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A large eastern consulting firm that is known to only work for hospitals even though it purports to work for medical staffs has suggested a new slap to the physician. This is called a disciplinary suspension. It is for those physicians that don't complete their charts, don't cover the shifts in the ED or other such administrative tasks. They recommend this be in the medical staff bylaws (this must be an oversight on the writer's part since they always recommend things be kept out of the bylaws). They state this would allow the hospital (not the medical staff) to suspend the physician for up to 14 days. This would not require a hearing nor would it be reported to anyone.
The companies employed resident MD, JD argues that the new JCAHO requirements that are anti the push that the company has made should not be passed. The company was wrong and so is the resident MD, JD. He also doesn't believe there should be an organized medical staff so the physician can be more easily controlled by the hospital. The organized medical staff is the one thing that protects the individual physician. He uses the JCAHO field review on MS 1.20 to show why physicians should not believe in the JCAHO. He again is wrong. They should not believe in JCAHO because it does nothing to help quality except jump through meaningless rings. It is a deeming organization and only that. It goes much farther than the COPs require the hospitals go and the reason is usually for its own pockets to be lined.
The company also puts out a medical staff legal column that is at times written by a non lawyer. In their last non-lawyer column, they talk about serving on peer review committees and do state correctly that if the hospital will not indemnify the physician for sitting on the committee, they should not partake.
In yet another column a new physician on the payroll wrote an article regarding medical staff member rights. He stated that the bylaws should make it clear regarding the rights of the physicians on staff. He obviously did not get the article approved since this is pro physician and against all the company stands for. Top
The University of California Irvine has taken over top spot on the bad hospital radar. They got in trouble 10 years ago for the fertility problems and recently for denying transplants to people on their list who died. They also have had a touch of nepotism in the cardiology department. Now a federal report continues to tell the hospital how bad they are. The report showed 30 people died awaiting liver transplants that were turned down by the university. The federal report stated the nurses were not completely trained and there was no quality control.
California has a Corporate Bar on medical practice. Therefore the hospitals can not hire physicians but must use a foundation to do the hiring. Once such foundation is Sutter Health. At Eden Hospital in San Leandro, Sutter attempted to form a foundation but was surprised by the physician's revolt. The medical staff voted to have Sutter delay it's entry and then they stated referring patients to clinics not affiliated with the hospital. That got the attention of the Sutter organization. All of sudden Sutter wants to work with physicians, something they forgot before and will likely forget again. They state they want to compete with Kaiser but they forget the best way to compete with Kaiser is to provide good care.
In San Diego, the physicians are protesting Sharp's decision that all seniors must belong to Secure Horizons, the plan where Sharp is the sole provider in the area. There are 45 physicians in the area that have been offered to work with Sharp but that means that their 22,000 senior patients would need to transfer their insurance. The physicians contend this is a money grab and the system contends this is to streamline their records. I doubt if anyone believes the system as the electronic medical records may be done on any insured on uninsured patient. This also may be illegal since it would force all the patients to go to one hospital system and not have choice. Top
The physicians and attorneys in Washington have agreed on malpractice reform. This is after both sides took a beating last year at the voting booth. In the compromise, the physicians did not get a cap on non-economic damages. The three strike clause that the attorneys wanted is also out. In is a 30 day grace period that if the physician states he/she is sorry it would be inadmissible in court. This is a true loss for the physicians. (See Recent Legislation.)
In another story regarding Washington and their short sightedness is that the state's OBs are quitting at a quickening rate. They are opting for a straight GYN business instead. The rationale is the legislature's refusal to provide meaningful med mal premium relief.
In Texas Medical Protective Insurance has again lowered it's malpractice rates. It states that it is lowering the premiums by 6% due to the more favorable med mal climate in the state since the reforms took place in 2003. Top
The American Medical Association has agreed to develop over 140 standard measures of performances for the government. This is supposed to increase the level of care and will be tied to the pay for performance of Medicare. This is supposed to be done by the year's end. The physicians will then report to the government on 3-5 measures per year. As usual, there is controversy with anything involving the AMA. The AMA made this pact with the government without consulting anybody else. The AMA only said they had made the deal after the group of seven specialties found out about the covert scheme. The groups wrote a letter to the Congress stating that the AMA can not and does not speak for the specialty societies. The AMA is again toast. Top
A prisoner in a California death row did the usual last minute appeals and one worked. He found a sympathetic judge who did not know medicine who ruled that the lethal cocktail ws possibly cruel and unusual punishment and banned by the Eigth Amendment. He stated that the prisoner should be either overseen by an anesthesiologist o make sure he was truly asleep before the paralysis and potassium was injected. He based his erroneous ruling on the movements of the prior prisoners when the lethal injections occurred. In fact, the dose of thiopental is so great, ten times the normal dose, that no one would be awake following the injection and the movements are only involuntary spasms. He gave the state another alternative, to only use thiopental for the fatal injection. This meant that the state would have to find someone licensed to actually do the injection. The ethics of finding someone who would inject the barbiturate to kill someone is a huge debate. The state could not even find an anesthesiologist to oversee the prisoner to make sure he was asleep. Now two California Assembly members have introduced a bill to not allow any medical personnel to participate in any executions. One of the legislators is a Republican physician. The AMA also has a guideline that physicians should not participate in executions. This means nothing since most physicians do not belong to the organization. Since this prisoner was not executed at the appointed time the state needs to get a new order of execution from the original trial judge. This probably will not occur since the judge is one that petitioned the Governor for clemency. Top
Palm Beach County, Florida, is a rich community with many specialists. The specialists are not willing to be on call at each hospital. The hospitals got together and have come up with a plan that they are trying to get approved by Washington. If they can get by the antitrust law, the hospitals will get together and have specialists at only one hospital for any particular specialty. This seems like a reasonable compromise and all the hospitals can chip in to pay the specialist on call. Top
The government is planning to investigate health insurers who have used Medicare Part D to enroll seniors into their HMOs. This would be much more profitable for the insurers. Paragon of Virtue Pete Stark is the one who is pushing for the investigation. The current focus of the investigation is Humana but should include Kaiser and PacifiCare. 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.