September 15, 2008 Recent News

Medical Malpractice




Medical Malpractice

The AMA reports that Texas is riding high since the passage of its med mal reform.  In the past five years premiums have decreased, many more physicians have moved into the state and physicians are able to spend more time with patients because they do not have to see as many to pay for their premiums.  The "others" do not agree.  They complain that the new physicians are not going to the rural areas.  They also complain that with the new physicians there are more medical board actions.  There are more physicians so there should be more actions.  There has been an increase of 12% in the number of board actions and the number of physicians has increased by 58%.  The Texas trial attys. use the same saw that the patients can not get attorneys to take their case.  Of course, if the attorneys were interested in justice and not money, they would take the cases.  The med mal reforms have been taken by the physicians to the state supreme court to make sure the constitutional amendment is legit.  The attorneys have taken the legal fight to the federal courts stating the caps deprive the patients of due process rights.  It is, of course, a state issue.

In Tennessee, the courts have ruled that hospitals that don't spell out that their physicians are independent contractors should be able to be sued under the law of vicarious responsibility.  The hospitals can no longer put the notice in the myriad of forms the patient signs in the ED or when admitted.  There should be signs posted in the ED and admitting areas as well as a separate paper or signature required that the patient has been informed.  

The Attorney General of South Dakota has refused to intervene in a lawsuit against constitutionality of the state's med mal statute.  The state now has a $500,000 limit on pain and suffering.       Top


A recent news article stated that whistle blowers have helped the government recoup over $9 billion in fraud.  This means two things.  The first is that the government is incapable of finding fraud on its own and the second is that whistle blowing for not only monetary fraud but also quality "fraud" by hospital administrators must be protected.  Those that complain about poor quality of care or how to improve the quality of care should not be labeled disruptive providing they go it in the correct manner.  They need to tell the administration and if nothing is done they need to tell the state or the accreditation organizations.

A group of nurses and technicians complained to Nevada about the care at a hospital.  This type complaint in the context of unionism and not true patient care need not be protected.

The liberal New York Times has pointed to the faulty Massachusetts health plan as a blueprint for care in the country.  It doesn't work well in the small state with a small amount of uninsured without major interference by the government and the usual cost overruns that equal the Big Dig in percentages.  It has done its job of covering the uninsured very well but the costs have been huge. The difference is the Big Dig was a federal government footing the bill and the health plan is a combination of fed and state mismanagement. 

Now one of the largest providers of healthcare in the Republic is warning the government that if goes forward with its plan to make business change who it insures and for how much may invoke a federal ERISA lawsuit. 

The wait to see physician in the Republic continues to grow due to the lack of physicians staying in the Republic after school and the more patients in the system.  The average wait times for internists are between 50 and 100 days. 

The FTC and the Department of Justice have issued a joint statement stating that certificate of need states have not kept health care costs down.  Illinois was a special target with its lack of competition.  The report states that physician owned facilities have brought lower costs, better equipment and spurring of community hospitals to improve their services.  For some reason the hospitals that already have theirs rejected the report.  They want to keep the CON but simplify the process (for them).

Aetna has agreed to have patients whose policies will be rescinded to have an outside review by a panel of physicians either before or after an internal review by the company.  If either believes the rescission is uncalled for the policy is reinstated.  This is for all policies sold in the country.

Health Net has agreed to reinstate 928 patients it illegally dropped after they submitted a claim.  The insurer also agreed to pay a fine of $3.6 million.  They will also pay about $14 million in medical charges they had refused to pay originally.  The legal profession, if you can call it that, was not happy since they may not be able to sue the carrier for damages and get their blood money.

The University of Chicago Medical Center under the auspices of Michelle Obama has set up clinics and subsidiary hospitals to care for those who may normally use the UC ED.  This is being investigated by Sen. Grassley. 

An article in May in the Mail  accuses the British NHS of starving patients.  Some hospitals gave a single scoop of mash as a meal.  Cases of poor nutrition increased 88% between 2005 and 2007.  When trays were given to patients there were not enough people to help feed them so the trays of food went uneaten.  Ain't socialized medicine grand?

The socialized British Emergency Care Services in 20% of the cases are performing under the standard of care.  This is from the Healthcare Commission.  The review included hospital accident, ambulance and emergency services as well as our of hours GP care and the NIH Direct telephone service.  See how well national health works.

An article on Yahoo states that physicians in Zimbabwe advise their patients not to get sick.  The care is terrible.  There are no labs or any fundamental equipment.  The problems are directly related to the regime of Mugabe and the lack of foreign aid to the country because of him.  

Happy Sicko!  In a recent article there have been seven deaths in a maternity hospital in Cuba, one of the stars of Sicko.  The deaths were caused by a bacteria in the OR.  For several weeks the Ministry of Health kept this under wraps but finally the word got out and the pediatric services are now closed at the hospital.

There was an article recently in our press for universal health care to prevent the minorities and poor from getting poor cancer care.  There is now an article from England with universal health care that states that people in poor areas are less likely to survive cancer.  Maybe it has nothing to do with the kind of health coverage but the thought processes of the different classes.  Yes, there are different classes. 

The Medicare Advantage programs got 12.4% more than traditional Medicare this year.  That is $8.5 billion.  This is still more proof that HMOs do not stem the healthcare costs.  The extra payments are ripe to be stopped.   

An article from Minnesota states that retail clinics have not cut total health costs.  They are cheaper than a physician office or emergency room but there has been no significant drop in the total and has been a rise in all total providers prices charged over the past four years.  The article concludes that this is against the usual reasoning of more competitors means lower prices.  They do not take into consideration that medicine is a regulated industry and the prices charged are irrelevant.  The providers raise their prices as do all other businesses as the cost of living increases.  This does not mean they receive more from the insurance companies.  If any business has competition in one area it may lower its prices in that area to meet the competition but it will raise prices in another area to keep up with the cost of living.  If they don't they won't be in business long.  

Medicare is criticized for paying over $1 Billion per year in questionable claims.  This shows how well socialized medicine will work.  The government can not do much right.

Medicare Part D premiums are to rise about 24% in 2009.  This is due to higher utilization of drugs and rising drug prices.

The Wall Street Journal had an article on medical tourism sponsored by employers.  The employers have found it is cheaper to send their workers overseas for care than to send them to local physicians. The employers are splitting the savings with the employees that are getting their elective surgery abroad.

The New York Times reported that 90% of the country's nursing homes were cited in the past year for federal health and safety violations.  The average was 7.6 violations per nursing home.  How does this make you feel about you or your family ending up in one.       Top


Corpus Christi, Texas, Trinity Hospital is catching heat for doing their civic duty.  A woman applied at the hospital for a job.  She was using a counterfeit Social Security Card, found out, arrested and rightly deported.  Then some do gooder advocates began claiming the hospital went to far by reporting the identity theft to the authorities.  They state there is nothing in the law that states the hospital is obligated to report the theft.  Please, save us from advocate do gooders.     

Philadelphia's Chestnut Hill Hospital is closing its maternity service.  It is the 15th hospital in the area to do this.  The rationale is that the combination of low reimbursement and high med mal premiums make the continuation of the service unhealthy.  Chestnut Hill delivers about 2% of the Philadelphia babies annually and was losing about $2.5 milli0on per year including the NICU which is expected in the Philadelphia area.  The Philadelphia Department of Public Health states the closing is a continuation of the region's continued obstetrical crisis. Don't tell that to the area's trial attorneys.   

We hear nothing from the biased AHA on the situation in Michigan's Oakland County.  There will soon be two new hospitals in the area that is now working at about 50% capacity.  The new hospitals are part of the good ole boys network, so not a peep out of the AHA.  The new hospital competition has forced the older hospitals to spruce up and purchase up to date equipment.  This is the same as when physician owned hospitals come into an area.

The hospitals may subsidize some of the costs of EMR for the physicians, but are not doing so.  This is due to both physicians not being interested in EMR and hospitals having more IT projects.  The hospitals that have helped the physicians realized that physicians with several hospitals tend to take their patients where they receive the best care, which includes rapid results of lab and x-ray.  

The Pennsylvania and New Jersey hospitals are not reporting any errors.  Either they are lying, not complying with the law or are the best in the world.  I would doubt the third. 

California has put the University of California Irvine under supervision due to problems with their anesthesia department falsifying medical records.  There have been multiple complaints regarding the department by both within and without the department.  A new department head has just been hired and is bringing in new people and cleaning up the mess left by the old regime. 

Eisenhower Hospital of Rancho Mirage, California, has decided to drop its Medical contract after the State reduced payments by 10%.  This is a major hospital in a large Medical area.   

USC is to open a new hospital in October.  Last week the Dean said that the LA County Board of Stupes would have enough staffing by the opening.  This week he stated he sent a letter to the Stupes with concerns regarding staffing.           Top


Greeley is at it again.  The organization infamous for being anti-physician and pro-hospital states that the physician accused of disruption is not allowed to confront his/her accuser and should just allow anything into to go into a file unrebutted.  The physician should use the information to improve no matter what the circumstances of the "disruption". It is this type of thinking that gives medical staffs who follow this type of bad advise a bad name. The organization lost the advertising by the AMA years ago due to this type of advice.  I have no idea why medical staffs listen to their biased speakers.  

The Arizona Republic has an article that the state's insurers may attempt to stop the practice of concierge medicine where physicians charge a yearly fee for more specialized care and also bill the patients insurer for that which is covered.  The insurers believe that concierge medicine may violate the contract between the physician and the insurer.  The problem is that without a policy on concierge medicine it will be difficult to cancel the contract with the physicians.  When they do the physicians who see both concierge and regular patients may drop the regular patients leading to problems with access to care caused by the insurer.

Seven cardiologists quit the Iowa Heart Center to work for Iowa Health Des Moines.  The cardiologists apparently had a non compete clause which caused a legal problem and suit.  The judge upheld the clause and now the two sides have come close to how much is owed to Iowa Heart.  The judge has now lifted the injunction.  The seven have agreed to work for Des Moines for seven years since Health is putting up over $2 million for them.

The New York Times had an article that physicians are rarely prosecuted in connection with prescribing narcotics.  The study only focused on the DEA and not local authorities.  The result is good as it allows those who are pain specialists to prescribe without much fear of prosecution by the feds. 

In another article about physicians and narcotics it was shown that the DEA is a growing impediment to electronic prescribing.  They have put in strict security which requires physicians to have to reenter the system for each prescription.  The other alternative, except for the logical bypassing of electronic prescribing altogether, is to use electronic for all regular prescriptions and fax for narcotics.

A study at a VA hospital showed cancer specialists and surgeons lacked empathy for their patients concerns.  Gee, I wonder how much time each physician was allowed with a patient.

 The American Society for Clinical Oncology is projecting a shortage of oncologists in the country by the year 2020.  The causes are a growing number of boomers that will require services, a greater number of women oncologists who see fewer patients that their male counterparts and fewer oncologists in general.  A consideration is that primary care physicians will care for the cancer patient with only occasional oncology visits.  Of course, thee is a growing shortage of primary care physicians as well.

The AHA has but out a misleading statement that implies that physicians who refer patients to physician MRIs may have a conflict of interest.  This came from one line in a 64 page report put out by the DHS.  The DHS did find that almost 1/4 of physicians that referred MRIs had some relationship with the provider of the MRI.  Most of these were people who had MRI in their own offices and therefore had no conflict of interest.         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.