Articles Posted in Patient Privacy

mom-300x171Big Medicine can paper over its troubles with basic fairness by slapping fancy terms on them: take “health and gender disparities,” for instance. But doctors, hospitals, and the rest of us can’t make medical care more equitable, accessible, safe, and affordable without looking at inequities, square on.

That’s why the New York Times, Washington Post, and Associated Press deserve credit for recent deep digs into the struggles of women, poor women, and especially black women with modern medicine:

Dumpster-300x251Although enthusiasts still wax on about  how technology will improve lives, patients may want to be wary about purported advances that may end up complicating and even compromising crucial parts of their medical care — including how their medical records are kept and how payers decide if they’re covered.

Let’s start with some kudos for dumpster-diving doctors in Canada who discovered flaws in hospitals’ disposal of supposedly confidential and legally protected patient health records. They went around unidentified facilities collecting from various bins a half ton of paper that doctors, nurses, and hospitals were ready to toss.

After examining the piles of paper, they found most private records had been properly handled. But thousands of documents also were not: They were improperly disposed of, and contained identifying or confidential patient treatment information, the researchers found. Though Canada’s patient privacy laws differ from those in the United States, they agree that patient health records must be guarded, and the researchers found violations of practice, policy, and potentially privacy laws.

probe-300x195With more than 10,000 boomers retiring each day and more seniors ending up at some point in their lives in nursing homes, regulators need to step up their oversight of elder care facilities. But there’s disturbing information they’re failing at this crucial task, allowing terrible abuses of older Americans who also may be evicted unfairly from facilities and who may be insufficiently protected when natural calamities occur.

The Minneapolis Star-Tribune deserves credit for its multipart investigation of abuses in nursing homes. As the news organization has reported of its findings:

Every year, hundreds of residents at senior care centers around the state are assaulted, raped or robbed in crimes that leave lasting trauma and pain for the victims and their families. Yet the vast majority of these crimes are never resolved, and the perpetrators never punished, because state regulators lack the staff and expertise to investigate them. And thousands of complaints are simply ignored. … Last year alone, the Minnesota Department of Health received 25,226 allegations of neglect, physical abuse, unexplained serious injuries, and thefts in state-licensed homes for the elderly. Ninety-seven percent were never investigated. That includes 2,025 allegations of physical or emotional abuse by staff, 4,100 reports of altercations between residents and 300 reported drug thefts. When the Health Department did investigate, records show that it often neglected key steps in a criminal probe. In dozens of those cases, for instance, no one interviewed the victims, and no one called the police. Health Department documents contain dire tales of residents being choked, punched, smothered with pillows, fondled and forcibly restrained.

clown-246x300Social media have become a “circus” for some plastic and cosmetic surgeons to clown around in unprofessional ways, including: videos in which one doctor has cradled fat removed from a tummy-tuck like an infant and put a baby face on it using a Snapchat filter. Other costumed surgeons have posted visual displays of themselves dancing before surgery and showing off on camera procedures or with tissues they have removed.

The abuses have become so bad that faculty and students from Northwestern University’s medical school, after researching incidents online, have published a prospective social media code of ethics for plastic surgeons, calling for its adoption by specialists at their next major meeting.

Robert Dorfman, one of the Northwestern students and an author of the draft ethics proposal,  has described plastic surgery’s social media landscape “like the Wild West out there, with no guidelines or rules.” Clark Schierle, senior author of the guidelines, a plastic surgeon, and a medical school faculty member, has observed that practitioners in the field are “uniquely drawn to social media because we tend to do more marketing and we are a visual specialty.”

tats-300x192Could pediatricians accomplish what many parents cannot? Can they talk to rebellious youths about the body adornments that are  all the rage now, and get kids to consider the health risks and long-term issues surrounding trendy tattoos, piercings, and body scarring?

In case you’ve fallen like Rip Van Winkle into a long doze or you’re senior enough to even understand the Washington Irving reference, tats and body jewelry worn in created openings and roughing up the skin to make interesting patterns all have become so common among the young that those who go without such au trendy beauty measures may now even be the outliers among their peers.

There isn’t good data on body scarring but the public opinion experts at the Pew Research Center found in 2010 that 38 percent of 18- to 29-year-olds had at least one tattoo, and 23 percent had “piercings in locations other than an earlobe.”

Medicine and law enforcement can be a combustible combination, as a widely publicized incident in a Utah emergency room has reminded. The ugly incident has underscored the importance of hospitals keeping big, upset guys with guns cordoned off from caregivers, as well as the importance of front-line medical personnel knowing, respecting, and protecting patients’ privacy rights about their medical treatment.

Nurse Alex Wubbels became a heroine for firmly and politely telling Salt Lake detectives that the law forbade them from ordering blood extraction and testing on patient William Gray. The unconscious truck driver turned out to be a reserve cop in a nearby small town, and he had been involved in a crash connected to a high-speed chase by Salt Lake officers.

nursinghome-300x200With more Americans than previously thought needing care in the nation’s nursing homes, will more of us start to pay greater attention to the unacceptable and under-reported elder abuse occurring there? And with calamities like Hurricane Harvey fresh in mind, will more sons and daughters, nephews and nieces, and other friends and loved ones take a bit of time now to think how safe their elder relatives’ care facilities might be and where they might go in catastrophic circumstance?

Although most previous research has indicated that just 35 percent of Americans will use a nursing home in later life, new study by the independent, nonpartisan RAND Corporation indicates that figure may be far too low. More than half (56 percent) of those now aged 57 to 61 will spend at least a night and likely much more time in nursing home care, RAND researchers found.

If seniors need the care, they stay on average 272 nights in nursing homes, though 10 percent of the population the researchers studied spent more than 1,000 nights in such facilities.

syphillis-150x150The myriad problems tied to the nation’s opioid drug abuse epidemic seem only to worsen and grow more complex by the day. They are, recent news reports say:

umcDoctors and hospitals across the country push the frontiers of medical science every day, finding new ways to improve health care and to change and save lives. But at the same time, some of medicine’s basics—like delivering babies safely and protecting mothers’ well being—also keep getting botched, especially for poor and black women. It’s a national disgrace, and it’s on sad, terrible display in the growing scandal in Southeast Washington’s only full-service hospital, which recently was ordered to stop delivering babies.

Why? The Washington Post, which has done some good digging and needs to do more, says that health regulators for the District of Columbia have provided sketchy details to officials of United Medical Center, which serves the poor and predominantly African American residents of the neighborhoods east of the Anacostia River, as to why the public hospital’s obstetrics unit was shut down for 90 days.

The paper says United’s staff failed to properly care for a newborn to ensure the infant didn’t acquire HIV from the baby’s mother, who was infected and had a high viral load. The hospital didn’t test the baby properly for HIV, failed to deliver the child via cesarean to reduce the chances of HIV infection, and didn’t administer a recommended antiretroviral drug as a postpartum precaution.

viagra-300x169This fall’s National Football League games will be markedly different in an unexpected way that also offers insight into the nation’s skyrocketing costs of medical care.

The makers of the erectile dysfunction drugs Viagra and Cialis are yanking $50 million in advertising from TV broadcasts of NFL games, their top contact point with male consumers.  Indeed,  the makers of both drugs are going dark with their costly ads across a variety of sports programs, including summer pro golf and tennis.

After billions of dollars in revenues reaped every year for their manufacturers, Viagra and Cialis both are Big Pharma hot shots no longer. They may have erased any remaining decorum on TV over the years with their advertising and marketing hype. But they cannot outrun a typical drug’s economic life cycle. Their patents are expiring, and their makers are trying to figure how best to exploit their profitable, branded drugs when generics—already regulator approved and ready to go—saturate markets and drive prices down, perhaps as early as next year.

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