October 15, 2006 News 

Hospitals

Physicians

Malpractice

Healthcare

Hospitals

When Drew/ King Hospital closes or reconfigures there will be alot of civil service employees that need to be reassigned.  They have about 2200 employees.  If the hospital reconfigures all employees will have to reapply for their jobs and hopefully many will not be rehired.  When those not rehired go to other facilities they will need to be monitored and if they don't measure up can then be fired.  The union is showing why their ranks are falling.  They stated that there should be due process for workers where there is no job for them, an untenable position.

The new plan for the Drew/King institution (I can not call it a hospital) includes the removal of most of the employees and the institution run by the Harbor-UCLA.  The CEO of Harbor is against the plan and may resign.  Drew/King would go from 252 to 42 beds.  Eventually there may be as many as 114 beds. Also the Drew Medical School would be out.  This would mean the University would need to cut back its training program even further than it already is.  If the transfer does not satisfy the feds and the $200 million restored, the institution will have to close completely.

The plan includes changing the name to Harbor-Martin Luther King Community Hospital to show the administrative change.  Community activists are against this also.

Kaiser of northern California after almost five months have transferred only about half of their renal transplant patients back to legitimate programs.  They feel it will take to years end to get all the remaining patients transferred.  Kaiser still has not done much to forward complaints to the California Department of Managed Care.  I wonder why??

In a further scrutiny of Kaiser, it has been found that Kaiser has negligently not removed the names of 90 patients who have died as far back as 2004.  Kaiser admitted knowing this but passed the buck stating it was the fault of data-processing backlog.  That is a Kaiser problem so they are blaming themselves.  Kaiser has now transferred all records to legitimate transplant centers.  However, UC Davis has found that about 20% of the patients referred to their program did not meet the criteria for transplant waiting lists. Just another of the many Kaiser screw-ups.

Kaiser has a contract with the infamous Community Hospital of Ventura to have the community physicians treat the members.  The reason is that Kaiser is required by law to provide members access to a hospital that is within 30 minutes or 15 miles of where they live. This hopefully shows that the problems at Community between the old administration and the physicians are behind them.   

The scrutiny of transplant centers has now spread to the Atlantic coast where hospitals in the Washington, DC area are under the microscope.  Washington Hospital Center did only five cardiac transplants in four of the past five years.  At Inova Fairfax Hospital only two heart transplants were done last year.  The centers defend their results but that is impossible to do with low numbers.  Baylor University has blasted the DC hospitals for their self serving statements.  The standard for heart transplants is 12 per year.  A major part of the problem lies with the Government not doing its job of closing underutilized transplant programs for many years.   They started to re-look at the problem after the Southern California and Kaiser transplant scandals came to light.  The government now wants to be mister nice guy and revise the numbers needed to nine in 30 months.  This is way too low to keep a team sharp. Where would you go for your work; to someone who does the work well frequently or to someone who may do the work well but only does it very infrequently?

A recent Press-Ganey poll stated that the number one concern of patients is the ability of the hospital staff to respond to the patient's concerns and complaints.  Hospital personnel are told not to tell too much for fear of law suits.  The next three complaints about hospitals are (1) staff sensitivity regarding the inconvenience that problems can cause, (2) patients not being included in discussions, and (3) lack of being kept informed by staff.

The AHA has had a flurry of comments.  One was on outpatient PPS system proposed by Congress. The hospitals believe that the payments should be raised and that quality inpatient criteria should not be tied to the outpatient payment system.  There should be outpatient quality criteria. The next comment was on the 2007 physician fee schedule.  They really didn't care about the physicians (they never do). They care about the pathology payments that they would get for slide prep technical component.  The last comment was on the lack of a ban of all physician self referral.  This self serving comment still is against the whole hospital exception of the Stark law.  

In Clarkesville, Indiana, a physician general hospital has received permission to build.  This is one of the first hospitals to be allowed since the illegal acts of the Indiana counties at the behest of community hospitals was overturned.  The counties had banned physician hospitals, an illegal act.

Memorial Hospital in Inglewood, California, had already announced it would close it's ED and now the hospital is considering closing beds in its med-surg and telemetry units.  The parent has another hospital 1 1/2 miles away and wants to consolidate services.  At the sister hospital services will be expanded to make room for the additional patients.  Any guesses as to who doesn't like the plan?  The unions, who have a new contract coming up in December.      Top 

Physicians

Only one quarter of physicians are using email to interact with their patients. About 10% are using it for full EHR purposes.  These physicians are almost exclusively in large organizations that can afford to pay the major money. This is more than the 20% of physicians that used email four years ago.  Most physicians do have computers in their office and about half use them for some office notes.  The insurers continue not to pay for email communications and so physicians continue to not to use them. The insurers are making the physicians the scapegoats by stating they want a more structured environment and not pay just for simple questions and answers.         Top   

Malpractice

The New Mexico trial attorneys are attempting to get their legislature to increase the amount of money that may be awarded for non-economic damage.  Now the plaintiff may be awarded up to $500,000 for pain and suffering.  The trial attorneys state that this is equivalent to $1.8 million.  The New Mexico law also limits wrongful death to $600,000.  The attorneys want that raised as well.        Top

Healthcare

Tufts Health Plan of the People's Republic of Massachusetts is starting to lay off staff.  It's membership is down 1/3 in the last four years.  The plan is one that makes physicians say "Mother may I" for some procedures.  This delays care, increases physician office resources and so does not endear itself to its physicians and members. 

California Blue Shield is going for new advertising.  It blasts the medical insurance industry and shows how good Blue Shield is.  A recent Harris poll showed that managed care is the third lowest ranked industry in the country as to serving their customers.  It is doubtful that the advertising will change consumer image of the industry since each ad shows that the industry is spending less on healthcare.  It should be noted that Kaiser has spent $40 million per year on its advertising and not healthcare.  Blue Shield is planning to spend about $12 million.     Top

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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.