Articles Posted in Medical Practice Management

bruinlogo-300x225USC, Ohio State, Michigan State, and now, UCLA: How can big universities, with all the supposedly smart folks who head them, be so blind and deaf to student complaints that school personnel may be sexually abusing them? And why do academics keep getting caught up in situations where they appear to or may be covering up wrongdoing against the young?

Officials at the University of California Los Angeles find themselves apologizing profusely for failing to disclose that they knew of accusations of inappropriate conduct by a gynecologist on the school’s staff while treating patients in university facilities, the Los Angeles Times reported.

Women say that Dr. James Mason Heaps wrongly touched their private parts, and UCLA learned of the accusations in 2017, putting the longtime staff gynecologist on leave in 2018. The school, however, did not disclose why Heaps was gone — until criminal charges were filed against him in recent days and he pleaded not guilty to them in court.

surgery-300x120Recognizing that seniors face different health challenges than younger folks could help doctors and hospitals better safeguard older patients who undergo complex and demanding surgery.

Paying heightened attention to age’s changes also can be beneficial to older adults in protecting themselves from damaging falls and getting retirees to keep moving to stay fitter — without getting hung up on a mistaken exercise measure.

A specialty group within the American College of Surgeons may be on a beneficial course in recommending new geriatric guidelines for older patients, a rising number of whom undergo extensive procedures that once were considered risky for those of an advanced age, the New York Times reported. This is a significant issue in surgical practice, the newspaper reported:

Praise be: Churches nationwide are leaping in with their congregations’ blessing and financial support, putting up small sums to buy up and wipe out one of the huge shames of the American health care system: patients’ medical debt.

The faithful work with RIP Medical Debt, a nonprofit organization based in Rye, N.Y., that provides the know-how to many kinds of donors to help eliminate bills that can crush patients and their loved ones for a lifetime, the Kaiser Health News service reported. Roxie Hammill wrote how this all works in modern medicine:

wheelinghospital-300x111As hospitals boost their size and power to push their profits even higher, they’re also raising alarms with federal regulators over their too cozy relationships with doctors who are pulling down big pay from them now as part of their staffs.

Uncle Sam long has sought to ensure that the billions of tax dollars that get spent in the health care system don’t become medical spoils, riches that get passed around a select few through kick-back and self-referral schemes. These are barred by regulation, notably in Medicare- and Medicaid-funded care, and by the “Stark law.”

Jordan Rau of the Kaiser Health News service reported that a hospital in Wheeling, W. Va., has gotten regulators attention by lavishing pay and perks on specialists in its employ, including $1.2 million a year for a pain specialist and $770,000 annually and 12 weeks’ vacation for a cardiothoracic surgeon. The money is far higher than what such experts command in the area and it’s more surprising because the treatment areas these high-paid doctors work in are big financial losers for Wheeling Hospital.

AmProgressBIRcosts-300x245When patients battle with the desperate extremes of a disease like a fast-spreading cancer, it isn’t just the radiation and chemo therapies that sap their spirits, there’s a  demoralizing runner-up concern: The constant battling with doctors, hospitals, and insurers over medical bills.

Medical billing and insurance-related costs are so over the top that they pile up a half-trillion-dollars a year in burdensome administrative costs — half of which is excessive and wasteful, according to new research from the Center for American Progress, a left-leaning think tank.

The center reviewed past studies of administrative costs in U.S. health care, seeking to address criticisms of their methods and conclusions. Still, the new findings raise points that may stagger patients, policy makers, and politicians, say Emily Gee, a health economist for the group, and Topher Spiro, its vice president for Health Policy and a senior economic fellow.

allenplaque-240x300Truth can be stranger than fiction, and for an investigative journalist covering the outrages of health care costs, ProPublica reporter Marshall Allen had a dream medical story call him on his phone: A well-known New York company reached out and told him he had been “honored” as one of the nation’s Top Doctors.

Not bad for a guy with an English degree from the University of Colorado and zero medical credentials, he reported in a recent, wry article.

He tried to explain to a saleswoman for the company how unqualified he was. But after a chat and after negotiating a “nominal fee” for his accolade — down to $99 from $289 — he bought a plaque and the right to promote himself as a specialist in “investigations” and a Top Doctor.

Hospitals keep getting bigger, but how about better for their patients, too? The data suggest that the prices they charge are rising in part due to industry consolidation, but consumers also need to be extra skeptical of national, direct-to-patient appeals about the advantages of various institutions.

Credit is due to the New York Times for scrutinzing the frenzy of hospital mergers and consolidations that now exert huge sway over patients’ choices, care, and costs:

hjobs-300x174It’s unlikely to surprise anyone who has visited friends or loved ones at a nursing home that such facilities too often are woefully staffed.

But why have federal regulators allowed themselves to be gulled about nursing home personnel levels, and how will not just these care-giving sites but also others, notably hospitals, deal with the growing need for and imbalances in health care staff, including a tilt toward “astonishingly high” numbers of costly administrative staff folks who don’t provide direct patient care?

Jordan Rau, a reporter for Kaiser Health News Service, deserves credit for digging into daily payroll records that Medicare only recently has gathered and published from 14,000 nursing homes nationwide. Rau found that:

roulette-300x188Although Americans may love to wager on ponies, lotteries, and even church bingo games, they’re getting restive and confused about playing the odds with their health — and doctors need to step up their game a lot to help patients better cope with medical uncertainties.

Dhruv Khullar, a physician at NewYork-Presbyterian Hospital and a researcher at the Weill Cornell Department of Healthcare Policy and Research, has written an excellent piece for the New York Times’ evidence-driven “Upshot” column, detailing a modern, thorny part of doctor-patient relationships:

Medicine’s decades-long march toward patient autonomy means patients are often now asked to make the hard decisions — to weigh trade-offs, to grapple with how their values suggest one path over another. This is particularly true when medical science doesn’t offer a clear answer: Doctors encourage patients to decide where evidence is weak, while making strong recommendations when evidence is robust. But should we be doing the opposite? Research suggests that physicians’ recommendations powerfully influence how patients weigh their choices, and that while almost all patients want to know their options, most want their doctor to make the final decision. The greater the uncertainty, the more support they want — but the less likely they are to receive it.

walmartclinic-300x209Americans are showing with their feet and their money how they feel about doctors’ offices and  shiny hospitals, places they’re shunning more and more. They’re racing to neighborhood clinics and urgent care centers that seem to be popping up on every suburban street corner and shopping mall.

Before these facilities transform U.S. health care, would it be worth asking what this trend might mean, not just for profit-seeking retailers, drug store chains, and, yes, also hospitals and doctors who are shifting into new lines of business?

The New York Times found that:

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