Setting the record straight about EMS myths. Well … really one myth … going to an emergency department by ambulance doesn’t mean you’ll go to the front of the line. The places that I work will frequently have patients who come by ambulance go directly to the waiting room. Other times when it isn’t as busy, the patients would have gone straight to a bed regardless of how they arrived. Calling an ambulance to try to game the system isn’t worth the expense.
One of the things people don’t think about when filing a lawsuit is called “subrogation.” If insurance has paid for care that is related to your lawsuit, they’re going to want to be reimbursed for the money they spent. If the government spent $250,000 on your care and you win a $500,000 malpractice suit, between the costs of suit, the attorney’s fees, and the government subrogation claim, you’re going to come away with very little money.
In this case, a patient is trying to block Oregon from taking $236,000 of her malpractice settlement – an amount that the state claims it paid for her care over 6 months. I’d like to see the itemized bill and receipts for that bill.
And if an insurance company is allowed to prevent a patient from receiving a “windfall” of a malpractice judgment, shouldn’t policyholders be able to prevent insurance companies from receiving a “windfall” of premium payments when the policyholders don’t use the insurance? You lawyers know of any “reverse subrogation” cases?
OK, these pictures are disconcerting. Now I’m going around looking at the size of senior citizens’ ears. How does a person’s appearance change with age? Ten photographic comparisons show that ears and noses get bigger, eyelids droop, and sun exposure kills a complexion. But the ear thing still weirds me out the most.
Dr. Ben Carson claims that Obamacare is “ the worst thing that has happened in this nation since slavery” and that it is “making all of us subservient to the government.”
The government that has the power to give everything to you also has the power to take everything away from you. Food stamp benefits set to be cut before the holidays. Maybe Dr. Carson was right.
Hospitals need to change their business models with the Unaffordable Insurance Act. Hospitals with better clinical outcomes and better patient satisfaction surveys will receive financial incentives under Obamacare.
For those of you who think that better outcomes and higher satisfaction are good measures of quality, be prepared to be transferred somewhere else when you’re a high-risk patient (hospitals won’t want to risk a bad outcome on your care) and remember the studies showing that highly satisfied patients are nearly twice as likely to die from their medical care.
United HealthCare fires “thousands” of doctors in Connecticut who are caring for Medicare Advantage patients. Slick move. United HealthCare took this action right before Medicare enrollment started, so that Medicare patients could enroll in the United HealthCare program and then find that there were a lot less physicians to take care of them. And when patients don’t have access to health care, they can’t utilize as many services … which means that United HealthCare doesn’t have to pay as much money for treatments and doctor’s visits.
United HealthCare stated that it was releasing physicians in order to build a “network of health care providers that we can collaborate with more closely ….”
But at least those seniors have medical insurance.
22 year old patient who was paralyzed after spinal surgery for scoliosis wins $4 million malpractice verdict … against law firm that represented her. According to the accompanying news article, a jury decided that the Virginia law firm of Paulson & Nace committed legal malpractice when they incorrectly filed the first complaint on behalf of their client, then
I find it odd that Paulson & Nace doesn’t have this $4 million malpractice verdict on their “Our Results” page. Must just be a web site programming glitch.
One thing that struck me about this article was the grace and determination with which this young patient is dealing with her disability. Very encouraging.
Why the Unaffordable Insurance Act won’t work.
“Many young people—who are two-thirds of the roughly 40 million uninsured—will prefer to pay the penalty ($96 in the first year) rather than buy coverage, especially since they can always [just purchase coverage] when they fall sick. That’s because Obamacare bans insurance companies from turning away patients with pre-existing condition or charging them rates much above what others pay—the so-called community rating mandate. Over time, this will unleash a downward spiral of adverse selection: Rising premiums will push more healthy people to drop out, leaving the insurance pool sicker, which, in turn, will cause premiums to rise further, which will require more subsidies from an already strained federal fisc—until the whole Rube Goldberg structure collapses.”
When you can jump into the insurance pool only when you’re sick, it kind of defeats the point of having insurance.
What’s wrong with the driver’s seats in Saudi cars? Leading Saudi cleric Sheikh Saleh Al-Loheidan warned that medical studies show that driving cars “automatically affect[s] a woman’s ovaries and … pushes the pelvis upward.” Even worse, children born to women who continuously drive cars “are born with varying degrees of clinical problems.”
Riding in cars apparently has no such detrimental effects, which leads me to believe that the Saudis don’t know how to properly design driver’s seats.
And I can only imagine what the constant driving must do to Saudi men’s woo hoos. The horror!
Oregon law capping civil damages in all cases doesn’t apply to medical malpractice cases, but cap doesn’t apply to prenatal injuries. Recent Oregon Supreme Court ruling states that injuries to a child occurring during delivery are not considered “prenatal” injuries and therefore are not covered by the cap.
When a patient files a medical malpractice case, plaintiff attorneys can talk to the treating physicians without a defense attorney being present. However, defense attorneys are not allowed to talk to the treating physicians without the plaintiff attorney being present. A Florida malpractice reform evened the playing field by allowing both sides to discuss the case with the patient’s physicians. Now a judge has ruled that the Florida malpractice law is invalid because it conflicts with Federal laws.
Study shows that emergency physicians spend 43% of their clinical time entering data in a computer and 28% of their clinical time in direct patient care.
Those numbers pretty closely correlate with the mini study I did about 18 months ago.
The “Ottawa SAH Rule” published in JAMA has 100% sensitivity in determining when patients have a subarachnoid hemorrhage. Wonderful. Every one of patients with age > 40, neck pain, loss of consciousness, onset of pain during exertion, thunderclap headache, and meningeal signs has a subarachnoid hemorrhage. Are we not supposed to scan and LP patients who have fewer than six of those symptoms?
The real issue is that the rule doesn’t do a very good job in saying when people don’t have a subarachnoid hemorrhage … which is the question we need to answer in order to affect our clinical care. Caveats to applying the rule are contained in an editorial to the article by David Newman and Jonathan Edlow.
Georgia lawmakers attempting to overhaul the state medical malpractice system. Proposed system is a “no fault” system similar to worker’s compensation claims. If a medical injury occurs, a patient is compensated. No determination of “medical malpractice” is made. The bill’s proponents believe that under such a system, defensive medicine and subsequent litigation would decrease. If doctors’ names are reported to the National Practitioner Databank, the new law will increase defensive medicine and will increase litigation as doctors do whatever they can to keep claims from being reported.
When both the medical association and the bar association are against the proposed legislation, someone should get the hint that there may be a problem.
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