April 1, 2006 News

Physician/Hospital Relations

Teaching

Physicians

Hospitals

Peer Review

Physician/Hospital Relations

All Saints Hospital in Racine, Wisconsin, is endangering their patients.  For whatever reason they have on staff a neurosurgeon, Dr. Harry Lippman, who has privileges at the hospital, and an office across the street.  The hospital has given orders that all emergency room neurosurgical patients are to be sent elsewhere.  The emergency room has lied to patients stating they need to be transferred since there is no neurosurgeon on staff.  It seems that there is an economic problem, since Dr. Lippman wishes to remain independent and the hospital has it's own set of physicians.  I would love to be the expert to testify or the attorney against the hospital for their independent negligence in any neurosurgical problem that may occur due to their inappropriate transfer of a patient.  The hospital should also be responsible for the bills for ambulances for transferred patients due to their policy.  One person had an ambulance ride to Milwaukee which she had to pay.  She should sue the hospital for the money.   

Tenet Healthcare has never cared about their employees or physicians until now.  The system is now trying to woo back physicians who have defected due to the lies and broken promises of the system.  This is hitting Tenet in the only place they understand, the pocketbook.  In the last quarter they lost $286 million.  The patient load was down 2.5% in the quarter.  The system is now sending hospital administrators to physicians to learn what they want.  This is the major reason physicians need to have privileges at several hospitals to give them leverage.         Top

Teaching

Harvard has begun a new teaching program.  Instead of the traditional movement between the teaching hospitals, they will stay in one hospital for an entire year and follow families.  They will report twice a month on the family status, any ethics problems or monetary snafus with the billing.  They will also learn the monetary effect of diseases and their treatments.        Top

Physicians

In one of the dumbest studies ever done, Dartmouth College studied academic institutions to see if we have enough physicians for the future.  They didn't study the amount of students.  They studied how many academic people were on the staff and related that to the number of patients seen.  What they found was some institutions are more efficient than others.  The academic physicians see almost no patients compared to the community physicians so who cares how many they or their inexperienced medical students see? 

The Washington Post has an article that physicians are providing less charity care that they had in the past.  Duh!!  They have no time since they have to keep a full schedule to keep up their salary.  In the good old days many physicians would volunteer at clinics and for teaching.  That one doesn't see anymore due to the reduction in pay by the insurers and government. The younger physicians also have a different mind set.  They are more for free time for the family than working the long hours their predecessors did.  

Speaking of payments, California has been ordered by a federal judge to pay physicians within two months the $58 million that has been withheld in the past four years for outside prisoner care.  Physicians had stopped providing outside specialty care to the the breach of contract by the state.        Top

Hospitals

It's always good to have Drew/King back in the news.  The University has its first non minority and first woman president in a Australian born psychologist.  Susan Kelly stated she enjoys challenges.  That's good because not only does she need to fight the entrenched civil service system, the poor hospital personnel, the cheating physicians but also the incompetent county Board of Supervisors. 

Allegany Hospital in Pennsylvania is still in the news for having refused to bow to state law in having a psychologist over the Department of Psychiatry.  The hospital is going against the JCAHO, state law, its bylaws and the AMA, APA and any other alphabet one can mention.  If nothing else the hospital leaders are stubborn and stupid.  They will cost themselves many thousands of dollars in a losing battle.

Modern Healthcare, a hospital newsletter, continues to rail against the community hospitals for their stance on specialty hospitals.  The magazine agrees with all who have looked at the matter that it is not about quality but about money. 

The LA Times has a story that Kaiser Bellflower Hospital has dumped a patient to skid row.  They claim that it was videotaped.  The hospital apologized after being confronted in a public meeting.  The patient left the hospital after being admitted for three days and was placed in a cab that took her to skid row and let her out.  Say this isn't true of a non profit hospital that wants it's patients to "thrive".  They want the thriving to take place on skid row.

The Los Angeles Board of Stupes has come up with a solution to the "dumping".  They will do nothing to the hospitals but will establish five regional homeless centers to put the hospital discharges.  This includes the suburbs.  This will become a NIMBY situation.  Each center would have 30 short term living beds and some mental health and substance abuse services.  

The Southern California Hospital Association has recommended that the hospitals attack the homeless problem by not dumping but by getting consent for discharges.  The hospitals should also attempt to utilize more social service for placement. 

The Denver Business Journal has an article regarding hospitals telling insurers they will charge them less if they take their competitors off their lists.  The hospitals deny that's what they do and blame the insurers who state they are getting the lowest cost based on volume.  

The People's Republic of Massachusetts' hospitals are not happy with each other but are happy with the state.  The University of Massachusetts Medical School and the UMass Memorial Hospital have pulled their residents from their rival St. Vincent.  This will cost St. Vincent 20 residents.  This is the equivalent of the fight between community hospitals and specialty hospitals.  It is all about money and power.  At the same time the legislature is continuing to consider healthcare for all, a financial bonanza for the state's hospitals.  Much of this money will go to the teaching hospitals at the expense of community hospitals. 

Partners HealthCare in Boston is thinking about selling patient data to the government, pharmaceutical and biotech companies, insurers and publishers.  I guess they like their name and want more partners.  They also like the money.    Top

Peer Review

The Eastern hospital consulting company almost had it right.  One their fronts stated in a recent article on external peer review that there are times when this is a desirable thing.  He then gave the way to set it up in the hospital.  The problem was he "forgot" to put it in the bylaws and allowed a committee controlled by hospital personnel to set up the "policy".  The general medical staff would not have input until the end and then would be told, not asked about it.  This is a terrible insult to the medical staff, but not surprising for this company.  It should be part of the bylaws and written by the medical staff and approved by the medical staff.        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.