Home / Healthcare Updates / Healthcare Update — 07-18-2014

Healthcare Update — 07-18-2014

More patients gone wild. Texas woman gets trip to the hoosegow after running a red light and colliding with another vehicle, then attacking the emergency department nurse who was trying to help her.

Adding pelvic exercises to a workout may help men as much as it helps women. Kegel exercises for men *may* improve incontinence and erectile dysfunction, and one company actually created a little weight lifting system that fits over the male genitalia. Gives new meaning to the phrase “pump you up.”

Not to be outdone, you can also see this article on weight training with a women’s genitalia using a jade egg. Who wouldn’t want a pelvic floor like a trampoline? Then again, just reading the article makes me think about getting one of these things for Mrs. WhiteCoat.
Hat tip to Instapundit for the link

North Carolina patient with chronic pain experiences an increase in pain for 2-3 weeks then waits until 3PM on a Friday afternoon to seek medical care in the emergency department rather than seeing their primary care physician in the prior 14-21 days. Given two pain shots and a prescription for pain medications but wife is still upset because he “was not adequately treated for his episode of pain,” so she writes letter to the editor of the newspaper.

Speaking about chronic pain … Salix gets approval for its new drug Relistor for treatment of chronic pain in non-cancer patients. Initially approved for opioid induced constipation and is an isomer of the drug naltrexone which is used to treat alcohol dependence and occasionally used to treat opioid dependence.

California’s Grant Union High School in the midst of a tuberculosis outbreak. 116 of 450 students and staff have latent TB while 5 students developed active TB including one who spread the disease to some family members.

New Jersey’s University Hospital cuts emergency department beds and opens “observation unit” to ease emergency department overcrowding. Kind of interesting how state hospitals work that numbers game. Will be interesting to see how much crowding increases in both the ED and the observation unit.

Naval Hospital Bremerton closing its emergency department and ICU and opening an urgent care facility

April 15, 2014 article in Huffington Post by Alexander Kjerulf titled “Top 5 Reasons Why ‘The Customer Is Always Right’ Is Wrong.”
Companies that exhibit this attitude create unhappy employees: “You can’t treat your employees like serfs. You have to value them … If they think that you won’t support them when a customer is out of line, even the smallest problem can cause resentment.”
The “customer is always right” sentiment also creates perverse incentives where “abusive people get better treatment and conditions than nice people.”
When companies enforce this culture, employees feel less valued, feel as if they have no right to respect, and gradually learn to provide “fake” good service where the courtesy is “on the surface only.” One expert noted that “when you put the employees first, they put the customers first.”
The article ends by noting
The fact is that some customers are just plain wrong, that businesses are better of without them, and that managers siding with unreasonable customers over employees is a very bad idea, that results in worse customer service.

FDA trying to regulate tweets. Maybe it should spend more time reviewing the safety profile of drugs so that it doesn’t recall medications for safety concerns after it has approved them for 30+ years … not that something like that would ever happen. Twice. Or more.
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  1. The closure of the ER at the naval hospital is the result of a larger trend. The vast majority of military medical facilities are becoming outpatient-only facilities. In the Air Force, the largest medical center (Wilford Hall) became an ambulatory surgery/outpatient facility several years ago. I have heard that the 3/4th largest medical center at Wright-Patterson OH is scheduled to lose inpatient care over the next few years.

    The reasons should be obvious. Today, if you are overall pretty healthy (as the military population will be), almost every medical intervention will be done in an outpatient setting. In past decades, the inpatient population was augmented by the retiree population. However, as a result of Tricare and associated budge pressures, military treatment facilities see very few retirees these days. Thus very few inpatients. It is far cheaper to ship them “downtown.”

    The real question is how this will effect military medical education. A very significant portion of physicians in past years were trained in whole or in part by the military (including me). However, with the lack of diversity increasing in the patient population of military facilities, it is an open question how long that can continue. If the bulk of a resident’s training has to take place at a civilian facility anyway, why have the military residency in the first place?

  2. If I had a letter to the editor like that, I’d post it on the ED wall, like restaurants do with reviews, under a sign that said “Reviews from our drug seeking patients!”

    You can’t ask for that kind of publicity. I bet the “I have chronic pain but waited until Friday afternoon to decide my meds were gone or not working” crowd dries up at that hospital. More time to take care of actual sick people like the woman last night with a HR of 18.

  3. I had to check that the source of that reported arrest of an assaultive ED patient wasn’t from GomerBlog.
    Such things are virtually unheard of in the wild.
    And for a felony, too.
    Yay, Texas!

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