August 15, 2004 News



Patient Privacy




In New Orleans a fake physician "Dr." William Graham sweet talked women into believing he was an abortion physician when in fact he was a liar who wanted women to delay their abortion until it was too late to have one. Now seven women have filed a federal lawsuit against him.  The judge has ordered the phone disconnected.  He is well known as a person who pickets offices and videotapes women entering Planned Parenthood offices.  He is being sued for fraud, false advertising, and trademark infringement.  It is doubtful if anyone will ever see a dime from him and he is not charged with any criminal offense.   

In Boston, a Public Health Committee with physician input, has made sweeping recommendations on bariatric surgery.  This runs from extra large wheelchairs to only doing the surgery in hospitals that do over 100 per year and with surgeons who have gone through a rigorous training program.   

There is a new test for getting one's license to practice medicine in the United States.  A new day long test has been developed using live actors who will grade the fledgling physician on his/her bedside manner.  The "patient" will not only have a disease that the doctor must find and order tests to differentiate but also take care of the patient's emotional needs as well.  The test is expensive for the student and also requires travel to the few sites that do the tests. 

A woman in Massachusetts has died 18 months post op stomach stapling.  Her 8 month fetus also died.  The death was an internal hernia with resulting infection and necrosis of the intestine.  This probably had nothing to do with the pregnancy but with the surgery itself.  I don't know why the complications happen in this state.  

The DEA has released federal guidelines for the use of narcotics.  If used for intractable pain, physicians will not be prosecuted for using morphine or its derivatives.  The new regs state how to diagnose severe pain and keep good records for the justification of the pain meds.  There are twenty states now out of kilter with the regs and they will be sent the regs to adjust their rules to the regs.       Top


A Massachusetts woman was in the waiting room of South Shore Hospital in Massachusetts, for asthma.  she became frustrated after being told she would need to wait two hours although she was having difficulty with breathing.  She used a phone and called an ambulance to take her to another hospital where she was admitted for two days.  The patient was offered treatment by the nurses but not a visit with the physician for several hours.  The hospital was investigated for EMTALA and cleared.

In University Hospital in Sherbrooke, Quebec, Canada, about 100 people have died from Clostridium difficile in the past year.  

King/Drew can not keep out of the news.  I guess when you are bad in one thing it just spreads to others.  As you know they have had their residencies in several specialties removed and have lost their CEO and other administrative personnel for incompetence, The State of California and the Medicare folk have come after them for various things but of course the JCAHO recently certified them.  Now the Feds are after them again.  This time for more nursing mistakes and lapses.  The did not give ordered meds and respiratory treatments to patients.  It was also found that psychiatric nurses had a census of 22 patients each.  The nurses could not even get weight correct. The hospital has submitted a plan of correction, as it always does.  The feds have not decided they will accept it.  The LA Board of Supes has not been heard from.  They are the ostriches.

After writing the above the ostriches have emerged.  They are frustrated with the poor performance of Drew/King and stated that the Drew Medical School would have to improve their performance or the County would pull funding.  Of course the Supes found that salaries at the Center were higher than the other County facilities and stated they need to be cut.  The Board is finally taking an interest, albeit a very tardy one.

Still on the lousy hospital, there is now a question of where the money is.  The auditoors are not able to account for millions of dollars of county money.  Not all is Drew/King's fault.  The county has to should a significant amount of blame since they did not set up a compliance program as required. There is also an accusation from the Accreditation Council that has already taken away three residencies from the hospital tha the Orthopedic program may have intimidated residents not to complain about the care given. The Council has threatened the program with deaccredidation.

At Swedish Medical Center in Seattle, the physician narrowly defeated a vote of no-confidence against the CEO.  The vote was 330-313.  The cause was the usual poor communication between administration and the medical staff as well as money issues.  

Lourdes Medical Center in Willingboro, Pennsylvania is practicing its name.  The hospital is hoping for a miracle to get permanent nurses to replace those that have been on strike since April 19. It is probable that the Labor Board would also order the striking nurses to be hired back by the hospital.  Also nurses just don't materialize.  They are an endangered species.  

In Chicago, the aldermen have asked the Assessor to start assessing Resurrection Hospital full taxes on their property.  This is due to the decline in charity care and aggressive collection tactics.  Resurrection is the largest Catholic hospital system in the city. The sidebar to this is the unions of Chicago are attempting to unionize the employees. 

Up the road in Milwaukee, Wisconsin, Aurora Sinai Medical Center is cutting care to the indigent.  The hospital lost $24 million last year and has lost $14 million this year.  The hospital has restricted the amount of these patients their physicians may see to restrict how many will be hospitalized.  

Kaiser Hospital and its Health Plan and physicians have decided they could use a facelift, which they don't pay for.  They are willing to pay for the cosmetic ad campaign to show it's not as bad as people believe.  They are paying $40 million to get people to believe they are good.  They want more members so the bureaucracy may increase. 

In Ohio, an opinion in the Columbus Business Times lauded the care in specialty hospitals and told the truth behind the general hospital's fear of the competition.   

M.D. Anderson has a huge backlog for second opinions for women with breast cancer.  Because of the backlog they will stop giving second opinions to those women who are treated elsewhere.  The pathology department will continue their second opinions on the slides.  The breast cancer advocates are against the hospital procedure since it does not allow access to this hospital.  Others state in this era of rationing of care, it is a reasonable step. 

I'm not quite sure why this is news but in Pennsylvania, the hospitals are reporting an ten-fold increase in gastric surgery for obesity.  It works, goes to the bottom line of the hospital and physician and is relatively safe if not done in Massachusetts. 

In Sanford, Maine, several hospitals were attempting to build a cancer center.  One hospital was left out and threatened suit.  That hospital is now in and another one is out.     Top

Patient Privacy

In Orlando, Florida, an administrative employee had stolen hundreds of patient identifications and was planning on selling them.  One of the intended buyers told Orlando regional Healthcare about it and the employee was fired.  The hospital also turned the ex-employee in to the Feds.  Orlando Healthcare has notified the patients and has recovered the records taken.  The fine is $250,000 and 10 years in prison for attempting to sell healthcare records.          Top


In Oregon, the voters will decide in November a non-economic cap as part of a tort reform platform.  Public Citizen, a Nader organization not known for its evenhandedness, has stated that the doctors of Oregon are not leaving.  They, of course, did not look at whether or not the physicians where practicing, only the raw numbers.  They did not look at the number of specialists that have stopped some of their high risk operations, only the raw numbers.  

In New York, the state is gearing up for a possible legislative battle in the med mal arena.  The impetus is a case, Desiderio v Ochs by the Court of Appeals, which asked the legislature to look at the laws.  The court followed the present law and raised a jury verdict of $40 million to $140 million.  

Candidates Kerry and President Bush both want med mal reform but in different ways.  President Bush has been asking for a cap on non-economic damages that has been stymied in the Senate by the Democrats.  Kerry is now asking for emphasis on preventing errors and promoting safety, meaningless terms.  He would allow specialized med mal courts and would bar attorneys who have three "frivolous" claims from being the attorney on other cases.  He also would bar the almost never used punitive damages from med mal cases.  I wonder what his vice presidential nominee would say.       

C-sections are on the rise due to malpractice concerns.  More OBs are refusing to do VBACs as they are more likely to lead to malpractice claims.  Even hospitals have stopped offering the procedure as one they offer.  This includes 250 in the country.  The C-section rate is now at 26%, when it used to be about 16-18%.  One of the main drivers in the hospital decision was the 1999 ACOG recommendation that VBAC be done only if all key personnel were available to do an emergency section.  The ACOG this year recommended that no VBAC be recommended to patients with two C-sections. 

Virginia Governor Warner has issued an emergency order to increase Medicaid payments to OBs practicing in rural and urban areas.  This brings the payment from 60-80% of that received from private insurers.  The state will pay half of the increase and the feds will pay the other half.     Top


Cigna in Denver originally turned down a one year old for a stem cell transplant for a rare disease called Sandhoff Disease.  There is no known treatment but there has been some help in Tay Sachs Disease, a related form of disease with stem cell transplant.  The coincidence is that the Cigna turnaround came the same day as a story about the original refusal appeared in the Denver newspaper.

A survey published by Health Affairs shows the HMOs are planning to reinstate the old restrictions (rationing) of care.  This is to help stem the rising costs of the plans and again make them competitive.  They still don't understand that the people don't want the restrictions on physicians and treatments.         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.