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Why patients file medical malpractice lawsuits

Physician

June 7, 2010

Time to turn our attention to an unpleasant topic: Lawsuits.

Who files them?

Why? And what actually happens?

There have been oceans of ink spilled about medical malpractice. An oversimplification of the various positions on malpractice and malpractice reform goes something like this:

(+) Malpractice suits are good. They keep healthcare professionals and hospitals on their toes; if the threat of a big payout improves safety and quality, then lawsuits provide an important regulatory …
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Why patients file medical malpractice lawsuits

MRI abuse can be dangerous and expensive for patients

Chris Rangel, MD

Conditions and Diseases

June 7, 2010

What is “MRI Abuse”? This is when the health care provider orders MRIs (Magnetic Resonance Imaging) in excess or for the wrong reasons. There are many causes of MRI abusive behavior but most evolve out of a significant misunderstanding of how to properly utilize this diagnostic tool. MRI imaging has a high sensitivity to detect anatomic abnormalities, does not expose the patient to high doses of radiation like a CAT …

Whistleblowers endure stress and personal hardship

Charles Bankhead

Health Policy

June 7, 2010

by Charles Bankhead

Whistle-blowers in the healthcare industry endure substantial hardship and often pay a high personal price for cooperating with Justice Department investigations, according to a report based on detailed interviews with more than two dozen informants.

Loss of employment, financial ruin, divorce, and a host of mental and physical health problems were common consequences of individuals’ decisions to report corporate fraud.

Cases can drag on for years before reaching a resolution, …

Tort reform for doctors in exchange for less salary

Jeffrey Parks, MD

Health Policy

June 7, 2010

Matt Steinglass at The Economist has interesting take on tort reform, specifically that limiting physician liability for adverse patient outcomes must come with an equable cost to doctors.

In Europe, the costs accrued due to medical errors are covered by the wide-ranging social safety net; the lottery system of massive medical malmalpractice judgments is virtually absent.

It’s part of the social contract: doctors accept limited salaries in exchange for limited liability; …

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Tort reform for doctors in exchange for less salary

The New York Times changes the Dartmouth Atlas narrative

Kevin

Health Policy

June 7, 2010

Several have asked me to comment on the New York Times versus Dartmouth Atlas spat.

In summary, the Dartmouth Atlas comprises of studies showing variation in care for Medicare recipients. Their main, take home message is that high-spending areas of the country sometimes had poorer outcomes than lower-spending ones.

Their work has been influential with the current administration, and among progressive health reformers. Last week however, the New York Times published a …

How drug information fine print fails to communicate

Steve Woodruff

Medications

June 6, 2010

As someone deeply immersed in pharma communications, and especially the newer realm of social networking, I’ve been closely following the ongoing process of the industry/FDA dance, trying to figure out how social media/web 2.0 approaches “fit” with pharmaceutical manufacturers and their various audiences.

And I keep wondering if we’re going about the whole thing the wrong way.

Think about the fine print PI (Product Information) you see in a magazine, accompanying a …

Should Americans be forced to buy health insurance?

MedPage Today

Health Policy

June 6, 2010

by Joyce Frieden

When it comes to the healthcare reform law, no provision is more controversial than the individual mandate – the part that requires every citizen to purchase health insurance or pay a penalty.

More than 20 state attorneys general are suing the federal government over the health reform law, in large part because of this provision. Several states have already passed laws declaring an individual mandate unenforceable in their state, …

Cocaine and drug addiction from work exposures

Jan Gurley, MD

Medications

June 6, 2010

It’s hard to look at the mug-shot of the 60-year-old woman charged with tampering with forensic drug evidence (basically, stealing police-confiscated cocaine) without wondering how things got to this point. I mean, surely they weed out the felons, and the known addicts, and do a background check, and then make you pee in a cup before they even hire you for a job like this. Right?

So just exactly how can …

Smartphones will be the hub of digital medical care

Jaan Sidorov, MD

Health Technology

June 5, 2010

As a former New Yorker, the Disease Management Care Blog has always had an abiding respect for the Big Apple’s taxi drivers.

That increased considerably after it left its wallet in a Manhattan cab and it turned up in Virginia a year later — in the possession of an individual allegedly involved in organized crime. This and other evidence of the cabbies’ shrewd business acumen makes the DMCB wonder why Hizzoner …

Choosing between Lasik and Lasek eye surgery

Kevin

Physician

June 5, 2010

by Tim Harwood

Hundreds of thousands of people each year are taking the plunge and choosing to have the life changing procedure that is laser eye surgery.

It is currently the most popular elective surgery in the world and the number of people having it done is likely to increase as the procedure becomes safer and more accurate. If you yourself are considering having laser eye surgery, then you will almost …

Will healthcare reform survive the Supreme Court?

MedPage Today

Health Policy

June 5, 2010

by Joyce Frieden

Partisan wrangling aside, the Supreme Court will have to address serious constitutional questions about the healthcare reform law, and it’s far from clear how the justices will decide the issues, legal scholars say.

So far, 21 state attorneys general are suing to overturn the law on constitutional grounds. One of their arguments is that by forcing individuals to either buy health insurance or pay a fine, the law violates …

Adoption lessons after Artyom Savelyev

Claudia M. Gold, MD

Patient

June 5, 2010

The trauma for Artyom continues. After having been given up to an orphanage by his alcoholic mother who lost her parental rights, being adopted by a US family, sent back to Russia alone when his adoptive mother allegedly was unable to cope with his psychological problems, he has now become the object of a tug-of war between Russia and the US over his citizenship. His future seems to hold unimaginable …

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Adoption lessons after Artyom Savelyev

How health reform will help breastfeeding mothers

Kenneth Lin, MD

Conditions and Diseases

June 4, 2010

Pharmaceutical companies and their shareholders are always looking for the next “blockbuster” drug, the label given to a drug that generates more than $1 billion of revenue per year.

Blockbuster drugs don’t necessarily have to save many (or any) lives – slick marketing more than compensates for marginal improvements in treatment efficacy — but they do need to target conditions that are common enough that millions of patients will buy them. …

Machine and technology fixation is why health costs are high

Richard Reece, MD

Health Policy

June 4, 2010

Obsession with medical technologies and machines characterizes American’s cultural expectations. We tend to think of our bodies as perpetual motion machines, to be preserved in perpetuity.

If the face of our machines sag, we lift it up. If our pipes clog, we roto-rooter or stent them. If impurities gum up our machinery, we filter them out. If our joints give out or lock up, we replace them. If we want to …

Doctors can report bad drug ads to the FDA

MedPage Today

Medications

June 4, 2010

by John Gever

A new FDA program seeks to enlist healthcare professionals in flagging improper sales tactics for prescription drugs.

Although the agency calls the program “Bad Ad,” its interest goes beyond broadcast and print advertisements to include misleading in-person presentations.

Housed within the Division of Drug Marketing, Advertising, and Communication (DDMAC), the program is intended to increase the number of eyes and ears available to monitor pharmaceutical companies’ promotional activities — especially …

Can children really have bipolar disorder?

James Baker, MD

Conditions and Diseases

June 4, 2010

by James Baker, MD

Using the diagnosis “bipolar disorder” for children with problems in mood has been controversial ever since a surge in its use in the mid-1990’s.

A recent article in the Los Angeles Times gives the pros and cons on the use of “bipolar disorder” in children through the opinions of two psychiatrists on opposite sides of the controversy.

The problem with using “bipolar” is that it requires a too-loose interpretation …

Shingles vaccine and the price of preventive care

Shantanu Nundy, MD

Conditions and Diseases

June 3, 2010

They say an ounce of prevention is worth a pound of cure, but is that still true in today’s money? Recently I had an illuminating conversation with a patient that got me thinking about how I may try to answer this question. This is the first in a short series on the price of preventive health care.

Mr. GR, as I will call him, had recently turned 60 years young. Though he …

Listening to nurses is key to being a good doctor

Doctor Grumpy, MD

Patient

June 3, 2010

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I’m a doctor. We get all the glory. And credit. And guess what? We only deserve part of it.

I started out in medicine in the mid-80’s, volunteering at an ER. And the biggest shock to me was learning how much of what happens in a hospital is nurse territory. Doctors will see you anywhere from 5 to 30 minutes a day, …

MKSAP: A 50-year-old woman is evaluated for a rash on the back of her elbows and knees

mksap

Conditions and Diseases

June 3, 2010

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 50-year-old woman is evaluated for a rash on the back of her elbows and knees. A similar rash has occurred in the past, with her first episode as a young adult. She has used over-the-counter hydrocortisone cream without relief. She does not smoke or drink and is otherwise healthy.

BMI should be routinely measured in pediatric patients

Emily P. Walker

Physician

June 3, 2010

by Emily P. Walker

Physicians should record body mass index (BMI) of their pediatric patients during routine offices visits, according to a sweeping new plan laid out by a White House task force on ways to shrink childhood obesity rates over the next 20 years.

The inter-agency President’s Task Force on Childhood Obesity was formed three months ago as part of the Let’s Move! initiative and was given 90 days to draft …

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