Articles Posted in Doctor-Patient Relationship

Medical leaders and politicians carp endlessly about medical malpractice suits, but when an emergency medical specialist diagnosed staffing shortfalls that threatened patient safety, guess what legal mechanism became crucial to his corrective crusade? Why, yes, of course, it was a lawsuit. A big one over wrongful termination.

Let’s not over-focus on the irony of a legal process that has won the doctor at long last a $26-million judgment, and, instead, pay keen attention to the blaring alarm raised by Dr. Raymond Brovont, an emergency medical specialist in Missouri (shown, right). In brief, he was fired after objecting to persistent understaffing in a hospital’s emergency department as part of the policies of a private contracting firm. As NBC News reported of this increasingly pernicious health care problem:

“What happened to … a former Army doctor named Ray Brovont … isn’t an anomaly, some physicians say. It is a growing problem as more emergency departments are staffed by for-profit companies. A laser focus on profits in health care can imperil patients, they say, but when some doctors have questioned the practices, they have been let go. Physicians who remain employed see that speaking out can put their careers on the line.

ecrilogo-300x112The coronavirus pandemic and the wrenching demand this public health nightmare has put on the U.S. health care system and its people have become such a worry that staffing shortages and workers’ mental health have become top safety concerns in 2022.

That is the evidence-based view of ECRI, aka the nonprofit, independent Emergency Care Research Institute. It has provided rigorous research to the public and parties in health care to better safeguard patients and their medical care for more than a half century.

The organization issues a Top 10 annual list of patient safety concerns, which is “typically dominated by clinical issues caused by device malfunctions or medical errors,” ECRI reported. But the group is raising different alarms this year about “crises that have simmered, but [that] Covid-19 exponentially worsened.”

deptvetaffairslogo-300x183One of the largest, most important health care systems in the country has plans in the works for a huge revamp, including shutting down many of its big, aging hospitals or slashing services there, shifting to smaller clinics, and refocusing its caregiving to parts of the country where its patients live.

Taxpayers will want to pay attention to these plans because they will pay tens of billions of dollars for them — likely with gratitude. That’s because this reimagined system provides care to millions of current and past U.S. service personnel and their families and is best known as the VA, aka the Department of Veterans Affairs, the Washington Post reported.

The Biden Administration has launched the VA on potentially decades of changes in the way it provides the nation’s sacred commitment to those who have fought with honor for their country and earned the right to quality care for what can be considerable, long-term health needs.

kffmarch22medicaldebt-300x149Medical debt, one of the most shameful aspects of the U.S. health care system, has only become more so in recent times, drowning patients in an ever-rising flood of red ink now climbing past $195 billion.

The money owed by millions of Americans to doctors, hospitals, labs, Big Pharma and others in healthcare and big systemic problems have raised alarms for experts at the Kaiser Family Foundation, the Commonwealth Fund, and the Consumer Financial Protection Bureau.

The independent, health-focused nonprofits and the federal consumer agency say that soaring indebtedness — increased by the cost of coronavirus pandemic care — keeps patients from getting medical treatments and prescription drugs they badly need and that could maintain or improve their health.

abuse-150x150Women suffer significant, sustained damage from head traumas inflicted on them during domestic abuse, and victims themselves, doctors, law enforcement, and too many others have underestimated the severity of this problem.

Here is the harsh reality of too many women’s terrifying experiences, as reported in a tough-to-read but important New York Times magazine article that quotes, among others, Eve M. Valera, an associate professor of psychiatry at Harvard University and a leading researcher on traumatic brain injuries among survivors of domestic violence:

“The Centers for Disease Control and Prevention estimates that one in five women in the United States experience severe intimate-partner violence over the course of their lifetimes, resulting in physical injuries, most commonly to the head, neck and face. Concussions are likely to appear with alarming regularity. Every year, hundreds of concussions occur in the [National Football League]; thousands occur in the military. Valera’s estimated number of annual brain injuries among survivors of domestic abuse: 1.6 million.

afampregnant-220x300The United States, the wealthiest nation in the world, has a really bad record on maternal mortality. And it only worsened during the coronavirus pandemic.

The National Center for Health Statistics found that 861 women died during pregnancy or shortly thereafter in 2020 versus the 754 comparable deaths in 2019, the New York Times reported, noting:

“The United States already has a much higher maternal mortality rate than other developed countries, and the increase in deaths pushes the nation’s maternal mortality rate to 23.8 deaths per 100,000 live births in 2020 from 20.1 deaths in 2019. Maternal mortality rates in developed countries have in recent years ranged from fewer than two deaths per 100,000 live births in Norway and New Zealand to just below nine deaths per 100,000 live births in France and Canada.

medicalrecords-150x150Patients, for their own protection, long have needed to secure copies of their medical records and correct inaccuracies they find  — a safeguard that has grown even more vital as research builds about unacceptable biases that doctors and others may show in their recorded observations about those in their care.

In two separate, published dives into tens of thousands of medical records, researchers found that black patients were 2½ times more likely than their white counterparts to be labeled with at least one negative description, and African-Americans with diabetes were more likely than whites to be labeled with medically disapproving terms including nonadherence, noncompliance, failed or failure, refuses or refused, and, even combative or argumentative, the New York Times reported.

Dr. Dean Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center and who was not involved in the studies, told the newspaper this of the disconcerting descriptions found in patient records:

Let’s flip the script on those who have rejected their role in quelling the pandemic and demanded their right to control their own bodies. It’s time to recapture common sense. Those who have advocated for increasingly unmoored and unfounded responses to the pandemic can’t stigmatize, criticize, mock, or abuse (physically or verbally) those who want to take heightened care in yet another challenging period of the pandemic. All across the globe, long before the pandemic, individuals in advanced societies covered their faces for various reasons — without question or issue from others.

Those who are immunocompromised (notably because they have survived cancer or are undergoing treatment for it), disabled, older, overweight, members of communities of color, or who have underlying health conditions may not be required to. But they certainly may choose to be safe and healthy rather than sorry. They may keep wearing upgraded masks, maintain distances, reduce their socializing with others, and avoid closed and poorly ventilated indoor spaces as well as mass gatherings.

If they haven’t gotten vaccinated or received their boosters, they may choose to do so now (and they may get their flu shots, too).

pillslotsa-150x150As the opioid abuse and drug overdose crisis rages, experts — after decades now of experience with powerful painkillers — continue to struggle with their proper handling and prescribing.

The federal Centers for Disease Control, on the one hand, has softened its earlier tough guidelines on the medications, while a  top government commission assailed the spiking U.S. overdose deaths and called synthetic opioids like fentanyl and the damage they cause a threat to the “national security and well-being.”

The U.S. Supreme Court also is scheduled to consider when doctors cross a line and act in criminal fashion in prescribing drugs — a professional privilege with wide latitude. The justices, in taking up this issue, consolidated two criminal appeals from doctors whom federal authorities convicted of running pill mills or distributing drugs resulting in death.

bruinslogo-300x214The City of Angels has become an epicenter of big settlements paid to women harmed by doctors in university health care systems.

The University of California at Los Angeles disclosed that it will pay $243 million to 203 patients who asserted they were sexually mistreated by James Heaps, a gynecologist who was affiliated with the school in various capacities for decades. As the Los Angeles Times reported of the claims against Heaps, including those that  led to the filing of criminal charges against him:

“Heaps faces 21 felony counts — including sexual battery by fraud, sexual exploitation of a patient and sexual penetration of an unconscious person — involving several female patients. He could be sentenced to more than 67 years in prison if convicted of all charges. He has pleaded not guilty and insists he acted in an appropriate manner, his lawyer said.”

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