Showing posts with label Malpractice. Show all posts
Showing posts with label Malpractice. Show all posts

January 1, 2021

Horrors in U.S. Healthcare

 

So I have been sick the last 9 days, and don't really know what it is (bad cold, flu, or Covid). 

But I am hearing that Covid is spiraling around just about every family that I know now. 

The new most contagious Covid variant is in at least 3 states, but I would suspect it's in all of them by now.  We'll find that out way after the fact. 

G-d only knows whether the Covid vaccines will work on the mutated Coronavirus and how this will impact the runaway pandemic.  Will it be back to the Vaccine drawing board?

While many healthcare workers have been extraordinary during these difficult times, I've been appalled at some recent cases of horrible care. 

Example 1:

Went to CVS Minute Clinic, they gave me some antibiotics, but said go this afternoon for a Covid test, which I had already booked prior at another CVS location that does the tests.  

I drive 10 miles sick to go there, and when I arrive they tell me, they don't have my appointment anymore even though I show them "black and white" my confirmation!  "The system must've kicked you out because you were at another CVS earlier in the day." I said, I need to be tested, and they were adamant that there was nothing they could do.  Their completely incompetent store manager told me to call and make another appointment for another day.  I said, I waited two days for this appointment, drove ten miles, and waited a long time on line.  He said, that's too bad and I should call the 800 number if I wasn't happy. I said, it's your mistake, so you call the 800 number.  I told him I wasn't leaving the line until they resolved this. The manager was a rude SOB, but finally one of the pharmacists said the nurse can put me back in the system and they would in fact see me. 

Well, lo and behold, a day passes, and I get a call the test didn't work.  Make another appointment.  Ok, now I really have no choice.  I go to another CVS, this one was actually much better and gave comprehensive instructions on how to take the Covid test. So much for good CVS and bad CVS!  

Example 2:

Someone else in my family was sick and also goes to the CVS Minute Clinic.  They give her not much more than Tylenol.  But tell her to make another appointment to take care of her ear.  She makes an appointment, and I take her to yet another CVS location the next day.  Well guess what, the Physician's Assistant refuses to treat her ear.  He sits us down and tells us that he has a wife and kids at home and doesn't want to possibly get Covid since she was at the Minute Clinic the day before.  I explain that all they gave her was Tylenol.  He says, "Anything can be Covid!  And I'm not going to go in the room to clean out the ear for maybe 20 to 30 minutes."  Well then why in the hell did this guy go into the medical profession?

Example 3:

I contact another pharmaceutical outlook (not CVS) for a prescription.  They quote me $2,500 dollars.  I say "That's 10 tens what they usually charge me so there must be a typo."  Oh no, that's the price for the branded drug.  Maybe you meant the generic which is only $250!  Same drug but ten times the price!

I'm sorry folks our healthcare system in the U.S. is very broken indeed.  By calling attention to these things, I hope to bring positive change for all our sakes.  ;-)

(Credit Photo: Andy Blumenthal)


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July 4, 2012

Electronic Health Records, Slow But Steady

The best article I have seen on the subject of Electronic Health Records (EHR) was in Bloomberg BusinessWeek (21 June 2012) called "This machine saves lives so why don't more hospitals use it."

What I liked about this article was how straightforward it explained the marketplace, the benefits, the resistance, and the trends.  

Some basic statistics on the subject of EHR:

The healthcare industry is $2.7 trillion annually or ~18% of GDP.

Yet we continue to be quite inefficient with only about half of hospitals and doctors projected to be using EHR by end of 2012.

Annual spending on EHR is expected to reach $3.8 billion by 2015.

Basically, EHR is the digitization of our medical records and automation of medical services so that we can:
 
- Schedule medical appointments online

- Check medical records including lab and test results
- Communicate with our doctors by secure messaging/email
- Send prescriptions into the pharmacy electronically
- Automatically keep track of dosage and refills
- Get alerts as to side effects or interactions of medication
- Analyze symptoms and suggest diagnosis
- Receive prompts as to the latest medical treatments
- Recognize trends like flu outbreaks or epidemics
- File and speed claim processing

So why do many doctor's seem to resist moving to EHR?
 
- Cost of conversion in terms of both money and time

- Concern that it can be used against them in medical malpractice suits
- Potential lose of patient privacy
- Lack of interoperability between existing systems (currently, "there are 551 certified medical information software companies in the U.S. selling 1,137 software programs"--the largest of which are from GE and Epic.)

The government is incentivizing the health care industry to make the conversion:

- Hitech Act (2009) "provides $27 billion in financial incentives" including $44K from Medicare and $63K from Medicaid over 5 years for outpatient physicians that can demonstrate "that they are using the technology to improve care."
- Patient Protection and Affordable Care Act (2010)--a.k.a. Obamacare--calls for "accountable care organizations" to receive extra money from Medicare and Medicaid for keeping patients healthy, rather than by procedure--"they are expected to do so using computers."

The big loophole in EHR right now seems to be:

- The lack of standards for EHR systems from different vendors to be compatible, so they can "talk" to each other.
- Without interoperability, we risk having silos of physicians, hospitals, labs, and so on that cannot share patient and disease information.

So, we need to get standards or regulations in place in order to ensure that EHR is effective on a national, and then even a global level. 

A number of months ago, I went to a specialist for something and saw him a few times; what he didn't tell me when I started seeing him what that he was retiring within only a few months.
Aside from being annoyed at having to find another doctor and change over, I felt that the doctor was not too ethical in not disclosing his near-term intentions to close up shop and giving me the choice of whether I wanted to still see him. 


But what made matters worse is that I got a letter in mail with the notification--not even in person--along with a form to fill out to request a copy of my medical records at a cost per page, so that I could transfer them--hardcopy--elsewhere. 

Of course, this was also the doctor who hand wrote prescriptions still and wasn't able to get test results online. 

To me, seeing someone with a great amount of experience was really important, but the flip side was that in terms of organization, he was still in the "dark ages" when it came to technology. 

I look forward to the day when we can have both--senior medical professionals who also have the latest technology tools at their disposal for serving the patients. 

In the meantime, the medical profession still seems to have some serious catching up to do with the times technologically. 

Let's hope we get there soon so that we not only have the conveniences of modern technology, but also the diagnostic benefits and safeguards. 

(Source Photo: Andy Blumenthal)


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