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Healthcare Update 07-10-2013

New York’s Eliot Spitzer campaigning in Connecticut’s Danbury Hospital emergency department? Nope. Just some slime that backed up from the toilet and leaked down the walls into about 10 treatment rooms requiring partial closure of the ED and requiring the hospital to use a “mobile hospital tent” provided by the state.

In a related article, if you ever wanted to know where the term “shit head” comes from, here’s the explanation: Some Oklahoma perv was arrested after he was found in an amusement park septic tank, looking up through the toilet drains while women were using the bathroom. A woman who took her 7 year old to use the toilet saw an eyeball looking up at her. Wrong on so many levels.

Speaking about … feces … a parasite in cat feces is now being termed a “significant public health problem.” The immature forms of the parasite, called oocysts, can survive up to 18 months and only one of them is required to cause an infection. Common sources of infection are sandboxes and vegetable patches where cats are more likely to relieve themselves.
Toxoplasma gondii has been called a “mind-controlling parasite” (no other puns about our elected officials here, OK?) because when it infects humans, it has been linked to schizophrenia, depression and suicidal behavior in adults and multiple congenital abnormalities including mental retardation in newborns.
Oh, and Toxoplasma infections are much more common in France. Draw your own conclusions.

Speaking about … infections … there’s a new tick-borne illness which is similar to Lyme disease (Borrelia burgdorferi) but worse. In addition, it doesn’t cause the typical spreading rash, most doctors don’t know the infection exists, and this infection will not show up on tests for Lyme disease. Introducing … Borrelia miyamotoi.

Speaking even more about … infections … a pair of studies in the European Spine Journal shows that back pain may be related to pimples – and may be treatable with antibiotics. Propionibacterium acnes, the bacteria commonly associated with acne, was found in discs of 43% of patients undergoing surgery for disc repair. Of those patients with these bacteria present, 80% had inflammatory changes in the adjacent vertebrae.
A second study showed significant improvement in disease specific disability, leg pain, and back pain after 100 days of antibiotic treatment.
More evidence to me that health is related to proper balance of bacteria in the system. Now we just have to figure out what that balance is.
Also makes me wonder whether chronic back pain or even ankylosing spondylitis may have an infectious basis as opposed to an “autoimmune” basis.

Another survey out  – this one by the Medicus Firm – shows attitudes of physicians toward practice preferences and the UnAffordable Insurance Act.
Out of 2500 doctors surveyed …
More than half preferred the East Coast as the region to set up practice
More than half of new graduates preferred employment by a hospital or academic center
The most common reasons cited for declining physician pay were hospital employment, declining reimbursements, and time wasted entering information into electronic medical records.
More than half of physicians rated the “Affordable” “Care” Act as either a “D” or an “F” in terms of being able to decrease health costs, improving the quality of care, improving efficiency of care, and as an “overall grade.”

Enforcing the UnAffordable Insurance Act will be the IRS. Yes … that IRS. The IRS will enforce 47 tax provisions under Obamacare and will also collect the penalties … er … um … taxes for noncompliance.
What could go wrong?

Oh, and under a 253 page Obamacare rule issued last month, states, local agencies and health insurers are required to share all of your protected health information so that the IRS can enforce the program.
While the sharing of information may seem nefarious and there’s no guarantee about what this information will be used for, HIPAA already allows sharing of information among protected entities for payment purposes, so your information is probably all over the place already.
If it’s not, then it will be.

Scammers are taking advantage of the Obamacare implementation to fleece some elderly people. They call up grandma posing as a Federal employee and tell her she’s been selected to be one of the first to get a new Obamacare insurance card. All she has to do is give up her bank account and social security number and … well … you know the rest.

When faced with a worsening cough, 60% of patients would rather see a physician assistant or nurse practitioner than wait an extra day to see a physician according to this study in the journal Health Affairs.
If we continue down the rabbit hole, I wonder how the responses would pan out.
Waiting 1 week for a doctor, 5 days to see a NP or PA, 3 days to see a newly graduated RN, 1 day to see a medical assistant, or same day appointment with a college student majoring in health care administration.

More good news from Emergency Medicine Australiasia.
People aged 65 and over comprise 13% of the population yet contribute 35% of hospital admissions and 47% of hospital occupied bed-days. Using multiple estimation methods, it is projected that by 2050, people aged 65 and over will be responsible for two-thirds of all hospital bed-day utilisation. Commensurately, ED attendances among older people are high in relative and absolute terms, with the fastest growth in ED presentations by patients aged 65 years or older. These trends are likely to continue into the future.
But just think about how much insurance everyone will have …

New Hampshire malpractice panel unanimously finds that cardiologist treating a 36 year old man did nothing wrong in evaluating the patient for syncope. Jury awards $1.5 million verdict against cardiologist anyway.

Missed meningitis case results in $1.72 million verdict in Reading, Pennsylvania.
Three month old infant taken to hospital emergency department on December 16. Diagnosed with ear infection and discharged on December 19. Taken to another hospital the same day and diagnosed with “bacterial infection.” Transferred to Children’s Hospital on January 14.
So a child with a fever was diagnosed with an ear infection, admitted to the hospital for three days, discharged, sought follow up care the same day at another hospital, another bacterial infection was diagnosed, and four weeks later the child was transferred to a specialty hospital?
Causation problem here?
Fear the bad outcome.

Want to get to the basis for physician dissatisfaction? Here are 10 regulatory irritants that are fueling the fire. #1 on the list is “meaningless work” to satisfy government regulations and that has no direct patient benefit.

6 comments

  1. “Also makes me wonder whether chronic back pain or even ankylosing spondylitis may have an infectious basis as opposed to an “autoimmune” basis.”

    The answer is yes; the infectious basis for ankylosing spondylitis is Klebsiella pneumoniae, as stated in the following:

    http://www.kickas.org/medical/11.shtml

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1001180/

    These are just the first two hits for a Google search of: klebsiella pneumoniae ankylosing spondylitis

  2. Would be interested to hear your thoughts on this:

    http://www.washingtonmonthly.com/magazine/july_august_2013/features/special_deal045641.php?page=all&print=true

    Fear the bad outcome? Fear physicians reaching conclusions from newspaper articles.

  3. Cool.

    The agency now documented to have been used expressly to go after the President’s political enemies now helpfully has not only all our financial information, but now access to every bit of medical data on everyone from birth, forever.

    No way that could have unintended consequences, nosiree.

    Why not just issue another arcane rule under Obamacare that says we have to give them our PIN numbers and computer passwords too, and maybe be available once a quarter to let them rummage around the house for a couple of hours if they feel the need while we take a government-administered polygraph?

    I was going to suggest letting them body scan and proctoscope us, but the TSA has the first one covered, and the proctoscopy report will be available online to the IRS as soon as we get a regular one, so that’s already covered.

    Another year of this, and I’ll officially change parties, and register with Al Queda.

  4. HIPAA-SCHMIPAA – means nothing any more. It really IS a JOKE.

    With everything that has been exposed regarding that tax agency – I can’t believe they will still be in charge.

    I always believed in standing up for what you believe in, but it sure seems like an effort in futility.

    What chance does the average American have when so many gov. officials, don’t know, don’t remember, and even the pres states he didn’t know but finds out from the press ..which is actually HILARIOUS when you factor in that the press blacks out all the important news about these investigations.

    We know the elections had to be fixed some how when you have precincts that had 0% Romney votes and voters saw Romney votes change before their eyes and lets not forget a certain amount 0f votes were counted in Spain. SPAIN? This corruption is so widespread and the republicans ..but for a few ..are useless.

    I’ve always believed good will prevail …but my hand is on the white flag. It’s not raised yet ..but it really seems hopeless and saying that is the antithesis of who I’ve always been.

    I’m seeing things go on in our gov that I really cannot believe.

    I am on such overload regarding all these scandals and I’d be optimistic if anyone wee ever accountable if things really changed for the better.

    What the heck happened to this country?

    How can such a dishonest agency be allowed to have all this info and be in charge of us as individuals, employers, etc?

    Gotta love how they released all those ss#s last week. OOPS. No accountability. Identity theft – who cares?

    And while America slept …

    Anyone who has known me would describe me as upbeat and positive and I always could find a silver lining. It does seem pointless now.

  5. OMG! I can’t believe one of these articles led to (with a bit of research) to someone I worked with yrs ago! 86 He was a good doctor then (still a resident or just out – forget now) and apparently is now. Even tho back in 86-87 and maybe early 88 too – not sure, I remember, especially that smile. One of favorite doctors I ever worked with. :)

    This was the doctor I wrote about in the 3rd post I wrote …when I was a newbie blogger back in November, 2006.

    http://seaspray-itsawonderfullife.blogspot.com/2006/11/sutured-on-sunday.html

    Small world! :)

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