Healthcare Updates — 06-20-2011


Debunking myths about the emergency department … or perpetuating them? Guest blogger at HuffPo asserts that emergency medicine is NOT the most expensive type of health care (accounting for only 2% of all healthcare spending), that 92% of emergency department visits require some type of treatment within 2 hours, and that most patients who visit the emergency departments are insured (40% of ED patients had private insurance in one CDC report).

Patients gone wild. Arizona man becomes upset in emergency department waiting room, pulls out gun, then shoots ceiling. Police arrive and man threatens suicide before being taken into custody.

With more and more episodes of patients gone wild, hospital violence is on the rise. Some hospitals are installing metal detectors, state-of-the-art surveillance systems, and 24 hour security teams to protect their workers. What is your hospital doing to protect its workers and its patients?

Opioids cause 50,000 emergency department visits per year and we prescribe more of them. Kids cough medications cause 1,500 emergency department visits per year and they get pulled from the market. Go figure.

$2.4 million judgment against a Boston surgeon after patient develops postoperative complications and patient requires 8 surgeries to fix problems.

$2.25 million judgment against California ambulatory surgery center after patient develops brain hypoxia during eye surgery.


Mining Medicare billing data to learn about patient issues is patently illegal under HIPAA. Using patient information for commercial advantage subjects violators to a fine of $250,000 and 10 years in prison. However, if the feds want to open up those same Medicare billing records for data mining to develop physician “report cards” and charge hundreds of thousands of dollars for the data … that’s fine.

The continuing in-network/out-of-network fight. Now insurance companies are trying to stick it to the ambulance companies. Either the ambulance companies become in-network providers and accept the insurance companies’ lowball reimbursement or else the insurance companies will send the reimbursement check directly to the patients, forcing the ambulance companies to go to the patients to collect the money for the ambulance ride.

As number of Medicaid enrollees continues to rise, their benefits are about to drop significantly. Federal subsidies to states are being cut from 67% to 57% on July 1.

Medicare now starts looking into doctors who order “double CT scans” – those “with and without contrast.” Some hospitals order none of such tests, some order the tests in 80% or more of cases. Radiologists say that double CT scans are “rarely necessary.” Has the American College of Radiology put out a position statement stating when double CT scans are appropriate?

Remember that patient you treated back in 1933? He just filed a lawsuit against you. At some point after being injured by another person’s negligence, many states have laws stating that you either have to file a lawsuit or move on with your life. The “statute of repose” gives plaintiffs a deadline by which they either must file a case or waive their ability to pursue a case. Not anymore in Ohio, though. The Ohio Court of Appeals recently ruled that Ohio’s statute of repose is unconstitutional.

Descriptive and funny story about one mom’s experience bringing her daughter to the emergency department. Made me laugh a few times.



  1. Re: Security

    We have automatically-locking doors on all the rooms (not just psych rooms) as well as big lockdown doors, cops, and security guards, all of whom have degrees in law enforcement at the very least. The security guards have tasers and handcuffs, and the cops carry their usual guns.

    My previous hospital had a bulletproof metal wall that came down over the triage window when you activated the “panic” button (I liked to test that thing), lockdown doors, and your average seclusion rooms with cameras, locks, etc.

    When you’re not allowed to throw anyone out, no matter how disruptive they are, you have to treat the place like a jail.

  2. Regarding the first article: well, if you count a fever in a 4 year old who’s parents didn’t bother to medicate at home and they came to the ER for that “free” Tylenol Rx, then yes, they “required” treatment within two hours.

  3. I think it is so disturbing the way gangs are seemingly on the rise and that a mob of people would attempt to get drugs out of an ED. A friend recently told me about someone being killed because they were shot by someone who wanted to steal drugs from the pharmacy. is this a new wave of crime on the rise? Are pharmacists going to have to work behind bullet proof windows? And then what about the customers picking up their medications? Will they need to be escorted by armed guards to their cars?

    Hospitals are there to help people. The employees should be safe and not have to feel concerned about an attack.

    That being said …I often shop alone at night. Every now and then I feel a bit uneasy …but for the most part just think it’s a safe small town ..although I do it down at the malls too.

    It’s disturbing and also sad. It really bothers me that so many people don’t have respect or value human life. It bothers me that schools, hospitals, pharmacies and churches had always been safe places may not be safe.

    We were so fortunate growing up when we did ..prior to the 90s. yes ..there has always been violence and crime ..but it has gone up exponentially over the last couple of decades. (Although NYC safer than it had been). I hate that we have to be so protective with our children and they hear all these things on the news, etc.

    And I know people may’ve lived in quiet desperation and things were happening going unreported. And we didn’t have instant satellite reporting every negative event.

    Still it seemed more innocent than now.

    What is going on with these violent people? And how do we stop them?

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