June 11th, 2011 by Shadowfax in Opinion
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It’s ever so satisfying to be proven right. Well, maybe “proven” is too strong a word to use, but there is a bit of strong evidence that, as I have said in the past, the practice of defensive medicine is driven by powerful multifactorial incentives and is very unlikely to change even if the most often-asserted motivator, liability, is controlled. Today, Aaron Carroll guest blogs at Ezra Klein’s WaPo digs:
The argument goes that doctors, afraid of being sued, order lots of extra tests and procedures to protect themselves. This is known as defensive medicine. Tort reform assumes that if we put a cap on the damages plaintiffs can win, then filing cases will be less attractive, fewer claims will be made, insurance companies will save money, malpractice premiums will come down, doctors will feel safer and will practice less defensive medicine, and health-care spending will go way down.[…]
Health Affairs in December, estimated that medical liability system costs were about $55.6 billion in 2008 dollars, or about 2.4 percent of all U.S. health-care spending. Some of that was indemnity payments, and some of it was the cost of components like lawyers, judges, etc.; most of this, however, or about $47 billion, was defensive medicine. So yes, that is real money, and it theoretically could be reduced.
The question is, will tort reform do that? Read more »
*This blog post was originally published at Movin' Meat*
April 3rd, 2011 by DavidHarlow in Health Policy, Opinion
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Health care social media continues to be a hot-button issue for hospitals and other provider types around the country. Health care provider organizations considering taking a first step into social media often articulate concerns about regulatory and legal barriers to the use of social media in health care. As regular readers of HealthBlawg know, I believe that an ounce of prevention is worth a pound of cure — in the health care social media arena as elsewhere. Careful planning up front will help you avoid the potential liabilities and pitfalls you may otherwise face in implementing a health care social media program. I invite you to take a look at this quick compendium of rules to live by, which I compiled with Dan Hinmon of Hive Strategies, and follow the link on the last page of the embedded presentation to download an expanded version. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
March 26th, 2011 by DavidHarlow in Health Policy, News
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Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies.
The data privacy and security concerns surrounding the transfer of de-identified data are significant. To “de-identify” what is otherwise protected health information under HIPAA, some outfits will simply strip data of 18 types of identifiers listed in federal regulations. However, the relevant regulation (45 CFR 164.514(b)(2)(ii)) also provides that this only works if “the covered entity does not have actual knowledge that the information could be used alone or in combination with other information to identify an individual who is a subject of the information.” Thus, the problem with this approach is that, these days, nobody can disclaim knowledge of the fact that information de-identified by removing this cookbook list of 18 identifiers may be re-identified by cross-matching data with other publicly-available data sources. There are a number of reported instances of this sort of thing happening. The bottom line is that our collective technical prowess has outstripped the regulatory safe harbor.
Is this the basis of the lawsuit brought against Walgreens? An objection to trafficking in health information that should remain private? No. The plaintiff group of customers is suing to share in the profits realized by Walgreens from trading in the de-identified data. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
March 17th, 2011 by Jeffrey Benabio, M.D. in Opinion
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I recently wrote a paper on social media with some of my colleagues at Kaiser Permanente: Ted Eytan, MD @tedeytan, Rahul Parikh, MD @docrkp, Vince Golla @vincegolla, and Sara Stein, MD @sarasteinmd. In the article, “Social Media and the Health System,” we argue that the benefits of engaging patients and colleagues in social media outweigh potential risks.
The two most common reasons that physicians resist participating on blogs, Twitter and Facebook are: 1. Fear of liability. 2. Lack of compensation for the time invested.
If we would like more physicians to be part of the conversation, then we’ll need to find ways to overcome these barriers.
What has your experience been like interacting with physicians on social media? Is there a place for physicians on sites such as Twitter and Facebook?
For physicians reading this post, you can also join the over 160 others who have commented on this article on Sermo.
*This blog post was originally published at The Dermatology Blog*
November 11th, 2010 by Kimball Atwood IV, M.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
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If you go to the website of the National Center for Complementary and Alternative Medicine (NCCAM), you’ll find that one of its self-identified roles is to “provide information about CAM.” NCCAM Director Josephine Briggs is proud to assert that the website fulfills this expectation. As many readers will recall, three of your bloggers visited the NCCAM last April, after having received an invitation from Dr. Briggs. We differed from her in our opinion of the website: One of our suggestions was that the NCCAM could do a better job providing American citizens with useful and accurate information about “CAM.”
We cited, among several examples, the website offering little response to the dangerous problem of widespread misinformation about childhood immunizations. As Dr. Novella subsequently reported, it seemed that we’d scored a point on that one:
…Dr. Briggs did agree that anti-vaccine sentiments are common in the world of CAM and that the NCCAM can do more to combat this. Information countering anti-vaccine propaganda would be a welcome addition to the NCCAM site.
In anticipation of SBM’s Vaccine Awareness Week, I decided to find out whether such a welcome addition has come to fruition. The short answer: Nope. Read more »
*This blog post was originally published at Science-Based Medicine*
