Lansing Personal Injury Lawyer - doctors

Medical Residency Programs' Acceptance of Pharmaceutical Industry Aid Raises Ethical Questions

David Mittleman — Fri, 26 Feb 2010 10:00:00 GMT

According to a survey conducted in 2006 and 2007, ¾ of the program directors responsible for medical residency programs that responded said that they believed it “was not desirable” to accept financial support from the drug industry. However, it seems that their ethics and morals might not match up with their practices.

In the same survey, published in the web version of the Archives of Internal Medicine, the surveyors found that drug companies paid for educational materials like pocket guides in 83% of medical residency programs that accepted their support, meals in 90%, office supplies in 68%, and drug samples in 57%. Moreover, medical residency programs in the South were much more likely to accept the aid than those in the Northeast—a comparison of 72% to 47%.

The news sent up a red flag for The Association of Program Directors in Internal Medicine, the group in charge of the survey. Specifically, when medical residency programs accept financial gifts from the drug industry there are definite conflicts of interest. Particularly, it is problematic for young doctors to receive so much of their financial support from drug companies, especially when they will be prescribing prescription drugs for the very first time. Additionally, the Program Directors discovered a connection between medical residents’ abilities to pass the test given by the American Board of Internal Medicine and their acceptance of drug industry aid. That is, programs where fewer graduates passed the tests were also those who accepted the greatest amount of financial support from the drug industry. While several schools have stopped accepting drug industry financing, there are still those who do. The reason many cited was that they received inadequate funding from other sources. While that seems like a more legitimate reason for taking the money, other excuses weren’t as palpable. For example, other respondents cited the popularity of drug industry perks amongst medical residents, while others said that there was encouragement from administration to do so. However, there is one group who could possibly ban pharmaceutical financing in all medical residency programs: The Accreditation Council for Graduate Medical Education. Nevertheless, the survey did not call for a blanket ban, but for more research.

Originally posted at InjuryBoard by David Mittleman

Going to the Hospital May Be More Hazardous to Your Health Than Staying Home

David Mittleman — Wed, 24 Feb 2010 10:21:37 GMT

Feeling sick? Going to the hospital may be more hazardous to your health than dealing with the illness you’re already experiencing. At least that’s been the experience of nearly 50,000 U.S. medical patients who have died from a hospital-acquired infection that they wouldn’t have gotten otherwise. Specifically, according to recent study conducted by the Center for Disease Dynamics, blood poisoning and pneumonia claimed 48,000 lives in 2006 alone, and led to 2.3 million extra patient-days and cost $8.1 billion. Overall, these two illnesses are responsible for one-third of the 1.7 million infections U.S. patients acquire from hospital stays each year.

The study researchers used the largest database that includes hospital discharge records from 40 different states. Overall, they discovered that patients who underwent invasive surgery or elective surgery were at the highest risk for developing blood poisoning or pneumonia. Furthermore, hospital-acquired pneumonia extended a patient’s stay by 14 days and added an additional $46,400 to the initial hospital bill. Similarly, hospital-acquired sepsis also extended a patient’s stay by almost 11 days and added an average of $32,999 to the final bill.

Sadly, the researchers also found that many of the incidences of these infections could have been easily prevented by improving hygiene in clinical setting. Two doctors at John Hopkins, Doctor David Murphy and Doctor Peter Pronovost, also wrote an accompanying editorial to the study published in the Archives of Internal Medicine. In the editorial they stated their concern with the growing problem of preventable hospital-acquired infections:

The knowledge that patients continue to experience harm from their interactions with the health system is unconscionable.

Originally posted at InjuryBoard by David Mittleman

NY Governor Patterson Proposes Legislation Restricting Pharmaceutical Company Gift-Giving to Docs

David Mittleman — Tue, 02 Feb 2010 10:21:54 GMT

New York’s Governor Patterson recently proposed tougher laws that would prevent pharmaceutical companies from giving gifts to doctors to entice them to promote the use of specific prescription drugs to their patients. Despite recent problems with the gift-giving practice, the pharmaceutical industry is fighting the governor’s proposal, arguing that the federal government already regulates its marketing practices.

New York isn’t the first state to propose legislation that affects pharmaceutical companies. In fact, nine other states have already enacted legislation. Overall, Governor Patterson argues that the proposed legislation “will benefit patient care and reduce costs in the Medicaid program, as more expensive drugs will not be prescribed for the wrong reasons.'' Nevertheless, Jan Faiks, a pharmaceutical company vice president argues that the move is unnecessary since the industry already has a voluntary code of conduct. However, as Lisa Ullman, the assistant counsel to the governor counters, the code of conduct is voluntary and not all pharmaceutical companies have adopted the code. Most importantly, there are no enforcement standards.

Under Patterson’s proposal, drug makers that violate the law would pay between $15,000 and $250,000 per violation and health care professionals who broke the law would pay $5,000 to $10,000 per violation. The New York Department of Health would be responsible for enforcing the law, relying on whistleblowers to report pharmaceutical abuses. While Patterson and his administration don’t estimate much in extra revenue from cutting Medicaid payments for prescription drugs, they do want New Yorkers to be safe and to know that they are being prescribed medications for the right reasons.

Originally posted at InjuryBoard by David Mittleman

Latisse Users Choose Vanity Over Eye Health, Eye Doctors Argue

David Mittleman — Wed, 09 Dec 2009 10:00:00 GMT

Preying upon women’s vanity, Allergan has seen its sales skyrocket to $47.7 million since introducing Latisse as an option to grow longer eyelashes. Using actress and model Brooke Shields as a spokesperson, Allergan expects that sales will continue to increase to $70 million by the end of this year. The success of Latisse, however, concerns some ophthalmologists who argue that the medication can cause eye irritation, redness, infection, itchiness, and darkening of the skin around the eye. Most importantly, eye doctors argue that the desire for pretty eyelashes is taking precedence over healthy eyes.

In fact, Latisse isn’t the original name of the drug, nor was growing longer eyelashes its primary aim. Instead, Latisse was originally marketed under the name Lumigan and was prescribed to treat glaucoma. Longer eyelashes were simply a side effect of the medication that translated into larger profits for Allergan, the maker of the product.

As increasing numbers of dermatologists, plastic surgeons and medical-spa physicians prescribe the drug, eye doctors are concerned that many Latisse users haven’t undergone a full eye exam. Moreover, the original version, Lumigan, wasn’t even approved for treating glaucoma until 2001. What specifically concerns eye doctors is that there is very little long-term data available on the effects of Latisse on the health of the eyes.

Originally posted at InjuryBoard by David Mittleman

Nine-Year-Old Florida Girl Nearly Dies from Misdiagnosed H1N1 Virus

David Mittleman — Thu, 03 Dec 2009 15:05:33 GMT

Rapid flu tests are used to determine if a patient has the illness so that doctors can immediately being treatment. However, in Hayli Murphy’s case, she almost died as a result of an incorrect diagnosis from a rapid flu test. In fact, some doctors are concerned that their peers are becoming too reliant on the rapid flu tests and are ultimately misled into not treating sick patients.

Hayli is 9-years-old and came with her mother to the emergency room on September 21, complaining of a high fever. She was given the rapid flu test, which showed a negative result. Nevertheless, Hayli’s mother brought her back to the ER the next day when her fever reached 104 degrees. Again, doctors gave Hayli a rapid flu test that came out negative. Instead, the doctors diagnosed her with pneumonia and sent her home with antibiotics. By the next day Hayli was so sick that her mother had to carry her into the ER. Finally, doctors administered Tamiflu, the antiviral used to kill the H1N1 virus, but Hayli still couldn’t get better. Instead, she spent the next 43 days in the intensive care unit, struggling for her life.

During her stay at the hospital, doctors gave Hayli a DNA-based test that proved that she was infected with H1N1. The DNA test is highly accurate, but takes more time to process. But now more doctors are urging their peers to use this type of test instead of the rapid flu test. In fact, according to some studies the rapid flu tests is only accurate 50% of the time. Furthermore, doctors urge patients to watch for the following signs in their children to determine if they might have the H1N1 virus:

· Fast or troubled breathing
· Numb or blue finger or toes
· Can’t touch chin to chest
· Symptoms improve and then return
· A fever with a rash

The Centers for Disease Control estimates that out of the 8 million people under the age of 18 who contracted H1N1 between April and October, 36,000 were hospitalized and 540 died. Please remember the tips above if you are concerned that your child has the H1N1 virus.

Originally posted at InjuryBoard by David Mittleman

The Doctor Is In and He Says Tort Reform Isn't the Cure

David Mittleman — Wed, 28 Oct 2009 16:26:12 GMT

Even doctors are starting to speak out about our insurance crisis. I recently read a post online by Rahul K. Parikh, M.D. that had me nodding my head. Dr. Parikh went straight to task and took on the proponents of "tort reform" (Crooked Justice) with the following line:

"There's nothing "sure or quick" about changing medical liability laws that will improve healthcare or its costs. Defensive medicine adds very little to healthcare's price tag, and rising malpractice premiums have had very little impact on access to care."

Why does he get it? It's because he's willing to look at the facts and put people first, not profit, not even his own profit. First, he noted that no matter how you look at it, malpractice lawsuits aren't the major factor in rising health care costs. As Dr. Parikh put it:

malpractice costs account for less than 2 percent of healthcare spending. Saving 2 percent of the over $2 trillion we spend on healthcare isn’t going to bend the cost curve.

Second, malpractice lawsuits are not frivolous. By and large, if you're willing (both as a client and a lawyer) to go through the incredible expense of suing a doctor or hospital, something truly significant has probably happened to you. Dr. Parikh reviewed a Harvard study published in the New England Journal of Medicine. He nails it on the head when he says:

Most of the suits were not frivolous: Almost two-thirds of cases involved errors by doctors.
Seventy-three percent of injuries in which a doctor committed an error resulted in payments. Seventy-two percent of cases in which there was an injury not due to physician error did not result in payment. Those conclusions do not paint the picture of a medical-legal system burdened by ambulance-chasing lawyers and their litigious clients.

Yes, that's right. Lawsuits were more likely to result in payment when the doctor made an error. Lawsuits were more likely to result in no payment if there was no error. Where's the frivolity? It's PR propoganda.

What isn't propoganda is the following. Tort reform will not save lives. Giving doctors and hospitals less incentive to improve practices and maintain care at high levels only puts us in jeopardy. Maybe that's what the doc meant when he wrote:

So for those who push tort reform as a panacea for a sick healthcare system, working to prevent injuries is a much more noble pursuit than writing up baseless arguments for the back pages of a newspaper.

Originally posted at InjuryBoard by David Mittleman

Autoimmune Disorders in Women: What to Look For and What to Tell Your Doctor

David Mittleman — Sat, 24 Oct 2009 10:00:00 GMT

Here is a daunting fact: one in five Americans has an autoimmune disorder, which occurs when the immune system attacks itself. Moreover, about ¾ of those with an autoimmune disorder are women, or about 22 million women total. However, there is an even more disturbing trend amongst women with autoimmune disorders: 40% of those who are eventually diagnosed with an autoimmune disorder were initially told that they were “too concerned with their health”. Essentially, a large percentage of women with serious immune problems are passed over and told they’re hypochondriacs.

However, armed with some simple information, you could prevent yourself from falling into the category of women who suffer needlessly. In fact, health experts say that the best way to protect yourself is to educate and empower yourself by learning names, risk factors, symptoms, and treatments for the seven most common illnesses women face.

1. Polycystic Ovarian Syndrome—the most common type of hormonal disorder among women of reproductive age, and one of the leading causes of infertility. It stems from having levels of androgens, a male hormone, that are too high. The most common symptoms are irregular periods (or none at all), more hair on the face, chest, back and limbs, moderate-to-sever acne, baldness, and rapid and substantial weight gain that seems impossible to control. There is no single way to diagnose PCOS, but your doctor can check your reproductive organs for signs of mass growths using a pelvic or vaginal ultrasound. However, it is your responsibility to first inform your doctor that you have the aforementioned symptoms. Otherwise, the doctor may never know that there is a serious problem because the illness is so easily written off to bad diet, lack of exercise, or other “simple” explanations for seemingly benign symptoms. While there is no cure for PCOS, it can be controlled with birth control pills and Metformin to help regulate the hormonal production.
2. Fibromyalgia—doctors aren’t sure what causes this painful disorder, which results in symptoms that include pain, numbness and exhaustion, and often begins in early or middle adulthood. While there is no lab test or physical exam that can find fibromyalgia, doctors can do a tender-point exam, which identifies places in the body that are painful to the touch despite no immediate physical signs. The test is positive if 11 out of the 18 spots tested come back positive. There is no way to cure fibromyalgia, but sufferers can take over-the-counter pain medications to quell the pain. Furthermore, stretching, exercise, and massage can ease pain as well.
3. Chronic Fatigue Syndrome—at least 1 million Americans are believed to have CFS. However, doctors are unsure what causes the extreme fatigue that is common to the disorder. Some studies indicate that it could be related to dormant viral infections, hormonal imbalances, and stress. The common symptoms include decreased physical or mental activity that doesn’t improve despite long periods of rest. Loss of concentration and unexplained muscle pains are also common symptoms. In order to diagnose a patient, doctors must rule out other conditions that cause similar problems, such as Lyme disease or thyroid problems. While there aren’t any treatments or cures, Ritalin has been effective in some patients in reducing fatigue. However, the treatment is still experimental.
4. Lupus—there are four types of Lupus, however the most common is systemic lupus erythematosus. SLE is a nightmare: a malfunction in the immune system causes the body to attack itself, including wreaking havoc on the skin, joints, lungs, kidneys, nervous system, and blood. Doctors suspect that hormones play a vital role in the development of the disorder, particularly because women are usually diagnosed between the ages of 15 and 45. Overall, lupus seems to strike during or following a pregnancy. The most common symptoms include fatigue, fever, joint pain and stiffness, chest pain, memory loss, and skin lesions. A diagnosis of lupus is confirmed if a patient has at least four symptoms: a facial rash after exposure to sunlight, painless mouth sores, kidney disease, swelling of the lining around the lungs and heart, and low counts of red blood cells, platelets, or white blood cells. While there is no cure for lupus, mild cases can be treated with over-the-counter painkillers. Moreover, anti-malarial drugs have proven useful in stopping the progression of the disease, while corticosteroids counter inflammation in the joints and lining of the heart and lungs. Overall, doctors suggest leading a balanced life since emotional stress seems to trigger episodes of lupus.
5. Multiple Sclerosis—MS strikes when the immune system attacks the protective covering of cells in the brain and nervous system. Eventually the destruction of the cells causes a breakdown in communication between the brain and body. Women are three times as likely to develop MS, and most scientists believe there is an environmental link like exposure to viruses or toxins. Classic symptoms include numbness or weakness in the limbs, dull pain, fatigue, and vision problems. Despite these symptoms, it is difficult to diagnose MS and to distinguish these symptoms from others that are related to other diseases like Lyme disease. However, tests for these other diseases can help rule out any other options and ultimately narrow the diagnosis to MS. Currently, those with milder symptoms from their MS are treated with corticosteroids. Other sufferers with more serious symptoms are put on an immunomodulator drug that helps prevent a complete relapse in muscle weakness and other symptoms. Exercise is also a crucial component in maintaining strength, muscle tone, coordination, and balance.
6. Rheumatoid Arthritis—RA attacks the lining of the joints through the immune system and can cause swelling, aching and potential deformities. The symptoms are easily detectable: simple activities, such as climbing the stairs or opening jars, can cause tremendous pain. It is difficult for doctors to diagnose RA, however, blood tests can reveal an antibody that is related to RA. Treatments include alpha inhibitors, or drugs that fight the inflammatory proteins. A second treatment is called DMARDs, which help to slow, reduce, and prevent joint damage. Finally, corticosteroids can cut inflammation around the joints, but become less effective over time.
7. Irritable Bowel Syndrome—simply stated, sufferers experience serious bowel problems including gas, diarrhea, and constipation, as well as abdominal cramping and pain. Doctors can usually pinpoint the problem by using the “Rome criteria”. In other words, if a patient experiences 12 weeks of symptoms out of 12 months, they most likely have IBS. The treatment is also very simple: eat more fibrous foods. Furthermore, some patients have found relief by using peppermint oil, a natural antispasmodic that can ease abdominal pain.

While most of these autoimmune disorders cannot be cured, they can still be controlled via simple methods. Be forthright with your doctor if you experience symptoms that you believe could be related to an autoimmune disorder. Most importantly, be persistent! If your symptoms bother you and interfere with your daily life, there is probably a more serious problem that needs further attention.

Originally posted at InjuryBoard by David Mittleman

Five Hospital Secrets That Could Save your Life

David Mittleman — Thu, 01 Oct 2009 12:57:25 GMT

Most of us don’t enjoy a trip to the hospital. If you are already sick, the first priority on your mind is getting better as quickly as possible so that you can get out of the hospital and back to your daily routine. While most patients do get in and out of the hospital with relative ease, according to several sources there are many who don’t.

For example, according to a 2006 study by the Institute of Medicine, on average, one person at every hospital is harmed by a drug error. Furthermore, The Centers for Disease Control estimates that roughly 2 million people a year die of preventable hospital-related infections. Finally, according to HealthGrades, a firm responsible for ranking healthcare facilities, about 195,000 patients die each year from hospital mistakes.

However, there are five secrets that the medical professional community doesn’t want you to know. These little-know ways of protecting yourself could save your life.

#1 Avoid the most dangerous month in the hospital, July. New interns start working that month and with the adjustment to the new environment, long hours, and stress of all the new responsibilities, you can expect increased errors in patient care. In fact, a National Bureau of Economic Research study of 200 major teaching hospitals, the influx of new interns corresponds to an increase in patient deaths by 1,500 to 2,750 per year.

#2 Checking a hospital’s rating can save your life. Preventable in-hospital medical errors cause more deaths than Alzheimer’s, diabetes, pneumonia, or kidney disease. The majority of medical errors are caused by improper diagnoses or failure to treat a problem in a timely manner. Checking into a hospital’s record on medical errors could save your life.

#3 Don’t just conduct a background search on your surgeon prior to your surgery—check your anesthesiologist, too. While complications from anesthesia are rare, they do sometimes occur, and can be deadly when they do. Ask your anesthesiologist the following questions: 1) What are your qualifications and are you a medical doctor trained in anesthesiology? 2) How many procedures have your performed? 3) Who else might be aiding you in my anesthesia care? 4) Will you monitor my heart and breathing? 5) Is an anesthesiologist on-call to the recovery room?

#4 You are not required to pay for your hospital and doctors’ medical mistakes. Since October 2008, Medicare stopped paying for hospital errors. If you are asked to pay for a medical infection or error, just say “no”—most likely, your hospital and doctors will not be able to pursue for payment due to Medicare’s decision.

#5 Your medical records aren’t as confidential as medical professionals would like you to believe. HIPAA doesn’t protect you from everything. For example, there are several exceptions: 1) Hospitals and doctors can share your information with other affiliated organizations, such as providers is other states. 2) Hospitals sometimes use some of your information to solicit donations. You can opt out, but many patients don’t understand their rights to do so. 3) Hospitals are required to turn over any of your medical information if asked to so for national security reasons. Talk about a total abandonment of privacy: there is no court order or review necessary prior to disclosure.

Please keep these five secrets in your mind the next time you have to make a trip to the hospital. It could save your life.

Originally posted at InjuryBoard by David Mittleman

Tort Reform Revisited: Why It Isn't the Answer to All Our Healthcare Cost Woes

David Mittleman — Mon, 21 Sep 2009 09:24:12 GMT

Yesterday I wrote about the curious case of McAllen, Texas and how putting caps on medical liability payouts wasn’t the magical cure for reducing the rising cost of healthcare. Nevertheless, doctors and Republicans seem to have a one track mind when it comes to this issue. For decades, these two groups have argued for tort reform, despite studies and real life case studies that show that capping jury awards in malpractice cases does nothing to lower health care costs.

Unfortunately, now President Obama wants to follow the same path. Deemed an “olive branch” to bring together Democrats and Republicans on this sensitive issue, the President recently directed the Health and Human Services Department to spend $25 million to help states and health care systems find alternative ways to resolve medical malpractice claims. Nevertheless, he has declined to put a national cap on malpractice awards, much to the chagrin of some doctors and Republican lawmakers.

Tort reform advocates like to argue that putting caps on malpractice awards will help decrease medical costs for doctors, which also means reduced costs for patients. Indeed, recent studies by the nonpartisan Congressional Budget Office showed that putting caps on medical malpractice awards would reduce doctors’ insurance liability payouts, which, in turn, would reduce medical fees for patients. However, the reduction in costs is extremely modest—in fact; national healthcare spending would go down by a meager .2 percent. Medical errors cost 44,000 people their lives each year: that’s more than the number that are killed by highway accidents, breast cancer, or AIDS annually. In light of those daunting statistics, it hardly seems worth the .2 percent savings in national healthcare spending to take away patients’ legal remedies for medical injuries that were caused by no fault of their own.

Michigan has some of the nation’s toughest caps on medical malpractice payouts: $410,800 for non-economic damages such as pain and suffering. So patients aren’t getting a windfall payout when they do sue, despite what some tort reformers would like you to believe. Instead of always blaming the lawyer or the “sue-happy patient”, maybe it’s time to point our fingers at the malpractice insurance industry that charges astronomical amounts simply because they can. More importantly, let’s focus on improving patient safety to being with.

Originally posted at InjuryBoard by David Mittleman

Reforming Health Care from Inside (Part II)

David Mittleman — Sat, 13 Jun 2009 07:51:00 GMT

Yesterday I wrote about the current state of the American health care system and the dangerous effects of its volume-based capitation method of compensating providers. Today I wanted to discuss the potential solution.

The recent New York Times article I mentioned yesterday discusses how some doctors are taking a more proactive approach to health care. Rather than wait for a seriously ill patient to come see them, these pioneering physicians are willing to see patients at the first sign of trouble. By utilizing technology to enhance their efficiency and reduce costs, the doctors are able to spend more time with each patient and address all potential issues before they worsen.

In my practice I have seen a number of cases where early, thorough intervention could have made a life-altering - or life-saving - difference. In one instance, a few more minutes spent with a patient might have resulted in a correct diagnosis and appropriately aggressive course of treatment. Instead, the patient was given a prescription for over-the-counter medication and sent home, where he died 24 hours later.

The answer seems to tie together the concepts of prevention, education, and a return a stronger doctor-patient relationship. For their part, patients should be engaged in their own health care and not afraid to ask questions. However, doctors have a monopoly on the information and expertise, and those who take proactive steps to educate and treat patients should be commended.

Originally posted at InjuryBoard by David Mittleman