Healthcare Update — 02-27-2013


Knowledgeable and honest. Yeah, that’s me. Study shows that doctors wearing white coats were most likely to be judged by patients as being the “best” physicians. Doctors wearing scrubs were also more likely to be highly rated. Of course my widespread appeal could also come from my stunning good looks or my debonaire personality …

Interesting dilemma. A patient in Washington DC called an ambulance at 1:26 AM when he was having trouble breathing. Just so happens that it was New Years Eve and about 25% of the entire DC firefighting force had called off sick that day. An ambulance arrived 30 minutes later and the patient arrived at the hospital exactly one hour after the initial call for help. Unfortunately, the patient’s condition was poor and he later died.
There is now a news article about how the family thinks the $780 bill for the ambulance is “appalling and hurtful.” A petition was posted on to get the DC Fire and EMS Department to drop the bill and 166,000 people have signed it, many stating that the family should sue the Department for damages.
Yet the bill went to the patient’s insurance company and a copy of the bill was sent to the patient’s family – clearly stating that insurance was being billed, so the family isn’t paying for the transport.
Should we not pay for less than desired outcomes? If so, should the lack of payment extend to all aspects of payments? Job performance? Government benefits?

Heads at the Joint Commission are about to explode. Hand sanitizer which increases patient safety by preventing the spread of germs is allegedly to blame for burns to a cancer patient’s body after static electricity supposedly ignited the alcohol in the sanitizer and set the girl’s shirt on fire.
Joint Commission news release: “Hand sanitizer is dangerous. No, it’s good. No, it’s dangerous. No it’s good. Well it’s sometimes dangerous and usually good and if any of your patients are injured by it, you’re going to have to come up with an action plan to show us why we shouldn’t decredential you for using it … or not using it. Now buy our new manual on hand sanitizer usage for $149.95 or we’ll do a surprise inspection on you.”

One doctor is keeping his office open late to help care for people who would otherwise have to go to the emergency department. Unfortunately, not many patients are utilizing the convenience. But emergency departments in the area are experiencing growing patient volumes. Wonder why the disconnect?

Johns Hopkins obstetrician/gynecologist commits suicide after being investigated for taking pictures and videotaping patients without their knowledge.

Good news for Australian rock band lead singer Jay Whalley. The brain tumor that was causing his seizures wasn’t a brain tumor after all. Bad news: The lesion noted on CT for the past 4 years was a tapeworm egg … which has now been removed.

Doctors at Boston hospital perform another face transplant – this one to replace the disfigurement of a Vermont woman whose ex-husband beat her with a baseball bat and then doused her body with lye. Kudos to the docs. Fascinating work.

Doctors and hospital sued for allegedly negligently performing a C-section. While getting the baby out of his mother’s uterus, the doctors accidentally cut the side of the child’s face, causing a half-inch laceration – which was repaired with a few stitches. In Cook County, a perennial “judicial hellhole” contender, that horrible mistake could result in a multimillion dollar judgment.
Go ahead, Matt. Defend this one.

Chicago’s safety net for dental care is “in the midst of collapse.” Lawmakers cut $1.6 billion from state’s Medicaid program and Illinois is already at the bottom of the barrel for Medicaid reimbursements nationwide. But … you guessed it … at least those patients have INSURANCE.
Soon, even more patients will have Medicaid “insurance” via the UnAffordable Care Act. Wonder what will happen then.

Fewer patients getting insurance from employer. Can’t wait to see what this graph looks like in the next couple of years when the UnAffordable Care Act is fully implemented.

Another way that employers are deflecting the costs of the UnAffordable Care Act … employee spouses must pay surcharges for insurance coverage or are dropped from coverage completely.

Newest cause for widespread panic? Deadly new virus found in Middle East. It is “well-equipped” to infect humans and has killed 5 of the 12 patients in which it has been confirmed. Symptoms include coughing, fever, and trouble breathing – similar to those of a chest cold or pneumonia. And no, the ZeePack won’t cure it. It’s a virus.
I was going to make the point that we don’t really know how many cases of the virus have really occurred because no one knew to test for it until recently and even now it is likely that only the sickest patients will get tested for the disease. In other words, no one is going to do an expensive workup for a fever and cough that is gone in a few days. However, I didn’t need to make the point because the author of the article does a very good job at presenting both sides of the issue (unlike some other journalists I know, cough cough Jim Dwyer cough cough). Well written.

You’ll need to spend a good 30-45 minutes reading it, but this Time article about why medical bills are so high is well worth it.
When MD Anderson Cancer Center in Houston demands $83,900 in advance before it will treat your cancer, but you can’t get an itemized bill of projected expenses that the $83,900 will pay for, that’s a problem. Is the treatment for most cancer care that much better than a suburban hospital? I doubt it.
Author Steven Brill also exposes the outrageous salaries that some non-profit administrators make – often multiple millions of dollars – while crying poverty on behalf of their hospitals.
One of the administrators who was quizzed about charges lied to the reporter and stated that discussing hospital prices violated HIPAA. Another administrator who was quizzed about charges of $77 for gauze pads costing less than $1 repeatedly refused to respond.
The recurrent theme in many of the multiple patient scenarios presented is a lack of transparency in billing.
Mr. Brill argues for more transparency, free market medicine, and tort reform so that doctors don’t feel compelled to “order a CT scan whenever … someone in the emergency room says the word ‘head’.”
Get a cup of coffee, grab a danish, and just read it.


  1. WC, what do you want me to defend? The case is barely underway.

    And “judicial hellhole”? Does anyone but tobacco lobbyists use that term with a straight face?

    You should be far more focused on the recent article in Slate by Matthew Yglesias arguing US physicians are overpaid, stemming from the Time story. You really think that in looking for savings that you’ll be spared?

  2. Retired because of this kind of crap. on

    One doctor is keeping his office open late to help care for people who would otherwise have to go to the emergency department. Unfortunately, not many patients are utilizing the convenience. But emergency departments in the area are experiencing growing patient volumes. Wonder why the disconnect?

    Because the ED doesn’t charge up front, and will continue to see you no matter how big your outstanding bill gets. THAT’S why.

  3. The MD Anderson Cancer Center article is not a surprise. When I had my son, 19 years ago, I asked for an itemized bill. And the reason is because I got some type of pain med that I didn’t “get”. I believe the nurse attending me took it. In any case, I was charged $3.00 for a single acetaminophen, not the brand name Tylenol and $10.00 dollars for each pain med that I didn’t get.
    It was 2 months before they sent me an itemized bill.
    Two years ago, my son kept telling me he had pain in his lower right side. I didn’t see any bulging, just slight redness an warmth… (but he didn’t tell me he’d gotten bitten near his privates…hence a bit of a lymph infection) and I was calling all the general surgeons in town asking if they would quote me a price for cash payment for a hernia. First they ignored the question, and told me if he had a hernia on one side, he probably had it on the other!! Without insurance, I wanted to know what I would be on the line for. Finally, after actually getting testy with one lady, she relented and told me the surgery itself would be $700. Anesthesia and facility charges would add to that.
    I hate the idea that you have to pull teeth when you want to be a responsible paying party.

  4. Pingback: White Coat Hype: Branding Physicians With Professional Attire | The ACUTE CARE Blog: Non-Urban Emergency Medicine

  5. I followed the link to the website regarding the lawsuit filed against the C-section injury. 1.5 cm laceration not worth even close to what the plaintiffs are asking. These attorneys are scum. No place to comment on their website. If there was I could post the same comment.

  6. the first thing is funny – and interesting. i had one ortho doc who wore only polos and khakis. when he walked in i asked if he was the surgeon or the coach.

    he wasn’t amused and got huffy with me… but yet it was how he chose to dress!

  7. my husband would have to pay $40 per paycheck to be on my insurance surcharge if he had other means to have health insurance. this is at a tertiary care center giant multi-center group that can’t provide for residents. i’d hate to see the benefit options they give anyone else here or anywhere the way things are going.

  8. I wonder if it would be to everyone’s benefit it Doctors, Hospitals, Ambulence services, etc. stopped billing for specific conditions, treatements, etc. and instead billed like a mechanic for labor and parts. You spend an hour with a patient, you bill for an hour of your time at your stated rate. period. No arguments. You could even put a time clock in your patient rooms just to keep things straight.

      • I don’t know what you’re hiring them for, but only specialists make that kind of hourly wage, or people in those international firms who primarily work for Fortune 500 companies (who have the juice to negotiate the fee if they desire).

        If you have received a bill with undocumented expenses, and not received explanation, contact the state bar and they will start an investigation.

        If you’re a client and don’t understand your bill, you have every right, and the State Bar will back you up, to get an explanation of it.

        The original poster had a good point. I don’t see physicians trying it any time soon, however. They want to complain about the 3rd party reimbursement system – not change it.

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