Tag Archives | hospital

Controversy Over Spinal Fusion

Debate over spinal fusion surgery continues to occur. A recent article tiled “Spinal fusions serve as a case study for debate over when certain surgeries are necessary,” appears in the Washington Post written by Peter Whoriskey and Dan Keating and published on October 27, 2013. (Note I have previously mentioned some of the controversy over spinal fusion in the post Tips to Prevent Medical Errors – AHRQ) The article mentions that spinal fusions being performed in the U.S. has risen over the years and that around half of the surgeries they reviewed don’t meet expert consensus on when the surgery should be performed. This article discusses a surgeon at a Florida hospital who was earning well over a million a year performing spinal fusions on patients. Auditors at the hospital began to wonder if all the cases were necessary and paid for an independent review which showed that 9 out of 10 cases was not medically necessary. A lawsuit emerged which provided several details on the financial arrangements between the doctor and the hospital. For example, the surgeon earned additional money beyond his base salary for each procedure after a certain threshold. The surgeons at the hospital were charging patients […]

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The Immune System in Critically Ill Children with Influenza

An interesting article discussed the results of a study looking at the immune system in critically ill children. The article describes a study published in early 2013 in the January issue of Critical Care Medicine. Recent evidence indicates that the suppression of innate immune system function can occur in critically ill patients. In this study patients with innate immune suppression produced reduced amounts of tumor necrosis factor (TNF)-α  when their blood is stimulated with lipopolysaccharide (LPS). The article states “Results indicated that despite high levels of circulating pro-inflammatory cytokines, critically ill children with influenza demonstrated lower TNFα production capacity compared with healthy control subjects. Further, children who died from influenza had markedly lower TNFα production capacity compared with survivors.” Hence this study suggests that the reduction of immune function in these children who are critically ill may make them more prone to death. Hence, this suggest that therapies developed to target the immune system could potentially be an effective treatment for individuals who are critically ill. Investigators from 15 different children medical centers helped conduct this study. Typically the immune function is not measured in patients with influenza. Source: “Study: Monitoring of Immune Function in Critically Ill Children with Influenza Reveals […]

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The Optional Alternative to Medical Injury Claims

Previously on this blog I have discussed some of the issues with medical malpractice in the United States and some potential alternatives. In this post Potential Alternatives to the Current Medico-Legal System in the United States I talk about some possible alternatives such as having some agreement directly with the physician and hence avoiding trial lawyers. In this provocative post How to Improve Your Chances to Win a Dental Malpractice Lawsuit I discuss the 4 elements you need to win a malpractice suit in the U.S. and a possible suggestion to help improve your chances of doing so. Last year, Kevin Pho known as “social media’s leading physician voice” discussed in a post written on July 16, 2012, titled “The New York medical malpractice crisis: Who’s to blame?,” how some financially struggling hospitals are going without medical malpractice insurance and just going bare as they say. He describes how if hospitals don’t have malpractice insurance than lawyers and patients will go after doctors who may have individual policies. Kevin says that conservatives have failed in their effort for tort-reform by focusing only on non-economic damage caps. Physician groups such as the AMA, ADA, and AAOMS have also seemed to focus more […]

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Justice and Fairness in the U.S. Healthcare System

An interesting article appears in the Fall 2012 issue of the “The Journal of Law, Medicine & Ethics” titled “Justice and Fairness: A Critical Element in U.S. Health System Reform,” written by Paul T. Menzel. In the article Paul discusses how unfettered competitive markets in health insurance generate market failure. The market failure of course is the fact that in an unfettered competitive market, health insurance will inevitably be out of reach for many (even most) of those who desire and need it most. In the article Paul discusses a term he coins the Just Sharing principle “The financial burdens of medical misfortunes ought to be shared equally by well and ill alike, unless individuals can be reasonably expected to control those misfortunes by their own choices.” Paul goes on to say “Just Sharing is incompatible with pre-existing condition exclusions, high degree of premium variation by subscriber risk, rescission of insurance when a subscriber becomes high-cost, and other market segmentation devices that inevitably arise in an unfettered competitive insurance market, creating market failure. If one only bars insurers from using these devices, however, then the “death spiral” for insurance begins: community-rated premiums lead even more of the likely well to […]

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Unnecessary Medical Care and Over Used Tests: The Choosing Wisely Campaign

The Choosing Wisely Campaign is an initiative which I believe I first heard about in late 2010 launched by the ACR (American College of Radiation as the Imaging Wisely Campaign) The Imagely Wisely Campaign was designed to have people aware of the fact that certain medical imaging tests such as CT exams were sometimes over used and did not always have to be used in some instances. It seems that the Choosing Wisely Campaign was launched by the ABIM Foundation which is an organization designed to advance medical professionalism to improve patient care. In April 2012 the Choosing Wisely Campaign released some lists of tests and procedures commonly done in 9 medical professions that should be questioned.  In February 2013 an additional 18 lists of tests or procedures were released. The press release is located at http://www.choosingwisely.org/wp-content/uploads/2013/02/021513_CW-Phase-II-Press-Release-FINAL.pdf On the website of the Choosing Wisely Campaign it states “An initiative of the ABIM Foundation, Choosing Wisely is focused on encouraging physicians, patients and other health care stakeholders to think and talk about medical tests and procedures that may be unnecessary, and in some instances can cause harm.” Consumer Reports is involved in helping to disseminate information to patients in a more […]

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