July 1, 2006 News



Plan B





King/Drew, the country's worst hospital is being inspected to see if will continue to get federal funds.  One would think they would be on their best behavior, but.  A patient recently died after being hooked up to a cardiac monitor and leaving her bed, wandering off the unit, falling and dying.  What happened to the monitor watch?  To make matters worse, when she was found she was not taken to the ED but back to the ward where she went into cardiac arrest and died.  If one can imagine, an internal investigation said the treatment was appropriate.  Unbelievable!

The second ED director in six months has been removed at the wonderful Drew/King Institution of lower medicine.  Dr. Patrick Aguilera went on administrative leave for sexual harassment allegations.  A secret survey has found serious concerns of working conditions in the ED.  The hours were long and the teaching of residents poor.  There were also no senior physicians to supervise the work.  Recently the LA County Board of Stupes approved a one year $12 million extension for Drew at the hospital as well as $2 million for retroactive expenses.

The axe continues to fall at Drew/King on the new staffers.  After the above ED person was canned, the administrator of the Comprehensive Health Center was fired.  She was picked by the ill fated Navigant Consulting Group that failed in its bid to turn the hospital around medically.  Both people were let go just prior to the crucial CMS inspection.  

Kaiser has continued to be criticized for its lack of speed in transferring their patients to the real transplant hospitals.  In the one month since the badly designed program was dismantled, 48 of 2000 patient records had been transferred.  This is miserable PR for the organization that uses the word "thrive" in their advertising.  They deserve to be sued by most of the patients on the transplant program.  Of course, with Kaiser one cannot sue but several thousand arbitrations should be interesting. 

The LA Times reported that Kaiser was blasted by the feds and everyone else for their poor handling of the patients for transplantation. CMS stated that Kaiser had inadequate staffing, poor planning and administrative chaos.   They won't do anything since Kaiser has already begun very slowly moving patients back to the University programs for transplants.  I wonder if the slowness has to do with patients dying prior to the transplant being done and money saved.  One of the heads of the Kaiser program was reported as saying there was nothing wrong with the program.  The paper reported basically that feds said the person  lied.

Kaiser is also being investigated by the California Department of Managed Care for the handling of patient complaints s related to the recently dismissed physician.  The Department is recently hearing that Kaiser patient's complaints have fallen on deaf ears.  We who have to deal with Kaiser have known that for years and have reported that to the Department with no results.  Now 140 files have been transferred to the Department regarding the one physician.  If they ever got the files on the other complaints, it would fill up a room.

The non-profit hospitals are coming under fire by the one entity they don't want to see, the IRS.  The IRS is beginning an investigation of the non-profits to determine the amount of charity care they give and what they do with the uninsured.  They recognize their audit rates are low and will now do something about this to the detriment of the non-profits who are billing full bore for the uninsured.

One non-profit, St. Mary's Hospital in San Francisco, a CHW institution, is going down a path of self destruction.  The CEO has taken lessons from the past CEO of Community Hospital in Ventura and is antagonizing the profit makers of the hospital.  He has made the anesthesiology department a closed department against the wishes of the surgeons.  Several of the major surgeons are leaving and more will leave for The CHW rival Sutter. The medical staff has taken baa lessons (see newsletter) and approved bylaws changes that are good for administration but not the physician or medical staff.  If more major surgical specialists leave, the previous in debt hospital will be again.  I don't understand the medical staff for not having any backbone and giving up their rights.  They deserve what they get.

The University of California Irvine has been under surveillance for their poor performance with their transplant program.  Now two of their top stroke physicians are leaving due to political concerns.  Soon, the hospital will be a shell of its former self.

Tenet has not stated that they will keep Alvarado Hospital open after the settlement for illegal physician recruitment. 

In Fresno, California, a physician owned cardiac hospital is going under.  The Fresno Heart Hospital will be sold to Community Medical Centers (CMC). CMC may build more ORs at the facility and expand the services.   

All know that the hospital EDs are having trouble staffing specialists.  More hospitals are going to the pay for physicians and one in Troy N.Y. has gone a different route.  They have hired "surgilists" to care for the routine surgical patient coming to the ED.  Specialists will be saved from routine ED duty and will only be called for their specialty cases that can not be handled by the surgilist.

Hospitals are also be bombarded for interpreters.  The biggest need is Spanish but regionally others are needed as well.  Some hospitals are paying their employees more if they speak another language and offer in-house classes in another language.  Several states do not want relatives to be used in the interpretation since it may be emotional and the people don't know medical lingo.        Top


Since UnitedHealth purchased PacifiCare, the northern California physicians have been refusing to contract with UnitedHealth.  Blue Shield is now coming after the employers by saying we have the physicians and they don't.  United states they have plenty of physicians but the tale is not the number but the location.  The spin is always interesting even when false.

CalPERS is possibly going to have people pay more for their care.  They are planning to raise co-pays for expensive therapy and lowering them for using a smaller less convenient and cheaper physician groups.  I wonder why the unions are against this plan.  If they don't like the increases in certain treatments they will get a hefty increase in premiums. The union mouth for SEIU goes off the tract into deep waters and away form the immediate problem.  She doesn't want any increases and of course is unrealistic.   

The unions are strong in California, if nowhere else in the country.  CalPERS voted to raise co-payments.  They will attempt to strong arm providers to lower prices.  The decision means the organization will pay over $55 million more for coverage next year and there will by a 11.6% increase in premiums for HMO and 12.9% for PPOs.  Most of the increase will be paid by the taxpayers of the state.  

SEIU also wants the County of Oakland, California to stop charging rent for the county clinics and also want the county to forgive the $6 million the hospital owes the County.  Why would the union care?  So they can get raises from the hospital and throw them into debt for the union instead of the county. The County said the claims by the union were false and that they should do their homework.  

Where is the most expensive health care in the world?  Why it's right here in the People's Republic of Massachusetts.  The average spending is over $7000 per person per year.  Why could that be?  A Harvard professor states the high cost is worth it.  I guess he doesn't know about the controversy about universal health care in his own state and cheap medicine for all.  Could it be that Harvard is in the People's Republic and is part of the problem?  The Republic has its care centered around the most expensive systems, the universities.  

Speaking of expensive and control the California Blue Cross has instituted a policy of paying the physician the same amount if a colonoscopy is performed in the ASC or the hospital.  The hospital based physicians in the University as well as the societies are not happy with this.  Blue Cross states that they don't care where the procedure is done but the physician will be paid the same.  The procedures performed at rural facilities and those done in the ER or on pediatric patients are exempt. 

In a quick article in US News the nail was hit on the head.  They state that Medicare releasing what they pay for certain procedures will not reduce any use of the procedures since the patients don't pay for the procedure.  A $10-$20 co-pay would get twice the attention. 

Empire Blue Cross will start paying for web office visits and will pay $25 for each online consultation.  The subscribers have already been able to make appointments, get lab and test results and prescription renewals.  

Kaiser will start a new plan for small businesses.  The businesses will be offered seven different plans including HMO, POS, and a PPO and indemnity plan for those who work outside the service area.       Top 

Plan B

The owners of Ralph's Thriftway grocery in Olympia, Washington refuses to stock the Plan B at his pharmacy on moral grounds.  Activists, who except for one do not shop there, are planning a boycott of the store.  They are also planning a complaint to the Department of Pharmacy.  The store said if people wish to boycott, that is their right as it is the store's not to carry the medication.          Top


Samuel Steinberg, a hospital administrator, has written a book "The Physician's Survival Guide for the Hospital."  The book is a help to physicians for helping understand the hospital, the committees and equipment purchases.  The book is available on online bookstores for $11.95.

A recent survey showed that physicians income has fallen about 7% against the general rate of inflation, 21%.  Attorneys have gained 7% over the same 8 years.  Primary care physicians had a 10% drop in inflation adjusted earnings.  

The New York Times had an article on market forces driving physicians to be more available.  Many are keeping holes in their schedules to accommodate drop in patients or taking later lunch so patients can be seen during their lunch time.  This is due to the store front physician or physician extenders.

A physician in the People's Republic of Massachusetts wrote an editorial piece in the Boston Globe.  In the article, Dr. Stephen Hoffmann writes about the obstacles in the path of physicians attempting to care for patients.  He talks about an entire morning of his gone due to fighting with a insurer over a PET scan that was necessary to determine spread or no spread of a liver cancer so he could determine the correct therapy.  He states that insurers dock the pay of physicians for ordering too any tests or expensive meds.  This is a perfect reason why California and other like states make it illegal for hospitals or insurance companies to own physicians. 

HealthLeaders Magazine has an article on paying for ED coverage.  It appears most hospitals are now doing it.  It quoted an MD administrator at Via Christ Medical Center, who obviously is naive, as stating that they require ED coverage by the bylaws and if physicians won't abide they are gone.  Then, she goes on to state that they do pay for those that are needed such as oral surgery and trauma surgeons.  I will assume there is more than one hospital of equal caliber in Wichita and that the physicians have or should have privileges in both.  If they were tossed off the staff at one for an administrative miscue then they take their patients to the other hospital.  The better solution is that in Boca Raton, Florida, where the hospital and physicians came together in good collaboration to work out the payment problems.  

Where there is a will there's a way.  Physicians that are hyping a medical device or new pharmaceutical are now being paid by nonprofit research foundations set up by the physicians and funded by the companies.  The foundations then pay the physicians for their "research".  Actually, the money may flow to the physicians pocket for business expenses or salaries.   

Four Tampa Bay physicians have partnered up to open a bariatric facility.  The 7000 foot building will house full availability for pre and post op care as well as an ASC.    Top


The stolen computer with the VA records has been returned and the government state the information has not been copied or accessed. An informer, who is now up for a $50,000 reward, told the FBI where the computer was.  

The VA has finally agreed to offer a one year free credit monitoring for all the veterans whose information was stolen due to the VA negligence.  This is huge as there are about 25.5 million vets affected. The VA is also spending $14 million to set up a call center and to notify the vets about their screw-up. This will cost an additional $200,000 per day to maintain the center.  The VA doesn't care how much it costs.  They will be reimbursed by us, the taxpayers. A class action suit filed an attorney stating he represents the 26.5 million veterans would not allow the VA from publicizing the credit check.  The attorney that filed the action wants mucho bucks for no work.  Hopefully, the finding of the computer will toss the suit. The suit wanted $1000 for all veterans plus attorney fees. The VA also wants money from you and I, the taxpayers for their credit checks due to their own negligence.  The Senate Appropriations Committee gave $160 million for the credit checks.  

After the above computer was returned, an announcement was made that another computer back up tape of vet records was stolen.  This time it was only 16,000 names.

Interestingly, The Senate Veterans Affairs Committee just approved a bill that would authorize $2.75 BILLION for unneeded facilities nationwide.          Top 


The California Nurses Association's attempt at going beyond the Left Coast is at 50%.  They had previously unionized 1,000 Illinois nurses but has just failed in unionizing one hospital.  The nurses at Flagstaff Arizona Medical Center rejected the CMS.  The CMS of course can not accept that nurses don't want to join their organization and pay them dues for the same thing they are getting without paying dues.  The CNS is now filed complaints about the hospital interfering with the election.        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.