November 15, 2007 Recent News

Physicians

Medical Marijuana

Malpractice

Insurers

Hospitals

Physicians  

A survey by a Texas firm shows that almost half of the physicians over 50 will reduce or end their practices in the next 1-3 years.  This is due to the problems in practicing medicine.  This may be increased by the impending Medicare cut.  The physicians also believe that the younger physicians do not have the same work ethic as those that entered the field 20 or more years ago.  In a continuation of a trend, 57% said they would not recommend medicine to their children and 44% said they would choose a different field (not medicine) if they had to do it over.  This is a sad commentary on the profession.  

Johnson and Johnson's subsidiary DePuy Orho paid over $6 million to two Boston Orthopods for "consulting fees".  They used the companies products at Brigham Hospital.  The Pods stated that they donated their take to charity.  The company was fined of $84 million.  Another otho company, Zimmer, will pay a fine of $169 million.  The sad commentary continues.

Physician adoption of EHR depends on the definition of EHR.  If asked almost 40% of physicians will say they have EHR.  If the drill down goes to a minimal set of functionality the percent drops to 14 and if full range the percent drops to 5.  Why?  It is cost and distrust.  As a follow-up to this story and to protect their turf, the American Health Information Community will present to CMS a resolution to mandate electronic prescribing.  Of course, CMS has no authority to do so.     Top

Medical Marijuana

A study by the University of California San Diego shows experimentally induced pain is ameliorated by inhaled marijuana at mid range doses.  High doses seemed to increase the pain.  The study is published in November Anesthesiology.        Top

Malpractice

Pennsylvania's

Insurers

Who would believe this of those wonderful people?  California's Health Net paid bonuses to its analyst in charge of insurance cancellations a bonus after the insure avoided paying over $35 million by rescinding insurance policies.  This was found during discovery in a law suit by a woman whose coverage was dropped by the "insurer" during the woman's chemo for breast cancer.  She is seeking $6 million.  This was an arbitration hearing that the judge deemed to be so important that he opened it up to the press.  It is against state law to tie compensation to denial of claims but the "insurer" did it anyway.  The arbitration went in the insured favor for payment of the chemo but the judge still hasn't ruled on the bad faith aspect.  The State is now going to look at the insurer and they should expect bad publicity and a large fine.    

Medicare Part D will be more costly as almost all insurers have raised their premiums.  This should have been expected as the companies used the first year as the loss leader to reel in the suckers.  

Kaiser is not gaining members but they don't care.  They can pay out less and still make money by raising premiums.  They made a net income  in the first three quarters of 2007 that doubled that of 2006. 

Hospitals are screening patients for drug resistant germs and increasing the use of the new antibiotics.  Are they doing this for altruistic reasons?  Are they doing this because it is the right thing to do?  No!  They are doing it because Medicare has stated they will not pay for some infections that arise in the hospital such as MRSA.  Although it is expensive to do the screening and treatment, it is less expensive than eating the cost of a major post op infection. 

Cigna and Aetna have agreed to change nationally their physician ratings.  The problem was in not separating quality as they perceive it from being cheap. This was done thanks to the New York AG working out a solution with the insurers.  United has not responded as yet.       Top

Hospitals

Cardinal Sean O'Malley of the Boston Archdioceses sent an email to Caritas Christi Health Care System and staff stating they have been treating too many uninsured patients and have become a financial drain on the entire system.  The system may be closed. Ain't Catholic charity wonderful.

Methodist Hospital of Sacramento California is vying for the right to be a trauma center in the area.  A problem may be the Joint Commission only gave the hospital a conditional accreditation.  Some of the problems were in medication orders and the overseeing of the medical residents.

California Rehab hospitals are being audited by CMS via an Atlanta company, PRG-Schultz.  The company gets paid a percentage of all the money it recoups for Medicare.  They have to date stonewalled all questions asked of it by California lawmakers and have a "pause" put on it by CMS.  After a bill was introduced in Congress regarding the company, they have stated that they have saved Medicare many millions of dollars and that almost none of the denials have been overturned on appeal.  They also stated that most hospitals have had no money taken away for their lack of medical necessity in admitting post op ortho patients.  The major problem is that it is not a fixed contract but is based on a percentage. 

Allina Healthcare Hospitals are in financial trouble.  They are asking all non clinical personnel to take paid leave so that it shows up as a liability on the balance sheet.  If not enough take leave, layoffs may ensue.   

Grady Hospital in Atlanta has been given an ultimatum.  They have to change their leadership or have the two schools that provide students pull out.  The schools want politics out of the leadership.  The idiots that run the hospital are like the rest of the politicians unlikely to give up patronage unless they have to.          Top

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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.