Healthcare Update — 09-26-2012


Macabre Monty Python plot? Organ donor network allegedly pressures hospitals to declare severely ill patients as being brain dead – even when the patients showed signs of life. If these allegations are true, should criminal charges be filed? Against whom?

Lindsay Lohan goes to the emergency department for an asthma attack … or a “bad lung infection.” Gets discharged with antibiotics and goes back to her hotel room. Asthma … bad lung infection … one of those ZeePacks and she’ll be back to normal. They cure everything, right? Surprised they haven’t tried Z-Packs for her alcohol problems. It will do about as much for alcohol problems as it will in treating asthma or bronchitis.
Speaking about criminalizing medicine … Conrad Murray was convicted of involuntary manslaughter for providing inappropriate medications that resulted in Michael Jackson’s death. The working theorem was apparently that inappropriately prescribing medications that result in a patient’s death should result in jail time. Let’s say that Lindsay Lohan develops clostridium difficile colitis, becomes septic, and dies after receiving antibiotics for asthma and/or bronchitis – a use of antibiotics which is medically inappropriate. If we follow the logic under which Conrad Murray was convicted, should Lindsay Lohan’s doctors then be charged with involuntary manslaughter? If not, where do we draw the line? I’d like to see what you all think.

“Car surfing” isn’t cool. It kills people.

In Qatar emergency departments, it’s no ID, no treatment… unless there is a true emergency. Wonder what happens if they try to vote.

Texas physician population increasing and costs decreasing since tort reform. Or are they?

“Silent Exodus” of physicians from the practice of medicine according to a survey of 13,575 physicians by the Physicians Foundation (.pdf file). Pessimism about the medical profession abounds. Doctors are working fewer hours and are seeing fewer patients. Almost a quarter of their time is spent on non-clinical paperwork, further decreasing their ability to treat patients. Half have limited the amount of Medicare patients they will treat and 26% completely closed their practices to Medicaid – that “insurance” more than 30 million patients will soon receive.
Hat tip to one of the best internal medicine blogs around – ACP Internist

What would Sam Shem say? Admitting services increasingly using electronic medical records to perform “chart biopsies” before accepting admissions. And in some cases, the biopsies are being used to try to block admissions.
Hat tip to Emergency Medicine Literature of Note


  1. What’s more likely, that multiple physicians and associated health care providers across several hospitals are engaged in a conspiracy to harvest organs prematurely, or that this one guy has an unrealistic expectation of when to stop end-of-life care?

  2. The NY Post article read more like sensationalism than reality to me. To many oddly-vague statements (e.g. “signs of life” without any qualifiers indicating how significant). The POV suggested someone who regards harvesting organs as inherently wrong.

    Whereas I’m of the opinion that if I’m so badly injured there’s doubt about whether my brain is even alive, I’d rather my organs get used by someone who will appreciate them than trying to resuscitate what’s left of my brain.

    • The best was the only “sign of life” that he mentioned was a patient “jerking” during surgery…nevermind that you can totally jerk as a result of spinal reflexes and still be perfectly brain dead.

      The comments section of that article was infuriating…all these people declaring that they will never be donors because doctors will kill them for their organs. Give me a flippin break. If those people had any real information about brain death testing, instead of this sensationalist BS news outlets put out, maybe so many people wouldn’t die while waiting for organs that never come.

  3. Whitecoat, you continue to be wrong about criminal liability for people dying from what physicians do.

    Conrad Murray was all about Michael taking “8” Ativans and then injected him with propofol for insomnia.

    Strangely enough, the guy died from this combination. Someone taking 8 Ativans for sleep should be referred to chemical dependency treatment and/or a sleep study or whatever, not knocked out with an anesthetic.

    When’s the last time you have ever given propofol to someone who has just taken an overdose of Ativan to help them sleep?

    That’s a combination of drugs that could certainly be expected to cause death and, in the hospital setting, would require, if justified for some reason, someone with an airway cart monitoring the airway, a cardiac/BP/oxygen monitor, and frequent checks for level of consciousness.

    Hi, not the same as a z-pack for bronchitis because that is not something that a regular person (not even needing to be a doctor/nurse would say “oh, that’s likely to kill the person”). PS Maybe little Lindsay got a touch of aspiration pneumonia.

    Conrad Murray killed Michael Jackson. He stayed with him 6 nights/week and could have helped, but chose to give in to his drug addiction instead.

    • Typo fart…”Hi, not the same as a z-pack for bronchitis because that is not something that a regular person (not even needing to be a doctor/nurse would say “oh, that’s likely to kill the person”) would think would kill a person. PS Maybe little Lindsay got a touch of aspiration pneumonia. “

    • Conrad Murray was not acting as a doctor in this case. The only thing doctor-like about him was that he had a license and could prescribe. He was doing a “procedure” that no doctor in the country could justify, AND doing it in a setting (MJ’s home) that also could not be justified. He did not keep records/a chart on what he was doing. He did not have privileges for what he was doing anywhere he actually did have privileges. There was nothing about this was was medical tx. This was not malpractice. It was manslaughter.

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