November 1, 2005 News




Flu Vaccine


The oft and rightfully attacked King/Drew Hospital in LA is back in the news.  The County Board of Stupes had the proposal to drop the hospital's OB, pediatric and neonatal wards pulled just prior to its meeting.  The Department of Health decided to keep the wards open for the time being even though it has very few patients and is a drain on the resources of the hospital.  The reason for the change is the potential for loss of funding from the state.

After the above debacle, the Board of Stupes again will try to solve the hospital's problems.  Of course, they know nothing about the hospital, how it runs or medicine in general.  What they do know is money and that they are spending alot on temporary nurses because they can not get enough of their own to comply with the strict mandate of the state.  The only one that makes sense in this mess is the head of the Department of Health who wants the advisory board to be devoid of all those with individual agendas such as the unions and competitors.  He wants the the Board of Stupes to allow a Board to run the hospital that has some knowledge of how to do it without political interference. 

At the meeting of the county board where the above was presented the board agreed to much of the above by asking the advisory board be either disbanded or have its bylaws changed.  The county board said the advisory board had too many conflicts of interest.  The county board again asked the head of the Health Department for an update in one week on the successes and failures and what it will take to fix it.

The Department of Health director is now stating that the hospital is unprepared for the upcoming inspection and well may lose over $200 million in federal funding.  It seems that Negligent Consulting is not doing its job.  They are also up for an additional six month extension at an additional $5 million.  In the meantime, Negligent is being docked money for expenses that have been disallowed by the auditors.

The LA Times is reporting the continuing errors and negligence at Drew/King.  This includes at least one death.  One of the problems was lack of supervision of a resident physicians. Another is a wait of four days for an MRI for a spinal trauma patient.  This at an institution that was a trauma center.  The director of the Department of health stated that the errors had no adverse patient outcomes except for one.  He is right but wrong.  Giving blood to the wrong patient is only lucky not to have caused another fatality.  There have been multiple problems with wrong drugs being ordered or wrong dosages given.

Staying in the LA area, St. Vincent Hospital which did an illegal liver transplant and has now lost its surgeons, is being investigated by the United Network or Organ Sharing.  They may get all their ability to transplant livers removed.  At the same time the rabble rouser Senator Grassley is calling for an investigation.  The typical response from Washington when they can do nothing else.  He rightfully doesn't like the fact that the illegal transplant took place about two years ago and is only now coming to light.  

A new company in Philadelphia is attempting to form partnerships with physicians to buy and operate hospitals all across the country.  This should drive the community hospital into a frenzy since they can not use their own tactics against them.  This will allow physicians some control in the hospital decision making and more input into the running of the hospital which has been botched for so long by MBAs.  

In Indiana another group of physicians is building a non specialty hospital in Merriville, outside Chicago.  The statement was made by a physician board member that "As a physician, we don't have control of how care is given.  But we know what care is needed."  

In California, Tenet has agreed to sell a two campus hospital in Huntington Park to a company that includes 25 physicians.  The trend continues. 

Now the community hospitals in the People's Republic of Massachusetts are complaining about the academic centers.  The centers are now at half of the hospital admissions in the state.  I'm surprised the community hospitals haven't asked for a ban on the academic centers for not allowing them to perform their civic duty.  Maybe the hospitals should have thought about this several years ago when the academic centers were admitting 1/3 of the state's patients.  They could have competed on quality and price.  Now they have little disposable income to buy equipment to compete and the downward spiral will continue.  Maybe the physicians should build specialty hospitals to compete with the academic centers.   

It was announced that the New Orleans's Charity and University Hospitals are not going to be reopened but will be rebuilt.  Now the Chicago Board of Stupes are going to raze the old main building of Cook county Hospital.  It is the end of the line for the old charity hospitals.  If they were still in business the new physicians would get great training from the professors and the needy would have a place to go to get first rate care without questions.   

In West Virginia, some lawyers are asking why HCA wants to sell five hospitals.  They believe it is because of one osteopath who's misdeeds threatens the organization with a loss of $330 million.  The judge ruled that in the credentialing case the West Virginia non economic caps do not apply.  HCA states it is part of its overall plan to sell the hospitals.  The attorneys are worried they won't get the big payout.  

Be careful what you do.  The law of unintended circumstances can come around to bite you.  Take the plight of the neurosurgeons in Raleigh North Carolina.  Five neurosurgeons dropped off the staff of the ED and the staff of Rex Hospital.  This left one neurosurgeon still on staff.  The hospital loaned the physician money to set up an office and to recruit another neurosurgeon to help with the neurosurgery at Rex.  Now the five that left are crying foul.  There is no need for any other neurosurgeons except for the ED work, they state. When they left the hospital they should have realized what the hospital would do.  If they were not comfortable with the hospital decision they should not have left, a perfect example of why physicians are poor business men.

In yet another act of stupidity UMass Memorial Medical Center has stopped its cardiac surgical program due to higher than average mortality.  The cause is the hospital's hiring of a chief of cardiac surgery that wasn't accepted by the staff and the hospital did not ask the staff.  This shows what may happen when the hospital does things without medical staff approval.  It is costing the hospital money and prestige. 

In Hawaii, the Wilcox Memorial Hospital in Kauai has notified its patients that a hard drive is missing from a computer with their medical record and social security numbers.  

That bastion of great medicine and excellent IT systems including Vista, the VA has blown away hundreds of millions of dollars according to the US Senate.  They have a failed $342 million financial management and a failed $600 million compensation and benefit system.  They do have a good EMR system.       Top


Pediatricians are usually docile creatures but anything that interferes with their care of the patient does rile their feathers.  The latest are those parents that refuse to allow their children to be vaccinated against diseases.  They are stating to the parents a fond fare thee well and asking them to go elsewhere.  This allows the physicians to continue to look after the health of the community as a whole.   

An article in the Baltimore Sun discusses the potential for a physician shortage in the next 10 years.  They state has the boomer age and require more care, the physicians will also age and cut back or leave practice. The medical schools are turning out the same number of physicians as previously but more are concerned with lifestyle than any other item.  This means working less hours and taking less call.  This means less in the primary care arena and more in radiology or large groups. Where there are a large number of any specialty, the insurers then clamp down on payments until a percentage leave.  Malpractice insurance affordability also enters into location of practice.  What this means for the patient is longer waits and more use of the emergency rooms as their physicians. There are also those who don't believe the predictions but if they are wrong it will be too late since the big ship needs alot of time to turn.  

Duh! Connecticut HMOs are paying lower rates to the physicians for caring for the indigent than those with private insurance. This means those patients can not see specialists in a timely fashion since no one wants to lose money be treating them.  They are paying the same as the state pays to the physicians for the same treatments.  All the payments under the program are too low and the physicians don't accept the low rates. 

Those physicians that work for the federal Health Resources and Services Administration, the Indian Health Services and the NIH and have had malpractice judgments against them in the last 10 years or so are in for a rude awakening.  There are 474 incidents of medical malpractice that money has been paid out on and the physician has not been reported to the NPDB.  They will now be reported as required under the law.     Top


The Connecticut Insurance Department has not allowed ProMutual Insurance a 12% premium increase.  This came after an independent analysis of the rate filing. Three weeks ago the other major insurer in the state said it will not increase premiums.  ProMutual may appeal or leave the state.   

In Texas, the malpractice insurers are reducing their rates.  This comes after the passage of Proposition 12, which 2003 amendment that capped noneconomic damages at $250,000. 

The Washington State nurses have decided via their "leaders" to not support the malpractice initiative on the ballot.  The amount of $350,000 was too low for the nursing leaders.  They like round numbers such as $1 million with that going up each year with the cost of living.  The "leaders" also don't like arbitration, they like a full on court fight.  The "leader" also wants a full disclosure of the books of malpractice companies.  This one all could support. 

Florida has been given the green light by the feds to change their Medicaid program to one that will put Medicaid beneficiaries into HMOs or have an opt out if they can be covered by an employee plan.  The main part is a cap on each beneficiary as to how much the state will spend.  This will not affect Peds (under 21 years of age) or OB.  After the cap is reached the HMO will be on the line to continue to provide services as will the physician, but the state will pay no more to the HMO.      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.