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Healthcare Update — 06-06-2013

See more updates over at EP Monthly.com

Patients gone really wild. 45 year old patient falls asleep in Harlem Hospital emergency department then wakes to find another patient sexually assaulting her. Assailant then stopped and began to urinate on her.
Comments to the article equate the incident to the future of health care in this country.

Schools requiring doctor’s notes to apply sunscreen on kids due to “possible–but quite rare–risk of being allergic”? We should probably require doctor’s notes to eat lunch, also. Food allergies are a big problem, you know.
It would be amusing to turn the tables on these moronic school officials.

“Sunscreen of 30 SPF or higher must be applied exactly 27 minutes prior to anticipated sun exposure. Sunscreen should be applied to all exposed skin areas including scalp and also applied to a 3.5 inch area of skin buffering any and all exposed skin areas. Sunscreen must be reapplied to these same areas every 30 minutes or fraction thereof. Application of sunscreen, times of application, areas of application, and reapplication efforts should all be clearly documented, signed by school officials and returned to this office for filing with the State. Any variation from these directions should be considered medically contraindicated and unauthorized by this practitioner.”

Hat tip to Instapundit for the article link.

Are US doctors paid too much? When this Forbes article compares US physician salary to physician salary in other countries without comparing the legal atmospheres, the regulatory atmospheres, the costs of training, the costs of malpractice insurance, and the costs of licensure, the article doesn’t effectively answer the question – even though it concludes that US doctors are underpaid.
Show me another country where a specialist has to pay $150,000 in malpractice insurance each year and then we’ll talk.

Kentucky needs 3,790 more physicians than it currently has – and that’s before Medicaid expansion and the UnAffordable Insurance Act take effect. With 25% of Kentucky’s primary care physicians at risk for retirement in the next 5 years, the problem will only get worse.
Now it is looking at allowing nurse practitioners to prescribe non-scheduled medications as one way to combat the problem.
Don’t worry, Kentuckians. You’ll still have insurance!

Connecticut hospitals have serious problems obtaining psychiatric medical care for children. On many days, more than half of the beds in the Connecticut Children’s Medical Center ED are occupied by behavioral health patients. Many sit in the department for days because there are “no psychiatric beds available in the state of Connecticut.”

Chicago’s Roseland Community Hospital threatened to stop taking new patients unless Illinois paid it more than $6 million in back debts.
On Wednesday, the hospital recanted and stated that Illinois did not owe it any money – and got $350,000 in funding.
Black Disciples gang members protested the possible closing of the hospital, stating that they deserve to be saved and that closing the hospital would amount to “genocide.”
Closures of other area hospitals increased the ED volume at Roseland by 40%. Many of those patients were uninsured.
I predicted this scenario years ago. When hospitals close, uninsured patients don’t stop getting sick. They find care at other open hospitals.

Oh, and don’t forget … the UnAffordable Insurance Act increases the amount of insurance coverage to young healthy adults.
The Rand Corporation also commented on the study, stating that “private insurance was acting as it should.
That is until workers are fired or their hours are cut so employers no longer have to pay for coverage to them or their families beginning on January 1, 2014.
Don’t worry, though. Our elected representatives have exempted themselves from the Obamacare requirements, so at least they will have health care insurance.

Another UK hospital at “breaking point” due to excess admissions amid report from College of Emergency Medicine stating that “emergency departments must change or face collapse.” This article also notes the challenges in providing emergency care to an aging population with a broader range of health issues.

It saves lives, but will insurance cover it? Swabbing cervix with vinegar will cause transient change in the color of cancer cells. People trained for 2 weeks could accurately perform the test and the screening reportedly decreased the cervical cancer death rate by 31% in India. Some Indian doctors are getting their asses beaten by patients for performing the exam, though.

With wait times soaring, New Zealand emergency departments begin handing leaflets to patients telling them “Actually, this was not an emergency.” Many of the “unnecessary” visits are on weekends when no primary care physicians were available and when “exorbitant weekend surcharges” at medical centers made it less expensive for patients to go to the hospital emergency department.

Some employers are trying to renew their current insurance policies before the end of the year to delay having to comply with Obamacare rules by another year. States are jumping in to prevent employers from doing so.

New York Senate passes a law making it a felony (meaning that it is punishable by at least a year in prison) to make physical contact with a police officer with the intent to harass, threaten, annoy, or alarm. The actual reading of the law is better than the news release which left out the “physical contact” portion.
How does this relate to medicine, you ask? I’ll tell you. It would be nice if the New York legislature felt as concerned about unarmed medical professionals in the emergency department and passed such laws to protect them as it did to protect armed officers with flak jackets.

Texas, on the other hand, is making it a third degree felony if health care personnel are assaulted while delivering care to a patient – which means “serious jail time.”

One comment

  1. In order:
    Doctor’s notes for suncreen?
    Cool. We can call it the Nurse’s Full Employment Act of 2013, since allowing unlicensed personnel to administer this dangerous topical medication would probably encroach on if not violate outright the nursing practice codes of 50 states. I’d be kidding, if not for the sanctimonious jacktards who keep trying make it illegal for our techs to reapply nasal cannulae, and who have forbidden them from applying topical Bacitracin to superficical abrasions while applying dressings to patients in urgent care/ED fast track. Because, y’know, it’s a much better use of a nurse’s time, at $30-50/hr, to slather on an item that’s been an OTC since Eisenhower was president. And a medical imperative.

    FWIW, a local teaching/county ED sent the county a bill for indigent care delivered, and got $0.20 on the dollar, so they offered a choice: either they close the ED forever, or get to limit their new ambulance catchment zone to 5 miles. The county went for “B”. So now, when medics call in a run, like Dominoes Pizza managers, anyone from 5 miles and 2 feet away, with GPS precision, gets diverted to other hospitals. And this was a decade before Obamacare swamps all the lifeboats, serially.

    And if Texas is serious about not just criminalizing violence against healthcare workers, but actually prosecutes it, I’m moving there to work. One of my ED docs is more sanguine: he just wants us all issued with Tasers, and the authority to use them on violent patients/faily members/etc., whereupon he proposes we bill the offender for electro-convulsive therapy at market rates.

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