Wednesday, March 3, 2010

Gerald O'Malley, DO: Some thoughts on the healthcare summit

Today, I worked a 7-3 shift in the ER while our political leaders were meeting to talk about what to do with healthcare. Ironic, considering there are roughly two dozen physicians in Congress and not one was seated at the table. Can you have a serious summit on energy policy without engineers? Can you have a serious summit on national security without law enforcement experts? The only members of the government that actually have any experience with the actual delivery of healthcare were absent, which should tell you everything you need to know about the healthcare summit of 2010.

As the snow swirled around outside in the most recent snowpocalypse to affect the city this winter, we struggled to get our patients out of the waiting room and into an exam room as quickly as possible. We waded through their poorly described complaints and tried to identify any life threatening problems quickly and efficiently.

We probably saved a half-dozen lives in eight hours; an acute myocardial infarction and a stroke, an ectopic pregnancy, an acute appendicitis, and a septic old lady were all “rocked and locked” — a euphemism for getting the job done quickly and expeditiously. In addition, we treated a number of “non-life threats” — broken bones and lacerations and asthma attacks and strep throats.
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We tried to follow the proceedings on TV and online whenever we could, but I had to wait to get home to watch the news in order to digest the proceedings.

I heard a lot of sound bites (mostly from Republicans) asking for tort reform, but beyond the sound bite, there was no follow-up discussion. The trial lawyers have spent so much money buying access and influence that I doubt any meaningful tort reform is possible.

Some idiot congressman actually suggested that a plan for “stealth patients” be written into the bill in order to “root out Medicare fraud.” He said that we should send “fake patients claiming to have broken legs” to MRI centers and if “they continue to treat them like broken legs, then we know there is fraud going on.” There are so many things wrong with that statement, including the fact that broken legs are not diagnosed by MRI, that I don’t know where to begin, and what’s worse is that this half-wit congressman was actually describing something that had been proposed by Senator Tom Coburn, who is an obstetrician! Maybe the physicians shouldn’t be at the table, if they are going to make ridiculous suggestions like that!

After work I picked up my kids and was driving home when I received a “remember that patient you saw the other day” phone calls from my vice chairman: “Gerry, you need to meet with risk management next week to talk about this case.” You don’t actually need malpractice to be sued — all you need is a bad outcome.

What are the odds that this patient was a “stealth patient” or someone that is already talking with a lawyer?

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