- Del Meyer, MD - https://delmeyer.net -

Paradox

Congratulations to Doctor William Au, the new Chief of Staff of Sutter who took a firm leadership position at his first meeting. He wants to strive for collegiality amongst the staff members. What a refreshing breeze. Nothing could stop us if we treated each other as colleagues.

The Orange County REGISTER reports that the lady who had her eggs removed at the now infamous UCI fertility clinic (and were implanted without permission), is suing the birth couple for custody of the resultant twins who are now seven years old… Dr Ricardo Asch, who has not worked for this clinic in over two years and lives out of the country, is suing to have his $95,000 UCI salary restored plus payment of all legal costs.

The “Ask a Nurse” program may not be a professional organization after all. An RN who works for them admitted to me last year that her directives had changed in recent years from getting patients into the hospital emergency rooms to getting patients in to see their own physicians the next morning, a much lower cost center by a ratio of 10 to 1. This month an RN who had works for “Ask a Nurse program, which is now nationwide, said their stock was doing well on the NASDAQ exchange. When asked if they were still directing patients to the low-cost centers, she replied it all depended on where the patient’s call originated from. “We’re a national organization now. If a patient called from Georgia, where the hospitals are paying our fee, I would send patients to the hospitals. If the call was from Pennsylvania, where managed care is paying my salary, I would direct patients to low-cost centers or give advice until the patients could see their own physicians the following day…” When doctors and nurses become bureaucrats, they will act like bureaucrats and do what’s best for the corporation–not necessarily what is best for the patient.

Anthony Edwards, after receiving the Best Actor award from the Screen Actors Guild for his part in playing a doctor on ER, dedicated it to the hard-working doctors and nurses everywhere who are just doing their jobs every day.

Debra Saunders, in her SFChronicle column, points out that when the government placed all nonessential workers on furlough, it lacked all sense of compassion and timing. Donna Shalala (Secy HHS) and Dan Glickman (Secy Agriculture) released new dietary guidelines during the partial shutdown. She states Washington wunderkinds decided not to differentiate between men and women, placing far more women into the normal range. She feels that even Big Brother in Washington should have figured out that men and women have different bodies.

Received a copy of Cost & Quality to entice me to subscribe for $200 a year. Articles were on cost-effectiveness of CME; need for full-time, around-the-clock in house hospital coverage, just like university hospital with housestaff. This slick publication at $50 an issue or nearly $2 a page, gave less meaningful data than the New England Journal of Medicine at $2 an issue or 2 cents a page, or the Western Journal, which is free.

A recent Medical Economics article asked the chilling question, “Are jurors competent enough to judge doctors?” The discussions had little to do with medical facts; most jurors fell for the smooth hired-gun testimony. The author felt so badly about being railroaded into voting the doctor guilty that she tried to get a reversal of the verdict after the jury was discharged.

Attorney General Lundgren recently spoke to the Comstock Club. After several references to the OJ disaster, one businessman asked what can business people do to improve the quality of juries: He answered, “If your firm can afford it, please pay your employees while they sit on juries.”

Scientific American questions the doctor glut discussed in JAMA when they run ads for doctors with $500K+ income. They quote some HMO stats that some doctors are responsible for up to 800 patients. To get them all seen, appts may be 7 minutes apart. They conclude that these statements make HMO stats problematic… Not to mention that any doctor seeing a patient every 7 minutes for an interim history, exam, review of lab data, writing requisitions and prescriptions, and recording everything that was done would have approximately 100% of his records deficient on any outside review, which would make him subject to peer review sanctions, reportable to the Medical Board and to the National Data Registry. He would be Professionally Dead. However, on internal review saving all those costs, he may be a hero and get a bonus.

Herb Caen in his SFChronicle column reports that a woman had a grand mal seizure in a Muni bus directly in front of UCSF on Parnassus. UCSF, rather than administering care directly, advised calling 911. Herb Caen responded, “O’ Ma Gawd!”

According to a recent conference report, the invasion of our privacy by computers tracking our activities, contributions, and nearly every purchase, in these days of desperate HMO practices, may result in the purchaser of Preparation H getting a phone call from a starving proctologist.