The British hospitals have instituted a dress code for physicians. There can be no ties, long sleeves, fake nails, jewelry and the traditional long white coat. The rationale is that they all may be harboring bacteria. Ties may look professional but are seldom laundered and worn daily. They have no medical purpose except to potentially be filled with pathogens. All should be bare below the elbows. In the US there is no such code since there have been no studies on ties. There have been studies on fake nails and they have been found to harbor MRSA.
Some pediatricians are not giving recommended but not required high cost immunizations to patients when their insurers are not paying enough money to cover the expenses. This is true in California with Blue Shield. Physicians are not giving Gardasil anti HPV, TotTeq anti rotavirus, Menactra anti meningococcal, and Prevnar anti pneumococccal and Flumist instead of the shot. The patients are paying for these themselves and then getting reimbursed by the insurer. This may lead to more patients seeking the immunizations at the public health departments.
In Maryland, the state has begun an investigation as to the claims physicians have made not getting paid. The state wants to know if this has any impact on the availability of physicians. The physicians state they are underpaid and in fact are in the lowest quartile for payments. The insurers state that higher payments mean higher premiums and doesn't take into account the overhead of the organization.
There are problems with the new NPI and the crosswalk that CMS created without much thought. CMS has stopped paying physicians as of September 4 for claims whose NPI do not match the old numbers. Top
St. Mary's Hospital in Daly City, California, just outside the city limits of San Francisco is having a mini revolution with its staff. The hospital wants to give an exclusive contract to a group of anesthesiologists and the medical staff are not happy campers. They have had a vote of no confidence in the CEO of the Catholic Healthcare West hospital. There have been complaints over the quality of care since the exclusive contract was awarded. The hospital has hired an outside consulting firm to try to quell the uproar but there is now a quieter uproar. The Vice President of Medical Affairs denies a vote of no confidence ever took place even though that has been confirmed by multiple outside sources. He may also be looking for a new job if the CEO loses his. The hospital has lost potential physicians and nurses due to the CEO and his management style. If CHW doesn't act there may be some defections from the medical ranks to other nearby hospitals.
All the hospitals in Minnesota have agreed to not bill for "never" occurrences. This includes the follow-up care for these mistakes.
The hospitals in the People's Republic of Massachusetts are seeing more patients now that there is universal coverage. This is good news as one hospital converted administrative space to medical space, a real change for the good. Many of the community health centers are picking up a lion's share of the business. The reason for the increase in the community health as they offer more services in one place than does any private clinic. Another reason for the increase is that three of the four insurers in the new health care system are directing their patients to these clinics for cheap care.
In Connecticut Valley Hospital, a psychiatric facility, had a federal investigation which revealed many deficiencies. They are told they will lose federal funding if they don't quickly fix their problems with nursing, patient wards and their records. The hospital is run by the State of Connecticut. The hospital had also been cited by the US Justice Department. How nice for the state.
The LA County hospitals are in financial difficulty. About 15% of the beds in the region are in danger of closing. It is due in great part by an influx of illegal immigrants and uninsured patients. The state mandate of nursing ratios has increased hospital costs and small hospitals are losing patients and staff to the larger ones.
The GAO has issued a blistering report on the care at the Veteran Hospitals. It has been now seven months since the report on Walter Reed and now 46% of the returning vets have medical problems. The hospitals and the DOD have different policies and are not working together. There are not enough nurses or social workers to care for the vets. Again, I reiterate that the VA system should be demolished in favor of giving the vets the same care as either our national legislators get or Medicare so they may see any physician.
Kaiser Hospital is on a hiring binge. They have hired 1700 nurses this year but still have alot of vacant positions. They need almost 2000 more. Kaiser's new Director of Hiring stated that Kaiser management didn't know their right hand from their left in the hiring arena. Now they are making a measured commitment. That's not saying much.
UCSF has been cited by CMS for problems with their pharmaceuticals leading to a patient death this past January. UCSF tried to blame some of their problems on a new electronic medical record system. That is either a cop out or a blast at their IT. Of course, the idiotic unions are saying that the problems are due to not paying enough to their people. Top
An article in Medscape General Medicine discusses what should be the rational guidelines for medical marijuana in the state of Washington. They first discuss the law and what it protects or doesn't protect. They also discuss the stupidity of the federal laws. The feds state that today's marijuana is is stronger than in previous years but then reclassify Marinol from a Schedule II to a Schedule III drug. The authors believe a 60 day supply in reasonable. This would be different for different people. If one uses the federal amounts being supplied legally to five patients in the country and the amount needed to get the correct dosage each of the five patients would need about four pounds per sixty days. Using the stronger marijuana most patients in Washington would need one pound per 60 days. They also recommend that the patient be allowed to cultivate 99 marijuana plants since the feds state arbitrarily that 100 plants or more is a minimum five years in jail. Top
The US Capitol of HMOs, Minnesota, is finding the enrollment in these products continue to decrease. In 2006, enrollment dropped over 8% due to employers dropping the expensive insurance for other plans or becoming self insured. Along with the decline was a 8.5% premium increase versus a 7.1% increase the year before. Many HMOs lost money in operations but made it up and were positive due to investments. 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