May 1, 2012 Recent News






Warren Buffett and his physicians have gone against all recommendations by either the Preventative Health Organization and common sense.  Why would an 81 year old be given a PSA test when it goes against the Preventative Health people?  The reason is that he is smart and he and his physician believe he has over ten years to live.  That is the criteria usually used by Urologists to determine whether or not to treat a prostate cancer.  The Scandinavian literature would have us believe that low grade prostate cancer does not need any treatment.  In the US, most Urologists do not believe the same way so we use resources and save lives.

Healthleaders had an article that most people already knew, nobody is paying any attention to the ridiculous recommendations of the US Preventative Services Task Force.  The article stated that as long as a person had at least ten years of life ahead, age is irrelevant in PSA screening. 

Some Democrats who are not running for re-election are bashing Obamacare as a possible reason for the defeat of Obama and the Democratic members running for office.  They say they wasted political capital on the bill and did not attack the economy.

The HSA market is soaring.  It is the best health insurance for those who can afford it.  It has a high deductible but the money put into the HSA is pre tax and can sit and grow tax free.  It is also tax free on withdrawal if used for medical expenses after the deductible.  If one takes the money out for non medical needs they are taxed at ordinary income rates plus a 20% penalty.  That penalty goes away at age 65.  Therefore won can use it as another IRA or save all the medical bills until after age 65 and then take out the money income tax free as well.  The Republicans in Congress are pushing HSAs on a national basis.      Top


Yesterday's AMA News has an excellent primer on hospital contracts with physicians.  They stress to have an attorney look over the contract even if you have to pay the attorney yourself and no matter what the hospital says.  They cite three examples.  The first is that you are told this is a standard contract and all are signing it.  That may be true but there may be addendums on some contracts that supercede the contact language.  The other is that the contract may state it is a long term contract but there is a 30, 60 or 90 day out making the contact in reality only a three month contract.  The third thing the cite is the contract may state that the physician is responsible for all expense overages.  Now, who has control of the expenses?  The hospital who may not be the most efficient of institutions and the physician must pay for the overages caused by the hospital.

The Journal of Palliative Medicine reports that patients and fellow physicians still believe that palliative medicine that happens to relieve pain but shortens life is murder.  This is 30 years after the creation of hospice.  The physicians that do palliation should be aware of the backwardness of their hospitals and state boards that will investigate them for the high use of opiates.  This is true even though the patient or his surrogate has agreed with the treatment process.   

North Carolina must have some terrible hospital administrators (See story below).  The Mid-West Carolinas Healthcare hospital is losing some of it's physicians and more may be leaving soon.  The exodus is caused by the hospitals financial and quality problems.  The hospital, to no one's surprise disagrees with the physicians.  Maybe new physicians should give this hospital a wide berth.  

Arizona has doubled its medical school enrollment in the last decade but most of the graduates go out of state for their training.  This is due to a lack of residency slots in the state. Since physicians tend to practice where they train, unless the malpractice climate or healthcare climate, such as the People's Republic of Massachusetts, this is bad for the future of healthcare for the state. There is an ongoing physician shortage in the state which will become much worse.  

The New York Times says that only 30% of hospitals are using computerized prescriptions and only about 30% of the prescriptions nationwide are computerized.  After all the hype of this over the past five years and that is as good as it gets, there is a systems problem.  The problem is a combination of money, learning time and the systems that constantly beep leading to people ignoring potential problems.

What is happening in the dental world?  In England a stupid ex-boyfriend of the dentist went to his ex-girlfriend for a toothache.  She got even by pulling all his teeth after giving him a large dose of anesthesia.  She may go to jail.  In this country a dentist in Kentucky accidentally dropped a screwdriver down a patient's throat.  The patient needed surgery to remove the object.  Here we do not send people to prison for this so he was just sued.         Top


Hackensack university Medical Center in New Jersey has voluntarily stopped its renal transplant program due to high mortality rates.  Their death rate for adults in the first year following the transplant was thrice the national average.  They have not had any problems in their ped transplant program.  They are stopping the adult program for four months to work out an improvement plan with the feds.  One of the problems is the small volume done at the hospital with a total of only 571 transplants over 13 years.  This is, and it's hard to believe, the fourth largest program in the state.  

The law of unintended circumstances may rear its head in San Francisco.  The city has approved a huge fee for allowing California Pacific Medical Center to rebuild in order to come up to state seismic safety standards.  It is feasible that the hospital will raise fees for the taxpayers and others who use the hospitals.  To me it is only fair that the city that made the costs to build so outrageous should have to pay higher costs to offset their own politicians folly.

Seven hospital is the People's Republic of Massachusetts have agreed to offer prompt apologies to the patients harmed in their institutions.  They will also offer financial settlements to prevent lawsuits.  If anyone reports something amiss the hospital will do a "root cause analysis" and if they find that the hospital or it's physicians are at fault the apology will come.  At present these apologies can be used in court against the hospitals and physicians.  There is hope that the legislature will pass a law stating these are not admissible.  The hospital coalition also will hopefully isolate the physician from hospital errors so the physician will not be reported to the medical board or the NPDB.  For some reason malpractice attorneys are leery of the movement.

Still in the Republic, Steward Health Care, the organizations that are purchasing many physician practices and hospitals in the Republic, is now selling the medical office buildings for $100 million and leasing them back with 24 year leases.  That is good for both the lessor and lessee.   

Two North Carolina hospitals are getting well deserved bad publicity for themselves.  Carolina Medical Center-Mercy (not) and Wilkes Regional hospitals are the only two in the state that not only turn patients over to collection agencies but also file law suits against those that do not pay so they can put liens on the homes.  These two non-profits potentially should be looked at by the state to determine if they deserve to continue to be considered non profits.      Top


Bloomberg reports that United Health and Wellpoint along with some other insurers are having to rebate premiums of a total of $1.3 Billion.  This is due to not having met the 80-20 rule for how much the companies have to pay out in medical expenses.        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.