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Month: June 2007

HOSPITALS/POLICY: King-Drew and the wider issues of care for the poor

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It looks like it might be the end for King Drew, or as it’s known now, King–Harbor. Some of the LA board of supervisors are in favor of closing the hospital immediately, and yesterday the State of California initiated proceedings to revoke its license. No one can pretend that this hasn’t been coming for quite some time.  A couple of years back, a long series in the LA Times found incredible graft, mismanagement, and corruption and appallingly poor care quality at King Drew. Given the hospital’s origins after the Watts riots of the 1960s, and its special place in the African-American downtown community, doing anything to King-Drew has always been politically charged issue. But after the recent incidents, particularly the one where the woman was left to die on the floor of the emergency department waiting room while nurses ignored her, and cleaning staff swept up around her, the hospital seems to have finally run out of defenders.

On the other hand, this is emblematic of a wider problem in American health care—how do you provide care to the poor in a system where there is no universal coverage or systemic primary care?  Bob Sillen, who now runs California’s prison health care system, but used to run Santa Clara Valley Medical Center used to remark that if there wasn’t a County Hospital in which to showcase how the poor were treated it would be impossible to get any attention on to the issue.

So it is my hope that as we enter a period of concern about the future of universal insurance coverage, we don’t abandon the extremely limited safety net that is in place for the poor while we all focus on fixing the wider systemic problems.

HEALTH2.0: User Generated Healthcare UPDATE

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We’re pleased to announce that Allscripts president Lee Shaprio will be joining the lineup at Health 2.0 San Francisco. Lee will be participating in the "Health 2.0: Looking ahead" panel along with EdVenture Holding’s Esther Dyson, RevolutionHealth’s Jay Silverstein, RelayHealth’s Bob Katter, Jack Barrette (ex Yahoo Health care Guru) PBGH’s Ted van Glahn, and CommerceNet’s Marty Tennenbaum. If you’ve yet to sign up, alas, we’re sorry – early bird registration is now closed.  The regular conference rate now applies. But some discounts are still available for those who are referred from some other select blogs and sources. Registrants from government, foundation, academic and poor non-profit organizations qualify for additional price breaks. And we’re working on a scholarship program for students and individuals.

Again, in case you missed the earlier announcement, the event will now *officially* be held at The Hilton San Francisco, September 20th, 2007. A limited number of reduced rate rooms ($189/night)  are available on site at the Hilton. The first block sold out within a day of going on sale. Our friends at the Hilton have kindly arranged to make an additional block available. After those are gone, standard rates will apply. Registrations are going well, and we’ll be announcing some
additional sponsors and a few more high-profile speakers shortly. So
please head over to www.health2con.com to check it out.

Continue reading…

JOB POST: Help Wanted, Intrepid Physician Needed

Who would like to join a Norman Rockwell inspired, old-fashioned New Hampshire General Practice, and put some grace in their life?   

The Last privately owned and operated General Practice in all of Strafford County New Hampshire seeks a young(er) associate physician. The good news: I am a Harvard educated MD MPH with 42 years experience, working this practice since 1989. I run an old fashioned General Practice/Walkin Practice and am on call 24/7 via pager and cellphone.  This generally means that all calls are handled before 9PM, and then we see those who called, the very next day, on immediate followup.

This “bygone era” immediate care approach gives me the lowest admission rate of any physician on the local hospital staff, and extraordinary acceptance by local and distant patients. (We see patients from New Hampshire, Maine, and Massachusetts, and further) Approximately 10,000 people in the Rochester catchment area, and beyond, believe that I am their family doctor, and have been fiercely loyal.

Continue reading…

PHYSICIANS: A “black box” for docs by John Irvine

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OB-GYN Dr. Gil Mileikowsky was forced from his position at Encino Medical Center in Los Angeles after he testified in a 2003 case involving a medical mistake at the hospital. A day after confirming in court that doctors in his department mistakenly removed both of a woman’s fallopian tubes in error, he found himself being escorted from the building by security on the orders of administrators. Tenet Health Systems, the company that operates the hospital, likely rues that day.

Enraged by his treatment,  Dr. Mileikowsky went to war, becoming an outspoken advocate of changes to the federal whistle blower laws
protecting doctors, arguing that administrators use dirty tricks to destroy
the reputations of doctors who speak out when mistakes are made — labeling them as "disruptive" and organizing "sham peer review" proceedings.  His passionate arguments won the support of the Association of American Physicians and Surgeons. He would be represented in court  by star attorney Alan Derschowitz. A California court threw out Mileikowsky’s subsequent case against Tenet.  Earlier this month, however, that decision was reversed, in a ruling that likely foreshadows serious problems ahead for hospital operators who want to avoid scrutiny of safety conditions at their facilities.  Last week, Dr. Mileikowsky testified to a hearing held by the Small Business Administration on the need for added protections in the system. His solution: a metaphorical "black box" at hospitals and an "FAA" to monitor safety conditions in the healthcare system. In this YouTube segment he talks about the issues involved and the current state of safety reporting. — John Irvine

UPDATE: You can learn more about Dr. Mileikowsky’s campaign against medical errors at the web site of the organization he founded, the Alliance for Patient Safety.

BLOGS: Healthcare blog 100

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So a couple of people have pointed me to the Healthcare 100. I was amused elated to find that I am #8. Actually it’s not really a health care blog list, it’s a health care and medical blog list. And the #1 is London Ambulance man who writes Random Acts of Reality. But then I was crushed to find on davidrothman.net that only a few days ago I was in the top 5. Now THCB is in free fall!

More seriously, it’s a fun list, but probably the leading blog in all of health care (certainly in term of revenue generation), HISTalk, isn’t on it

JOB POST: Data analyst – IPRO

IPRO,
one of the leading health care quality improvement organizations in the
United States, is seeking a talented, motivated individual to bolster
our health informatics analysis in the production of Web-based health
care report cards. The position is part-time (22.5 hrs. per week), and
the work week is flexible.

IPRO’s clients include federal and
state agencies, health care providers, managed care organizations,
commercial insurers, corporations, business coalitions and unions.

Continue reading…

HEALTH2.0/TECH: Another Health2.0 aquisition–Healia snapped up by magazine & publishing giant

Healia, one of the leading new health care vertical search engines, despite being an early stage start-up, has already attracted the attention of the big boys. And one of them, Meredith the publisher of lots of female-aimed magazines, decided that it liked it so much it bought the company yesterday. It’s going to use the technology at home, and then try to sell it on.

In addition, Meredith and Healia will expand the functionality of Healia.com and will offer the technology through licensing and distribution agreements with select health organizations, consumer Web sites, employers and other premier partners.

Hopefully they’ll let it alone enough to let Tom Eng and his team keep building it out.

POLICY: Eye-candy, Channel swimming and care for the uninsured.

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This kid (young man’s name is John Heineman) is swimming the English channel to raise money for a free clinic in Iowa. His aunt wrote to me pointing it out, and he certainly sounds like a very interesting and incredibly determined guy. He’s combining an interest in health policy with charity work and incredible sporting fortitude/insanity. Even thought he went to Oxford, I wish him lots of luck.

Of course the picture is for enjoyment of the female/gay readers of THCB!

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