilty for paying these providers as the providers are for submitting the bills.

“I am so pleased that justice was served.” Now give me my 30%.
Quote from Florida malpractice attorney after winning $7.5 million medical malpractice case against a doctor who failed to evaluate and treat a conduction disorder of a 13-year-old girl’s heart.
Couldn’t find out more about the case during a web search, but did find another recent $7.5 million malpractice judgment in Alabama after patient brought to Brookwood Medical Center and admitted for back pain, then developed incontinence and paralysis of the legs. The patient had developed cauda equina syndrome and wasn’t treated quickly enough. But remember … imaging in patient with back pain (which is the only way to diagnose cauda equina syndrome) is considered “unnecessary” testing according the Choosing Wisely campaign.

Connecticut woman wins $12 million in medical malpractice case after surgeon punctures her colon during routine hernia surgery. Doctors didn’t realize the complication until after patient developed abdominal infection and went into septic shock.
I’m betting that one reason for the large verdict was because defendants started pointing fingers at each other. Surgeon alleges that it was the resident who punctured the colon. Resident denies it. Hospital says it shouldn’t be responsible for the resident’s actions. Patient says she didn’t know a resident would be operating on her.

CPAP machines soon to become an “uncovered benefit” for our country’s veterans. Veteran’s sleep apnea claims have increased by 150% in the past 5 years with total costs more than $1 billion per year. 90% of patients with the disease are rated at 50% disabled, enabling them to receive monthly payments of $822 in addition to their pensions.
But the winds of change are a-blowing. A military budget expert is now on record saying “sleep apnea is not a combat injury, especially if it’s caused by obesity.”

Sasquatch Music Festival overloads local emergency department every year, increasing its volume six- to seven-fold. Them’s the breaks.
I used to work at a trauma center near an outdoor concert ampitheater like this. Same thing used to happen to us. ED and ambulance services were constantly busy with people passed out from unknown drug cocktails or who had drank too much. We would plan our schedules around which bands were playing. Jimmy Buffet and OzzFest used to be the worst. The ampitheater owners were at least somewhat cool about it, though. Every summer, the owners would show up with dozens of free tickets to each concert for the people in the ED who weren’t stuck working.
Or maybe that was a secret plan to have more emergency medical personnel available on scene ….

Pardon me while I pick my jaw up off of the ground. Poll states that there are MORE emergency department visits due to Obamacare? That can’t be. They told us that there would be LESS emergency department utilization once people had insurance.

8 Responses to “Healthcare Update Satellite – 06-04-2014”

  1. BD MD says:

    Loss of consortium worth 2.5 million?
    I’ll bet his hands and mouth work…

    It’s sad what happened to him. At least now she can move to a big house and hire consortium. This is utter crap when we reimburse stuff like that. What a nation of wimps
    We have become…

    Of course it’s all so clearly negligent. Everyone is an expert in retrospect.

    I sometimes wonder….

    • Matt says:

      Yeah, lucky her. She gets to clean up her husband’s crap for the next 30 years.

      You’re apparently an expert without seeing any of the evidence. That’s a neat skill.

      • BD MD says:

        2.5 million dollars worth of crap…?
        Many, many women or men clean up their spouses crap…I’ll bet most don’t get one cent…

        But I don’t think that was said…

        It was lack of consortium…

        Maybe all my patients with HTN and ED can have their wives sue me for LOC…But if I didn’t, they would for the disabling CVA that resulted…

        Or maybe they can sue their spouses for simply not wanting to have consortium with them.

        This is NOT a thing that should have a monetary award attached.

        BTW, incontinence can mean many things…They didn’t say he was disabled and unable to care for his own hygiene…

        The devil is in the details…

      • Matt says:

        Indeed it is in the details, of which we have none. Consortium is more than just sex.

  2. Matt says:

    ““I am so pleased that justice was served.” Now give me my 30%.”

    Do you ever get tired of accusing other people of being greedy when you have no idea of the work they do? Physicians sue for money all the time.

    http://www.amednews.com/article/20130527/profession/130529955/6/

    • WhiteCoat says:

      Sorry, where did I say anything about being greedy? I missed that part.
      But the fact that you acknowledge 30% of $7.5 million is “greedy” seems to prove the very point you argue against.
      I more think it’s ironic that a lawyer would have an economist testify that a patient needs a certain amount of money to care for himself for the rest of his life, then take 30% of that money away from his client, then brag about it in a newspaper.

      Your year old link is pointless. A doctor sued an insurance company when it retaliated against him for ADVOCATING ON BEHALF OF PATIENTS WHO WERE DENIED COVERAGE. So you’re saying that the providers were retaliating against the patients and deliberately caused the patients to suffer their injuries?
      Also, the judgment against the multiBILLION dollar insurance company was half of the judgment against the doctor, who likely had $1 million coverage and now is left owing $6.5 million dollars.
      But I will give you credit. Both examples involved lawsuits. And both involved plaintiffs and defendants.

      You need to do a better job picking your windmills, Don Quixote.

      • Matt says:

        Are you honestly trying to sell that implying the attorney was being greedy wasn’t your point? If you weren’t implying that, my apologies. What was your point then?

        How would you propose the lawyer get paid? Obviously the client can’t pay his hourly rate. What would you consider a fair amount, given the cost and the risk? It’s interesting that you squawk about how people don’t understand how hard you work everytime it’s suggested that physicians are paid too much, but you’re quite confident that you know when someone else is.

        So it’s ok to sue for millions iif the defendant has billions but otherwise not? Are you advocating that one should only be allowed to sue for a percentage of net worth, regardless of the harm caused?

        Are you also upset that the physician in my link paid his attorney a percentage? Who are you mad at? That doctor wasn’t suing on behalf of patients. He was suing to get himself paid. He can’t sue on behalf of those patients. Nice try though. It’s ok that physicians have collected hundreds of millions suing insurers for payment. Just stop calling everyone else greedy. People are entitled to freely contract for their services and sometimes they will make more money than you. That’s ok too.

      • Matt says:

        Do you ever get tired of selling the old “greedy lawyer” line? Really? Do you ever think, “Maybe there are injured people out there who insurance companies stiff, and maybe they really need attorneys and can’t pay hourly. Maybe it’s more financially risky and difficult work for the lawyer than I can imagine since I’ve never done it.”

        Does that ever cross your mind? Or is your liability carrier’s rhetoric just so ingrained in you that you really believe this stuff? And that a whole profession is just out to get you for money, with no thought for their clients, much less carrying any moral code of their own? They’re just naturally evil, greedy people.

        I know you’re capable of seeing how silly it is to think that way, because you point out how hard you work, how people can’t comprehend what you do and what it takes to be able to do it, etc. whenever the layman rants about greedy arrogant doctors. But are you so blind that you can’t see you’re doing the very same thing to others? And to no discernible end unless you’re a major stockholder in your liability carrier?

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