Articles Posted in Primary Care

oighhslogo-150x150Buh-bye? Arrivederci? Sayonara? Can it be that the coronavirus pandemic puts an end to one of the disgraceful ways that Big Pharma and medical device makers push their wares on all-too malleable doctors — with big-money speaker programs?

The inspector general’s office of the giant federal Health and Human Services (HHS) agency has warned drug- and medical device-makers that these pandemic-paused marketing shams should not resume. The $2 billion that industry players have forked out for the in-person gab fests in the last three years looks sketchy at best to federal watchdogs and prosecutors, the HHS inspector general warned in a rarely issued “special fraud alert.” It reported this:

“The Office of Inspector General (OIG) and Department of Justice (DOJ) have investigated and resolved numerous fraud cases involving allegations that remuneration offered and paid in connection with speaker programs violated the anti-kickback statute. The Federal government has pursued civil and criminal cases against companies and individual [health care providers] involving speaker programs … Our enforcement experience demonstrates that some companies expend significant resources on speaker programs and that some [health care providers] receive substantial remuneration from companies. This Special Fraud Alert highlights some of the inherent fraud and abuse risks associated with the offer, payment, solicitation, or receipt of remuneration related to company-sponsored speaker programs.”

bruinlogo-150x150The University of California has offered to pay $73 million to settle with 5,000 women their class-action lawsuit asserting a staff gynecologist sexually abused them during medical procedures. This is yet another big case involving claims of years of widespread and sordid professional misconduct that somehow went undetected at a major institution, which has acknowledged it reacted poorly when confronted with a problematic clinician.

The proposed settlement still requires the sign-off of a federal judge, and it may not go through if more plaintiffs decide against joining this deal, as lawyers in Los Angeles have said they will not.

James Heaps, 67, a one-time gynecologist who is at the center of the scandal at UCLA, also still faces criminal charges for his actions during his 1983-2019 career at the university, in its student health center and at its medical center. The Los Angeles Times reported that the doctor was first arrested  in June 2019 for sexually touching two patients in 2017. But then:

With the pandemic  tearing through the United States and overwhelming U.S. health care system,  we pause from the grim news to tally  some of the nation’s blessings in this time.

We can be thankful for the courage, fortitude, dedication, and skill of an army of health workers of all kinds. They have put themselves and their loved ones at formidable risk and strain to treat patients under unprecedented duress. They have dealt with fear and uncertainty, giving little quarter, and approaching their own breaking points. Some health workers have themselves fallen ill, with some dying. Their sacrifices cannot be forgotten, and we need to give sustained and extra support to health workers as the pandemic enters its next perilous phase.

srabuse-150x150The coronavirus pandemic’s terrible toll on nursing homes and other long-term care facilities may be much worse than now estimated, as resident advocates, watchdog groups, and experts  tally “excess deaths” in the facilities — perhaps one additional casualty beyond any two formally attributed to Covid-19.

These fatalities are unacceptable, resulting from frantic and low-paid health workers’ inability to care for the aged, injured, and chronically ill infected with the coronavirus while also dealing with the needs of people so frail they require institutionalization. It’s tough reading, but here is what the Associated Press reported:

“As more than 90,000 of the nation’s long-term care residents have died in a pandemic that has pushed staffs to the limit, advocates for the elderly say a tandem wave of death separate from the virus has quietly claimed tens of thousands more, often because overburdened workers haven’t been able to give them the care they need. Nursing home watchdogs are being flooded with reports of residents kept in soiled diapers so long their skin peeled off, left with bedsores that cut to the bone, and allowed to wither away in starvation or thirst.

docofficegoogle-300x188A federal criminal case concluded with felony convictions for a Virginia gynecologist. But the questions are only now beginning as to how a doctor could have caused so many women so much harm for so long without other clinicians, hospitals, administrators, insurers, and regulators stepping in to stop him.

As the Washington Post reported, jurors took 2½ days to convict Dr. Javaid Perwaiz on 52 counts in what prosecutors alleged was his years of defrauding insurance companies by performing life-altering hysterectomies and other unneeded surgeries on women patients. He is scheduled to be sentenced in March, facing a maximum sentence of 465 years imprisonment.

His conduct, condemned and proven by prosecutors in a trial that ran for weeks, included “performing diagnostic procedures with broken equipment and scaring patients into surgery by falsely claiming they had cancer,” the newspaper reported, adding:

apnursinghomesurgechart-270x300Coronavirus cases are spiking among residents and staff at nursing homes and other long-term care facilities. They increased four-fold between May’s end and late October — even as deaths among the vulnerable also doubled, disturbing new data show.

Those are the findings of Rebecca Gorges and Tamara Konetzka, University of Chicago researchers who analyzed federal data at the request of the Associated Press. They focused on 20 states hard hit by the latest pandemic surge.

Konetzka said the data raise major questions about the Trump Administration’s efforts to safeguard the aged, ailing, and injured in institutional care by sheltering them from infections in their surround areas and increasing testing for residents and health workers. But Koentzka, an expert on long-term care, told the AP this about such a plan:

coronacasednov13cnbc-300x135Although company-reported data on the potency of a prospective coronavirus vaccine provided rare glimmers of hope, the rampaging coronavirus pandemic triggered clangorous coast-to-coast health alarms: Infections are skyrocketing. So, too, are hospitalizations. And, yes, deaths are spiking, as well. Records are falling each day.

Covid-19 is raging unchecked among the American people, with a season of travel and festivities with friends and families bearing down on the country.

Will travelers heading across the country or around the block to Thanksgiving feasts or December religious celebrations also ensure that public health forecasters’ glum models turn into lethal reality?  Will the 1,000 daily deaths occurring now double to 2,000 by mid-January and will the U.S. coronavirus death toll hit 440,000 by March?

calvtexascspancapture-300x151Although it’s risky to read too much into justices’ comments about cases argued before the U.S. Supreme Court, legal analysts found strong suggestions in such remarks to assert that the latest GOP challenge to the Affordable Care Act may have exceeded the legal validity of its extreme contentions.

This could mean that Republicans — state attorneys general as well as the Trump Administration — may find failure in California v. Texas. This is political partisans’ legal push to get the high court to strike down Obamacare, focusing on the individual mandate that imposed financial penalties to ensure that Americans obtain health insurance.

The mandate originally was portrayed by supporters as integral to Obamacare, ensuring its insurance markets did not get swamped with only the poorest and sickest Americans and dooming federal efforts to provide affordable health coverage to poorer and middle-class Americans. The high court, in an earlier and important case, upheld the ACA, arguing its use of the mandate was a legitimate exercise of government taxing powers.

docnotes-300x154Millions of Americans may be finding that their doctors routinely refer to them with terms like SOB and BS. But patients will be better off with this knowledge, once they learn how to translate medical abbreviations.

The Associated Press reported that hospitals and health care systems nationwide quietly are complying with deadlines, and, under a 2016 federal law, are opening up convenient, fast access to patients to not only view and access their electronic health records but also physicians’ notes about their care. As the AP wrote:

“If you already use a patient portal such as MyChart to email your doctor or schedule an appointment, you may soon see new options allowing you to view your doctor’s notes and see your test results as soon as they are available. You may get an email explaining where to look, how to share access with a caregiver and how to keep other eyes off your information. Many people won’t notice a change. About 15% of health care systems already are letting patients read doctor notes online without charge. That means about 53 million patients already have access to their doctor’s notes.”

elderaide-300x200Nursing homes put their residents at heightened health risks by scrimping on personnel costs and failing to deal with significant staffing shortfalls, especially as the coronavirus inflicted some of its highest death and infection tolls on the elderly, sick, and injured in long-term care, media investigations have found.

The profit-focus by health providers is not unique, and it has put huge burdens on poorly paid, lightly trained, and over worked home health aides. They have toiled to keep the vulnerable out of institutional care, even as the agencies that employ them give them little support.

Here is what the Wall Street Journal reported about long-term care facilities, based on its “analysis of payroll-based daily staffing data released … by the Medicare agency …  [for hundreds of] nursing homes that reported to the federal government virus-related deaths in the first half of 2020″:

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