Gene Uzawa Dorio is an internal medicine physician who blogs at SCV Physician Report.
Four years ago, as chairman of the hospital ethics committee, I was asked to convene an emergency meeting brought by a distraught family as medical decisions had to be made for their ill loved one. The hospital, HMO lawyers, the family, three adult children, and their mother were at the meeting.
The father had arrived at the hospital unconscious and was admitted to the intensive care unit, where medical care was …
Harriet broke her hip and needed surgery. Post-operatively, the hospital was swift to push her out the door, while Medicare controlled the financial strings. Instead of going home, she went to a nursing home.
During the pandemic, she never saw her family in person, then contracted COVID-19 and died alone.
For over 30 years, I have visited patients in nursing homes, and during this time saw older adults shepherded by the health …
A pediatrician decides a struggling teen with mental illness needs hospitalization to neutralize psychologic demons impacting their personal and social life.
A workers’ compensation doctor requests a neck MRI in a powerline worker with growing right arm numbness and weakness to search for potential paralyzing nerve impingement.
An orthopedist orders special testing to determine if an elder patient with right hip pain which limits walking and driving might need surgery to improve …
I had never heard the term “throughput” before a meeting at our hospital two years ago. It was used to discuss how the emergency department (ED) could yield greater profits by faster patient turnover. Coordinating various duties (including intake, admitting, and cleaning staff; lab and radiology; nurses and doctors) patients could be shuttled into and out of the ED earning the hospital $2 million more per year.
This strategy was implemented …
Hospitals have always served as a lifeline to survival. Whether from pneumonia, heart attack, stroke, or trauma, they have been a community safeguard between life and death.
Today, a cost of care has been added to the patient treatment discussion forcing medical decision-making to look closely at expense. Financial considerations have come to the forefront as preservation of resources will be important to national health care. This can be a threat …
Born in Canada, our mother came to the United States after World War II and blended into the Greatest Generation. Raising a family in the second half of the 20th century saw her contribute to a thriving American society then maintain retirement health on Medicare. But in her early 90s, this tranquility was threatened when her HMO hospital tried to kill her.
She went to the emergency room with symptoms of …
Most primary care physicians (PCPs) who admit patients to a hospital are family practitioners or internists. Since medicine becomes more complex each day, PCPs must remain up-to-date on the latest treatment related to drugs, surgery, procedures, risks, complications, and costs. This might require your PCP to be a quarterback bringing together a team of consulting specialists to guide you through your hospital stay.
The economics of hospitalization are changing, and since …
You have a persistent cough and poor appetite, but for six months your doctor has prescribed an assortment of antibiotics after an initial chest x-ray showed a small pneumonia. Finally, short of breath, you go to the emergency room where a CT scan reveals untreatable lung cancer. Later you find your doctor has received a bonus from your HMO insurer for not ordering a CT scan earlier.
Physicians count on experience …
Two decades ago, I admitted a patient to the intensive care unit for a heart attack. His children were grown, and he looked forward to retirement purchasing an RV to relax and travel the country with his wife.
Invasive cardiac technology had not evolved, so he remained in the ICU on intravenous medication to control his symptoms. On the fifth hospital day, his wife brought a letter from the insurance company …
Draping a shroud of 30’s Depression on any dust bowl child can thicken the skin, so my 88-year-old patient learned to be fiercely independent with a “talk to the hand” attitude, and “don’t get in my way” personality. Even after her husband passed away, she remained autonomous traveling and golfing in her social circuit.
Living life as a smoker was always a threat to her health, and this year became a …
Once the 2008 economic spiral began and, unemployment escalated with wallets and purses zipped closed, causes were not initially recognized. Since then, the causal details of this downturn were ferreted out pinpointing emanation from Wall Street banks.
Public discontent demanding change has been ignored allowing potential for recurrence. Why? Business has influenced legislators swaying their vote as they filled campaign coffers.
In the …
When you go shopping, everything has a price tag. Buying a new car is challenging, but ignoring dealership costs may result in sticker shock when you receive the first payment notice three weeks later. Few of us would ignore costs this way.
In actuality, this happens everyday in health care as we interact with medical professionals, have an examination, and are given treatment without knowing the price.
Headlines alert us how health …
Two decades ago, a decision was made by Medicare policymakers that carotid endarterectomies would not be allowed. Their claim was too many were being done costing Medicare money. The following year, data revealed a sharp rise in debilitating strokes, so wisely, surgical criteria was developed recommencing the use of this quality-of-life saving operation.
For years, there have been other misjudgments against Medicare patients that are only now becoming apparent. Let me clarify …
In his farewell address to the nation on January 17, 1961, President Dwight D. Eisenhower warned the American people about the looming “military-industrial complex” which would sway public mindset and enhance money flow from government to the defense industry. This concept persists today with the practice re-adapted and launched against the health and welfare of the American people through the “hospital-industrial complex.”
Health care organizations like the California and American Hospital …
“Throw grandma under the bus” clearly conveys anger, sympathy, and fear when health care decisions are made outside the realm of medical professionals. Within the doctor-patient relationship, alignment of physician expertise with an individual’s personal decision should keep insurance company executives, hospital CEOs, and government authorities from interfering.
Are we naive to believe interference isn’t already occurring?
A doctor orders a breast MRI to further evaluate an abnormal mammogram, but the insurance …
Advancing technology has allowed life to be simple. Nowadays, when you go shopping, you slide a credit card and voila, sold. Why does it seem though some things are getting more complicated?
Dioctyl sodium sulfosuccinate is another name for Colace. We are forced to have two names for one drug: a brand name, and a generic. The pharmaceutical companies tell us they have patents mandating we live in their complicated world, …
Over the past twenty years, Wall Street business has covertly taken over the medical profession while doctors have been distracted by a deluge of procedural, financial, and legal paperwork. A strategic plan was launched to extract exorbitant profit benefiting business, and is now mainstream without challenge from our profession nor the public.
Legal boardrooms were abuzz in the 1990s as a blueprint assault was made against organized medicine, redirecting a profession into a …
We are fortunate in our country to have the best medical technology in the world. Unfortunately, delivery of this technology, reflected in a worldwide healthcare ranking of 37th, is a disservice to the American people and must be rectified especially when Cuba is ranked 39th.
As provisions of the Affordable Care Act are put in place, a daunting factor is the shortage of doctors who will be needed to provide this …
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