October 27, 2008 Recent News






About half of the hospitals are having difficulty in increasing their surgery due to a lack of anesthesiologists.  This is due to many opting out of hospitals into pain management and interventional diagnostics.  This is according to the Advisory Group.

The Advisory Group also is telling hospitals that radiology is by far the biggest contributor to the bottom line.  

A recent Press-Ganey survey showed that nurses are not happy campers.  This was in all hospitals no matter the size or location.  They don't like the compensation and mix as well as the senior administration (they can join the physician in that one).  The latter is the most important as to how they listen to the rank and file nurses not the clipboarders.   

The HealthGrades Study showed that the five star hospitals had mortality rates that were 70% lower than the lowest ranked hospitals.  The Midwest had the best risk-adjusted death rates and the Midsouth had the worst.  The Midwest also had the highest percent of top rated hospitals at 26%.  Under 7% of the Northeastern hospitals were in the top ranking.  The study looked at 17 procedures and conditions.  They made a big deal out of the top ranked hospitals reducing their mortality rates 13.2% over the years of the study versus 12.3 percent for the lowest ranked hospitals. It is interesting that if all hospitals did as well as the top ranked hospitals it would have made a difference in only 480 out of 41 million Medicare patients. The numbers are so small as to be insignificant.  

A woman with a broken leg waited 19 hours in the ED at Parkland Hospital in Dallas, Texas.  She got so frustrated, she left and got self help.  Her name was called 33 hours after she checked in.  Two weeks later she received a bill from Parkland for the time spent in triage, $162.  About 20% of patients who come to this hospital leave without seeing a physician but if they do wait long enough to be seen in triage they will be billed. She has no insurance and is not going to pay the bill.  I don't blame her.  Yes, she saw a nurse but had absolutely nothing done.  It seems a little out of touch to bill that amount of money for a six minute triage and then making someone sit for 33 hours.       Top


Gee, a real newsflash.  Healthcare experts (?) in a discussion decided that medical technology is the cause of high healthcare costs. The makers of med device makers disagreed.  The Center for Studying Health System Change said the aging population plays a minor role.  The study then went to the physician as the one who decides which technology is worth the cost and how it should be used.  The report went on to dismiss healthy lifestyles and med mal lawsuits were minor players.  

The LA Times had an article on "The Battle for Medical Bills".  It showed how the insurers have consolidated into what is basically a monopoly and are systematically denying hospital and physician bills or parts thereof.  Even the insurance industry spokesperson agrees that billing needs to be simplified.  More physicians and hospitals are dropping out of insurance networks so they can bill the patient directly and get the money due them.  This is standard operating procedure for Prime Healthcare of the LA area who buys hospitals and drops all contracts.  They then bill usual and customary rates for the services provided and sue if not paid. California has a new law because of Prime.  The state does not allow balance billing by ED physicians or hospitals for ED patients.  The provider and the insurer must negotiate the amount to be paid and if they can not then the state will set the payment.

The US infant mortality decreased 2% in 2005, a start.  We are still in the bottom third of the world due to preterm birth and preterm mortality, frequently due to drugs and lack of prenatal care.

In the IT arena another bust.  Only a small percentage of people are using the internet to look up their hospitals and physicians and only about half of those that do look up make any use of the information.  Only 6% have ever heard of the Hospital Compare website.

The Wall Street Journal published an opinion piece by a Pennsylvania vascular surgeon who blasted the Governor for putting his political agenda ahead of the people of the state.  He is pushing hard for universal coverage so he can get a  position in the Obama Cabinet, if he elected.  He is doing it on the back of the state's physicians by using funding that is supposed to help pay for med mal and lower premiums.  The Governor is causing the State to lose physicians.  The article states the number of practicing physicians is down 6% from several years ago.  Only 20% of the new physicians are staying in the state as opposed to 60% in 1992. The physician states that his med mal premiums increased 40% since last year and this is directly related to the Governor's plans.  He ends be stating that if one can not find a physician directly blame Governor Rendell.

The NHS GPs are complaining that the hospitals in Jolly Olde are putting patients lives at risk by not having good discharge policies.  The hospitals are not real good about timely notification of the GPs that take care of the patients when they are released about what happened in the hospital.  Sounds like some of the University hospitals in the Bay Area.       Top 


The economy is hitting the legal profession.  In some big firms across the country, attorneys are being laid off.  It is usually the associates and not the partners, but can be both as well as support staff.  In San Francisco, a large law firm folded entirely.  The clients are not using as much legal work.

In Los Angeles the Mayor has vetoed a planned $96,000 outside bid to help the city's attorneys with a law suit against the city for discrimination against the homeless.  The mayor states that the city can use its own resources to defend the suit.        Top


Physicians, do you ever wonder why there is not a friendly atmosphere between you and the hospital administration?  The following is from the Advisory Board, a national corporation that advises most hospitals:

Our Work on Hospital-Physician Engagement
Special Message from Our Executive Chairman

"How can we get our physicians on board?" That one question comes up in almost every conversation I have with you and your peers across the country. Accordingly, much of our work in the past 12-18 months has been devoted to identifying best practices for taking hospital-physician engagement to the next level.

Advisory Board resources to support hospital initiatives
One of the major insights coming out of our work here is the importance of creating transparency around key performance metrics to support a more data-driven dialogue with physicians. Toward that end, I want to take this opportunity to mention our recently launched Crimson Initiative, an unprecedented national cohort of progressive hospitals and health systems with the shared ambition of setting a new standard in hospital-physician collaboration. This initiative features a robust, Web-based analytic platform to track and document individual physician performance on cost, utilization, quality, and efficiency metrics, along with best-practice-based support in sharing performance data with physicians.  

Any questions as to what happens next???      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.