Articles Posted in Doctor-Patient Relationship

anxietykid-150x150Americans live such nerve-wracking, glum, stressful lives that not only young people but also adults up to age 65 would benefit from regular screening during their doctor visits for anxiety and depression.

That’s the draft recommendation, newly issued and up for public comment, by the U.S. Preventive Services Task Force, an independent, blue-ribbon group that provides influential guidance to the federal government on medical tests and treatments.

As the New York Times and other media outlets have reported, the task force recommendations on anxiety and depression screening for most regular folks in this country were in the works before the coronavirus pandemic hit. The advisory has only taken on greater urgency as the pandemic worsened what already were grave concerns about the nation’s mental health.

catholicmedicalcenter-300x123He cut a dashing figure in ads and billboards for a New England community hospital, which had an administration desperate for a lucrative heart care program in a region  with famous academic medical centers. Dr. Yvon Baribeau, a Canadian-trained heart surgeon, seemed a perfect fit for the Catholic Medical Center, a place where he told colleagues he practically lived because he became one of the institution’s best-paid and busiest specialists.

He earned more than $1 million annually, and just one of his many operations brought in $200,000 to CMS before Baribeau suddenly retired at age 63.

What patients and the public didn’t know about the much-promoted surgeon was his shocking mistreatment of patients in a variety of ways, a notoriously poor medical performance that the Boston Globe has reported made him the holder of “one of the worst surgical malpractice records among all physicians in the United States.”

PrEP-pills-150x150While increasing numbers of Americans tell pollsters that they are forgoing religion and seeing its practice diminish in importance in their lives, those with religious fervor are finding a federal judiciary willing to delve into the complexity of faith and medicine in deeply polarizing ways.

The looming midterm elections, pollsters say, already have been upended by the U.S. Supreme Court’s overturning of a half-century of settled law in turning back to the states critical decisions about women’s reproductive health and the allowance of abortions, including in cases involving rape and incest.

A federal judge in Texas with demonstrated extreme views has further stoked the increasing fires over religion and health care by ruling unconstitutional the process by which Obamacare decides what kinds of preventive health care must be covered by private health insurance, as the New York Times and other media outlets have reported.

fingersxd-150x150The quality of medical-scientific information is strained — and patients should know this, be warned, and watch for ways to protect themselves from bungled communication, bluster, hype, misinformation, and disinformation.

Although regular folks may have unprecedented access via the internet to resources on medical services and developments, a trio of recent news articles underscore the importance of the familiar warning Caveat emptor (buyer beware):

docmisbehaviormedscape-300x179Patients may be reluctant to think ill of their doctors or to imagine that highly educated, rigorously trained professionals could mistreat or cause them harm. Doctors themselves know this picture is way too rosy for some of their colleagues.

In a survey of 1,500 practicing MDs, all of whom voluntarily responded to an online questionnaire, Medscape — a web-based medical news source — reported this information about doctor misconduct:

“Physicians tell us they’re seeing more frequent incidents of other doctors acting disrespectfully towards patients or coworkers, too casually about patient privacy, angrily or aggressively at work, and even sometimes criminally. Such behavior is still relatively uncommon, and many respondents say they are proud of the high standards of attitudes and behavior shown by fellow physicians.”

dive-180x300Even as Congress lumbers into creating the next crisis for millions of Americans and whether they can access and afford health insurance, the giant, built-in flaws in the current coverage system keep sending far too many patients and their loved ones into a financial morass with which politicians and policymakers refuse to reckon.

Successive Democratic and Republican administrations have clashed over health insurance, notably the coverage extended to poor, working poor, and middle-class folks under Obamacare. But the people in charge have erred, big time, by blindly accepting a health care fallacy that plagues the U.S. system, according to Aaron E. Carroll,  the chief health officer for and a distinguished professor of pediatrics at Indiana University. He said this in a New York Times Opinion article:

“The Affordable Care Act was supposed to improve access to health insurance, and it did. It reduced the number of Americans who were uninsured through the Medicaid expansion and the creation of the health insurance marketplaces. Unfortunately, it has not done enough to protect people from rising out-of-pocket expenses in the form of deductibles, co-pays, and co-insurance. Out-of-pocket expenses exist for a reason; people are less likely to spend their own money than an insurance company’s money, and these expenses are supposed to make patients stop and think before they get needless care. But this moral-hazard argument assumes that patients are rational consumers, and it assumes that cost-sharing in the form of deductibles and co-pays makes them better shoppers. Research shows this is not the case. Instead, extra costs result in patients not seeking any care, even if they need it.

bag-150x150If patients can benefit from price transparency by hospitals, shouldn’t employers and health insurers post online what they are paying for medical services? Yes, say federal regulators, who started requiring this effective July 1.

The federal Centers for Medicare and Medicaid Services (CMS) has ordered parties that act as health payers to make public a wealth of economic information that previously had been closely held, NPR and the Kaiser Health News service reported:

“[H]ealth insurers and self-insured employers must post on websites just about every price they’ve negotiated with providers for health care services, item by item. About the only exclusion is the prices paid for prescription drugs, except those administered in hospitals or doctors’ offices. The federally required data release could affect future prices or even how employers contract for health care. Many will see for the first time how well their insurers are doing compared with others. The new rules are far broader than those that went into effect last year requiring hospitals to post their negotiated rates for the public to see. Now insurers must post the amounts paid for ‘every physician in network, every hospital, every surgery center, every nursing facility,’ said Jeffrey Leibach, a partner at the consulting firm Guidehouse.

denismcdonough-150x150One of the nation’s largest health care systems had its ambitious plans to reshape itself for the 21st century torpedoed by a dozen members of the U.S. Senate, with taxpayers and veterans left in the lurch with great uncertainty about the future medical care for those who valiantly have served this country.

Just a few weeks ago, Denis McDonough, the secretary of the Department of Veterans Affairs (shown right), met a deadline from Congress to detail significant shifts in how his sprawling agency cares for former military personnel and their families.

He provided a proposal — a plan only — to shut many of the VA’s 1,200 big, aging hospitals and clinics or slash services there, shifting to smaller facilities, and refocusing the agency’s caregiving to parts of the country where its patients live. His plans and the future of VA care, which already have been under study for at least four years, were then to be taken up by a blue-ribbon group, the Asset and Infrastructure Review (AIR) Commission. The commission then would have reported back to Congress for possible action.

SBClogoThe University of California has agreed to pay yet more to hundreds of women patients who have credibly accused a UCLA gynecologist of sexual wrongdoing, with the now $700 million in approved settlements setting what is described as a national record for the largest such payouts involving a public university.

bruinslogo-300x214The UC system, one of the nation’s largest and highest ranked in academic achievement, says it must issue medical facility bonds to cover the staggering costs of claims against Dr. James Heaps and his sexual misconduct between 1983 and 2018 because the institution has exhausted its insurance coverage, the Los Angeles Times reported. University officials called the actions of the onetime health service and specialty doctor practicing at its renowned hospital “reprehensible and contrary to our values.”

The latest, increased UCLA payout of $375 million (for 300-plus cases) comes atop previous settlements of $244 million (for 200 cases), $73 million (for 5,000 claims), and $2.5 million (a single sexual assault incident), the newspaper reported.

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.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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