Tuesday, July 22, 2008
ARBITRATION AGREEMENTS
Under Virginia law, you can revoke an arbitration agreement signed with a medical provider, while receiving care, up until, 60 days after care ended. Specifically this applies to nursing homes - so as a matter of course, when leaving a nursing home, we would recommend you send a letter to the Administrator of the Nursing Home, in writing, revoking the arbitration agreement. At least this protects your right to access the court should anything happen.... or, learn later, something did happen.
Tuesday, July 15, 2008
Abuse by Home Health Aids
Today's Wall Street Journal featured an article on the "home health" care industry. Without regulation, families have sadly learned the hard way, how difficult it is to find quality, and qualified help. Criminal records, physical abuse, financial fraud - the unimaginable has occurred to our nation's seniors.
While we support the idea of care at home, we recommend the following before hiring anyone to provide care:
1. Get full name and social security - and a copy of their driver's license
2. Use personal information to run criminal back ground check
3. Ask for, and call references
4. Check license information with state department of health
5. have other family stop by, unannounced
6. If problems, do not hope they will resolve - act fast
We are so sorry for those individuals who have been abused by their home health care workers - please do what you can to protect your family!
While we support the idea of care at home, we recommend the following before hiring anyone to provide care:
1. Get full name and social security - and a copy of their driver's license
2. Use personal information to run criminal back ground check
3. Ask for, and call references
4. Check license information with state department of health
5. have other family stop by, unannounced
6. If problems, do not hope they will resolve - act fast
We are so sorry for those individuals who have been abused by their home health care workers - please do what you can to protect your family!
Breaking news - you may not be on coumadin for long!
A local physician told me in a deposition once, that he hates having to prescribe coumadin. When I asked why, he explained it was such a difficult drug to manage and required so much attention. Well, I know what he means. Coumadin, a blood thinner, is generally given post op to prevent blood clots - but amount, and frequently, depend on the patient. Blood tests should be done weekly, and physicians must adjust dosage based on PT/INR levels. Is it a burden? The doctor I deposed thought so, and I imagine the blood tests aren't fun for patients either.
With 300,000 people dying a year from blood clots, it is clearly an area where good medication would be welcome. So what is the breaking news? Three possible coumadin replacements are currently in last stage testing before FDA approval. While I am often skeptical of the FDA and the approval practice, it will be interesting to see how the future of blood thinners will affect most patients.
With 300,000 people dying a year from blood clots, it is clearly an area where good medication would be welcome. So what is the breaking news? Three possible coumadin replacements are currently in last stage testing before FDA approval. While I am often skeptical of the FDA and the approval practice, it will be interesting to see how the future of blood thinners will affect most patients.
How to avoid medicine Mix-ups
I am on malaria pills for a trip I took recently. What if I get sick and need an antibiotic, do the two meds mix? What about those elderly adults on 7 or more meds. My Mom has MS and cancer - she is on 6 mds, and 8 vitamins at any given time. Which of her 14 doctors should be in charge of medication management?
The answer - all of them, and the pharmacist. Ways to avoid mix ups:
1. use the same pharmacy, that way, all meds are recorded in one place
2. keep an updated list with you and provide to every doctor
3. ask when prescribed something new - "why" and "how will it interact with your other meds?"
4. Are there foods that should be avoided?
5. Also keep a list of vitamins and supplements - they can interact with meds as well
Please be diligent friends and future clients.... we would hate for you to have a medication mix-up.
The answer - all of them, and the pharmacist. Ways to avoid mix ups:
1. use the same pharmacy, that way, all meds are recorded in one place
2. keep an updated list with you and provide to every doctor
3. ask when prescribed something new - "why" and "how will it interact with your other meds?"
4. Are there foods that should be avoided?
5. Also keep a list of vitamins and supplements - they can interact with meds as well
Please be diligent friends and future clients.... we would hate for you to have a medication mix-up.
Thursday, July 10, 2008
EARLY CONCERNS ABOUT LAS VEGAS GASTROENTEROLOGIST
Do you remember reading about the gastroenterologist in Las Vegas, Dr. Dipak Desai and his Shadow Lane Clinic? You know... the doctor whose patients (numbering in the thousands) were advised by health authorities to undergo testing for hepatitis and HIV. Authorities investigating a cluster of hepatitis C cases observed clinic nurses reusing syringes in a manner that contaminated vials of medication and infected patients.
Two interesting discoveries have come to light since this news broke in February. First, Judy Witman, one of his medical technicians, became concerned about Dr. Desai's professionalism years ago. Witman, who now works for a Pennsylvania hospital, quit her job at Desai’s clinic after a few months and notified the Nevada State Board of Medical Examiners about Desai’s behavior in 1989. Guess what? Her phone call was never returned by the Board of Medical Examiners.
The second interesting fact? Dr. Desai was very active in the tort reform movement. He contributed $25,000 to the Keep Our Doctors in Nevada lobbying effort — the largest donation in the state! But it paid off — as voters agreed with physicians that it should be much more difficult for individuals to sue doctors for malpractice.
Maybe he knew his contributions would help him keep his license in the future!
Two interesting discoveries have come to light since this news broke in February. First, Judy Witman, one of his medical technicians, became concerned about Dr. Desai's professionalism years ago. Witman, who now works for a Pennsylvania hospital, quit her job at Desai’s clinic after a few months and notified the Nevada State Board of Medical Examiners about Desai’s behavior in 1989. Guess what? Her phone call was never returned by the Board of Medical Examiners.
The second interesting fact? Dr. Desai was very active in the tort reform movement. He contributed $25,000 to the Keep Our Doctors in Nevada lobbying effort — the largest donation in the state! But it paid off — as voters agreed with physicians that it should be much more difficult for individuals to sue doctors for malpractice.
Maybe he knew his contributions would help him keep his license in the future!
Wednesday, July 09, 2008
MEDICARE FRAUD and WHY YOU SHOULD BE UPSET
If you were any where near a newspaper today, I am confident you read an article about Medicare fraud. This time, dead doctors were paid for services and supplies. Yes, you read that right.
How does this happen?
When you and I go to the Doctor, services are rendered, co-pay is collected, and the rest is billed to Medicare, insurance company, etc. The insurance companies and Medicare take it in good faith, that you actually needed that care, sought it out, received it etc. Well, for physician practices across the country that wanted to make more money, a wonderfully illegal and fraudulent practice arose where bills were issued for services not rendered. How did they realize this? The physicians were dead.
Now I would notice if Anthem sent me an invoice for a visit I did not attend, to a physician that I knew was not alive - but Medicare doesn't send families statements, they usually just pay, so that is how the fraud went unnoticed.
And what a shame too - Millions of our tax dollars not used to help. In a tight budget process, where Medicare is getting cut and health care costs are on the rise, the average citizen is who pays for this fraud. And do you think there will be any criminal actions taken? I would hope so, but I am not holding my breath!
How does this happen?
When you and I go to the Doctor, services are rendered, co-pay is collected, and the rest is billed to Medicare, insurance company, etc. The insurance companies and Medicare take it in good faith, that you actually needed that care, sought it out, received it etc. Well, for physician practices across the country that wanted to make more money, a wonderfully illegal and fraudulent practice arose where bills were issued for services not rendered. How did they realize this? The physicians were dead.
Now I would notice if Anthem sent me an invoice for a visit I did not attend, to a physician that I knew was not alive - but Medicare doesn't send families statements, they usually just pay, so that is how the fraud went unnoticed.
And what a shame too - Millions of our tax dollars not used to help. In a tight budget process, where Medicare is getting cut and health care costs are on the rise, the average citizen is who pays for this fraud. And do you think there will be any criminal actions taken? I would hope so, but I am not holding my breath!
Tuesday, July 08, 2008
WHAT I WOULD HAVE DONE DIFFERENTLY
I just finished reading a thought provoking article in the New York Times entitled, "What I Wished I'd Done Differently." The article is a personal account of the mistakes made by its author, Jane Gross, in caring for her aged mother.
The article deals with the problems of nursing home and assisted living care. Ms. Gross acknowledges her mistake in failing to find a geriatric specialist ( a doctor who has specialized training in caring for the elderly) to take care of her mother.
I cannot say it better...read this compelling story for yourself.
The article deals with the problems of nursing home and assisted living care. Ms. Gross acknowledges her mistake in failing to find a geriatric specialist ( a doctor who has specialized training in caring for the elderly) to take care of her mother.
I cannot say it better...read this compelling story for yourself.
DO YOU REALLY READ THE LABELS?
FDA announced yesterday it will begin requiring warnings on certain epilepsy drugs, that the medications may cause suicidal behavior.
11 drugs, used for pain and epilepsy management will be required to include the labels. Pfizer, maker of Lyrica, testified that the FDA's research did not match its own. Despite their efforts, the new medication will include the same label.
GOOD? BAD? Indifferent?
The Warning in many ways is a liability issue - families can no longer say they had no idea that the drug had possible side effects, but will the labels be read or understood such that prescriptions or use will change? Will families seek alternative treatment, or ways to counter balance the possible side effects such as counseling, etc?
At the very least I think it is good that the FDA is involved with side effect research, and mandating the spread of useful information. I fear however, that as drug companies deny the link, the average consumer will miss the message - and that is, that no drug is without complications.
11 drugs, used for pain and epilepsy management will be required to include the labels. Pfizer, maker of Lyrica, testified that the FDA's research did not match its own. Despite their efforts, the new medication will include the same label.
GOOD? BAD? Indifferent?
The Warning in many ways is a liability issue - families can no longer say they had no idea that the drug had possible side effects, but will the labels be read or understood such that prescriptions or use will change? Will families seek alternative treatment, or ways to counter balance the possible side effects such as counseling, etc?
At the very least I think it is good that the FDA is involved with side effect research, and mandating the spread of useful information. I fear however, that as drug companies deny the link, the average consumer will miss the message - and that is, that no drug is without complications.
Monday, July 07, 2008
VIRGINIA COULD LEARN SOMETHING FROM FLORIDA
In 2004, Florida passed a law known as the "Patients' Right-to-Know Amendment." The law allows patients to see previously confidential hospital or physician records of any adverse medical incident at a facility. Such incidents can range from medical malpractice to a near miss, such as a doctor almost giving a patient the wrong medication. Virginia should follow Florida's lead.
In Virginia, as elsewhere, hospitals are required to investigate the facts surrounding medical mistakes and other poor outcomes. The process is called "peer review" and its purpose is to learn from mistakes and take steps to prevent the recurrence of those mistakes. This information should be available to the public.
Don't you want to know if your doctor or hospital has had a large number of medical mistakes? I do!
In Virginia, as elsewhere, hospitals are required to investigate the facts surrounding medical mistakes and other poor outcomes. The process is called "peer review" and its purpose is to learn from mistakes and take steps to prevent the recurrence of those mistakes. This information should be available to the public.
Don't you want to know if your doctor or hospital has had a large number of medical mistakes? I do!
Wednesday, July 02, 2008
MORE ON HEART ATTACKS
Yesterday I wrote about some of the important signs for heart attacks and I received several email questions. Before I answer I must disclose that I am not a doctor and don't play one on TV or elsewhere....
Here are my answers to two questions about heart attacks. First, most people survive their heart attacks. The literature I found indicated that most of the 1.2 million Americans who experienced a heart attack last year survived. Secondly, some of the risk factors for heart attacks include:
- Men with a waist size of more than 40 inches and more than 35 inches for woman
- Blood pressure constantly over 130/85
- Fasting glucose over 110
- Triglycerides over 150
- LDL cholesterol over 100
- HDL cholesterol under 40
My advice: Get an annual physical examination and get these studies conducted.
Here are my answers to two questions about heart attacks. First, most people survive their heart attacks. The literature I found indicated that most of the 1.2 million Americans who experienced a heart attack last year survived. Secondly, some of the risk factors for heart attacks include:
- Men with a waist size of more than 40 inches and more than 35 inches for woman
- Blood pressure constantly over 130/85
- Fasting glucose over 110
- Triglycerides over 150
- LDL cholesterol over 100
- HDL cholesterol under 40
My advice: Get an annual physical examination and get these studies conducted.
Tuesday, July 01, 2008
THE FEAR OF HEART ATTACKS
I will really miss Tim Russert, the Washington, DC bureau chief for NBC News. He was fair and honest with his opinions and his reporting, and my wife and I always watched "Meet the Press" on Sunday mornings. His death on June 13, at the age of 58, was shocking! The reported cause of death - heart attack!
Russert's death got me thinking - what are the signs of an impending heart attack? Looking back at some of the medical negligence cases we have handled over the years, and a little medical research, revealed the following signs/symptoms of a potential heart attack:
- pressure and fullness in the chest area which may come and go
- discomfort in the arms, neck, back and jaw
- lightheadedness
- shortness of breath
Interestingly, women may have symptoms different from their male counterparts including sudden sweating, nausea and vomiting.
If you or a loved one experience any of these symptoms, get to a hospital emergency room immediately and don't let the ER staff keep you waiting to see a doctor. Your life might just depend on it!
Russert's death got me thinking - what are the signs of an impending heart attack? Looking back at some of the medical negligence cases we have handled over the years, and a little medical research, revealed the following signs/symptoms of a potential heart attack:
- pressure and fullness in the chest area which may come and go
- discomfort in the arms, neck, back and jaw
- lightheadedness
- shortness of breath
Interestingly, women may have symptoms different from their male counterparts including sudden sweating, nausea and vomiting.
If you or a loved one experience any of these symptoms, get to a hospital emergency room immediately and don't let the ER staff keep you waiting to see a doctor. Your life might just depend on it!
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