Hospitals

November 15, 2019

13 million and one reasons why simultaneous operations should be barred

A big Boston hospital has offered 13 million and one ways to try to make good with a former orthopedic surgeon who assailed the respected institution and colleagues for performing simultaneous operations in which doctors went from suite to suite, working for hours on multiple patients at once.

Massachusetts General Hospital insisted this practice was safe. Dr. Dennis Burke, a hip and knee specialist whose patients have included former Secretary of State John Kerry, disagreed. He told his bosses at the Harvard-affiliated hospital that simultaneous procedures put patients at risk, and, at minimum, they should be told that the surgeons they flocked to for surgery on them might pop in and out of their procedures.

Burke infuriated his bosses by taking his criticisms outside the hospital, including to investigative reporters for the Boston Globe. The newspaper dug into hospital surgeries, particularly in orthopedic cases where operations lasted for hours.

November 10, 2019

Hospital tries to stick ER nurse with $1 million in debt for her preemie’s care

by Patrick A. Malone

It’s the price and cost problem, stupid. That’s a fictitious but new tattoo that voters might want politicians to take up as they consider the many major problems with the American health care system, especially as yet more medical billing outrages surface.

Marshall Allen, a reporter for ProPublica, the Pulitzer Prize-winning investigative site, posted about a doozy: It’s about almost $1 million in charges that a hospital group sought to saddle a new mom with, even as she wrestled with pregnancy complications and an ailing premature baby.

That mom also happened to be an emergency room nurse. And the chain that flubbed her medical bill was her own employer: Dignity hospitals. That’s a Christian medical enterprise that describes itself as the fifth largest health system in the nation and has as its motto, “Hello, human kindness.” As Allen reported, it’s worth noting this, too, about Dignity:

November 7, 2019

‘Any One of Us’ shows harsh realities and hope for spinal cord injury patients

by Patrick A. Malone

Extreme sports may be to blame. Or it might be a falling tree, an error with a surgery, or an auto wreck.

As the title of the tough, direct, and new HBO documentary makes clear, “Any One of Us” might suffer from a calamitous spinal cord injury (SCI). The 1-hour and 25-minute work by first-time director Fernando Villena focuses on pro mountain biker Paul Basagoitia but is carried by a “chorus” of 17 women and men who all have had significant injuries to their spinal cords.

November 3, 2019

Raging wildfires and major power shutoffs: Big tests in Calif. raise questions for the rest of us

by Patrick A. Malone

California’s raging wildfires may seem a far coast away, and this seasonal calamity attracts little attention among policy makers in official Washington. But the fires are sending sharp warnings that the rest of the nation might well heed.

The disasters have uprooted hundreds of thousands, destroyed dozens of homes and other buildings, and led to shutoffs of a basic service — electricity — to huge swaths of the nation’s most populous state. They also raise serious issues to anyone who is concerned about the:

fragility of the health care system, particularly the vulnerability of hospitals that the public will desperately need but may not be open in crises, despite the notable resilience that care givers and institutions now display;

October 30, 2019

For patients, a glimpse into data on the quality and safety of surgery centers

by Patrick A. Malone

They may be more appealing and convenient because they’re located in the neighborhood with better hours and more parking. They also may be less costly because they lack the high overheard of big hospitals. But those booming same-day surgery centers have patient safety issues of their own.

Their doctors and nurses may not be as well-trained as patients might find at big hospitals or academic medical centers, with 1 in 3 centers not having staff who were all board-certified, according to the Leapfrog Group, a consortium of big companies and other major health care users focused on patient concerns.

Leapfrog has issued — to its considerable credit — its first safety and quality study of the facilities, also finding that, “not all ambulatory surgery centers and hospital outpatient departments provide surgery consent materials before the day of surgery. Just 14% of ambulatory surgery centers provided the information one to three days before the surgery, while just 20.7% of hospital outpatient departments do so,” Modern Healthcare, an industry news source, reported.

October 25, 2019

Lawmakers order schools to give teens more time for California dreaming

by Patrick A. Malone

If millions of young folks in the nation’s largest state seem even sunnier than before, that may be because they are getting a wee bit more needed shut eye: California has become the first state in the nation to order public schools to roll back their start times, so middle school classes generally won’t start before 8 in the morning and high school teaching doesn’t start until after 8:30 a.m.

The rule — pushed by experts and resisted by parents juggling already hectic and conflicting family schedules — will be phased in over three years. It also will be accompanied by yet more research on how teens doze and how sleep can best benefit their rapidly growing minds and bodies.

California’s later start to teens’ schools got a boost from groups like the American Academy of Pediatrics, the California Medical Assn., and the California State Parent Teacher Assn. They cited a growing body of research, including by organizations like the RAND Corporation, tying more sleep from later start times to adolescents’ better school performance and health.

October 24, 2019

Seniors are getting urine over-tested and joints over-injected

by Patrick A. Malone

It’s the 21^st century, and excellent information is more available than ever due to communication and technology advances. But doctors and hospitals keep harming patients by testing and treating them in ways that are unsupported by rigorous medical evidence, and by carrying out safety recommendations in extreme ways.

Just consider:

Hospitals have become so obsessive about protecting seniors from falls while under their care that they’re all but lashing them to their beds, damaging their already shaky fitness, according to Melissa Bailer, a Kaiser Health News reporter whose work appeared in the Washington Post. She quotes experts as warning of an “epidemic of immobility” for older patients.

October 22, 2019

Caveat emptor: It’s not only an open season ‘for’ but also ‘on’ health coverage

by Patrick A. Malone

Americans in coming weeks will make important decisions on the national and personal level about how best to safeguard themselves and their loved ones with a crucial component of the U.S. health care system: their insurance coverage.

Though the exact timing of the open enrollment season varies by geography and plan, it’s that key time for millions who get their coverage via Medicare and may wish to make changes. These are important weeks, too, for many who obtain health insurance under the Affordable Care Act, aka Obamacare. Many workers are hearing a lot from their human resources folks about their employer-provided plans.

It’s clear from the political polling and the sometimes-dreary Democratic presidential debates that there’s huge interest and lots of devil in the details about Americans’ health insurance options.

October 18, 2019

Flu shot urgency rises with warnings from Down Under and vaping illnesses

by Patrick A. Malone

It’s an imperfect predictor, health officials concede. Still, a nasty season of infections Down Under has increased the urgency of their recommendations to the U.S. public to get the annual flu shot before Halloween and certainly before everyone sits down for Thanksgiving dinner.

Although concern already had been growing about bad months ahead in the United States for flu, an early and “fairly severe” season in Australia has increased officials’ worries, the New York Times reported.

That’s because the Aussies, while not a 100% reliable bellwether, showed the more populous States about flu severity as recently as last season, according to Donald G. McNeil Jr., who has reported on disease outbreaks in more than 60 countries for the New York Times. He wrote this:

October 15, 2019

In U.S. health care, experts assail $1 trillion-plus in waste, fraud and abuse

by Patrick A. Malone

Politicians almost by reflex decry the skyrocketing cost of U.S. health care by blaming much of it on waste, fraud, abuse. They, alas, really may be on to something, newly published research shows.

Health care experts, including a medical leader of health insurer Humana, “combed through 54 studies and reports published since 2012 that estimated the waste or savings from changes in practice and policy,” leading them to some jaw-dropping calculations about how well spent is the $3.5 trillion or so that Americans drop on health care, the New York Times reported.

Answer: Really badly. The researchers, in their published work, estimated that 20%-25% of American health care spending is wasteful. That turns into giant sums, fast, as the newspaper reported, including: