Healthcare Update — 12-17-2012


Man faces 6 to 30 years in prison after being convicted of aggravated battery for stabbing emergency physician in chest with steak knife. During trial, patient stated “If they’d followed emergency room protocol, we wouldn’t be here right now.”

We do it to the heart … why not to the brain? Stents may help certain stroke patients.

Why we need to dump the FDA. +1.

Cute … or scary. In the Christmas spirit, Loyola Medical Center comes up with the Twelve Days of Trauma and how much trauma care costs.

Is he molting? Baby develops abscess in his neck. When opened, doctors pull out a 2 inch feather. Another story here.

Another case of getting what you pay for.
California patients with Medicaid can find few specialists to treat their non-emergent medical problems. One man has been waiting more than a year to find a physician to perform his cataract surgery. Dermatology appointments can take up to a year. Appointments for cardiologists can take up to 18 months. Many times the patients are told to go to the emergency department with their problems.
As California plans to cut reimbursements to physicians an additional 10%, expect to find even fewer specialists available.
But at least the patients have insurance … the same type of insurance that millions of other patients will receive with the Affordable Care Act.
Affordable for whom?

Charleston West Virginia’s 36 most frequent emergency department patients sought care an average of 27 times in 6 months. Eighty percent of those patients had Medicaid “insurance.”

CDC graph: Half of all visits to emergency department by patients 18 years old or less are covered by Medicaid – an increase of almost 50% in 10 years. Percentage of privately-insured patients drops more than 20% over 10 years.

California Blue Cross Blue Shield wants to increase rates by 12-20% despite sitting on record surpluses. Wonder why.

Emergency department in Emerson Hospital, Massachusetts shut down for hours due to hazmat scare and five people decontaminated due to exposure to … road salt.

Just because we can do it a little faster, does that mean we should do it a little faster? Stroke patients get tPA before they even get to the ED. Door to needle time for tPA was 36 minutes less, but how many systems will be able to afford sending a portable CT scanner, neurologist, and radiologist out on every 911 call for weakness? Will the significant addition of cost justify the outcomes?

Avoiding holiday heart syndrome. Doesn’t happen that often, but interestingly, I saw a case of holiday heart a few days ago.
Remember that atrial fibrillation is often a symptom of some underlying problem, so this diagnosis is usually made after other problems have been excluded

Insightful and thought provoking article about why many states are choosing not to be involved with the “exchanges” required for Obamacare. You mandate it, you own it.

Another emergency department closing. Alabama’s Cooper Green Mercy Hospital closing emergency department and turning it into an acute care center.

Jury awards $1.5 million to family of patient who committed suicide after receiving repeated phone prescriptions for Paxil without physical exam.

Prisoner caught hiding a needle in his clothing in a Baltimore emergency department. Struggle ensued. Prisoner grabbed for officer’s gun and the gun fires. Fortunately no one was hurt. Should we prevent police from carrying guns so these types of incidents don’t happen in the future?

In addition to the 10 reasons physicians shouldn’t practice in Florida, I was going to start putting up 10 reasons why physicians shouldn’t practice in California. Then I saw that one public psychiatrist was paid $822,302 in 2011 while 15 others made more than $400,000 per year and 93 made more than $300,000 per year.
Of course, working an average of 76 hours overtime every week of the year – much of such work taking call from home – doesn’t leave much time for any other activities.
I’m not sure if this would be a pro or a con for working in California.


  1. I’ve been wandering for a while about the logic of why Repub governors aren’t setting up their own exchanges. Because now they’ve ceded control and are HELPING the federal govt to set up a national plan.

    I’m a doc who actually thinks that single payor is a good idea. And I find it ironic that the Repub governors are facilitating this.

  2. Most Governors Refuse to Set Up Health Exchanges
    12/15/12 – NYTimes [edited]
    === ===
    Gov. Tom Corbett said he would not pursue an exchange. “State authority to run a health insurance exchange is illusory. Pennsylvania would end up shouldering all of the costs by 2015, but have no authority to govern the program.”

    In Tennessee, Gov. Bill Haslam decided against a state-run exchange because the Obama administration had failed to answer numerous operational questions.

    Gov. Chris Christie of New Jersey cited similar concerns. “New guidance continues to trickle out of Washington at an erratic pace.”
    === ===

  3. Which governor would want to commit to a plan where they will be totally on the hook for the cost after 3 years? The responsible ones, even though they may be out of office by then, won’t. The irresponsible ones won’t either, because they may still be around to shoulder the blame.

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