Monday, May 31, 2010

Googlechondriacs

I think that we need to somehow change how google lists medical conditions. It seems that it lists them by number of hits or who pays the most instead of what is the most common answer. When you type symptoms or a medical condition, often the thing that comes up first is WrongDiagnosis which is sponsored by attorneys. So, when you type headache, you get stories of missed tumors or bleeds and how to sue instead of descriptions of what is a tension headache. It is even worse when you look up belly pain, the first sites are for lawyers and the second sites are for herbal tonics.

So, with Google we get people who come to the ER convinced they have a tumor or bleed who dont believe us when we say it is a migraine and others who go home convinced we are idiots because we didnt prescribe the herbals that they saw on the internet.

I cant even go into medications because I am fed up with all the people who come in with seizures becuase they stopped their dilantin once they looked it up and saw all the attorney adds.

Letting the flight attendants fly the plane (again)

I got called into a special meeting. One of our outside hospitals had filled a complaint against one of our pulmonologists. The complaint was that an older gentleman had presented to their ED with pneumonia. When the NP tried to call and arrange transfer, the pulmonolgist at the medical center where she wanted to transfter the patient to told them that he would only take a call from a physician and would not accept any transfer from a NP. This caused the NP to get riled up and file the complaint. After all, she was a ARNP, PhD., The pulmonolgist explained that he was tired of being responsible for people who dont know what they are doing and then having patients show up with totally different things than what he was told. He used other language like idiots and imbeciles. Anyway, I tracked down the patient. When the NP had left after her shift, the patient was indeed transferred, but it was to CCU. He didnt have pneumonia, he was in cardiogenic shock, what she though she saw on the chest xray as pneumonia was CHF.

I made sure that she got a copy of my findings and a copy of our new policy that transfers will only be made between physicians. I made sure that her hospital medical director and CEO got copies as well.

NP does not equal NP

Another Patient Death - Patient Saw NP And Was Sent Home

Family settles lawsuit with Heartland

ST. JOSEPH NEWS-PRESS, MO. Sat, May 22, 4:41 AM

May 22--A family and Heartland Regional Medica... avoided a jury trial in a wrongful death lawsuit this week.

The parties settled on a $725,000 judgment Monday in Buchanan County Circuit Court. The lawsuit accused medical malpractice by Heartland's Urgent Care Clinic, Heartland Health and James Weaver, a nurse practitioner, in the death of Timothy Allen Weber.

Mr. Weber's wife, Michele Weber, his parents and his three children were plaintiffs in the suit, filed in March 2009. The case was set for a jury trial this week. The parties reached a settlement and the case was dismissed on May 17.

According to court documents, Mr. Weber went to the clinic at 1115 N. Belt Highway around 10:35 a.m. on April 14, 2008.

With valid complaints and ailments, he was discharged about two hours later without normal vital signs and no testing or treatment for gastrointestinal bleeding, which led to his death.

It is also reported that he was never examined by a physician while at the facility.

Mrs. Weber found her husband at their home approximately four or five hours after his discharge from the Urgent Care Clinic.

He was pronounced dead at 5:40 p.m. at Heartland's emergency room.

An autopsy determined the cause of death to be hemorrhagic gastritis

Monday, May 24, 2010

Cachexia


I was watching the news and saw some recent photos of Hillary Clinton. She looked like there had been a rapid weight loss and there is definately a redistribution of her facial fat that is not typical with dieting. Curious, I looked back over the last few months and there definately seems to be something going on. From the dates of the photos it is happening fast. She also has changed her posture and hardly ever shows energy. Something is going on, chemo perhaps?

Saturday, May 22, 2010

People get p*****off when you fix their disabilty

We had a patient who came in with a multitrauma who had wrecked their car and injured those in another car. The patient had taken too much oxycontin for her fibro. (Patients will always be too disabled to work but they will always be able to drive). Anyway, she was blitzed on narcotics. It wasnt her oxycontin but that is another story. While she was in the hospital she had problems tolerating her tube feeds and after alot of testing it turns out she has a gluten sensitivity. When she was told that she didnt have fibro and all she had to do was follow a different diet all she said was "I still get my disabilty checks right?"

Sunday, May 16, 2010

Fannie Mae Health Insurance

Sorry that I have been away. We are getting creamed at work. The effects of "Obama Care" is beginning to hit. The new quotes for health insurance that is hitting small businesses in our area and the surrounding states is scary. Because of the increased demands on the private insurance companies as well as the costs imposed on business, rates for health insurnce are going up between 27 and 37%. As a result, companies are dropping healthcare. Patients cant get Medcaid because it is out of money. So, there are now more people without insurance and those who have it have giant deductables and are waiting until it is very late to get care. Medical centers like our that have an open door to the indigent are getting creamed. The indigent is now increasing, the underinsured is skyrocketing. The cost of practicing medicine are increasing exponentially with the new bill. It is like medicine is being done by Fannie Mae. Give everyone "healthcare" that they cant afford, hide the cost and stick it to future generations. Then let it forclose and destroy the whole thing.