September 10th, 2010 by John Mandrola, M.D. in Better Health Network, Health Policy, News, Opinion, True Stories
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“Ouch! That really hurts! You win, please stop torquing my arm behind my back. “Uncle! I said, Uncle!!”
Yes, the threshold has been reached. We docs no longer need a tennis court or a Mercedes, our kids are fine in public schools, and we will happily buy our own damn pens.
But, please, just give us some modicum of autonomy. Throw us a measly scrap and let us take care of our patients as we see best. Like Dr. Saul Greenfield so beautifully said today in the Wall Street Journal. The paragraph that stood out the most for me is as follows:
Physician autonomy is a major defense against those who comfortably sit in remote offices and make calculations based on concerns other than an individual patient’s welfare. Uniformity of practice is a nonsensical goal that fails to allow for differing expression of disease states.
Really, it isn’t hyperbole to surmise that the overwhelming majority of doctors would decide, if faced with a choice between less compensation and less autonomy, to choose less compensation.
As a teen my dad told me the best part of being a doctor would be the autonomy. He was right, and that’s what hurts the most these days.
JMM
*This blog post was originally published at Dr John M*
August 30th, 2010 by Nicholas Genes, M.D., Ph.D. in Better Health Network, Health Policy, News, Opinion, Research
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Here’s a confession: Despite my steadfast advocacy of medical blogging as a means to promote understanding and education, I continue worry a lot about professional liability. Not just whether the things I write could hurt my career, but, in terms of academic output, is blogging a waste of time? What view does my department’s leadership take on blogging?
Still, I’ve continued to support medical blogging as a useful academic endeavor, hoping that someday this support would be borne out. When sites like Sermo and Facebook came along, I despaired that more physician opinions were going to be hidden behind walled gardens, available only to select colleagues or friends.
Then, last week, some revelations — I discovered a member of my department’s leadership was blogging, or at least, had commented on a blog. How about that! The other revelation? Facebook may be the last great hope for academic discussions to flourish on blogs.
This all arose from a pretty academic question about emergency department implementation of electronic medical records. Does the degree of implementation (full, partial, or none) impact patient wait times in the emergency department? Read more »
*This blog post was originally published at Blogborygmi*
August 30th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News
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More than one-fifth of hospitals are government-owned, but states and counties are out of cash to keep them open. So, charitable hospitals are being sold to for-profit groups or facing closures. Rising costs and more uninsured patients run smack into falling Medicare and Medicaid reimbursement. When bonds come due, there’s little chance of states and counties paying them back. And the facilities are often standalones, and they can’t fall back on corporate backing. This year, 53 hospitals have been sold in 25 arrangements. While the deals often stipulate that care for the poor continues, no one is certain exactly how or even whether such services will continue.
That said, other charitable hospitals are making big profits. What are they doing differently? First, they’re competing for patients, so they’re increasing room sizes, offering amenities and even investing in high-end procedures such as robotic surgery. They continue to offer community care, but they’re acting more like for-profit institutions to cover their charitable missions. But this conflicts with an old-fashioned view of what charitable care is supposed to be.
Stepping into the breach is the Centers for Medicare and Medicaid Services, which is offering one solution, by increasing reimbursement for inpatient services in rural areas. The agency is expanding a pilot program by increasing reimbursement for inpatient services. Facilities are eligible if they offer care to rural areas in the 20 states with the lowest population densities, have fewer than 51 beds, provide emergency-care services and are not a critical-access hospital. (Wall Street Journal, Washington Post, Modern Healthcare)
*This blog post was originally published at ACP Internist*
August 30th, 2010 by GruntDoc in Better Health Network, Health Policy, News, Opinion
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In another one of the things I had no idea about, there’s a market to assist FMGs [foreign medical graduates] in getting U.S. residencies, which makes sense. Allegedly, this guy was willing to go the extra mile for his clients.
Full marks for creativity, but…
Mr. Everest allegedly provided an employee at the hospital with forged letters from a California hospital to show that the applicants had been accepted into a second-year program. And he gave her a check for $4,000, followed by another check for $2,000. She reported him to hospital officials, and later told him she knew the letters were forged. He then allegedly gave her $6,000 for time to get a letter from a different hospital—which was also forged—and gave her $3,000 more before he was arrested.
Geez.
– Via Hospital Bribe Alleged – WSJ.com
*This blog post was originally published at GruntDoc*
August 17th, 2010 by DrWes in Better Health Network, Health Tips, News
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Sending a child off to college? Call your lawyer first. From the Weekend Wall Street Journal:
After a few clients ran into difficulty getting information about adult children who were ill, Sheila Benninger, an attorney in Chapel Hill, N.C., began recommending that clients’ children designate a health-care power of attorney after they turn 18 to identify who can speak for them if they can’t.
She also includes a Health Insurance Portability and Accountability Act, or HIPAA, release form that allows patients to determine who can receive information about their medical care and whether information about treatment for substance abuse, mental health or sexually transmitted diseases can be disclosed.
You don’t have to use a lawyer. Generic health-care power-of-attorney forms can be found online. If the school has a HIPAA release online, it’s best to use that more-tailored document.
Parents should keep a copy in an email folder, where it can be easily accessed in an emergency. And students should designate a general power of attorney so someone can pay bills or handle other issues if they go abroad.
It’s good advice for those of us shipping one more child back to college this week.
-WesMusings of a cardiologist and cardiac electrophysiologist.
Hat tip: Instapundit
*This blog post was originally published at Dr. Wes*
