Law Pushing for Cameras in the Operating Room
“Julie’s Law” is a Wisconsin bill named in honor of Julie Ayer. The patient had breast augmentation surgery in 2003. Sadly, the patient flatlined during the procedure. CPR was initiated, but too late. The patient was transported back to Wisconsin where she died three months later. According to … Read more
Doctors Flummoxed by DNR Tattoo
A recent report in the New England Journal of Medicine highlighted a case of a patient who presented to the Emergency Department, unconscious, with a Do Not Resuscitate tattoo sprawled across his chest. The 70 year old man was quite ill on arrival. His blood alcohol level was … Read more
Not Mastering the Art of Being in Two Places at One Time
Dr. Reinaldo de los Heros was practicing as a psychiatrist in Maine. On October 10, 2017, the Board of Medicine suspended his license for 30 days. (He had multiple interactions with multiple Boards of Medicine throughout the years. For example, in 1999, he pleaded guilty in Massachusetts for Medicaid … Read more
Necessary Action or Elder Abuse?
This story caught my attention. I have mixed feelings. Dr. Anna Konopka is a general practitioner in New London, New Hampshire. Ever heard of it? Neither had I. 4,000 people live there. Not a big community. Dr. Konopka graduated from medical school in Poland in … Read more
The Migration from Third Party Insurance to Accepting Risk
This is not a story of medical practices becoming insurance-free. This year, a number of friends and colleagues explained they received a note from their long time health insurer. These were all people insured on the individual market. Their insurance plans were “grandfathered” so they … Read more
Who Bears the Risk for Medical Decisions About Pacemakers at Risk of Being Hacked?
Thirty years ago, no one would have thought of this scenario. Hacking into a pacemaker to cause harm. Abbott Laboratories release a software path (firmware update) in late August to reduce the risk that someone with malicious intent could gain unauthorized access to a patient’s … Read more
Divorce Is Politics by Other Means
Carl von Clausewitz was a Prussian general and military theorist who famously said: “War is a mere continuation of politics by other means,” (“Der Krieg ist eine bloße Fortsetzung der Politik mit anderen Mitteln”). I leave the full parsing of its meaning to other military strategists. But, the quote serves as a useful segue to discuss how … Read more
Cease and Desist
If you’re a surgeon, I have little doubt you have done a stellar job in selecting your patients. You’ve never made a mistake. Never looked back and wondered “What was I thinking?” Never overruled your staff when they detected “red flags.” Never talked yourself into … Read more
Delivering Bad News – or Delayed Good News – to Patients
When a person is sick, they are stressed and anxious. No surprise. And it’s human nature to fill in the blanks with bad news. That’s why ambiguous information can be magnified into a worst case scenario. A close relative was being evaluated to a medical … Read more
WTF is MACRA?
I’ve had it with acronyms. SGR [Sustainable Growth Rate] was replaced by MACRA [Medicare Access and CHIP Reauthorization Act] which allows physicians to choose between two Medicare payment programs: (a) MIPS [Merit-Based Incentive Payment System; and (b) APMs [Alternative Payment Models]. According to CMS [Center … Read more
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