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In Georgia the physician owned ambulatory surgical centers are beginning to flourish. This is due not only to the flow of money but to the lack of the hospitals reaching out to the physicians in joint ventures. The hospitals have always wanted to keep the revenue stream to themselves and only now realize that half is better than none. Now they are attempting to keep the physicians from opening their own facilities by offering joint ventures. The other major problem for the hospitals is the CON procedure which allows the physicians to bypass the procedure. The hospital association wants the physician owned ambulatory centers to be a part of the CON process. The state looks at all exemptions requested to make sure it is truly exempted. The major aspect is cost. If the project does not cost over $1.35 million it will probably be exempted. After the exemption, it must still be state licensed.
The Maury Hospital in Tennessee is opening its ASC three years later than it thought it would. The local physicians opposed the hospital CON since they already had their own ASC. The physician's ASC has outgrown its space and is planning on expanding the physician space but not he operating room space.
Please see New Legislation section for more on this issue. Top
The malpractice debate is beginning to focus on the national arena. The Democrats accuse Bush of catering to the insurers and of course they don't see themselves as the attorneys lackeys. The Senate Democrats are working on legislation to forbid collusion among insurers on setting prices, a good thing. This would have no effect on the limits of pain and suffering awards or the limits on attorney fees. The Democrat's anti insurer stance will not make more physician take high risk deliveries or do other high risk surgeries. The Senate Democrats want the $250,000 cap on non-economic damages raised significantly, but at least they are talking about some kind of cap.
In Florida, the Winter Park Hospital will lose its emergency surgeons. The last group to take ED call plans to give it up and have all emergency surgery done at its sister hospital in Orlando. The malpractice crisis had left one group as the only ones left that would take call. This became a burden on those physician and so they have said "no more". Last year about 460 emergency surgeries were performed at Winter Park. This last group decided only to be on call at the Orlando campus. Two of these surgeons have no malpractice insurance and the group does most of its elective surgery at the Orlando hospital. Florida Hospital has other campuses and multiple problems with ED coverage in all. Last week a group of six orthopedic surgeons stated they would no longer do micro hand surgery at any of their hospitals. At Florida Hospital Altamonte there is only one of seven Orthopods that will take call.
In Broward and Dade Counties, Florida, physicians have stopped delivering high risk babies. This means those mothers all go to Jackson Memorial. The reason is that almost all south Florida OBs are going without insurance.
In the Orlando area another hospital has changed its rules regarding malpractice insurance. It found that if it wants to continue to have an OB service it had to get rid of its malpractice required rule. In two Florida Appeals rulings it has been decided that the hospital is liable if they allow the physicians to go bare.
The only Level I trauma center in Orlando is may close next month. The neurosurgeons have decided they will not staff the trauma center after March 31. The reason is liability potential.
In Mississippi, binding arbitration is coming of age. The Mississippi Supreme Court allows it as long as it is not under duress or unconscionable.
In Oxford Mississippi more than a dozen physicians were told that their insurance company may be bankrupt and they would need to hire their own attorneys if they are sued. Some continued to see patients while others said no to patients until the problem is resolved.
Illinois doctors are starting to shut down high risk services and are stopping taking new patients. In Joliet, two of the city's neurosurgeons limited their practice to backs. No full time on-call neurosurgery in the city. In Belleville the neurologists gave up giving TPA for strokes. This means people will need to be sent over an hour away for the treatment.
Recently, over 500 physicians rallied in the Illinois Capitol for malpractice reform. They were greeted by the Governor and those state legislators in favor of insurance reform. The Democratic Governor and the Democratic controlled legislature may attempt to focus on the insurance industry and not touch tort reforms sacred to their lobby money Tort attorneys. The physicians have threatened to increase arbitration pre-treatment if no tort reform is passed.
Ah, yes. Even the People's Republic of Massachusetts is feeling it but not as much. The state has a huge amount of teaching hospitals who pay their employees malpractice insurance. Will there by another tea party? Doubtful, since the physician's spines went out in 1776 with the tea.
In West Virginia, the legislators want the Medical Board to weed out more "bad doctors". They want to investigate all doctors who have had three malpractice judgments against them in five years. This would entail the investigation of all of nine doctors. Of the nine, six do not practice in the state and the other three have been investigated. Three of the nine are plastic surgeons who were sued over the silicon implants. Another legislative thought gone awry, but if gets the tort reform it's worth while. Now the law may be changed to include settlements as well.
In another article, the Charleston Daily Mail states that the payouts by physicians and their insurance companies in the last decade is about $500 million. There were 294 court judgments with 2/3 decided in favor of the physician. They think that means there was no payout in those cases but who paid for the defense costs. Of the 93 plaintiff victories the payout was over $1 million in twenty of them. In settlements, there were 2040 and 63 were over $1 million.
A national poll has found the 76% of Nevadans favor the new malpractice reform plan advocated by the physicians. The Democrats oppose it stating that the $350,000 limit except for gross negligence is okay. The poll found that those who don't vote for the malpractice plan may lose their legislative seats, if the physicians target them for removal.
Oklahoma physicians are beginning to come together for passing of tort reform in their state. A recent rally was held at the state Capitol. The tort lawyers stated the problem was national and not one of Oklahoma. The Lt. Governor believes that tort reform is exceedingly important. Top
The Oregon Health Plan, a social experiment started ten years ago is not working. The decrease in money has left the Plan with no money for the prescriptions, mental and dental care that was the centerpiece of the plan. The plan will look like the standard Medicaid plan it was supposed to replace. The famous Oregon list of diagnosis is basically dead since the Feds who pay 60% of the Medicaid money would never allow the list to shrink as money declined. Top
Sixty Minutes, the CBS "news" program did a hit piece on the Redding California Tenet hospital. The segment centered on the work of two physicians at the hospital. One is a cardiologist and the other a cardiac surgeon. Both have been accused of performing unnecessary procedures. The piece basically hung them without a trial. They interviewed Rep. Stark, not a great paradigm of virtue, who spurted that the hospital administrators are poster children for unethical business practices. The physicians may or may not be guilty of the charges but they deserve their "innocent until proven guilty" time. The Medical Board of California attempted to take away their licenses but could not use hearsay and therefore was prohibited to do so until they had actual proof of wrongdoing. The story explained that both Tenet and the physicians refused to be interviewed for the story. This intimates guilt but in fact only means they did not want to be asked loaded questions by a reporter who did not know all the facts. Top
To date the country has inoculated about one percent of the 450,000 health care workers it had hoped to vaccinate by this time. There is no way the second round can start with the anemic showing of the first. This badly thought out and executed scheme deserves all it is getting.
In Florida, there have been three reactions linked to the smallpox vaccine. This is up to 24 nationwide. This is in the small population of people given the vaccine.
In California's Central Valley, the large respected hospitals have decided not to participate in the inoculations. Several small hospital are participating.
In Philadelphia, most of the city's hospitals are not participating. It appears that the government has made alot of vaccine that is going unused until the Congress gets it's act together to pass liability reforms for the vaccine and payment for any workers who have to leave due to the vaccine. Top
In a surprising move, the Sutter controlled and prestigious Palo alto Clinic stated it is considering moving to concierge practices. This is a 280 physician group. This is the first major medical group in the country that is considering this arrangement. Initially only several physicians would be involved and that the rest would still practice as usual. This may change slowly. Top
UCLA is the largest system of healthcare in the entire UC system. They were $7 million in the hole and had to borrow the money to keep paying salaries. What to do? They hired the Hunter Group, a tough organization who did the turnaround for Stanford. The UCLA vice provost stated that he expects the Hunter Group to recommend the elimination of almost 500 jobs over five years. If that's the case, why can't UCLA just do it on their own? Top
A southern California Democrat has authored legislation to make the state the universal insurer for its residents. They would use existing Medicare and Medicaid funds along with a 6% payroll tax and a 3% wage tax to fund this system. This system is doomed to fail. Has anybody looked at how well the state is now run by these same people. The bond rating has just been reduced again. The Governor and Legislature has bankrupted the state with their give everything schemes. This is beginning to look alot like the People's Republic of Massachusetts. Also, the State is already not known to be business friendly and with the increased taxes, more business will leave, creating more people without insurance. The stupidity of the legislators never ceases to amaze me. Top
Kaiser has utilized central California hospitals to house its patients in lieu of building its own. Starting April 1 Modesto's Memorial Medical Center will no longer be used. This means the patients will need to change to another Modesto hospital or go to another town for treatment. Memorial has been a Kaiser provider since 1996. Now all Kaiser patients needing CABG will have to go to Sacramento about 90 miles away. 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.