Articles Posted in Medical Practice Management

capnurse-300x169What’s in a name? The Covid-19 pandemic should force a major change in the big misnomer of long-term care institutions: Let’s stop labeling them with the term nursing — as if they provide significant medical services to the elderly, sick, and injured.

Instead, the coronavirus may lead the public to bust the myth put forward by owners and operators of nursing homes, skilled nursing facilities, assisted living centers, and other similar centers about how they treat some of the nation’s most vulnerable people, especially based on growing evidence amassing in news reports.

The care facilities knew they were not hospitals, with extensive equipment and highly trained doctors and nurses. The facilities found they often were sorely lacking gear — especially personal protective equipment. They too many times did not have the staff with the skills or training to treat already fragile residents infected with the novel coronavirus or recuperating from significant bouts with a debilitating illness. They did not have the Covid-19 tests they needed. They struggled to isolate the infected.

kffpostponedcarepoll-300x178Doctors, clinics, urgent care facilities, and hospitals are laboring to get out an important message tied to the Covid-19 pandemic: Patients should not delay seeking their needed medical services, especially urgent or emergency treatment, due to fears of getting infected with the novel coronavirus.

It made sense to postpone many types of medical services as states sought to reduce the virus’ wildfire spread and to prevent the U.S. medical system from potentially getting overwhelmed with Covid-19 cases, experts say.

But public health restrictions are easing, and medical practices and facilities have set up ways to minimize the possibility of coronavirus infection, such that patients may want to reconsider their highest anxiety.

cmsnursinghomecases-300x146Federal regulators have issued, at long last, the data they have collected on the novel coronavirus’ effect on nursing homes, giving an incomplete but still  devastating look at how in just a few months some of the nation’s most vulnerable people have been savaged by Covid-19.

With 12% of the nation’s nursing 15,000 homes yet to report, the Centers for Medicare and Medicaid Services (CMS) has tallied “25,923 resident deaths tied to Covid-19 … and 449 deaths among the facilities’ staff. The [U.S.] survey also found about 95,000 infection cases at nursing homes across 49 states, about a third of them among staff members,” the Wall Street Journal reported.

The newspaper finds that figure far too low, noting:

cashhandle-300x200Cui bono? That query in Latin — Who benefits? — affirms for linguists that sketchy practices date to Ancient Rome and earlier. But who knew the phrase would be so applicable for U.S. taxpayers considering dubious aspects of many of the nation’s pricey Covid-19 pandemic responses.  Herewith a sizable list of conflicts and coziness in the public  funding of pandemic responses.

VP’s chief of staff dealing with health care issues but without giving up stocks

covidmarcshort-150x150While Vice President Pence has headed the White House pandemic task force Marc Short, his chief of staff has served at his side. This has given him full access to the highest-level discussions about strategies and approaches that not only will affect Americans’ health care but also the fortunes of numerous Big Pharma, medical supply, and other major enterprises in the field dealing with the novel coronavirus.

covidhospitalbed-199x300When it comes to aggravating parties in the U.S. health care system, a certain French phrase captures an uncomfortable reality: “Plus ça change” — as in plus ça change, plus c’est la même chose or “The more it changes, the more it stays the same.”

We can see that here:

howardnewhospital-300x169Even as the Covid-19 pandemic shows the terrible toll inflicted on African Americans in the District of Columbia by health care disparities, city officials have announced they are advancing with a pricey plan to plug a giant hole in area medical services by helping to fund not one but two new hospitals that will serve impoverished communities of color.

The facilities will be in Wards 1 and 8 and will replace the Howard University Hospital and the United Medical Center (UMC) in Southeast D.C., Mayor Muriel Bowser has proposed.

The City Council in the days ahead will consider her latest $700 million or so plan to try to improve medical services for some of the poorest residents in the city by working with Howard, its medical school — one of the main training institutions for black doctors — George Washington University Hospital and two big health systems, Adventist and Universal Health Systems.

sagepoint-300x176With nursing home operators bleating up a storm of weak defenses and denials, soaring Covid-19 infections and deaths have laid siege to far too many long-term care facilities in Maryland, Virginia, and the District of Columbia. The consequences have been dire.

In Maryland, the Baltimore Sun reported:

“Nearly three-fifths of Marylanders killed by the coronavirus are residents of long-term care facilities, according to [a recent state] update of nursing home data …The Maryland Department of Health reported that 793 of the state’s 1,338 victims, almost 60%, were residents of nursing homes, rehabilitation facilities and similar long-term care facilities. An additional 11 deaths were staff members of those facilities, with more than one of every five of Maryland’s confirmed infections being a resident or staff member of congregate living facilities.”

magazines-199x300For those who may have more time on their hands due to the pandemic and who may be seeking deeper digs into Covid-19, excellent long-form coverage is abounding.

Consider, for example, taking time for the New Yorker article by  Siddhartha Mukherjee, a cancer doctor, biologist, and best-selling nonfiction author who delves into the question of “What the coronavirus crisis reveals about American medicine.”

His premise includes in its painful illumination a quote from Warren Buffet, the Oracle of Omaha, whose quip assumes a different poignancy when applied to the post-pandemic state of medicine:  “When the tide goes out, you discover who has been swimming naked.”

silence-300x192Historian Doris Kearns Goodwin highlighted a crucial strength of the 16th U.S. president as he led the nation through one of its most divisive times: Abraham Lincoln encouraged dissent and welcomed opposing points of view, going so far as to appoint three better-known political rivals to top positions in his administration.

That extraordinary lesson in crisis leadership seems to be getting lost in the nation’s battle with the novel coronavirus.

Too many doctors, nurses, and experts in science and medicine have been censored, disciplined, and dismissed for speaking truth to power, warning, for example, about unacceptable conditions for health workers treating Covid-19 infections, news organizations have reported.

drscope-300x200The public health restrictions put on much of the nation to battle the Covid-19 pandemic also have created complications for patients’ receiving other kinds of health care — a reality that the nation will need to deal with in the weeks ahead.

Doctors and hospitals will need to see whether their coronavirus case loads are such that they can begin to reconsider providing what were deemed nonessential medical services, including often performed procedures like shoulder, knee, and hip surgeries.

Most hospitals, responding to federal and state requests, put off elective procedures, notably because they did not want to put patients and heightened risk and because medical facilities nationwide have experienced desperate shortages of personal protective equipment and drugs. Some institutions have pressed ahead with operations they have deemed needed, despite questions from critics.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
Washingtonian Top Lawyer 2011
Avvo Rating 10.0 Superb Top Attorney Best Lawyers Firm
Contact Information