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It was just two weeks ago that I praised the MBC for their stand. Now they go and blow it. They want to release to the public misdemeanors committed by physicians and settlement results. I truly do not think anyone minds the former but the latter is going to screw up the courts. One of the reasons people settle a dispute is the confidentiality that may attach. If this goes away, there will be more malpractice cases tried, taking up court time and other resources. I also am not sure if the MBC can overturn the Federal and State Arbitration Acts or contracts between the parties. Top
I just returned from a conference where I was told by Hal Bressler, the head attorney for JCAHO, that it was all right for hospital boards to put terms into the medical staff bylaws unilaterally, however, it is an automatic Type I violation if it is ever attempted to be enforced. I would advise all medical staffs to either have the hospital remove any unilateral changes or if they will not remove the offending verbiage turn the hospital in to JCAHO for the violation. THE BYLAWS CAN NOT BE UNILATERALLY AMENDED!!
Mr. Bressler also stated that JCAHO will be doing their own Business Associate Agreement (BA) for use by the accredited institutions. This is somewhat logical since they have about 18,000 institutions to credential and could not have their legal staff review each one's BA. However, this is against the spirit of the HIPAA law that states the covered entity makes the BA and is responsible for the privacy. Mr. Bressler stated that if the institution does not conform to their BA, they will not be inspected. The usual collegial, non-egotistical JCAHO response.
The other JCAHO information that came out of the conference was regarding the sentinel event and the unanticipated outcomes standards. The former has been not successful with the reporting to JCAHO. All agreed that a root cause analysis should be done but the consensus was not to report. This is especially true in New Jersey where a court has already allowed the report to be entered into a malpractice case. The latter can be circumvented and should be by physicians giving patients a good informed consent. By doing this there will be no unanticipated outcome and therefore nothing to tell the patient. Top
The mammogram has not only been found to be fallible with a 5% false negative and a 30% false positive rate but also is in question of whether or not the early use actually saves lives. This is the same argument and statistics as prostate ultrasound.
The FDA will now authorize states to oversee the quality of mammography. the states will now be allowed to inspect the facilities and enforce the Mammography Quality Standards Act. Top
A bill moving through the Florida legislature would allow the administration of general anesthesia by people with a college degree and a two-year master's degree in anesthesia. They would have to be supervised by physicians. The bill is being pushed by those anesthesiologists who own personnel firms and anesthesiologists in general. It is being opposed by the nurse anesthetists. The tension is the usual, turf and money. Nurse anesthetists do not need to be supervised and so bring no money to the physicians. The anesthesiologist could supervise up to four of these people at a time and collect money. I really do not believe I could allow someone like that to put either me or any of my patients to sleep. Top
San Luis Obispo is considering closing their County hospital. The cause is the usual, money. This would have the Medicaid patients treated at the private hospitals. Several years ago the Board of Supervisors laid off physicians to save money. This angered the local medical people and failed to hold costs. In 1999 the Board had a turnaround plan to limit losses to $6.5 million per year. The hospital lost $9 million. The county would need a contract to care for the uninsured at the four private hospitals. Top
Dr. Bryson, of Kerrville, Texas, had his license suspended for writing prescriptions over the internet. He is attempting to have the license reinstated. He had written over 20,000 prescriptions over two years for an internet pharmacy. He made about $9000 per week for two years consulting with patients by phone and writing the prescriptions. He paid a $15,000 fine in Missouri for writing prescriptions and agreed to stop writing prescriptions for the state. Dr. Bryson started working for the internet drug company after losing his job in a county hospital and filing bankruptcy. It should be interesting if he gets his license back. Top
Penn. Medical Malpractice
The state Senate had passed a bill that favored the trial lawyers of the state. The House passed their own bill which was more toward the physicians with tort reforms. There now needs to be a reconciliation between the bills before final passage and forwarding the bill to the Governor. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.