The University of Pennsylvania has approved new guidelines for those who have no hope of meaningful recovery. They will be started in one year and will focus on dignity and alleviation of suffering. The policy allows for the transfer of the patient to a different hospital if the family of the patient requests. This will stop the use of treatment modalities that are not helpful to the patient recovery and cause the patient more suffering. This means not starting patients on ventilators but also not taking them off if they already are on one. Some hospitals will not fight for the physician when the physician refuses to do further treatment. They are afraid of law suits. This leaves the physician to transfer the patient to either a different physician who will go along with family wishes or to another hospital. The flip side is the patient requesting to withdraw treatment and the medical staff refusing. The University of Pennsylvania emphasizes that the physician should not start an invasive procedure such as dialysis or ventilator care without a discussion of the length of the treatment and when it is to be discontinued. Top
In the November 13, 2002 Wall Street Journal, there is an editorial about the recent election and the slap on PI attorneys. It describes the defeat in Mississippi of the soon to be Chief Justice of the Supreme Court, who was very tort attorney friendly. In Ohio there Supreme Court has also changed with the election of a conservative judge. This may allow the judicial passage of a legislative tort reform that was passes several years ago and then tossed by the Court. This may also, with the new Senate and House Republican majority, allow President Bush to push his national tort reform, providing he has the votes to override a certain Democratic filibuster.
Three health systems in Jacksonville, Florida are helping their physicians. They lowered their required malpractice coverage by 1/2. They also have allowed the physicians to post a letter of credit or escrow account for $250,000, as allowed by Florida law. While the latter might seem steep, it is much cheaper than insurance.
Florida Hospital in Orlando Florida is a subsidiary of Adventist Health. They are subsidizing their physician's malpractice insurance in order to keep the physicians they have from leaving the state. The System is going to insure up to 500 physicians state wide.
An entire medical staff in West Virginia has voted to move the hospital to Virginia, a half mile away. The hospital states that if would be too expensive to move the hospital. However the president of the hospital states the move would be better for recruiting, malpractice and business. The hospital already provides malpractice insurance for its medical staff. It would also make it easier to have a closer alliance with medical schools.
In Los Vegas the critical shortage of OB/GYNs is becoming worse. Already 30 physician have left, leaving only 80 OB/GYNs remaining to handle both patients. To make matters worse an HMO doesn't like criticism, deserved or not, and has suspended several other OBs. There is now a waiting list of up to six months for routine gynecologic surgery since OBs come first. The HMO spokesperson says there are enough doctors (22) to cover the specialty and that a six month wait is OK for non-emergent cases with pain and fear.
In Pennsylvania the physicians are feeling a little better since tort reform was passed. There are two new commercial insurers in the state and five new mutual physician owned insurers with fees 1/2 of the state insurance company. Even the State Insurance has decreased it's rates by 15%.
The largest malpractice insurer in Illinois, ISMIE is halting new applications starting the first of the year. They state they need to do this in order to remain financially viable. ISMIE is an affiliate of the state medical society and recently increased premiums only 15%. Those new physicians just finishing residencies and those who are with clinics will still be able to purchase insurance.
The Georgia physicians are going to the state capitol to rail against the high cost of insurance in the state and to lobby for significant tort reform. They have a shot after the recent election where the powerful Democrats backed by the PI lawyers were removed from office and pro-business Republicans elected. Top
The cardiologist in Redding who is under investigation by the FBI for unnecessary procedures, Dr. Chae Hyun Moon, was previously placed under supervision at the rival Mercy Hospital. In 1996, Moon was supervised by the cardiology lab medical director because of concerns regarding patient care and employee safety. This led to a court case where Dr. Moon sued to get back his privileges. The case was dropped but Dr. Moon is no longer on the staff of Mercy. I do not know, but assume Dr. Moon was reported to the Data Bank at that time.
The State of California Medical Board has elected to go into the public limelight. They will seek a temporary restraining order (TRO) against the cardiologist Dr. Moon and the cardiac surgeon Dr. Realyvasquez, Jr. to have them cease their practice pending an investigation by the Board. If the TRO is granted, the MBC will have 30 days to file formal accusations. The physicians would then have 15 days to request a hearing and the hearing would need to be held within 30 days of the request. It will be hard for the MEC to get their ducks in a row with hard evidence by that time frame. It will not be hard for the Board to fabricate evidence in that time frame. The TRO was heard before a state Superior Court Judge who told the MBC basically you have no evidence, only hearsay. The TRO was rightfully denied. In a twist in the case one of the patients who the FBI relied on for their warrant is the attorney who is representing the plaintiffs that have filed suit against the physicians and hospital. He testified at the TRO hearing. Is there a conflict of interest?
I was informed that three patients just filed suit against the physicians for un-necessary surgery and against the hospital for conspiracy with the physicians to defraud to increase profits. The above mentioned patient/attorney stated he plans on filing many more suits. It is important to be the first attorney to file so you get your name in print and continue to be quoted. This may lead to other clients in the same matter. Top
Two physicians and two hospital employees have been suspended at Medical Center of Louisiana for allegedly stealing medical supplies. The accusation is that excess supplies were ordered and the excess sent overseas. Top
An article in the Philadelphia Inquirer questions the long term viability of Cigna Healthcare. They are currently in the slow death spiral of decreasing stock prices and profit, increasing premiums leading to decreased consumers and decreased profits. All investment people rate the stock as a "sell". The only thing that was holding up the company was its stock buy back program. That recently stopped due to low funds and the stock is now falling to the level it deserves.
National Century Financial Enterprises, Inc. is a lender to the health care industry. It is now going under and will cause countless bankruptcies in the industry. To date, National is several months behind in payments. The company got a temporary restraining order in its state of Ohio to force providers to cease asking the payors to pay them directly instead of National. The trial is still in session regarding the providers attempt to overturn the order. The CEO of the organization has resigned.
As a direct result of National Century's financial problems, PhyAmerica Physicians Group Inc. has filed for Chapter 11 bankruptcy protection. The company supplies physicians in 30 states.
Also in the upcoming cavalcade of bankruptcies related to National Century is Tender Loving Care Health Services Inc., a subsidiary of Med Diversified, Inc. Med Diversified is planning on a $1 Billion suit against National Century
In another part of Ohio, Renaissance Health Plan is being liquidated by the state. It has a $8.1 million deficit. This defunct HMO offered both commercial and Medicare contracts.
The Nevada physicians are now going to attempt to get an any willing provider bill passed in the state. This is in direct response to the managed care organization that suspended some of their critics. Currently more than 20 states have some form of the any willing provider clause. This means that if a provider accepts the reimbursement, they will be accepted into the plan. Top
Ft. Meyers Florida voters turned down by a 57-43% vote a tax to help fund the only trauma center in southwest Florida. Following the vote two Lee Memorial Hospital trauma surgeons who have been there for a short period of time have told Lee Memorial they have sent out their resumes in order to go elsewhere. Top
In a long article in the Chicago Tribune the JCAHO has again been criticized for their methodology and laxness. The article points out under one percent of hospital fail their accreditation and others such as Palm Beach Gardens have received high marks as they were almost closed for infection control problems. The article criticizes the allowance of hospitals to choose the patient records that will be looked at for compliance and the three month lead time notification given the hospitals. They also state has have many that the agency focuses on paper and not quality. This has led to the JCAHO changing its format after all these years. The article went on to state the high salaries of the executives and the coziness between the agency and the people they survey. The article then states the use of consultants by the hospitals to get ready for the survey. These consultants are often part of a spin-off consulting business of the Commission. The cost for the consultation may be $10,000 for a three day evaluation and of course the JCAHO preparation for the hospital can run well over $40,000. Hospitals have temporarily removed clutter and old instrumentation from the hospital while the survey takes place and then returns the elderly equipment for patient use when the survey is over. The CMS has encouraged competition and there are two other accreditating agencies. The AOA will accredit any hospital or ASC for Medicare. They seem to be more focused on outcomes and not paper. Their cost is much less than the JCAHO. Also the state Departments of Health will survey for the Conditions of Participation for free. Some hospitals are afraid to leave the JCAHO but those who have have continued with their managed care contracts and have not been chastised by their peers. (See New Legislation/Fines) Top
Pennsylvania's Aliquippa Hospital has some problems. The hospital had filed for bankruptcy, possibly due in part to not billing for physician services in the radiology, emergency room and anesthesia departments for about six months. This has led to a physician revolt and the resignation of the CEO and all the non-physician members of the Board. A new management company has been hired to turn the hospital around. A new board was put in place by the remaining physicians on the Board. 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.