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Healthcare Update — 09-04-2013

Find more updates on my other blog at EPMonthly.com

University of Iowa settles malpractice lawsuit after plaintiff attorney obtains confidential documents about why a neurosurgeon left the hospital system. Point to remember is that those confidential settlements aren’t as confidential as you might believe.

Not sure whether this is a good or bad announcement. On one hand, emergency department closures across Nova Scotia are down by 21% and 25 of 38 hospitals had no ED closures over the prior year.
On the other hand, emergency departments were still closed 5% of the time and one commenter notes that the professionals staffing the emergency departments to keep them open are paramedics and LPNs, not physicians.
So is some care better than no care at all?
Is this a model that should be replicated in the US?

Another study showing how gut flora may play a large part in weight control. Swiss study shows that patients gained an average of 5 pounds after they stopped smoking – even when their diet went unchanged. While gut flora of control patients who smoked and who didn’t smoke remained the same, there was a significant shift in the intestinal bacteria of those patients who stopped smoking — including an increase in Proteobacteria and Bacteroides.

Small community hospital in Florida closes its doors and residents lose nearby emergency services – although with only 3-4 inpatients per day this week and 25 beds, it likely didn’t have a large ED volume.

Rural North Carolina’s Blowing Rock Hospital also closing its emergency department effective October 1.

Oh, and add Flint River Hospital in Montezuma, GA to the list of hospitals closing their emergency departments.

Yet another hospital closes. Chicago’s Sacred Heart Hospital is now closed and some of its physicians are being sued by the feds for performing “unnecessary” tracheostomies on poor and elderly patients. Criminal charges could also be filed.

Multiple patients in Denver area hospitals are having bad reactions from synthetic marijuana, including Black Mamba and Spice. Reactions include hallucinations where patients jump off buildings and cessation of breathing requiring ventilator support.

Jury awards $6.4 million to patient who had mitral valve prolapse and who was never referred to a cardiologist. More than 10 years after the diagnosis was initially made, the patient became “very ill”, complaining of fatigue, loss of appetite and abdominal pain. He was sent to several consultants, but none apparently evaluated his heart. Two months after symptoms began, patient suffers a stroke due to bacterial endocarditis.

Patients gone wild … er, um … vampire? Unresponsive patient wakes up when medics trying to draw his blood and bites one of them on the back. Police officer punches patient in back of head to get him to let go. Blah! But they vere taking MY blood! Blah! Blah!
Just another day in the ED …

Georgia’s Floyd Emergency Department having a lot of patients going wild. First a patient gets upset with staff, throws a cup of urine on a staff member, then begins cursing. He gets arrested and charged with multiple crimes. Then, in a separate incident, another inked patient gets arrested for swearing at hospital staff and then fighting with an officer called to the scene.
Same town, different story – woman arrested for DUI and unlawful conduct during a 911 call after trying to get a friend with an asthma attack to the Floyd ED.
Rocking times in Rome, GA.

The latest rage: “Foam parties”? Go out dancing and end up with three feet of bubbles all around you on the dance floor. All fine and dandy until someone loses an eye. The Florida Department of Health investigated one such party after 35 patients went to local emergency departments with complaints of eye pain and irritation. Half were diagnosed with corneal abrasions and many also had trouble reading the first letter on the eye chart during exams. Symptoms lasted from minutes to months.  Did I mention that this happened in Florida?

Patient suffered asthma attack and used inhaler at home before laying down to recover. Friends later find her unconscious and try to revive her by putting her in a shower. She was dead. Friends then put her in a car, bring her to a trailer park, and dump her body on the side of the road. Now the friends are charged with multiple crimes and the deceased woman’s mother, a police lieutenant, wants answers.

Ohio health care premiums increasing by an estimated 34% due to the Unaffordable Insurance Act. White House tweets that really the premiums are a 21% savings.

 

8 comments

  1. University of Iowa settles malpractice lawsuit after plaintiff attorney obtains confidential documents about why a neurosurgeon left the hospital system. Point to remember is that those confidential settlements aren’t as confidential as you might believe.

    I’m disappointed that you missed another important point there:

    “After his resignation from Iowa, he took a job at Mount Sinai Medical Center in Miami Beach, Fla., where he works today.”

    Yay, Florida!

  2. Small community hospital in Florida closes its doors and residents lose nearby emergency services – although with only 3-4 inpatients per day this week and 25 beds, it likely didn’t have a large ED volume.

    Yet it had 95 staff members?

    • Staff can include admin/cafeteria/housekeeping/nursing/pharmacy/billing/operators/security etc, etc, etc.
      A hospital can run through 95 staff members fairly quickly

  3. With the amount of emergency departments closing down, what is your opinion and take on these free standing emergency departments that are popping up like weeds across sure suburbia? Are they a fad ? What is the long term outlook on this business model?

    • Free standing EDs take advantage of the fact that they don’t have a hospital attached. So they still have to evaluate all patients under EMTALA, but they aren’t on the hook for all the hospitalization costs if a patient who can’t pay requires a lengthy admission or extensive surgical care. The freestanding ED can’t provide the inpatient services, so they call an ambulance and transfer the patient to a hospital, which has to take the patient according to EMTALA law. In addition, since it is still an emergency department, the freestanding ED gets to bill at a higher rate and can include a “facility fee” that adds several hundred dollars to the bill.

      In the same vein, urgent care clinics generally aren’t considered emergency departments and can therefore request payment before performing any services for a patient. No payment = no service. That is why you also see a lot of urgent care centers popping up as well. This model can thwart the unfunded EMTALA mandate. If you look back through all the hospital closings I have on my blog, you will see that a substantial number of hospitals are closing their EDs and opening up some type of acute care clinic … this is one major reason why.

      • Originally posted by Whitecoat: “Free standing EDs… still have to evaluate all patients under EMTALA”

        No they don’t.

        Not if they are, 1) independently owned, 2) not affiliated with a hospital, 3) are in a state without its own EMTALA-like statute, and 4) opt out of Medicare and Medicaid.

        http://www.ucaoa.org/docs/Article_Freestanding.pdf

        (“A freestanding emergency center that is affiliated with a hospital and accepts Medicare and/or Medicaid is generally subject to EMTALA while an independently owned facility may forego the federal requirement by opting out of the government insurance schemes.”)

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