October 15, 2008 Recent News

Medical Malpractice




Medical Malpractice

West Virginia has found that their Med Mal claims have dropped by about 1/2 since their reforms went into effect five years ago.  The physicians of the State are also happy and are not leaving as they were doing prior to the reforms.  As a matter of fact the number of physicians in the state is increasing with a steady number of population.  The problem is that the Supreme Court has not ruled on the lowered non-economic caps as yet.        Top


The AHA has put out on their site a article by the VA that they say shows physician specialty hospitals are not as cost effective as community hospitals.  The article, when read, uses information not from any hospital but from other sources, such as the AHA and then applies their own statistical analysis to the number to see if the specialty hospitals are as cost efficient as community hospitals.  They found that specialty hospitals were not as cost effective as community hospitals except for cardiac hospitals which were the same.  There was no mention as to the funding for this study from the VA.

In another article the GAO states that hospitals may have incentives to under report hospital acquired infections.  I'm sure, knowing hospitals, that they would never do such a thing on purpose just to show they were better than their neighbor hospital.

Of course when hospitals such as the for profit Danville Virginia Regional Medical Center lets go one of the only physician taking care of Medicaid patients in the community, there is not a peep from the high and mighty AHA.  The physician had been taking care of the Medicaid patients for 14 years until the hospital went from non profit to for profit when it was sold to LifePoint.  The problem, according to the physician was that he was keeping people well and out of the ED and the hospital.  When the hospital is not making money they cut the program.

The Chicago Tribune has an article from the Cleveland Clinic Journal of Medicine that quotes a Baltimore internist who blasted teaching hospitals and hospitals in general for their uncaring way toward nursing, patients and physicians.  He stated that his hospital Johns Hopkins had management retreats for the department chairpeople where they talked ad nauseum about customer service but at the same time had 12 hour ER wait times due to a "lack of beds".  He stated there were no lack of beds, only lack of nurses to staff the beds.   

In Buffalo, New York, the merged Kaleida Health and Erie County are fighting a court order to hold open board meetings.  This is a drawback in New York when the non public hospital merges with the public.  If they had an overriding board but kept separate hospital licenses this may not be a problem.  

The Wall Street Journal had a story about non profit hospitals closing their less than profitable inner city hospitals and fleeing to the suburbs.  The AHA, as usual, says nothing about this for profit move.      Top


Medicare's changes in handling claims and payments has led to a significant delay in payment to California physicians.  This, in turn, has led to a decrease in seeing new Medicare patients.        Top


The NHS in Britain is offering a 20 Pound bribe to people who are prone to illness and have not seen a practitioner.  The critics say not to spend money on losers when the money is needed now for cancer curing drugs and the lack of personal responsibility.  The Health Secretary wants to equal things out by targeting people from disadvantaged backgrounds.   

The Members of Parliament are not happy with the NHS giving their physicians a "eye-watering" raise in pay.  What happened is the GPs had gotten reduced working hours for the same pay and were five performance bonuses. Now the physicians will get money directly proportionate o the number of patients on their list and the health needs of their local populations. Along with the raises the GPs had to keep open after hours and about half now do.  

It is interesting how the media spin the story.  The headline is "Survey indicated 15% of online health insurance shoppers may be "uninsurable".  This means that 85% are insurable.  That wouldn't be a story.  Buried in the story is that these people either have pre existing conditions or body mass index of over 39.  These may be insurable but at a higher premium.

The Washington Post doesn't believe that the uninsured get the same treatment as insured patients.  I wonder where this paper has been.  Of course they don't.  A physician must take into consideration payments for tests and treatments with all patients.  With insured patients it depends on the whim of the insurance company.  With uninsured it depends on what the patient desires, taking costs into consideration.  Any physician who doesn't is not doing the patient a favor.

The Principal Financial Group has found that more people are taking control of their own healthcare.  They are doing this by using generic durgs, attempting to take better care of themselves and talking more to their physicians.

When the Congress passed the mental illness parity act they added about 1.6% to the medical premiums of fee for service plans and about 0.3% for HMOs.   

The following was published in Modern Healthcare regarding the stupidity of EHRs:

Article published October 10, 2008
EHRs don't save Texas doc time, money or paper

I can't stand it any longer! This nonsense that electronic health records will save money must stop! We have a six-man orthopedic group in Lubbock, Texas, and have had one company for six years and were ill advised to switch to another this year. Both are nothing special, don't save time, don't save money, don't save paper, are not safer for patients.

My God, who are the idiots who have convinced our legislators that these systems will somehow save money? Improve patient safety? Hogwash! Try to update a longstanding patient's profile in your computer ... see how long it takes you, how slowed down your office will be. I just read that there are only 50 practices using our current company in the U.S. I know why—the system has huge flaws, like not being able to fax batched documents. Where are the efficiencies? For $250,000, I could have hired more staff, funded my pension and taken a hell of a vacation. Somebody please stop this misinformation.

Mark Scioli, M.D.
Lubbock, Texas



  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.