December 15, 2005 News






Finally, after many delays the high risk specialists in New Jersey are getting the money promised to them by the legislature.  Neurosurgeons, OBs and radiologists are getting checks of about $11,000 to help defray their med mal costs.  This is a three year program.        Top


It is always nice to see things do not change.  Upon my return from five weeks in other countries and hearing no world news nor reading any paper that had anything in it except Rugby scores, the country's worst hospital continues to make news. Yep. Yep.  King/Drew still reigns supreme.  Now it has been found that the CPR training of its nurses was up for the highest bidder and did not have to occur.  The seller was a nurse manager who was supposed to train the nurses and physicians in CPR. This might not be as bad as it seems since only 35% of the hospital's nurses are not from an agency.

In the most important piece of news from the City of Angeles is that the head of the Department of Health will no longer be the Board's whipping boy.  Dr. Thomas Gaithwaite has resigned leaving the four County hospital's leaderless.  He is going to Pennsylvania and starts his new position in the middle of January.  Now the sun will shine on the true culprits of the Drew/King fiasco, the Board.

Another Southern California Hospital is in trouble.  This time it is the University of California at Irvine.  They got caught with their hand in the cookie jar in the liver transplant scandal and now the feds are upon them.  The hospital had 32 people die waiting livers as the hospital turned down livers to transplant.  They have already had their Medicare certification for the liver transplant program withdrawn.  The current inspection is to see if there are other problems with the hospital.

In an article in the Dayton Business Journal, the problem of specialists taking call is again in the forefront.  The problem is more acute in urban areas as physicians have choices as to where to send patients.  With more choices the specialists go to those hospitals with less ED call.  This is especially true with plastic surgeons.  

Wisconsin's is losing about 1/3 of it's physicians at the Milwaukee campus after it tried to transfer them to Aurora Health Care.  The hospital believes the physicians are fungible and will be replaced but not by experienced physicians. 

The problems at Yakima Hospital have been solved according to the state of Washington.  There is also a new CEO after the medical staff have the old one a vote of no confidence.  All this started when the hospital's eight emergency room physicians quit over poor patient care.   

Hillcrest Health System in Waco Texas has a minor mutiny on its hands.  The neurosurgeons signed a contract with the hospital to cover the ED but the hospital was not supposed to recruit any other neurosurgeon.  The physicians kept their part of the bargain but the hospital did not.  Now the neurosurgeons have written a letter to the medical staff explaining their side and accusing the hospital administration of lying.  They also state the quality of care at the hospital has generated problems with patient satisfaction.  The hospital denies the quality of care aspect but not the recruitment action.  This will pit the present staff against those employed by the hospital.  This may also make the neurosurgeons move to the competing Waco hospital. This could be a true lose lose situation and the hospital has already lost by their quality of care being openly questioned by the physicians. 

In a fascinating report the Children's Hospital of Pittsburgh stated that their mortality rates increased following the installation of computerized patient order system.  They state that problems now are the time for entering an order, several minutes versus several seconds and the need for two people at the bedside, one to examine and one to enter orders. 

The OIG has taken a rare step in proposing exclusion from the federal program Miami's South Shore Hospital.  They have failed to comply with a prior Corporate Integrity Agreement.  They now have 30 days to comply or it's bye-bye federal funds.  

In Texas, more surgeons are opening surgical centers to stop the spiraling hospital costs and to become more efficient.  This is forcing hospitals to change their thinking or perish.  They must get rid of the cross-subsidization of the hospital.  Specialty hospitals are now back on the drawing board with Congress' inaction and Medicare's illegal moratorium to run out. 

In Kentucky, a new revision of the state's health plan would make it easier for hospitals to increase their beds.  The flip side is that it would also make it easier for new hospitals to open and the present hospitals are afraid of competition. 

In a Milwaukee Journal article there was a discussion of urgent care centers of Covenant Healthcare being a long arm of a hospital emergency room.  They then charge the ridiculous prices that EDs charge when the patient believes they are going to lower cost facility. The other urgent care facilities in the area are actually that and do charge less than ED prices.  The Covenant urgent care staffs the urgent care clinic as an ED but the patients aren't aware of that until after they are treated.  Covenant is hiding behind EMTALA in not telling the patient how much the charge may be until after they are treated.  That is appropriate in an ED but not in one who uses the signage Urgent Care.   

El Camino Hospital in the California East Bay made news earlier this year when the administrator and the anesthesiologists got into a fight regarding forcing the anesthesiologists to take the same insurances as the hospital.  This created such tension that the anesthesiologists were physically shown the door and scabs fro Stanford were hired with law suits.  Now the cantankerous CEO has left for a high paying job at Legacy Health Care in Oregon.  His salary at the community tax based based El Camino hospital was $441,000 base plus bonuses and perks.  I have had prior dealings with the CEO and found him to be as advertised.  

In Southern Illinois where the malpractice crisis is the worst, two hospitals are attempting to keep physicians. Belleville's Memorial Hospital has started its own malpractice company and is insuring some of its physicians that are having problems paying for the insurance elsewhere.  Nearby St. Elizabeth Hospital is attempting to get physicians by hiring a medical director that helps physicians with their practices.  They are also spending about $300,000 for physician techie stuff as well as started a GP residency program with St. Louis University and bringing in St. Louis private Orthopods.    Top 


There was a recent online discussion on a listserv I belong to.  It centered around core privileges and the new CMS and JCAHO considerations about how they don't take into consideration recent competencies.  Most of the hospital attorneys were for core privileges and the physician attorneys were against them.  The rationale for the hospital attorneys were to make sure they had an adequate stable of physicians to take ED call.  The physician attorneys took the position that if someone has not done any ortho procedures in years since they are only doing hand surgery they should not be on the general ortho ED back up.  One of the most interesting posts was from a physician who stated that even if one has not done a procedure in many years they may still be competent to do it.  That may depend on who is doing the competency.  If it is the physician or his insurance carrier it may be one answer.  If it is the hospital or their attorney it may be another.  This is another good reason for medical staffs not to allow the hospital attorney be their attorney for bylaw issues.  They need to hire one that works totally for them and not with an allegiance to the paying hospital.  However, they find this out too late.    

Patients do trust their physicians but still utilize the internet for more information.  This is good as long as the patient can sort out the quackery from the peer reviewed articles.  This is especially true in cancer treatment.    Top


The Cigna Board has given itself a nice raise.  As they continue their poor pay to physicians they increased their own pay by 40%.  They justified the huge jump by stating there has been no increase in their $170,000 salary in three years.  The outside directors did get a $50,000 retainer in stock and the rest in cash.  Now they get $225,000 of which 1/3 will be in cash and 2/3 in stock.  They also get an additional $10,000 for each committee they serve on and being eliminated is the annual $61,000 deferred compensation which is paid on retirement or death.  If you ever wondered why people want to be on Boards, now you know.        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.