The plan for the Geek Squad hospital outpost is to consult on hospital's renovations, which include fun consumer electronics for patients' use. But they're also there to...get your hankies ready...provide free tech support to patients' families.

Best Buy is donating a Geek Squad to Children's Hospital in Minneapolis, where its tech support experts will help patients and parents with everything from computer bugs to Web pages to uncharged cell phones.

The tech support will help patients stay connected to friends, schools and the outside world, said Dr. Alan Goldbloom, president and chief executive of Children's Hospitals and Clinics of Minnesota. It will also help parents telecommute to their jobs while spending time with their hospitalized children.

"When kids are in with serious illnesses, we want to make it as easy as possible for the family to be here 24/7 for them," Goldbloom said.

Well done, Best Buy. We wish this project well. No, really. They'll probably even plug in video game systems for free.

Geek Squad setting up shop in Children's Hospital? [City Pages] (Thanks, stir0021!)
Children's Hospital gets its own Geek Squad for patients and parents [Trading Markets]

(Photo: The Joy Of The Mundane)

Some organizations are struggling to find revenue as wealthy donors as well as corporate sponsors reduce contributions, said Andrew Hastings, vice president of external affairs at the National Philanthropic Trust in Jenkintown, Pennsylvania, which helps donors establish charitable funds.

The number of gifts of $1 million or more from individual donors fell 50 percent to 133 in the second quarter of 2009 compared with a year earlier, based on a study by the Center on Philanthropy at Indiana University in Indianapolis. Overall, private gifts to U.S. organizations involved in arts, culture and the humanities declined 6.4 percent to $12.8 billion in 2008, according to a report by the Giving USA Foundation, the research unit of the Giving Institute in Glenview, Illinois.

If your actual net worth were no limit, what kind of building or fund would you establish?

Getting Name on Building Becomes Cheaper for Donors [Bloomberg]

(Photo: mattbuck4950)

Note what factors don't seem to have an effect on whether MRSA turned up in random spot checks at homes:

When they tried to figure out what might make it more likely to have the bacteria at home, they ruled out many supposed risk factors, including working out at a gym, having children who attended day care, having a recent infection or recent antibiotic use, and even working in a health care facility.

The one variable that overwhelmingly predicted the presence of the germ was the presence of a cat. Cat owners were eight times more likely than others to have MRSA at home.

To be fair to cats, it looks like humans pass the MRSA over, sort of like growing it on a pet-shaped garden. For example, check out how this man's dalmation became a four-legged MRSA dispenser through no fault of his own.

Dr. Oehler recounted the case of a diabetic man with recurrent MRSA skin infections that were eventually traced to his dog, a Dalmatian who carried the bacteria but was not ill.

"He would sleep with the couple in the bed and lick them in the face," said Dr. Farrin A. Manian, chief of infectious diseases at St. John's Mercy Medical Center in St. Louis.

Dr. Manian believes the dog was infected by its owner, but then served as a reservoir for the bacteria, reinfecting his patient.

Run away! Wrap everything in Saran Wrap!

All scaremongering aside, the risk of catching MRSA from your pet is incredibly low, so don't go euthanizing anything just yet. Instead, just start washing your hands.

J. Scott Weese, a veterinary internist and microbiologist at the University of Guelph in Ontario, believes MRSA infections transmitted between people and animals are relatively rare.

His tests of randomly selected dogs, for example, have shown that at any given time only 2 to 3 percent carry MRSA on their fur or skin or in their saliva. And even if a pet becomes colonized, meaning that the bacteria take up residence and reproduce, veterinarians say most healthy animals should be rid of it in a matter of weeks.

For protection, Dr. Oehler recommends hand washing or using hand gels before and after playing with a pet, not letting a pet lick people around the face, and not washing pet food or water bowls in the same sink that food is prepared.

People should also wear gloves when attending to pets that have open wounds, he said, and should keep any of their own broken skin bandaged.

"Tie to Pets Has Germ Jumping to and Fro" [New York Times]
(Photo: KaCey97007)

WSJ reports:

Michael Gurion, an Atlanta attorney, says he didn't object when an optometrist collected around $70 from him during a visit a few years ago for an exam and contact lenses. But months later, when he looked at his insurer's explanation of benefits, he discovered he'd only owed about $25. He called the optometrist's office and was told the difference was being kept by the practice as a credit toward future visits.

If you do end up paying in full before leaving, watch for the insurer's explanation of benefits in the mail. If it's less than what you paid, ask for a refund.

Beyond Co-Pay: Surprise Bills at the Doctor's [WSJ]

Here's how it started: A few weeks ago, Betsy McCaughey, a former Lieutenant Governor of New York and the current chair of the Committee to Reduce Infection Deaths, said into a microphone, so she knew it was going out to the public,

"Congress would make it mandatory - absolutely require - that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner [...] The bill expressly says if you get sick somewhere in that five-year period, you have to go through that session again - all to do what is in society's best interest or your family's best interest and cut your life short."

Betsy McCaughey is either stupid like a farm chicken or a very mean person, because either she truly misread the proposal (which makes her sort of unfit to be in any position of leadership, especially one concerning health care) or she is deliberately misreading it in order to terrify senior citizens for political purposes, by trying to convince them that we live in some sci-fi future where they'll be killed by an army of Obama clones. To be clear, the sci-future we do live in has cool smartphones and corporations that use the government to take advantage of private citizens, but it's not Logan's Run. If it were, I'd have already pried out my palm gems and sold them to buy more smartphones.

What the proposal does say is that for the first time ever, Medicare will be required to cover counseling about end of life topics, which is something it never paid for in the past. At minimum, it will have to pay for a session once every five years; if you're really sick, it will pay more frequently. But the sessions are up to you, obviously. The point is, the government will have to help you find out what your options are instead of leaving it up to you to foot the bill.

According to PolitiFact, a spokesman for the AARP said McCaughey's statements are "not just wrong, they are cruel. We want to make sure people are making the right decision. If some one wants to take every life-saving measure, that's their call. Others will decide it's not worth going through this trauma just for themselves and their families, and that's their decision, too."

Consumer Reports has a handy list of tips for how to make those difficult decisions when it comes to "aggressive medical care." The advice is free, politically neutral, and best of all not filled with lies. If you have a loved one who's freaked out by the Euthanasia Menace of Obama, maybe you can read through the list with them and sort out fact from fiction. Then you can make up your mind about health care reform based on the real issues, not fearmongering from idiots.

"Scaring Seniors: Reform opponents spread myths about euthanasia" [Consumer Reports Health Blog]
"Get better care, no matter where" [Consumer Reports]
"McCaughey claims end-of-life counseling will be required for Medicare patients" [PolitiFact.com]
(Photo: fffriendly)

Keller said AMR needed to increase its charge for bariatric patients to pay for more manpower and transportation equipment. The bariatric equipment includes extra large and reinforced cots, as well as a winch to help technicians load the patients into the back of the ambulance.

"These people have special needs during transport," Keller said of the bariatric patients. "Many of these people don't fit our standard cots. Our normal cots will hold over 500 pounds, but when you max out the ability of the cot, you put the patients at risk. Having these resources means a little less manpower and a much safer way to lift the patients."

Keller said as a general rule, AMR will begin charging patients the increased bariatric fee if they weigh more than 350 pounds. He said the technicians, however, would use their discretion and consider the overall size of the patient in determining if they are bariatric. "We look at the length and width," Keller said. "A patient could be 325 or 275. We will look at the qualifiers of the patient and the special needs, and then we submit them to the insurance and see if we agree."

AMR previously charged $629 to transport overweight and critical care patients. The price for Medicaid and Medicare patients will hold steady, and the new $1,172 fee will only apply to patients with private insurance.

What do you think? Should extra-large or sick patients have to pay more for an ambulance ride?

Some overweight Topeka patients to pay more for ambulance use [Wichita Eagle]
AMR rates rising for obese [The Topeka Capital Journal]

[Consumer Reports Health]

If you have a claim you think was unfairly denied, it's worth giving them a shout.

The Milwaukee Journal Sentinel doesn't say if she then returned to finish attending the surgery, but Dean Health admitted to the paper that interrupting her during her job just to give her the news "violated medical protocol." We guess her manager had a long list to get through.

"Nurse called out of surgery and laid off " [JSOnline] (Thanks to Erik!)
(Photo: SarahMcD ॐ)

STRIKE A DEAL, THEN CHECK IN If you need shoulder surgery, for instance, but don't have insurance - or are facing a high hospital co-payment - call the hospital's billing department and explain that you would like to discuss getting a discount and why. Dr. Moritz suggests saying, "I'd like to pay the lowest rate you give an insurance company."

Bargaining Down the Medical Bills [NYT via Consumer World Blog] (Photo: Todd Ehlers)

Be wary of "affordable" plans [Consumer Reports Health Blog] (Photo: Listener42)

Dallas hospital bills woman who waited 19 hours and never saw a doctor [Chron] (Thanks to Chester!) (Photo: xxxlps)

The NYT has an interesting article about the movement to standardize the bracelets:

The goal is to prevent potentially dangerous mistakes, like giving the wrong food to an allergic child, or allowing a patient with balance problems to walk unescorted down a freshly waxed hallway. The drive was spurred, in part, by a notorious 2005 Pennsylvania case in which a patient nearly died because a nurse used a yellow band thinking it meant “restricted extremity” (don’t draw blood from that arm), as it did at another hospital where the nurse sometimes worked, when at this hospital it meant D.N.R.

While the new color-coding has been quickly embraced by at least 20 states and endorsed by the American Hospital Association, the purple bands, typically embossed with the letters D.N.R. to reinforce the message, are meeting with some resistance.

The nation’s leading hospital-accreditation agency, known as the Joint Commission, has expressed caution about the new system, citing concerns about branding patients by their end-of-life choices, or inadvertently broadcasting those choices to family and friends who have not been consulted.

The commission also said that children who do not understand the system had been prone to trade the wristbands like baseball cards.

Awwwwkkwaaarrrdd. The main takeaway for the consumer is that hospitals make mistakes, so it's a good idea to ask questions about the bracelets that they put on you and make sure that everything is as it should be. If something doesn't seem right, speak up for yourself or for your family.

Hospital Bracelets Face Hurdles as They Fix Hazard [NYT]
(Photo:Chester Higgins Jr./The New York Times)

Medical Bills You Shouldn't Pay [BusinessWeek] (Thanks to Eric!) (Photo: jgodsey)

Hospitals in Los Angeles and Orange counties submitted phony Medicare and Medi-Cal bills for hundreds, perhaps thousands, of homeless patients—including drug addicts and the mentally ill—recruited from downtown's Skid Row, state and federal authorities allege.

City attorneys began investigating after receiving reports back in 2006 that hospitals were dumping homeless patients on Skid Row streets. What they found, they say, was that some hospitals were using conditions such as dehydration, yeast infection, and exhaustion as reasons for keeping homeless patients in beds for "as long as three days" in order to maintain full patient loads and collect money from the government.

Agents arrested Rudra Sabaratnam, CEO of City of Angels hospital, and Estill Mitts, operator of a Skid Row health assessment center, FBI spokeswoman Laura Eimiller said. They were in federal custody and were scheduled to be arraigned Monday.

The city attorney's office said it filed a lawsuit against the corporate owners of the three hospitals — along with Sabaratnam, several doctors and others — in connection with the alleged scheme.

Representatives of the hospitals did not immediately respond to calls seeking comment. Los Angeles Metropolitan and the Tustin hospital are owned by Pacific Health Corp., and Los Angeles-based Intercare Health Systems owns City of Angels.

"FBI: LA hospitals used homeless in medical fraud" [Associated Press]
(Photo: Getty)

A doctor at the hospital, William T. Kumprey, was tired of seeing Farnam.

Farnam had been to the hospital several times in the last month or so. He had used his fake heart attack routine at Silk — an exotic lounge — at several restaurants and while getting out of various cabs.

The doctor told Farnam he would call the police the next time he caught him faking the clutch of death to avoid paying his bills.

Farnam let it slip that he had, earlier that very day, after a hearty meal for which he did not pay, absconded to Froedtert Hospital.

The doctor called police.

The 52-year-old faces nine months in jail and a $10,000 fine if convicted.

Cardiac arrest: Man faked heart attack when dinner bill arrived [Milwaukee Journal Sentinel]

Some highlights:

• Interest rates can jump to as much as 27.99 percent retroactively. That's the rate Chase HealthAdvance's zero-interest plan charges, for example, if you miss a payment or don't pay off the debt in the promotional period. By contrast, the average fixed-rate credit card charges 11.9 percent, according to Bankrate.com.
• Consumers report that they sometimes feel pressured by medical providers to finance needed medical care, in some cases while sedated or recovering from treatment.
• Doctors and dentists have financial incentives under these arrangements to encourage patients to sign up for more expensive treatments and to steer them to extended financing plans that take a smaller cut of the practitioner's fee.
• When hospitals persuade patients to tap unused credit, those patients can lose the power to bargain for discounts or even obtain charity care

Overdose of Debt [Consumer Reports]
(Photo: Getty)

Among the many hospital personnel who stopped in to see my father after surgery was a "financial counselor" from the billing office, who basically started stalking him from the minute he left the intensive care unit.

After making several unsuccessful visits to his room on Tuesday and Wednesday, she slipped her card under the door asking my dad to call her. A little busy recovering from major surgery, my dad didn't get around to it. So on Thursday, the woman called him on the phone in his room, waking him from a much needed painkiller-induced nap to demand a $1,500 down payment on his surgery.

Still connected to IVs, a morphine pump and creepy-looking blood drains, my dad had enough to worry about without getting hassled by the billing office, like dying from a blood clot, or acquiring a drug-resistant infection from the guy in the next room. (Family and hospital staff alike were visiting the guy barehanded despite a big sign on his door warning people not to come within three feet of him without gowns, gloves and masks.) So I went down to the billing office to complain. A supervisor informed me that the counselor was making a "courtesy call" to inform my dad of the limits of his insurance policiy, but she acknowledged that it was hospital policy to wrest as much cash as humanly possible out of patients before they leave the building.

I told the supervisor that hassling post-op patients was incredibly inappropriate, especially given that most of them were too doped up on painkillers to even sign a consent form, much less negotiate billing options. If the hospital had wanted to discuss payment issues, it could have done so when my dad pre-registered with the hospital two weeks earlier. After some perfunctory apologies and some lame excuses, the woman thanked me for the feedback and I left. Later a nurse told us another patient had also complained of a similar shakedown, and she said the nurses were horrified but powerless to do anything about it.

Disgusting, but emblematic of for-profit hospitals. Avoid them if you can.

Hospital Shakes Down Post-Op Patients, In Their Beds [Mojo Blog]
(Photo: Getty)

Since 2004, UCSF said it provided the names and addresses of 30,590 patients to Target America, paying the company $12,000 a year.

Hospital officials said it contracted with the company to assist "with identifying names of individuals who could potentially receive communications from UCSF."

"Identification of potential donors who were active in the philanthropic community was one objective, along with identifying individuals who had corporate relationships, such as board service, or were affiliated with relevant community programs and health care biomedical organizations," Kaarlela said.

After the breach was discovered, the hospital said it required Target America to hire "an objective third-party firm" to investigate. UCSF received the forensic analysis report March 26. It showed that information was potentially accessible from July 1 to Oct. 9 last year "if a query for a specific name was made." Notification letters were mailed to patients April 4.

To Dixon, the expert on medical identity, the disclosure lag was far too long.

"In Internet years, that's a century," she said.

In January, California began requiring health care providers to alert consumers if their medical information is breached. Swift notification is considered important so consumers can monitor credit reports and bills.

According to Joanne McNabb, chief of the California Office of Privacy Protection, notice should be given "in the most expedient time possible, without unreasonable delay."

"It's a judgment call, the how and the when part," McNabb said. "The idea is to give early warning so that people can take defensive action. On the other hand, you don't want to needlessly worry people."

It's not the worst case of lost records we've seen, but mining for donors seems so much worse than "whoops, lost another laptop!" At least people's social security numbers weren't included with the data. People who think their identity may have been stolen should pour themselves a stiff drink before sitting down to read this comprehensive post.

6,000 UCSF patients' data got put online [San Francisco Chronicle] (Thanks to Paul!)
(Photo: Getty)

Dr. Susan M. Trocciola, who was a resident in trauma medicine at the time, testified that she placed a finger in Mr. Persaud's rectal area after conducting a physical exam of his spine to check for a spinal-cord injury.
 
Whether the rectal exam was performed was a matter of dispute. Mr. Persaud testified that he felt a finger inserted in his rectum, but Dr. Trocciola said the exam was never carried out.

Mr. Persaud was not necessarily the most sympathetic plaintiff. It emerged during the trial that Mr. Persaud, a native of Guyana who did not complete high school, had been convicted of two misdemeanors: attempted aggravated harassment for making phone calls to an ex-girlfriend's mother in 2001 and criminal mischief for threatening a fellow motorist with a baseball bat after a minor car accident in 2007. Mr. Persaud had filed a workers' compensation claim and also sued the owner of the site where he was injured. He was awarded about $4,000 in the compensation claim, but the suit was settled for a negligible sum, Mr. Marrone said.
 
In a phone interview, Mr. Marrone said of his client, "He's not a perfect person, but he's not a criminal by any standard of the word. He's got a lot of anxiety. He reacts negatively in stressful situations and he has a short temper."

RELATED
"Doctor Forces Rectal Exam, Patient Punches Doctor, Police Arrest Patient, Patient Sues"
(Photo: Getty)

On March 15, my dad had triple-bypass heart surgery at Jewish Hospital in Louisville, Kentucky. My mother immediately started planning for his aftercare. My mother is disabled and uses a walker to get around; my father normally takes care of her.

My father's doctors, along with the hospital's case worker and my mother tried to get their health insurer, Anthem Blue Cross/Blue Shield to approve off-site cardiac rehab. They initially approved the request and made arrangements at an approved facility. The day before checkout, March 19, Anthem changed it's mind. My father's doctors kept him another day to execute an emergency appeal. But to no avail, Anthem determined my father was "too healthy" and would have to go home (and basically perform self-care). It pushed my mother to the verge of a nervous breakdown, but thanks to friends and neighbors they made it work. Anthem was kind enough to provide a visiting nurse, three times a week, even though daily care was recommended by the doctors.

Yesterday, they received the attached letter, approving the rehab stay. Well, great, right? Let's go to rehab! Well, no-no-no. The approval was only good until 3/24. So, he'll have to re-apply.

In a stunning development underscoring the plight of non-profit hospitals struggling with the increase in uninsured patients, the Catholic ownership of St. Francis Hospital & Health Center on Wednesday said it will shutter the hospital because nobody would buy it.

The religious order of nuns that oversees St. Louis-based SSM Health Care said it could not even give the hospital away to other health facilities "for free."

Saddled with tens of millions of dollars in losses from uninsured patients who could not pay their medical bills, St. Francis would be abandoning its core mission of caring "for the people of its communities regardless of their ability to pay." SSM will seek a closing application with the state, a process that could take several months.

The closing would erase a deeply established health-care facility in a struggling south suburban town, forcing residents to travel further from home and potentially stressing other facilities with an influx of thousands of patients, many with limited means.

"Unfortunately, in spite of St. Francis' outstanding clinical reputation, reimbursement from commercial insurers could not cover the cost of providing care to the growing number of Medicaid and uninsured patients," said Sister Mary Jean Ryan, SSM's chief executive officer.

Maybe a network needs a realistic set for a TV doctor show?

SSM to Close St. Francis Hospital & Health Center (Press Release) [St. Francis]
The hospital they just couldn't save [Chicago Tribune via WSJ Health Blog]

The error occurred in diagnosis before the surgery took place. The surgery staff followed all appropriate safety protocols, including marking the surgical site and pausing before surgery to confirm the final details.

Unfortunately, the side of the affected kidney was incorrectly identified in the medical chart several weeks before the surgery took place.

"The fact is, my kid has leukemia, and if he doesn't get this treatment, he will die," Robert Mitchell said. "The way they made me feel was that they were pressuring us to take him home and let him die. We'll try anything that has a chance of succeeding, and I will not give up fighting for it to be covered.

"Go to their Web site, and their mission statement says they treat each person with compassion," he said. "I think that's a bunch of hoopla."

Paul Tate, a spokesman for Primary Physician Care, said the company is not authorized to discuss Paxten's case.

(Thanks to Adam!)

"Insurance won't cover child's critical leukemia treatment" [Asheville Citizen-Times]

RELATED
www.primaryphysiciancare.com
(Photo of Paxton Mitchell: Citizen-Times)

Research has shown a link between sexualized images of teens in the media and mental health problems in girls, including eating disorders, low self-esteem, anxiety and depression, according to the Boston-based Campaign for a Commercial-Free Childhood.

(Thanks to Darkwing Duck!)

"Group: Hospital should nix retailer name" [BusinessWeek/AP]
(Original photo before it got corrupted: D'Arcy Norman)

The box "had a document indicating it was sold because the shipping company could not deliver it or find its owner," and UPS told MSNBC that it keeps undeliverable packages for at least 3 months before liquidating them. What we can't figure out is how three full months elapsed between early December, when the box was shipped, and the end of February, when the box had clearly already been liquidated and was being offered for resale by a private business.

(Thanks to Sarah!)

"Medical records sold to teacher as scrap paper" [MSNBC]
(Photo: Orin Optiglot)

Before even reviewing the picture, I heard a woman yell, "What do you think you're doing?!" I looked up, seeing an angry looking woman briskly coming down the hall at me.
 
"Taking a photo of the sun," I replied.
 
"You're in a hospital!" she shrilly declared.
 
"Yes, obviously."
 
"I've called security, you stay here!"

Kurt didn't stay there, but told her his father had been there for 3 weeks now and he was going to go join him at dinner.

And so I did. I joined my father at dinner. Within minutes, someone tapped me on the shoulder. It was a security guard.

"Sir, can you come with me?"

"Certainly."

"Were you taking photos in the hospital?" he asked, seemingly bored.

"Yes, I took a photo out the hallway window in the 3rd floor of the sun." I showed him the photo.

"Okay, just don't do it again. Thanks." It seemed like he was just a guy doing his job so I agreed and went back to sit with my father.

"See, they're all pinheads," commented my father.

He exasperatedly explained to me that I could not take photos anywhere on the hospital grounds because it violated the employees' rights. I was also told that I was not allowed anywhere but with my father. Failure to comply with these requests would result in being escorted by the still present security guard. At this point, he also demanded my driver's license as proof of the incident.

• to protect the privacy of employees;
• to protect the privacy of patients;
• to prevent situations where someone taking pictures may get in the way of helping the sick and injured;

It seems reasonable that those three needs can be met with a sign posted at every entrance that says something like, "Please do not take photographs of employees or patients. No cameras allowed in hallways or treatment areas." Hey, and then you could also tell employees to memorize and repeat those two restrictions one time only to offenders, along with "Hospital policy!" at the end. If they spy a repeat offender, they call security. Another problem solved! You're welcome!

In other words: We get that the hospital wants to protect the privacy of employees and patients, but obviously a simple explanation of the no-photos policy would have sufficed. Bringing two employees to twice interrupt a visitor's dinner with his father is the kind of overreaction that happens when you equate photographs with terrorism, and cameras with guns.

Kurt writes,

I wanted to point out that I didn't take a picture of any person, or that I couldn't possibly know their absurd policy since there was no signage posted anywhere. And if a search of their site is any indication, the only person who is aware of this policy is the the head of security himself.

We tried contacting Resurrection to find out what their official photo policy was, but we were transferred from the front desk to security, then given a number to guest relations that didn't work. (The security guy said it was probably closed for the evening.) Nobody we actually spoke with was willing to say anything about a photo policy for visitors.

This writer thinks there's another reason for all the photo banning currently in vogue: it's a superstitious attempt to retroactively prevent 9/11 from ever having happened. Letting a stranger shoot a photo has become a symbol of invasion and assault, of scheming and revenge. Or maybe it's also a fear of Flickr. At any rate, this writer half-seriously suggests maybe earmarking some public funds for a national re-education campaign about the moral neutrality of "Taking Photos."

"Hospital forbids photos of the sun!" [fiftytwofifty]

(Photos: security guard: Getty; seminar: kerryank)

Barbara later told reporters, "Luckily I had a $5 bill. I gave it to her."

Workers at Staten Island Physician Practice (SIPP) were appalled when they learned of what had happened to Mrs. Antonelli, calling it "insane" and "crazy."

"It's not our policy," said Sally Cohen, center administrator for SIPP, who was surprised that someone would worry about payment on the spot instead of billing the patient after the fact. She said she will investigate what happened and address the situation with the employee. "We're all in this for medicine. If it is an incident, I will take care of that."

Mrs. Antonelli's son, Thomas, rushed to RUMC after she was brought there and was stunned when he heard the story from his mother.

"She's on a stretcher and they're worrying about five dollars," he said, pointing out that if the receptionist was acting against policy, some of the other workers could have stopped her on her way out the door. "It's insane. When I go there [over the weekend], I'm definitely going to go in and find out who that woman was."

Doctor's office commits cardiac infraction [The Staten Island Advance via Gothamist]

The patient was taken to to the emergency room at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, given 8 stitches on the head, and was told he would need a rectal exam to see if he had a serious spinal injury.

He refused.

He adamantly objected to the procedure, he said, but was held down as he begged, "Please don't do that." As Mr. Persaud resisted, he freed one of his hands and struck a doctor, according to the suit. Then he was sedated, the suit says, with a breathing tube inserted through his mouth.

After Mr. Persaud regained consciousness, he was arrested, then taken — still in his hospital gown — to be booked on a misdemeanor assault charge. Gerrard M. Marrone, who was Mr. Persaud's lawyer, got the criminal charges dropped, then helped Mr. Persaud file a civil lawsuit against the hospital.

"Psychologically, it changed his life completely," Mr. Marrone said of the episode. "He hasn't been able to work. He has absolutely no trust in the system at all: doctors or the police. He has post-traumatic stress syndrome."

Forced Rectal Exam Stirs Ethics Questions [NYT]
(Photo:Getty)

According to Reuters, "the study found the largest racial disparity in providing stronger medications was found among patients in the most pain and those aged 12 or younger."

"There is no evidence that nonwhites have less severe or different types of pain when they arrive in the emergency department," Pletcher said. "We think our data indicate that opioids are being underprescribed to minority emergency department patients, especially black and Hispanic patients."

A factor may be that white patients are more likely to expect and demand relief from pain and better convey their symptoms in comparison to minority patients, the report said. Whites — who are more likely to have health insurance — may also be overprescribed the drugs, it said.

The investigators acknowledge that it is conceivable that the disparity represents overprescribing to white patients, but they think it a more plausible explanation is true undertreatment of pain in minority patients. This may not be a result of physician bias but could reflect expectations and assertiveness of the patients.

The results were stunning. Within three months, the rate of bloodstream infections from these I.V. lines fell by two-thirds. The average I.C.U. cut its infection rate from 4 percent to zero. Over 18 months, the program saved more than 1,500 lives and nearly $200 million.

A large body of evidence gathered in recent years has revealed a profound failure by health-care professionals to follow basic steps proven to stop infection and other major complications. We now know that hundreds of thousands of Americans suffer serious complications or die as a result. It's not for lack of effort. People in health care work long, hard hours. They are struggling, however, to provide increasingly complex care in the absence of effective systematization.

Excellent clinical care is no longer possible without doctors and nurses routinely using checklists and other organizational strategies and studying their results. There need to be as few barriers to such efforts as possible. Instead, the endeavor itself is treated as the danger.

RELATED
"The Checklist" [The New Yorker]
(Photo: Getty)

The basic advice is to wash, wash, wash. Practice good hygiene, wipe down surfaces and keep yourself clean when you're at the gym, take care of all cuts and scrapes and keep them bandaged, and make sure your children don't share their belongings with friends—especially since staph is hardy, and can be transferred down a long chain, e.g. from Mom who works at the nursing home, to her daughter, to your daughter, to the rest of your family. (Something similar to this actually happened to a doctor quoted in the article.) And above all, respect antibiotics; your bank account will thank you when you don't have to spend months trying to recover from an infection.

Without question, people need to show far more respect for antibiotics. Misuse of antibiotics allows bacteria to evolve and develop resistance to drugs. But parents often pressure pediatricians to prescribe antibiotics even when they don't help the vast majority of childhood infections. When you do take an antibiotic, finish the dose. Antibiotic resistance is bad for everyone, but your body can also become particularly vulnerable to resistant bacteria if you are careless with the drugs.

I recently contacted my deceased pet's (pictured at death) vet to request that they send me a series of full-body x-rays they shot about 7 years ago. While I haven't been able to speak to a doctor or head administrator yet, the receptionists have informed me that x-rays and other medical images of their animal patients are the legal property of the hospital. They can loan the images out to me for a month, but then I must give them back. This seems really odd."

First of all, I PAID out of pocket to have the x-rays taken. Second, the pet is deceased. There will be no need for any veterinarian to refer to those images ever again. Third, how can it be that I have full ownership rights to x-rays (that are paid for by my insurance company) of my own body, and yet I don't own rights to my pet's x-rays? There IS the possibility that, somewhere down the line, I signed a waiver of my rights to those images, but is it even legal for the vet to request such a waiver?

What's the real deal here? While I'm sure very few people ever ask for their dead pet's medical records, is there any chance you can look into this for me? How can I go about getting those x-rays in my hands?

Much appreciation from
the c-side

These plans often cap out at amounts far lower than the market cost of any procedure, or have complicated rules on pay outs—Aetna's new offering, for example, pays up to $7,500 a year for inpatient care, but limits the daily amount of a hospital stay to $250.

As our reader Laurel puts it,

They market themselves as a way for temp firms and other places with hourly employees to increase the perception that their employees are 'valued.' The employer pays little - sometimes nothing - for the 'benefits.' Payment is deducted automatically from employee payrolls.

My fear is that, with the push toward universal insurance, scam-scum like this will qualify as 'being insured,' leaving workers in the lurch if they become ill.

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"More Kansas Insurers Offering Limited-Benefit Plans For Employer-Sponsored Health Care" [Medical News Today]
"Wal-Mart has a limited benefit plan, called Starbridge." [old WSJ article, found through Google ]
(Photo: Getty)