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A survey by CMA of 300 California physicians showed that the physicians believe the current system is unsustainable. Approximately 80% of the physicians also stated that if they were to start anew, they would not choose medicine. The major problem is mangled care with their unreasonable restrictions.
The VA continues to be investigated for hits terrible handling of the claim disability system as well as problems at Walter Reed. They never mention the other multiple VA hospitals that provide the same or worse care than Reed. When will they learn they need to drop the system and put all on Medicare?
Who is telling the truth? Physicians state that United Healthcare is the worst paying insurer in the country in terms of promptness. The insurer states that they pay 95% of claims promptly and in accordance with state prompt pay laws.
The Socialist health system of Hungary has collapsed. As patients age the country can no longer pay for all the care. The country has now reduced the government costs by having patients pay a co-pay for visits. The government also slashed it pharmaceutical payments by up to 50%. Slovakia has also begun the change to some self pay and private insurance.
The California Nurses Ass. has joined the AFL-CIO in order to push for universal health care. Top
Congratulations to King Hospital in Los Angeles. They have again shown why they are the worst quality hospital in the country. Recently, a patient died in the ER from sepsis secondary to a ruptured bowel. This caused the medical director to be fired and the knowledge that 40% of the nurse assistants and LVNs failed their initial skills test. This hospital needs to be shuttered. In another case a man was in the ER for four days with headache and vomiting. He checked himself out, went to UCLA and had surgery for a brain tumor within hours.
Hospital revenue per physician has dropped. The figure per physician specialist has dropped about $300,000 since 2004. This is from increased competition and the hospitals not being able to compete.
Kaiser continues to have problems due to its ill fated transplant program. New charges have surfaced regarding the delays in transplants caused by Kaiser's negligence. Kaiser had been fined $2 million for its violations.
A study by Medical Care shows that hospitals that focus on the bottom line decrease quality. This was a study at four hospitals in Massachusetts.
In San Jose, California, there will be a new 80% physician owned hospital, California Center for Healthcare and Biomedical Technology. It will have a office building and a short stay hospital with eight operating suites. About 30 physicians will be involved.
DeKalb Medical Hospital in Georgia has opted out of the state's trauma system. This decision has incensed the physicians who work in the trauma area. It means that patients will need to go to Atlanta for trauma care keeping the paramedics transporting the patients out of the county and not available for other emergencies. The decision was made in order for the hospital to recruit physicians more easily since they wouldn't need to be on call as frequently. The hospital is also losing money and having to cut back its staffing.
The Seattle VA hospital has problems in its psychiatric unit that may be patient hazards but have refused to fix them. Then there was an inspection and the hospital is retrospectively attempting to fix the multitude of problems. The problems were not from a lack of money but of leadership.
A recent article extoled the virtues of physician extenders (PA and NPs) in the hospital setting. At some teaching hospitals the extenders are a must due to the restrictions placed on resident working hours. They are used as first assistants in surgery, do admitting H&Ps, write orders and call consults. This has been used for some time at the Boston Brigham and Women's Hospital. Many of the states restrict what extenders may or may not do but more are becoming more liberal. There are still turf issues as well as reimbursement issues. Top
The University of California at San Francisco has lost due to theft a computer with at least 3000 names and personal medical information. Top
Governor Rendell of Pennsylvania still has his head in the ostrich position. He states there is not a crisis in the Philadelphia area for OBs. He does state there is a problem. Since 1997. 13 hospitals have stopped their OB service and about 20% of the OBs in the area are going to stop delivering babies in the next year. Rendell is looking to give decreased care by increasing nurse mid-wives instead of looking for med mal solutions.
Novant has started a physician run med mal company that will only insure physicians that work in Novant hospitals. It should be interesting how long a company with only 691 potential enrollees can last.
Some physicians in New Jersey have attempted to get around the State's inability to pass med mal reform. They are having patients sign binding arbitration contracts which cap pain and suffering at $250,000 and limit punitive damages. The attorneys don't like this but that is too bad. This is exactly what Kaiser insurance and many other physicians do when people come to their office for the first time. As long as it is not at a time when they need urgent care, the agreement should be legal. The major problem with the idea in this state is the physicians are opting out of traditional insurance and going to self-insurance pools. This may put the physician at risk. There are many of these in New Jersey at present since the State Fund is so expensive. Top
An article stated that Palm Beach County, Florida, will need about 20 neurosurgeons for its rising population in about four years. It has 13. A study showed a lack of almost all surgical specialties currently except neurosurgeons. Originally there were 22 neurosurgeons in the county but nine were either retired or did not take emergency room call for head trauma. The law keeps hospitals from speaking to each other about the shortages and coming up with a regional trauma center for neurosurgery instead of a neurosurgeon at every hospital. The national supply of neurosurgeons is also tanking with many less taking the residency programs.
The purchase of a local physician group by Kaiser in Ventura County, California, has put a strain on the rest of the physician population. About 50% of the groups patients opted not to go to Kaiser adding to the load of the rest of the physicians in the area. The local hospital has also seen a 17% increase in patients since the purchase. Kaiser has signed a contract with the hospital for care of their patients.
For those that love the Universal Health System, a study in England has shown that about 69% of physicians rue going into medicine and will not recommend it to friends or family. Approximately 2% of physicians had excellent morale as opposed to 54% who rated morale as terrible. It is interesting that the NIH staff survey showed 73% of different physicians were generally satisfied.
Physicians in the ambulatory center of Greater Southeast Community Hospital have walked off the job. They are due three months of back pay. The hospital promises payments but they have made those promises in the past.
Some pediatricians are not giving the shot to prevent cervical cancer in some females due to payment problems. They must buy the vaccine for $120 a shot and get $122 per shot as payment. This does not pay them for the loss of time value of money nor storage of the vaccine. Some plans state they will pay only $90 per shot or $30 less than the cost of the vaccine. Physicians are now giving patients prescriptions to be filled at pharmacies for the vaccine and then give the shot. The insurers are not covering this since they require the vaccine be from the physician.
The idiots at Public Citizen are back. They have come out with new rankings of the states with the best to worst medical board sanctions per 1000 physicians. It is their contention that the more physicians that lose their license per 1000 physicians means that the state is doing its job. It does not take into any consideration that maybe there might not be a need to sanction that many physicians. They do believe that all physicians in the country are the same and therefore the sanction rate should be the same.
Physicians working at academic centers are getting smaller pay hikes that their private practice brethren. They got an average of just over 3% wage hike where those in private practice got about double that percentage. 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.