September 15, 2005 News





Some good news about Drew/King for a change.  The Board of Stupes voted to spend all of $32 million to renovate six Ors and a recovery room along with fixing some corroded waste lines, air ducts and electric panels.  The Board hopes to give another $32 million later if the hospital is still there to address infection control and patient safety issues.  As usual, they got the order backwards.

A Tenet Hospital in Culver City, California has been purchased by an organization that owns 10 IPAs as a minority shareholder and by physicians on the hospital staff.  The hospital is 420 beds and could serve as the nucleus for an HMO. 

Another physician hospital will open this month.  Century City Doctors Hospital in Los Angeles has undergone a huge facelift.  There are about 180 physician owners.  Guess where their patients will go?

The Texas Attorney General has interceded in the battle between Baylor College of Medicine and Methodist Hospital.  The AG wants the two to kiss and make nice to each other.  The AG has forced the two entities into meetings to attempt to resolve the dispute.  While the meetings are in progress another large group of physicians deserted Baylor for Methodist.  Eleven more cardiologists went over making a total of 80 physicians that have deserted Baylor to go to Methodist.   

Texas Health Resources fired its CEO after an internal investigation found irregularities in the leasing of physician office space.  The matter has also been reported to the feds. 

The feds have set up emergency medical shelters in 40 locations.  Each will hold 250 beds.  They have also suspended until September 25 all med mal claims against physicians and all licensing requirements in the Katrina locales.  The med mal under the fed tort claim law will go for those who apply under the federal program.  

Pennsylvania outpatient surgical centers especially those owned by physicians are increasing rapidly.  Now over 20% of all surgical procedures are done in the centers.  There will be more centers than general hospitals in the state.   

Westminster Medical Center in New York has been roasted by the state.  An audit has shown mismanagement, sloppy accounting and wasteful spending.  There was no fraud just ineptitude.  The hospital says there is a new management team that has fixed the problems.  Anyone want to bet on that?  The waste stated was by the hospital executives having alot of good dinners and retreats. The CEO said part of his job was to get donations which required the going to the yacht club and other fine establishments.   

The hospitals in New Orleans want to try to reopen but they have a few problems.  There are no people to be patients and their are no people to staff the facilities.  If people did come back to staff the hospitals there is no money to pay them.  Many of the physicians have lost their possessions and homes so are looking to permanently relocate to other locales.

There has been some minor criticism of physicians for concierge medicine but there does not seem to be any criticism of hospitals who are building VIP suites for those who can afford the very best.  This may be $250-$400 per night above the insurance fee.  The high rollers get extended visiting hours, extra beds for the spouse to sleep marble bathroom and a refrigerator.  Many also have web access and fax machines.  I guess it is okay to have two tier systems for hospitals but not for physicians.  Patient choice only works for hospitals since they seem to be fungible. 

Kaiser of Northern California is flush with money and will use it to build more hospitals and a cancer center in San Francisco.  This is a new concept, having patients go to one place instead of what they are doing now, sending the patients all over the area.  This will take the patients from their communities and send them to the one locale, no matter the cost on the patient.       Top


In 2004 specialist physician compensation climbed a whole 1.4%.  The primary care went up 3.13%.  Declining specialist were ophthalmology by 6%, urology by 2.41% and ortho by 0.1%.  On the other side neurology went up 10.54%, general surgery up 6% and psychiatry up 12.5%. In primary care all three went up with FP up 2.32%, peds up 1.47% and the big winner is internal medicine at 5.36%.  

Georgia is looking forward to an influx of physicians due to their med mal climate.  The inflow has already started with those finishing residencies in other states filling out applications for licensure.  

An interesting article compared the hours a resident works to alcohol intoxication.  Those that worked less had the better reflex and thinking modes as did those with lower levels of blood alcohol.  If the residents worked 80 hours a week, the legal limit, they had the same reactions as one just below the legal alcohol limit.  

What happens when you don't play nice to physicians and they have freedom?  They move.  In Jacksonville, Florida, six pediatric orthopedists moved from Nemours to  the rival Orlando Regional Healthcare.  The physicians were not actively recruited, which says alot about the place they left.  Nemours will close its orthopedics until they can recruit new pods.     Top


Blue Cross and Blue Shield of the People's republic of Massachusetts are again reverting to the stingy HMO mode of business.  This includes pre approval and waits for needed radiography.  Those practices that order the most will face the most stringent restrictions.  The Blues now join the other mangled health plans of the state in the use of pre approvals.  Unlike the much vilified Tufts Plan, the Blues will not deny a procedure only advise.  At Tufts, the patient may be stuck footing the bill if they go ahead without the pre approval.  Currently the Blues policy is only for primary care physicians as the Blues believe they know not what they do. 

Just two weeks after the VA said how good they have become as compared to their terrible reputation in the past, the Palm Beach VA was castigated for not providing timely radiology and for their poor follow-up with no readings for several weeks.  I again preach that the VA is nothing but a boondoggle and should be gotten rid of.  The veterans would be better served in the private sector without the massive costly duplication of services.  

In a awe inspiring moment a JAMA article has found that those with insurance get better follow up care after an ER visit than those with Medicaid.  Could this have anything to do with the two tier system that the government created by paying less than adequate  amounts for care?  Even the uninsured who stated they could pay $20 upfront and arrange for payments got in sooner than any Medicaid patient.        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.