Oklahoma has a significant amount of boutique hospitals. A Board of Health member physicians doesn't like them. He believes they make their state dysfunctional medical system of which he is a part, more dysfunctional. The OHA is neutral since they have members in both camps. The community hospitals are not neutral and accuse the boutiques of skimming patients, nurses and specialists. They are playing the bankruptcy card. If the hospitals would pay the nurses more and give them better working conditions, they wouldn't bolt for the greener pastures. If the hospitals weren't so greedy and would have allowed partnering with equal or high physician control this would not have been a problem. The specialty hospitals provide shorter stays and higher percentage of cardiac patients that go home instead of to a rehab center. Top
The Orlando, Florida will stay open for one month by the use of government funds, so sayeth the hospital Chairman. The Chair is hoping to get the County to help pay the neurosurgeons who are quitting. This Level I closure would hurt the central Florida community but the neurosurgeons need to be paid for their services. It should be remembered that a trauma center is not an emergency room in which EMTALA might apply. There is no rule that states a physicians must be on the trauma panel, just back up the ED. Of course, the Chairman has no authority and the neurosurgeons will quit at the end of the month. The County will propose patients go to Level 2 trauma centers after the neurosurgeons leave. The state requires a six month notification and this has been given. If they don't give the required time they are subject to $1000 per day fine. This would be cheaper than paying the physicians or installing the computer equipment necessary.
The University of Maryland will lay off a surgeon, anesthesiologist and intensivist if it does not get an infusion of cash. These three employees are costing $600,000 per year. The other state trauma hospitals are also feeling the crunch and either closing or decreasing services. Top
The AMA has put five more states on the medical malpractice watch list. They added Illinois, Arkansas, Connecticut, Kentucky, Missouri and North Carolina. The physicians in these states are giving up doing the high risk services due to malpractice premiums.
On the other side of the coin is the Democratic controlled Trial Lawyers and the crusade of an organization to make medical boards clamp down harder on physicians. They believe that of the 35,000 physicians with payouts for medical malpractice over a 12 year period only 8% were disciplined is too little. They go by statistics and not cases or settlements to lessen litigation costs. The states need to focus on whether individual physicians should be punished, whether it was a system problem or an individual error. As all who have studied the problem now agree, most medical errors are system errors and not individual errors. The organization continues to focus on the wrong element, individuals and the opening of the Data Bank to plaintiff lawyers.
The Nevada legislature has been given a report that fewer physicians have fled the state than previously been believed. The Democratic Assembly leader was "shocked" to see the report just days prior to the vote of the legislature on tort reform. The study comes from the State Board of Medical Examiners which has no way to immediately track moves. The Board does state that the number of physicians applying for licenses has decreased in each of the last three years. The Board also does not keep any statistics on how many have closed their practices to new patients or have stopped doing high risk procedures like OB.
As an example, Lake Mead Hospital may have to close its maternity ward due to not enough OBs. There are currently only six OBs left to cover the patients and the ER. This is down three from the recent past. This puts them on call more frequently than at the physician's other hospitals. This may lead to the physician's hospital resignations. Desert Springs Hospital has had to close its Orthopedic ward due to lack of Pods.
In Florida, there will be a rally at the State Capitol on March 27. all the physicians in the state have been asked to close their offices and attend. Hospitals will continue to be covered. Top
San Francisco General Hospital with the only trauma center in the city has barred the smallpox vaccine for all healthcare workers with direct patient contact. The Department of Public Health also states that due to shortages of personnel, no time off is permissible for those who have been inoculated. This is not making the CDC happy campers for their ill thought out program.
A southern California adult has smallpox in his eye. It is the same strain as the one used for the military. The person had direct contact with someone who had been vaccinated. Top
In the VA system, patients are waiting an average of seven months to see a primary care physician. The average wait time with an appointment is 1.5 hours and over half had their appointment cancelled and postponed an additional 2.6 months. Top
Kaiser Woodland Hospital has had several cases of mismanagement of children during anesthesia or sedation of children. The problems came to light in a recent series of articles by The LA Times. Now, after the bad publicity, Kaiser has agreed to not allow their anesthesiologists to sedate children under two years of age unless they have in-depth pediatric anesthesia training. There are now three of the anesthesiologists trained for pediatric work. The Kaiser people have also threatened to fine anesthesiologists who routinely call in other anesthesiologists to assist them on night and weekends. This should lead to alot on commonality between the physicians and the administration. Top
Blue Cross and Shield of Massachusetts has agreed to compensate physicians for using E-Mail to communicate with patients for non-urgent problems. The physicians will be compensated the co-pay amount plus $20 per online visit. The insurers will decide what qualifies for the payment. This means this experiment may be short lived. Top
The medical licenses of two New Jersey physicians were suspended for two years under a settlement. The physicians were treating addicts with general anesthesia and ultra rapid detoxification using naltrexone as an abdominal implant. This led to immediate withdrawal but the patients did not feel them since they were under anesthesia. The Board attempted to take away the licenses but an ALJ basically stated there were other problems that may have caused the complications. He did state that the physicians violated five medical standards and should have screened for cocaine addiction and have done pre-op EKGs on those over 40. The doctors also have to pay $25,000 in civil fines, $350,000 to the state for their legal costs and $30,000 to 10 people who were injured from the experimental treatment. Top
In Pennsylvania UPMC dropped all it's Aliquippa physicians and sold the 17 person chattel to another organization. They did this since UPMC no longer has any hospitals in the area and would not want their physicians o refer to other hospitals. UPMC is also looking at other areas where they have no hospital.
In Columbus, Ohio, the Mt. Carmel System is adding another office building for its physicians. They currently have a waiting list for space in their existing buildings. The St. Ann's campus, where the new 100,000 square foot building would go, is also opening a $27 million Woman's Pavilion. The hospital has averaged double digit percentage in outpatient and inpatient volumes . The most interesting thing is with all this growth, this system is the one that has threatened to kick physicians off the staff if they join any specialty hospitals. If this sounds greedy to you, you're not alone. Top
The Wall Street Journal had an article about the long arm of the hospital going after uninsured patients. The featured case was that of Yale-New Haven Hospital going after a patient's husband for $55,000. They charge 10% interest on the original amount of $18,740. The hospital has placed a lien on the house and has taken money from his bank account. His wife died from cancer after treatment at the Yale hospital. The husband has not filed bankruptcy as yet.
Redding Medical Center is laying off 150 employees due to the federal investigation causing less patients coming to the hospital. There will be 50 jobs lost due to a decrease in home health and the others throughout the hospital.
The Hunter Group, a consultant group hired by UCLA, has recommended decreasing the 105 primary care physicians pay whose productivity is below the national norm. They should eliminate 475 hospital positions over three years. They should renegotiate insurance contracts for more favorable terms. They should bill more timely, hire LVNs over RNS and reduce supply costs.
In Atlanta, the physicians and the insurers are at odds over payments. An infectious disease specialist is getting paid for antibiotics but not the saline vehicle that is used for infusion. The doctor will need to eat the charges for this due to bundling. This is part of the allegations in the national class action suit against the insurance companies that is now centered in Florida. The physicians are taking the problem to the Georgia Insurance Commissioner so they know up front what the insurance companies will pay and whether or not they want to be part of the program. 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.