Articles Posted in Conflicts of Interest

cdcnhomesmay72021-300x156Residents and their loved ones may have reached a major turning point with nursing homes and other long-term care facilities, agonizing as to whether the institutions really can provide safe, hygienic, and welcoming places for the vulnerable — or whether other, tough options must be considered.

Who can forget that that 132,000 elderly, injured, and seriously ill residents died of the coronavirus during the many months of the pandemic, and almost 1.4 million infections were recorded in 38,000 long-term care facilities? The institutions — even as the pandemic’s terrible toll keeps rising — still account for a third of all U.S. deaths due to the disease.

The facilities’ covid-related deaths have plummeted by 91% since December, especially as public health officials campaigned to get residents and staff vaccinated, the New York Times reported (see chart above, based on federal data). But public confidence in long-term care facilities also has plunged, as reflected in admissions and occupancy:

uvahealth-300x200The University of Virginia health system has decided to end decades of draconian bill collection, giving a reprieve to tens of thousands of patients and their families who faced harsh legal actions to recover crushing medical debt.

The taxpayer-supported institution proclaimed itself “proud” that it will stop aggressively suing its own employees, university students, and hard-working and poor Virginians after they experienced illness and injury serious enough to require hospitalization.

The university jammed the state courts with these actions, as well as liens against properties — including those of family members and not just patients themselves. The process to clear the debt-collection backlog may take a year or more. The health system “will release all liens and judgments filed against all households making less than 400% of the federal poverty level, or about $106,000 for a family of four,” the Washington Post reported.

disabledkidsfla-300x233When doctors, hospitals, and insurers bellyache about malpractice claims with little evidence on their prevalence or outcomes, patients and politicians should push back: And they can cite the nightmares people in grievous circumstance have suffered when their constitutional right to seek justice in civil lawsuits gets stripped away.

The Miami Herald and ProPublica, the Pulitzer Prize-winning investigative website, have conducted a joint, deep dive into Florida’s decades-old legislative experiment, purportedly to assist families struggling with infants’ birth-related and catastrophic disabilities. The state’s neurological injury compensation initiative also was promoted as a way to stem a problem seen mostly in anecdote and not evidence — obstetricians and other specialists supposedly fleeing Florida, reputedly due to spiking malpractice insurance costs.

The media investigators, in a multipart series , have found that eliminating medical malpractice lawsuits for this slice of patients has benefited not the patients but instead, doctors, hospitals, and insurers.

devicemakerpaymentsHA-300x257Although Big Pharma has taken deserved heat for selling its drugs by slathering doctors with cheesy tchotchkes, lavish or even cheap meals, and pricey trips, as well as lucrative consulting and speaking opportunities, medical device-makers’ physician-payment programs also should get a tougher, deeper look.

That’s because device manufacturers paid doctors $3.62 billion in the years 2014–17 — 1.7% of the revenue in their business sector and more than seven times the percentage of drug industry revenue spent on payments to MDs, according to a new study published in the respected medical journal Health Affairs.

The payments have come under increasing fire, as even the smallest sums — yes, even for a slice of pizza and a beer or a few sodas — may sway doctors in prescribing drugs or favoring treatments, notably with certain medical devices. The sketchy product-promotion spending may not benefit patients and may boost health care costs, a growing body of evidence from studies is showing.

stop-150x150Although state licensing boards have taken more than their fair share of criticism for failing to discipline bad doctors as quickly and severely as circumstances merit, regulators appear to be trying to get ahead of a problem that especially plagues women patients and women health staff: doctors’ sexual misbehavior.

This inappropriate conduct can encompass a range of bad acts — all of which are unacceptable and should result in serious consequences for offenders, a viewpoint in the Journal of the American Medical Association argues. The article describes a review and consensus reached by the Federation of State Medical Boards, representing the 71 state medical and osteopathic regulatory boards — commonly referred to as state medical boards — in the United States, its territories, and the District of Columbia.

The authors wrote this:

usccampus-300x165The University of Southern California apparently has set a record — one which parents should pray no college has reason to challenge and for which the educators and leaders at the Los Angeles campus should be sorry and ashamed.

The Trojans have announced they will pay $1.1 billion to settle lawsuits over the tawdry actions of Dr. George Tyndall, who was the lone gynecologist for young women treated in the student health service.

The school has admitted that he saw 17,000 patients in his three decades at the school and sexually abused many of them. As the Los Angeles Times reported:

cookmizzoudmv-150x150It’s long been routine, if often controversial, for operating rooms to welcome medical device sales people and surgical trainees to watch the work of surgeons and nurses. But now the University of Missouri health system may have reset the bar with its $16.2 million settlement with almost two dozen patients over questionable knee surgeries.

The contested procedures were performed in part by a veterinarian.

That vet, James Cook, is listed on the university’s web site as the William & Kathryn Allen Distinguished Chair in Orthopaedic Surgery. The explanatory text online and a posted video has him describing how his chief role at the school focuses on research in people and animals in joint disorders. He says he is experimenting with techniques, notably in dogs, in which live materials can be used to replace problem joints.

cmsnursinghomecompare-300x139Federal regulators, by allowing owners and operators to self-report quality and safety data and failing to audit vital information with diligence, have “broken” the national nursing-home rating system — what was supposed to be an invaluable tool for consumers to make life-and-death decisions about where to place vulnerable loved ones needing round-the-clock care.

Instead, the New York Times reported, the popular and convenient star rankings have become little more than an inaccurate means for facilities to advertise and market themselves, even while keeping from the public their serious problems — including abuse, neglect, over medication, sexual assault, and killings of the aged, injured, and ailing.

The system’s glaring shortcomings were exposed even more by the coronavirus pandemic, the newspaper reported. It launched its deep dig into the ratings when it became clear that highly rated homes, when the pandemic struck, did not fare notably better, as might be expected.

declinenhomedeathsnytfeb21-300x189Just as good news expands about vaccines and declining coronavirus cases and deaths in the nation’s nursing homes and other long-term care facilities, grim information also is developing on how the facilities’ ownership, particularly by wealthy investors, can be lethal to residents.

The positive effects of early efforts to get vulnerable long-term care residents and staff vaccinated can be seen in the accompanying graphic (courtesy of the New York Times). The newspaper reported this:

“Throughout the pandemic, there has been perhaps nowhere more dangerous than a nursing home. The coronavirus has raced through some 31,000 long-term care facilities in the United States, killing more than 163,000 residents and employees and accounting for more than a third of all virus deaths since the late spring. But for the first time since the American outbreak began roughly a year ago — at a nursing care center in Kirkland, Wash. — the threat inside nursing homes may have finally reached a turning point. Since the arrival of vaccines, which were prioritized to long-term care facilities starting in late December, new cases and deaths in nursing homes, a large subset of long-term care facilities, have fallen steeply, outpacing national declines, according to a New York Times analysis of federal data. The turnaround is an encouraging sign for vaccine effectiveness and offers an early glimpse at what may be in store for the rest of the country, as more and more people get vaccinated.

btallycongresswork-300x240Congress has given U.S. service personnel slightly improved help if they find they have been harmed while receiving military medical care and want to pursue justice via legal actions.

Lawmakers, as part of a big bill at year’s end dealing with many different matters affecting the Department of Veterans Affairs, also quietly approved legal provisions that were part of the eponymous Brian Tally VA Employment Transparency Act. These were signed into law by President Trump before he left office.

The Military Times describes these new requirements for the giant veterans’ health agency:

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