Home / Healthcare Updates / Healthcare Update — 06-26-2013

Healthcare Update — 06-26-2013

See more updates at EP Monthly.com

In cats they are called hair balls and are considered a bad thing … New fad has fashion models dipping cotton balls in orange juice and eating them in an attempt to suppress their appetites and lose weight. I can’t even come up with a pithy comment for that one.

$4 million settlement in New York after mother seeks care for UTI symptoms at 26 weeks gestation, doesn’t receive antibiotics, and child is born 11 days later with neonatal sepsis.

Florida Governor Rick Scott is now backing legislation to crack down even further on expert witnesses in medical malpractice cases.
The legislation was sparked by one doctor who misrepresented his credentials under oath when testifying as an expert witness.
Now plaintiff attorneys are crying foul because the restrictions will “benefit doctors and corporations at the expense of injured patients and consumers.” In other words, “bwwwwaaaaaaaaaah, our contingency fees are going to dry up.”
Could Governor Scott’s interest in improving expert witness standards possibly be because Florida is one of the suckiest states in which to practice medicine and he’s trying to make a turd smell a little more like a rose?

Chicago-area hospital adding a “Telestroke Program” to its facilities. Now neurologists can view patients over computer cameras to determine whether they need to be transferred to a higher level of care.
Will be interesting to see how much benefit the web cams will have. Not like you can do strength testing over the internets.
Anyone out there use a video link to neurologists?

Not to be outdone, the University of California at San Diego is instituting a study on use of telemedicine for emergency department patients.
The principal investigator for the study, Dr. David Guss, states that “underutilized physicians” during lulls in patient volumes are an “unneeded expense.”
Ahhhhh, the emergency department of the future … one doctor running around frantically performing procedures on critical patients while a bunch of other doctors write work notes and Norco prescriptions from the comfort of their home offices.

New York’s Long Island College Hospital blocks ambulances from bringing patients to emergency department.
One neonatologist threatens to “call the cops” if the hospital attempted to move her patients out. Tough to run incubators without electricity.
The hospital is losing $1 million per week, but a judge ordered the hospital to maintain staffing levels anyway. Maybe they can use Monopoly money to pay the staff..
One less hospital to care for Brooklyn patients in an emergency.

New York isn’t the only place where judges make idiotic rulings. Ontario Court of Appeal rules that obstetrician was negligent for relying on the treatment plan of a consultant specialist who misdiagnosed a patient’s aortic rupture as a pulmonary embolism. Obviously, the obstetrician should know more about medicine than every other specialist. If he agrees with the specialist and there is a bad outcome, he’s liable. If he disagrees with a specialist and there’s a bad outcome, he’s still liable.
Ultimate effect of Ontario Court of Appeal’s ruling: Physicians are responsible for knowing everything about medicine and will be liable for misdiagnosis regardless of what a consultant says.
Does Canada have a problem with defensive medicine yet?

According to a Mayo Clinic study, we are officially The United States of Pill Poppers. Seven in ten people in this country are on at least one prescription medication. Half are on at least two prescription medications. Twenty percent are on 5 or more medications — most of those patients come to my emergency department.
Antidepressants and opioids were tied for second place on the list. Guess what class of medications was first …

AMA adopts policy labeling obesity as a disease, meaning that 30% of all Americans are now “sick” if they weren’t “sick” from some other medical illness already.
Now people who are overweight get discriminated against because they aren’t considered obese. Is declaring obesity a disease a way to get more treatment or is it a means for more people to become “disabled”?

Wait times for placement of psychiatric patients from Vermont emergency departments at an all time high average of more than two days. Longest wait recorded was just shy of two WEEKS.
Tropical Storm Irene destroyed the state psychiatric hospital and the state still hasn’t replaced the 54 beds.
And we don’t see some clueless judge ordering the state to fix this problem, do we?

Patient sues urologist after allegedly botched penile implant left patient with an 8 month erection and a scrotum the size of a volleyball.
His lawyer reminds everyone that “It’s not something you want to bring out at parties and show to friends.” Some people may disagree with that statement.

Patients gone wild to the extreme. California scumbag Antoin Haggard gets mad at emergency department staff and begins throwing his poo at them. Arrested and charged with aggravated assault.

Could Matt have been right? Did I just say that? Illinois’ largest medical malpractice insurance carrier scores record profits even after the Illinois Supreme Court overturned damage caps. Investment gains are high despite lower premium revenue.
Despite the decreasing premiums, the Chicago area is still one of the most expensive markets for medical malpractice insurance. Base premiums for an obstetrician were $138,000 and premiums for a surgeon were just shy of $100,000.

The UnAffordable Insurance Act keeps piling on the good news. Free sharing of Americans’ protected health information is required. But it is only shared to make sure that everyone is getting all of the benefits to which they are entitled. [wink, wink] Hey – what could go wrong?


  1. We use tele-neuro. We are a community hospital and designated stroke receiving center. Tele-neuro (at a community hospital an hour away in a larger city – within our larger hospital system) can do an assessment via webcam and assess if the patient needs to be transferred for a higher level of care. The nurse stays in the room with the patient while the neuro assessment is performed and assists with the evaluation: holding up a pen for the patient to identify, noting physical response for the physician. Sometimes family is there to assist with comparison to baseline. The neurologist has access to CT or MRI results on the computer. We can do alteplase or medical management, but can transfer the patient via heli if the neurologist wants to do an intervention. It works well for us.

  2. I use teleradiology for Neuro consults. It works great!! Patient’s love it because they’re seeing the specialist “right away”. Our neurologists use our nurses to help with the exam and NIHSS stuff. So I don’t really have to be in the room during the consult. I think the decision is what is NIHSS score and is TPA indicated? Does it really matter if the strength is 4+/5 or 4/5? I was skeptical at first (5 years ago). But I’m a strong proponent now. It makes my life way easier.

    We also use the machines for SW consults as our Social Workers staff in multiple locations and it’s not always easy for them to drive from place to place.

    There are also rumors that our pediatricians are going to start using them to help with bed placement (do they need PICU, does the transport team need to go get this kid or is ambulance OK etc).

  3. We use Tele-Med for Pediatric emergencies: puts us right in contact with the PICU at the university hospital 75 miles south of us. The real strength isn’t in running the code (although have a bit of hand-holding is kinda nice); it’s in the consultant knowing exactly what’s coming when the stabilized patient gets there.

    and on another note:

    SUNY/LICH: if there are no MDs/DOs/RNs to care for patients at the hospital (or more commonly, a hospital is overwhelmed with an ER is full of ICU patients because everything ‘upstairs’ is full) exactly what is the hospital supposed to do? Call for help, except every other hospital has it’s own problems that closely resemble every other hospital in the region. When something like this happens, there’s a bunch of fingerpointing and lawsuits, but nothing actually happens. And if a court orders the hospital to stay open, the court should be prepared to foot the bill.

  4. That judge who decreed by virtue of ignorance whether a hospital sould remain open should be enterred into a “Do Not Treat” list among all area hospitals, and informed he will not be seen until every other patient in the county has been cared for first, regardless of acuity.

    Stupidity should hurt. And if it kills him, oh well.

    He should also be sentenced by the supervising judge in his district to go stand at the ocean, and issue decrees to the tides.
    Followed by a mandatory mental health evaluation hold.

    What a tool.

  5. Seeing your belated near-acknowledgement cheers me. Here’s another prediction based on this quote:

    ““If rates continue to fall, the industry’s financial results will eventually become insupportable and therefore unacceptable,” writes Chad Karls, a Milwaukee-based actuary at workforce consultancy Milliman Inc., in the Medical Liability Monitor, an industry newsletter based in Oak Park. “As painful as that scenario is to contemplate, it might prove to be the industry’s one and only path back to a truly ‘hard’ market.””

    That is when we will have another “crisis” if Obamacare hasn’t completely changed the game by then and we’ll see the same claims of 2003-2008 all over again. I say 2018 at the latest is when the next “crisis” hits. The more things change. . . .

  6. ” In other words, “bwwwwaaaaaaaaaah, our contingency fees are going to dry up.””

    Yes, how dare someone care about their income. I’m surprised you could hear the attorneys though over the caterwauling of physicians worried about Medicare cuts. To paraphrase them: “bwwwaaaaaaaah, our incomes will only put us in the top 95% of US households, not the top 99%”.

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