text"Medicine (and the post office) are the only
Transcription
text"Medicine (and the post office) are the only
text"Medicine (and the post office) are the only businesses that get paid no matter how badly they do. Imagine hiring a mechanic to do a tuneup, and he accidentally drops a bolt down the running engine and it breaks a valve. But he says that his tuneup ""uncovered"" the weak valved condition and now he must do an engine rebuild. While putting the engine back in, it falls on the fender making a big dent and also strikes and cracks the windshield. So you get charged for an engine, body work and a new windshield. Why don't mechanics try to get away with that and why is it so easy for doctors get paid for such incompetence?""Hear, hear.""Garrick - I wrote an article about that called ""MediCar"" where you go in for 4 new tires and when you pick up the car you are handed a bill for tires and a new windshield. They explain that it's your fault because your windshield is so clean that the new, student, intern mechanic couldn't see it and dropped a hammer on it. When you refuse to pay they say, Oh that's OK, we'll just file a suit against you and report it as a bad credit.""It's the same in Australia Shannon Koob. The taxpayer ar paying a fortune for the unnecessary radical surgery I was tricked into, because unscrupulous doctors needed guinea pigs to learn to practice laparoscopic surgery on....""The doctors and facilities always benefit when a mistake is made because insurance companies pay no matter what, and this includes Medicare. If the mistake results in a longer hospitalization or time in a nursing home, these facilities get paid; the specialists who are called in get paid well too. Mistakes actually make more money for doctors and facilities."Marian I absolutly agree! Its true and then we have laws like MICRA where is better off to kill a patient then rather pay on going fees for actual damages it takes to live."This is nothing new. Doctors have been getting away with ""mistakes"" for years because they know there is little or no enforcement of health laws. Even Moliere commented about bad doctors in the 1600's when he wrote, ""We can spoil a man without paying one farthing for the damage done. The blunders are not ours, and the fault is always that of the dead man...and never yet has one been known to complain of the doctor who killed him.""" "Michelle. I'm convinced of what you say. I believe that all too often what may have started out as a mistake or carelessness or even cluelessness morphs intentionally into criminality in a CYA effort. We need to call it what it is murder. As a 'gentle' start towards adopting that terminology, I'd be happy if authorities and licensing boards just started out with charging manslaughter." "Unnecessary surgeries like hysterectomy are performed for the sole purpose of making women patients for life. Why else would healthy vital hormone-producing organs be routinely removed in over half a million women every year? Facts: Hysterectomy is the second most performed surgery in the U.S. 90% are known to be medically unnecessary. Only 1% are considered to be life-saving. It doesn't take a rocket scientist to connect the dots here... Women necessarily have to turn to hormone drug pushers once they are no longer able to make their own. Big Pharma and doctors make out like bandits. Then, regardless of buying and taking artificial hormones, many women go on to develop heart disease, brain disease, eye problems, sexual dysfunction, thyroid disease, bone loss, etc., etc. and so many specialty areas/fields profit. Hysterectomy doesn't happen by accident. Hysterectomy isn't performed to save lives. Doctors hysterectomize women intentionally for profit. It is what it is. Hysterectomy is not the only surgery that purposely abuses for profit but it's probably the best and most obvious example we have. Elizabeth Plourde, author of 'Hysterectomy - The Ultimate Rape', says ""In reality, the lifetime after-care cost is in the tens of billions of dollars. Just osteoporosis alone, one of the major outcomes of hysterectomy, costs Americans between ten and eighteen billion dollars a year."" This is why everyone should care about the medical abuse of women via hysterectomy. The mentality of the doctor who abuses women for profit via hysterectomy is alive and well in many specialty areas/fields today. Many in this group know exactly what I'm talking about... I flat don't have the energy to call a spade anything but a spade at this point. No sugar-coating such evil. It's obviously wrong, unethical, immoral and it should be criminal. It's critical that those of us who've been devastated and traumatized by doctors for profit take a stand and speak out loudly at every opportunity. We must stand together on this. Please sign my petition on Change.org regarding unnecessary hysterectomy http://www.change.org/petitions/help-stop-unnecessary-hysterectomyand-castration""Allan, I would love it if law enforcement would start charging doctors and nurses with murder. The problem is, they rarely do. Every attorney and advocate I have spoken to about this have said that the authorities never ever go after a doctor. Other doctors and nurses will not testify against them because they themselves will be blackmailed or lose their jobs. If a medical ""crime"" happens in a facility, there seems to be some kind of immunity against prosecution; but if you give your loved one a little poison in his ice tea every day, that's murder because it happened outside of a hospital or nursing home. It's called ""standard of care."" or in other words, if all the doctors are ordering black box drugs without consent, it is considered acceptable. Doctors know they above the law, and they also know that any ""mistakes"" they make will make them more money. Doctors also know that if it comes to your word against theirs, they will always win, even if you have medical records that back you. The agencies that are supposed to police doctors and nurses protect them as well. For example, I filed a complaint against a nurse for falsifying a consent form for twice the amount of Ambien an elderly person should get; the health department gave the facility a citation, then the nursing board cleared the nurse, saying she had done nothing that violated the nursing code. (The investigation took 2-1/2 years.) Your best defense against ""mistakes"" is to be as informed as possible, ask questions, and ask to see your records every day.""You brought up a very significant point Marian. When enough doctors do something wrong, it's considered to be 'the standard of care'. Most people don't know realize this. That's why over half a million women end up hysterectomized every year. It's considered 'the standard of care' to remove women's healthy sex organs. Your example of doctors ordering black box drugs without consent is also a perfect example of the danger the is inherent in 'the standard of care'. Of course, no harmed patient can sue a doctor unless their doctor acted in a way that is considered to be below 'the standard of care'. Harmed patients are caught in an insidious web. In other words, they're trapped in a web that's meant to trap them.""Some (many, most or all?) States have ""Mandatory Reporting"" laws for medical ""professionals"" requiring, not asking or hoping, that if something is happening that is not right, it be reported either up the chain or to law enforcement. Nurses, doctors, pharmacists, lab workers, and other licensed medical personnel are seldom or never sanctioned for failure to report abuse, malfeasance or malpractice. If some of these people were to lose their licenses and right to earn a living in their profession for failure to report these issues, their co workers would take notice and maybe the Code of Silence could be broken as in ""Hmmm, be disciplined by my employer for blowing the whistle on someone or go to jail and lose my income"". There are also laws/regs requiring an institution to formally report a practitioner that has failed to properly treat. A few major hospitals losing their ability to accept Medicare and excluding all doctors who accept Medicare from practicing at those hospitals for these violations of the CMS Conditions of Participation would jump start to practical changes as well. It is not that we need more laws and regs., we need to somehow pressure those that have the power to use it. If everyone who has suffered and found the regulators guilty of failing to protect them as required by their charter would network with everyone they knew to pressure their State and Federal congressmen and senators to call for hearings and provide hard data to them of regulator failures, perhaps some broad sanctioning would occur? Seems to me to be a better use of time than to pressure these same public officials to tighten a reg or pass a new law or fund a new study. Maybe pressuring for strict enforcement of ""Mandatory Reporting"" would be an easier pill to swallow for law and reg enforcers than murder or manslaughter charges.""Thank you all for using the correct definition for 'standard of care' - especially in conjunction with the use of black boxed drugs. The wagons have been circled by one and all healthcare safety agencies. When a Board Certified Research Physician working for a QIO puts in writing that a black boxed drug is NOT black boxed nor would those specifically mentioned drugs mentioned in the 'non existent' black box warning intensify damages, especially given in MEGA doses. That is flagrant, in your face lying. When I asked where he got his cutting edge medical data to make that statement - he said he used a PDR would not give me the date. PDR info from Wiki - Originally distributed as a promotional item, the PDR has come under recent scrutiny with the lack of reporting of updated and accurate drug dosages along with adverse drug effects. Often dosage information can be taken from phase 1 trial information where clinical drug information is incomplete, resulting in higher PDR-recommended dosages than therapeutically effective dosages for many medications. And since most of the information is taken from drug data sheets generated by drug manufacturers, it is more likely to not include drug studies reporting the worst side-effect and adverse effect data.[2] This is opposed to evidence-based medicine or clinical reviewed material which examines all such data but is not contained within the PDR.The PDR has also been criticized for its being paid for by the various pharmaceutical manufacturers that present medications within its pages. This criticism stems from the lack of special interest disclosure and the potential for guiding medical recommendations apart from evidence-based medicine[3] The lack of medical editorial capacity within the PDR which is standard in the review of all scientific literature by informed scientific peers has also been criticized.[4]While proponents may argue that the controversies with the PDR may seem insignificant, critics allege that in fact, most physicians and pharmacists rely on it in a bound, online or PDA version for drug dosaging and the lack of transparency in its formation most certainly leads to adverse patient outcomes. This behavior by an agency of the DHHS charged with patient safety is outrageous in my opinion. But, to have the total stonewalling that harmed patients are experiencing takes even more entities to turn a blind eye.""Shannon Koob this is truly unbelieveable what happened to you. They don't call the heart a VITAL organ for nothing. You had yours EXPOSED, your body cut open, your chest cracked for nothing. UNBELIEVABLE! What was the doctor's mea culpa? Nothing more then a ""Oopise, my bad""?!? Our bodies are not our own anymore."Allen J. Van Putten - you wrote that most/all States have mandatory reporting. Can you provide some links on that?"Google 'mandatory reporting' or 'reporter' and you'll find plenty of citations. Add a State's name to make it specific to where you are. Some are general and some have special provisions for abuse of children, seniors and/or disabled.""This has mandatory reporter requirements as of 2006. http://www.americanbar.org/content/dam/aba/migrated/aging/docs/MandatoryReportingPr ovisionsChart.authcheckdam.pdf. What we saw in Virginia is that the regulators refused to apply the regulations wholesale. Folks keep saying that we need more regulations. We don't need more regulations in general, we need people to have the wherewhithal to enforcement them.""""In lawsuits and interviews, they (doctors) describe increasing pressure to meet the financial goals of their new employers (hospitals) ��� often by performing unnecessary tests and procedures or by admitting patients who do not need a hospital stay."" nyti.ms/QvAC2r""Dr. Marty Makary is scheduled to be on the ABC network show 20/20 tonight, Nov. 30, talking about his NY Times bestseller, "" #unaccountable What Hospitals Won't Tell You and How Transparency Can Revolutionize Healthcare."""Thanks David. I'll be sure to watch:)I am recording it: 9 pm CT."Well advocates, activists, seems to be a new wave of gloom and doom in the patient safety realm. Los Angeles does not stand alone, things are getting worse all over the country. So, what are we doing wrong? First thing we might think about doing is accepting this reality, and stop dancing around the term patient safety. Lets just call it ""Keeping Patients Safe from Healthcare Harm."" http://www.nbclosangeles.com/news/local/UCLA-HospitalGets-F-in-Patient-Safety-Report-Leapfrog-181282681.html""Enlisting the help of some of the fiercest patient advocates known to man, would be a start :)""Time after time, nurses, doctors, and healthcare professionals see what is happening yet are intimidated into ""keeping quiet"" the problem will continue until that issue is resolved.""This is just one case of many, where a nurse has stood up for their patient, and been crucified for their advocacy. http://www.linkedin.com/groups/Amanda-Trujillo-Fired-Advocating-Patient4172177.S.190241244Andrew Lopez""Thanks Andrew for your thoughtful comments, you are so right. I know of Amanda and her story. Amanda and others like her need to be rewarded and thanked rather then put through such misery. Healthcare delivery and the very fiber of how it is delivered is backwards and nothing will change until there is real healthcare reform. After 17 years of hoping that the system will fix itself I have accepted the fact that the changes must come from informed consumers of healthcare. Public education of the facts will make the difference. After the public begins to demand safer care, good providers will no longer fear speaking up and doing the right thing.""It can be difficult for patients & family members who have been affected by ""Healthcare Harm"" to trust doctors, nurses and ""Members of the Establishment."" I get that.""Realize though, we know the system well enough to guide you to where you can make a difference. Andrew Lopez""It is very hard for them, most providers do the best that they can do given the circumstances of the severely flawed system.""Many a health inspection, investigation has been initiated by an anonymous tip telling the investigators where to look :)""We need you to make it work, we need providers, clinicians to get out there and talk about this issue. Graciously of course, but the pubic still has little to no clue until it is way too late. Most folks believe patient safety means that patients' slip on wet floors or have personal belongings stolen from hospital rooms. The industry really does not wish to educate the public on the facts. Simple facts that some media outlets, such as this one, have brushed upon. Yet, as active as this group is, there is little concern driven about safer care to even those who are advocates for single payer, Obamacare and other healthcare related venues.""Awareness is the Key Jeni. We've made hundreds of thousands of nurses aware of Amanda's situation, it will be millions in the not too distant future. She gave us permission to spread her story via Social Media, and we have." "In telling her story, and others, we are raising awareness among consumers as well. We could look into doing something collaboratively :)""I want to see more and more insiders stand beside her, check out the video I am posting here, saw it at a patient safety conference years ago.""We are mad as hell about what has happened to her Jeni, and the world is going to know about it . . . . and how it puts patients in imminent danger.""Channel some of that anger constructively Jeni. Make examples of high profile cases and show people how it could happen to them, or to their loved ones. Show them how it is happening every day. Andrew Lopez""Been constructively doing this for over a decade. Do you know what righteous anger is? When we see greed, personal gain and fame overpower what is right and just, it soon becomes apparent that it is time to clean house.""Hmmmmm, have a websiite or somewhere I can read about it?""High profile cases are good teaching tools, but I have learned from the past that most people look at these situations as rare and unusual. Remember, 687 people die every single day due to medical harm, (according to the last study done by healthgrades). We see far less then 100 of these cases profiled each year nationally. The public is totally unaware of the true figures, and sadly, most of these high profile cases are about lawsuits, which push the consumers even further away from concern as we all have had that false sense of security thinking that lawsuits reduce medical harm."You are exactly right Jeni. Most people have no earthly idea just how dangerous healthcare/medicine is until it's too late for the reasons you state above.What are you doing December 3? The US Senate MedTech Caucus and FDA are announcing MDIC-Medical Device Innovation Consortium. Who is invited to represent the harmed patient?"ProPublicans,My 23 y o daughter's best girlfriend was yesterday diagnosed with acute myeloid leukemia (I don't know which flavor). Although I'm not consulting to the family, I'm curious to know if this disease is subject to some level of misdiagnosis..."I'm wondering if this is something Isabel the computerized symptom checker would be helpful with."My impression is that it is not. Diagnosis is the result of a white blood count, with a very striking result and an automated process. That said, lab results can be wrong with poor sample handling. I would, no matter what get a second opinion from a hemetologit and an oncologist. My best friend in kindergarten had aml and she is still around. It responds well to treatment but it looks like chemo is tough."A second opinion is always worth it! I would do that first."In any case, I didn't know about Isabel. Nice to know.""Bart, make sure that she gets a second and maybe even a third opinion. A few weeks ago I happened to turn on CSPAN and learned a great deal about young people and cancers. Please watch this video of the Natl Press Club Meeting in it's entirety. Your daughter's friend and her family will be in my thoughts and prayers.""Jene, pls provide a link to the video you mentioned." http://www.c-spanvideo.org/program/309386-1"Ok, and now for the most gruesome country in the world.... http://www.dailymail.co.uk/news/article-2240075/Now-sickbabies-death-pathway-Doctors-haunting-testimony-reveals-children-end-lifeplan.html#ixzz2DcUKj73D. So glad we have modelled our new fancy health care system on the UK."I makes you wonder if there is a conscience anywhere in the medical profession.I've wondered that from the time I was tricked into unnecessary radical surgery and harmed beyond repair Debra...."Should I write to the NY Times about this article?? And if so, to whom?? It's got so much whacky crap in it I don't even know where to begin. This is why we suffer . . . NO ONE in a position of power(?) seems to ""GET IT!"" [Or . . they do, but they also ""get"" a little something-something for doing nothing legally substantive for PATIENTS. Oh sure, bribes NEVER happen in Washington, D.C. {rolling eyes}] My point is, I would like to ""rebut"" this article because if this is the extent of what is being currently done (and proposed) to HELP PATIENTS . . .OY VEY!! All Americans, each and every one of us, are exposed to the very real risk of iiatrongic injuries, and this whacky crap is supposed to he helpful to PATIENTS?!? HOW exactly????????? http://www.nytimes.com/2012/09/23/health/new-system-for-patients-to-report-medicalmistakes.html?_r=2&"It drives me nuts too."There was a lenghty discussion about this article in this group when it came out,""Cary Parks I just read it last night and became part of the group about a month ago . . . I'm always late to the party :-( As Roseanne Roseannadanna would say ""Nevermind"" ;-)"My blog about Hospital Safety Score from the Leapfrog group now available on IPAD/Iphone. Compare facilities in your local area. Thank you at Leapfrog for this important work! http://reginaholliday.blogspot.com/2012/11/a-b-c-d-or-f-leapfrog-andhospital.html"Have three questions - Leapfrog is a non profit, who is paying the bills? Leapfrog is using data from the hospitals/CMS - who are not reporting facts to give said hospitals a grade? Hm, we have already established the reporting method is hugely flawed. You are telling patients who have been harmed to contact ProPublica - will these reports be used for some purpose?"http://epatients.net/archives/2012/11/new-hospital-safety-score-data-a-key-enabler-forinformed-choice.html E-Patient Dave deBronkart post might help on Methodology"It looks like Leapfrog is funded through dues though they might also have grants, I will have to ask.""The sources are CMS Hospital Comapre, The Leapfrog Hospital Survey, AHA Annual Survey here is more on Methodology http://www.hospitalsafetyscore.org/static/downloads/HospitalSafetyScore_ScoringMeth odology_November2012.pdf""I find it interesting that Inova Fairfax does not end up super high performing. But the ICU staffing concerns me because when I ask nurses how many patients they were covering, it was always too many.http://www.leapfroggroup.org/cp? frmbmd=cp_listings&find_by=hospital&name=inova+fairfax&cols=oa"Pro Publica is gathering information on harm. I hope they use it to shine a light on these matters and do a county by county comparison like they did for autopsy rates. But Marshall Allen could probably answer that better than I. I have hope for the White House initiative in May 2013 also. Too many people are falling through the cracks...what white house initiativeI mentioned it in the blog post from the NY times piece: http://www.nytimes.com/2012/09/23/health/new-system-for-patients-toreport-medical-mistakes.html?_r=1&"Oh, that boondoggle.""We don't need a new system - we need regulations that are in place now to be enforced. If this does get passed - how many years, how many more patients will be harmed or die. It really seems redundant to me, wasteful, inhumane. DHHS has the biggest budget of all government agencies last time I checked. They list employee numbers at 88,000+ - bet that does not include 'contractors'. Not one of them assisted, validated my well documented complaint - flagrant disregard for my civil rights, my patient's rights and caused life altering damages, which if they had read the medicine guide for the black boxed drug - would not have occurred. What am I missing? I know about the patient survey on harm. Just wondering who it will be presented to. Any grading done for hospital safety that is based on hospitals reporting/data is of no value. Hospitals own TJC, work closely with QIO's and CMS seem to coordinate with the QIO's - it's an inside job. Another extra layer, sigh."Anyone have the date logic died?Michelin Anderson The point is patients will now have more ability to judge for themselves if a facility is dangerous and get out of it. Where is your blog so I can read about your advocacy mission?"How can I ""Like"" Michelin Anderson's post 10 times. Mr Pres. You now control and have controlled agencies that have the power to mot only make this happen but effectively ban any medical service provider, from Drs., Hospitals, Nurses, pharma sales etc. from 95% +/- of their income. Why invent more costly taxpayer funded stuff that history tells us will be as efficient as, say, the post office?""Regina Holliday, you say ""The point is patients will now have more ability to judge for themselves if a facility is dangerous and get out of it."" Yeah right! Let's see, pretty much everyone using our health system understands that smoking, to say the least, is bad and that overeating/obesity is bad etc. etc. etc. How's that working? So tell me again how it will be good for ""patients"" to judge for themselves? Seems like ""judgement"" is a long lost art. We need the regulators to do their jobs and use the enforcement tools they already have. Nothing will stop a Doc like being put out of business and trading his prescription pad for a striped or orange outfit at the nearest prison.""After my husband died painfully and suffered a great deal from medical error, I have dedicated everyday of my life to the improving the rights of patients. I think all of of us must work together to create a better tomorrow. That means government, providers and patients all working together to create a system that cares for people. Each night my sons go to bed without a goodnight from their Father. I know the pain that you are speaking from, but nothing will change if we do not work together to make a better system.""Regina -would you believe I refused to admit myself to a hospital because I knew their history? Would you believe I voiced this many times, clearly, loudly? Would you believe I refused many tests - and they still did them - one - they had to knock me out totally so that was a sedative. Your theory puts the onus back on the patient - somehow I don't believe is an answer for sick people to get safe, humane medical care.""I agree with you Allen J. Van Putten and Michelin Anderson. I too told the doctors who forced me into unnecessary radical surgery that I had none of the symptoms they instisted I had, and they bullied, threatened, mislead and misinformed me until I finally gave in, because nobody had warned me that it was my body, my choice, and doctors had no right to force me into an operation I did not want and did not need.""The issue of low health literacy in the U.S. needs to be addressed if any initiatives, or even the status quo, are to work/work better. But the dysfunctional medical culture may be the primary reason for preventable medical errors.""How do you 'work' with an entity that lies? How do you deal with an entity that disingenuously avoids facts you present them in writing? Not picking on you - thank you for your devotion to this cause. I really want to know why they can't read medicine guides or acknowledge a certain black box warning exists - online, in pharmacies - how do you deal with that? I personally walk away from new doctors who do this. You really can't convince someone whose livelihood depends on certain facts to not be recognized.""June, I hope you won't give in next time. Experience makes us wiser. MA, there are some fiendish institutions around-no doubt about that.""Has anyone been keeping up with the case of Amanda Trujillo, the nurse who was punished because she educated a critically ill patient about an invasive procedure the patient was about to submit to?" http://www.nurseratchedsplace.com/2012/04/the-war-against-amanda-trujillo/I am sorry you each have suffered so. Are you familiar with my Walking Gallery project? Perhaps you will join us some time. I find sometimes pictures communicate better than words. http://reginaholliday.blogspot.com/2012/06/walking-gallery-walks-onyear-two.html"I will never give in ever again Claudia Kim Nichols. I would never have let them harm me in the first place if I had been warned to beware of doctors who try to push drugs, tests and procedures on you. All we get in the media and on TV is how marvelous doctors are, and the TV ads are full of scare tactic ads, so I was totally naive about the dangers of modern medicine. I'm far wiser now, but most people I talk to still have blind faith in their doctors.....""Regina my wife was at Inova's ER 3 times in 3 days with severe neuro symptoms. Turned away twice and admitted the last time after being transferred from the ER of another hospital since Inova was a level 1 trauma center. When admitted she was not seen by neuro for 31 hr. Walked in and by the time they starred treating her she no longer had any feeling from Mid chest down.Can't walk, can't sit, unable to turn in bed, can't control bowels or kidneys. Sex is history. Going shopping will be forever changed event. What good would this rating system do. EMS made the decision. So she is made a paraplegic but the dump a load steroids in her (14 x the. f d a limit to""I'll say this AGAIN . . . PATIENTS FIRST! With all due respect for the committment and time involved Regina Holliday -- the link you provided about patient reporting is, once again, NOT FOCUSING ON THE PATIENTS THAT HAVE BEEN HARMED!!! Read it. Where does ANY of it have t do with the harmed patent?? Oh, sure . . . report it and then what? Blow your legal statutes of limitations? That's what happened to me. I reported on the FDA Maude reporting systems and I wasn't even CLEAR at what had really happened to me. Blew my products liability statute as a result. And BIG WHOPPIE DOO the patient gets to ""report"" it. Then what? How is that going to COMPENSATE the victim? How is that going to HELP THE VICTIM? We are getting our throats sliced, bleeding out over here . . . and they give us this band-aid?!? To Quote: ""Federal officials said the reports would be analyzed by researchers from the RAND Corporation and the ECRI Institute, a nonprofit organization that has been investigating medical errors for four decades."" FOUR DECADES and they STILL need patients to report these things to get THEIR JOBS AS MEDICAL PROVIDERS RIGHT?!?!?!?!?!?!?! FOUR DECADES OMIGOSH. It took less time to get freaking seat belts in cars to protect drivers and passenge""I told my story to the Health Service Commissioner, the Minister of Health and the Hospital Compaints Dept. This is what they wrote to me, and this was 6-9 months after the surgery......""All the pain and complicatiions you are going through is common after a hysterectomy, go find a pain clinic...The doctors did no wrong...They made no money on your surgery....You should be lucky they put you in immediately, some women have to wait up to 9 months for elective surgery in some public hospitals.. It's a matter of science and knowledge...You signed a consent form...You are being unrealistic, go see a psychiatrist""...These are just a few of the comments the complaints depts. told me, Those doctors involved in this surgical racket, abused their power, committed a total breach of trust. They violated every single one of my health rights. they violated their duty of care and they blatantly violated the Hippocratic Oath and first did the moste grievous bodily harm. They lied ,fabricated, deceived, coerced and bullied me into surgery I begged not to have and the HSC tell me the doctors did no wrong....The system is geared to protecting doctors reputations rather than protecting patients from unnecessary harm...That last sentence was said by Dr Phil Hammond in his book, ""Trust Me, I'm Still a Doctor.""""I liked everything that Leapfrog did (since maybe 2001 or so since they got started), until they did this score. I've looked into it and I won't use it in decision-making. This is not an academic input. I'm considering a major operation in the DC area and I may just look at the scores to see if they surprise me in some way. I won't choose my hospital based on them. The main thing I don't like about the scores is that any hospital gets an ""A"". A implies excellent performance on patient safety, and the data that goes into the scores - the part on outcomes - not on processes, is just not valid enough for anyone to merit an A. Also, I disagree with the A score for patient safety on principle. If a hospital administrator sees his or her hospital with a score of A on Leapfrog he or she may come to the conclusion that their hospital is doing as well as it needs to do on patient safety, which isn't true of any hospital that I have ever heard of - and I talk with people who work in hospitals, not just patients. (There are entities that deserve an A for safety - maybe Qantas Airlines or Alcoa? - but I don't think there are any in healthcare in 2012.) A numerical score would have been better. A ""90"" would have allowed room for improvement, an A doesn't, and encourages complacency. People who run hospitals have a lot of legitimate competing priorities and having an A on patient safety allows or even justifies putting money and attention elsewhere. If I was a hospital patient safety manager and my hospital scored an A I'd feel good, but I'd also expect less attention when I came to a meeting and said that patient safety problem x, y, or z, needed more staff time or other resources directed at it. (Substitute C diff infection, pressure ulcers, or problems with the electronic health record, or your favorite issue for x, y, or z.) The fact that Leapfrog also charges hospitals to advertise their A score gives me the heeby-jeebies.After writing the above I figured I should check out the Leapfrog web site, because I hadn't seen it in a few months - since the weeks after the ratings were issued. I can't figure out how to get a letter score on hospitals. Only bars (like on a cell phone) for ratings across a variety of combined domains) to indicate status. And it looked like there was no data for Sibley in DC, so now I'm really confused.""""there are some fiendish institutions""..........because there is no accountability. I did not 'give in"" I was totally isolated by being profoundly deaf with no proper communications offered and no supporters available. Within 24 hours - I began to have an event which was brought on by the toxic stew of drugs I was given - no one seemed to grasp I was not HOH but profoundly deaf. They ignored my questions as to why IV was burning my hand, why my thumbs stopped working, why my legs would no longer support me. It got much much worse. I was released crippled weighing 16 pounds lighter and told a bad infection did this - blech. By the fourth day I went into respiratory and heart failure, wasting. Everything they gave was what I should never been given. I arrived uncrippled, on no meds just had maybe a sinus infection. You better believe if I had not had insurance they would have released me quick. The event was recorded but not reported - to me or anyone else. Quell surprise. being health literate is not acceptable to physicians - questions are not appreciated. I grew up with ten doctors families - I know they have to put one foot in their pants at a time just like us - never deified a doctor except when they are truly caring human beings who want the best possible outcome for each and every patient - now they are agents for big pharma, own laboratories, financial backers for hospital expansions - that is a nightmare scenario if there ever was one.""You are so right Michelin.Their are some fiendish institutions, because there is no accountability..Dangerous doctors know this, so they know they can commit criminal and medical malpractice and never, ever be accountable. In other words, they have a licence to kill and maim, and they will always be protected by the system." "Contued..limit for 14 days and instead of DQ it they started treating the steroid psychosis with anti psychotics - exactly the wrong thing and over our witten objrctions. We finally got her out only to have her Ems'd back to Inova the 'level 1"" trauma center. They discharged the next day and again we thought we were away from there clutches but less than a week later she was again EMSd to Inova. Unbeknownst to each other my daugher and I both were calling 911 to have them reroute the ambulance to another safer Hosp. They refused and when we arrived we told Inova that we wanted her transferred immediately to a safer hosp. Again refused so we called the Hosp Pres at home (like 2 am)and demanded transfer from him. He refused and she was admitted. The very next thing she was sent to ICU where she was not fed for 8 days. No nutrition from ANY source while laying flat on her back with arms and hands continually tied to the bed rails. Can't move feet, legs, butt, stomachs, or chest and, for good measure your hands are tied in moots and your arms are tied sideways to the bed rails. Sounds like gitmo doesn't it except they just got a million $ new soccer field or whatever. So finally 28 days after she was admitted we finally forced Inova to release her. Incidentally per their weigh records found in my wife's chart, she lost 49% of her body weight during the period of starvation and got a stage IV pressure ulcer from being tied on her back. You could see the bones of her sacrum through the hole. The dr was asked by an investigator - brought in by our complaint to Medicare that they were trying to kill her - whe he ordered her to without nutrition and the reports has him as answering ""that she was a paraplegic"". The state of VA and Medicare are justr fine with that.So I would contend that though we are fairly knowledgeable consumers, we neither could keep her out if Inova's clutches nor get her out once she was there and we needed real help, not some wonky statistics being reviewed by some new ""help agency"" which won't be published in the Main Street media because hospitals by ads and their execs hobnob with the docs and admin.I don' think I'm too cynical. I just live in a real world.""I got news for ya'll . . . hospitals aren't making the errors. It's the doctors and medical providers, directly. Hosptial ""ranks"" mean nothing. Another way to obfiscate WHO really causes the harm, injury, death. HINT: it's a medical provider (a doctor, a nurse, etc.) doing the deed. Hospitals are inanimate objects last time I checked. The methodolgy beckoning a hospitals' grade I couldn't care less about. It's useless. It's the medical providers inside the hospital that cause the pain/damage. Real people who are using the hosptial as merely facilities to inject drugs into our bodies, use scaples to cut us open, etc. . . . FOCUS people. FOCUS!! These ranking methodlogies, blah, blah, blah are meaningless to me. Because, once again, it's up to the PATIENT to read their ranks/reviews?!? Give me a break. Medical providers should not harm patients. Period. When they do . . . it's the hospital?!? The patient just didn't pick the right one?? I'm trying to undestand the logic with the latest ""spin"" on the hosptial rank mentality. DON'T HARM ME when I am in a hospital. Period, end of story.""I have a long post above that I started writing before I saw any other posts... As I understand it Leapfrog used to be entirely funded by payers (like GM, GE, etc.), but now they are also soliciting money from hospitals... See http://www.leapfroggroup.org/56440/CompetitiveBenchmarking""Noel Eldridge - bingo! Regina Holliday - please do not take any of our comments personal - some of us have utilized our research sources to stop this insanity for a while now. You cannot take any organization at face value - we don't live in America anymore - it's Americanistan, third world medicine at Swiss prices. Can you say ALEC?""Oh golly gee Noel Eldridge, no conflict of interest there :(""I love you Carla. You just told my story. It was doctors who lied through their teeth and fabricated nonexistent bleeding and cancer. It was doctors who totally deceived, coerced, mislead, misinformed, bullied, threatened and harmed me beyond repair, after telling me they's done hundreds of laparoscopy radical hysterectomies, when in truth they were just learning the new procedure. It was doctors who discredited, slandered and blacklisted me in the aftermath of the harm they inflicted on me for personal gain...IT WAS DOCTORS!...The very people who swear to put the patients best interest first and above all DO NO HARM!......IT WAS DOCTORS!.....""The hospital's administration is the prime facilitator of all activities in the hospital. They dictate the hours and standards to followed be ER corps and hospitalists etc. they dictate by contract with radiologists anesthesiasts, surgeons etc how many have to ge at the Hosp and how many minutes one of these provider has to get to the Hosp when called. A doc must have Hosp privileges before he can earn one greedy dime there""REgina, also, don'y take it personally, but I think the project is a horrible idea.There exist already five six seven entities that purport to be ""The"" place to send your complaints. Imagine being in an ICU that had starved your mother and trying to get help to cut the bureacracy to get her transferred as her life depended on it and each time the precious minutes from your maybe dying mother are spent ""sharing"" with someone who after a half hour or seven days, or three months, finally admit that they can't or wont do a blessed thing. I am not super enthused with telling my story. But I want changed processes. This is another, for patients, dead end. Maybe researchers think its great, but if I want a should to cry on, it's not someone on a 1800 line.Noel, I am really sorry that you need surgery. I would not rule out having surgery elsewhere-- I have had surgical procedures all over the country. I would find a place well recommended by patient boards with some real volume and with experts for post-op care for your underying condition. I have been thrilled to death with Duke, which is not that far. I realize they have had some errors, but the place is better than anyplace in NOVA. Your point is well taken.Conflicts of interest that would be considered venal in other situations are normal in medicine and unti that gets address, I think progress on anything else is a problem.""I would never have been near a hospital if it wasn't for a female doctor who came to the local Community Health Centre once a week to do Pap smears. She was a doctor since 1969 and the staff there thought she was so altuistic and caring for giving her time to the patients who went there for Pap smears. Under the guise of a caring woman's doctor, who had our best interests at heart was a snake-in-the grass who was looking for trusting, unsuspecting women to sell out to her equally unethical gynaecological buddies to be exploited for personal gain. I'm still in shock at all the lies and fabrications she told, and how she manipulated and coerced me into unnecessary tests and then fabricated they found something wrong, and insisted on me seeing her gynaecologist buddies, who destroyed my health and my life for personal gain....""Re the conflict of interest comment above, the part of the Leapfrog rating I don't like (outcomes) are the part taken from government agencies and re-used by Leapfrog. I'm not critical of Leapfrog's data on processes, which they compile themselves. My biggest distress beyond the low-quality (government) outcome data is the letter score (which I couldn't find tonight but I saw earlier). I think one letter to represent the performance of hundreds of people (from surgeons to room-cleaners) for tens of thousands of patients doesn't make sense. Other problems with the letter score, from my point of view, are above.""True that Allen J. Van Putten -- but it's not the administration doing the procedure, administering the medications, etc. If they are allowing the few rouge doctors to continue having ""privileges"" in their institutin, shame on them. The need to grow a pair IMHO and the administration should be held accountable if they're continuing to allow Dr. Mengele privileges. But, the hosptial itself, I'm sure, is not ""bad"" and does have good doctors and nurses who are just as sick of it all as we are. Rank/Review the hospitals administrator, Chief of Staff, etc. If the ER docs, staff, etc. are too burned out, then they need to protest their working hours, hire more staff, but don't take it out on the patients in the form of doing sloppy work and saying ""we're too busy"" (I'm going to write a comment about the NY Times article which was linked. But tomorrow, another day, another subject. However, in that article they are saying doctors are ""in and out"" and can't really discern things. OMIGOSH. I'm too tired now to write my thoughts this evening.) Perhaps the name of the administrators are a better way of ranking: Joe Blow, Administrator at Mercy Mercy Me Hosptial gets an ""F"" -- they're the man/woman in charge.""Hospitals have policy manuals - employees do as they are told or they don't work there. There is even someone who 'checks' records - making sure certain things are not found it the records.....really a plum job/snark. Well , that is not as important as being a Patient Advocate and telling me I cannot get my full records, that the hospital does not release full records. Like I just fell off a turnip wagon and do not know my patient's rights.. Or possibly the COO who tells me they will not correct all the errors - the errors that paint a picture of an extremely urgent situation - telling me that even though they have my age wrong - their records are a legal document and can't be changed. My admitting info looks like whoever filled it out was drunk or drugged - nothing is true. And there is a reason for it -""I wonder, do we get a special exorbitant consultant fee for helping everyone figure out how to do their jobs. And noel, that is correct. A place I might recommend for brain surgery might be a disaster for abdominal surgery. That is the level of granualarity of data you need. Just because some says they do X surgery on their website doesn't mean they are proficint at it."The AHA and others have described why the CMS HACs are not useful measures - in essence they are just too rare (falsely rare) to be representative of reality. And the PSIs are better used for case-finding for quality improvement than for measurement. See this slide set: http://www.ahrq.gov/qual/qitoolkit/webinar0215/toolstouse.htm and look at slide 29 and some others in the set and see what you think."Carla, I would recommend looking at Mom's medical records before saying oh, no, they aren't bad. They, pretty much across the board were bad. But I agree with much. Administrators have no skin in the game. I suppose we could boil them in oil every-time a patient died, but that would lead to excessive turnover. I think that the legal authorities to penalize administrators who chose not to correct harmful situations -- we haul slumloards in, we haul sloppy food producers in, why not hospital admins.""We should boil them in oil if the patients' death was advoidable and a result of medical error . . . but you're right Debra Van Putten it might be too much turn over. But maybe, they would get someone in that cared and ran a tight ship! Good analogy about slumlords, sloppy food producers . . .""If the harmed patient was listened to and believed, there would be a lot of unemployed dangerous doctors, and patients would be much safer. But instead dangerous, and even struck off doctors continue to cause havoc wherever they go, because they are protected by the system..One example is Graeme Reeves, ""The Butcher from Bega"" a gynaecologist who harmed thousands of female patients. Thousands of complaints over a 12 year period while unlicenced, he caused horrific mutilations to his female victims. Nobody would listen to the women, so he kept on causing harm to unsuspecting patients. It was only when a group of women marched into parliament that the story finally came out....""Just to clarify ProPublica's mention on the Leapfrog site: we are not affiliated with Leapfrog, but they are referring to us any patients who contact them with complaints about suffering harm. We appreciate this very much, because we can document those stories in our Patient Harm Questionnaire, which many of you have completed. The questionnaire is a great way for us to identify individual patient stories and issues to pursue (and yes, we are pursuing several), and stories to refer to other journalists. It's been a fantastic tool for this work, so we hope that many people and organizations will refer patients to it. In case you have not completed it, here's the link: http://www.propublica.org/article/patient-harm-questionnaire""That's great that you are getting more information from ""LeapFrog"" Marshall Allen -- our opinions on this message thread are our own, nothing personal to LeapFrog. We all have our own axe to grind with what has happened to us. It's hard to go through, we all process the pain individually. My stance, in a nutshell: Money from the insurance carriers DOES go somewhere, but it never reaches the patients who have been truly harmed. That's why they are insured -- for THEIR medical malpractice, to compensate and make right by the patient (and/or patient's family). Since when did doctor's medical insurance become the means to enrich the defense firms and their cronies?That's pathetic, humiliating and amazingly cruel for patients when that light bulb goes on. We are victims and yet, no one hears our voices, which is why I mentioned (in one of my comments above) our throats are slit . . . we are silenced, one way or the other. There is nothing being done legally, substantively to help patients who have been victimized by the games people play. Ring, ring. ring. ""Hello?"" -- Hey Medical Community, it's for you. It's the 21st Century. They're calling to remind you to GET A CLUE!""." "Patients will always be harmed while dangerous doctors are allowed to keep practicing. In 1976, in the USA, certain responsible doctors had carried out their own investigation of colleagues' work. They reached the conclusion that 5% of all doctors were unfit to practice. This meant that 16,000 incompetents were merrily making wrong diagnoses, issuing wrong prescriptions, recommending inappropriate treatment in the USA. Yet the licensing boards which were supposed to protect the public against malpractitioners struck off a mere 66 each year, on average....." "Park was arrested last month after prosecutors say a woman reported waking up to find her pants down and Park exposing himself during dental treatment. Prosecutors say three other women with similar claims subsequently came forward.Read more here: http://www.sacbee.com/2012/11/28/5016298/merced-dentist-charged-withabusing.html#mi_rss=AP%20State%20News#storylink=cpy""The World's Worst Medical Mistakes by Martin Fido... We all come into contact with the science of medicine at some point or another, placing our trust and wellbeing into the hands of doctors, nurses and drug companies. However, our trust can sometimes be misplaced. Mistakes can occur, and often on a massive scale, as the tragedy of Thalidomide has shown. But there is also stories that don't achieve front page publicity - the victims of the wayward scalpel, of shocking misdiagnoses and of the imposter doctor." ".....MEDICAL INCOMPETENCE..... Medical incompetence had various causes. Some bad doctors were alcoholics, or had become addicted to their own drugs. Some went on doing exactly what they had been taught at college, blissfully unaware that medical science had moved on, and the old ways were now either inadequate or completely inappropriate. Some had forgotten most of what they learned in college, and stuck to a little tread mill of cures that were not the universal panaceas they imagined. Doctors were prescribing antibiotics for illnesses which academic studies showed to be unresponsive to them. Doctors were recommending quite unnecessary operations: especially tonsillectomies and hysterectomies. Perhaps most disturbingly, patients were dying on operating tables they should never have been on. It was estimated that some 2.3 million unnecessary operations took place in the USA every year. 11,900 people died because the surgery they should never have undergone in the first place. 6 billion doses of antibiotics were prescribed - 22% of them were unnecessary. An estimated 10,000 patients died or came close to death because of antibiotics they should never have been given....."http://www.youtube.com/watch? v=RKmxL8VYy0M&feature=player_detailpageFascinating. Thanks for posting!"I agree. The doctors at Inova kept changing my wife's meds and not listening to the family on things like ""she took that drug 3 years ago and had this or that serious adverse reaction"" and sure enough, they'd order it over my objections and 2 days later the same adverse reactions occurred. I finally started telling the doctors that I wanted her treated by a chemist instead of a doctor. Absolute incompetents.""I agree with you Allen. I almost died from a drug a doctor gave me. I told her what my symptoms were, and she totally ignored me and gave me the wrong drug, which made me 10 times worse. I always felt the chemists were more accurate and helpful, but we have to get the prescription from the doctor. Even when we know what works, we have to go to the doctors for the prescription. Waste of time and money. I rarely got sick before I was horrendously harmed by a botched totally unnecessary radical operation, so I rarely went to the doctors, and rarely took prescription drugs, but to be given the wrong one really frightened me. I will never trust doctors for as long as I live. They destroyed my trust completely, not only in doctors, but in humanity itself.""June Gardner, that's part of the trauma. Medicine is identified to us as an authority for the purpose of helping us with it's knowledge and skill. When the practitioners of medicine use those skills with very self-serving intent, followed by an absolute denial of responsibility, we lose trust not only in doctors, but that distrust can spread to other authority. If doctors can disappoint so seriously, so we see the depths of human depravity, what's to stop humans playing the role of another authority from doing the same? Traumatized children of abusive parents don't trust other adults, and adults are traumatized by betrayal as well. When an adult is betrayed by another individual, we have enough experience to realize that not all individuals are to be placed in the same bin of distrust as that bad individual. But when an entire group of people, such as the medical profession, follows the line of falsity laid down by the one who victimized us, then it is different situation. The contract with society seems to be one-sided. I imagine the same idea has occurred to victims of mortgage fraud who lost their homes recently. And since bullies are attracted to people who exhibit signs of previous victimization, because they know they will make easier targets, the traumatized victim is more likely to invite abuse again, which justifies their traumatized outlook.""Doctors say, ""Trust me. I'm a doctor. You must obey my orders. I'm in authority here."" And the media reveres doctors, always talking about a new breakthrough or a new miracle drug, so what is the public supposed to do. Even the smartest of people can be a victim of medical incompetence. The problem is that there are too many programs on the good that doctors do, and no programs on the dark side of medicine, so the public can have their guard up when something doesn't seem right to them. If one person had told me that 90% of all gynaecological procedures are unnecessary, I'd still have my 6 healthy organs fully intact, and I'd be jumping for joy, not wailing in pain from a badly botched unnecessary radical operation...."The victims of medical error have no choice but to experience the following list."It seems to me the story is the same Worldwide, when a patient has been harmed by Iatrogenic Neglect....""This is an interesting article Garrick Sitongia. The outcome of the findings is what we need to implement, and I've mentioned this to a few people: Medical care providers (doctors, nurses, etc.) must become mandated reporters when iatrongic patient injuries occur. They use ""statutory"" . . . same thing. And I quote from the site: ""��_Statutory obligation for health professionals to disclose & report all medical errors and in particular any medical error that has harmed a patient. ��_Statutory obligation to give an open, full and honest disclosure of the occurrence of the medical error, and the extent of damage sustained by the patient - to the patient and his/her family,��_Statutory obligation to provide genuine remedial medical care for the iatrogenic victim.��_Statutory obligation to provide fair compensation in case of serious iatrogenic damage - a Victim's Compensation Fund.��_Full access and control over medical records, checked by the patient for accuracy before release onto any Electronic Data Base, including rights to full copies of all manual and computer coded records.��_Developing national and international systems of recording medical errors with their route cause analysis and a statutory obligation to include the patient's experience."" ��_Developing national and international systems of improvements of healthcare by preventing medical errors."We so need this.If you have pain from damage and radiology reports are coming back as normal you should be worried those reports are not legit..I had two tests done and then started to question the reports..I figured out what was going on..Other reports I found had been amended and they had gotten rid of the original reports for the purpose of concealment..Now I am stopped from getting any medical tests done.."I was talking to a nurse after I was butchered, and she told me they had to sign a confidentiality form, where they were not allowed to report anything that went on in the hospital, or else they would be sacked and sued. So is it any wonder that they don't report dangerous doctors. It has happened already. Read about ICU nurse Toni Hoffman on the web, after she reported Jayant Patel. And when a doctor blew the whistle on a very well known Neurosurgeon, he was the one sacked and discredited and his life was so destroyed that he nearly committed suicide...So you see why nobody reports bad doctors, and even when they do, like the group of doctors who got together and exposed Professor Kossman who defrauded Medicare and Private Health Insurances by charging for operations he didn't do, plus for doing unnecessary operations on accident victims and performing dangerous surgery way beyond his expertise, he wasn't put in jail. He was given a job at a well-known private hospital. Doctors are above the law....""PATIENTS FIRST!! PATIENTS FIRST!! PATIENTS FIRST!! And my after-thoughts . . . in the states that have ""caps"" it should be stautory that: 1) defense lawyers have ""caps"" as well, and ALL states 2) defense lawyers or insurance companies should be able to settle the case. As it is now, ONLY DOCTORS can ""authorize"" their insurance carriers to settle. Why should the doctors who have harmed their patients have this say? It is a conflict of interest. OF COURSE with the deep pocket insurance companies, why wouldn't doctors just let this illogical system ride out? Patients CAN NOT file a claim. A patent HAS TO SUE. Then when we do -because we are forced to -- we are targeted as sue happy, and all our cases are deemed frivilous. This type of system sets it up for the doctors to lie, deny, obfiscate the truth, with their insurance carriers being used to perputate their lies and medical cover ups the insurance carrriers are set up to pay the defense firms -- covering for the sins, their crimes against their patients. This should be illegal to do. Insurance companies ARE paying out ""compensation"" -- to the defense firms. There is NO incentive for the doctors to offer a ""settlement"" to patients they have harmed when they know they have their hired guns paying the defense firms. Even though most settlements have ""without admitting guilt"" language, doctors just string out the pain and suffering of the patients by NOT authorizing settlements. It's the Fox guarding the hen house mentality that TRULY raises the costs. It's the defense lawyers that get the compensation, when it should be earmarked for the harmed patient. PATIENTS FIRST!! That why doctors have insurance. But it doesn't go to patents that have been harmed. It goes to line the pockets of the Defense lawyers are financially benefitting by this provision -- e.g., givng the doctors the authority to settle, which they NEVER authorize. They continue to harm us with this system in place. Auto insurance is NOT that way. Homeowners insurance is NOT that way. Only the medical malpratice insurance is that way. Why? Because it lines the pockets of the defense firms. The insurance companies pay out -- but it's NOT to the patients harmed. It's to the defense lawyers who have NO CAPS, can drag a case out for fun and provide. This is, indeed, cruel and unusual punishment to the harmed patients (and/or their families).""Carla, I believe you've connected all the dots here... What we have is a very incestuous and insidious system with regard to doctors, hospitals, insurance companies, med mal lawyers, etc.""Carla, Elizabeth L. once wrote that they keep all the money circulating at the top, and only a small part gets to the victim. You have explained how that works.""I just read in a book called ""The World's Worst Medical Mistakes. Out of 16,000 incompetent doctors who were making wrong diagnoses, issuing wrong prescriptions, recommending inappropriate treatment in the USA, the state licencing boards which were supposed to protect the public against malpractitioners stuck off a mere 66 each year on average."If you are someone you know was a victim of a hospital acquired infection please call in on Thursday at 5:00 PM (CST). (646) 652-2105"This really needs more exposure, it is so important for so many.TRANSPLANT Policies - PUBLIC COMMENT PERIOD OPEN UNTIL 12/14/2012 The OPTN, which was established by Congress and is being operated by a private, nonprofit entity, is requesting public comment on all open policy proposals (proposals highlighted in yellow below). All public comments received are considered by the OPTN prior to approval of any final policy by the OPTN Board of Directors""This is alarming to learn & needs more Journalism interest.Proposal to Clarify Priority Status for Prior Living Organ Donors Who Later Require a Kidney TransplantAffected/Proposed Policy: 3.5.11.6 (Donation Status) and 12.9.3 (Priority on the Waitlist)Kidney Transplantation CommitteeThis proposal seeks to clarify the allocation priority assigned to prior living organ donors who later require a kidney transplant. Current policy is unclear as to whether the priority is to be assigned in the event that a prior living donor requires a second or third transplant. This proposal would clarify that the priority is to be assigned with each kidney transplant registration for prior living organ donors.Affected Groups Living DonorsTransplant Social WorkersOrgan CandidatesNumber of Potential Candidates AffectedThis proposal will affect a small number of candidates. Since 1996, there have been 33 prior living organ donors listed for more than one kidney transplant.Compliance with OPTN Key Goals and Final RuleThis proposal will promote living donor safety by clarifying that prior living donors who experience kidney failure will receive additional priority with each kidney registration. http://optn.transplant.hrsa.gov/PublicComment/pubcommentPropSub_301.pdf""Too many prospective living kidney donors are told they'll ""go to the top of the list"" if they need a kidney in the future, which is patently UNTRUE. A living kidney donor is given four points of priority, which amounts to approximately one year of wait time. Of equal importance is that this priority is local, not national, because we don't really have national allocation in the US. This proposed policy simply says that if a living kidney donor needs a second or third transplant (as transplants aren't not cures and most recipients need multiple transplants to achieve a 'normal' lifespan), the same four points of priority will be applied each time the person is listed.""To me there is a bigger problem of promoting kidney donation to save a life, and then the donor is put at risk. I hear so many people donating do they truely understand the longterm risk."Of course they don't understand the longterm risk because we don't know the breadth and depth of the long-term risk. Why? Because no one has bothered to track or study us.Snapshot of a life - a story that reveals more than an obituary about the person behind the lawsuit. http://www.answersforlisa.blogspot.com"And just think how many exclusions the OIG would be doing if only hospital etc records were honest, if only Medicare did quality inspections instead of the Joint Commission and if all Medicare contractors understood the Regs (the VA QIO has stated to us that in 20 yrs they have never made a referral to the OIG but rather they have a 'kumbayah' conversation with the )http://www.fiercehealthcare.com/story/oig-targets-surgeries-predicts-recordrecoveries/2012-11-28?utm_medium=nl&utm_source=internal""have updated Windrum's Matrix of Dying Terms to what I believe is its final version (3) and edited the blog post describing it accordingly. The Matrix will help anyone wanting to differentiate among the many dying pathways in our complex milieu, so as to minimize needless harm at end of life.Many thanks to Jennifer Moore Ballentine, EPatient Dave deBronkart, and Jerome Stone for their contributions. A full article is soon to be submitted to the American Journal of Hospice and Palliative Medicine. http://www.hospitalpatientadvocate.com/windrums-matrix/"Awesome Bart!"FDA meeting on pharmacy compounding has been scheduled for Wednesday, December 19, 2012 from 3 to 5 p.m. It will be held at FDA���s White Oak Campus in Silver Spring, MD. The meeting will be webcast. The deadline for submitting comments to the public docket is January 18, 2013.""Our very own Marshall Allen sat down with Fortune magazine's Mina Kimes to find out more about Synthes, a medical device maker that navigated around FDA rules and convinced doctors to use its bone cement for an unapproved use. When docs used it, some patients died on the operating table. This is a podcast, so click below to listen. (There's also a transcript you can read.)" Excellent interview Marshall. Thanks for posting Blair:)"The Albany Times Union has a story today about a claim against medical staff! Amazing! But wait: It names a town and others, none of them TU advertisers. If they were, there wouldn't be a word about it. http://bit.ly/UZyzmc"Maybe the medical system is biased to treating her with low priority because her injury was due to illegal drug use. Victims of iatrogenic disease know what it is like to be treated with very low priority. Such treatment bias is not ethical.I met a 92 year old woman (with her daughter) while at the Cincinnati Eye Institute yesterday who had been severely harmed by a very well-known eye surgeon. The daughter told me that her mother wasn't treated properly before or after the surgery; most likely due to her old age. This poor elderly woman has extremely painful nerve damage now and loss of her sight. They tried to file a medical malpractice complaint but said no attorney in Cincinnati would take the case due to the good name of the doctor and due to the mother's age. This 92 year old woman is utterly devastated by not only what's been done to her but by the fact that there's no way to seek remedy or justice. Meeting her and hearing her story and seeing the tears in her eyes as she told it was nothing short of heart-breaking! Certain classes of people are absolutely discriminated against by doctors/hospitals/lawyers."I wanted to let you know about an exciting conference that I am co-organizing in Washington DC next February called Selling Sickness 2013: People Before Profits. The two-day conference (2/21-22) will bring together more than 200+ influential academics, healthcare reformers, consumer organizations and advocates, and progressive health journalists to examine the current scope of ""disease mongering"" and over-treatment. It's really important to have the voice of the consumer and patient represented. Registration is now open: www.sellingsickness.com""All of you who have had an issue with the Joint commission dumping a well documented complaint, can you contact me offline at puttd at msn dot com???"Don't understand your contact info"Carla, can you delete your post. I wrote it the way I did because writing it up means that it can be sucked up by scammers. Thanks"thanks!Brava Debra Van Putten - superlative letter! Just now able to view - have to go back and read again. Brava!!"This is one of the adverse events in healthcare that doesn't get a lot of attention, although it causes some terrible outcomes (including deaths). While I was working for the Dept. of VA this is one that received a few rounds of special prevention efforts. (I wasn't deeply involved in these, just on the periphery.) http://www.nytimes.com/2012/11/26/health/after-dozens-of-deaths-inquiry-into-bedrails.html?hpw&_r=0 Fixes to this problem are surprisingly complicated and expensive when the number of beds are considered.""Thanks for posting, Niel. We have a tool called Nursing Home Inspect that lets you dive deeper into the issue, by searching inspection reports for facilities across the country. A search for ""bed rails"" and ""strangulation,"" for example, reveals 21 violations: http://projects.propublica.org/nursing-homes/findings/search?utf8=%E2%9C %93&search=bed+rails+strangulation&state=ALL&ss=ALL""Interesting data on 21 problems, but there's something like 15,000 Long-Term Care Facilities and 5,000 hospitals in this country. All with beds... Some have done things to more or less completely eliminate the problems with bedrails, but I don't know if anyone knows if the some I refer to is a large majority or a small fraction. For the others may be a matter of luck for the patients and for the administrators.""Very true - wasn't trying to suggest otherwise! Nursing home inspect just provides a deeper look at one piece of the issue. (A general search for bed rails, not just strangulation) actually reveals nearly 1800 violations: http://projects.propublica.org/nursing-homes/findings/search?utf8=%E2%9C %93&search=bed+rails+&state=ALL&ss=ALL)""Something interesting, that needs research. I am finding out that many people that have survived kidney removal for kidney cancer and are now classified Cancer free but now suffering from CKD. How do drs solve one problem and then create a long term disease that requires dialysis." "Iatrogenic illnesses ar rampant in the medical profession, but we don't learn that until we become one of their victims...""Right you are Georjean Parrish. Many cancer treatments are more deadly than the cancer. Dr. Burzynski doesn't cure all patients but his cure rate is higher than most and there are no side effects. That is why he has been repeatedly attacked by the FDA, the NIH and the Texas Medical Board. If his treatment were to become mainstream then many pharmaceutical companies wouldn't be able to sell patients on their chemotherapy drugs. And the scans using gadolinium based contrasting agents are nephrotoxic meaning they can cause renal insufficiency. Here is the study that shows that gadolinium based contrasting agents are nephrotoxic. http://www.scribd.com/doc/80320227/GadoliniumBased-Contrast-Media-Nephrotoxic""In Australia, one course of chemotherapy costs $29,000 dollars. And most chemo patients need more than one course of treatment. Also chemotherapy can destroy the bone marrow years down the track, causing patients to need bone marrow transplants. Chemotherapy is not only dangerous, but is a billion dollar business for the Pharmaceutical company. Is it any wonder that they don't really want to find a cure for cancer......""If you look up Mary Kelly Oconnor https://www.facebook.com/mary.oconnor?fref=ts she has had Kidney cancer and has been a tireless advocate for patients. She can steer you to some good kidney cancer groups, I would bet. Mary's website pretty much saved my life, so she is a good egg of the first order.""How can I edit the post the last words after dialysis needs to be ""AND TRANSPLANT"" The chain of guaranteed revenue for generations. I would love to find a journalist/researcher to work on a Cost benefit/health effects article.""Kidney function naturally decreases with age, but nephrons are also damaged by sodium, toxins, disease, etc. The reason humans have two kidneys is to be able to compensate for the nephron loss that occurs over the course of one's lifetime. Removing a kidney takes away that safety net (otherwise known as 'renal reserve'), leaving the remaining kidney (and person) susceptible to disease, damage, toxins, etc . Current medical literature advocates for a partial rather than full nephrectomy (kidney removal) for tumors whenever possible in order to salvage nephrons and therefore, kidney function, preventing the advent of CKD. <The irony that this same industry is constantly trying to convince the public that donating a kidney is safe is apparently lost on them.Keep in mind that chemotherapy can be damaging to the kidney too. And that transplants aren't cures, but merely treatments, and that not everyone has an improved quality of life after a transplant. PS. There are living kidney donors that have ended up on the wait list in need of their own transplant. Not that the industry likes to admit it....""BTW OPTN has proposed policies up for public comment, including change to the deceased kidney allocation policy. I encourage everyone to read it and let OPTN know what you think: http://optn.transplant.hrsa.gov/policiesAndBylaws/publicComment/proposals.asp"Here is additional Living Donor Information - I would never allow my family to put their quality of life and life expectancy at risk. http://www.livingdonor101.com/index.shtmlhttp://rantpolitical.com/2012/11/23/localpolitics-the-alleged-compassionate-hospital/"Survey: American Doctors Splintered Over Many Ethical Issueshttp://commonhealth.wbur.org/2012/11/doctors-survey-ethics" "Doctors are all too often not the source of a cure but the cause of disease or disability itself. Arrogance, presumption and plain foolishness have caused some doctors to persevere with theories and treatments that caused appalling damage and suffering to their patients."This is an interesting analysis and discussion of this current reality."This is a good article, I predict that steroids will be the next addiction crisis in this country. first of all, taken in super-physiologic doses they are highly addictive. Why because why they relieve pain, they cause muscle weakness and bone weakness that leads to more pain. The withdrawal symptoms are very bad -- supposedly as bad as heroin -- and as someone who had Cushing's I attest that withdrawal is no piece of cake. So, you have steroids, they provide short term pain relief, but as that goes away, it leaves increased pain sensitivity, and worse pain because of worse physiologic function. We have far less than a full understanding of the effects of steroids, but we have an increasing body of evidence that they are poisions.""This article fails to mention that for those of us who are disabled with spinal stenosis and pinched nerves, these spinal epidurals are a godsend in providing fleeting pain relief. This is the only procedure that Medicare will pay for to provide relief for pinched nerves that turns me into the tin man. Can you even imagine what it would feel like if you had two by fours tied to your arms and legs? Medicare refuses to acknowledge PRP or plasma rich platelet therapy used by athletes and others to regrow cartilage because it does not have FDA's blessing. Had I not been misdiagnosed and the victim of medical error which caused me to lose my entire life savings seeking competent care, I would have the thousands it costs to get PRP privately. As a disabled person now on SSDI, this is not feasible. Medicare only stabilizes people so they continue to live in pain. There is no other surgery or procedure available to regrow cartilage. With PRP, it's likely I would be ""abled"" and could go back to work. The system needs renewal.""Anna, I would say that most likely your doc is selling your health for a couple bucks. Every time you get an injection it weakens the surrounding tissue. But you don't notice it. You only notice it when the steroids are done. And because of the weakness, things hurt and guess what, a steroid shot sounds good. The truth is that Medicare pays for many many different strategies fir pain management. I would consider finding a more reputable doctor with a wider range of treatment alternatives. In fact there was a re bet court case overtubing the ""improvement only requirement with Medicare, so a trip to a physical theatpist might be more positive than before.""Debra, I did physical therapy, chiropractor, you name it. Nothing works on pinched nerves except relieving the pressure by getting some kind of cushioning like cartilage (PRP therapy which Medicare doesn't cover) or numbing the nerve (steroids). I am well aware that steroids destroy tissue. I am doing everything I can think of (because I cannot hold a job due to my physical condition) to scrape pennies together so I can get the PRP treatment. It's an uphill battle. One of the most challenging things about pain is that it is difficult for others to relate because they cannot see the pain. It seems no amount of my verbalizing my limitations can override their visual perception.""Did your doctor tell you that it takes a minimum of one year to recover from the harm caused by steroids. Because that's what the board certified endocrinologists I have seen say is the case. if you talk to endos, they have a very different view of steroids than the rest of the medical community, which IMO is pretty steroid happy. You could end up spending your money to fix what the steroids did.""Debra, Believe me I have the same concerns about taking steroids injections and appreciate where you are coming from. I am not spending my money (depleted in first years of being disabled due to failure to diagnose). I am spending your money through Medicare and get what they cover that works for me. If you were in excruciating pain, would you continue to suffer, seek euthanasia or take steroids to provide relief during some months of the year? I would seek euthanasia without the steroids. Again, I am doing what I can to come up with private money for PRP as a disabled person still ill including reviewing my options to be able to file a medmal suit given the two year statute of limitations. I need pro bono legal aid which is non existent for complicated cases. I've been working on studying medical books and the law to determine my rights the last 10 years as a disabled person. I was a successful commercial real estate broker working for a publicly traded real estate investment trust before I was fired for being too sick to perform my supervisory duties adequately. In Virginia, anyone can be terminated for any reason at any time. It's a ""right to work"" state.""If we were harmed by a criminal in the street, we would get support and compensation, yet if the perpatrator has a medical licence, we are harmed all over again by the system...""June, You are so right. It is quite eye opening as to what our licensed medical professionals are allowed to get away with under the auspices of ""sh-- happens"" in our legal system. Many states put such low caps on possible monetary restitution that attorneys don't want to bother with the cases because the workload is greater than the reward.""California's cap on medical malpractice of $250k was put in place in 1975. If it were adjusted for inflation the cap would be $1,075k in 2012. http://www.corporatecrimereporter.com/news/200/naderbrownmedmal10112012/"Colorado also has a cap. It is beyond unconscionable.You can thank MICRA for that! "California was the first state to come up with that criminal law and so others copied. Do you realize that it was put in place 40 years ago and not one change has been made, the Capp is 250,000 which is about NOTHING today."My daughter Jessie at the age of 7 was not considered for a trial because of her age and economic award instead of looking at the negligence the doctors did to her which caused her death www.shellybeenz.comI become more committed to this cause the more I read. I am so sorry Michelle Massey."That my friends is SICK that the insurance companies get to have billions at their disposal and we are capped at 250,000 which in todays economy is not even enough for one expert witness!"Another tragedy of the law is that it keeps bad practices in place as well as bad practictioners.Exactly! Why is it that the doctor that was involved with Jessie's death had no consequences? He had been named 2 times before for malpractice and Jessie makes 3. He is stil practicing and if you look him up it say history malpractice...none. my daughter meant nothing! That means all of your parents would have the same thing happen. All she needed was an antibiotic."Michelle Massey, Like you I work to change these things. I remember Karl Rove and his rants across the country about frivolous lawsuits...there are no frivolous lawsuits....no lawyer would take a case if it was frivolous. At first I blamed Karl Rove but then I thought why do Americans believe such a liar? It is the attitude of average Americans that we must reach and debunk the lies such as the lies Karl Rove and others like him tell. Mistakes increase our healthcare cost too. All around there are no good reasons to cover up these mistakes except to protect the doctors, their liability insurer or the company that made them."So because of Big business and the very people that need support are actually stepped on by the money and those involved have to know its profit if people die rather than live with some kind of ongoing care."That is what happened with us. Jessie died. No ongoing care, no actual damages. According to MICRA""A member of the healthcare syndicate told me that doctors don't tell the patient the truth because they are afraid of being sued by the original doctor. That is where the real threat of the ""frivolous lawsuit"" comes from.""I think, sad as it is, it is profitable for them no matter what with the current paradigm. If a patient is sick for the rest of their lives they make money as well by treating the symptoms. We simply have to work to change the system. And lawsuits are a huge incentive for them to do the right thing and pay attention to what is best for their patients. I like lawsuits because it is an inherent control on the doctors and institutions that should be responsible for patient care. Lawsuits reduces cost either way in my opinion.""I was healthy before I was tricked into this barbaric operation, and now my health is destroyed by dangerous doctors, and the medical establishment is making a fortune from my iatrogenic illness...."June I am so sorry for all of your pain and I do not mean just physical torment either.A very disturbing story."What I have learned is that evil thrives when good people do nothing. We are a small group, but at least we are trying to do something to warn others about the dangers of a system that has grown so corrupt."http://ezinearticles.com/?Chronic-KidneyDisease-Diet---Find-Out-What-Doctors-Dont-Want-You-to-Know-About&id=3548552 http://ehealthforum.com/health/topic16839.html#b http://www.livingdonor101.com/kidneys.shtmlThe New England Journal of Medicine is commonly regarded as one of the most esteemed journals in medicine and influences the practice of medicine around the world. But about two-thirds of its articles on new drugs are sponsored by pharmaceutical companies and most of those are cowritten by their employees."One comment is very insightful. ""you people"" wrote that after a drug is introduced the line is moved to reclassify a large fraction of previously healthy population into the risk category. This explains why on two recent checkups, my BP of 120/80 was used as justification to try to invoke anxiety about my health situation, and the second the nurse practitioner acted worried and concerned and I was given a prescription for a statin. One must consider the side effects of having a BP 120/80 versus the long term side effects of taking statins, including the financial downside.""Thanks for sharing, Cristy Wright. An important piece. I also wanted to make sure everyone had seen Retraction Watch, a blog that tracks retractions from different journals. It's run by the executive editor of Reuters Health and the managing editor of Anesthesiology News: http://retractionwatch.wordpress.com/"What do people do when you reach a point of saving gone and live on a fixed income and can't afford rx and dr bills and not to mention abdominal binder and spanks my surgical incisions all have huge hernias. Medical providers and the media - an unhealthly alliance about to be exposed. http://www.answersforlisa.blogspot.comThis will be show to remember."Please join our candlelight walk and vigil in memory of children who will never again be coming home for Christmas. We will gather at the northwest corner of Dundas Square on Thursday December 13th 2012 at 6 pm and walk to the headquarters of the College of Physicians and Surgeons of Ontario at 80 College St. The CPSO is the selfregulating body for the medical profession. Its mandate is to ""serve and protect the public interest."" We feel our children died because of medical negligence involving toxic/lethal pharmaceutical effects. We complained to the CPSO. Our complaints were dismissed. We feel the College of Physicians and Surgeons of Ontario did not take adequate disciplinary action. We feel the CPSO protected their own. We feel the CPSO is no longer committed to patient safety and is no longer capable of serving the public interest. We want the CPSO investigated and replaced by an independent organization not controlled by physician members. We are the Coalition for Physician and Surgeon Oversight. Read our horror stories at www.cpso.co. Share your own story. Take action. This vigil is our first public event. If you want to change the way the College of Physicians and Surgeons conducts itself, join our walk and vigil. Dundas Square is at the southeast corner of the intersection of Yonge St. and Dundas St.E. in Toronto. The College of Physicians and Surgeons of Ontario is at 80 College Street, 2 blocks east of Yonge Street and 4 blocks north of Dundas Square. Please bring a candle, a flashlight or a lantern. Some of us will carry posters."Good summary introduction on this topic in NY Times. http://www.nytimes.com/2012/11/27/health/hospitals-face-pressurefrom-medicare-to-avert-readmissions.html?hp"There are many ways in which medicine and its practioners can become corrupted and fail to serve their clients. Not least is the tendency to uphold the established order and to find ""scientific"" reasons for doing so. This tendency is virtually inherent in all regulatory organisations and, as these increased in numbers and power, it was to become an important trend during the nineteenth century. As the profession became more organised and knowledgable, weakness, bigotry, greed, power-seeking, hypocrisy and corruption in doctors were increasingly focused on women. The medical profession developed in a way that was particularly harmful to women. It usurped their traditional function of the care of the sick. It changed this function to suit itself, with far-reaching consequences, both for better and for worse. It used this unique position much less to improve the health of women than to enhance its own power. It used, and often grabbed at, women as patients in order to consolidate and support itself.....Further, some doctors perverted scientific knowledge to their own ends and added the weight of their ""expertise"" to the perversions of others..""I have no doubt in my mind that the doctors who harmed me perverted scientific knowledge, by fabricating I had cancer, to exploit me for personal gain....""Fun stuff scientists like to think up http://www.dailymail.co.uk/news/article-2238242/Cold-War-era-U-S-plan-bomb-moonnuclear-bomb-revealed.html"This might be a good one for the ProPublica reporters to look at. Maybe the various company stockholders would be interested...This is a wonderful satire. Universal healthcare is a solution."Good satire. But if they carried it out, if air travel REALLY worked like health care, one plane per day would have gone down with all passengers, err I mean patients on board.""The families of passengers would have to complain to the FAA to get them to investigate. But the FAA would make absurd excuses, deny the plane crashed and tell everyone to wait more time for the plane to land. When it was obvious the wreckage was the plane, they would say the black boxes are ""lost."" Then airlines would raise prices and blame it on a culture of litigation.""This is from the UK, a much smaller country. I don't know if the US medical system works the same way. http://www.dailymail.co.uk/news/article-2238031/One-doctor-month-dodges-misconductcharges-assault-retiring-early.html""Veronica James, The UK, a group of 5 countries, has a much smaller population than the US, and therefore their one doctor a month statistic may not be the same number about the US." http://www.cbc.ca/whitecoat/episode/2012/11/23/sully-show/"The Albany Times Union has an article today about hospitals' use of social media. The story (with the another of the TU's childish puns in the headline) says some use Facebook and Twitter to connect with the public, while others have no presence on the sites. The story says that Glens Falls Hospital uses Twitter to communicate with the public, while St. Peter's Health Partners (created by the merger this year of Northeast Health, Seton Health and St. Peter's Hospital) has no Facebook or Twitter accounts. This leaves it with just my page listing unreported malpractice lawsuits against and related Twitter links it as its most visible online presence.The TU story is here: http://bit.ly/10KlJvo My page is: http://www.northeasthealthclaims.com"HAPPY THANKSGIVING"On this Thanksgiving day, our thoughts turn grateful to those who have made our progress possible. We are thankful for you and wish you and your family a very Happy Thanksgiving!"Happy Thanksgiving everyone. May God let this day be full of joy even when.............With LoveHappy Thanksgiving from An Empowered Spirit.. "Nine years after Lisa's Baker's death in Samaritan Hospital in Troy, NY a Web page is ready for many expected new visitors.http://bit.ly/hStVoJ""David Baker I'm so sorry for your loss. It is amazing how they will cover up things instead of admitting their mistakes. I think that is the hardest part of all this. They call you crazy, they invalidate your instincts, they deny what you know is the truth and it is never their fault. Why does it have to be like this? I just don't know. They blame instead of accept responsibility. We never get to the point of forgiveness, how do you forgive when they won't even acknowlege they made a mistake.""Thank you, Sharon. You are exactly right; they compound the error by refusing to acknowledge it. And so they make the same mistakes, over and over. As you say, it doesn't have to be this way. And it shouldn't be.""Another area of the law that should be discussed in any patient advocacy group but generally isn���t until someone is personally impacted by it is ERISA. ERISA was signed into law by President Ford in 1974 to protect employees that contracted with their employer for benefits. There may be a part of the law that actually works to protect employees but I haven���t encountered it. The below linked brief is now before the US Supreme Court regarding ERISA and subrogation. USAirways, McCutchen���s employer paid for his medical expenses through the employer healthcare plan for which he contracted and paid premiums to participate and is governed by ERISA. Through no fault of his own he was hit by a teenager that didn���t have a decent insurance policy. His lawyers sued and won a small settlement but not enough to take care of him. Now comes USAirways and says we want all of that settlement money and we don���t care that this man is totally disabled and will have nothing to live on, we want our money. With the corporatist Supreme Court now seated it is likely they will rule in favor of USAirways and the disabled man will live in poverty for the remainder of his life dragging his family with him. I opine that this is totally short-sited on the part of corporations for if you impoverish a family with this type of behavior you inadvertently take one or more consumers out of the market, consumers that may have purchased your product or services. Is it nonsensical and corporations that are in the business of impoverishing Americans are really hurting themselves but this post isn���t about them it is about the inherent unfairness of ERISA and how the law absolutely must be changed. http://www.scribd.com/doc/114091163/USAirways-v-McCutchen-Respondents-Brief-on-theMerits-18Oct2012""How to lie with statistics. Scroll through this. Wow. They sure are improving. Scroll down the the HACs. Mom had at least seven. Inova Fairfax (IFH) had fifty something HACS in 2011. Then look at Serious reportable events. We were in the dozens as they are defined. Yet Inova is reporting only 13. So, for you health reporters out there and policy wonks. Hospitals can lie in their documentation. Unless individual complaints are disclosed and the data is reported based on audited data and data that can be compared to third party sources, it is not trustworthy. http://www.inova.org/upload/docs/about-Inova/Inova-QualityMatters-2012.pdf"Debra Van Putten you hit the nail on the head. Thank you for this post.They doctored the data.Garrick - lol"Covering up their mistakes is rampant in the medical establishnment. No matter what you do, they have another lie to cover it up...""Just to showing ""doctored"" is a verb which may mean corrupted or falsified."Oh my gosh I didn't see this and posted the same story. I'll delete mine. Thank you for posting this.Because I have an 82% chance of getting cancer and I do believe in science I'm going to see if I can become a patient of his before and if I get cancer. This is a great story but shows just how powerful pharma is and if we don't pay attention it could be taken away from us.got a meeting tomorrow with the chiefs at the hospital. more bull???? I am sure but I gotto go so they can't say I didn't."Mary Lou, you will be in my thoughts and prayers. Is there anyone there who you can take with you to this meeting?"How did it go?I think I ruffled a few feathers. Supposed to have another meeting in the future. LOLhttps://www.youtube.com/watch?v=UbBURnqYVzw&feature=youtu.be"This is good. Thank you for posting the link. Corporate farming, made up food for higher volume/yield, yup it's all done for fun and profit. Dr. William Davis puts it out clearly and the more we open our eyes the more we see.""Just reading ""Wheat Belly"" - great information!""Before you become a victim, investigate, before you vaccinate, The life you save may be your child....Nora is a victim of Gardasil vaccine."I would not get my daughter vaccinated and everything I see on Gardasil I have her post to her facebook account to warn other girls her age. Thank you for being here to spread the word. I am heart broken about your daughter. She is beautiful and she has support from this member of the group. Let me know if I can do anything.me too sorry to hear that"My 13 year old son is getting the HPV vaccine shots. It seemed like a good choice to the four of us - him, me, my wife, and his pediatrician.""Noel please do research on Gardasil. Even if you decide to get the vaccine you will be glad you read up on it. There have been over 10,000 deaths with this vaccination. There are many families that have been bankrupted from taking care of their kids after getting one of these vaccines. You are wise to be here checking things out."Just got back from the hospital. I think I ruffled a few feathers. Supposed to have another meeting in the future. LOL"Time for ALL advocates/activists in healthcare to come together and understand how connected we all are to one another in our separate causes. Each path leads to one SINGLE road, where healthcare is finally affordable, uniform and safe. We live in the GREATEST nation in the world, why can't we just do this NOW and do it RIGHT? http://www.cepr.net/calculators/hc/hc-calculator.html""I have a question for people here. This is not about poor bedside manner, arrogance, or other negative experiences that one might normally attribute to a appointment with a doctor. This question regards going to a doctor or medical service in which you are trying to get help or answers regarding your medical injury. I would like to find out if anyone else here has experienced strange psychological treatment from a doctor or other medical person during an appointment Did you have an unexpected experience of being treated in way that was strange, bizarre, or as if the person treating you was trying to make you feel odd, intimidated, uncomfortable, put-off, or undefined negative psychological treatment? Did you feel the person was actively trying to ""mess with"" you? Did you feel the person was trying to put you in an unfamiliar state of mind, or otherwise make the appointment seem like a traumatic event on a subtle level?""Not in my experience, which is not extensive."Absolutely they attempt it all the time with patients when it was a medical error or they are unable to diagnose. Its not all doctors it usually happens with ones with strong egos."I've found that everyone in the medical establishment treated me like I was the perpetrator and the doctors did no wrong. But I have to remember in the area I live in, they all belong to the same Health system called ""Southern Health."" So of course they will side with each other. It shocks me how they can do such harm, and turn it into blaming the victim. All because I trusted them, even though I kept telling the doctors, who kept fabricating non-existent female problems, that I had nothing wrong with me, and I even said what they were doing was wrong....But they kept manipulating and coercing me until they wore me down. I berate myself every day for my ignorance in thinking that doctors know best.....I was phsically, emotionally and psychologically harmed by doctors, then revictimized and retraumatiized all over again in the aftermath." "Preparedness and a good offense may be the best defense - Written and well prepared questions seeking specific answers, intervening if the answer goes offtopic and a video recording of the whole thing.""People who have experienced medical harm make many providers uncomfortable, this happens for several reasons. One that you might not know about is that those who have not had first hand experience with a bad preventable outcome are truly in denial of such events and assume that there is something that the patient is not clear on regarding the situation. Others just do not like to hear things about other providers. We always tell patients to say as little as possible to the new clinician, briefly mention that we had a rough time somewhere else or lost someone, but we really want to move forward and heal the best we can. They do NOT want the details, when you are candid with a new provider, most of the time they will respect you and do the best that they can. However, if you do what I said and still get resistance, run as fast as you can from that provider, no good will ever come from that relationship.""How many times Doug, did I wish I had had a tape recorder and recorded all the lies, fabrications, manipulations and bullying those doctors involved in this racket said to me before I was butchered. They way they abused their power, manipulated, bullied, violated my health rights, totally mislead and misinformed me would be on tape, and it would be hard for them to lie and deny that they did nothing wrong, if I only had the proof....."Outright hostility is what I experience from most doctors. Any doctor that follows the profits before patients' paradigm has no use for an aware patient. We threaten their very existence and we should feel confident that when a doctor puts himself/herself in that position of hostility towards a patient that has been harmed we know we are in the presence of a perpetrator and need to get out of the situation as quickly as possible."I wish I had listened to my feelings when the gyno/oncologist who bullied and threatened me into this dangerous, unnecessary, radical mutilations, Sharon. The hatred and contempt on his face when I said I had no pain, no bleeding, no symptoms whatsoever, and begged for another option, should have been a dire warning that I was dealing with a perpetrator....."An option: Bring a patient advocate with you to all your appointments- it can be a family member or friend who is capable of moderating the conversation. Consider changing doctors if the odd interchanges persist."Joleen Chambers, I went to three GPs in Eugene Oregon. There is a honeymoon period that lasts 2 - 3 appointments in each case. The doctors play the delay tactic for as long as possible first, then the strangeness starts in every case. In Eugene, the doctors are very well coordinated and scripted in denying treatment to medical injury victims.""What you are saying is easy to see in hindsight, Joleen, but I don't have family and friends close by. And who would ever believe that there would be a group of doctors in cahoots together, lying in wait to find trusting patients to trick into unnecessary surgery, for personal gain. Not many people know that unless someone informs them. Now I don't trust one word out of a doctors mouth, and I warn everyone I come into contact with to have their guard up.""Trust But Verify - A method of self-advocating or for a loved-one is to 1. check the providers credentials and background, 2. get a second or third opinion about diagnosis and treatment plan, 3. compare the treatment plan against evidencebased treatment plans, 4. thoroughly understand your condition and receive a thorough Informed Consent for recommended surgery, medication and therapy. All this before agreeing to a treatment plan.""Doctors ""mess with you"" because they know they can and they have impunity. Period. That, in and of itself, is strange psychological treatment. I'm in the Portland area of Oregon. The medical / legal community here is a very cultish sub-sect in a our local society. A suspect the judge assigned to hear the motions in my lawsuit is related (by marriage) to a partner in the defense firm. Of course my case got just far enough to allow the defense firm's billable hours to profit, I estimate, $150,000 in ""defense"" of my suit. Then it was tossed out on a ""technicality."" Ironic how my lawsuit was allowed to play out for fun and profit -- all on my pain and suffering! It was allowed to proceed to a certain point, then the judge knew it was time to play gatekeeper and denied my civil rights to trial. The incestuous nature of the judge and the defense firm . . . yup, no wonder attorneys in the Portland Metro area aren't taking on medical injury cases. And if these judges were not so insulated and protected, any other form of conspiracy on this level would be investigated on RICO charges. The two most powerful CARTELS in the United States of America are the ABA and the AMA. Don't kid yourself to think this isn't a double-headed snake. Don't kid yourself that patients aren't bitten twice. -- That is PSYCHOLOGICAL strangeness. The cruel nature of this two-headed monster who made a lot of money off my injuries. The medical community billed over $111,000 for ""services rendered"" (botched surgery and ""revision""). The legal defense firm probably billed $150,000+, easy! I'm guessing over $260,000 was billed off MY medical / legal issues. And me . . . the injured patient? Zip, zero, nada, dodly squat . . , oh wait . . . here's what I got: my body my body permanently damaged, I couldn't work for about a year, all my savings were drained, I was forced to file bankruptcy to save the assets I do have, in May 2011 I literally had $75 cash -that was it! How's that for weird psychological treatment?!?""I think the problem is the system. It is built around profiting by treating symptoms and fee for service so the more services the more profit. Doctors have become incentivized to never cure. Profits from cradle to grave are built into the long-term plans and forecasts of the pharmaceutical companies, medical device and equipment manufacturers. It is up to us to educate and change the system as sick as we are, health permitting and if you are committed to making the system better for all. One way is to get involved in what treatments are allowed for reimbursement by the insurance companies and we have our work cut out for us because I believe the AMA controls the diagnostic codes used for billing. I never pass up an opportunity to speak about what happened and the cancer fear mongering I allowed myself to buy into. One of the ways we can do this is by convincing policy holders how much it is costing them and getting them to connect the dots. Not an easy feat but one that has been made easier by the complexity we're been forced to digest with the banks. Once those with pensions realize their pensions are gone they will fight to reel in the banks and stop blaming homeowners. Once those paying premiums for health insurance can't afford the premiums due to the predatory and deleterious treatments provided they will get it and change the paradigm.""You don't have to be sick to be harmed by doctors. You only have to trust them. They will find illness where none exists, and fabricate non-existent cancer, etc.. to trick you into unnecessary procedures, and if they botch it and leave you crippled in agony for the rest of your life, all the better. They get rich trying to repair the damage they inflicted for personal gain in the first place....... Also, Doug, what you said is very good advice. What a shame we have to be harmed before we realize that.""Yes, by many of my doctors. But only when I got well enough to start asking questions. Then when I got my medical records to find out my pcp willfully witheld information and later documented in my records by a fellow dr. I found more information in the weeks prior to my surgery. Even the terminology of ""volatile combination of drugs, with an order to terminate one of them"" This was the same combination the pharmacy flagged when dispensing and per record the Dr and said to fill.""I went in to have a kidney stone removed during a Day Surgical procedure, in 2005. I was supposed to return to work the next day. It's now been more than seven years and I'll NEVER be able to return to working as the RN, BSN or the MSW clinical social worker, or the MAT-educated teacher that I was. The 72 year old surgeon ripped my left ureter out with the ureteroscope, THEN chopped my healthy left kidney out (without the knowledge or consent of myself or my legally designated health care power of attorney - my sister), which left me with paralysis of my left flank and stage 4 kidney failure in my right kidney! The SAME urologist is now 79 years old and was recently sued AGAIN, for causing the DEATH of a male who had a circumcision done! The Oregon Medical Board REFUSES to seriously INVESTIGATE medical malpractice lawsuits that are filed in any Oregon Court. Their ""investigation"" of a malpractice claim consists of reading the ONE SENTENCE REPORT submitted to them, by the MD's BILLIONAIRE MEDICAL MALPRACTICE INSURANCE LAW FIRM. They make NO ATTEMPT to learn the ""other side of the story"", nor to conduct an independent review of the situation!Going up against the LARGEST LAW FIRM in the State of Oregon, when one is SEVERELY ILL and PERMANENTLY DISABLED, not to mention newly impoverished, is one of the most SOUL-CRUSHING EXPERIENCES OF MY LIFE! The settlement I received was PATHETIC and more than half of it went to my attorneys. The total settlement amount hasn't even BEGUN to cover all of my medical expenses, THUS FAR, let alone all those that my insurance companies and the federal government (via Medicare and Medicaid), will be paying longggggg into the future! All of my retirement savings was used up long ago and my 11+ years of university education have been flushed down the toilet! Meanwhile, this elderly, incompetent surgeon is still ""practicing"" on other gullible, vulnerable citizens & visitors within Oregon!How many more people have to be MAIMED or KILLED within Oregon, before the Oregon Medical Board will start CLOSELY EXAMINING WHAT'S HAPPENING IN OREGON?!?!?!" "Janiece Staton, I am interested in contacting you. Can you message me here on Facebook?"I'll be happy to."BTW, in case those of you here don't know this, EVERY MD practicing within the USA has a GUARANTEED CHANCE of winning a medical malpractice lawsuit in 85% - 95% of cases, IF THE CASE GOES TO TRIAL! That's why personal injury attorneys are reluctant to take medical malpractice cases to a jury to decide. It doesn't matter WHAT the MD did or didn't do, nor what the outcome of the event was, most jurors CANNOT and WILL NOT believe that an MD could POSSIBLY hurt, maim, or kill a patient! Too many Americans are GULLIBLE, when it comes to BELIEVING in the ""GOD-LIKE"" knowledge and abilities of MDs!!!!!""Janiece Staton, you hit the nail on the head. Most doctors I encounter don't care about the patient and even those that do it is futile to go against the billion dollar liability insurance companies. I have been thinking about this a long time and individually we can do nothing but as a group we have power. And we can amplify that power by enlisting the help of the DHHS, Office of Inspector General and the health insurance companies. We have to get to the health insurance companies before they take them over and continue to force treatments and bad medicine on the general population. After all their on-going viability depends on keeping their insured healthy. I am sorry for you and what you have been through. Unfortunately I know it is true and that others will continue to be injured.""Not ALL MDs are incompetent, only SOME of them are. The same is true for RNs, social workers, occupational therapists, speech therapists, physical therapists, respiratory therapists, medical technologists, etc. The problem comes with not making retirement MANDATORY for elderly MDs, just like retirement is MANDATORY for pilots and others in high-risk occupations. ONE incompetent MD can kill or maim just as many people as ONE incompetent or unhealthy pilot can! We MUST require MDs to undergo REGULAR TESTING to make certain they REMAIN COMPETENT! Right now, only BOARD CERTIFIED MDs are required to take REGULARLY every 10 year EXAMINATIONS to PROVE that they are STILL COMPETENT to practice! All MDs who are NOT Board Certified, don't have to take ANY further exams, once they graduate from their residency programs! In the case of my elderly MD, he graduated from medical school back in the 1950's! I had NO IDEA he was a OLD as he was, when I had my surgery (I've never been good at judging people's ages), or else I NEVER would have chosen him to perform my surgery!Just as ELDERLY DRIVERS are a HIGH RISK GROUP, so are ELDERLY MDs! We MUST start VIEWING these NON-CERTIFIED, ELDERLY HEALTH CARE PROVIDERS as the HIGH RISK PROFESSIONALS that they ARE!""It doesn't MATTER whether they are COMPASSIONATE or NOT! Elderly MDs are NOT SAFE for the general welfare of their patients! It's the SAME for elderly pilots and long-haul truck drivers! Right now, that MD who butchered me is STILL cutting on people and SEVERELY DAMAGING THEM and can continue doing so until he's 198 years old! There's NO ONE TO STOP HIM!"Veronica James I agree with Janiece Staton but will add that the system is broken. We have to fix the system and get those that are injured the diability benefits they deserve and force the doctors and their insurance companies to accept responsibility. Why should our government have to pay SSDI benefits for the injury of incompetent doctors. You totally miss the point and I hope you will join us in making the medical community and insurance companies pay when they should so as to get them out of the market when they injure or refuse to pay. It is people like you that don't get it that are harming those of us that were injured even if you are also a victim. I hope you will reevaluate your position."I AGREE that it is the MD and the hospital who need to be held FULLY RESPONSIBLE for their negligence. Until the LAWS change, however, it's a losing battle, from the start. The hospital where I had my surgery wasn't sued, as my attorneys KNEW I'd have NO CHANCE of even getting a tiny settlement from them - they're the #2 corporation in Oregon (even IF they are technically a non-profit)! That's how CORRUPT our state is - a ""non-profit"" can become the #2 business in the state! How does that happen? By allowing that religious group to own their own INSURANCE COMPANY, along with their own substitute ""bank"" (in the form of a Credit Union)! There's been MASSIVE corruption, at all levels of the state government, to allow THAT pile of crap to come into existence!There's NO ETHICAL reason why anyone OTHER than the surgeon and hospital where I was injured SHOULD be held accountable for how I was maimed and left permanently disabled. No ""criminal"" could get away with doing that to another person. However, since an MD is ""licensed to operate a scalpel"", instead of a motor vehicle, s/he can DO AS s/he WISHES here!""Janiece Staton I'm very sorry for you. Thank you for sharing your story. You wrote: ""Going up against the LARGEST LAW FIRM in the State of Oregon, when one is SEVERELY ILL and PERMANENTLY DISABLED, not to mention newly impoverished, is one of the most SOULCRUSHING EXPERIENCES OF MY LIFE!"" -- This pretty much sums it up. It is soulcrushing!! This is the insult to injury that patients here in Oregon, and in the nation, endure. And most people do not understand how devastating it is in all aspects of ones life. It is unduly cruel, as a patent, to go through this. It happened to me, although the defense firm wasn't #1, they were still very aggressive and cruel. I suffered and they billed off my pain and suffering, as ALL defense lawyers do.""Veronica James I too know the pain. I was poisoned by gadolinium based contrasting agents and GE's product is the least stable of all of them which I had 11 times. They have admitted liability but still they fight the lawsuits and most of us can't get a diagnosis because the manufacturers of most of the gadolinium based contrasting agents paid for the diagnostic guidelines, which eliminates 99% of all of us that were harmed. According to the manufacturers and doctors, If we wave our magic wand and say they are not sick well everyone will believe us and the victims will go off and die somewhere without compensation, without us having to own what we did or take responsibility. There, problem solved so says GE and others like them. And radiologists and other doctors alike are saying that they eliminated the disease when people are still being harmed and still being injected with the toxic metal that never should have been approved by the FDA in the first place. The predatory healthcare industry must be stopped, it is serious and it is killing people and precious and scarce resources are being used to harm patients for profit. My only hope is that we focus on how to fix the system. To minimize someone's pain and suffering by telling them, ""it's okay some old doctors are okay"" is not my idea of validating someone's pain. I feel invalidated daily by those that say things like this to me. It's time to stop and listen to the pain of others and not minimize their pain. It is then we will begin to understand and change the system. My hope is that we change the broken parts of the system and it is why I am here. Old doctors don't need our support but harmed patients do.""Read this heart wrenching Motion for Expedited Trial, GE was counting on the mortality of this disease. http://www.scribd.com/doc/76550639/GE-MDL-19091073-main"Sharon Hanson was the motion granted?I don't believe so. My understanding is GE is covering this up and may have settled all the cases with pennies of what should have been their liability. Some say the trial lawyers did very well and now won't take anymore cases. If I want to sue I'll have to do it myself pro se and I may do just that."I've just read these heart wrenching stories and I'm crying as I'm writing. I live in Australia but everything you say is happening here too. I was harmed horrendously by greedy doctors running a surgical racket, and they look for the most trusting patients, because they are the easist to exploit. I rarely went to the doctors, as I was rarely sick. It was scare tactic TV ads for Pap smears, etc..that lead me to this female doctor of 40 years standing who did Pap smears every week at the local Community Health Centre. She pretended to be so altruistic and caring, but her true agenda was to find easy prey to sell out to her gynaecological buddies for unnecessary radical hysterectoimies. The mutilated 6 healthy organs and healthy lymph nodes from my body, and botched it so badly that I'm left an invalid, and I haven't stopped crying from the agony I've gone through since June 2005. The more severe the pain, the more I bleed out. But I'm the one discredited and blacklisted by the whole system...So I understand everything you are all saying. The system is not only broken, but very dangerous and corrupt.....""June Gardner I have heard that about Australia and the UK. In the UK just because the government runs healthcare doesn't mean the pharmaceutical companies and medical device and equipment manufacturers don't have a grip on types of treatments, scans and drugs that are administered. No matter where you are on the planet they want to treat you from cradle to grave. The horror stories I have read about both countries makes my skin crawl."I concur that Medicare should try to recoup what it pays out for patients like me who finally get diagnosed under Medicare and the proper surgeries. This medical care should have been provided by the providers under my employer's insurance Cigna which turned a blind eye to my complaints as well as media inquiries made on my behalf. There's no line in Cigna's computer software to record member complaints I was told."One reason medical costs are so inflated is that hospitals -- in order to maintain their non-profit status -- write off losses. I suppose these losses are incurred by the talked about ER patients without insurance who have no means to pay for being seen. I don't see being seen as synonymous with getting proper health care, but many believe that if you are seen in an ER, you are getting proper care. Hospitals have protocols doctors must adhere to so instead of addressing the patient's complaint, they have to run the same series of tests on every patient that comes in -- standard blood tests, chest x-ray, etc. in order to ""rule out"" the most common health problems. How about saving money by listening to the patient and addressing the patient's concern rather than spending time and money on fictional illnesses that need to be ""ruled out.""""""Is TKR under attack by data analysts and federal agencies? I think not, and here is why.""This is a quote from a recent article by ""McCann PD"" (what? no first name?!?) in his/her article ""Are We Doing Too Many TKR's?"" published in the American Journal of Orthopedics.Why would he/she even bring that up?!?The brilliant argument compares patients to computers, and I quote: ""For example, the number of computers used in the United States has increased exponentially from 1991 until 2010. We clearly do not overuse computers!"" If I were a debate team coach, McCann PD would get an ""F"" on this assignment. And they would get an ""F"" for philosophy AND logic. But, it's orthopedic medicine, so yeah, it's BRILLIANT!! {rolling eyes}And you know the article is a bunch of crap when authors, who try to get their point across, use such silly non sequitors. Pretty pathetic. ""Any formal fallacy will have a non-sequitor at its conclusion."" Nigel Warburton, Thinking from A to Z, Routledge 1996) http://amjorthopedics.com/Article.aspx?ArticleId=MKLmezy/IzA="Great information and great ideas from the Summit. We will be updating you soon with information that you can use to help all of us get justice and make a change.Me too! I now writing up a page to start adding links and pictures too!Great to meet you!"Even in terms of 1 life saved for 3 overtreated, there's a false assumption. They assume that when they catch cancer, they are saving a life. That's simply not true. Many cancers - even invasive ones - regress and disappear. Those are not factored in.And when they say that they've saved a life, they're basing it on survival from time it was discovered. That means that an earlier-found case might survive just past the point when it would have been discovered without the mammogram - and that's not life-saving, nor is beneficial in terms of quality of life.There may be a place for mammograms, but it's definitely not in this wholesale approach.""I agree with you Heidi....Also I read in an article that said a survey that was done on women who had mammagrams yearly for 10 years or more. It said that some women developed breast cancer, which was caused by the long term use of mammograms."has anyone here met/heard this gentleman speak? http://blogs.windsorstar.com/2012/11/15/every-halfsecond-counts-says-hospital-patient-advocate/New resource over on ProPublica: three ways to tell your patient harm story. The inspiration for this post came out of the feedback we got at the Consumers Union summit this week - so thank you!i wish we had a ste like this in canada"Want to help develop a national agenda for patient advocates? Please read, comment and share http://reginaholliday.blogspot.com/2012/11/dear-patient-advocates-e-patientsand.html""Women who have watched this video, decide against undergoing a hysterectomy.""Ten years ago the NIH set out to prove that chelation therapy didn't work to improve a patient's outcome but the results were not what they expected even after the study was tampered with it still showed those with heart disease were slightly better off than those that received the placebo. NIH Trial Gives Surprising Boost To Chelation Therapy http://www.forbes.com/sites/larryhusten/2012/11/04/nih-trial-gives-surprisingboost-to-chelation-therapy/""I wrote about this study a year ago. It's a particularly good study, but for some odd reason (sarcasm), just kinda disappeared. http://bit.ly/ZTjCoo""They did a survey in two towns in a Sweden, I think. One town where they did mammagrams, they found a number of women had breast cancer. The town where they did not do mammagrams had no breast cancer. Since the breast is very sensitive to radiation, the mammagram has caused the breast cancer it is supposed to detect..""The study showed something highly significant - that early detection probably isn't such a good thing. Many, likely most, breast cancers - even advanced invasive ones, like those investigated in this study - naturally heal without doing anything. Therefore, early detection could be making things much worse.""I agree Heidi. In my case I had 12 MRIs and became very sick from the gadolinium based contrasting agents, gadolinium is a toxic metal and they are still injecting it into patients. I don't have cancer but I do have four autoimmune disorders and and undiagnosed case of gadolinium-induced fibrosis which the medical community ignores. The manufacturers that are/were being sued paid for the diagnostic guidelines so only those close to death can get a diagnosis. And the lawyers and GE forced settlements on the victims that were well below the damage they caused. Our system is so screwed up. I intend to get involved and change that.""Consumers Union Patient Safety Advocates write letter to The Joint Commission pushing for transparency, timeliness and accountability to patients when filing complaints."Can additional consumer patient advcocates sign on?"This reminds me of the incredible anger I had at the denial by the medical center who butchered my nose with an improper surgery, how intense the betrayal of trust is. The hospitals get our trust by getting labeled with accreditation (accreditation --> credentialed --> credible).It was not just the improper surgery injury, but their denial of the injury no matter how obvious that my nose is structurally damaged. Then they lose my medical record, and somehow prevent other doctors from telling me the truth and thereby prevent any help reaching me. The extreme double standard of how such an institution can commit crimes against my human rights, followed by continuing to insert themselves in between me and outside doctors like a bully or crime syndicate, while holding an accreditation is the most backward corruption of truth and justice I have imagined. The message is, ""We're bigger than you so we can do anything we want to you. And we're accredited so we tell any other authority what to believe.""""Accreditation, board certified no longer have any meaning. Nor does 'consult your physician'. This disdain was earned through personal experience at a great cost which was life altering. Not just my words but my medical records. If any WHO reports are based on TJC or DHHS data, then they are meaningless.I never imagined TJC as being international and I do not have any faith they are less corrupt in other countries. This is global maim and murder incorporated. I did note that the spokesperson for TJC said they ""are not able to respond"" to their letter listed in the article. That's TJC style shining through - flick any questioning off.""I'm sorry but 'write a letter' to the Joint Commission??? Don't make me laugh. The JC is no more independent than - well, in this country of dependency, you can pick your metaphor. The JC is bought and paid for by the hospitals. Does anyone remember in the past 6 mo when 'AmandaJointCommission' joined this forum with great fanfare. Her JC JOB was in PR for the JC but when members asked questions like why there was no transparency, gave concrete examples etc., did she ever respond? No. Like the coward the JC is, she just disappeared.A more effective thing, IMO, would be to pressure congress to remove CMS's authority to delegate hospital Medicare approval (deemed status) to the JC. 'Course congress isn't exactly known for its 'bravery' either.""Lori Etheridge Nerbonne I just sent another complaint letter to JC which was made basically a ""picture book"" of what happened to my mom so that someone with no more that a sixth grade education could understand it. There is zero question that her treatment violated the Conditions of participation and equally clear that everyone is stonewalling -- JC, the survey group, etc. my email is puttd at msndotcom. I would love to forward it to you and join whatever efforts you may have. JC has sent denied twice, basically within 24 hours of receipt of very detailed complaints, running hundreds of pages in documenation. Obviously not a credible process, which is what I just wrote Mr. Chassin a couple days ago. Clearly they are not using Medicare's standards. The harm at issue was the intentional starvation of a patient, causing a heart attack for seven days, with the documented reason being that she was a paraplegic. What happened to Mom is THE example of what constituted immediate jeopardy in Medicare's own manuals, so it is just not possible that the hospital did not have a serious violation. We have over 100 medication errors alone, including schedule II narcotics appearing to be missing. Plus the hospital hiding that she had cancer and a whole host more."Maybe I was unduly harsh on Ms AnandaJC equating her own nonresponsiveness to JC's cowardice. Another possibility might have been --- Could have been that she saw all the problems the folks are having with the Great J C and the screw you responses those folks were getting as Professional replies and AmandaJC was so ashamed that she quit her job and went to work for a tree hugger group. Nope I'll stick with my 1st thoughtTune in now and send to your friends"I [laced this on my timeline, please everyone place it on your timeline as well.""Hi Deirdregoogle jessiegeyer/micra and there is a link On Jessie's fate told by Mommy. It is written out and has always gotten some attention, that weblink is pink from my past website. My newest is more of the aftermath and the Medical Injury Compensation Reform Act passed in 1975....40 years old! I will be adding links to my site and would like to fill a whole page of stories of people around the country so if you would pass this on as well it would be such a great help for me to take it to the whitehouse. Jessie's Law/Abolish MICRA should be taken to the federal level. Capps DO NOT work. And it is unconstitutional.Let me know if you cannot get that link, any search jessiegeyer/MICRA."A great thanks to ProPublica and its staff for coming out to the Patient Safety Summit in New York. If you are a part of this group you are in safe hands. I encourage you to send in your information about your harm and any other information you have such as falsifying documents or your concerns of how the system is working for you. ProPublica will help you.................. let's work together to make a change.Yes I was there as well as Marshall Allen. He is a great man and he and his staff are committed to finding solutions to help us get justice."Monday-Thursday and it was held in Yonkers, NY at Consumers Reports Headquarters"Sorry Monday-Wednesday"Thank you for having us, Deirdre Gilbert-Dickson! It was great to meet some of you in person. One of the best ways people can help is by filling out our questionnaires (one for patients: http://www.propublica.org/article/patient-harm-questionnaire and one for providers: http://www.propublica.org/article/providers-share-your-observations-onpatient-safety) and continuing smart conversations in the group, both about the root causes of the problem and attempts at solutions you've seen."Blair I placed the questionnaire on my timeline and asking people to forward to their friends."We were honored to be invited there, Deirdre Gilbert-Dickson. It was great to meet so many of you in person, and reconnect with those I already know."Marshall and Blair I received a comment from Elizabeth that she was kicked off the site and I pasting my response. I hope that I can help you and your team see the hurt that people are feeling."Elizabeth, I am sorry to hear that. I believe that they want to hear what you say and it is ok to let them know how you were hurt, what they don't want is putting things on the site that makes others feel uncomfortable. I believe that you can tell your story, share your pain, share your experiences and then ask them to help you solve that problem. I am like you in that I will not sugar coat what happened, because you are right the boards are not doing anything to help curtail this problem. What happens when we are hurt we tend to bring in the feeling part, but we have to put the feeling aside, tell the truth and ask for ways to change this. When we work together in harmony we make changes. What we want is the assistance of doctors, politicians, nurses and others to help us make change.""I must say something to those who write on other peoples pages. If someone else agenda does not fit your agenda then one must make a conscious decision to find one that does. If the developer of the page gives a request what they want to see happen on their site then one must respect that right. We can not change other people visions. Your vision is yours and other peoples vision is theirs so if the platform does not fit, find one that does. Not a form of disrespect but just a right. Hope that helps.""Frederick Lury, DMD, whose office is at 1090 Toll Gate Road in Warwick, was in the process of selling his practice with intent to retire, when his office was found to have ""misbranded narcotics and an expired solution"" during an inspection on September, 2012. http://www.golocalprov.com/health/newwarwick-dentist-surrenders-license-over-controlled-substances/"Too many Dentists On Probation that are disciplined with a short suspension but licenses quickly reinstated with probation REPEAT their harmful pattern to unsuspecting patients...Dental Boards MUST provide information to the unsuspecting patients of DENTISTS ON PROBATION"Prescription pain killers connected the dots, and all were prescribed by the same doctor noted in the L.A. Times article. But the doctor is not responsible for what happens when patients leave the office with a prescription http://www.topix.com/business/dental/2012/11/rising-tide-of-californians-are-dyingfrom-taking-prescription-painkillers"http://foodmatters.tv/2012-free-screening"So if it was bogus, how come there was no physician discipline? Really?""Turns out some of these parties were funded by a bogus cancer charity that she set up with her doctor husband, Scott. """"Dr. Stanley West who wrote the book ""The Hysterectomy Hoax"" attended a US gynaecological seminar on the subject of medical economics. It provides an insight into the business attitudes of some professionals. The topic was how to care for women in order to maximise fees. The experts who led the discussion reminded us that gynaecologists make most money by performing surgery, and that the highest fees we can generate come from hysterectomy. With that in mind, we were urged to ""cultivate"" our patients carefully. Initially their care would require advice on contraception. Then, in the normal course of events, we would supervise our patients' pregnancies and deliver their babies. Once a patient had completed her family, we were advised to plant the idea that she might some day need a hysterectomy. The culmination of their years of care would be the hysterectomy, after which no further gynaecological oversight would be necessary. With proper planning, the advisers suggested, each year of practice would produce a lucrative 'crop' of women ripe for hysterectomy.""This is horrifying. I have long wondered whether the outrageous C-section rates in this country are motivated by profit. Physicians say women request C-sections, but in doing so they abdicate their (usually closely-held) position as commanders of all things health-related. They pretend it's the woman's fault for asking for a Csection.""Of course they are motivated by profit Teresa. 90% of all gynaecological procedures are unnecessary, and you only have to read the dozens of books on unnecessary hysterectomies and dangers of modern medicine to know that. ""The Hysterectomy Hoax"" by Dr. Stanley West is a good book to start with. Also ""Women Under the Knife: A gynaecologists Report on Hazardous Medicine"" by Dr. Herbert Keyser, explains how some unscupulous gynaecologists use the cancer scare, among other things, to coerce women into unnecessary hysterectomies. He calls it fraud. He calls D & C's (curettes) Dollars and Cents....""For those Affected or Interested, an Excellent piece on the Fungal Meningitis Outbreak on PBS This Eve, Here tis:http://video.pbs.org/video/2288525071""This Needs to Be Surfed, into Pain&Neuro Patients, Care&Feeding Of, Because it will Grab Peoples Attention, & shows how much ""Small"" Government affects care, & Damages done. These Injections just harden the cartilage, & give temporary Relief. They are a Revenue Generator, for Dr's how are scared by Law Dogs, of Rx'ing Scripts for Real Pain Meds, a POLiTiCAL Thing. Wrong. Suicides by Chronic Pain Patients are Bad enough Already, it has Got to STOP."Are there any doctors on this page?"I know there are some, Kirpal Singh, but it's hard to know for certain with this many group members. Are you looking for anything in particular?""just wondering what their thoughts are about the posts on this page. in addition, i'd like to know if what they are doing to address the issues on this page within their workplaces, associations and business transactions (from malpractice insurance to medical device purchases).""Good questions. I monitor pretty much everything on this page and can tell you that few providers participate in the conversations, which I think is too bad. On the other hand, this is a great venue for patients and their loved ones to engage, so that's a good thing. We've recognized a need to engage with more providers, and have tried doing so via a different social media platform called Branch. You can see that here: http://www.propublica.org/article/discussion-the-top-patient-safety-challengesmedical-providers-face.""By the way, for those who have not checked it out, we launched a Patient Safety section on our propublica.org site that includes some of the resources and topics from this page, as well as other stories and blog posts. It's a way to broaden the discussion of these problems beyond the Facebook group. You can see it here: http://www.propublica.org/series/patient-safety""My family and I were recently and tragically made acutely aware of just how dangerous it is to be gravely ill in a hospital. Our 82-year-old father underwent elective surgery to remove a non-cancerous polyp from his colon. The surgery was performed at North Florida Regional Medical Center in Gainesville, FL. The surgeon was not one of my father's regular physicians and didn't take the time to become familiar with my father's overall health or medical history. If he had, he would not have performed the surgery (we were actually told this by the surgeon's PA after the fact).But that's not the worst part. The worst part, and what I firmly believe led to my father's decline and eventual death, was the lack of acceptable care on the part of the nursing staff. So many errors were made, so many things were ignored or disregarded that I was absolutely dumbfounded, having previously and for years held this hospital in very high regard. Despite the fact that my father was incapable of feeding himself, he was provided with a tray of food three times a day and that tray was retrieved later, untouched by him. When I noticed this and asked what my father had eaten, the nurses would hurriedly say that my father just hadn't had an appetite that day. Yet, if I sat and fed him or assisted him in feeding himself, he ate the food. Bottom line: the nurses didn't have time to sit and feed my father.My father developed ICU Psychosis - not uncommon in elderly patients who spend a lot of time in small windowless rooms with little sleep and a constant influx of unfamiliar faces. Due to this condition, he thrashed about in his bed and suffered hallucinations. Did the nurses check to make sure his legs were still covered and on the bed during the day or night? Only when they had to go into the room for something else like blood work or checking vitals. Did they take care to close the door all the way or turn off the lights when they left the room to help him sleep? Absolutely not!We finally got it: a person's chances of surviving a hospital stay increase dramatically if a family member or other loved one remains at the hospital with the patient 24/7. This was confirmed by a respiratory therapist who told us that she would never let a family member stay at the hospital without a family member in the room as much as possible. She said the nurses just didn't have time - they were spread too thin. We began to spend every day and almost every night at the hospital with our father.The weekends were the worst. That's when recent nursing school graduates would replace the week-day nurses. Honestly, half the time it was completely obvious that they had NO IDEA what they were doing or what was going on with our father. Probably the worst example I can give is when my sister arrived at the hospital later than usual, about 3:00PM on a Saturday. She found my that my father was not wearing his oxygen tubes (the ones that go into the nose). When she asked the nurse about this, the new nurse said that he was ""off oxygen"". My sister asked who had told her this and asked if my father had. The nurse said that my father had been speaking Spanish to her. This alarmed my sister who asked my father to say something to the nurse. My father, at that point, had lost the ability to speak clearly and the nurse said, ""See? He's speaking Spanish!"" My father was NOT speaking Spanish, he was speaking English he was completely lucid - but his speech was not clear. He had been without oxygen ever since the nurse began her shift hours earlier in the day. There were NO orders that he be taken off of oxygen. That day marked the beginning of a dramatic decline in his health from which he never recovered. The charge nurse was told that we did not want this nurse to handle our father's case and we were told that she was removed from it. The next day, however, there she was again. We had to cause a scene before she was taken off his case.I could go on. There were so many other examples. And, in case you're curious, this was CCU - the Critical Care Unit (one step down from ICU). I will say that there were some wonderful nurses who became like family, but even they seemed to have little help and were grateful for help from the family (in changing his bed, feeding him, ensuring a bedpan was brought to him timely AND removed timely, ensuring that his oxygen tube was in place, etc.). Quite frankly, this hospital is no place for the gravely ill. I checked at hospitalsafetyscore.org and was not surprised to find C-grades across the board. My heart is broken for my father and the family he left behind."sounds so familiar. even here in Canada mistakes are rampant"I also feel that elderly patients are disregarded and too quickly determined to be ""beyond hope"". Because my father's speech became garbled (the cause was never fully determined), the staff assumed he had dementia. We had to repeatedly tell them that he did NOT have dementia and that he was actually trying to tell them something. Many of them assumed, as well, that he was hard of hearing, which he was not. My father became so frustrated at this that he actually yelled at one of his physical therapists, ""I'm not deaf, you don't have to yell!"", but the therapist couldn't understand him and just ignored him as he undoubtedly would have any other elderly person who was ranting and raving. I recorded this event on my phone before I spoke up for my father. What if I hadn't been there?"so true. you do have to be there 24/7 and question everything that seems wrong. i have learned the hard way by losing my son to incompetence. i agree they don't care about the elderly as I have witnessed many times with my mother. very scary"I am so sorry about your son, Mary-Lou." check out my site if you haven't already www.justiceforjosh.comgood to talk with you. gotta go to bed now. work tomorrow"Another direct experience, reality based example of why the US is 37th in the world for health care, between Costa Rica and Slovenia.""Yes, 60 minutes per hour, 24 hours per day. Review the medical record every few hours, befriend a few care-givers to help you understand what is going on, record everything and Speak-Up when anything isn't right.""Mary-Lou, I read your son's story. Oh, God, it sounds so familiar. Losing an 82-year-old father is sad enough, but losing a beautiful young son is a tragedy beyond understanding or description. You and your family are in my thoughts and prayers. I wish you peace.""Hi Vicki Del Valle Schneider. ""Welcome"" to this group. You've lived it, as did I and my family during each of my parents' terminal hospitalizations in 04 and 05 (Mom/respiratory collapse/ICU; Dad self-admit for pacemaker eligibility testing, nosocomial MRSA and attendant buffoonery, including the exact feeding/watering scenario you experienced).Even after the fact this tidbit may be helpful. It's what I whittled thoughts down to over a long time:First: hospitals don't provide care -- they provide bodily repair services under the removed direction of independent physician-scientists, and nurse-monitoring on some schedule.Next: advocating for a hospitalized loved one emanates from a place of continuous skepticism which causes us, always and for every situation, to inquire what impediments exist to the timely and/or successful delivery of [whatever: procedure, resource, goal]. Using this truism we can then always ask, in whatever language we tend to use, what can go wrong. The idea is to ask ask ask ask and uncover what you don't know you don't know. So you don't have to know what you don't know in advance; that'll emerge if you focus on uncovering what impediments exist to timely success, be it for small or large events. Example: family-supplied, admitting MD-approved Rx's taken away and supposed to be dispensed at 6:30pm? The doc probably won't know what process the facility has to go through to fulfill the service (it'll pop your eyeballs when you learn it). So, take nothing for granted; instead ask ""exactly what process has to unfold in order for these meds to get dispensed on time"" and don't take vague assurances of success as an answer. Drill down far enough and you'll learn that the nurse has to write new scripts, the pharmacist has to come up, read 'em, read the bottle label, pull a pill and examine it, and sign off. For each and every med. And then you ask about pharmacy staffing over shifts, etc. Today I'd also go down and talk to the pharmacist. It's like overseeing a child; the entire system is so understaffed and overworked that the system itself is childlike in its discontinuities.So remember: the definition of what hospitals actually provide (it ain't ""care,"" a term that ought to be stricken from the medical lexicon until it's re-earned), and advocacy is at root the job of uncovering impediments and protecting against them.The former thought is in my book, the latter developed several years after its publication.""Thank you, Bart Windrum. I feel that I learned these lessons at the expense of my father's life. Too high, that cost." "You and I share that gruesome unfortunate lesson, Vicki. My dad's death was very likely premature; despite his weak heart he rolled outa the house and drove here and there every day and I can report he had no MRSA before the too-large urinary catheter some incompetent lazy nurse shoved up him (before we got there).""Don't even get me started on urinary catheters! I had to have a full-blown argument with one of my father's nurses (in front of the nurse's supervisor) in order to get him to change my father's catheter after I arrived at the hospital to find him writhing in pain. The nurse's response to my father's complaints (and my father, a former Marine Sergeant, thought pain was for weenies), ""Oh, he has a known prostate problem."" My father had no prior history of problems with catheters - he was used to them. For him to cry out in pain whenever he moved, well, it made my blood boil. Needless to say, the catheter was repositioned and my father was fine afterwards. It makes me physically ill to think of him in pain like that. I share your disdain for the word ""care"" under those circumstances.""Hi Vicki Del Valle Schneider, so sorry to hear about your father, but thank you for sharing your story with our Facebook group. I wanted to ask you to also share your story by completing our ProPublica Patient Harm Questionnaire: http://www.propublica.org/article/patient-harm-questionnaire This is the form we're asking people to complete so we can identify stories and issues that we should pursue for our reporting at ProPublica. Sharing your experience would be a big help.""And then there was my sister's subsequent hospitalization. For me, ""thrice bitten, a zillion times shy."" ""Those circumstances"" are ever and always unless direct experience in real time is qualitatively different. Hence, ""care"" is a term I do not use. It's ""treatment"" by ""treatment groups"" (not care teams, apparently a dual oxymoron). This is not about blame, it's just getting our heads screwed on straight so that when we pass through those double doors we're oriented toward the tasks at hand.""What a brilliant observation, thanks Bart, ""care teams, apparently an dual oxymoron.""""It's the words we use in our heads, Garrick. I *really* wanted to get to the bottom of why my patient-family failed, fell victim to, the machinations of a system professing care and delivering the absolute opposite, twice in a row, during the deaths of both of my parents. The ICU at West Boca Medical Center (and this is the very first time I've named the place since January 2004) was a callous place���to the bitter end, failing to come turn off the monitor alarms or offer my grieving sister a modicum of solace. The egregious banal errors and communication failures culminating in UNinformed consent around Dad's MRSA affair at JFK Medical Center in Atlantis FL, a Jayco 100 at the time (again, the first time since May 2005 I've named the place) directly contributed to, perhaps caused, his demise. I *had* to take the blinders off. The little words in our heads matter a lot, because we can't afford to lose days and weeks to believing what, I must unfortunately label, delusions and lies on and of a systemic scale.Tonight I find myself angry. The picture of Vicki's dad going unfed, as did mine 7 years ago; nothing changes. I've grown to almost loathe the use of the word care. I see it as a usurpation and I really dislike that all of us continue to use it. Like lambs. Maybe people think I'm silly when I've pushed for us not to use it anymore. But it's got to be us, because health""care"" won't stop the selfidentification. Wishing won't make it so. Mostly, medicine ought not have a lock on the notion of care. Most everyone in every endeavor take care in what we do. Medicine seems, to me, to want to own the notion of care because it'll always come down to ""well we have good people who really do care"". That may be true. But we cannot continue allowing that ultimately weepy sentiment to leech our resolve to redefine and restate our experience. Want to change the playing field even a miniscule amount? Take ""care"" out of the conversation, and before putting it back in wait until it manifests itself predominently.""I too experienced the loss of both my parents within two months of each other from 'treatment' at a rural hospital in WNC. My father preceded my mother, who most likely passed prematurely. Thirteen years have not mitigated or brought any resolution. Words do have meaning and it is particularly gulling to read health""care"", board certified, always consult your physician, we 'care', excellence in health""care"". Their ineptness is well known yet nothing changes. Garrick Sitongia, those statistics are my mantra except they are from the last WHO report done in the year 2000 - someone deemed it was too 'expensive' to do it anymore(Bu$h adm.). US is most likely closer to 57th now in care and still number one in cost. We all know here that the figures are not correct as there is under reporting going on. This is Appalachia at it's worst. mill town attitude I thought - except now it seems it is nation wide. Only those who have been actively involved - actually lost a loved one under Mengele torture treatment realize what is going on. Those who are bereaved or damaged themselves are tasked to blow the whistle along with the pain and sorrow. We are now blessed with the internet and can share our stories - never to be silent until health'care' is a reality, as Bert Sebilia said - take ""care"" out of the conversation and before putting it back in wait until it manifests itself predominantly. Hoping for peace of mind for all of us in our quest to put humanity, humane medical treatment back in true care.""Beyond tragic Vicki... Words fail period. As I read all of our horror stories, I can't help but notice that, more often than not, patients who are harmed or killed have undergone an 'elective' surgery they most likely didn't need in the first place. (This s is what happened to me!) I didn't need surgery nor did I consent to it. Now, I'm disabled. Here's my story http://www.hysterectomyconsequences.com/my_story And, more often than not, these surgeries were suggested during a 'checkup' or 'wellness' visit we really didn't need. Those of us who've been unfortunate enough to experience our 'healthcare' system up close and personal know that it is not a HEALTHcare system at all for it has little to do with health and nothing to do with CARE.""I am a nurse with 30 years of hospital experience. I have advocated for my father when he was hospitalized, only to be told by his surgeon that I was not making any friends among the staff. I informed him that I would advocate for my father, and was not there to make friends. I'm deeply sorry that this series of errors happened to your father, Vicki. I have a few bits of advice for people who think a loved one has been harmed: 1) Report it all the way to the top. Demand to see the chief medical officer of the hospital. Do not stop at lower-level administrators who have no power to change things. 2) If you are too stressed yourself (which happens easily when a loved one is seriously ill), enlist the help of a friend or family member, or a qualified professional advocate. Many studies confirm that intensive care is disruptive to families, as well as patients. You will need help. And one more: 3) take care of yourself. You simply cannot be there 24/7. If you try to be, you'll suffer for it. You can be most effective as an advocate if you are rested, nourished, and cared for yourself.""The statement made to you Teresa about how you're not making any friends says everything about how patients and their families are viewed by medical 'professionals'. What kind of thing is that to say? When I read that, I felt like I had been punched in the stomach. Too many memories I guess... We are treated with such disrespect. Talk about being kicked when you're down. And people wonder why we feel the way we do about doctors and hospitals. Bart's words ring very true 'Thrice bitten, a zillion times shy'. I think he expressed how many of us feel.""I can't speak from experience going to the top but during Mom's ICUization (a natural occurrence; she accepted assistance and it led where it led) we did engage the Director of Nursing. Ultimately I wrote a section in Notes from the Waiting Room: Managing a Loved One's (End of Life) Hospitalization that I titled ""Who Not to Complain To and What to Know if You Do."" You see, it took us two meetings w/the nursing director for me to realize that (a) she couldn't change the culture in that ICU and (b) she probably was a primary cause of it. If this sounds like caving, perhaps it is. Yeah, I'd probably try again at a higher level but that's only because I haven't had the pleasure of experiencing a hospitalization for some years.Note to Michelin Anderson: in your entry above you attributed words I wrote to someone named Bert Sebilia..."I read that chapter in your book Bart. I think your experience is unfortunately typical and I think your advice can serve to prevent additional heartache in two ways. It helps families know better how to complain if they choose to do so and it also helps them to understand from the get-go that things may get worse instead of better. This is something that most don't expect... Bart's book is a must-read by the way."Note to everyone: when you *do* have that meeting and the first response to your presentation is ""That's not who we are"" the thing to say is ""I'm very sorry, but it's exactly who you as an institution are collectively and if that ends up meaning individually, then so be it. Our experience here suggests 'who' this facility is.""This is a powerful truth to lay bear and we cannot back away from it. It is the essence of acting to attempt to foster accountability.""Teresa Goodell - The peer pressure and family pressure tactic to ""sit down and shut up"" isn't working anymore. http://bg2.funformobile.com/blog/blogItem.php? item=16257860&uid=1snsq2neay&p=1&aid=118713"I got a recommendation from a co-worker and I went to my first appointment yesterday...it did not go well. Do you just blindly trust your dentist?"Tina, I ran into a woman who used to work for me recently and I didn't recognize her. Her face looked completely different. It was distorted greatly. She was in obvious pain - physically and mentally. I asked her what was wrong and she began to tell me a horror story that was almost unbelievable. She had been to a dentist for implants and she was basically tortured by a very angry dentist. I won't go into the details here... It was bad. Very bad. He ruined her face on top of the damage he did to her mouth. From what she told me, it sounds like he's either an alcoholic and drug user/abuser. I don't see any other way a doctor could do what was done to this woman. She is completely traumatized! And this is a woman who battled breast cancer for the two years she worked for me. She is a very strong woman. I can only imagine what this doctor did... Her family and those she works with don't believe her because they trust doctors. I think that's perhaps the worst part for her. It's so difficult to survive being violated by a doctor/doctors anyway. But to have our families not believe us on top of everything else is too much:("i agree people do not want to hear the truth. they like to live in their dream world"Robin Karr, I have shivers from reading your comment. I won't go into the details about the extensive and irreparable damage I suffer from because my former dentist (on probation) tortured me in 3 surgeries one without anesthesia for 6 hrs. He said I didn't need anesthesia because his technique was so great but it was because he wasn't permitted due to his probation and he was hiding that. It's sad when the Dental Board states the dentist is not negligent and victimize the victim again. Families side with the ""powers that be"" more often than not""When talking about what happened, she kept saying ""He raped me Robin"". She was sobbing... She said he very angrily put his hands up in her face and completely pushed her jaws and nose up out of place with no anesthesia! I could see from looking at her face that he did what she described. Truly horrifying! I can't stop thinking about her... I'm so sorry for what you've endured Tina. Honestly, it's only because of your many posts here that I immediately believed her without question. She needs someone like you to talk to right now. I fear she's suicidal. She doesn't have internet or I would have told her to join this group. If she could share her story here and find others who know she's telling the truth, it would help to validate what she's going through at least..." "She deserves so much support...it's so sad that non compliant dentists and the Dental Board members keeping them licensed make victims of dental abuse and neglect suffer an additional level of pain when seeking assistance to ""correct/address"" the irreparable damage. We pay dearly both physically and financially and damages that affect our entire health"I truely dont understand why when a dr really causes someone to code when they over dose them on meds you cant do any thing about it ! Its truely rediculious! I myself died on june 12 th of this yr evens tho they resesitated me i know i died but because there was no so called long term physical empediment or long term so called suffering (but what about mental suffering im scared to ever go into surgery again) so the dr goes scott free no one here will take my case i think its just crazy an i was done unjustly an lived to tell about it ! PRAISE MY GOD that i did everyday!"You are here for a reason Patty. Just like we all are. I too am petrified to ever have surgery again, since I was horrendously butchered by a group of doctors who needed a guinea pig for experimentation and training practice."I have the same anxietiesI'm sorry that happened to you Patty. I hope you are doing OK now. I too am afraid of surgery and yet my body is falling apart ever since I took Levaquin. I will need surgeries again and again. My life is so painful now I'm not as worried as I used to be. Death does not seem so bad anymore.Did the doctor ever apologize?Very sad that you say death does not seem so bad anymore Mark but I think many of us here feel the same way sometimes:(If i hadnt been worthy of the LORD wanting me back here id not been here i have to give him all the praise an glory! Keep your faith an KNOW that GOD is your savior he loves us all ! I still think about it and i hope it never comes to that again but if it does i know whose on my side! GOD BLESS YOU MARK!"God gave us free will. I didn't listen to my will. I let unscrupulous doctors force their will onto me, and I suffer the appalling damage they inflicted on me every single day. I too pray to God, but my prayers are for Justice, and it will take a miracle for justice to prevail in a system geared to protect the perpetrators.""Even with all of Davita's known problems, legal dilemmas and history of dismissals, our State Commissioner of DHHS signed the Certificate of Need approval for them to come and run Eastern Maine Medical Center's clinics. Money/profits over patients is a very frightening thing." "Agree Kathy, profits over patients is frightening... I think many of us are facing this reality now."sorryplease call in"Hi everyone,I'm new to this community, and really grateful to have found it. Does anyone have any personal experience with or resources about cardiac catheterization-induced heart attacks (from blood clots)? In solidarity,Laura""Hi Laura, Here is an Informed Consent for cardiac catheterization with risk potentials: http://www.southdenver.com/media/pdf/procedures/CardiacCathConsentFormt.pdf""Hi Doug Hall thanks for the link. yes, a consent form was signed, although it's my belief that full information was not orally given to the person... i guess i'm curious to hear if others have had this experience, or know someone who has, and if so, if they were successful with medical malpractice?""A thorough Informed Consent is difficult, at best, during an emergency. There are risks to be balanced with the expected benefit for every procedure. I'm not an attorney but I want to make a friendly reminder that negative outcomes do not necessarily mean there has been negligence. Here is a link for the evidence requirements to pursue medical malpractice: http://www.nolo.com/legal-encyclopedia/medical-malpractice-basics29855.html""I was bullied, threatened, totally mislead and misinformed into a unnecessary radical hysterectomy by deceptive and fraudulent practices by unscrupulous doctors, Laura, but the whole system sided wth the doctors, so I had no hope in hell of getting any compensation. Most of the injured patients I talked too, said they would not have had the surgery, if they had been properly informed." "Very very few harmed patients are successful with medical malpractice because of tort reform. In my case, there was no emergency and yet my former doctor admitted he purposely had me sedated so he could purposely obtain consent for my elective surgery from someone other than me so he could purposely remove healthy organs. He even stated there were certainly no signs I had cancer! He admitted he castrated me for no reason other than 'hormonal bloating'; which all women on the earth experience. The O.R. nurse admitted she knew the consent she obtained was illegal since there was no emergency. YET, there's NOTHING I can do. I've pursued legal remedy since 2008. I've been through three lawyers, my case has been dismissed and re-filed, my trial date has been moved several times and is now set for 2014. I'm representing myself at this point because no lawyer will take over my case. My situation is common. Pursuing a malpractice complaint is very draining physically, mentally and even financially... There is little reward even if you're successful and win due to caps on jury awards. Here's a portion of my former doctor's testimony. It's quite incredible on many levels... http://www.hysterectomyconsequences.com/testimony_of_bradley_busacco_and_mercy_hosp ital_or_nurse""Hi Laura Delano, welcome to the group. We're glad you joined, though we're always sorry that this is a group that has so many members! I wanted to urge you to please share the story of the cardiac cath with us here at ProPublica. We're asking patients or their family members to complete a questionnaire, so we can gather stories and topics that we should pursue. Here's the link to the questionnaire: http://www.propublica.org/article/patient-harm-questionnaire""Doug Hall Thanks for the link on med. malpractice-- yes, i am aware that not all negative outcomes are malpractice, just very much hoping that this is, because it has caused complete and total devastation of quality of life for this person, who was totally healthy before. June Gardner There was definitely pressure from the doctors to have this procedure done and although a consent form was signed, it didn't feel like a choice at all for this person. I am so sorry to hear of all that you've been through. Robin Karr Your experience sounds so horrific, too. I'm not going to lie-- your legal struggles are not an encouraging sign, but it sounds like from what I'm learning here that this is simply the state of affairs in medicine. Thanks to you both for sharing your personal stories here."Marshall Allen I will definitely take a look at this questionnaire! I look forward to getting more involved with this community. These are pretty good... http://www.achd.net/food/literary.html Could be used in hospital in addition to food service locations.....another reason to have a Professional or Family Advocate double checking everything 60 minutes per hour: This story is about a Pediatric Hospital that caught 234 medication errors in 1 month on 1 unit. Also mentioned that the new systems only stopped half of medication errors that would have caused harm. The emerging role of family member as Patient Safety Intermediary is well justified. The Advocate and Patient are the last line of defense to catch errors of commission and omission: http://stillwatergazette.com/2012/10/31/lakeview-earns-patient-safety-honor/"It says many of the medication errors would never have been known about. This adds tremendously to difficulty in diagnosing and prompt treatment, and dangers that the wrong drug can do. The wrong drug won't fix the problem, but people believe the right drug was given. The conclusion is the drug didn't work, and so the right drug will never get a chance.In the other case, the patient might complain about the strong side effect from an incorrect drug that was administered which nobody knows about. The mystery about the patient's condition deepens. Then many things have to be considered. Maybe the side effects of the wrong drug are known and the mistake recognized. Maybe the patient is diagnosed with a second condition, and given expensive tests that come out negative. Perhaps even a psychiatrist is called in to evaluate for psychosomatic situation (and this goes on the record). Psycho active drugs are then prescribed. Of course, the hospital will profit from any mistake it makes.""I don't know if this is relevant here, but ""The Medical Error Action Group"" was started in Australia, by Lorraine Long, whose mother went into hospital with an asthma attack and died. The hospital said her mother died of natural causes, but the truth was that she was poisoned by the wrong drugs, given to her at the hospital, which was then covered up. If her daughter didn't do her own investigation, she would never have known the truth. We believe what the doctors tell us.""""Blame is being placed on the building���s outdated backup power system, which has raised concern that aging infrastructure at U.S. hospitals has created a risk for similar outages that jeopardize patient care.""""Backup systems should be designed so that they may be stress tested without disrupting the current system operation. The backup system was probably inspected, but not tested.""Hello! Thanks for admission. Unfortunately I belong in your group many times over after an almost unbelievable chain of iatrogenic events. In April of 2007 I had hardware put in my broken left ankle. It broke apart and twisted around a bit. During the surgery to drill out all the pieces I got a hospital acquired infection. They had to cut away the dead tissue, irrigate, put new stuff in and try to sew it shut. They also put a PICC line in my arm to inject myself with antibiotics. The first try popped something in my ear. The next try was too long and coiled inside my heart. Third try was supposedly OK. I knew I was having an adverse reaction to something but no one took me seriously; apparently the admitting physician wrote that I drank 30 beers a day not the 30 beers a week I told him so they were convinced I was having withdrawals as I pissed myself and shook and sweated and hallucinated. My blood pressure was all over the place. Still, they sent me home and I kept injecting the stuff for 17 days as I got progressively worse until my arm swelled up and turned purple. I had blood clots all along the PICC line from my heart to where it came in. I spent a few daze in the ICU. Turns out I had been given contaminated syringes of heparin. I still had lots more damage though, including ruptured tendons in my ankle, cartilage lesions that required a cartilage transplant, a broken blood vessel in my foot, giant swollen veins that needed to be removed, and a whole lot of other problems from head to toe including insane headaches, intense anxiety, auditory hallucinations ringing in the ears and on and on and on. I just figured that the dirty needles had done all this damage until one day I came across an article in Alternet about a class of antibiotics called fluoroquinolones and the long list of 'symptoms' like ruptured ankle tendons fit me exactly. I knew immediately I had been floxed, the slang term for victims of these drugs, in my case Levaquin. Cipro and Avelox are the other big two but there were plenty more until they were banned, and once these ones are banned they have more, new ones waiting to be released. These drugs should only be used as a last try rather than as a first choice as they are now. The executives of Bayer and Johnson & Johnson know damn well what they are doing to us; not only selling a drug that might hurt us, rather, they are counting on it to hurt us so we buy more pain relievers, antidepressants, muscle relaxers, sleeping aids, antibiotics, and so on. These men and women belong in prison for the rest of their lives and I won't rest until I see justice. Best wishes to all of you with whatever troubles you are facing!""right on, Mark""The serial string of errors and incompetence that some of us experience could be a slapstick script for a Three Stooges show if it wasn't so sad, immoral and deadly.""Exactly, except for disaster in medical care just isn't funny. I will write a book about it though. Or am writing one."Thats what I did was wrote a book about my experience and hopefully it will wake up some people out there that could use the support. I was cringing reading your chain of events that you just want to push pause at some point and it just keeps going. Keep spreading the words! So Sorry that you belong to the same club as I."So sorry at what happened to you Mark. As I've said over and over again. We put our trust that doctors have our best interest at heart, and only after we have been harmed by them, and the revictimization in the aftermath of that harm, do we realize how broken the system truly is.""Hi Mark A Girard, thanks for sharing your story. I couldn't help but be reminded of this article by Kerry O'Connell as I read your account: http://content.healthaffairs.org/content/31/8/1895.full.pdf""Also, Mark A Girard and others - please share your story with us at ProPublica, so we can better investigate these various matters: http://www.propublica.org/article/patient-harmquestionnaire"If only we all had known then what we know now.they put me on leviquin also an i had a bad reaction to it also i just stopped taking it!"I once had a reaction to geodon? and it made me feel like the flu, body aches, temp, shakes and so I told him and he said well let's just try it again to make sure. No offense Doc but let's not and say we did.""Dr Mendelsohn said the same thing Michelle. Just say you'll obey the doctor, but go home and do what you know is best for you."I've done that many times Michelle."Thanks everyone. Marshall Allen, thanks for sharing that story with me; I can see why my story reminded you of this one. Here's something crazy-one of the surgeons involved in my case was from what must be the same giant orthopedic outfit in Golden Colorado. I will send him an email and ask him.""Glad you found the story helpful, Mark A Girard. Incidentally, Golden, Colorado is my home town. Totally irrelevant, I know."Place this on your calendar for tomorrow. Send to your friends."Defensive medicine blamed for patient death... What do you think? I don't buy this excuse because of 'Tort Reform'. It's nearly impossible to find anyone who is able to successfully pursue a medical malpractice complaint. So, why are doctors so worried? http://t.co/3chvGGf6"They are paranoid.I completely agree with both!OMG I can't help but wonder where that came from."Every exposure to medical treatment poses risks. The reason for overtreatment is not fear of lawsuits, but motivated by fee for service profit. Most doctors are employees of hospitals or medical centers. I assume that there is an annual review of employment performance for doctors as there is in any other white collar industry, which is basically a cost versus expense analysis of the employee. It is a yearly post-employment job interview which asks the employee, what have you done for us this past year? Avoidance of profitable tests and surgeries on patients is not going to make points."Garrick Sitongia - I couldn't agree more! Any fear they may possibly have about malpractice is so overwhelmed by greed that it is not measureableI had a hard time getting through the article because again we go off on a spin of many things yet who still gets hurt? The ones that are the victims. "Agree with you Garrick and Allen when you say doctors aren't worried about malpractice nearly so much as they're worried about not making crazy money. The article attempts to get the reader to feel sorry for the poor doctors who just can't win and are damned if they do and damned if they don't. Sadly, many people buy into that. They don't know what we know...""Right Michelle, it's the victims who, at the end of the day, get hurt!""Doctors know they can get away with whatever harm the commit. That's why it was so easy to fabricate cancer and mutilate 6 healthy organs from me. They knew they would never be accountable, that the system would take their side, while the harmed patient is discredited and disgarded.""This is the most ridiculous article I've read in a long time. Hmmmmmmm . . . yeah, a medical error is JUST like a baseball slugger's 100 mph swing that gets thwarted by some fan's flash going off causing good 'ol slugger to blink {rolling eyes} WTF is Birdstrike, Dr even talking about!?! OH PLEASE -- dude must not know what a ""non sequitor"" is. He writes: Case No. 1 "". . . then had a coronary catheterization which perforated one of the arteries in her heart and killed her,"" but goes on to blame her death on ""defensive medicine."" Maybe, just maybe if one of the patient's arteries in her HEART wasn't perforated, she wouldn't have died. Defensive medicine caused this patient to die? Since when do ""concepts"" and made up crap perform heart caths on a patient? I'm not a doctor, but I'm going to take a ""stab"" at it and I'm going with the COD as a perforated artery in her HEART caused by someone who . . . . . what!!?! . . . . . . blinked!?!?!!! The patient's death was caused by someone who shouldn't have PERFORATED her artery. I didn't even read the dribble any further -- MY artery was just about to burst."Defensive medicine has killed and maimed countless patients. I know of 3 people who died having operations that were totally unnecessary to begin with."""defensive medicine"" is a concept. The bottom line: the doctor does the deed. No matter if somone needs the procedure/ operation, or not (which is another topic, i.e., unnecessary procedures) if it's botched, it's botched. I didn't need my surgery and my surgry was botched. At least do the procedure without harming, maiming and killing people, geez! Then . . . we'll talk about being used as guinea pigs.""Exactly Carla. It's bad enough being tricked into unnecessary surgeries, but to have it so badly botched is unconscionable, and a reprehensible miscarriage of justice.""Thursday I will be hosting""LIFE"" Radio show and I will be talking about the falsifying of medical records, and refusal of medical records. Please inbox me if you are interested."Please clarify refusal.Some entities are refusing release of medical records and making it difficult for them to access the records or investigations relating to their cases. Some entities are charging enormous fees that people can not afford to get records. In my case I am being refused the investigations surrounding information found in the medical records. good question to put to the panel that Blair is bringing together.ok let me knowHer post is about 11 or 12 down from this one. You need to post in there.I am"Freedom of Information sent me out my medical records for free (Australia), but the contents was full of falsehoods and fabrications. No wonder the complaints depts. didn't believe my story."http://www.cbs42.com/content/localnews/story/The-caseagainst-mercury-in-your-mouth/qpJNJ_tqCkCx0JsPMedd4g.cspx"My husband has had all the mercury removed from his mouth- when they do that- it can weaken the surrounding tooth, as they have to drill all of it out...which results in root canals!""Amalgam fillings split my teeth and then I had these damaged molars over drilled and gold crowns filled with amalgam - then a few root canals and now last week had a molar extracted because of infection - had to take amoxicillan but also am taking probiotics, supplements, chlorella,cilantro etc. and eating well. I am NOT amused with those health professionals I trusted for too many years!""When I was 19, a dentist said I needed 21 fillings. I didn't know any better then so I allowed it. In reality, I only needed 2 fillings. The teeth he didn't touch are still healthy today, 46 years later. He destroyed my teeth for personal gain." "Paramedics arrived a short time later, but they couldn't save her. Nor could staff at the hospital. Katherine, age 27, was brain dead. Nobody said anything to me, said Patricia Dawkins, who didn't learn her daughter was in trouble until after the ambulance had pulled away from the back of the building. I asked the girl at the desk, Is something wrong?'""Despite admitting responsibility, in the words of his settlement, Choi bargained with the Dental Board and received three years of probation and remedial education without any restrictions on his practice. Choi continued seeing patients and administering anesthesia as though nothing had happened. He still has a license today.""792,012 others like this http://www.thepetitionsite.com/1/Pass-Tinas-Bill/Please read/sign...THOUSANDS OF UNSUSPECTING PATIENTS ARE TREATED BY HUNDREDS OF PROBATIONER DENTISTS EVERY DAY." Signed petition Tina! Please sign mine @ http://www.hysterectomyconsequences.com/petition_to_president_of_acog_the_presidend _and_lawmakersThank you Robin Karr!http://www.focusonline.ca/?q=node%2F463 http://www.youtube.com/watch?v=W1-K4kh8fcc http://articles.mercola.com/sites/articles/archive/2012/10/27/medical-errorskill.aspx?e_cid=20121027_DNL_art_2"These errors kill the equivalent of four jumbo jets' worth of passengers��_ every week, Dr. Makary says, and this is likely a conservative estimate.""They've tried to kill me over and over again but I'm Tough, Tough with a capital T!""As a newbie here my first thought is that improved electronic record management has got to be somewhere near the top of the list of ideas as to how to reduce these horrible numbers. I would also say that the system needs to pay far more attention to what the patients are saying and experiencing. A new level of transparent electronic information management where everyone in the loop has access to the information would go a long way towards solving these problems. Instead of trying to convince one doctor after another after another that all these problems started the same day, the day I took Levaquin, instead I would go to the Levaquin page and click the boxes for the symptoms I was experiencing, like spontaneous tendon rupture, cartilage lesions, hematomas, blood clots, bloated blood vessels, and so on. As a patient I would be able to read what the doctor had written as I have had very bad experiences due to mistakes into what doctors have written.I'm sorry but my experience is that the system is horribly broken and failing miserably at doing anything except extracting money from the people. The drug companies are beyond immoral and doing far more harm than good. In fact, it is a reasonable proposition that more people would live longer healthier happier lives if we closed them all down and stopped giving anyone any drugs for any reason. We have gone to the side of over medication to the point we are shortening lifespans and causing tremendous amounts of misery. The executives at the companies bamboozling doctors into believing their crap as safe all belong behind bars. The stuff isn't safe. It isn't even close to safe."Hi agian Mark I understand www.shellybeenz.com"What happened to me was a deliberate racket run by unscrupulous doctors looking for easy prey to experiment on. The doctor who lied, bullied and threatened me into this radical mutilations, told me he'd done hundreds of these types of surgeries, that he could do them with his eyes closed. I recently found an article about him, and it said that he was completing his training the the hospital where he harmed me. So, in reality, I was used as part of his training. He lied to my face about everything."That is terrible June. I think I just ran head-long into a broken system but not corruption on a face to face level. Avoidable mistakes as far as I know. I hope things improve for you."No Mark. Things will never improve for me. For over 7 years I've suffered numerous complications because of severe internal damage. and to get blacklisted on top of that is unconscionable. Read the article called ""DEADLY MEDICAL PRACTICES"" by Trudy Newman. Much of what was written in that article happened to me firsthand. And I had nothing wrong with the organs and lymph nodes mutilated out of me. The morining after he did the operation, the doctor who threatened me into immediate surgery by saying I had cancer, came in with a smug look on his face and said I was as clean as a whistle. That I had no cancer. All my removed organs were healthy."I'm sorry to hear that June. I had a long series of iatrogenic events. My doctor got fired and my case got transferred to another clinic."Thanks Mark. Seems like most of us here, have had a long series of iatrogenic events, and millions more trusting, unsuspecting patients will no doubt be added to that list in the future, because nobody stops these dangerous practices, you can mark my words on that.""Yes yes, did you know my lawsuit lasted 3 AND HALF YEARS. Then we had to quit because we went broke." "That's why I didn't, Michelle. The doctors who harmed me covered their tracks too well, and I had no chance in hell of winning, even though they committed criminal and negligent malpractice. I tried so hard to get my story out to the public, because I didn't want this to happen to another woman. But nobody would listen, and the media took the side of the doctors, so all I could do was say a prayer for any woman who came into contact with these bad doctors, and hope they listen to their intuition and run."I hear you! Same here. But there has to be a way!Please visit http://www.sacbee.com/2011/09/18/3918688/falsified-patient-records-are.htmlStay tuned for show on Thursday"Deidre, thank you for the opportunity to be on your show to discuss ALEC and it's impact on health care."you are welcomed anytime join in the conversation we welcome your thoughts"How Payment and Governance Regulations are Changing Medicine.An op-ed published in The American College of Surgery���s 'Surgery News' This article has Free Access" "http://en.wikipedia.org/wiki/Blacklisting""One patient created a graph showing that every time his primary care physician knew about appointments he had with other physicians, those appointments did not result in diagnosis or treatment. All those physicians pretended to be helping, but eventually workers in one physician's office let him know that his primary care physician called them and told them not to diagnose or treat his injuries.[15] They were protecting the physician who caused the injuries.""""I believe this is one reason that the defense demands a list of the plaintiff's doctors. In my case, the defense even found out about doctors I saw but didn't disclose to them; like a gynecologist in Kentucky - not Ohio where I live and where my case is filed. I saw one doctor who was initially nice to me, listened, performed tests I needed, etc. Then suddenly, he turned into someone I didn't recognize - throwing my chart at me during one visit. I went to him for swollen glands in my neck and he told me to quit making appointments for conditions that don't exist. The swollen glands were beyond obvious. People at work were commenting on them... Another time, I made an appointment with an endocrinologist who told his receptionist to tell me he wouldn't see me. She asked me to leave in front of a waiting room full of people. Until being harmed by unnecessary hysterectomy, I never experienced anything remotely like this. I know others here have experienced the same and worse.""I would like to say this doesn't happen, or doesn't happen often, but I've talked to enough living donors in the past four years to know that it does - far too often.""I would like to say it doesn't happen even while it was happening to me. I tried to look for alternative explanations. But after all that good faith effort, all I am left with is overwhelming evidence that doctors really do treat me that way because of my medical injury.""This is what is happening to me. I could make my own graph. No tests or specialist care. I also heard about the website called ""Doctors know US"". I could not get a requisition to get an MRI of my spine where I live. A relative helped me get the MRI of my spine. Last year I was denied a bone scan after I was told by a private clinic I could get it done. No justification to deny the bone scan because I had a copy of my MRI spine and X-ray with me showing 10 findings in total.. I was told by a GP i need to see an endocrinologist but the doctor I had to go to said it was not needed as he knows all about the thyroid.. I had untreated thyroditiis in my teens and early 20's..This was a misdiagnosis so they won't send me to the endocrinologist so I cannot get anything official in writing. Even with test results to confirm it. I have a distended abdomen and I am in pain..I suspect I have an enlarged liver but I cannot get any medical tests done.. I have complained about the pain to a few GP's. It really does not matter to them. I know this and understand exactly what they are doing!! One doctor looked at his computer and turned to me and asked me if I was bringing a lawsuit. This is how they warn each other..Where is the privacy that we patients are suppose to have.. IMO that does not exist either..I learned a long time ago that my records were being illegally accessed.."http://boards.straightdope.com/sdmb/showthread.php?t=243379"Some of the comments on the site via the above link are very disturbing... I guess most people just won't see the truth until they experience what we have. I didn't say in my other comment but the doctor who threw my chart at me eventually refused to see me also. Before he told me to find another doctor, he told me that his diagnosis for me was 'irritable bowel syndrome'. When I asked him how I could have this with no symptoms, he said 'Since we don't know what's wrong with you, that's going to be the diagnosis"". He laughed. I should also mention that the reason I was looking for another doctor in the first place was because the one who unnecessarily and illegally removed my healthy organs told me to find a another doctor. He told his nurse to tell me I had too many problems since the surgery... People who have not gone down this road to hell have no idea what it's like.""if you are sent to the ER to rule out and diagnose septic knee and then they tell you, your child is fine, she just has a flu like virus in her knee and then 2 days later on Halloween she goes suddenly into shock and is dead within hours and you find out the ER did NOT rule out or do the proper tests and you believe them when they say she is ok! Then she is gone! What do you do???"@Michelle Septicemia and Meningitis are often labeled as the flu in the ER and the person is sent home. From what I have read this is very common..That's so outrageous KariAnn! Wouldn't you think doctors would know the difference between flu-like symptoms and something as serious and lifethreatening as Septicemia and Meningitis? I do!!yes but if you are diagnosed that and sent by a pediatrician to the ER doc then should the doctor do the proper tests to rule it out??The stories of Misdiagnosis are endless.. People who have red or purple spots do NOT have the flu. No idea how they missed and dismiss these obvious signs..."Why say you did something when you obviously did not? Why not offer another solution like say you no this can be serious and I dont think it is that so you might want a second opinion, or something to alert me that everything is just fine?"www.thepacket.ca/News/2009-06-04/article-1430760/Family.www.shellybeenz.comI am sorry but we disagree.So sorry for your loss Michelle.Thank you and I do understand that these problems we have in our healthcare system are endless and when you have been on the recieving end of a nightmare it just changes your whole attitude and emotions for people like me. I just want to make a change!"The link above by Tee Rhudy is scary. The company tracks patients who ever filed a lawsuit against a doctor and makes the list available to doctors so they can reject those patients. They might expand that to compiling lists of patients who filed a complaint with a state medical board. Although it is not public information, members from all states could report a patient who filed a complaint with a state medical board. The patient could move to another state and be blacklisted for having filed a complaint. Also, there is no reason why a doctor couldn't report patient complaints from years past, so any of us who filed a complaint could sometime in the future be blacklisted by some doctors from that.""We put our trust in doctors, and when they betray that trust the results can be devastating. I know, because it happened to ne firsthand.""How can treatment of terminal cancer be worse? Of all of the medical treatments at her disposal, only morphine, a 200-yearold drug, was helpful.""The link only goes to their home page. Do you have the link to the article? But, yeah . . . morphine is a great for pain. But it doesn't really cure anything. Link please :-)"So sorry; the precise link is: http://www.freakonomics.com/2012/10/16/when-a-daughter-dies/comment-page2/#comments"Thanks Claudia Kim Nichols -- this is a MUST READ. A very sad tale and the frustrations are felt from a father who is also a doctor. If he had a hard time getting ice chips for this daiughter imagine what the layperson/family can not even address. Being as pro-active as he could with his daughter's situation, he was frustrated too. To quote: ""We finally depart the hospital, no doubt with a well-deserved reputation for being a very difficult family."" Again, my point of being the ""proactive"" patient,family,friend only brings upon the labling. It should not be a well-deserved reputation for being a very difficult family. That's a shame and not deserved at all. Pity.""What we found was a culture so unresponsive to anything but the worst of bullying, we had to embrace being as unpleasant as possible to get anything done. Being nice put you on the bottom of the list, being a terror was the only way to get people to move. We noted this to everyone we gave ""the treatment"" to, tried being nice and then noted the lack of result for niceness and that they only had themselves to blame for the bad treatment. We kept telling people, you have trained us to be ""difficult."" Don't complain if we have paid attention to your lessons. If I had it to do over again, I would have been meaner and more awful, I feel guilty that I tried to be decent -because mom was the one who paid the price for an attempt at civility.""Debra Van Putten - it verifies to me that for the patients, nobody is really in charge. The doctors and nurses are like free agents wandering around doing some things on time and correctly, forgetting other things or getting mixed up. The patient's own advocate must become the boss and supervise direct people, forcibly if necessary, to get the right actions for their own patient.""But, you can't. Mom's case was point in fact. We told them how they were going to screw up before they did. The only time we got them to do something was afterwards and after someone's nether regions had been chewed. And then someone new would start, we'd give em a chance and they would make the same mistake. Maybe they would stay long enough to chew on them, but usually they were clear of the scene before the error was obvious. It was like ground hog day. And the problem with forcibly is that it could land you in jail or result in your being kicked out, leaving your loved one completely at their mercy. We called APS, and got a stupid hospital employee who said that their colleagues would never do such a thing. Well....they did. I mean, I suppose I could have purchased a gun but that is not how we do things... anything short of that we did. And we weren;t paying their salaries and the sociopath who was said starving people was ""great care.""""The saddest part of the case is that a vibrant 50 year old died of a terribly aggressive cancer for which there was essentially nothing but comfort care to be done. Sadly if ice chips had been given and the woman apsirated and died, there would be vultures circling to charge negligence. Strongly adversarial stances do little to advance compassionate and safe care. Only by working together can we make lasting change to our health care system.""If you are dealing with a psychopathic doctor, and you question him about his decisions, he is most likely to deliberately harm you while he is operating on you. I know, because it happened to me first hand.""Diana Behling, what kind of ""working together"" do you propose to make lasting improvements to our healthcare system?""Me too June. All I did was advise the hospital intake nurse that the wrong surgical procedure was listed on my hospital consent form. Within minutes, I was purposely knocked out against my will and the wrong surgical surgery was purposely performed on me. Six healthy organs were removed. I guess NO doesn't mean NO afterall...""I should clarify my comment above. How do you work together with a system that many victims have come to learn to be a system which has the priority of professional image and income over patient care. The system which denies truth necessary for healing to protect professional egos and prevent litigation? This system which protects psychopathic doctors because they generate income, too bad and tough luck for the victims.""Several books on hazardous medicine say that the system will always protect the doctors, regardless of the harm they do to their patients. And you are right Garrick, psychopathic doctors do generate income for the hospitals. You only have to read the book ""Sick to Death"" about Dr. Jayant Patel dubbed ""The Butcher from Bundaberg"". Even after being struck off in America for killing and maiming a number of patients, he came to Australia, where he was given the position of ""Director of Surgery"". He killed and maimed a number of patients, and even though the hospital knew about the harm he inflicted on his patients, they offered to renew his position for another 2 years at $8,000 a week, because he generated the most money for the hospital by operating on numerous patients. He was practicing without a licence and the Medical Board didn't bother to check him out, even though his incompetence and revoked medical licence was on the web for all to see.""There are many ways to meaningfully engage patients in the effort toward improving the delivery system. The portrayal of physicians as psychopaths is disconcerting. There are bad doc's for sure...and plenty of good, conscientious health care providers. Many health systems are working with patients to advance safety science with the consumers perspective included. It's an important step.Many systems have strong policies for disclosure and transparency. There is no quick fix to a complex problem, I know in my heart that flame throwing on either side will never fix anything.""Diana Behling, the doctor intentionally starved my mother for seven days because she was a paraplegic, and then demanded an unnecessary trach and got mad when he was fired, what would you call him??? Sociopath seems to be a good description to me? What about the doctor has overdosed her to the point of hallcination, refused to tell us what medication she was on, and when he was chewed out by us and one of the other doctors, thought it was just hi-lar-ious that we would be unhappy at him nearlykilling her? Do you think we can have a ""meaningful engagement"" with him??? How about the SIX board certified pulmonologists who lied to us, lied to mom and lied to her normal doctors as to her medical condition--she had lung cancer, precluding us from having her transferred to somewhere that would have treated her. Do you think that hospital has a ""strong disclosure policy.""We've seen mom's records. they are full of lies -- like the 2by 3 cm stage II pressure sore, which upon tranfser is documented by an honest hospital at a stage IV, 10 cm by 10 cm. the problem is the hospitals that would rather lie their way to compliance than actually be safe. And personally, I wish someone had burnt the place down before mom went there. It seems to me that your""heart"" needs to be more on our side that protecting evil people. Because that what the doctors were who treated mom. Evil. that isn't to say that all doctors are evil. But these folks sure were. And they only thing they understood was a swift kick in the balls. And where they need to be in jail. Not in an ""encounter group"" or in ""sensitivity training."" You can't graft a conscience into someone who has none." "I didn't say all doctors are psychopaths. But the few bad doctors are well protected even when one crosses state lines to see far away doctors. It is apparent to any doctor anywhere when there has been medical injury. There seems to be an unwritten rule to protect professional image first, patent second. I was told that the threat of slander is taken seriously, even a false threat because it besmirches the image of the bullied doctor that he is not a trusted team player to the other doctors in his own local area. So that is how a bad doctor can bully and reach across far distances to prevent any good doctors from telling the truth to his victim.I would like to know if there is any idea of how to work with a doctor to get to truth about one's injury. Being nice and patient gets one a bill for nothing done except being lied to.""If you don't think its fair, what words would you use to describe parents who did the same thing to their kid? Would you think that ""constructive engagement"" would be the appropriate solution? How about if I starved my dog? Would you think that a good talk would be the right response? Why should patients be treated worse than dogs?""Diana Behling, where'd you go? A little push back and we get crickets? And by the way, Diana, most of here have tried to ""engage the system"" regarding errors and have been told to go pound sand, or worse. if you were to look at this site, you would see that patients feel that there is NO meaningful way to engage the medical profession, except for legal action. That's why we are less than warm and fuzzy crowd.""Hey Debra Van Putten, let's hold off on calling out other members of the group, please. (And yes, I guess I'm ""calling you out"" here, but I'm only doing so because it's impossible for me to message you privately.) I know you're passionate about these topics, and you bring a lot of knowledge to the comments you make, so please do not misunderstand me. But I would appreciate it if you would refrain from getting overly aggressive with other members of the group. It's not the type of thing that's most likely to lead to the type of constructive give and take dialogue that will be most beneficial to the group.""The doctor who was struck off in America, came to Australia and given the position of ""Director of Surgery"" was bringing in loads of money to the hospital. At one time, he didn't have a bed for a patient he wanted to operate on, so he went over to a patient on life-support and pulled the plug and said to the nurses, ""Now we have another bed"".......... I revered doctors. I trusted them. I put them on top of the list as trustworthy and having our best interest at heart. My trust was so misplaced, and I paid the most horrendous price for believing in doctors.""@June - We all have and nobody seems to understand when you place that kind of TRUST in a doctor, and it is BETRAYED, that itself is a harm that isn't easily erased. Especially when they are unaccountable and unresponsive." "Most of the people in this group understand the ultimate betrayal by the very people who took the oath, FIRST DO NO HARM. I'm so glad that in this group, I don't feel like I'm screaming in the wind. I feel that we are kindred spirits who have been devastated by a system that destroyed our health, or the health of someone we love. And the most unconscionable thing of all, is the doctors who harmed us have no remorse for the harm they caused.""And weaving this back to the original message thread, even a doctor -- trying to do what's right and best for his daughter who was suffering -- has a story to tell."Even doctors aren't immune to this dangerous system.The fact that even doctors aren't immune should speak volumes... Just say'n..exactly instead of blaming victims for hikes in rates they should no by now that they need to look at the insurance and drug industry that spends billions to keep an outdated law like MICRA on the books. 40 years without one change? huh?I would love to see the day I can face-to-face ask my doctors why?"I tried that Georjean, but when I made an appointment to see him, he was nowhere to be found. Instead, I got another gynaecologist who told me that I cannot see the doctor who operated on me without a mediator present. I wonder why? Maybe I'm not the only one he butchered for personal gain."It's obvious. He has had experience with victims who have decided to confront him about what he did to them. He cannot face you without a someone to help him debate you. Two against one.Some people get it worse than others"Hi guys, ProPublica is hosting a series of online discussions specifically for healthcare providers on the subject of patient safety ��� and we���d love to present questions from this group. So. If you could ask a doctor, nurse or other care provider one thing - what would it be? Please keep questions constructive. We always like to emphasize in this group that one bad doctor doesn���t represent the entire medical profession. The goal of this new online discussion series is to see what providers think about various issues related to patient harm. Their insight, combined with yours, is key to understanding it persists, and what to do about it. Thanks, and as always, let me know if you have questions!Thanks! And as always, let me know if you have questions.""Q: If you harmed a patient, what would you do?""Q: If you knew a patient was harmed, what would you do? [this is someone else's negligence and/or malpractice]""Q: If you saw any of your colleagues harming patients, what would you do?""Q: If a patient asks for another option, and asks for information on the operation, what would you do?......The reason I would ask these 2 questons is because the doctors who saw that I was harmed by a colleague, took his side and went against me. Also, when I begged for another option, the gyn/oncologist yelled that I had no other option, and bullied and threatened me into immediate, radical 100% unnecessary surgery and botched it beyong repair, after looking me in the eye and telling me he's done hundreds of these surgeries, that he could do them with his eyes closed. He also totally mislead and misinformed me. I'm sure the questions will be answered with lies, because that is exactly what happened with me.""Oh God I am so sorry! This is more common than you think and I bet no one believes you. I met this one women and we were there to testify before congress about this very thing you just told me and this women I met had a breast removed because of cancer and they took the wrong breast, so they went back and took the other one. Then she finds out that she did not have cancer at all and her chart was mixed up with the one who did have cancer. She tried to sue but could not because of how the law is set up."I am so sorry and I would love to use your story and the details of your pain and how it has changed your life. Including relationships. You will help someone with your story!sad but trueYou did nothing wrong IT was done to you"If you read the letters sent to me by complaints departments, where they believed the lies of the doctors, and totally discredited the 100% truth that I told them, you would be shocked. I get so outraged that this could happen. I revered doctors. I trusted them, and they betrayed my trust to the enth degree, and first did the most grievous bodily harm for personal gain.""Would you follow up with and treat a patient who has been harmed by another doctor? If not, why not?"are you asking me?I would like to know if or how many times have you witnessed these kind of problems in the past 5 to 10 years ago?I would ask what is being done about the rate of infection - they keep saying that knee replacement has a very low rate of infection but it just is a lie. Almost every single person I know who had a knee replacement ended up with an infection. And I know doctors from overseas who have visited here and are shocked by how many infections we have with this surgery. Is anything being done to further disinfect the surgical suites where this surgery is being done?"The patient is the last line of defense against error. For the patient who is aware of the potential for error the few minutes for the following is time well spent. 1. Ask the physician to explain what is the new medication, why is being ordered, am I listed as allergic to it and is in compatible with my other medications. 2. You can use a free iPhone apps to look up the same information for the new medication on the way to the pharmacy. 3. Ask the pharmacist the same questions as #1. Obtain a complete copy of your medical record and make a list of your current medications and ask a pharmacist to do a medication reconciliation with your currently active medications. Take them as ordered and report sideeffects right away. A little research will go a long way to avoid injury.""What Blair asked: ""So. If you could ask a doctor, nurse or other care provider one thing - what would it be?""""How can we shift clinician perception that patients should NOT ask questions? That's the biggest one, IMO. Without the help of those MDs/RNs/et al who support shifting the culture of medicine from a patriarchal hierarchy to a collaborative effort that INCLUDES THE PATIENT, all the discussion in the world is just so much hot air.""Thanks for your responses so far, guys.""My questions all have to do with the safety of prescribing fluoroquinolone (will refer to as FQs) antibiotics, as I belong to a handful of people throughout the world that has been poisoned by FQ antibiotics.1. Why is the current black box warning regarding tendon damage/rupture, ever discussed with a patient before prescribing it? Not saying all doctors/nurses don't, but very few do.2. Do any doctors worry about the safety of patients who encounter FQ toxicity? And if so, the why is no one taking responsibility to ensure we are taken care of when patients get to the toxicity level?3. Why are FQs prescribed for both minor & major infections (as if being handed out like candy), when it is only supposed to be used as a last line of defense?4. Why is severe joint damage not listed as a possible adverse drug reaction in a black box warning?I am a victim of FQ toxicity. Multiple doses of Levaquin and Cipro over a six month period for what I thought was curing my infection, has ended up ruining my life. I have severe joint pain, nerve pain, muscle wasting, etc. I just want to know why no one will admit that there are greater risks with these meds then what is mentioned, and why no one will help us with it. Thank You,Leslie""profits before people! I know it sounds like impossible no one would let this stuff happen, but they are callous and do not listen to the patients when they tell a doctor who already knows everything and there will not be consequences. SICK!!"What are the obstacles to incorporating continuous improvement and transparency practices ?"How would you categorize, and systemetize a solution for, this harm:MRSA-stricken 84yo man needs minor surgery to relieve MRSA site (wrist). OR only option due to prior infarctions and 2/3-atrophied heart. He specs: ""no intubation."" Anesthesiologists refuse; he/family admit to hospice, meds stopped, he dies 4 days later. 18 months later is the first time I learned that (a) DNRs are suspended during surgery; (b) life support reintroduction is allowed anywhere from 2-48 hrs post op (via consent form���we'd not been presented w/one); [c] the existence of the phrase/option ""time-based trial"".So, our options under Dad's autonomy were foreclosed but due to nondisclosure of relevant policies and options.""Please find the time to watch this very informative presentation.The Affordable Care Act - After the Supreme Court Decision http://vimeo.com/50871983""Medical device maker Medtronic Inc edited health journal articles and paid doctors millions of dollars for company-sponsored studies of its Infuse bone-grafting product used in spinal surgery, according to a U.S. Senate report published on Thursday."Someone once told me to not use a new drug until it has been on the market for at least 5 years. I'm thinking it's safer to make that 10 years. This is just another example of why.The amount of time a drug has been on the market is no guarantee if it is used off label (not for its original purpose). Apparently that is not the case with Medtronic; just gaming the system to it own advantage."Garrick Sitongia, maybe extend that time way out. There is a group of antibiotics, been around for over 2 decades, lots of them have been pulled or banned. Some are still being used, black boxed.....no doctor in my area 'knows'(clueless they say) abut the BB..... if one is given a RX for this - you get a copy of it from the pharmacy - but a hospital - not so lucky. You won't be consulted. If things go badly as the manufacturer says can especially if used concomitant with certain other drugs that intensify the risks of permanent damages(mega doses). The reporting is done by FDA, the hospital knew I had an event, it was recorded for two days -but they did not tell me. They released me crippled telling me I had a bad infection - terrible - painful, quality of life gone. No watch dog agency will report - long story. Oh, after the lack box was placed - usage tripled - it can attack every organ in your body and it is not rare. They just don't report it.""Michelin Anderson, one should always check prescriptions on the Internet for side effects and lawsuit activity. Just put the drug name and the word lawsuit into the search engine and see how many hits there are for the combination.""One can't do that in a hospital, deaf. Also, you don't get treated like a hearing person - I am late deafened. Night and day change in attitude. I had no support; half the staff thought I was hoh or retarded since I did not respond to them talking and I did tell them I was deaf but it throws people when you speak. Not been on any medication for over a decade and had always checked prior. Once you take this - it's in your DNA - cascade effect usually but mine was immediate and they did not listen to me. They refused me my records for a while it was weird - I know my rights. It was a nightmare til I found out the drug that had been given to me - except the only cure for some is surgery and pain pills. By the second day I could not walk. All so unnecessary. It is really hard to come here and other blogs and read about what is happening to people - it's pretty flagrant and the reason is also flagrant. When I read about the great idea of putting the onus on the patient to be responsible - I shutter. It is very important to make people aware but they have been brainwashed and, while I understand it - I will never shut up. In this area there is a joint venture being put together - doctors investing in expanding the hospital. Most of us here on this blog have experienced total push-back from the agencies charged with patient safety. I want my life back - not a lawsuit. Where did common sense and decency go?"Michelin Anderson - you put a lot in a nutshell. A major summary of what a lot of us here have experienced. It can take a newly injured naive person a couple of years to finally see the big picture. I think the common sense and decency left when psychopaths were hired to manage hospitals. Sorry to be so cynical."As I have been known to mention implications of ALEC sponsorship and involvement by medical corporations to limit liability, I have found that Meditronic has been a member but dropped out this year."There is no trust for the medical device companies to lose. They squandered their credibility to buy market share. Patient harm exposes the evil truth.The evil truth is available for your viewing pleasure at alecexposed.com$34-Million Dollare Spine Surgeon http://www.medpagetoday.com/PainManagement/BackPain/35550? utm_source=twitterfeedThank you for speaking! I was wondering if this group is for abolishing the MICRA laws in this country? Jessie Geyer/MICRA"I am so glad that I have found a group that understands just how bad our healthcare has become and the power of money that backs these horrible nightmares that are one after another, I have been advocating for so many years and the same stuff is happening except it is much worse!!!!!"The Spine surgeons are doing much wrong by the way they are treating patients with devices and instrument (for spine fusions) yet the patients gain no benefits of it n terms of better quality of life. It has been going on for 20 years now.Exactly right! So glad to hear you speak out!I need people like you to make a change but it will take all of the ones who know but have not really had their voice heard!"That's the real tragedy Christer. A lot of these things have been going on for years and years - even when the truth about adverse side effects/consequences is 'known'. Thousands upon thousands of innocent and unsuspecting patients harmed and killed! This is beyond outrageous. Many of the procedures, surgeries , medical devices, drugs, etc. have KNOWN adverse consequences and yet, there is 'silence' about it. So, the harm continues...""Its a sad, sad story that tells a lot about our ways of dealing with life, nature, people and the planet as a whole. One can only begin where you stand, by showing the surgeons in a way that they can understand, that is by science. That fusion for Low Back Pain isnt a good thing to do.""Ohh do I hear you! And since Jessie's death 9 years ago I have been exposed to the most horrific stories of people and little children killed in such negligent circumstances! OMG! This is my lifes work now and I need to get the ball rolling somehow and keep it going, and every single person counts.""I've heard so many horror stories after I was harmed. But most people who I talked to want to put it behind them, and have no interest in joining a patient advocate group.""Sadly I have found the same thing however I know by numbers that there are so many of us out there, it is just a matter of reaching them in any way we can. When I get my media website I would love to put up your story and anyone else that would be willing to let me do it for them if they can't. Why in the heck is this so hard to do?? Because we have to fight the Drug and Insurance Agencies that have billions at their disposal to make sure we are kept out of the media.""Thank you so much Michelle. I would really like to have my horror story told. I'm still in shock at how this can happen in a first world country, in the 21st century."Oh yes I know! I still shake my head the more I hear and I still cry for those everytime. If we could talk than I would put your story on my site and I do have plans with gathering first hand stories that need to be told and heard from the public. Let me know how we can talk?"My book will be coming out soon and it is about pain and suffering. It is called Like Shattered Glass...and it is very rough and a hard read because of the subject, but I want people to know that I do understand and that we need to help victims instead of stepping on their necks because of something that we had no idea could or would happen. MICRA is the Medical Injury Compensation Reform Act passed in 1975 going on 40 years old and it needs to be thrown out. You will not believe that a law like this exists and in combination with our failed healthcare the combination is from HELL!"I live in Australia Michelle. I don't know if you are interested in doing stories on medical malpractice from other countries.It is all the same!And I would be [email protected]"Thank you Michelle. It's very hard to put my story together, as so many appalling things happened before and after I was butchered. I'd have to leave a lot out as it would fill a book. But I am not very good at expressing what I really want to say, and I've been vilified by the medical establishment, so no-one wants to help me. I've only learnt to use a computer 6 months ago, and am only familiar with facebook at the moment, but I will get their slowly. Thanks again, Michelle.""Could it be that the problem is in large part, how physicians are trained, mentored, and acculturated to the profession?""You hit the nail on the head, Terri. In one of the books I read on hazardous medicine there is a chapter called, ""NEANDERTHAL MEDICINE MEN"" The first 2 pages is an eye opener and gives you a glimpse into the mentality of the profession. I will write it on my Timeline if anyone is interested."I do think this is a VERY big part of it. The younger ones who speak out against senior medical staff don't make it very far...and nurses who stand up to doctors seldom get commended for it...EVEN when the doctor is wrong and knows that he is wrong.HCA recently fired a nurse who blew the whistle on unneccessary heart procedures in Florida - kept the physician"Read about what happened to ICU nurse Toni Hoffman, when she blew the whistle on Jayant Patel, who was struck of in America, and did so much harm in Australia that he was dubbed 'The Butcher from Bundaberg."" Patients aren't safe when the Medical Board allows dangerous doctors to continue doing harm to numerous unsuspecting patients. Even after thousands of patient complaints about one dangerous doctor, nobody listened to the patients, and the doctor was allowed to continue practicing for another 12 years before a group of women marched into parliament and demanded action. It was found that he'd been struck off well over a decade ago."That is so true! After my daughter died in 2003 is when I became aware of these ugly little secrets that goes on behind the scenes. Dr. Slomoff is responsible for Jessie not getting an antibiotic and she died two days later from septic shock which was what she was sent to him for....anyway he lied about the care that he gave Jess and finally when we were in depositions I found out that he had 2 previous malpractice claims before Jess but I was not allowed to know what for! About 2 months ago I called the medical board to check him out and he was like doctor of the year! NO Malpractice in history!"What many people don't realize is that medical boards may know a certain doctor is dangerous and yet work to protect that doctor. Many 'assume' they don't know but sometimes they do... Even though my former doctor admitted via sworn testimony that he purposely had me sedated before he arrived surgery so he could purposely obtain surgical consent from someone other than me so he could purposely remove healthy organs, the medical board does not see an issue. A representative from the board recently told me that my doctor probably just gave false testimony. Unbelievable comment on many levels. When a medical board is willing to protect a doctor to that extent, well I don't know what to say... I really don't.""same here, that is why the law MICRA has been in place for 40 years without one change made. Not one! The money backing this horrible law that prevents you from holding a doctor or hospital responsible for their negligence is from the Drug and Insurance Industry is just to powerful! We must keep talking and sharing...I guess."medical boards are a joke! They are made up of all doctors and for some reason doctors are looked upon as the al mighty!makes me sickThe feed back that I have gotten from you very smart and informed gals has given me a great push for today and I want to thank you all! The counrty needs to listen to you!I would like to help in any way I can!"Such a Fresh Idea I had to share, we do have hope. http://engagingthepatient.com/""The original article is http://www.thenaturalrecoveryplan.com/articles/research-modern-medicine.htmland this was based on a 10 year old study by Dr. Barbara Starfield���s study in the Journal of the American Medical Association. The following is an interview of Dr. Starfield, and she really describes what is wrong with the medical system. http://jonrappoport.wordpress.com/2009/12/09/an-exclusive-interview-with-drbarbara-starfield-medically-caused-death-in-america/" http://www.drugwatch.com/2012/01/18/orthopedic-surgeons-and-medical-devicecompanies-cosey-bed-fellows/The orthopedic community is one of the worst offenders. Thanks for the link Robin. http://www.medpagetoday.com/PainManagement/BackPain/35550?utm_source=twitterfeed "Tort reform harms. It makes for a very dangerous medical environment. Since pursuing legal remedy has become nearly impossible for most harmed patients, doctors and hospitals know they won't be held accountable. This is not in anyone's best interest."Here is a far better document than a line on wikepedia... http://www.ama-assn.org/ama1/pub/upload/mm/363/prp2007-1.pdf"CNN ran an op-ed online this morning by American Association for Justice (AAJ) President Mary Alice McLarty on medical errors and patient safety. In the piece she challenges the talking points used by people trying to limit patients��� rights and highlights the importance of the civil justice system:The civil justice system gives families of patients who have died or have been injured by medical negligence an avenue to seek accountability. It also provides an incentive to health care providers to improve patient care. Removing that accountability and incentive leaves people at risk for more injures from negligent care.The calls for medical malpractice reform are misguided because they center on stripping away patients' rights when they should be focused on preventing the deaths and injuries from occurring in the first place.She also draws on the Texas example to show how so-called ���tort reform��� will not lower health care costs, improve quality, or protect patients.""In comment to ""More-studentswant-to-be-doctors.....The more doctors, the more unnecessary surgeries. Dr Mendelsohn said that if only necessary surgeries were performed, then 90% of doctors would have to look for another line of work.""Okay, so the stats are 195,000-200,000 (depending on which report is read) patients die from hospital errors per year. Then, toss into the mix, the surgerical errors where the patients survive. That's a lot of errors. The number of medical medical malpractice suits filed per year on average: 15,000 - 19,000, something like that. Hmmmmmmmmm, I'm not a math whiz, but GEEZ that doesn't seem like patients/plaintiffs are flooding the court with law suits. Seems like 10% of those patients harmed actually file a malpractice suit . . . or . . . alternatively 90% DO NOT! And from the Kirpal's link from Wikipedia I read this: ""Physician advocacy groups say 60% of liability claims against doctors are dropped, withdrawn, or dismissed without payment."" So, of the +/- 10% of patients harmed that actually file a med mal lawsuit -- 60% don't go anywhere. Yeah, the whopping 7,000 cases are really flooding the system. We need MORE tort reform?!? {rolling eyes} I'm sure the medical community [read: insurance companies] would be THRILLED with even LESS. Haven't patients' rights been blocked enough?!?"You're right. Check this out in Colorado where I am from Contract cases take up 77% of the docket while tort cases including medical negligence only make up 6%. http://www.courtstatistics.org/Civil.aspx"Yay someone does know the facts and you are correct even being slightly generous to the numbers. I have been fighting the MICRA law since my daughter was killed and how can it be that the numbers that the insurance industry throws out like oh 98,000 die every year....I still see that number in print more than the correct number of 200,000- 225,000 which was from the CDC back in 2004.""I'm new to the group, Marshall Allen invited me. Here's my thought for the day: Something is quite wrong when consumers have better protections on the books when they buy a defective car (Lemon Law) then when a doctor botches their surgery.""And if your car gets busted, they gotta give you an estimate, you can insist on manufacturer parts (or no-name brand if you have a budget) and if you are in an accident, the insurance company for the insured has to compensate you promptly for your damages or risk a susbtantial penalty for failure to negotiate in good faith. (in Virginia I think its like 3-5X the amount of the damages.) They are not allowed to bait and switch, and you normally have the right to the parts they replaced, so you have proof that they fixed the right thing.""Welcome, Carla E. Muss-Jacobs! I'm glad you joined and hope you find the group helpful!""Or the medical device industry gets federal judicial entitlements that interfere with patient protections from failed implants. No warranty, no clinical testing, no UDI, no post market research. You are on your own. With no honest feedback, the harm multiplies. Poor federal public policy assures more ""lemons""."check out this law MICRA and the death of my 7 yearold www.shellybeenz.com"Hi Michelle Massey, so sorry to hear about the death of your little girl. Will you please complete ProPublica's Patient Harm Questionnaire, so we can understand the details of your story? Your website is quite good, but completing the questionnaire helps us organize these stories so we can identify things on a broader scale and share stories with other media outlets. Here's the link: http://www.propublica.org/article/patient-harm-questionnaire"Veronica you are being sucked into a complete false hood of made up facts and facts that have been thrown around since I first met up with MICRA coming up on 9 years ago. If only you really knew the truth..www.shellybeenz.com. Please read and listen. Thanks so much. In loving memory of Jessie Geyer."FDA is making available two lists of customers (consignees) who received products that were shipped on or after May 21, 2012 from New England Compounding Center���s Framingham, MA facility. The first list includes customer names and addresses, organized by state. The second list contains the same basic information as the first list, but is organized alphabetically by customer name and also includes the specific products shipped, the quantities of product shipped, and the shipping date. The lists were prepared based on information provided by NECC, and FDA cannot vouch for the completeness or accuracy of the lists. Products shipped by NECC may be missing from the list and facility information may be incomplete. Nevertheless, this is the best information we have available, at this time, to help inform facilities and healthcare providers of NECC products shipped to their facilities since May 21, 2012.""Really interesting results from a new study, presented via a short video. I wasn't at this conference... THIS IS NOT A PRODUCT ENDORSEMENT. But it shows that the way to make things better isn't just for people to be smarter or more conscientious. New and better tools can potentially make a big difference too... http://www.excelsiormedical.com/video_Marc_Oliver-Wright.php"So Thankful for Dr. Pettit and Vanderbilt !It's great to celebrate someone who really went the extra mile and kept at it to find the answer."How state officials let hospitals hide deadly medical errors.www.answersforlisa.blogspot.com""It's no different in VA, sadly."and no different in OH:("I'm sorry to hear about Lisa's case. This is another example of why hospitalization of a loved-one needs a new approach by friends and family. Someone take charge and assign tasks to those who say they want to help. 1. Get thorough information about the disease or injury. 2. Have someone with the patient 60 minutes per hour and Speak-Up when anything isn't right. 3. Research the physician(s) and facility. 4. Make a record of everything and compare it to the medical record every hour or at least once a day. Yes, it's inconvenient, but now essential."http://csn.cancer.org/node/248383 This site worries me and seems to encourage kidney removal vs second opinion from a doctor. How do people sleep at night???Isn't it a forum of patient survivors sharing their experiences and support?Current medical literature (and there is quite a bit of it) advocates removing as little of the kidney as possible to preserve nephrons and maintain kidney function. This position is incredibly ironic considering the same faction of the medical industry keeps pushing for more people to be living kidney donors. http://www.gao.gov/assets/600/592406.pdf GAO report on unsafe injection practices. "am thinkin' I am just going to avoid treatment entirely at this point. seems like the medical community is really struggling with the concept of ""do no harm."" I have never really been a gambling kind of girl...I don't even buy lottery tickets. Seems like every time we allow ANY type of medical intervention we must do it with the mind-set of, ""OK...bring on the consequences...this is worth the risk...of WHATEVER HAPPENS."" I just cannot seem to get on board with that mentality. Thanks for posting Terri.""there are no guarantees in medicine, other than that there are no guarantees in medicine. what's necessary is open communication and collaboration of both clinician and patient toward the best possible outcome. this requires a biiiig culture and mindset shift, again on both sides of the equation. patients must understand that docs are human, and therefore as fallible as all of us are. docs must recognize their own humanity, and that of their patients. it's slow going, but the change is a-comin' ...""Collaboration, cooperation, coordination, continuous improvement."What Terri said!"In my personal experience of over 14 specialists and 9 general practitioners I have had 2 who were willing to listen and learn more. These 2 took extra measures, expressed sincere concern and recognition of the problems. They did research and conveyed a desire to learn more about what was going on...They were willing to be REAL about the limitations of our knowledge and willing to acknowledge my own personal awareness and intelligence. Although I am extremely thankful for those two, I cannot help asking myself, ""What happened to make the rest the way the are???"" and ""How can patients re-train or avoid these types of practitioners???"" (Won't mention my thoughts about the need for the PATIENT to train the medical professional.) I think Dr. Marty Makary is really on to something with his ideas about transparency. This will make it easier for patients to find the doctors and facilities which have a professional protocol in place that does not dismiss the value of patient input.""Patients most definitely should train clinicians. The Society for Participatory Medicine is one org that's working on doing that. All of us who have experience with what I call the healthcare car wash need to help other stay inside the car, not get strapped to the hood ...""Sheila Kalkbrenner - to answer your question about what happened to make them the way they are. Google: moral decline medical school. For example: http://student.bmj.com/student/view-article.html?id=sbmj0305135a http://www.healthbeatblog.com/2011/05/medical-school-how-the-hidden-curriculumsnuffs-out-compassion/And especially this one: ""Vicarious empathy significantly decreasedduring medical education (P # .001), especially after the first and third years.""http://casemed.case.edu/caml/pages/JournalClub08/March-DWolpaw.pdf"I apologize if this is a duplicate post. http://ethicalnag.org/2012/10/16/industryco-opted-patient-engagement/"thanks for posting this. The patient groups I have been in have been very sensitive to who is invited due to the sensitivities of data mining. It is also true that many ""patient"" groups have nothing to do with patients and have everything to do with corporate agendas. Its a wild world out there.""Nursing-Sensitive Value-Based Purchasing Nursing-sensitive value-based purchasing has been proposed as an initiative that would help to promote optimal staffing and practice environment through financial rewards and transparency of structure, process, and patient outcome measures. http://onlinelibrary.wiley.com/doi/10.1111/j.1547-5069.2012.01469.x/full"Thanks for adding me. My dad was in Clara Maass Hospital and developed Stage 4 bed sores. It was a contributing factor in his death."Hi Jennifer Giuliano-Dahn, welcome to the group. I'm sorry to hear about the harm your dad suffered. Will you please tell us about it by completing our ProPublica Patient Harm Questionnaire? We use these questionnaires to track issues and stories that we need to pursue as we write about these topics. Thanks to you, and others, for completing it: http://www.propublica.org/article/patient-harm-questionnaire"I'm sorry Veronica. It's a disgrace."Thank you Marshall. Yes, I will do that.""The book ""Unaccountable: What Hospitals Won't Tell You and How Tranparency Can Revolutionize HealthCare"" by Marty Makary, MD (Bloomsbury Press) is now at number 10 on the Washington Post hardcover, non-fiction bestseller list. http://www.unaccountablebook.com/"We saw Dr. Makary on his book tour and he is a really nice guy.New study puts the cost of medical errors at a trillion dollars a year. Extraordinary. http://www.mediregs.com/economics_of_quality_careWhat does it take for health care consumers to demand change?"Holy Double-Down, Batman! The last time I read an article it was 100,000 patient deaths/year. This recent article suggests 200,000/year. While these are very thorough in-depth studies, once again, the costs to PATIENTS who have been harmed, and/or what happens to PATIENTS after they have been harmed is not mentioned. For each gazillion dollars/year spent, there is a patient behind the $ Dollar Sign but nary a mention of the financial impact on them, the emotional toll, the aftermath of these ""errors."" Again, we get that there are medical errors, the stats are in. And after 3 decades -- THIRTY YEARS -- PATIENTS are the ones getting harmed and still no mention on how this all impacts them?!?!?!?!?!? It costs the U.S. $19.5 Billion/year to deal with these errors . . . but what is the cost to the PATIENTS?!? Medical procedure: $10,000. Medical procedure gone wrong: $50,000. Cost of harm to the patient: PRICELESS""Of the people I know who have died, over half have died because of medical error.""Who would have ever thought that the day would come when any of us could say what Debra said??? Unfortunately, I think many of us could say this... Carla, you are so right.. The cost of medical harm to the patient is indeed *PRICELESS*""All the money in the world can't bring your health back, once it has been destroyed by doctors.""You'r right June... Once your health is gone, life takes on a whole new meaning. Sickness and pain become a 'new normal':("Death due to medical error is the number 3 cause of death in this country. Third. More than Aids. More than breast cancer. but the medical industry somehow make it stigmatized. And that is a second source of trauma."and its even larger than that.....for every person reported there are two that have not been reported or being blocked in every way to stay silent so their costs of their error are not calculated....i pray for the day when help is more available and action is truly implemented. It does seem like there are strides but we are so far off. its been nine years for me and the closer i got to finding out what happened to me the more obstacles I got and even recently i found out many are still lying so that I couldnt get help, luckily for me there are a few that didnt fully shut the door and hopefully within the next month or so my story will get told....the more ""people"" ""the public"" hear our stories and learn about the lengths that were taken not to help medically, financially, emotionally many of us and the amount of deception and malice involved...... I think we will see some major changes. A few stories here and there or an error and a fix within a week or so does impact people but on a smaller scale but people like us that have been harmed and then lied to or manipulated for YEARS, those of us who we find out even the people who knew the truth or were on our sides were behind the scenes setting us up or telling different stories I think this will force major action. Money controls everything and for those of us that have been involved in these injuries where the damage and costs involved are in the millions and didnt need to be......people will start to see how drastic it needs to change. Call me gullible, call me naive but i do believe its possible. They got the best of me for the longest time and truly had me beat, every corner I turned there was a stronger oponent more powerful .....now is our time to matter, i think when we group together the way a few of us have and propose our stories they are starting to listen.....a package deal approach is working and hopefully we can stop one or many from having to endure what we have.......i fear for my daughter (our children) with our healthcare system the way it is and I pray we can change that before our children have to endure our corrupt system.""Mentions in particular Michigan's drug immunity law, as well as the WIand NC bills. And ALEC.http://www.huffingtonpost.com/joannedoroshow/meningitis-fda_b_1990305.html"I mentioned this exact scenario occuring on Deidre's show last week."It's every patient's nightmare. You go through a high-risk diagnostic test or even surgery -- sometimes with pain, side effects or even serious problems -- and find out later you didn't need it. Someone you trusted, your physician, put financial gain ahead of your best interest. It's tough to fathom, but this week's news shows it really can happen."This happens far too often. And it's getting worse instead of better! I talk to people everyday who tell me they were operated on only to find out later they didn't need surgery.the use of cat scans is a exaple of this overuse.The doctors actualy are the ones who own the equipment here I heard awhile ago.Anyone who has adominal pain gets one even though a any confident doctor can diagnosis with out just as good"I can not stand articles like this. It shifts the burden to the patient. A cardiac condition and the layperson is supposed to get online and find out all they can?!? A CARDIAC CONDITION????? Or any condition that is making a patient S-I-C-K. People are SICK when they go to a doctor. I don't want to know what a doctor knows. I'm sick. I want quality care. That's why I go see a doctor -- to make me feel better. When the doctor screws me up, don't place the burden on ME becasue I didn't do the crap in this article. How cruel to even suggest that patients must do their own ""quality control"" review. ""Make sure you ask the right questions boys and girls."" OH COME ON! GIVE ME A BREAK! How can a sick person even muster the focus?? So, let me get this straight, on the one hand a patient is supposed to take so much control over their health care and ""play doctor"" and do all this exhaustive research about their care and treatment . . . but on the other hand, if something screws up by the health care provider all of a sudden the patient doesn't know a damn thing becasue they're not a ""medical expert""?!?!?!?!? Oh laughter in, indeed, the best medicine. I'm LMFAO on this one. There are TEN bullet points in the article for patients -- TEN. I'm sick. I don't have the strength or the energy to do this crap. I go to a doctor because I'm sick. If the doctor can't do their job, if they lie to patients and bilk insurance, then get rid of them and stop protecting them. If they are so ""human"" then FIRE THEM when they screw up. If they play the insurance system and order tests that don't need to be ordered and do procedures that aren't medically necessary -- AUDIT THEM and be punitive. But for the love of all that is Holy . . . don't -- DO NOT -- make it the patients' burden and responsibility to get health care providers to perform their jobs honestly, with integrity and with care/compassion. It is NOT the patients' job to make sure the health care providers are doing theirs.""The sad thing is that doctors say, ""TRUST ME. I'M A DOCTOR. YOU MUST OBEY MY ORDERS. I'M IN AUTHORITY HERE"" And because we are honest ourselves, we take what they say at face value. How misplaced our trust is when we are mislead, misinformed and harmed by the very people who said, TRUST ME. I'M A DOCTOR........""Carla E. Muss-Jacobs's concern is important. While patients do have to practice the real ""defensive medicine"" in today's health system, strong pressure must be kept on the culture in medicine that tolerates and even covers up neglectful, incompetent and at times unethical actions by medical practitioners. It is not a solution to have all patients become their own doctors."Let's be crystal clear on this... *Unnecessary surgery is intentional harm*Exactly well said Robin Karr"Cutting you open and chopping out healthy organs is barbaric, archaic and the ultimate violence against your body."Anyone want to comment? http://www.kevinmd.com/blog/2012/10/nationalreporting-answer-reduce-medical-errors.html"For 13 years the IOM has made the numbers known. We got it. The problem is ubiquitous. Now, how does healthcare become as safe as airline travel?""Comment on his post, on his site. It's well read. He seems to think M&Ms are gonna fix the problem, and that it isn't that big of a problem. It's just patients making mountains out of molehills.""Yeah but he seems to think that hospital oversight is just peachy -- people just have to pay attention. it's not the most clearly written article, but he makes it sound like of the complaints that he had heard on hospital boards, most of them are bogus. And that patients are not reliable in understanding when an error has occurred. I think he is arguing that physicians should be accountable to the hospital, not third parties."I agree Debra... I read this article on Twitter today and I thought he seemed double-mined - not real clear about what he was saying..."OMIGOSH -- Jerry Sandusky was ""well respected and well-funded"" too and look at what that guy got away with. WE HAVE GOT TO STOP THE JERRY SANDUSKY MINDSET IN PATIENT CARE! Patient error is two-fold: 1) the prevention, 2) the ""cure"" for those patients who have been injured/harmed. On the prevention, that's up to the hospitals, audit boards, etc. As a patient I know there are risks involved to any medical procedure. But when it jumps into NEGLIGENCE and MALPRACTICE stop covering up for Dr. Sandusky. There is so much talk about prevention, and nothing, absolutely nothing available for patients who have been harmed. Why isn't that issue addressed? It never is. What about the errors made, the negligence, the malpractice. Why is the medical community NOT addressing ""WHAT TO DO WITH THE HARMED PATIENT?"" Why do I have to suffer years of fighting when I was grossly injured by the orthopedic surgeon. Where are any of those doctors speaking up for me? Or, for you! There wouldn't be such focus on ""prevention of errors"" if the reality of those errors aren't made. ""Errors"" ARE made by medical providers. And those who suffers from the errors -- patients! And yet, crickets chirping when it comes to addressing the patient in this equation."AMEN Carla!"I agree with both Robin and Debra that the point he was making wasn't very clear. The general direction seems to be ""we don't need no oversight, because things are working fine as they are.""The danger with a complaint system is it can be used for ulterior motives such as to punish a snitch or whistle-blower. Their solution seems to be to not have a complaint system. The priority shifts from protecting the physical patient to controlling their own bully culture.He did not provide much evidence for not having a complaint system. A meandering writing style can mean the writer doesn't have facts to back up the core claim and wants to get from point A to point B without explaining himself.""""Dr. Sandusky"" the new Dr. Hodad...""Carla - The prevention can't be left to the hospitals and audit boards. If they took prevention seriously there would be far fewer preventable errors. The patient and friends and family of the patient have a responsibility to become well informed about the physician, the diagnosis, the treatment plan, the evidence supporting the treatment plan and to to have someone with the inpatient 60 minutes per hour to monitor for best-practices care. Yes, it's inconvenient, but now it's essential.""Doug Hall I made my opinion known about shifting the burden to the patient in another posted topic. I'm not going to reiterate and I don't know how to link it here. Bottom line, I'm sick and my family/friends are not doctors . . . I don't have the energy to perform ""due diligence."" I resent that you're suggesting the burden should be equally placed on patients. Not only are they ill, but you actually belive it's fair to the patient to put a new burden of responsibility on them? Last time I checked, patients aren't going to the doctor/seeking medical care and treatment because they feel good. So you're saying that patients who are ill need to muster up strength to prevent a medical error from occuring?!? Seriously?""I'm sorry to know you're sick and that you resent my opinion. Not everyone has the family, friends or professional Patient Safety Advocates available to help with their care. Yes, I'm suggesting that the patient, as much as they are able, and their close network get involved, a lot. The statistics have shown for years that the average patient has a 25% chance of being injured by their healthcare and that each inpatient incurs one or more medication errors per day. A family Advocate need not be a physician to be effective as your safety proxy.""I wasn't sick Carlo. I was easy prey for uncrupulous doctors running a surgical racket. They destroyed my health and my quality of life and disgarded me like a piece of trash. Some doctors make us sick. I reported it to a number or departments, but they just revictimized and retraumatized me, so I gave up.""doug, let me remind you that sometimes you can be hauled by ambulance to whatever third world hell-hole is nearest. and they may refuse to transfer you. Investigating and all those patient responsibilities mean nothing when you are taken by ambulance to a hospitall. I think all level I trauma centers should have a complete colonoscopy level audit by a reputable third party every year, if not every six months. And even if you are not a critical patient (1) it is nearly impossible to get honest and specific info. especially that a doc is ""bad"" (2) if you are sick you likely don't have the time and energy. I would also note that often docs don't give a hoot about ""input"" and so you can do all the defensive learning in the world, you still don't have a prescription pad or order sheet. We told the doctors and hospital what the correct course of action was for my mom with respect to almost every error they made. They did them anyway, many of them multiple times, and sometimes pretty much spitting in our face. We are not going to get anywhere until we get rid of the 10% who are drunks and sociopaths.""And i will second a comment by Noel Eldridge in one of his presentations: sick people who are trying to be the safety cop tend to get pretty emotional when doing so in critical situations, When someone is doing something that you know and your mom knows is going to kill her, and the other person is refusing to fix the problem and being a jerk to you to your face, or going behind your back, it is really pretty difficult on day 10 to treat that person coolly and dispassionately. The gut response is more akin to something that will draw blood and hurt-alot. People in that circumstance should not be required to be a bloodless litigator when dealing the staff -- the staff should be dealing with the problem because the job of the family is to support the sick person, not be Marcus Welby Jr. I would give anything to have been able to spend with my mother the weeks I spent busting heads at Inova, to no avail.""We start with a two pronged approach: a commitment to continuously improve our practices, and a commitment to strip away our blinders by measuring what we do through the eyes of our customers. Period. And we work both objectives synchronously. Bad reporting will take care of itself as practices improve. You can bet the ranch on that."And we will LEARN. http://bit.ly/XCaaEW"I thought the same thing Veronica... Then, I thought that this girl's family probably doesn't see it that way because they have no idea how much more horrific their whole nightmare would be if, on top of everything else, the white wall of silence that so many of us are familiar with went up."Doug's comment disappeared..."Like you Veronica, I agreed with Doug also."http://sco.lt/6SXx2nThis is scary! Never really thought a lot about how viruses could effect medical equipment..."Times Square NYC Reuters Billboard on Oct. 9, 2012 for World MRSA Awareness Month, October. MRSA Survivors Network, the global leader in the fight against MRSA and HAI's -raising awareness to the MRSA epidemic."It seems as if October is the month for everything I care about."Oct.2, 1961 was the first time a UK microbiologist saw MRSA under a microscope, so Oct. 2 is World MRSA Day and October, World MRSA Awareness Month.""Yes! Staten Island University Hospital is making its visiting hours more flexible. Article quotes/cites the report by New Yorkers for Patient & Family Empowerment, done with assistance from NYPIRG. Excerpt: ""Advocates, such as New Yorkers for Patient & Family Empowerment, maintain that family-centered visiting policies promote quality of care, healthcare efficiency and more positive patient outcomes."" http://www.silive.com/news/index.ssf/2012/10/staten_islands_hospitals_move.html""I LOVE this example of patient centeredness. I proposed a similar thing....the right for every patient to have a bedside advocate during their entire hospital stay, in 2011 in Maine. It was knocked down along with the rest of the proposal that was for improved MRSA prevention in our State. Maybe it is time to bring this up again! Great work!"http://bit.ly/Qtcj2L"'The solution, the IOM suggested, was not to punish ���bad apples��� who miscalculated a drug dose. Rather, it was to learn from those errors to build a safer heath care system.'..............I guess that is why when a doctor is asked what they do - they say 'I practice medicine"". On the surface that can almost sound humble. The doctor I was seeing certainly meant it to be. But, the truth is far different - common sense and history tells you when there is no accountability - there is no impetus to be mindful. Our elderly, handicapped are treated with disrespect and disregard. The best measure of a person or country's humanity is how they treat their most vulnerable. The dignity of a sick patient is just as important as their illness. I feel foolish making that statement - it is a given. Yet, it is ignored. Personally, I know you cannot legislate to make a person respect another no matter what the profession is. The fact that one puts one's health - life - in another's hands seems to make no difference. It also seems the more a patient educates themselves - the less likely their input/questions will be listened to or answered - healthcare givers seem to take it as a challenge to them personally. Wonder what would happen if the rules and regulations were enforced?""I agree with what you said Michelin. Respect for the individual should be 'a given'... Sadly, it's not. I'm not sure how we got to the place we are today with regard to seeing so much harm via medicine but I suspect the root of the problem is money more than anything. The article I posted above doesn't really address it but i believe it's a huge factor. Doctors and hospitals are under huge financial pressure today like never before in our history. And, we all know what can and does happen when money's involved with anything. Just think about how fighting over money divides families like nothing else can. I've seen it many times... It's as if otherwise nice, loving, caring, ethical and moral people go 'crazy'... Medicine has become nothing more than BIG BUSINESS! The drive is clearly to make money. Most of us here know that but there are many who don't. Until I was intentionally harmed via an unnecessary hysterectomy, I didn't realize this - at least not to the extent I do now. Now, I'm WIDE AWAKE!!! In your last sentence, you asked a very good question. I too wonder what would happen if rules and regulations already established were merely enforced... What would happen if we quit trying to figure out ways around 'enforcement'? I strongly suspect, as I've said many times before, that we'd see a noticeable reduction in medical malpractice - via negligence and on purpose via unnecessary procedures/surgeries."...perhaps an occasional reminder of who works for whom.Good point Doug!"""Practice"" is what students and apprentices do. They are expected to make mistakes and the worst that can happen to them is a bad grade. Should patients assume the surgeon is using them for ""practice?"" Is a bad mark on a sheet of paper what patients should anticipate what will happen if they become the victim of a medical error?Are doctors steering us into accepting an attitude that by having surgery we are volunteering for their lab experiment?"Feds say they want to roll out a prototype system that makes it easier for patients to complain about healthcare errors and harm. Look for it to start next year somewhere in Pennsylvania. My column today."I think this is a good step. My concern is a legal one. When a patient reports, are they aware of the consequences in doing so? Do most people know about the statute of limitations? They could report something and not realize that they have now documented their own ""time stamp"" with regard to when a prudent person realizes. What they might not know is the legal element of the statute of liminations will, then, start to toll." "Supposedly this would be confidential and protected from discovery. there's a possibility that it would be done under the auspices of the Patient Safety Act of 2005, which created Patient Safety Organizations and protections, to allow confidential information about harm and error to be shared without fear of discovery or litigation.""this is completely stupid. AHRQ has nothing to do with any effective enforcement mechanism. This is a complete blind alley masquerading as a solution. We need enforcement, not studies.""First of all, I am not in favor of more 'confidential"" complaining, as the beneficiaries of that appear to be hospitals, not patients. I want every person whose toe crosses the threshold of Inova to know that the place starved my mother, on purpose. If I could, I would spray paint the entrances with abandon hope anyone who comes here. Flee flee! I wish that every single complaint against Inova had been public and seachable on the internet because we would have made sure mom went elsewhere on the first visit. I want the people who work there to be ashamed of their jobs, to be embarrassed to answer where they work. I want the administrators be questioned on what went wrong when they try to find a job elsewhere. I have nothing to be ashamed of. Inova does. Number two our problem is not a lack of places to complain to; there is a surfeit. the problem is that they don't talk to each other and nobody wants to actually hold providers accountable, to impose sanctions, to impose serious penalties and to generally kick butt. Which, I would hope honest doctors and honest administrators would want to have happen to the bad guys. Cheryl Clark patients are not afraid of ""discovery or litigation."" That;s the HOSPITALS. so if it is being written to prevent discovery and litigation, it is being written to favor HOSPITALS, not patients. If you look at the British system, if there is a patient complaint, it is investigated, the patients can be compensated through the complaint process and the fruits of that investigation can be used by plaintiffs in suing. They have in fact reformed the system to make sure that can be. And that information is cycled back into the process to prevent errors. I am not in favor of much of the British system, but this makes a whole lot more sense than fifteen complaint processes that remind one of the song, 'we're on a road to nowhere."" With everything hush hush so there is no accountability, no public awareness, no useful information and just a distraction to pretend that we are doing something when we are not.""As i understand it, the patient or his or her loved ones, would be free to litigate the incident. The protection for the hospital might come in case, months or years later, an attorney wants to find out what these hospital folks were told about prior incidents. The hospital would agree to set up this system under the patient safety act which established psos in 2005. I'm sorry if that wasn't clear in my column or prior post. The other piece of this that needs emphasis is that i think the idea is to get patients to report less egregious types of incidents and/or harm, or near misses. ( the egregious ones are more likely to be discovered). For example -- My nurse brought up the wrong medication, she realized this and went back to get the right medication. I had to wait, but i got the right medication an hour later. From a hospital perspective this might be helpful in shedding light on a process flaw that resulted in the nurse bringing the wrong medication in the first place. Also this is not a study. It's a pilot project. I think it's worth a shot. A pilot project.""I agree with Debra Van Putten. We KNOW THE STATISTICS ALREADY!!! The studies are out there and there is enough evidence that patients are harmed. We get that. There needs to be a system in place to ADDRESS THE PATIENTS WHO ARE HARMED! It needs to be fair, and compensation should be directed to the victims of medical error in a timely manner. That's why doctors/health care providers have insurance. And if the insurance lobby, and the institutional investors aren't happy with their dividends that year, blame the doctors / health care providers for screwing up the patients! In clear cases of gross negligence, STOP CREATING LIFE IN HELL for the patients who have been harmed. Talk about adding insult to injury. When I was injured I was under anesthesia and had nothing to do with it. And yet, as a patient the wall of silence goes up. You know who profited from my pain and suffering -- the defense law firm. My total knee replacement was so botched by the orthopedic surgeon that another orthpedic had to grind out my femur and tibia and implant metal rods to correct the misalignment. I couldn't walk. The diagnosis AFTER my TKA ""malpositioned prosthetic components."" I didn't do that to myself. Let me know if you want to see the ""before"" / ""after"" x-rays. My leg was so curved it doesn't take a radiologist to see it. It's plain as the nose on my face. They didn't want my case to go to the jury and the judge tossed my case out on a technicality. I received NOTHING . . . the second surgery was $50,000, took over 6 hours, I suffered and continue on various levels. I received nothing. Zip, zero, nada. I imagine the defense law firm racked in over $150,000 in their brilliant {rolling eyes} defense. The AMA and ABA are the biggest cartels in the Nation. Who drives up the costs? Look at the defense law firms (huge lobby) and the AMA. The medical malpractice insurance companies don't care about patients. They care about their investors. They'd rather pay the defense law firms rather then compensate the patients adn they'll fight dirty to keep a patient from their basic cvil right -- a jury of peers. Do a study on the costs of defense firms and the profit they earn off the pain and suffering of patients. I was under anesthesia when my leg was butchered. I woke up in hell. Thank you AMA and ABA for all the good work you do in protecting patients. We have no rights, we have no voice. Pathetic. My dog would have had better care and treatment at the vet. My orthopedic surgeon, who butchered my leg, made the cuts wrong and inserted the prosthetic device and then, pretended the surgery was successful. I couldn't walk. I healed with a disjointed leg and was on a walker, then a cane until the second surgery -- six month later. I have serious injuries. I should have gone to the vet for care and treatment. PLUS the procedure wasn't medically necessary (I only needed a partial ""unicompartamental"". PLUS the orthopedic surgeon used a new procedure that was experimental, unscientifically proven, non-peer reviewed and not FDA approved. Yup, the vet would have been kinder had I been a dog.""1) I still don't understand the utility. I have yet to get coherent information about what will be done with the information or why we can't make the current reporting system hand over the data to AHRQ. QIOs receive complaints, state licensing agencies receive complaints, HHS OIG gets complaints, 1800-medicare gets complaints. Why have another complaint process?2) I don't why on earth as a public policy approach we would not want to do everything in our power to absolutely crucify someone who knows of a problem and chooses not to fix it? What good does it do to let hospitals know they have problems and have them use that information to further their interests and not patients?3) What is the point about collecting more data about piddly problems when Medicare flat REFUSES to address serious problems, like a hospital that intentionally STARVES a patient. If that is a problem that Medicare won't/can't address, why bother with ""my aspirin was 20 minutes late.4) Figuring out what wrong with aspirin 20 minutes late is the hospital's job. Why should we pay public money to do that?5) It seems to me that the most pressing issue it to STOP PAYING the Hospitals for errors. And the Obamacare changes are poorly done and counter productive. All of this needs to be dealt with as a matter of contract compliance and Hospitals should not be treated one iota better than any other federal contractor. What folks don't seem to understand is that Hospitals dont vote. Patients vote. Got it?""Why do we need hospitals to agree? where did they get a veto. They are contractors. Does Lockheed Martin get a veto on what contract oversight happens to them? I think not. Do we rely on whispering sweet nothings to the management at Lockheed in the hopes that they have a conscience that bad equipment will unnecessarily hurt our troops, because after all, it would offend their sense of dignity and professionalism to double check what they are doing? Not likely, that's how we got $2000 toilet seats. I think that that a much better use of time and money is to FIX the current oversight process. Nothing is going to work without that. and, if you look at the medicare regulations, hospitals are already required to do that fault analysis. We are paying them already to do it. It's current policy. So why the pilot?""Cheryl Clark, when mom was at Inova, she was supposed to get dilaudid, a scheduled narcotic with serious street value, the meds were always late, usually by an hour to two hours. When we got mom's medical records, the nurses recorded the narcotic as having been administered up to several hours after the time of the chart entry (psychic nurses), We had doses entered in the chart up to sixteen hours after the state time of the dose -- i e, a med given at 8 pm on tuesday is actually accounted for on Wednesday when the nurse comes in for the next shift, Either the pharmacy was playing games or the nurses had a side job dealing, because the number of doses recorded in the charts did not square with what mom actually got--mom was constantly shorted, yet restrained for 20 days due to inadequate medication. The paperwork was more than hinky. It was replete with red flags. Medicare did not care. DEA did not care. The state of Virginia did not care. So, in the scale of things that call for government spending, the sorts of things you are talking about aren't a priority. There are much bigger fish to fry. And if a place like inova doesn;t care about someone not accounting for scheduled narcotics, they most certainly aren't going to care about figuring out why noncritical meds aren't on time. And by the way, an hour delay is not considered, in general, a medical error.""In my findings I have found that the information is not being reported. According to the Joint Commission adverse incidents are supposed to be reported if the hospital gives the doctors 30 days, well there is where the manipulation begins. The hospitals starting giving 29 or less days which means they don't have to report it. The Joint commission claims on their website that it is urged but not necessary for them to report it and if someone else reports it they will investigate but the information is confidential, and this is the real problem I had, they claimed they destroy the evidence."Oh this just makes me so upset and angry these doctors and hospitals are not held accountable for the horrible things they do. They bankrupt us patients ruin our lives and the lives of our families and yet they still get paid. They gave it made. You can complain to the doctors the hospitals the board of medicine contact lawyer after lawyer just to be told there's nothing we can do. These doctors and hospitals get away with it and they know that they have messed up not even an apology. Then you hear the cost of healthcare is so much because of the malpractice insurance they have to pay....what they cannot be sued. It's like all these doctors and hospitals the board of medicine these lawyers the insurance the drug companies they all work together the system is fixed so that these doctors know they will not e held accountable and they can give you whatever crappy treatment they want and guess what you still got to pay or it even though you have lost everything you job your insurance savings family your home and cars but the docs still got their money they still have their fancy house cars families vacations and most of all their life. Something has to change these bad doctors and hospitals have to e held accountable."Amy Houck, you see the picture. They get paid when they do it right, and they extract several times more from the victim when they do it wrong. I can't think of any other business that has created as part of it's business model such a wicked advantage." "I was tricked by a group of corrupt doctors running a racket, because they needed guinea pigs for surgeons-in-training to practice on. They botched it which cost me and the taxpayers tens of thousands of dollars and destoyed my life. I wrote to a number of complaints depts., including the government Minister of Health and my local member or parliament, etc. They all sided with the corrupt doctors, who lied through their teeth, and falsified my medical records, etc. We, in Australia, haven't got a hope in hell of getting redress, let alone justice. The system sides with the doctors and does everything to shut the patients up, including blacklisting them, and spreading rumours about them. It will be a cold day in hell before the patients are heard and validated.""June Gardner, it's an international problem. I wonder if there is any country one can go to relative to your home country, where those doctors would tell you the truth and not first be loyal to the cover-up.""Australian health minister shocked to find out he was kept in the dark about a fatal medical malpractice investigation, forces disclosure with a ministerial directive.http://au.news.yahoo.com/thewest/a/-/national/15105974/qldgovt-in-dark-on-medical-malpractice/"The group of doctors running this hysterectomy racket have it honed down to a fine art. They have got away with it for decades and have covered their tracks with lie after lie after lie. That is probably why the complaints depts. said the doctors did nothing wrong.the topic of this group is patient safety. Not Obama spin.Health care fraud has a human face too. Individual victims of health care fraud are sadly easy to find. These are people who are exploited and subjected to unnecessary or unsafe medical procedures."Healthcare fraud? Interesting, isn't it, that what's measured is dollars - not the cost to human lives. Notice that NHCAA is an organization of insurers & government. It's not surprising that insurance companies focus only on the money. But it says far too much that it's the government's primary interest. Ever notice that not one penny goes to the people who were harmed? When that changes, I'll be interested in these fraud reports.""Being a victim of the hysterectomy racket, where doctors in cahoots with each other, look for easy prey for a teaching hospital by tricking unsuspecting women into unnecessary radical hysterectomies, by fabricating cancer is fraud. Healthcare fraud seems to be more important than human life.""And if it were a corporation and the issue was securities fraud, destroying the documents would be the fastest route to jail"http://news.yahoo.com/blogs/sideshow/45overused-medical-procedures-costing-americans-billions-study-212121533.html"I think there are three sides to this story ...1 the practitioner who may in fact overprescribe, 2 the patient who at times demands unnecessary tests, treatments and antibiotics, 3 the lawyer ready to cash in on the situation. It isn't useful to vilify one without examining the contribution of all to the problem in order to achieve lasting solution and true health care reform." http://content.healthaffairs.org/content/early/2012/10/12/hlthaff.2011.0605.full.ht ml"I have been a hospital nurse for many years, and for most of that time I have been concerned with a patient-safety issue that has slowly been acknowledged over the years but still has not been effectively addressed. That issue is delayed inhospital defibrillation in cases of cardiac arrest. It fits in the ""failure to rescue"" category in the patient-safety lexicon. I'm convinced that these 'failures to rescue"" cause thousands of deaths each year in the US alone. The American Heart Association has recognized the problem for over a decade but has not come up with an effective approach to address the problem. I believe this failure has been due to problems of politics, institutional culture, and device industry influence. The fix the AHA offered--in-hospital AEDs--has recently been shown to decrease overall survival (see ""Bad Shock: Automated Devices for Jolting Hearts May Save Fewer Lives in Hospitals,"" by Lilly Fowler, at Fairwarning.org).I think a simple, cost effective remedy can be found.""Hi John Stewart, thanks for your comment, and for your participation in our group. I have a couple of questions. First, will you please complete our Provider Questionnaire? ProPublica is building a pool of nurses, doctors and other providers who can help us with our stories and offer us ideas. Here's the link: http://www.propublica.org/article/providers-share-yourobservations-on-patient-safety Second, I'm wondering if you can be more specific about your post. How do politics, institutional culture and device industry influence come into play? And what's the simple, cost effective remedy that you see as possible?""I thought I had submitted the Provider Questionnaire early this past week--unless I hit the wrong button when I tried to submit. Please let me know if you can't find it, and I'll submit again."Thanks for joining us. It is very nice to see a provider here."The comments at the end of the article are interesting. The quality of manufacturing and adequate, recurring training can address issues raised. Yes, inexperienced staff need extra training as they do for everything. The reason for the slow response is no mystery: Fewer healthcare professionals caring for more and sicker patients result in delays in all areas of care. Link to article: http://www.fairwarning.org/2011/11/bad-shock-automated-devices-forfailing-hearts-may-save-fewer-lives-in-hospitals/""Financial conflicts of interest pressure the premature fielding of new medical devices. Devices to market, followed by a general denial of a need to keep track of the results at the outset. Financial conflicts of interest likely are also to blame for the lethargic delay in the testing and followup analysis of new devices, procedures and prosthetic implants after they are put into the field."This is something that some people have been trying to address for a while. I don't know the details but remembered a colleague doing some work on the topic. This presentation from 2006 by Dr. John Gosbee (my former colleague when we both worked for the Dept of VA National Center for Patient Safety) touches on the topic on slides 32-34. There is probably more info out there by now... http://patientsafety.im.wustl.edu/content/documents/Gosbee_MedicalDeviceDesign.pdf "The AHA should encourage objective evaluation of innovative approaches to treatment-particularly those that involve new technologies, before they gain widespread acceptance. In the emotionally charged atmosphere of medical care, the momentum of a new technology too often puts the burden of proof on those who question the evidence for it, rather than on those who propose it. The result is that the technology quickly becomes the accepted thing to do [and] further attempts to test it are subject to the charge of being unethical.... [6] AED manufacturers will keep the AED option in the forefront of discussions about delayed in-hospital defibrillation; as a public service organization, the AHA should actively encourage consideration of a broad range of alternatives. There may be ways to achieve the goal of rapid in-hospital defibrillation less expensively--and much sooner--than by making progress contingent on the successful marketing of AEDs to hospitals."Oops-I accidentally posted the previous post prematurely. It's a response to Garrick from something I wrote in 1996: Stewart JA. Delayed in-hospital defibrillation. Annals of Emergency Medicine 1996; 27(1): 5-6. The paragraph with the [6] reference is from a Brookings Institute publication."The paragraph with the [6] reference describes an inverted ethical attitude toward more testing. It would seem more testing could be a threat, and that the defense mechanism is to reverse the perception of who is unethical by calling the charge to test unethical, rather than the unwillingness to test as unethical. There are two possibilities, 1) that the device is considered ""good enough"" and testing will delay widespread deployment, or 2) further testing will delay profits.""I thought there was a reply from Marshall Allen asking what ""simple, cost effective remedy I"" I advocate. I can't see the reply now, but I would like to respond. An answer to the question can be found at http://www.sjtrem.com/content/18/1/42. The link leads to my open-access article. I'll point out that after all the editing and proofreading, a clause was omitted. After the colon in the first paragraph of the Discussion section, there should have appeared ""clinicians trained and authorized to use the defibrillators were typically intensive-care physicians and nurses who were often far from the scene of the arrest."""Listen inInteresting article and interesting comments after the article - pertains more to opinions about how to improve safety and quality than the Presidential candidates.Interesting comparison to the airline industry. I think I actually agree with Dr. Johnson on this."On the topic of patients reporting adverse events there was another item published today, this one sort of on the skeptical side. http://www.post-gazette.com/stories/opinion/perspectives/dont-putthis-on-patients-sick-people-are-supposed-to-monitor-medical-errors-really-657941/" "Wow, this is a really good article. this is one of the best things I have seen written in a long time"Who sent the information about ALEC with the information about a state legislator who went to the strip club. If you sent that can you put it out again for me."In recent years research has confirmed that a high proportionof unnecessary surgery is still being performed, even by reputable surgeons. This practice needs to be considered in its social perspective.If a nonsurgeon were to cut someone open with a knife, remove a perfectly healthy organ and simultaneously rob the same person of $1,ooo, he would be charged with assault with a deadly weapon, attempted murder, robbery, and numerous other offences. If he said in his defence that he did it for the victim's own good, a jury could justifiably find him criminally insane.On the other hand, this same procedure ceases to be a crime when performed by a suitably qualified medical practitioner, who has judged in his professional opinion the operation is required or 'indicated'.Many surgical procedures still have no demonstrated proof of their effectiveness or of their value to the patient.""Good analogy June.. This is the exact same thing I told the police in regard to what my former doctor did to me. They told me if what happened to me at Mercy Hospital had happened in an alley somewhere, they could file charges. They said that when a doctor is involved, it's considered 'civil'. Outrageous!""After I was butchered, I felt as though a criminal held a gun to my head, took me down a dark alley, knocked me unconsious, mutilated 6 healthy organs from my body, sewed me up and left me to fend for myself. So when I found a book titled ""Bad Medicine: Is the health care system letting you down."" and read what I wrote above, I realized that what he wrote is exactly how I felt. Like I was harmed by violent criminals.""The issue you raise here June is indeed one that needs attention. It's difficult to face the aftermath of medical 'negligence'. It's beyond difficult to face the aftermath of 'intentional' medical harm. When a person is intentionally harmed via an unnecessary surgery, the trauma is huge! Unspeakable really...""I thought of the same thing a few years ago . . . why was the orthopedic surgeon that butchered my leg able to get away with it? Oh, yeah, he was licensed.""I've said this over and over I know but I'll say it again here. Until doctors are charged with 'crimes' and prosecuted like anybody else, we will continue to see unnecessary surgeries performed and we will continue to see harmed patients. It's really that simple. Doctors have always had a 'license to kill'. That's nothing new. Doctors have always had the freedom to heal or harm. What's different is this... Today, what we see is too large a number of doctors giving into financial pressure and performing unnecessary procedures and surgeries, prescribing dangerous drugs, etc. when there are alternatives - including the alternative to do nothing.""There is also the sad truth that other doctors who know that a procedure was botched are allowed to remain silent. There is no mandated reporting laws that require doctors to report sub-standard care, negligence, malpractice, etc. So they remain silent. It's almost as if they are aiding and abetting the wrong-doer. There are a lot of co-dependents in the medical arena, the silence of doctors not wanting to get involved is deafening."You bring up another good point Carla. The problem is surely compounded by the wall of silence!I agree with everything said here. I tried to file complaints with police and attorney general and both said they couldn't help. And I know there a other that were involved in my care that repeatedly told my family of the rogue behavior in the urology dept. It is criminal and should not have statue of limitations. And yes ALL parties knowing and covering up the horror are just as guilty in allowing these doctor to achieve their dirty deeds"All of you have just told my story. The medical system do not screen medical students for personality disorders, so at least 30% of doctors have disturbed personalities (that last sentence was written in a book about bad medicine). In other words these doctors have psychopathic traits and you'll recognize them. They lie to you face, they lie to everyone around them. They fabricate all sorts of non-existent medical problems. They deceive people. They manipulate people. they have no remorse. They abuse their power. They violated your trust. They violate your health rights. They violate their duty of care. They one zillion percent violate the Hippocratic Oath and FIRST DO HARM.""Welcome to our new members! I just wanted to re-post our guidelines, so everyone is on the same page. We do moderate this group, and delete things that are offensive or not directly related to patient harm. Let us know if you have questions, and thanks for joining. Click here for the guidelines: http://www.facebook.com/groups/patientharm/doc/218667131585176/""If you ever need to send messages to state or federal legislators or media use Congress.org (luv that URL; no connection to .gov). The site provides information on who to send to as well as reasonably automated mechanisms for sending out messages en masse. Using the link provided, the media wizard will show you all the media outlets for your state, let you pick up to five and send the message to those five adding in previously entered information (who you are, etc) as it sends it out. I put the message in Word and copied it into successive groups of five until I was finished. Using this service, I was able to send a message urging 45 newspapers in Virginia to watch the Bill Moyers presentatation on ALEC and to use journalistic investigation to inform the public. Total time involved (including interruptions!) about 1 hr.While you could use this to send any message to any newspaper in any state, it is probably better to focus on those in your state.In addition to this wonderful service, Congress.org has a lot of other great information and other services available."Thanks for posting this Cary!"Something to think about....""when no one is accountable, no one is safe.""""Agree Kirpal... That's what I've been saying for years. I wrote a very long letter to a local reporter regarding this very issue. I sent him the testimony from my medical malpractice case wherein my former doctor admitted he altered my record and obtained illegal consent for surgery. I also sent him the testimony of the O.R. nurse who admitted she 'knew' she obtained illegal consent and further stated surgeons at Mercy hospital don't ask to see surgical consent since they can 'assume' there's consent when the patient is in the O.R. afterall. What happened to me and what's happened to so many of us who belong to this group MATTERS to EVERYONE - whether they know it or not. The kind of testimony I have revealed to reporters substantiates just how serious a problem we have here. It's nearly incomprehensible that a doctor and nurse would make such admissions! And, on the record no less! The reason they can and did is because they know it won't matter. Tort reform has effectively put an end to filing and pursuing medical malpractice cases in this country. And, you sure can't pursue criminal charges... Oversight agencies look the other way.. This makes for a very DANGEROUS medical environment for everyone! When doctors and nurses are never held accountable, we all have reason to worry.. and worry a lot." https://www.federalregister.gov/articles/2012/09/10/2012-22028/agency-informationcollection-activities-proposed-collection-comment-requestSubmit your comments regarding adverse event reporting by November 9"October 13, 2012TO: Doris Lefkowitz, Reports Clearance Officer, AHRQ, [email protected]: Request for Comment ���A Prototype Consumer Reporting System for Patient Safety Events.���I completely support the goals of this project and believe it is necessary to improve the performance of oversight of consumer health care practices.1. Safety event intake form and follow up. I cannot express strongly enough the need for adverse event reporting. We cannot understand our successes if we do not understand our medical errors, i.e, mistakes, harm or injury, and near misses. This procedure should allow any patient who is subject to an error to voluntarily report safety events through a Web site or by telephone. The questions ask what happened, details of the event, when, where, whether there was harm, the type of harm, contributing factors, informed consent and disclosure, whether the treatment was coerced or other options denied, and whether the patient reported the event and to whom. Information should be collected regarding whether the respondent is willing to have CRSPS staff follow up to clarify information. If a respondent consents, CRSPS staff should be able to follow up by phone, or a field visit, and ask questions about any information that was not clear in the initial report and annotate the report with this information. Reports and findings should be posted to the state regulatory board that governs the practitioner���s license. 2. Health care provider follow up. For the subset of consumers that consent, patient safety officers at health care provider organizations who maintain the adverse event reporting system will contribute supplemental information about the consumerreported incident which occurred at their facility. CRSPS staff will contact the health care organization to share the consumer report with the patient safety officer or other appointed liaison. The liaison will determine if the consumerreported incident matches an event in the provider's Incident Reporting System, and if so, provide additional information. Providers should provide written protocols for management of the procedures that are reported as adverse events and where negative outcomes are confirmed, a plan of corrective action shall be filed for review along with evidence of implementation.Collected data collected should be analyzed to produce estimates and basic descriptive statistics on the quantity and type of consumer-reported patient safety events, examine the variability of responses to questions, examine the mode of data collection by event types, and conduct correlations, cross tabulations of responses and other statistical analysis.The proposed collection of information is necessary for the proper performance of AHRQ health care research and health care information dissemination functions, and makes a practical contribution to understanding health care costs, services, opportunities for improvement, and regulatory maintenance. This information has practical utility for consumers, providers and regulators. The accuracy of AHRQ's estimate of burden (including hours and costs) of the proposed collection(s) of information appears to be sound. This should integrated as a component to Electronic Health Records Systems in order to enhance the quality, utility, and clarity of the information to be collected and to minimize the burden of the collection of information upon the respondents, including the use of automated collection techniques or other forms of information technology. Submitted reports and their resolution should be maintained in patient files for examination and confirmation and should require that patient���s receive a copy and confirm with their signature.Very Respectfully,Terri A LewisHealthCare advocate""So glad to have found this board of like-minded individuals and that MaryAlice McClarty's OpEd was posted. I caught up on a lot of your posts and I am truly sorry and sickened. You are an inspiring group. Keep up the good work of getting out information about the horrendous effects tort reform has on injured people and their families. I will point out that I hesitated to join this board as I will likely be accused of having an ""agenda,"" I am a plaintiffs lawyer that regularly sues profit seeking companies that harm individuals - I am completely biased because I see the injuries, many of which could and should have been prevented, and I am not in the least bit embarassed about this bias. I am proud of my work and I am so glad to see others working hard toward the same goal - justice for those harmed.""Yes Jessica, we are all seeking justice for harmed patients! Glad you joined...""Hospitals' lawsuit settlement exposed unhealthy deal. http://www.answersforlisa.blogspot.com""Hey guys, noticed a lot of you posting about the meningitis outbreak. Marshall Allen wrote a column last week that provides some good context for the news; it explains compounding pharmacies, like The New England Compounding Center, which made the steroid shots linked to the outbreak. Check it out, and let us know if you have any questions.""Thank You New York Times. Maybe you can find out why physicians use drugs for spinal procedures when the package insert clearly states that they are not intended for epidural or spinal use. Maybe you can tell us why those physicians are not held accountable for ignoring FDA guidelines and why this is an ""acceptable standard"" of practice in our current medical system.http://www.nytimes.com/2012/10/16/health/tracingcrucial-components-of-meningitis-outbreak.html?smid=fb-share""Hello friends, I need your help. I am in discussion with some senators on changing the bill with Tort Reform, but I need you to send me your personal letters of your trials and issues you suffered or family members suffered. I need you to reach out across the country to friends, family and anyone you know who is fighting this battle. My email is [email protected] or fax is (877) 2073288. I also need you to send a letter to your state representative and the senator of your state"When do u need this by?as soon as you canWhich bill and which senators?God I pray we find justice since these representative and senator are corrupt! God help us find honest powerful people to help us. It is our prayer <3 May God continue to bless you and hold them accountable for the death of your daughter"thank you, Proposition 12 is what we voted for , but then they came up with HB 4 that protects doctors. Now each state may have their representatives and some senators working in the background with ALEC. Go to www.billmoyers.com and read how this work. The documentary will discuss the very reason why we do not have a voice. I found that many representatives in Texas have backed out of ALEC because the heat is heading their way. Our Governor and State Representative John Zerwas however refuses to withdraw membership."So this pertains to Texas. Thanks!SO true money blocks all morals and ethics yet I believe in time like all issues justices wins and crooks go to jail. I rejoice EVERY time I see them go to jail <3 Thank God for the internet because it shows us their deeds if we look hard enough. ALEC Full episode United States of ALEC---------http://billmoyers.com/episode/fullshow-united-states-of-alec/"You can go to alecexposed.com and see where your state stands. If you are not from Texas your endorsement on Texas would not exists. However, whatever state you live in, please take a look at the site and see if they are rewriting bills under your noses. If you find that they are then speak out. This issue referenced is hard for me to explain, but if you view the documentary it will give you some background on what is happening and what needs to be done.""This is not a singular state issue. It is nationwide effort by ALEC, corporations and legislators to change the fabric of everyone's life and will Deidre speaks above to a statewide proposition to be voted on by the public most of bills pushed by ALEC are put in place w/o a public vote. An example of efforts in other states from the Moyers show was ALEC effort sponsored by Glaxo in NC to limit corporate liability/tort reform. Didn't make it. This year.Takes a while to dig through alecexposed but you can be sure that efforts in your state based on ALEC models are being put forward. The success of those bills are usually predicated on how many state legislators are members of ALEC.A very sad component of this is that corporate financial sponsorship (some of which can be substantial) is currently tax deductible for the corporations as ALEC portrays the organization as a educational organization; not a lobby."God help Oregon: http://www.sourcewatch.org/index.php/Oregon_ALEC_PoliticiansTo stay germane with this particular FB group: here is where ALEC focuses their current interests on healthcare issues http://alecexposed.org/w/images/f/f2/ALEC_on_Health_Care.pdf thanks for the pdf up above. I urge you all to send this information to your news media in your state. let them see what they are doing behind our backs. keep sending it daily until someone takes notice"I am in California. My daughter was killed from 100% preventable medical error, I had a trial. The hospitals here are so well protected. The MICRA law, the $250,000 cap, since 1975, that makes it almost useless to go to trial, all add up to the conclusion, as a patient in a hospital, if something goes wrong, you really have no recourse. The ripple effect on my family is unimaginable, and I am not alone. I would be thrilled with an apology at this point."I am so sorry Lenore to hear about your loss ; apology probably will not happen because they do not want anyone to know. How long ago has it been since your daughter passed away?Today would be her 21st birthday. she died december 15 2002"I am so sorry; my daughter passed away February 14, 2011 due to medical negligence. You are right the system has created a manipulative tactic in getting away with negligence. I am fighting hard and I am working on something that I hope will bring justice for all that have been hurt by this. Keep me up in prayer that God will open the doors that I need to get this out. I am praying for you today in hope that God can give you peace. I had a rough day today myself but I'm pushing through. Please send me your story to [email protected]." http://www.tennessean.com/article/20121017/NEWS03/121017013/1/NLETTER04/Meningitis-outbreak--TN-deaths-rise-to-8"The US has no long-term living kidney donor data - but the Swiss do, and it isn't great."Wow.Wow is right. http://www.alternet.org/speakeasy/martharosenberg/shameless-drug-company-stillcashes-bone-marketSo many women have fallen prey to this... especially the millions of women who have lost bone health via hysterectomy!I need you to call in tonight and ask questions."Diedre, at some point I wish you would do a show on the impact of ALEC and corporate sponsorship of state legislation. While ALEC's tenecles reach far and wide, there are direct implecations for health care such as limitations on deregulation of health, Pharma and Insurance industries, weaking public health, limiting accountability oif companies for liability, privitizing medicaid/medicare and opposing health care reform.There is a lot of information on ALEC in previous posts in this forum and if you need any other information just ask and there are several of us who can help you."that sounds great Robin will be on next Thursday so lets do the 18th will that be OK. If so send me your email address to [email protected]"Deirdre, is your show tonight at 5 central time instead of 7? Want to be sure and listen!""Will do. If you haven't already seen the Bill Moyers special this last weekend, here is the link. http://billmoyers.com/episode/full-show-united-states-of-alec/There are documents and other information on the earlier post for your reference but view the show. It specifically discusses the trail of Glaxo's support of ALEC which influence legislation limitiing liability in the state of NC.""Hi Robin-Yes the time changed due to conflicts, so we will remain at 5:00 PM (CST). To Cary thanks I briefly looked at it for it was only a snippet but I am going to click on link now."Thanks Deirdre!Cary how can I get in contact with the attorney in the docDidn't come from an attorney. Came from Center for Media and Democracy at Alecexposed.com I'm sure that someone from CMD would be glad to be on your show.thank you"Deirdre, were you able to get in touch with anyone from CMD and ALECexposed?""Cary I talked with alecexposed, do you know any information about ALEC- I want someone to talk on the show Thursday""Who did you talk to at ALEC? They are extremely busy right now. It tends to get lost in the national politics but there are many ALEC influenced bills up for voting that need their attention.If you are not able to get any of them for your show, I will discuss. Maybe Marshall can join.""Ok Cary I will love to have you on to talk about it. I spoke with Matt Glazer with Progress Texas out of Austin who is working on ALEC as well. Can you check with Marshall and see if he would be interested in being on the show to discuss it. Please send me your e-mail so I can send you the request to be a guest form. It is for documentation. Thank you,""Marshall, please join this call. I can speak to this subject but I would like someone from Propublica on board for moral support."Hi Cary I have Phillip Martin from Progress Texas who said he will call in and talk about ALEC so just join in on the conversation.Cary you will be able to talk and ask questions too......"Excellent. I can tie in liability limitation within ALEC to my brother's death. In his case, liability worked as it should but ALEC seeks to change that in the name of protecting business interests. It is the real-life impact of ALEC crafted bills that are missing in the shadows of state government; until it is too late."Great we need the transparency. This is what is needed."Deirdre, please PM me.""Deirdre, need you to message me in FB about calling in.""It's International Infection Prevention Week. The CDC is circulating this - a nurse who saw it from the other side when her own husband suffered a preventable infection: ""In healthcare, we often think of healthcare-associated infections (HAIs) in terms of what they mean for our healthcare organization. As an infection preventionist, I know I did��� until an HAI affected my family. I wonder: Do we really stop and think about the impact of HAIs on patients and their families? Are we putting enough emphasis on the most important aspect of preventing HAIs���the patients and families?"""Thanks for reposting! http://www.tennessean.com/article/20121016/NEWS07/310160027/Meningitis-outbreak-TNrevokes-compounding-pharmacist-s-license?odyssey=tab|topnews|text| FRONTPAGE&nclick_check=1"I am observing that the patient is almost never a factor in outcome planning for delivery of health care services. We really need to begin with the patient and attack a plan for outcomes, working back from there. NOT rocket science."http://www.tennessean.com/article/20121006/NEWS07/310050133/Asmeningitis-outbreak-spreads-epidural-steroid-shots-come-under-attack"Could it be that we get what we PAY for ? We do not pay for outcomes, we pay for activities. First rule of continuous improvement - never, never confuse activity with productivity."http://www.tennessean.com/article/20121006/NEWS07/310050133/Asmeningitis-outbreak-spreads-epidural-steroid-shots-come-under-attack"Hospital's non-response shows the real intent of its lawsuit against web page. http://www.answersforlisa.blogspot.com"There's precedent case law federal and state First Amendment - refer to EFF ( Electronic Frontier Foundation ) there will be other sources - should not have to reinvent wheel in the local court - who's the firm's legal handlers?"Also New York's Civil Rights Law, section 74. Thanks!" "California refers to the SLAPP and anti-SLAPP [Strategic Lawsuit Against Public Participation] We have a local litigious CEO Tri-City Healthcare (Hospital) District who time after time continues to fail in courts will pursue because ""the board said I could ! "" - Run you down, if not run you out!!!"""New York also has anti-SLAPP law. But it only applies to government entities."Good information here, What about Az"Oops can a person use the hospital name in a website nameI think so. The words are proper words - not a made up name. And I took it first. I also made the hospital admit that it had not registered any of the variations of its name. "Read the description of this book. It describes the sadistic doctor who took great pleasure in causing me so much pain and suffering, after tricking me into unnecessary radical hysterectomy for training practice.""Alabama mothers who have had a poor experience in a hospital should be allowed to birth with a midwife, without fearing their midwife will risk prosecution. http://www.alabamabirthcoalition.org/""This is the book where Dr Phil Hammond said, ""The system is still geared to protecting doctors' reputations rather than protecting patients from unnecessary harm."" His first book called, ""Trust Me I'm a Doctor"" was written 20 years before this one, and you will be shocked at the disgusting things they got up to in medical school. It made me sick."This article is a reminder that this election matters - for reasons including the prevention of preventable bad outcomes for people who are ill (including those who might otherwise find out too late that they are ill). And it's not just the Presidential election that matters but the House and Senate too. http://www.nytimes.com/2012/10/14/opinion/sunday/kristof-a-possibly-fatalmistake.html?ref=opinionThank you for sharing this Noel! Please read... http://getoutdemvotes.com/disabled-in-ohio"1) We don't need the giant sell out to the insurance companies and the medical industrial complex called Obama care to address risk pooling and pre-existing conditions2) Obamacare does nothing to reduce the cost curve, which is why this guy did not have insurance and is why he probably would not have insurance under Obamacare, but would choose to pay the fine. What we need is to be able to have low cost, high deductible catastrophic plans for people like this, and Obamacare is wholesale eliminating those kinds of plans. 3) If Obama had really cared about people dying without insurance, he would have addressed the ""gap"" ie the 29 months people who have been approved for disability have to wait for Medicare to kick in. That is the #1 population dying without health care -- the rules are very tricky and its easy for COBRA to run out, it is very expensive and these are people who can't work. But Obama did nothing for this very vulnerable population. Nothing. To me it says volumes about what the program was and was not about. 4) As for preventing medical errors, the ""reforms"" Obama put in place are a ptomkin village that is easily gamed and IMO will cause many deaths as medical providers game the rules. 5) While I appreciate the shout out on Swedish (they literally saved my life) I have seen the same hospital system be quite unforgiving about finances towards patients with less well ""connected"" but equally fatal diseases. And to me that is the most scary thing about Obamacare is that what treatment you get will not be determined by medical necessity -- but rather the decisions of a political organization making political decisions based on who has the best lobbyist. If you have breast cancer and Susan G. Komen and $100k a dose drug manufacturers behind you, you will have Cadillac care. If you have a kid with a mitochondrial disorder with parents too poor and busy to organize and no big name drug, you will be out in the cold. If you have a disease where the choice is a cheap generic or an expensive designer drug where you get stuck paying 10% of the designer drug, the committee is going to give coverage for the designer drug, you'll be bearing the 10% cost and you will have ZERO coverage for the nice workable generic. that is the outcome the structure that has been set up is designed to make. And unlike current insurance, there is NO appeal, by design. It is a 100% political process and geared towards people with well known, well studied, well-financed and sympathetic diseases. It is death for those who have rare diseases, unsypathetic diseases or diseases for which there is not an expensive drug and therefore drug manufacturer lobbying. And it is designed to create a two tier medical system. Those who can afford to opt out and those who can't. So, I will be voting for honest reform, based on caring about patients, not lobbyists. And that means NOT Obama,""And if you want me to cry for someone who didn't buy a catastrophic policy because he wanted to spend his life reading and playing poker instead of working... I can think of many more compelling people in need of free medical care -- like the lady I posted about last week with the huge brain tumor who can't get treatment in Canada. Swedish actually specializes in the care she needs and they do not provide it for free to people like her. They will make her take out a mortgage on her house and have $100k upfront and if she doesn't have $100k, it's tough luck, go die. But since brain tumors don;t have the lobbying groups that breast and prostate cancer have.....""My point isn't that people should get good care for free. It's that everyone should be insured, especially for such predictable problems as prostate cancer in a 50-60 year old man. We don't give the people the option not to wear seat belts anymore or to drive cars uninsured. It's just my opinion, but I don't think we should be having uninsured people anymore in this country. And we should be moving the society in that direction - everyone insured. We can afford it. Taxing capital gains at the regular rate would probably cover it. So would raising the cap on Social Security - income over $110,000 isn't subject to the SSI deduction and this makes no sense. I say this even though it would hit me. (My salary is a matter of public record and is Google-able somewhere.)I don't want you to cry for anyone you don't want to cry for. I spent 3 hours today with fellow members of Metro Maryland Ostomy Association, all of whom have plastic bags stuck to their bellies to collect feces or urine (myself included). None of us were crying - some might cry for us though at this point we don't need it. Re #3 ""If Obama had really cared about people dying without insurance..."" This is unfair - everything in the ACA was negotiated and the thing just barely passed as it was. If he could have sat in a room and designed the whole thing himself who knows what would be included. It would certainly be different than it is.Re #4 I can tell you straight up from first hand knowledge that you are 100% wrong. I am one of the people who has set up the way we're measuring patient safety at the national level for the Partnership for Patients program. The data will not be gamed. (Most of it comes from random chart review, and the charts are abstracted by people that have no connection to the hospitals or to the success of the program.) The measures set up earlier (pre 2009) to have Medicare not pay for care after adverse events are producing puny results, but those are another story and they are unconnected to the Affordable Care Act (Obamacare). You can see what I'm talking about from the slightly-out-ofdate info on-line at http://www.qualityforum.org/Setting_Priorities/NPP/Partnership_for_Patients/Quarter ly_PFP-NPP_Meetings.aspx - download the slides for the Jan 19, 2012 meeting and see slides 125-136... The bottom-line number for 2010 was calculated as 145 (not 137) and this was sent to Congress."I have a lot to say about that issue at the moment. Hope to be able to share what we are learning about consumer safety from the meningitis outbreak. System failure on every level and catastrophic incompetence in responding."Noel, ""it will not be gamed."" Pardon me but Baloney sausage. Take a look at my mother's medical records. Fake diagnosis codes to avoid bounce back penalties. Which later resulted in misdiagnosis and mistreatment. Stage IV pressure ulcers misreported to avoid never event repporting. Drug overdoses papered over to avoid never event reporting. Falsifification and alteration of medical records to hide EMTALA violations. And yes that is plural. Miscoding of a half-dozen HACs. Medicare Regional Office personnel engaging in falsification of records -- I'll give you names- with the stated purpose of refusing to implement patient safety regulations. Starved on PURPOSE because she was disabled and left, on purpose, in that situation by Medicare paid personnel, without treatment for known lung cancer, and the main response from Medicare is how annoying we are to expect justice. Mom died because of people gaming the rules, with impunity. This is Kathleen Sebellius, not ""some other administration."" The Obama administration does not give a ___ about patients. That is clear to us in spades. Power point slides mean nothing. chart reviews mean nothing. Do you really, really think that these people are honest when they chart?????? How do you intend to defeat those who lie. Because nurses are taught in nursing school now how to jigger the charts. I'd love to show you where Inova charted mom as having a 2 cm by cm stage II pressure ulcer, with pictures taken, mere hours later, by National Rehab showing a stage IV, with a sore at stage II to a diameter of a dinner plate covering her entire buttocks. Unless the ambulance crew took a flame thrower to her rear end in transit, its pretty obvious that Inova lied. Period. And since you are a disabled person, let me warn you that Medicare, the state of Virginia, and Inova believe they have every right to starve you to death if you get taken there by ambulance. I'd suggest not traveling across the border, because euthanasia of the disabled is legal here. Our family has that in writing. Obamacare does not require people to have insurance. It just taxes them if they don't and it defines as insurance a very expensive bells and whistles definition that many people will not be able to afford without real efforts to move the cost curve -- which Obamacare worsens. It crowds out/bans lower cost solutions that have provided minimal coverage. There is a very good chance that, post-supreme court decision on state mandates - Obamacare will result in fewer people being unisured as corporations dump their lower cost plans and people can't afford the full monte insurance that the state exchanges will be mandated to offer. I have a question for you Noel Eldridge. You think that government should mandate insurance coverage -- an essentially coercive requirement. Yet, everyone seems to think it anathema to institute anything approaching a coercive approach with respect to medical providers, even though we are the ones paying them. Because let me tell you, if we videotaped everyone and anyone who didn't wash their hands lost their license, we would eliminate HACs. If doctors were not allowed to side step medical license rules that do not allow them to behave as pharamcists, we wouldnt have the fungal infections. Why should individuals be subject to government coercion and commercial enterprises not? Isn't that backwards? You all in the kumbaya quailty movement just do not understand that there is a substantial portion of institutions that would rather use patients as billing fodder and care not a whit about safety because they can lie their way out of trouble. There seems to be an unreasonable belief in the medical industrial complex as good an honest. How many people have been killed by unethical medicine vs. big oil. Why not sic IRS level enforcement on them, not us. And as for not second guessing the deal -- it seems to me that if he had bothered to show any leadership, Obama could have gotten gap coverage. To me, that is the most awful disgrace. Maybe if we had a Repub. working health care reform, it would have been a priority: http://medicareadvocacy.org/InfoByTopic/Reform/Reform_BilltoEnd24moWaitingPeriod.ht m. Why give Obama a pass on this??? This was done with a 100% democrat control of government.""I don't mean to be unkind Noel, but do you really believe that people in the medical profession are honest and that doing chart reviews is the answer or a rational tool for accountability? Two of the ER doctors claimed that he had done a full neuro exam on her and that it was fully normal. She had just had a failed surgery to repair torn extensor tendons in her fingers. She had a fused wrist. She had a permanently torn rotator cuff. And the CT was obvious for a spinal cord impingement. One sent her for a head CT for hallucinations. Obviously lying. Through their teeth. Mom had a history and physical about six times at these hospitals. All of the doctors listed a history of having had a Coronary Arterial Bypass Graft surgery. Which was obvious from the skin on her chest she had never had. But of course, the medical profession is filled with people with integrity who would never lie in the charts. but I have no doubt up the complexity of the patient and up the DRG. it's one of the problems I have with EHR. One doctor who is a jerk or stupid or corrupt could screw you up for life with misleading notes that gullible doctors will believe hook line and sinker and it won't matter what the patient says.""I should be clear about what I'm saying and what I'm not saying. What I'm saying is that I don't think that when we pull about 30,000 to 40,000 random charts out of about 32,000,000 or 33,000,000, and have people review them to find certain types of infections, adverse drug events, specific bad outcomes from procedures, etc., that it can't be gamed. It would require a massive and new conspiracy to be perpetrated with no one finding out about it.I am not saying that everything that occurs during a patient's inpatient stay always ends up in their chart (medical record). To say that would be idiotic.What I am saying, going back to that, is that if we review random charts from 2011, 2012, and 2013 the same way did for 2010 charts, that we should be able to tell if, overall, things are actually getting better or not for the whole nation.This is unrelated to accountability of specific doctors, hospitals, etc., with respect to specific instances of adverse events.""The only way to make it meaningful is to compare the data that is there to data that is not there, and with other data bases that will demonstrate the presence or absence of adverse events - medical accidents to disability applications, Wage and earning reports, applications for other public benefits. Follow the yellow brick road.""Getting back to my original point, which I admit is peripheral to the point of this Facebook group: The United States would be a better place for its citizens if all or almost all citizens (and legal permanent resident aliens) had health insurance. This is a nice summary of what the other option is... http://www.nytimes.com/2012/10/15/opinion/krugman-death-byideology.html?ref=opinion""First, the Obamacare ""quality incentives"" upped the ante on incentives to lie. Second, it doesn't have to be a conspiracy. All that has to happen is that the wound care nurse decided she doesn't want to get into trouble, so she just downgrades the pressure ulcer from a IV to a II. Because the hospital is going to get penalized for a IV and if its a bad hospital administration, they will 'solve' the problem by having the nurse lie. I went to Marty Makary's book signing not that long ago and a nursing student made the point that they are being taught how to ""shave"" patient records to limit hospital liability when things go wrong. It's part of the curriculum. It's part of the culture. Second, while 30-40k files sound impressive, with about 5000 hospitals accepting medicare, that is about 6-8 files per hospital. That is not enough for a statistically valid sampling at the hospital level and allocating files on a per hospital basis gets pretty messy pretty fast. I used to do federal agency contract compliance. That would not be a methodology that would fly in other agencies, including VA. That's why I think direct surveys to patients, validating data and identifying issues, based on dx codes is a much more powerful method. Makary made the point that most specialties have developed internal measuring methods that are harder to game. Ask those questions of patients, and when you get a red flag, see if the institution is telling the truth -- that is a much more powerful tool. The medical records are 100% self-serving.third, even if you are going to go to all of the work of gathering all of this data, what are you going to do with it? Because if you are not taking enforcement action, its just a whole lot of hot air. that's what bureaucrats do with problems they don't want to address. they have studies and form working groups who have conferences and symposia and that keeps all of the eager beaver people who they want to not bug them busy bugging each other and making up power points and giving talks and feeling like they are accomplishing something. They give them awards. And then they ignore them and go make policy while the other folks are power pointing. So, if this is a giant power point effort, which takes the heat off of a real effort, tied to real performance measures, I think it actually gets in the way of real change. Because it acts as a fig leaf.it makes people think a problem is being solved when it isn't.""What are the new incentives to lie? I truly don't know. Maybe I should.The sample I referred to comes from 800 of the approx 3400 hospitals in the medicare sample each year on a rotating basis. It's the Inpatient Quality Review sample that CMS collects. I'm not a statistician, but people who are tell the same size is pretty good. The 95% confidence intervals are pretty tight.I worked for VA for almost 10 years. They've done some great work, like developing NSQIP before ACS took it national with AHRQ funding. But VA can't measure patient safety (they can measure quality) any better than anyone else can. That's the huge challenge we're trying to address.ACS's NSQIP is unconnected to accountability but it still seems to make rates of quality problems go down, which seems to indicate that increasing accountability is not the only way to improve outcomes.Which real patient safety performance measures are you referring to that might be getting ""in the way of real change?""Is someone in the government thwarting real change? If so, who and what? How does any bureaucrat benefit from thwarting real improvements in patient safety? What bad things would happen to bureaucrats if patient safety was shown to have improved markedly?""Um, the penalties imposed by Obamacare. I used to do contract compliance oversight and audit of federal agencies. Also not a statistician, but we had statisticians set up the sampling for each agency we did. I don't think you have a deep enough sample. And I when I am talk about VA, I am talking about their contract compliance. I don't see why we should be more careful about contracts to supply toilet paper than we are about contracts to provide health care. But it is very obvious to me that our government cares more about conforming TP. And given the amount of money needed to do a proper sample and proper analysis, I think it would be a huge waste of money if it were unconnected to actual enforcement.I look at HHS and I see the Department of Defense in the era of $700 toilet seats. So we have an organization dedicated to jawboning quality and reducing government waste. Wonderful, but that is not going to touch the people who are dedicated abusers of the system. Because they are unconnected to audited, real, data, I suspect that the Obamacare 'penalties"" really function as penalties for telling the truth about performance,and are not actual performance penalties. For example, Inova received very little in the way of penalty. We know that they are poor performing on multiple measures from Mom's case and the staff's reaction. We know the records are garbage -- they are only ""performing' because they are lying. And it is cheaper to lie than to perform. So, when all is done, hospitals that are succeeding honestly will get less than those that lie. It is a poorly designed program. And because we have a poorly designed program that people *think* is doing something, they will not push for a program that really does something. Having a well designed quality system is not cheap. Having accountability for quality is not a high priority for the current administration and it is in competition with various pet projects of the administration (such as the huge bureacracy that obamacare is requiring). If you don't know the bureaucratic maneuver of pretending to do something so you don't really have to do something, well..... You still haven't answered my question -- why should we not have coercive enforcement for government funded health care. Why the squeamishness. We do it everywhere else in government, and with people who are doing very complicated things -- in many cases, activities that are far more complicated than the delivery of health care (ever build a ship? a fighter jet? a rocket?) Why the disdain for requiring honesty, penalizing dishonesty and having standards that are mandatory. Are doctors really of a higher realm than say, nuclear scientists, who live with all sorts of requirements? Because the mindset of ""these are untouchables"" is the same as how we treated defense contractors in the 1970s. With the same result of runaway costs and non-existent accountability that things actually worked. There are models for how to manage acquisitions and HHS is nowhere on the same planet as any other federal agency, much less the private sector, in this area. And addressing this will push the cost curve down. Which will make insurance affordable.""Let me put it another way. The data that you are using is like using contractor test data to validate system development. You can't do that. You have to have independent V&V for quality measures. No IV&V, no pay. That is how things work in the defense world. And you were there. There is a statute -- contractors cannot validate the workability of their own products. In addition, we have DCAA auditing the numbers and making sure that the books reflect the program realities. Two things audited. With Medicare, we just validate that the charge matches the billing code, with almost nothing to look back behind the actual records. That is why 40% of the money is wasted. If you are the third organization or fourth or whatever that is reviewing performance based on unaudited data (as the term audited means elsewhere -- ie traced back to make sure it meets reality) it's not adding to the discussion. You don't know if your numbers are improving because people are lying better or if they are performing better. For example. Mom, after her spine surgery, had a visible pocket of fluid in the surgical area. She also had signs of sepsis. The hospital chose to ignore that fluid pocket -- even though in a previous instance of that happening, mom was lifeflighted across the state of florida for immediate evaluation and surgery. The numbers look better for the more recent hospital, but in fact the previous one had the better care because they actually took care of the problem. The second problem is that anything that is voluntary is, well, voluntary. So, if you are in mom's situation and are taken by ambulance to a hospital that believes it is acceptable to abuse patients to death and you have no choice because it is the level 1 trauma center for the area, you are screwed. Patients should have the right to have appropriate treatment anywhere they might be taken-- especially when it's a life-threatening situation. Deciding to let hospitals decide if they want to participate does not protect the most vulnerable. As I said, Inova believes it is allowed to kill you because you are disabled and apparently the state of Virginia won't quibble with them on that. I have it in writing. So if you are in a car accident in Northern Virginia, you might very well be toast in a very drawn out and painful way. Don't you think it's more important to deal with the lying, abusive Inova's than getting marginal improvements at the honest, decent, and trying hard Johns Hopkins. Or do you think that there should be a sign on the bridge to Virginia -- we reserve the right to withhold medical treatment for disabled people in this state??? Should we just require a disclaimer on the Virginia tourism ads -- visit only if you are 100% healthy and have evacuation insurance??? Cause I can tell you that places like Inova are not going to change except at the pointy end of a sharp stick and even then, they are going to fight it tooth and nail. The only thing they are going to do voluntarily is window dressing. And do you think its fair for Hopkins to compete for funding with Inova when one is lying its way to ""excellence"" and the other is actually doing the hard work?""Noel, let me make a modest proposal. Pull my mom's medical records from Inova for a review by your office. Her name was Sharon Van Putten. She was at Inova Fair Oaks on June 27 and June 30 of 2011. She was at Inova Fairfax on July 1-21, August 17-18, and August 29-September 27. We have all of mom's records. We have a detailed analysis of every single one of Inova's errors. We have the inspection reports which demonstrate how completely incompetent and/or corrupt the program management side is on Medicare, at least in Region 3. And then you make an opinion as to the validity of random record reviews and whether medicare's processes make any sense whatsoever. There are over 100 medication errors alone. She was starved for seven-eight days. She had six rounds of hosptial acquired sepsis, including two with a multi-drug resistant Klebsellia while the hospital was sharing equipment among patients -- including a chair that I used at night while managing mom's breathing equipment and then used by other patients during the day, without so much as an alcohol wipe to clean it. With inova doing advanced imaging to figure out if my 67 year old mother, who had never had a UTI in her life, had a deformity causing the constant UTI's -- while not noticing that its nursing staff did not know how to do a cath and that a stage IV pressure ulcer is close proximity was left undressed. we can look at the coding for the August 17 visit, which was deliverately miscoded as a cardiac event to preclude a bounce-back penalty from the July 21 visit. And the Mis-coding of the August 29 visit -- also to avoid bounce-back -- which prevented us from getting mom transferred to a competent hospital. Mom quite literally died from people gaming the system. So, before you express confidence in hospital record keeping, take an opportunity to see the reality.""and to put a finer point on it, the Joint Commission had no problem with the abuse of my mother, either. So to our family, this looks like nothing but a bunch of blah, blah, blah." independent evaluations are always best by third party examiners"If you look at this article, Australia has Price Waterhouse do forensic audits on hospital data and surprise, there is ""fudging"". We don't have anyone audit hospital data, much less some like PWC. http://www.abc.net.au/news/2012-07-03/canberra-hospital-datareport-findings/4107462""I don't have any authority to pull anyone's charts. The strange/spooky thing for me is that I was a patient at that same hospital in 1999, where I had my colon removed due to ulcerative colitis. They saved my life - I was in the process of slowly bleeding to death thru my colon, which is not a good way to go...Again... I'm not saying that all medical records/charts are accurate, just that on-average there's no reason to think that they will be more wrong in 2013 than they were in 2010, and if that's the case looking at about 1/1000 charts at random and looking for adverse events, such as pressure ulcers, adverse drug events, infections, etc. We will be able to have some idea if, on average, things are getting better or not."Veronica - I did read your write up of what happened to your mother. Sad and outrageous.Need a malpractice lawyer the hospital was located in VA any help would be great so far VA seems to be really tough and lawyers are all too busy or have conflicts with UVA seems to me that all the laws protect the hospital and it's doctors.That seems to be the norm in many states.Just in case you haven't seen this: http://www.ehow.com/about_5101195_requirements-medicalmalpractice-suit.htmlThe main problem is most injured patient don't find out what really happened until they finally after many requests get all their medical records and in my case it takes a long while to read through 40 lbs of paper then when you find out all the neglect and harm lawyers tell you it is too late. I find this fustrating as part of tje staute of limitations states from the time of finding out what really happened but lawyers won't help"The bottom line is tort reform has effectively stopped most harmed patients from filing medical malpractice complaints - regardless of evidence. Tort reform is a huge huge problem! And it effects EVERYONE - whether they've been harmed yet or not. The white wall of silence stands stronger than ever via tort reform. Until we get rid of tort reform, doctors, nurses and hospitals will continue to harm via neglect and even on purpose because they have no fear of being sued or exposed. I took the following quote from the CNN article you posted Georjean... ""Tort reform violates the Constitution and is an infringement on patients' rights but, more important, because when no one is accountable, no one is safe."""thanks everyone its so messed up these doctors just go on hurting others and think they are above the law and worst of all they get paid even though they screwed up big time they get paid alot of money."One doctor in a book I read said that if a patient annoyed him, he deliberately harmed them. The patient only has to disagree with a decision these types of doctor makes, and they could be at risk of deliberate harm."thats horrifying unbelievable that they get paid no matter how badly they mess us up...its just wrongWhat is the nature of the injury?Debra Van Putten it's very long and complicated but I've been told by many other Drs what they did was completely wrong and they also refused to treat me after I lost health insurance while I still had a stent in my pancreas and a drain in my stomach and continued complications from they first surgery they did"Amy, sounds like my horror story,"Sorry Georjean Parrish :("Sorry for you too,Amy Houck. We r blessed by God to be alive""I would look at a couple places -- superlawers.com, the washingtonian top lawyers list. It looks to me thatboth the southern (Richmond) and NoVa lawyers cover UVA. Look at the attorneys sites to see if they are plaintiff or defense side attorneys. If you are finding folks with conflicts, you are contacting defense attorneys""Here is the Virginia Trial Lawyer's find a lawyer directory. Search under ""malpractice."" https://www.vtla.com/index.cfm?pg=FindALawyer""We are alive for a reason, and that is to inform as many people as we can about how dangerous doctors and hospitals are to patients. As Dr Hammonds says in his book, 'The system is still geared to protect the doctors' reputations, rather than protecting patients from unnecessary harm.' It's a shame we had to learn that through our bad experiences with the medical establishment."did you all see this"Attachment UnavailableThis attachment may have been removed or the person who shared it may not have permission to share it with you.""I sent it the attachment, I thought it was my flyer""well I sent it again, let's see what happens""If it is in your file/picture gallery, you may need to set the share to public.""""That said, it is important to note the following. Had the contaminated steroid been regulated by the FDA and you happen to live in Michigan, no lawsuit would be possible ��� at all. Had the case involved a misleading label on a generic drug, and the brand name version has been approved by the FDA, no lawsuit would be possible ��� at all. Had the case involved a Class III medical device approved by the FDA (as opposed to an injected steroid), no lawsuit would be possible ��� at all."""Watch this video! Australian women harmed by J&J surgical mesh sue for justice and to expose the corruption of the medical device approval system.Drugwatch.com sent me the following to post on my web site about transvaginal mesh - labeled a risky medical device by the FDA. http://www.hysterectomyconsequences.com/developing_organ_prolapse_after_a_hysterect omy"RIP Senator Specter, and thank YOU for recognizing those who suffered medical harm before Any other lawmaker. We will always remember you and thank you. http://www.cnn.com/2012/10/14/politics/obit-specter/index.html?hpt=hp_t1"Spector sat in on the congressional hearings about my brother's radiation overdose. sometimes we confuse the concept of smaller government with stupid government "Valsartan is the generic for Diovan, which just became allowed for sale in the US. My questionis how does a hospital have access to this back in 12/2008-early 2009. My medical records show I was given this when I was in the hospital."That's a good question Georjean..."In my latest story for ProPublica, I look at the link between the deadly meningitis outbreak and the evolution of the compounding pharmacy industry, which has also led to patient harm elsewhere. I'd love to hear your thoughts about it, and please pass the link along to others who care about these problems."Marshall - i'm writing my column on the issue of c.p. but where did you get 12 deaths? cdc site says 11. is there another?"It does say 12 now: http://www.cdc.gov/hai/outbreaks/meningitis-map.html They had done their math wrong on that spreadsheet just after 2 p.m. EST, when it posted. The state breakdown totaled 12, but in the bottom of the total column it still said 11. But they fixed it now."wow. thanks. i just saw that. ZIP."Marshall, I wish I had known you were working on this particular story. I read this with great interest. My post is long but I hope you'll read it. After my hormone-producing sex organs were removed in 2007, I became very familiar with compounding pharmacies and compounded hormones. I could write a book about what I've learned. I take compounded progesterone orally but i receive estrogen and testosterone via pellets. I have had major side effects from the pellets - much like you describe in your article. However, of all the many things i've endured via just trying to 'replace' my hormones I can't produce now, I would have to say that being 'scammed' by a HRT (hormone replacement therapy) center/doctor/pharmacy is at the top of my list. I changed to a new HRT center a couple of years ago and they had me do my own at-home testing via blood and saliva. Although this is not uncommon, it is a pain and it's expensive. After testing, I had to see a particular gynecologist (recommended by the center) in order to obtain a prescription for my HRT. I spent a small fortune by the time I met with the representative at the HRT Center (who knew next to nothing about HRT), paid for their lab (this place worked with exclusively) to read my blood and saliva test result and met with the gynecologist (who didn't seem to have a clue...). This HRT was all in cream form that had to be rubbed into the skin. It was a nightmare! Something was wrong and I knew it. I became really sick, depressed, etc. So I wrote to the owner of the HRT center. By the way, her husband owns the pharmacy which compounds the hormone creams. This should have been a red flag for me! The woman I wrote to forwarded my e-mail to her pharmacist-husband telling him that my HRT wasn't working and that I was a nightmare customer. She copied me on her e-mail to him by mistake. She said a lot of other things I won't go into here... Anyway, after I saw the e-mail exchange between the woman who owns the HRT center and her pharmacist husband, I knew I had been scammed and I set out to prove it. At the very least, I wanted my money back. I needed my money back in order to find another HRT center so as to obtain hormones. After reading the e-mails, I realized that the pharmacist was 'using' the gynecologist as a 'front'. He was the one who was really prescribing the hormones and that's why they weren't working for me. He was merely using the doctor to hide behind for legal reasons. I telephoned the doctor and told her that I wanted to change to a different pharmacist. I figured that if she was not in on the scam, she should have no problem with me changing... If she was the one who truly prescribed my HRT, then she should have been fine with me changing to a different pharmacy. I'd done this in the past with other doctors and there was never a problem. As I suspected, she didn't know how to deal with my request. She panicked and told me she would have to make a phone call and get back with me. I knew then that I was right. I should say here that I recorded my conversations with this doctor. She called me back and told me that I could not change to a different pharmacy. I knew I had been scammed and that she was in on it. I immediately emailed the pharmacist and told him what i had figured out. I told him that I knew he was illegally prescribing hormones and filling them and I told him how I knew and about recording my telephone conversations with the doctor. I asked for all of my money back and told him I would report him if he didn't make things right with me. He wrote me back and admitted I was right, gave me all of my money back and he thanked me for not turning him in. Following is what he wrote in his last e-mail to me (thanks for the grace.. Shawn will send out a check to you on monday certified mailjeff). If I had the energy to turn him in, I would. But I don't. This is but one example of the scams going on with regard to the many HRT centers that have popped up all over the country. Doctors remove women's organs thereby victimizing them and then HRT centers/compounding pharmacies victimize them even further. It's victimization upon victimization... It does not end.""I have some unsatisfied questions from this story? First, who is writing the prescriptions for these prescriptions and why do they still have licenses? Surely, the doctors had some incentive to have this go through this pharmacy. With the spine injections, the drug in question is commercially produced and is available at low cost from Walgreens. Viagra and valium are also available at Walgreens. On the hormones, were the patients choosing to take these hormone based on the advice of a TV celebrity or based on the advice of a board certified endocrinologist (and believe me, I am generally not a fan of endos, but, if you are going to play with hormones, you better know one)? If there was a doctors prescribing outside of his/her scope of knowledge, what has happened to his/her license? Because I guarantee that in 90% of these problems, the underlying issue is a doctor who is a quack. Even with the meningitis -- steroids are no better than saline in results for most people -- why were these people getting the injections in the first place is a better question. These are also situations where patients would benefit going into the appointment or the pharmacy with a clear idea of what the standard of practice is-- and for all of the docs who don't like getting questions, this is why some us ask so many. The reason I ask is this. there are many compounders who are very reputable. They are a life saver for patients with rare diseases. if you have a rare disease, it can be nearly impossible for drugs to get approved through the FDA process, and if they are, they will have orphan designation and not be affordable. 5% of a $10k a month drug = not in my budget. often, medications for other illnesses can be used, but at differing doses. Compounders are critical for specialists in these sorts of diseases to have any access to medicine. The trade offs are different with rare diseases -- and nearly one in ten people have a rare disease - so its not all that unusual.The easy policy response is to say that compounders are bad. but the real problem is the doctors and nobody will go after them. The risk is that if you go after compounders in general, you will cause serious access issues for some patients.""Debrah, I agree with you when you say compounders are necessary. There are certainly good ones out there. I use one now that I've been using for several years. They have been a God-send for me. But, there are many out there (just like with anything else) who are taking advantage of so many women and men needing and wanting hormone replacement. There's a huge amount of money being made off of the desire to remain young. Suzanne Sommers has touted bioidentical hormones for years and sold many many books about them. She helped to create the hormone 'frenzy' we see today. There are as many men at the hormone center I go to as there are women. Why? Because they are trying to hold onto and/or recapture their youth... Every time I go, it's $300 just for the estrogen and testosterone pellets. They are making crazy money."http://vitals.nbcnews.com/_news/2012/10/10/14345111compounding-pharmacies-heroes-or-outlaws#.UHXAxheU1GQ.twitter"My bet is that 95% of the people who got the spine injections had absolutely zero medical need for them. And I bet that half of them were told no by some other doctor and found someone who would do it anyway. And I bet that the places that did them were cut rate places -the drug is available and cheap -- the only reason I see to have it compounded is that its even cheaper or you don't want to hit someone's radar from doing so many injections and therefore ordering so much product. Only someone who is doing serious volume would bother to have it compounded. To me, the real culprit is the doctors. And likely more than a few patients who did not care. The compounders have no customers without someone with an MD writing a scrip.And I think the system should come down on the doctors who are really drug dealers with no more scruples, than punish patients across the board -- including those who really need treatment. but that is how we always handle problems with the medical system. We do not have consequences tailored to the mal-feasors.""And if I might add, if we had searchable Medicare data on places in real time, I bet that someone would have identified these shot mills for what they are, and may cut this off earlier. No reputable hospital or orthopedist is going to be buying special brew when FDA supervised stuff is freely available. and if there is some place of repute, they should be outed for cutting corners that shouldn't be cut." http://americannewsreport.com/meningitis-outbreak-raises-more-questions-aboutspinal-injections-8816044"How do the 12 deaths compare to the 88,000 a year due to medical errors (mostly RX)?""Try 180,000+ due to medical errors. \"Robin Karr Thanks for sharing your story"This was predictable, preventable. I collaborate world wide with a group of folks injured by spinal procedures including ESIs. This is simply system failure on every level. Our entire medical model needs a big wake up call."Huge problems with informed consent and the 'theory of the problem.' When we theorize the problem in terms without understanding the potential impact of an off the shelf solution we are in big big trouble."The National Disaster Medical System Federal Partners Memorandum of Agreement defines a public health emergency as ""an emergency need for health care [medical] services to respond to a disaster, significant outbreak of an infectious disease, bio terrorist attack or other significant or catastrophic event. For purposes of NDMS activation, a public health emergency may include but is not limited to, public health emergencies declared by the Secretary of HHS [Health and Human Services] under 42 U.S.C. 247d, or a declaration of a major disaster or emergency under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act), 42 U.S.C. 5121-5206)."" The Act appears to have provisions for infectious diseases that have the potential to threaten national security by incapacitation public employees, the military, etc. It does not have a provision for multi-state iatragenic events such as the fungal meningitis outbreak. Covered events trip the coordination of specific public responses. Noncovered events reply on individual states to determine their own response systems and transfer the risk of the event to the individual, affording them little or no protection beyond existing regulation. The BP oil spill is the closest recent event that parallels this man made disaster, followed by the multistate salmonellla outbreak of 3 years ago. Public officials need to evaluate whether the multistate coordination of public resources large multistate adverse events should be coordinated through the Stafford Act and VOAD agreements.Among the observed problems with the current event management system - inconsistent local hospital responding to presenting affected individuals; potential loss of employment with loss of insurance coverage for the event; crossover of workman's compensation cases (prior injuries) complicated by secondary insults; physicians who refuse to treat due to fear of personal litigation; inconsistent response to information requirements at the state public health level; cross state address for affected individuals who received treatment across state borders which has the potential to result in refusal of coverage at many levels; lack of coordination of legal claims; resultant bankruptcy filings due to personal and unanticipated medical bills while claims are litigated nationwide...a national declaration would pave the way to cut through the morass of problems and deliver necessary support and information much faster. Why is this important? Most of the affected are already affected by disabling levels of chronic pain which already limits personal resources for response.Worse yet, reports are emerging that treating physicians require a waiver of liability and waiving of patient rights through coerced signing of 'informed consent' forms in order to receive treatment.""Terri Lewis, your last sentence says a lot!.... Informed consent has become nothing more than a legal document many doctors hide behind. Often, consent is coerced. And when it isn't, it's often not 'informed'. Huge issue!"HUGE issue."Because statistics and studies are often biased or simply inaccurate due to the nature of the study...If even only one person suffers an adverse event, that adverse event should be described in the informed consent form and patient education process PRIOR to performing the procedure...otherwise it is not *informed* consent it is just an excuse for the physician to avoid taking the time to know what he is selling. This takes more time and may result in the patient choosing NOT to have the procedure affecting the wallet of the pain management industry but it will affect their wallets more if the lack of genuine *informed* consent becomes grounds for malpractice. It isn't right now."Perhaps this information process should be part of the pre-op protocol and handled by a patient advocate instead of leaving it up to the physician who is going to benefit from selling the product/procedure."Marshall,Saw report on current compounding lab problem last night on CNN. While there are specific problems with these labs regarding the meningitus outbreak, there certainly does appear to be a gap in oversight of these labs. Thanks for addressing this subject in your article."I would be remiss in my personal campaign to spread the evils of ALEC if I did not note that ALEC's influence on state legislatures in the area of liability limitations may have direct bearing in this case. I did look at the ALEC Exposed corporate database and did not find the two compounding labs in the list. It will remain to be seen if corporate liability limitation has already taken root in Mass and if the national scope of the outbreak would be subject to state limitations.These are LLCs. The only way to know what is going on may be through SEC filings? Personal tax returns? HCA's filings?"Geez, Terri. I dunno. I'm just looking at similar issues where Glaxo worked with ALEC and legislators in NC to push liability limitations. Tabled for now. Not sure if limitations would apply to mega corps, LLC's, doc in the box, etc. but it is clear that ALEC's bill mill laws are designed to limit the ability of those who are injured by businesses to seek full redress in a court of law.""I'm working through the Nashville media resources to follow individuals, so my comments reflect the variation in experience. This will break new ground in law as it breaks individuals and families who cannot wait for the law to follow. It's coming like a freight train." "Terri, please make sure you are taking care of you in the midst of all of this. Thanks for fighting.""somewhere tonite, it is approaching beer:thirty""""when no one is accountable, no one is safe"" Patients are unfairly the only accountable 'stakeholder' for failed implanted medical devices.""Huh?? ""The civil justice system gives families of patients who have died or have been injured by medical negligence an avenue to seek accountability. It also provides an incentive to health care providers to improve patient care. Removing that accountability and incentive leaves people at risk for more injures from negligent care."" -- I'm not sure what that paragraph even means. The civil justice system is on life-support itself when it comes to families of patients AND patients who have died or have been injured. Where was my avenue?!? Where was yours?!? Oh sure, in ""theory"" the civil justice system is there to give patients an avenue. Don't know about you, but Civil Justice Avenue was a one-way street for me with the defense attorney deliberately putting up road blocks every step of the way and the court being the gatekeepers to access. The plane crash stat I've read before. Think about this, each day, according to MADD (Mothers Against Drunk Drivers) 28 deaths occur due to alcohol related crashes. That's about 10,220 souls who tragically die a year. And yet . . . we know more about MADD (a worthy cause) and their efforts against drunk drivers, victim compensation, etc. . . . But when nearly 10 times more souls are lost with ""preventable medical errors"" Civil Justice Avenue is spewn with bodies and no one does a thing other them attempt to put in MORE roadblocks. And we aren't even tallying the number of patients who are among the walking wounded on Civil Justice Avenue due to medical/doctor/hospital error who obtained nothing civil, and certainly no justice. Pity.""The fifth annual Global Handwashing Day will be observed on October 15, 2012. This observance increases awareness and understanding of handwashing with soap as an effective and affordable method of preventing disease around the world. Handwashing with soap has an important role to play in child survival and health. About 2.2 million children aged <5 years die each year from diarrheal diseases or pneumonia, the top two killers of young children worldwide (1). Handwashing is not only simple and inexpensive, but handwashing with soap can reduce the incidence of diarrhea by 30% (2) and respiratory infections by 21% (3) among children aged <5 years. Although persons around the world clean their hands with water, very few use soap to wash their hands. Washing hands with soap removes bacteria much more effectively (4). Additional information on Global Handwashing Day is available from CDC at http://www.cdc.gov/features/globalhandwashing. General handwashing information is available at http://www.cdc.gov/handwashing. Information on water-related hygiene is available at http://www.cdc.gov/healthywater/hygiene/index.html."Please listen to Deirdre's radio show at 6:00 EST tonight. I will be talking about unnecessary hysterectomy and lack of informed consent. You can listen afterward as well. Here's the link for the show... http://www.blogtalkradio.com/deirdregilbert/2012/10/11/life-radioshow#.UHbMWxbqFGQ.facebookGood job Robin!you can still listen veronica... Interesting summary of how patient safety programs may be in the same boat as Big Bird. And how it may play out after the elections.Interesting analysis.Listen to Robin Karr"The meningitis fungus horror continues. Turns out, not only has this happened before, almost the exact same thing in the Carolinas 10 years ago, but your local friendly hospital or clinic, or physician, may be relying on products from these compounding pharmacies for your care. And those providers may not even know, and never cared before now, where these medicines were coming from. Hospitals and infusion clinics, nervous anyone? My column today."What are we doing locally about this situation ? ? ?"I hope, going after the doctors who were apparently selling unlicensed meds -- this was mass manufacture with distribution by those docs without a prescrip. Likely in support of injection mills -- the new profit center for pain clinics as there has been a crackdown on narcotics.""All the hospitals have to do is incorrectly stage the pressure ulcer by totally ignoring objective standards like the Braden Scale and then they still get paid. http://www.fiercehealthcare.com/story/medicare-penalty-doesnt-curb-hospitalacquired-infections/2012-10-11?utm_medium=nl&utm_source=internal""You mean like the 2 cm by 3 cm stage 2, that turned into a 9 cm by 9 cm with a stage IV center in the 30 minutes mom was in transport? No, that would never happen. Those top hospitals are top because they are good, not because they are better liars!"A close up photo with cm measure on admission and daily. It seems this would be easy to add to an electronic medical record. Another reason to enlist a professional or family Patient Safety Advocate to monitor decubitii."Yeah, we asked the hospital that caused the sore to take pictures -- $2 bi in cash on hand and the place claimed it couldn't afford a digital camera.""Hospital company fights lawsuits even after the state finds its care lacking.http://www.answersforlisa.blogspot.com"of course they're fighting it... thanks for posting davidHospital inspections: You guys have been so helpful in filling out our map of how states handle hospital inspection reports. We only have about a dozen states left. Would you mind contacting a state (or another if you have already done one?) It would be very much appreciated: https://docs.google.com/spreadsheet/ccc? key=0Aq4RTfI9gHGudEF4QkIwZVp1VTc4V2xMNjhlalhsS3c"And if they have no scruples on billling, why would we think they have scruples without our lives??"this is beyond alarming! where's the outrage here? seriously! and the only reason hospitals are the least investigated regarding criminal cases is because criminal charges aren't filed. we know that...http://www.timesfreepress.com/news/2010/mar/08/roboticmedical-arms-race/I thought about you when i posted this Georjean...My God.... http://www.postandcourier.com/article/20091218/PC1602/312189922"That's what I say Krissy... ""MY GOD'"http://highbrowmagazine.com/1634-escape-fire-documentary-shedslight-american-healthcare-crisisGreat Point Veronica!The United States ranks 1st in cost of healthcare."The medical device industry is producing implanted devices that are traded worldwide though they fail at a high rate-(m-o-m hips, surgical mesh, ICD leads). Patient harm is an unacknowledged by-product of 'innovation'. Torture is too kind a word! Researchers must follow the money trail to see how profit is privatized and costs are spread to taxpayers.""I couldn't agree more Joleen! Torture is too kind a word. Drugwatch.com recently asked me if they could post information on my web site and blog about health problems caused by transvaginal mesh. Of course, I agreed to post information for them and I've done so. There are many dirty little secrets out there with regard to medical devices and they need to be EXPOSED! As I always say, yesterday would be too late! Here's the post from my web site... http://www.hysterectomyconsequences.com/developing_organ_prolapse_after_a_hysterect omy""Interesting case of an unregulated drug. I can kind of see it for topical drugs and maybe drugs taken by mouth, but drugs that will be injected or infused... seems like not such a great idea."Thanks for joining in the conversation. compounders are a life-saver for a lot of folks with rare diseases."I had a compounded drug I was taking by enema. Long story. Suffice to say it was related to Ulcerative Colitis. One day I noticed tiny black spots floating around in one of the containers. I called the pharmacy and they told me to throw out the batch and they'd send me another one, which they did. The idea of IV or spinal drugs coming from unregulated or lightly regulated facilities gives me the heebiejeebies.""The tough thing is what do you do? If you have celiac, you can't take alot of meds due to the fillers. If you are taking something for an off label use, you may not be able to get the right dose - I've had meds I have had to cut in eighths. And as has been seen in some diseases, the FDA steps in, ""regularized"" things and the med goes from $20 to$20,000 cause now its an orphan drug. And people can't afford it so they either go without or they go overseas to some place that might be dicey.And the spinal injections are overused and the sourcing is the least of the worries for the steroid junky docs in many instances. Corticosteroids kill muscles. So about the last thing you want to do with someone with spine pain is to inject a steroid and weaken their spine muscles. They will have more pain due to weaker muscles. And then need more injections. Its just like a drug dealer. To me, its like people getting sick from contaminated rat poison injections. Sure, its bad that the stuff is contaminated, but what the heck are you doing putting that in your body instead of doing PT? Getting off of soap box now.""Where I currently work (AHRQ) is on the same legislative chopping block as Big Bird. I read the bill that planned to eliminate us, but I didn't know it was the same bill as went after PBS. http://www.forbes.com/sites/michaelmillenson/2012/10/05/should-patient-safetyagency-move-to-sesame-street/"I am a global mental health humanitarian advocate. If I am allow my I post my global cause group?Thank you <3"World MRSA Awareness Month - October. Today's press release received 289 pick ups the first hour. The media is interested in this topic and more stories about the truth of the MRSA epidemic and HAI's needs to be told.http://www.prnewswire.com/news-releases/stop-mrsa---worldmrsa-awareness-month-october-173275281.html""Thank you for giving it a place in our hearts and mind- Happy World MRSA Awareness Month to you, Jeanine and all others whom feel heard today. This including cancer and mental health that share October awareness limelight <3""http://theconversationproject.org/news/Don't miss this discussion tonight at 6:30 with Diane Sawyer.""More than 200 people, including many of you, have completed our Patient Harm Questionnaire. Thank you! We've been going through these stories and identifying leads and important stories to follow-up. This is an important tool for us as we tackle the complexity of patient harm that happens all too often throughout the country. If you have not yet done so, will you please complete the questionnaire? Also, please pass it along to others you know who have also been victims of patient harm.""Two more patient stories submitted to the questionnaire today, since I made my request. Thank you! Please keep them coming and I'll post updates when more arrive."btw Marshall I've not completed the questionnaire because the harm occurred long enough ago that I can't provide the provenance or documentation it asks for."Hi Bart Windrum, if you don't have the documentation, that's OK. Please complete the questionnaire anyway. There is still value for us in finding out what happened to patients and whether it was acknowledged, whether there was an apology, whether they complained, the outcome of complaints, etc. The idea is to get enough aggregate data that it reveals important trends in the way patients who are harmed have been treated."Marshall what is the best way to provide the documentation and letters sent basically stating this is our answers to your questions and you will not be allowed to ask more you just need to be greatful you are cancer free and alive. Then letters asking me to find new dr."The questionnaire can just include an overview of what happened, and then we will follow up from there. We don't need all the documentation right now. We unfortunately are not able to follow up with every patient. There are just too many people being harmed, as you all know. But we also collaborate with other reporters, so we can share the patient stories with other journalists (with the permission of the patient, of course). In addition, we're compiling quite a body of data that could be useful for other research, or for stories that use aggregate numbers to highlight trends."done"Great. Thanks much, Bart!""Marshall, I filled out the questionnaire. Did you get it? I did so about a month ago.\""Hi Cynthia, we do have your completed questionnaire. Thank you! And looking in my Inbox it appears I sent you a confirmation and thank you on Aug. 17. If you did not get it I will resend.""Thanks, Marshall. Please resend. No, I did not get the confirmation. Want you to know that it is a pattern because my email account is compromised and I have been trying to get Microsoft to help me with it which they have quite a bit. I am telling you this ahead of time because if you do not get a reply from me it is because of interference in my account. I always reply to people - always.""No worries, Cynthia. I resent it. It's more of a form email at this point, just to acknowledge to people that we received their info. So no need to worry about not replying."Do you see my post Marshall Allen re: Brucellosis: Is the Devil in Your House?I have not received it yet"I cannot get on this site and share. I am being prevented from sharing my articles, the ones that are most incriminating cannot be seen. Please tell me if you see my posts. I cannot see them.""Yes, your posts are showing up."Marshall Allen I filled out the survey a few days ago and havent received a confirmation. would like to get one if possible. ThanksI checked and we did receive yours Amy Houck. We don't send those emails out daily or anything so that's why you hadn't received a confirmation yet.We've had six more questionnaires completed since I put out the request yesterday. Thanks everyone! I'm hoping that more of you will be able to get to it this weekend. Please also pass it on to others.great thanksAm I allowed to name a mental health treatment center for son on the questionnaire?"Jake Sims: Yes, please do.""Marshall, I was just on the ProPublica site. It is now 1:35 on Saturday, October 6. The first post I see on that site is one from Wednesday and it is from Deirdre Gilbert , This shows Marshall that what I am all about is a threat to those hacking my computer. I called Microsoft and an engineer told me I was hacked."I tried to fill it twice but stopped every time because I feel we have a long ways to go before the stigma of mental health- birth brain injury is met with compassion and understanding. I am grateful you might consider. We just now seeing the lawsuits/ settlements against big pharma. I know that it is up to me and not placing my hope on my son lack of care. I finally realizing this. The battle is mine alone.See if you can spot Olga Pierce Well I finally finished the painting entitled #Cinderblocks inspired by Partnership with Patients in KC... http://www.flickr.com/photos/45128746@N04/8069379601/in/photostream I could not fit everybody in but I love all of you.She's been immortalized by your hand - nice!She was a powerful addition to the day."Very happy to be there, and I have to say I've never been subject of portrait before.""I received a phone call last night from C H I N A! Lady from some hospital there saw this site and wanted more information about my situation because she was certain they would be able to help me reverse my kidney disease and my need for dialysis. REALLY? And exactly how much is that going to cost me to fly there go through your diagnostic testing and then be told ""oh you have no kidneys at all we can't help you."" ? Seriously scary especially in that the only place I have ever listed my personal cellphone number is when I placed a pic of a sign I put up in front of our house. This means this person or group of people have been scanning through this page and my personal one for personal, private information to try and contact me. So, if any of you get an email from Lina at Shijiazhuang Kidney Disease Hospital, China --phone number was (00)86 311 89262796 and email addy was [email protected] PLEASE do *NOT* respond. She claimed I had left her a message on her website requesting their help with my kidney failure. I don't even know of their website. Unless they can grow me new kidneys there really is nothing they can do. I truly believe this place is nothing but a scam to try and give people hope and then bilk every penny they can from them. If you choose to proceed with them do so with all due diligence. Blessings & Peace. Amy"http://cynthtggt.hubpages.com/hub/On-Brucellosis-Is-theDevil-in-Your-House"This is the storyhttp://cynthtggt.hubpages.com/hub/OnBrucellosis-Is-the-Devil-in-Your-House""I need to post this story again that I wrote about my family because I think it is important to know about a disease that I was refused a test for, let alone a diagnosis. My family's exploitation is a SECRET exploitation that my government is retaliating against me for writing about on my blog http://targetedpatient.blogspot.com. http://cynthtggt.hubpages.com/hub/On-Brucellosis-Is-the-Devil-in-Your-House" http://bioethicsdiscussion.blogspot.com/2012/09/medical-mistakes-patient-as.html "CALLING ALL PATIENTS ON BLOOD THINNERS: There's a Stanford researcher who is interested in talking to patients about issues relating to blood coagulation. Particular topics are use/management of blood thinners; hemodialysis; and experience with real-time and/or continuous monitoring systems. If you're interested in talking with the researcher, please send an email to [email protected] expressing your interest and I will provide contact information. I need not know specifically how you meet the criteria, only that you wish to make contact with the researcher. Thank you in advance!" http://cynthtggt.hubpages.com/hub/The-Silence-About-Brucellosis-And-ItsConsequences-for-Me-And-For-Us-All"We were never told any of my doctors where consultants, not even noted on their medical records, business cards or websites and NEVER disclosed by the hospital. The only place I found the reference was on the Intraoperative Patient care report: there is a specific section that has Consultant(s) and guess who's name I found E.Castle.""What this practice is in reality, however, is the result of a horrendous medical system that has engulfed the United States.""Shannon Koob I couldn't agree with you more. The cancer industrial complex does not want to cure cancer. If they did they would but there is no profit in curing cancer so they poison us ensuring we can���t get away from them until we die. They want to control us from cradle to grave literally and our politicians and the FDA work on behalf of their paymasters the medical industrial complex. Proteomics and Ovacheck could detect cancer early but that technology (available since 2002) is being suppressed. It is corruption plain and simple and why we will continue to be harmed by our healthcare system. By and large our healthcare system is worse than worthless. Doctors feel they have a right to extraordinary profits at our expense and pharmaceutical companies always, always put profits before patient safety. The treatment recommendation for me a carrier of the BRCA gene mutation is to hack my breasts off with a kitchen knife, cut out my ovaries and uterus and pump me full of Tamoxifen, a known carcinogen. Because I opted out I allowed myself to be fear mongered into getting injected with the highly toxic gadolinium based contrasting agents and received about a dozen injections. This is why I am now totally disabled and still they are injecting people with this highly toxic metal of which at least 1% stays is retained.""In one single disease affecting people with diabetes, I found Exhibit A of what's wrong with the healthcare system. My column today.""Our story has made it to finland and the Arab Times.http://suomenkuvalehti.fi/kuvat/2012/10/02/hospital-investigationq02183swhttp://www.arabtimesonline.com/Portals/0/PDF_Files/pdf12/oct/04/16.pdf" "Thanks for sharing this - in today's world, Americans get better news coverage in foreign press. Wonder why?/s"http://cynthtggt.hubpages.com/hub/Part-II-The-DevilAnd-The-Medical-Corporations-Exploitation-of-Human-Sexuality http://cynthtggt.hubpages.com/hub/On-Brucellosis-Is-the-Devil-in-Your-House True story of my life."Yes, after much debate (!), the film went live a few hours ago. You can see the film at the BMJ���s YouTube link below where, if you have good bandwidth, you can see it at high quality and full screen: http://www.youtube.com/user/BMJmedia/videos"Patty if you can listen to the show tonight and if you could call in would be greatly appreciated. See the post. Anyone you know tell them to call in and listen."I need you to all call in tonight at 5:00 PM (CST) and ask questions on the show or make some comments. check the post on ""LIFE Radio Show""""I am bothered by the refusal to treat you as well. It is sad to me that as soon as you apparently began to receive Medicaid, the willingness to treat you stopped. "" reply to complaint....UVA refused to treat me once I lost my job and health insurance while still having a drain and stent left inside me that was placed by their GI Dr Wang...bad medicine, bad doctors, bad hospital"bad state regulators...Yep but hospital and doctors take no blame for the harm they have caused...what can a person do?"That's because the Virginia regulators generally cover for hospital. I would look further south -- the lawyers there are a little less goosey. Allen,Allen, Allen, and Allen is well respected. There are others. Have all of your records before you go. if you don't have alot of damages , they are not going to be too interested."I know it's wrong how they cover it up...any ideas besides the allens?"Sandy waterman has a good site. www.superlawyers is a good place to look. I used to have access to verdict information, but I cut that off; I would google for verdict malpractice virginia and see who has been getting good ones."Thanks so much will look into that"""Too often healthcare is driven first by the needs of the hospital, insurers, physicians, nurses, and departments than by the patient and family experience.""http://www.hospitalimpact.org/index.php/2012/10/03/how_hospitals_can_s urvive_the_age_of_the?utm_medium=nl&utm_source=internal"this is alarming! especially the findings about radiologists...Two words: Second OpinionThey should give the same survey to used car salesmen just to see if there is any difference between them regarding truth telling."This week���s show explores a scheme involving state politicians and powerful corporations to remake America, one state house at a time. To learn more, visit: http://billmoyers.com/episode/preview-theunited-states-of-alec/"I think there should be a NEW debate question - How will you deal with the Healthcare Patient Harm outbreak that has/will cost Billions of dollars now and in the future?http://www.nbclosangeles.com/news/local/PomonaHospital-Accused-of-Experimenting-on-Patients-163818006.html"What do patients do that find out they were probably part of a doctor's RESEARCH project, that was not in the best interest of the patient or consented to?"that is honestly a terrifying situation. i got a pacemaker implanted in june and i would be outraged to find that out.This page appears to be not moving on my view of it. Was the last post an hour ago? What I see on the top of my page is the post from Georgean Parrish. Just want to be sure I'm not frozen on my page. Thanks anyone who can reply.you're fine. georjean's post is the last one posted..."yes, the last post was an hour ago" Thanks. Not kidding when I tell you I have a hacker on my computer. They watch and listen."I am trying a crowdsourcing experiment. Are you willing to call your state health department and ask if they post hospital inspection reports online? If so, please enter the results here: https://docs.google.com/spreadsheet/ccc? key=0Aq4RTfI9gHGudEF4QkIwZVp1VTc4V2xMNjhlalhsS3c"Cool idea!Charles Ornstein is a great reporter - I promise if you work on his project it will be worth it! "Arguably, CMS should have all of the inspection reports it reviews online as well: http://www.justice.gov/oip/readingroom.htm""Debra Van Putten, The Association of Health Care Journalists (of which I am president) is pushing hard to get those reports online ASAP. Stay tuned."Thanks!!!Hear hear!!!!See: http://hospitals.nyhealth.gov/about_inspections.php"It would be interesting if any investigation was done related to either of these poor souls: http://www.fairfaxunderground.com/forum/read/2/895689.html; http://www.washingtonpost.com/local/fairfax-man-hit-by-car-dies-5-days-afterhospital-sends-him-home-autopsy-points-to-liverlaceration/2011/12/30/gIQAZE6LRP_story.html; We would note that we complained about Inova's ability to properly address delirium in the ER and poor practices in radiology. Who knows. if our complaints had been publicly addressed, these people might still be here. Or if Inova settled with them on the cheap, it really wasn't fair."it also might have protected the current bond holders on this issuance who invested thinking that Inova had a clean regulatory history: http://www.moodys.com/research/Moodys-assigns-Aa2-and-Aa2P-1-ratings-respectivelyto-Inova--PR_251423"You don't think that the fact this bond issue, done under Virginia's tax exempt status with certification by the State of Virginia that Inova was not subject to any regulatory action or investigation - you surely wouldn't think that might have anything to do with Virginia's state inspection/regulatory report being altered? Ethics wouldn't sink that low, ya think?""No, I am sure that the attorney general had no idea that the state was doing the bond issuance. And that Erik Bodin's request for a huge data dump ""because he was concerned about what had happened"" in late June went nowhere near the lawyers who did the disclosures for this deal. I'm sure they kept all of mom's information private and it was all an oversight."And that call from Mark Zehner was a complete accident on his part...I bet he can't confirm if there is an investigation either....The call from this Mark Zehner???? http://www.sec.gov/news/press/2010/2010-5.htm"Yep, that guy. He called me at home personally...""You're sure it was this guy?? >>>>The Municipal Securities and Public Pensions Unit Deputy Chief is Mark R. Zehner. Mr. Zehner has served as Regional Municipal Securities Counsel in the SEC's Philadelphia Regional Office and as Co-Chair of the Municipal Securities Working Group. Previously, he was an Attorney-Fellow in the Office of Municipal Securities in the SEC's Washington, D.C. office. Earlier, Mr. Zehner was a Partner with Saul, Ewing, Remick, & Saul LLP in Philadelphia. He received his J.D. from the University of Pennsylvania Law School, and his B.A. in Government from Dartmouth College.<<<< Why would he have an interest?"Charles Ornstein - I was going to respond with result for Florida but see that FL is already handled on your chart. Should have looked there first : )"I wonder if there has ever been an executive of a publicly traded health care company, which, in advance of an adverse decision, has chosen to short the stock. The current system certainly lends itself to insider trading." "Charles Ornstein - in my state, NC, the health department only does sanitation inspections - only available by calling your county division and they will mail or fax it. The Joint Commission supposedly does the 'real'(cough, cough) medical inspections.""It is Mr. Ornstein's organization who alerted the public that data regarding physicians and I believe healthcare facilities was going to be scrubbed from online. It was done last Sept, 2011 if my memory is correct. AHCJ captured the info. AHCJ did get and publish a contact list of senior HHS media officials in June of 2011. I just reviewed my letter from TJC regarding my complaints against the hospital - it states TJC was satisfied, case closed and - Please be aware our current Public Information Policy precludes us from providing you with the specific results of any complaint investigation. Is this how it is done in other states?" VJ - Those letters are really creative aren't they. I was asking if other states really do publish complaints or any notice of number of complaints. I am zero for 4 or 5 agencies taking a report.It looks like someone has already checked on AZ. Correct?What is the difference with this and the AZ medical Board ? http://www.azmd.gov/http://www.azmd.gov/GLSPages/RecentActions.aspx"I see the comment in place for NYS. My experience is that you have to file a Freedom of Information Law petition to obtain a copy of the inspection report. It takes persistence, but I was successful in obtaining the survey. By contrast, nursing home inspection reports were available on the public website the last time I checked (several months ago)." http://health.yahoo.net/experts/dayinhealth/surprising-things-surgeons-dont-tellyou http://newamerica.net/publications/articles/2012/the_cost_of_assuming_doctors_know_ best_72049"Following is why doctors often don't tell patients about surgical alternatives and/or less invasive ones... ""Here's the icing on the cake in terms of health care spending: Patients also tend to choose less invasive (and therefore less expensive) treatment options.""""Veronica James you are so right. I found myself being told I had a cyst/tumor on my pancreas I had never really had any health problems never a surgery and was sent to a specialist he really made me feel like he knew what he was doing that he was an expert and that he seen this all the time it was no big deal just a simple surgery and I'd be back to normal no lifestyle changes at all in abou 6 to 8 wks max. I thought is was no big deal went ahead with the surgery no 2nd opinion woke up with the worst pain I could have ever imagined he had removed about a third of the tail of my pancreas along with my spleen I was sent home 5 days later a very horrible 3 hr drive home. I could not get to the bathroom shower out of bed without help a few weeks later even worse pain complications started that was in November of 2010 I've been in and out of the hospital every month since then lots and lots of procedures drains stents surgeries infections and the worst part the surgeon acted Upset with me because I kept being sent back to him no other dr wanted to fix me he had been the one that did the surgery he said he had never had to go back and fix anything he had done. He ended up putting me off on a GI dr in may of 2011 this gi dr found right away I had pancreas divisum he treated me by placing drains inside of me to drain the abscess that I kept getting into my stomach and placing a stent in my pancreas I seen him in june and again July of 2011 he removed the stent and changed it out and p,aced a new drain the I lost my job because of being off sick for so long so I lost my health insurance that's when the gi dr stopped seeing me even though he had placed the drain and stent inside me he reused to remove them wouldn't even refer me to another dr locally I did get state Medicaid but the hospital and gi dr refused to treat me I was at my local ER I. Sept and oct of 2011 where they tried to transfer me back to UVA hospital and they refused me both times I ended up being sent to a gi dr in Morgantown WV I was referee by my local gi this dr in Morgantown told me what a train wreck I was how everything UVAs Drs had done everything backwards that I should have never had surgery on my pancreas everything was caused by the pancreas divisum why the surgeon didnt know he had no clue he removed the drain and stent and got me to John Hopkins were I met an amazing Dr he helped me as best he can he didn't worry about the money he just helped me to get better him and his team paid for my home healthcare since I would have to be on iv antibotics for many weeks they said I didn't need to worry about the money I just needed to focus on getting well. How amazing they helped to try to fix a mess that another hospitals Drs had made and they didn't even care about the money. They did have to open me back up and found stitches that were in my abdomen that were causing the infection and abscess he cleaned everything up and restitched my pancreas. Now I'm still not normal like I was before surgery but they did their best and they are still there if I need them in the future. I have missed most of the last 2 yrs of my life being sick and I now have chronic pancreatitis suffer with pain and nausea every day is a struggle I am unable to work and the Drs from UVA have not even tried to check on me last time I heard from the surgeon was may of 2011 and the gi dr in July of 2011 they chose money over my health. Of course this has caused a huge financial burden as well as all of the pain and suffering myself and my family has had. So many hours of missed work by my loved ones and then my family lost their health insurance as well. I am no longer able to provide for my son like I once used to be all of our savings are gone no hope of helping him with his college plus we are in debt with all the medical bills. All because of a greedy hospital with a surgeon that was to happy to cut and a gi dr that wanted money over my health. It's so sad and the worst is that it will continue to happen to others. I have filed complaints but no one has taken it seriously and the laws are made to protect the doctors and hospitals. These Drs get to continue on with their lives after they have ruined mine and families.""veronica, i am so sorry for all that you have been thru. its sad that we put are trust in these doctors to care for ourselves and our loved ones never thinking that they are going to do harm. Truth i that medicinie is now a business and unfortunately we are the ones that pay the price. Prayers for you" "http://cynthtggt.hubpages.com/hub/Part-II-Aspects-of-the-DevilI was directed to this site by a journalist from Consumer Reports. I am glad to find this site and be able to share my experiences, as well as look at everyone else's experiences. The topic of medical abuse consumes me because of what happened to me. My hope is that we can somehow find a way to empower the patient and empower ourselves. Some way. I look forward to sharing and listening. Thank you FB for this site!""Thank you Veronica! I have so much more to say, and so glad I am being responded to on FB. I finally found a group who understands where I am coming from!""Hi, Veronica, yes I did already fill out the questionnaire on ProPublica."Another unbelievable travestyHow completely disgustingI don't have the strength to read this; it sounds so unbearable involving a precious new born and an other family suffering the ultimate loss. I do pray those who caused this nightmare are held accountable and never able to harm anyone else. Unthinkable.What the fuck? Everyone involved in that travesty needs to have their licenses revoked.They truly are animals.The doctor and everyone ought to go to jail.this is so horribly wrong....prayers for justice for the familyridiculous law"it is not only ridiculous, it's unconstitutional!"How do I show I am a member of this group on my timeline? I am new to FB and do not really understand it all."Hi Taggart Cynthia - what you post and do in this group won't automatically show up on your timeline. but if you want people to know you're a member (which we would love!), you can post a status update saying you joined, and paste a link to the group. This is it! http://www.facebook.com/groups/209024949216061/"Please share this with anyone you feel may be interested.Targeted: FALSELY ACCUSED TO COVER THEMSELVES http://targetedpatient.blogspot.com/2012/09/falsely-accused.htmlIts a sad day in healthcare when a doctor can dictate erroneous information about their patients with no fear of discipline."You are certainly not the only one who feels that way...its disgusting and despicable...unfortunately they can do it, they do do it and in some cases quite often.....it has been done to me countless times and until someone in a position to publishes or speaks on patients behalf enough to implement a change it will continue to happen.....we are trying but people in position to change aren't listening we need a more known voice. Just today I got my records from one doctor things were specifically omitted so there would be no record that there wad ever a surgery scheduled then cancelled records were changed....the person in medical records said she had never had a doctor make records disappear where on her system they were there but yet missing from the file.....i am not sure about that but either way once again ot happened and who do we go to for help.......""I feel you Melissa, we just have to keep SCREAMING our stories..The only way change can take place is awareness..""I have questioned whether an ER doctor who performed an LP on me had concealed that fact as it looks like an addition on the bottom of the chart. When I was returned back to that hospital I also question why nothing was done or looked into regarding the LP. Complications from an LP I have learned are life threatening and are dealt with by a neurologist. I do know that the ER doctor lied about the real condition I was in and back dated the timing of when I get the stiff neck and legs to 4 weeks instead of 2 hours earlier. Also, lied on the glasgow coma scale. When my spouse returned home from overseas and asked why I was not walking, talking or eating no one would tell him anything. I was returned back to ER's over 40 times. All involved avoided any accountability and responsibility for the condition i was left in by denying medical help, concealing what was medically wrong with me, and withholding information from my family who never knew anything. I did not sign a consent form to have an LP done either. From briefly having an infectious disease expert look at my records he told me that my records have been stripped of all the things he would have expected to find. I did find a printed copy showing necessary tests got cancelled because the spinal fluid was hemolyzed and no repeat was done. After having a CT of my head confirm an infection and then having a full vial of spinal fluid taken I was gotten rid of out of the ER 2.5 hours later without the tests for the infectious disease done. Tests take 2 days to confirm. When I was returned back to an ER shortly after the LP drowsy, photo phobic and I could not feel my limbs I was denied medical help. Then a cover up ensued. Their is so much cover up still going on. Now I am dealing with concealment of damage issues. This is when they stop you from having medical tests to find out how much damage you are dealing with to stop a person from suing or exposing them . I got 2 tests done at first but had to question the radiology reports as being fraudulent. Once I raised those questions about the validity of the radiology reports I have been stopped from having any diagnostics tests. It was not very hard to see what they were doing because they changed 4 past radiology reports and got rid of the original reports out of hospital and GP records. Did they not think I would not notice the difference in how my body looks now.""You are certainly not alone. It took me a long time to get the hospital PA to release mine(I did sign the required forms), telling me they don't release all records and I now find I don't have all of them. They only gave me three pages originally - admitting - full of errors. Then when I called about those errors - they complained ""I was just not happy about anything"" - now that I do have what they say are full records - they will not change anything per the hospital COO. In reading info provided by Debra and Virginia - there are CMS statutes saying they have to make these corrections." Its also a good idea to go to the hospital and request to view the records. I found a lot of stuff not given to me in the hospital records. I did this twice and brought my camera with me and photoed them. Also found a long strip of EEG paper. If a radiology report is amended the original report should exist so look to see if its in hospital or GP records.Looking for a lawyer that would be able to go up against UVA hospital in Charlottesville VA"If you have had a prednisone injection lately: http://www.nytimes.com/2012/10/03/health/meningitis-cases-are-linked-tosteroid-injections.html?hp"Dr. Nelson asked for a more firm reading. Radiology delivered that addendum stating there was nothing wrong with my heart 2 hours before I was prepped for surgery."Here's a link to a breaking story in Oneonta, NY. http://thedailystar.com/breakingnews/x354173457/Fox-Hospital-sued-for-126-million" "Unfortunately this kind of judgement is bad in two ways.1) It reinforces that people who sue for malpractice are out to win the lottery.2) It implies that medical malpractice is so rare, that when it happens it is a huge judgement in all the news."The circumstances of the case warranted a high verdict. The hospital destroyed this woman's heart. She is going to need a heart transplant. The suffering she has experienced and will continue to experience is immeasurable. Her medical costs will be astronomical."100,000 people are killed every year in hospitals. This woman's medical injury severity was not an unusual occurrence. For some combination of the right reasons, this became a show case."Dr. Jenkins noted that the history and physical examination was dictated with erroneous information regarding the patient���s blood pressure.http://www.knoxsblog.org/2012/09/iheard-it-through-the-grapevine/#comment-2060See the comment."Did you hear this through the grapevine yet:http://www.washingtonpost.com/local/investigation-ofwomans-care-at-va-hospital-mired-in-bureaucracy-confusingreports/2012/10/01/7b433d4e-0bd5-11e2-97a7-45c05ef136b2_story.htmlPat Christiansen���s response, in writing to our concerns, on 9/21/2011��� ���your mother is getting great care.���Just in case the grapevine wasn���t working too well over there."Well the young lady would seem to better qualified as COO/interim CEO of Inova Fairfax and she probably wouldn't have an idiotic smirk on her face should she screw up either. Wouldn't take much improvement to the current situation. http://m.washingtonpost.com/local/investigation-of-womans-care-at-vahospital-mired-in-bureaucracy-confusing-reports/2012/10/01/7b433d4e-0bd5-11e2-97a745c05ef136b2_story.htmlLeft a link to your story - made a good comment on Silvia it will take them a few minutes to view the link before pulling.Thanks."I've been reading prior entries in Knox's (CEO of the Inova System) blog and found this to be ironic. On August 31, 2011 his blog was about weight loss and how to accomplish same. On Aug 31, 2011, my wife was in his hospital in her second day of zero calorie intake which was to last a week. I posted the following as a comment to that blog (it is a moderated blog so I doubt it will pass through the self serving screening process) which is why I'm also copying it here: Interesting post about losing weight. Let me give you another route. On the day of your post, my wife was a patient of your Fairfax Hospital. She was admitted on the 30th. From her admission through September 5th, she received no nutrition - not a calorie either by mouth, by IV or by feeding tube. Your nurses faithfully recorded in her records, every 2 hours, that she was not receiving nutrition but no one did anything, no one contacted the doctor to have him change is orders nor did anyone fulfill their obligation as a mandatory reporter and contact elder abuse authorities. Nor did anyone inform the family that this was happening. My wife did not have a DNR and she wanted to live. When we found out, we complained and Patrick Christianson in his email to us, stated that he investigated our claim that my wife was being abused and reported that upon talking to his staff, he found my wife was ""gettng great care.""We complained to CMS and they sent a state investigator for an onsite investigation. In the state report about the failure to feed complaint, the investigator states that they spoke with the doctor involved to get a reason for the starvation and quoted him as stating ""she was very sick and she was paralyzed..."" Not an acceptable reason for involuntary euthanasia, I believe. But your blog was successful in its message as under your direction, my wife lost one third of her body weight in 7 days. Maybe you could market that approach and write a book - ""The Inova Diet.""""This is the best Video about a doctor talking openly about a mistake. ""Awareness is the greatest agent for change""""I think you might find this movie interesting. It's about doctors and patients who care about making the health care system more caring. http://youtu.be/qX-EkeKXA4U"MRSA Survivors Rally for World MRSA Day http://www.prnewswire.com/news-releases/mrsa-survivors-rally-for-world-mrsa-day172265091.htmlToday is World MRSA Day - rememebering all of those who have lost their life and suffered with this preventable disease - join the fight against MRSA and HAI's! http://www.MRSAsurvivors.org"Hello everyone! I just joined after receiving an e-mail from Kelly, Assistant to Dr. Marty Makary. I wanted to share this short documentary with you about my family. It's a measurable piece about the long-lasting affects of a medical error. Feedback is welcomed and encouraged! :) https://vimeo.com/46597387""Hi Tim Gort, welcome to the group. So sorry to hear about the medical mistake your daughter and your family suffered, but thank you for sharing your story. The video is really touching and I hope others watch it.""Hi Tim Gort, you have a beautiful family and such sweet daughters. I really sensed the love you all share. Thank you for the courage to open your home and hearts to everyone."I am so sorry for your loss. The loss of hopes and expectations and a certain future.Thanks all. Looking forward to learning and sharing with you."Query for doctors/researchers: I have new original work which I'm considering submitting for peer review publishing, which I've never done before. I don't know if an entity like NEJM or JAMA would even run a piece by a lay person through a peer review process; in the NEJM world it seems that the categories under which I might submit are perspective, special report, sounding board, occasional note. The piece would include 1 figure, 2 if possible.I'm concerned about future use. I see that NEJM says it'll own the copyright to the work. I cannot put myself in a position to be locked out of future use, development, and presentation of this work, and this is the crux of my question. What are medical industry norms around publishing? You guys publish studies all the time. How do you manage intellectual property rights and ongoing refinement and presentation of work published in these journals?"Is it something that would work for the Journal on participatory medicine?Thx D I'll check it out.http://triblive.com/home/2661285-74/transplant-kidney-dialysispatients-waiting-organ-policy-transplantation-age-proposed?goback= %2Egde_154079_member_170659515#axzz27yiFTHZKhttp://www.ti.ubc.ca/news/what-doctorsdont-know-about-drugs-they-prescribe#NAME?"Somewhat helpful are sites that report consumer reviews of doctors such as RateMDs.com. However, in my experience, finding a doctor with five stars won't help if you are looking for a doctor to tell you the truth about your medical injury. Highly rated doctors demonstrate ethical amnesia along with the rest.http://www.ratemds.com" http://www.modernhealthcare.com/article/20121001/INFO/310019976/va-hospital-caseshows-confusing-bureaucracy"As often happens, I thought that link was about VA hospitals as in the Dept of Veterans Affairs. It should be noted that Va in this instance is Virginia."We were just glad to get a story out.Here's the post version. It appears to be going national:http://www.washingtonpost.com/local/investigation-of-womans-care-at-vahospital-mired-in-bureaucracy-confusing-reports/2012/10/01/7b433d4e-0bd5-11e2-97a745c05ef136b2_story.htmlHigh five and hugs Debra and DH - brava!! Going to read at both links.I have been posting it on Ken Cuccinelli's site and he keeps removing it! To bad amanda joint commission isn't still here. Joint Commission had no problem too.It's great this story was finally published! Thanks for sharing Debra. Hope some good comes from it.... Your family has suffered more than enough."Yeah, I think that the Joint Commission should explain why they had no problem with this." "Veronica, according to Linkedin, Amanda's job/position includes ""Monitoring *social media outlets*, while *creating*/pushing out engaging campaigns or messaging that promotes a* positive reputation for TJC*."" Tells us a lot I think! Could say a whole lot here but I won't....""We talk, you listen. Can't put lipstick on a pig.""No one with TJC will answer a true complaint - not in their policy manual. Other wise, the US would be overtaken by herds of pigs wearing lipstick."We keep posting it on Ken Cuccinelli's site and he keeps pulling it off.Cuccinelli is outspoken on pro-life issues... makes me wonder why he's not concerned about your mother being starved to death in a Virginia hospital. I guess he's pro-'birth' rather than pro-'life'."I am preparing to post the link with a question over there(KC) myself. You have to have certain zips and area codes. I shall get it done, maybe not tonite tho.This published article is very encouraging and solid proof that dedicated people with a ton of wherewithal (knowledge, equilibrium) can accomplish media support -I salute all here who do take up the mantle, even though in many cases their loved one is gone. What you do may save many others." The reason he does not care is that Virginia sponsored a $350 million bond issuance in favor of Inova while Virginia was 'investigating'. Jobs are clearly a higher priority over involuntary euthanasia."I'm just making the point that politicians like him say they are pro-life but aren't. If he were truly pro-life, he would care deeply about what happened to your mother - all of it! I don't understand why people can't see through this...""The 4th Annual Conference of the Natl Assoc of Healthcare Advocates will be held Nov. 1-3 at the Hyatt Regency in Boston, MA. Please share or retweet with anyone who might be interested.""Robin sent me this i have since commented on there several times,, its sad this is still happening, i just dont understand for those of us who are living through the hell there is no help, where are all the experienced doctors????""when a mistake happens or someone screws up, the solution is to look the other way rather than to acknowledge the problem and try to fix it."Find out what patient safety advocates are saying about the CDC healthcare-acquired infections meeting last week!"Several years ago; I spoke to one of the big wigs at CDC in Atlanta, about MRSA; his answer to my questions (4of them) was this, 1) there is NO LAW that states we are required to report staph infections; 2) we will NOT report them until there is one on the books - 3) WE will decide what to report and what not to report - do I trust the CDC - NO!!!! Will I ever trust the CDC - - - NOT NO--- HECK NO!!! They are nothing more than pencil pushing bureaucrats that sit in an office all day to collect their above average government pay checks - Their attitude is you have to loose so many lives before they take interest - I guess 100,000 plus annual loss of life from Hospital Acquired Staph Infections is not a large enough number.""In January 2013, acute care hospitals will have to start reporting MRSA and C.diff hospital-acquired infections (confirmed by lab tests) to CDC's National Healthcare Safety Network. A year later we should start seeing information about these infections posted on the Medicare Hospital Compare site."Dianne - The CDC is far from perfect but the reality is that they are not a regulatory or enforcement agency. My experience having been at the Consumers Union/CDC meeting is that the staff members we met with are as frustrated and dissatisfied with the pace of progress as we are but are dealing with the constraints of their mandate (e.g. cannot force change on states only advise). I agree that we cannot simply leave this work to any government agency but I also think we can work with them where appropriate while ensuring public pressure exists to speed change. We need a variety of inside/outside strategies to make a real difference."Dr. Marty Makary's book ""Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care"" is on the New York Times best seller lists! http://unaccountablebook.com""Dr. Marty Makary's book ""Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care"" is on the New York Times best seller lists! http://unaccountablebook.com"Check out my blog post about visiting the CDC with other patient safety activists to talk about C. diff and other HAIs."Christian, you mention some special setaside time at CDC to discuss C.diff. I'm mostly ignorant of HAI issues aside from my dad dying due to MRSA. Are these two infections considered in the same or different categories by CDC and/or medicine?""Bart - Though both MRSA and C. diff are HAIs, they differ in how they are transmitted, with C. diff being the harder to tackle from an environmental cleanliness aspect, owing to the difference in their makeup (C. diff enters a sport form outside of the body, which is resistant to most antibacterial cleaners). Also, while MRSA transmission and death rates have been declining (though not by nearly enough) over the last few years, C. diff's are rising. So while they're largely both considered HAIs, C. diff has become a bigger priority recently, though that could change again.""Stainless steel looks clean, but can harbor pathogens. Copper and brass surfaces kill germs. I think of all metal surfaces that didn't have to be steel were replaced with copper, hospitals would be significantly less dangerous.""With the exception of C. difficile spores, copper killed concentrations as high as 100 million Colony Forming Units of these organisms within approximately two hours. A concentration of 1,000,000 C. difficile spores was completely killed within 24 hours. Most of these organisms can survive for days on common surfaces, while C. difficile spores can survive for months.""From the PDF link at the bottom of: http://www.antimicrobialcopper.com/us/news-center/articles--publications/armedforces-poster.aspx""The Empowered Patient Coalition has updated our Hospital Guide and it is now a free download on our website. Please share with others so patients and their advocates will be informed and engaged when seeking medical care. We need your help to get the word out! http://www.empoweredpatientcoalition.org/publications/journals-and-books""It causes me great sorrow to have to say that there are copyright issues with this material. Unless this matter is resolved, I would urge members of this community to exercise caution in their use of this publication."My virus scanner is showing a trojan horse.Hello all: This is to say that the copyright issues on the Empowered Patient Guide to Hospital Care and The Patient Journal have been resolved. Please feel free to use these publications under the existing joint copyright to Julia Hallisy and Helen Haskell."Debra, so is mine."I have checked with my web hosting service and they assure me that there is no problem on our end as far as a virus. If you message me I can always send you a pdf if that makes you feel more comfortable. "Please visit this site and sign the petition to regulate coroner and medical examiner. They are unaccountable to anyone - they can send innocent to prison with an incorrect cause of death and a guilty go free when they refuse to investigate a suspicious death. It could be your loved one... http://www.causes.com/causes/794844-regulation-of-coroner-and-medical-examiner" thank you for your assistance - with a little assistance we can get attention of our legislators."I can't sign this petition because a window opens, and it says it is contacting facebook, but the window never completely loads. Can you post this petition on a site that simply has one put their name and info?"it won't let me sign . is this because i am canadianHope you've been - and will be - following the #MedX tweetstream. Excellent content coming out of Stanford.And another"And we see in action, the Medicare rule that if there is news coverage of a mistake, we handle it differently....http://vitals.nbcnews.com/_news/2012/09/25/14095982-report-ohionurse-didnt-realize-she-took-kidney?lite""Might I suggest that each medical person and hospital administrator who was involved in this fiasco voluntarily donate a kidney if medically able as a demonstration of their sincere apology for this situation. Surgeon, hospital management, nurse. Perhaps they could start a chain that will get this guy a new kidney."Using ROBOTIC since it is so SAFE.Doctors who make serious mistakes or behave unprofessionally stand a much better chance of being disciplined in Alaska than Mississippi.The Minnesota Board of Medical Practice has done the worst job of disciplining doctors in the nation"Since 1998 I've been observing District Hospitals in California (48), and other states e.g., Washington, Idaho, Montana, No & So Dakota, Texas, Minnesota, etc., with publicly elected boards with revenue from taxpayers - who hire the CEO (Chief Executive Officer) to manage the hospital. In California it appears the CEOs (Control Elected Officials) are managing the elected boards and the (COS Chief of Staff) Medical Executive to keep costs down for the CEO's year-end bonuses, as they tag team pushing ""real"" peer review out the door, failing to report adverse and sentinel events, all in the name of risk. In confidence, I'd appreciate learning more from California members and those from other states what you have identified in the area of peer review and lack of or it's impact on patients who have been the subject of medical errors, negligence, turned into futile care. Contact [email protected]""By the way I'm not a Journalist I'm a controversial elected official with a ballot designation of ""Consumer Health Analyst"" who sits on a District Hospital Board for 12 years, with 7 members with a majority of medical (doctor, nurses, pharmacist, accountant for physicians & groups) and plenty of quid pro quos to go around for those in bed. Needless to say, I was their target as I stood up for obvious common sense over padding pockets. Having the experience of working with professionals over the last thirty years I've fulfilled the requirement of representing or advocating for Consumers on medically dominated boards, a federally mandated California Medicaid committee, a federal OIG task force, regional health planning board and committees, the 2-plan model pilot programs established to move Calif. Medicaid into managed care, and represented the US as a consumer with medical professionals affiliated with the United Nations as a think tank in Norway evaluating, comparing and contrasting systems. I've stood up for what is right for Consumers only to find Consumers not engaged locally to help me with holding their local hospital district and CEO accountable. Corruption at this hospital is very deep, and I chose not to run for another four years as I decided I will do more for Consumers in another way. Knowledge is power and I now know intimately how the hospital internally works - Surely this will be useful to those whose plight is to improve and change the way we do healthcare at the hospital - It galls me that CMS is offering bonuses while the new venture of Obamacare and the ACO may be another way to bury the bodies. Obamacare will bring in 47 - million uninsured while the Medicare baby boomers 70 million may become the victims of Dr. Death to minimize costs for those cases with medical errors, negligence, poor peer review, and the year end bonus scheme!""Yes, however I'm eager to network and help with our stories - I'm hopeful ProPublica and other groups we belong (friend with Gil Mileikowsky (the empowered patent & Citizens for patient safety) will be able to pull all of us together to move our concerns to the legislatures of respective states and the federal government. I'm impressed Veronica with all you've taken on as a loving daughter and your Mom's first advocate - your story is heartfelt. Hopeful again with the newest development with ProPublica's help - and are there other organizations similar for a national awareness - investigative reporting with national media - to develop pressure on the elected to make the changes. OR should there be a train the trainers to take the experiences on the road to give the tools to others to know what to do in situations like yours and others? What better way to educate the Consumers to take control by learning and having a tool kit to advocate for their loved ones. Relying on the system certainly is not going to do it. As the lobbyist have the ears and hands of those who can make law. Consumers for health and medical care must organize themselves to do the same. My experience with Legal Services Corporation, Centers on Law and Poverty, are unable to do the legal advocacy on the state and national level because of their funding sources. Same holds true with the ""free"" clinics, each organization unions, AMA, appear to only represent their interest while ""using"" consumers as their interest but as a national coalition of Consumers - I'm unaware of any and I believe this is exactly what must occur - a National Coalition of Consumers!!!""i don't think people understand how scary the ACO's are or how misguided Obamacare is. Regardless of your policy goals, its horrifically bad policy implementation."Congratulations ~ ! ~ breaking the 1000 mark ~ ! ~ As the group's focus is national I'm interested in linking and outreach with California members too. Please contact me at [email protected]"It's nice to see that this group has broken the 1,000 participant level -- more people, more input, more awareness.""Hello, my name is Elbert Chu and I'm a freelance journalist and masters student at the City University of NY in Marshall Allen's health investigation class.I'm working on a story about how some nursing homes dose residents who are not diagnosed with schizophrenia or psychosis with antipsychotics. These chemical restraints not only rob people of their personalities, they also endanger many lives. My project is focused on NYC. I'm wondering if you have experience with a loved one who was inappropriately given these drugs in a NYC nursing home? These drugs include Zyprexa, Risperdal, Haldol, Clozaril, Seroquel and others. If so, please leave a comment below and we can arrange an interview. Thank you.""I'm not in NY and mom wasn't in a nursing home, but she got antipsychotics instead of correct medical treatment for an iatrogenic drug overdose, even though they were contraindicated due to prolonged QT and swallowing issues and the family had forbade it, in writing and it was on mom's chart in big letters written by a nurse. Marshall has my email address.""Hi Debra, thanks for the note. Sorry to hear how your mom was mistreated. It is good to hear about families who are aware of the dangerous cocktails of drugs and want to avoid them, but so frustrating that mistakes persist so often.""By the way��� if anyone with experience in NYC would rather get in touch directly, you're welcome to email me: [email protected]""Hi Veronica James, what a tragic mistake. Glad to hear you didn't give up hope. I appreciate the heads up. I will take a look at the files."As some of you know COPD is often misdiagnosed or mistaken for asthma and/or bronchitis for years. It is different."I am looking for more guests for the show, so if you are interested please let me know."your the best!!!Thanks Daniel so are you"I'm working on a story about how rare it is for patients to complain about a medical mistake or the harm they've suffered in the hospital.I'm going to include a mention of this new proposal to have patients blow the whistle when they've been the victim of a medical error. See the NYT article for more details. This is a particularly interesting idea, since the current systems to acknowledge harm to patients are so woeful. Most patients do not complain, for various reasons, and other methods, such as having hospitals self-report harm to patients, are ineffective. I wanted to run this latest idea by you all and include some of your thoughts in my story. What do you think of this new method being proposed, as it's described in this story? Do you think it'll work? Is it a good sign? Are you doubting that it will make a difference? Share your thoughts below!""Of course hospital administrators say they welcome it, but there already is a path to report errors - state medical boards. But state medical boards are of doctors and for doctors and little comes of that. The point is who will control the reporting data? For example will hospitals volunteer (out of the spirit of cooperation) to hand out questionnaires to patients, then collect and keep them internally and if any patient has the audacity to track the report submitted, the response will be a lie or that it was ""lost?""Or, will the government agency who controls the data be made of doctors and keep the information a secret, anonymize it, and provide it for certain restricted research purposes only?It is simply PR for patient safety to simply collect reports about patient injury. Where the rubber meets the road is in making an effective action from it.""I realize that I have probably way, way crossed the threshold of dominating this conversation, but I have another point. It is dicey business for alot of people to make a complaint. It doesn't matter, the doctor or facility is going to know who is causing trouble if the inspectors show up. If you have insurance that limits you to one or two providers in the area for a particular specialty, if you are in a hospital or a nursing home, if you are in an integrated health/provider plan, etc. there is significant risk of retaliation that can result in your being plain 100% denied health care with no remedy. If you think that is paranoid, how many health providers are afraid of ratting on their colleagues for fear of retaliation? If they are afraid, why wouldn't patients have a reasonable fear. There are laws that protect and provide damages to employees/health care providers who have been harmed by retaliation for whistleblowing. There are virtually no protections for patients who whistleblow there isn't even a right to have someone facilitate your transfer to another facility. And if there is a low success rate of having complaints addressed, it is the much smarter thing to do to shut up. when mom was in the hospital, we had one lawyer tell us to not complain because it would make the mistreatment worse -- but we had no choice. I think there should be some thoughts about the ethics of asking people to come forward at substantial personal risk but then doing nothing of substance with the information and doing nothing to protect them. Some researcher's personal curiosity or desire to do a presentation is not a valid reason to ask patients to put themselves at personal risk.""And by the way Martha Deed, bravo!""marshall, thanks for your response... i'm merely going by the many posts i've read since joining pro publica a few months ago. many people say they've reported medical error and filed complaints. maybe they haven't. i don't know... maybe i'm the only one who has filed all the appropriate complaints for no reason.""I think you're right about that, Robin Karr. Many people have complained. I'm sure the ones who say they have complained actually did. But from the questionnaires I'm looking at it appears that most people do not complain. Others have said this too, including Julia Hallisy at the Empowered Patient Coalition, who said her questionnaires have shown the same thing. She estimated that perhaps 10 percent of patients complain." "Complaining is very difficult and the results are often minimal. I complained to the NYS department of health which cited the hospital twice as a result. But the physicians were not cited -- only nurses and respiratory care staff. While those citations were merited, they were not what I considered to be the main problems with my daughter's care. I lay out the complaint process I went through in NYS using the primary documents -- medical records, complaint forms, responses, etc. in my book, The Last Collaboration. Complaining is definitely not for the fainthearted or for someone whose skin has been thinned by grieving the loss of one's only child. http://www.amazon.com/The-Last-Collaboration-Not-very-funny- modernization/dp/061564595X/ref=sr_1_1?s=books&ie=UTF8&qid=1341258273&sr=11&keywords=%22The+Last+Collaboration%22""How many of the people who say that they did not complain learned of the error after terminating care? We did not learn about many of the errors in mom's care until after she was dead and we had had time to review the medical records and then it was an 'oh crap' that is what was going on moment. In fact, every time we look at mom's records, we have a couple more ""oh, crap"" moments as we figure out the incredibly poor handwriting. We take turns verifying information out of the records because it is just that upsetting. Given that we had had a pretty clear indication that the hospital did not care ('your mom is getting great care' from the COO of the hospital after mom had been starved') we had no reason to talk to the hospital. It would be a completely pointless conversation. If we had not had an already working set of complaints, I am not sure that we would have had the motivation to make a complaint given how painful the whole situation was. But we had people asking questions so we felt obligated to continue... It's part of why I think asking people the broad question ""did someone make a mistake"" is not the right approach. More pointed questions that include what the norms are would be more effective.""Right, Debra Van Putten. I'm not criticizing these folks for not complaining. There are so many complicating factors involved, as you and others have noted, that it's not necessarily a surprise. But at the same time complaints, particularly to state licensing agencies, result in independent investigations that result in public inspection reports. They can also lead to citations and fines - though state regulators and laws vary in terms of how much they hold providers accountable. So they're an important way to flag problems and quantify the problem of patient harm, but one that is not really capturing the full extent of the problem.""marshall, not too long ago we had a really good discussion on this same issue. there were many comments. hopefully, you can go back and take another look at them as you work on your article.""Marshall, no offense. I have skin as think as a gator. I will also say that some people distinguish ""making a complaint' as something different than saying something. The odd thing is that Medicare actually has a very detailed grievance process that is supposed to capture data, set off an investigation that gets wrapped up into the quality plan and result in a response to the patient any time there is concern, even informal, about something serious or that cannot be resolved with those persons present. It appears to be supremely ignored. If that rule were enforced, there would be data galore, I suspect."Robin Karr - it was that discussion that led to what I'm working on now.i suspected as much:)"Another reason people might not complain is that there are language barriers, educational barriers, time and financial barriers (dad has probably spent about $2000 on copies for complaints and we have easily spent thousands of hours) or legal barriers, such as being illegal. I suspect that hospitals take one look at folks, make a socioeconomic assessment based on appearance and treat people accordingly, knowing that certain people are unlikely to ever be able to complain or sue. Go read Crasspolination and its boards and you will see it is true for at least a voluable minority of the medical community. Mom had missing teeth because of side effects to steroids for the RA and she could not tolerate dentures because her mouth was so dry. We suspect that part of why we were treated so badly was that mom looked poor. And there are code words throughout mom's medical records indicating that -like references that Mom and dad were from West virginia (not, from Naples Fl, both retired bankers). Doing a structured survey based on billing data might also help address the problem we were discussing last night - inspectors and reviewers who are themselves incompetent. One could have clear experts in an area write the questions and then the data could be assessed with algorithms and non-technical personnel. One could much more easily implement consistent and correct standards and have less of a risk of having the process hijacked by someone who is corrupt or lacking medical expertise themselves.It's certainly not a 100% solution but it certainly would help with creating a baseline of care for everyone and reward hospitals that are honest about their performance, vs hospitals that have compliance (or even excellence) due to flat dishonesty.""yes,I complained. And because an internal ""adverse event"" report is never shared outside the hospital, if the doctors circle the wagons,and stand by their story that they did no harm, what are the options?I never signed a confidentiality agreement. and that ended up being meaningless. I know exactly how the doctors and hospital staff messed up, and my daughter ended up dead. Who else do you complain to? at some point, it just seems to make sense to help ""empower"" other patients, the doctors dont seem to be changing""Solving the problem of medical errors is key to cutting the cost of our healthcare system, and we won't solve that problem if we don't listen to the patients. So it's good to see the administration making this effort. Also:, The educational impact of placing these questionnaires in hospitals and doctors' offices will be unprecedented. Nothing like this, nothing on this scale, has ever been attempted before in patient safety outreach.""Suzanne, every single person on Medicare is supposed to get a piece of paper at admission informing them of their option to complain to the Joint Commission, state regulators and QIO. With addresses and phone numbers. All of whom work 9-3 pm, are on never ending vacations, and rarely do anything. And all of whom take months, if not years to investigate complaints, if at all. It has made zero effect. So, this is been there done that from my perspective.So while I applaud your optimism, I am not so much." "And Lenore, I really feel like I am ""post"" empowered patient. I feel it very stressful to have to monitor, check, finagle and cajole medical professionals into doing what they are supposed to do. When I go to a restaurant, I do not, Gordon Ramsay style, go perusing through the frig to see if the place is safe. When I buy a car, I would take offense if Ford thought it was my job to test the integrity of the steel frame. If I go to the grocery store, I don't think I should have to require sourcing records from the produce manager. If I fly on a plane, I don't think I should have to make the pilot do a pee test, or give me his/her resume or interrogate the crew as to the plane's maintenance. In order to avoid being at risk of bad doctors, I drive 250 miles each way about once a month to see my primary specialist. That costs me about $250 a month. I pay $600 in health insurance. I pay about $250 a month in meds. My primary won't do anything for me, but I see him so that I don't get yelled at by the specialist. Sad to say he is the best I can find and he is generally not too disruptive. PPACA is going to want to make him the captain of my medical team. Yeah. Let's put the village idiot in charge when even he at has the sense not to be in charge. Brilliant. I have back up meds for all of my meds ordered from overseas so that when the specialist and my primary get into a fight over who gets stuck dealing with insurance, I am not short of critical meds. That I pay for out of pocket. I have one med that if I am without, I die within 2448 hours. So, the annual two-year old tantrums are a problem. Going without while the two of them and the insurance company is not an option. Hopefully the new doc will be better.Since I try to keep my head down to not have food fights, if there is a test I need and the doctor won't order it when I ask nicely, I order it from self-pay lab and adjust medications accordingly. I have been fired as a patient way too many times by bringing the ""standards o care"" to doctors who get really irate. The only thing I ""need"" a doctor for now is an imaging order or a surgery recommendation. And proof to disability that I am still having severe muscle issues. So that I don't end up homeless. but I still gotta pay $600 a month in insurance in case I get in a car accident and I can't convince the ambulance crew that I really, really am refusing to go to the hospital. Mind you, a simple trauma can kill me like that.I am tired of being my own advocate -- that is what my doctor's job is. I don't have the money to pay someone else to tell my doctor what to do -- and my disease is so complicated, it would not work. I really do not want to be spending what energy I have ""advocating"" but there is no choice. The local hospital is so bad that if I had an emergency, I would under no circumstances go to the ER. I would self treat. And if the problem gets to be too tough for me, well, apparently that is my tough luck. And it is entirely foreseeable that I would end up in that position. So for me, if I can hold the hospital accountable, the life I save is not some strangers'; it may be my own. If I can't, the person who may very well be the one to suffer is me. A campaign of brochures being sent to kiosks at doctors office in the hopes that they are returned to an impotent agency is useless to me. It provides me with no safety net. It provides me with no assurance. It ensures that if I get very sick, my choice will be to use my overseas antibiotics and pray that they are not adulterated and to pray that they work.""It���s not that most patients don���t complain. Many patients complain informally while they are still in the hospital to the people they think are the responsible authority. They talk to the nurse manager, or the administrator in charge of Patient Services and they assume that their complaints are taken into account somewhere. Many are often told as I was, ���You will receive a Survey in the mail. Please be sure to explain your concerns there. We take them very seriously.��� Well, my survey NEVER came. Even after I wrote and called asking for one. I even wrote to the President of Press Ganey asking for a Survey and was told I could not have one if I wasn���t in the ���randomly selected 30%���.It took over 100 letters and multiple phone calls to the local health dept. before they began an investigation into my ���immediate jeopardy��� adverse event. The law says they are mandated to arrive within 24 hours. People told me to give up��_. But I wouldn���t!It took almost 4 years of letters and calls before the Dept. of HHS/Office of Civil Rights got involved to investigate the disappearance of photos from my medical records. And only because I had a photo of a nurse HOLDING the hospital camera over my body!!Most patients will try one or two resources to be heard before becoming discouraged and depressed��_then at the insistence of well-meaning others who think they are becoming obsessed ��� they give up and move on.""Debra, I understand feeling post empowered. I just refuse to give up the fight, and helping the ""consumer to beware"" is a bandaid on a fatal wound, and it's something to do in the moment, because the real change takes a long time,as we all know""Most of the time we do not know who to complain to. And we are busy dealing with the results of a bad surgery. And we dare not sue -- who is going to win, you with your one lawyer that you probably can't afford or the doctor/hospital with their team of doctors? So we keep seeking further medical help to deal with the complications of a bad surgery." "What's different about this is the list of types of errors and types of reasons. While patient advocates might have added other types and reasons, this approach is much more likely to cause patients to think about the issue and look more closely at their own treatment. It's not simply a boiler plate statement of where to complain. It is much more educational. Also, it is an express invitation and request for patients to provide this information and a commitment to provide the information to a couple research organizations for analysis. And it is a very public admission that medical errors are widespread and systemic. This is very different. It has not been done before.""���Currently there is no mechanism for consumers to report information about patient safety events.��� Currently there is no mechanism for providers and healthcare organizations to report information about patient safety events.""Federal officials said the reports would be analyzed by researchers from the RAND Corporation and the ECRI Institute, a nonprofit organization that has been investigating medical errors for four decades""Then what? The article fails to address what happens after the reports are analyzed. Research purposes, followup, etc? Who know as the article doesn't address that. Other than speculation on our part, lack of that information makes it difficult to provide commontary.""it was important to match the patients��� reports with information in medical records""This would be a critical component of any patient safety initiative and unfortunately isn't going to happen any time soon. Mandatory reporting by healthcare organizations of incidents would require legislation and who knows if that would ever happen.Questions:What happens to the data after analysis? If there is followup, what methodology is being used? Is any action being taken?Who has access to this data?""Suzanne, IOM has been reporting how widespread medical errors are for more than a decade. Anyone who has regular contact with the health care system as a patient knows that it is broken. There are dozens of agencies now that one could complain to, none of which speak to each other and are completely stovepiped. If you don;t know what the agency does and exactly how to phrase the complaint, it will be ignored and even if you do, it will be ignored. I suspect that most people who work in the profession realize that it is broken, but the problem is that nobody thinks he or she is the problem. It is always someone else. The data already exists for a ""couple research organizations"" for analysis. The problem is that none of that information escapes in a way to protect patients. If people don't see results, they stop trying. And there is no system that reliably produces results, and most are structured to make sure that the output of the system is not doclosed.""Empowering patients"" (which is a fancy way of saying that patients should do alot of the doctor's work for free) isn't a very good paradigm for people who are working two jobs, don't have alot of education and are raising kids. They don't have the time and money to ""empower"" themselves. They are just trying to keep the diapers changed. If you are stuck in a wheelchair and doing rehab for 10 hours a day because you got paralyzed, you and your family does not have tons of time to do tons of writing to officials, and your family doesn't either. Do you really want to spend your evenings learning the difference between translabial vs transphenoidal pituitary surgery, steroid hormonogenesis charts, and the merits of RIA vs tandem mass spectrometry. Trust me, I've done it and sometimes it has been pretty important to me. But it is something I really shouldn't have to do, and there are alot of people who don't have the time and education to geek out on this sort of material. It's why we train doctors. And if you want me to write up why the last endo I fired was incompetent, you better know your steroid hormongenesis chart. Which 99.9999 percent of the population isn't going to know off the top of their head. The likelihood that anyone who receives my complaint understands the problem is equally unlikely. But it was a potentially fatal error. This is not a problem that is going to be fixed by brochures in the waiting room.The information is aimed at the wrong people. And it subtly minimizes the problem. The solution to a system is killing more than 180,000 people a year is not a brochure handout.""A few states do. Access is very limited. Even the federal government doesn' have access to those state records. As noted above, ""it is important to match reports with medical records"". So with this initiative the federal govt would have the information sent in by the patient and the (few) state would have the incident report and the federal govenment would have the patient report and never the twain will they meet.""One thing that you should be aware of Marshall Allen is that many ""patient groups"" are funded by drug companies who use them as fronts to push their meds. So some people who claim to be ""patient advocates"" are really sponsored touts with a non-patient agenda. It's a wild world out there. If you ask someone for a comment, ask them where they get their funding from before deciding what category they fit in. Fancy website + professional staff= need to figure out what the real agenda is. Board = 95% licensed medical people= is it really a patient oriented organization.""""Martin J. Hatlie, the chief executive of Project Patient Care, a health care safety coalition in Chicago, welcomed the federal plan."" Look at who is on the board. All medical professionals. I would say that it is not fair to say this is a ""patient safety coalition."" It is a medical professional organization. The story did not accurately represent the source and lacked a legitimate patient source.""He may be a wonderful patient advocate. He may be a great guy. But to say that a 100% medical professional led organization is a patient organization or a patient inclusive organization is not fair. There are undoubtedly doctors who are strong advocates for patient safety. That is a great thing. But that is not the same as the patient voice. If you watch the blogs, there are meeting after meetings about patient empowerment, the patient voice, the patient experience where not a single actual patient has a seat at the table. We get represented by advocates, doctors, nurses, social workers, insurers, regulators who all think they know what ""we"" want, but that viewpoint is tinged by their own. This group has had a different take on the proposal than anything that is in that article. And in part its because of who was asked to comment. I am really glad that Marshall is going behind the front groups.""Marshall, one has to know who to complain to; that'd be a given in the proposal. That said, there are a zillion complaints. In certain of them I think it'd be useful to be able to frame a complaint in a larger context if possible. Ex: Dad ain't getting fed and watered. Conclusion: the place don't care and there ain't enuff staff. Larger context: cruise and/or ask to determine what the PT (census) / staff ratio is on the unit. With this info a complaint gets a bit more concrete when it becomes evident that there truly ain't enuff staff to round and serve.""Bart, who do you think is supposed to do that framing? Because as a family member, I have no access to the staffing plan, etc. In our case, there was indisputable evidence of starvation and the inspector was too dumb to understand that admission date of August 29, start date for nutrition of Sept 4 = starvation. Inspector cited the fact that the hospital told her that mom got fed on Sept 4 as proof that all was well without even checking the admission date. We have had another person be told there is no black box warning on interactions between levaquin and corticosteriods. And on and on. If you can't even get the correct facts into the inspections.... it really is an exercise of futility.""I want to respond to a couple of things here. First, while I was quoted and am very pleased AHRQ is developing this project, I wish Robert Pear the NYT reporter who wrote this had not described it as a system for reporting malpractice. It gives the impression that this is designed to be a whistle blowing system, and that is not the objective. The objective is to create a pathway for consumers to contribute to safer care by reporting what they see and experience that COULD cause harm. A malpractice event, by definition, HAS caused harm. Sue Sheridan and I did ten focus groups of consumers as part of the first phase of this research, during which they told us they would be motivated to report events that caused harm, as well as errors that caused no harm (e.g. patient has known allergy to aspirin, is given aspirin by mistake, but luckily has no reaction), near misses (patient was going to be given aspirin but spoke up and stopped it), and unsafe conditions that accidents waiting to happen. Hospitals and other healthcare settings could use that info to make corrections. Currently, they only get that stuff from professionals, and every piece of evidence suggests that professionals underreport. What was striking to AHRQ -- an AHA! moment I believe -- was how unafraid the focus group participants were to report. We asked whether they would like the system to accept anonymous reports, and the answer from most was ""make that an option"" but most said they would have no hesitation putting his or her name on a report, because they wanted to be able to track it and see how the report was used.The fact is that there currently are""Continuing, the fact is that there currently are many places for consumers to complain or whistle blow. Those pathways exist at state licensing boards, the Joint Commission, QIOs, and professional societies. I don't think they work well, but also don't think we need another that won't work well. I think complaints do have value to health care organizations and wished they used them more, but they don't. Its time -- past time really -- to provide a pathway for all the consumers who say in every study where they are asked to report information about risk that might be able to protect the next patient. I love that that innate generosity of human spirit shines through in this research, and that's why I like this idea so much.""Debra Van Putten, I don't presume that anything any of us enter here is a panacea. Marshall asked for input and we all have some of that.There are just too many variables for any one suggestion to cover the bases.""As for Project Patient Care, we are an organization that is modeling partnership between providers and users, starting at the board. We have never once claimed to be 100% consumer run or driven. However, we did establish ourselves as an independent non-profit in reaction to a demand from a healthcare provider organization that it have approval power as to which consumers sat on our board. We said no and moved out. Interestingly, our ability to do that was facilitated by a physician who respected that decision and gave us the funds to become established as a 501c3 as his contribution to the principle of always including the patient voice. Our board now includes a person who has experienced multiple life-changing medical errors and has never worked for healthcare. There is a prominent journalist/pundit on the board -- Michael Millenson. We also include a healthcare professional who lost a family member to medical error. As for me, I have worked for organized medicine but it was a long time ago. Much more recently, I was intensively involved in caring for ill and dying parents. I saw repeated errors, fired a doctor who wasn't meeting my family's needs and, along with parents, my siblings and their spouses, repeatedly intercepted errors that could have had unwanted and devastating outcomes. So, I feel much more like a patient advocate than a defender of the system at this point in my life. I do have hospital clients, but they hire me when they want help in finding patients who will push them forward in becoming patient-centered. At Project Patient Care, we like this model of partnership between providers and users. In our experience, it produces better deliberation and better results when diverse voices are listened to and each have weight. We're proud of the fact that we are bringing the consumer voice prominently into the discussion of safety in Chicago, not just in our own organization but in our community events. I hope this helps clarify who we are and what drives Project Patient Care.""Martin J. Hatlie, why do you think this will work differently than the other organizations? How are consumers in themidst of a crises to know that *this* is the real deal organization, and the other's aren't. How is this going to remedy on-going problems caused by the harm? For example, my mom wasted 30 of her sixty SNF days recovering from a hospital caused pressure sore. If she had not had the lung cancer misdiagnosed, she really need some of those rehab days for recovering from the hospital acquired paralyzation and if she had lived, mom and dad would have had to go out of pocket for that cost or mom would have gone without. She was also running through huge amounts of hospital days because the hospital was so poor. We could have easily run through all of her medicare days without an ounce of improvement. We made our complaints while mom was still in the hospital because we needed help getting her out and because her pressure sore was getting worse. What is there in this to accomplish an intervention for someone who is in the midst of bad care, not a retrospective. Are these organizations going to take over the statutory responsibilities of the QIOs and state survey organizations. Will they have the authority to exclude doctors and hospitals from medicare. Will they have the authority to declare an immediate jeopardy. Will they have the right to cut hospital reimbursements. I understand having a place to complain, but my real question is where the teeth come to actually make a change. Some hospitals care and that is wonderful. But there are other hospitals that really don't and those are the ones that are scary - and quite impervious to feedback. Our family has, collectively, been at a lot of hospitals. Not all are a horror. But the ones that are bad seem very entrenched in being bad.""Information is really great if you are having a voluntary procedure, but sometimes you have no choice about where they take you-- and the policy here is that EMT decides where you go, not choices. If the Level One trauma center in the area is a death factory, and you have a level one trauma, they're gonna keep hauling your butt back no matter how many times you try to crawl away. And mom did try to crawl out of the hospital -- she didn't get very far, but she did her best.""Debra, I think we are kind of agreed here. I don't think another complaint system will work be the real deal more than the ones that exist now. Rather than re-invent, lets fix what existing ones become the real deal and handle complaints better. In addition I favor this new system AHRQ is designing, which has a different goal. This is the system for those who want to offer what they see to those in healthcare trying to improve it. The new system is not the place to go if you want to make a complaint that law or regulation will use their power to correct. It is the place to go to report information that will help healthcare organizations learn. I think you need both kinds of systems, but they are different. At least, I think so.""I have a couple concerns. One is that it seems to me the priority needs to be to make the actually regulatory processes work and to get them to be non-stove-piped. And they don't. Medicare has testified that they don't. The second concern I have is based on the sheer frustration and difficulty we had when we couldn't get mom out of a hospital that had caused her to be paralyzed and starved. There are so many places you can call. Everyone wants this huge amount of data, that in the fog of a current problem is impossible to get. In fact, it is really hard to get after the fact. Any place that isn't a solution, is, honestly, a waste of time. And if QIO, the state survey agency, CMS OIG, CMS Ombudsman, and the CMS regional office can't hand over the information, its really is an undue burden on patients to have to file yet one more complaint, just for the purpose of research. Mom was in the ICU and likely dying if I could not get her help. And trying to get through the alphabet soup and palm-offs by people who would not help was horrific -- even for someone who is pretty good about getting around federal government agencies. And at the end, I failed and mom died in the most traumatic of circumstances because we could not get her help. She was beaten because we complained.The package of materials that we put together on our complaint about mom's care after she died-- after round one resulted in an altered inspection report-- was about 15 pounds of paper. We included, by complaint, the pages of the medical record that pertained to our concerns. That too has done nothing. So it seems to me that if you are going to do all of the work as to create yet another round of paperwork demands on patients and their families, it should be a system that holds the rest of the system accountable. Anything that registers complaints without doing something in a direct and tangible manner about them puts a fig leaf over the problem -- at great pain to some of us. The ""curiousity"" of researchers is not a sufficient reason to put someone through this. That is my two cents. We don't agree. I don't particularly want to be heard. I want to grieve. I don't care to have my grief and my mother's suffering the subject of prurient observation. I want the people who did this to us, intentionally, willfully, and sadistically, brought to some sort of justice.""The Joint Commission has an extremely valuable franchise thanks to federal statute. Why not require them as a condition of that franchise to hand over the data you want, in the format you want. If not, they are no longer have accreditation authority. Why not burden them, instead of patients?" "Debra, I think getting regulatory processes or bodies to do their jobs more effectively is an important goal, something your experiences seem to have energized you to do something about. You sound like a human rights advocate to me, and their are many human rights issues to tackle in health care. Your passion comes through your posts.""Four rules in washington; 1) Information is power. Someone proposes a solution that cuts you out of the information loop, it's a bad deal for you. 2) He who has the money makes the rules. If you want to make real change, not jawbone, find the persons who write the checks and and who get the money from Congress and convince them. The policy wonks don't matter. The problem with HHS is that it is overrun with policy wonks and no central check writer. 3) avoid the slow roll. If someone offers you a ""solution"" that just gives them time to avoid a solution, refuse. because the bureaucracy will see it as ""problem solved"" and move on, and you wont get what you want. 4) If you want to make people decide, create a cliff. Create penalties for not doing things. Make the penalties as automatic (and not subject to political tampering) as possible."Socalled ���never events��� in medical facilities should be made public says @DrMartyMD in his new book ���Unaccountable.��� http://amzn.to/PftwvCWhat a great group!"Thanks, Deborah Hatter-Grant!""The Obama administration wants consumers to report medical mistakes and unsafe practices by doctors, hospitals, pharmacists and others who provide treatment."I'd be happier if he dealt with the complaints he already has."Thanks for all your great comments on patient complaints. I included several of your thoughts and suggestions in this story that published today. As you can see, I linked back to the original Facebook discussion, because there were so many interesting insights.""Thank you Marshall Allen for your article which includes many useful links. I see you put in the link to ���A Prototype Consumer Reporting System for Patient Safety Events.��� I wanted to look into this.https://www.federalregister.gov/articles/2012/09/10/201222028/agency-information-collection-activities-proposed-collection-comment-request" "marshall, i think you wrote a great article and here's why. you did't merely write an article about patients not reporting error/harm, you made the point that when they don't (for whatever reason), this creates a danger for everyone. you hit the nail on the head in my opinion! this is exactly the point i made with a local cincinnati reporter last spring. he didn't seem to get it... thank you for making that most important point."1. It is sometimes cheaper to let you die rather than to treat you for a serious condition. http://www.nejm.org/doi/full/10.1056/NEJMp1206862#.UGCYNi1v5a0.facebook#t=comments New call in number is (646) 652-2105i will be listening! "http://www.govhealthit.com/news/joint-commission-praises-620-hospitals-quality? topic=30,31,34,19" http://www.jointcommission.org/improving_americas_hospitals_joint_commission_annual _report_quality_safety_2012/"One of those is the one that killed my mom. So, not exactly the best of resources. And yes, the Joint Commission had proof of mom being intentionally starved."Sounds like something for a Marshall/Elbert to investigate."I am wrong. they were on last year, but not this. It really grated to see them touting it.""#1 The chairman of Aetna, the third largest health insurance company in the United States, brought in a staggering $68.7 million during 2010." http://www.wcpo.com/dpp/news/region_northern_kentucky/florence/State-suspendsFlorence-doctors-license-says-15-patients-died-in-his-careHealth insurance companies like to keep secrets. And they like to save money"Just an observation. Billing fraud. Two day turn around to get a letter out of DoJ. Complaint about a nice Grandmother being nearly starved to death, beaten, left to die... 377 days and counting:http://www.nytimes.com/2012/09/25/business/us-warns-hospitals-on-medicarebilling.html?hp""And I would note that I told Ms. Sebellius more than six months ago that all but one of mom's H&Ps had been cloned by unscrupulous doctors, quite notable because they record a surgery that mom obviously never had reported in the first, incompetent H&P. Complaint obviously not read. Once again ... patients on the forefront, completely ignored.. I am heading to the doctor's office to go read some groundbreaking, totally innovative brochures, so I can get up to speed on that patient empowerment thing. And for those of you who don't know me well, that is irony.""And if I might note, I also wrote Mr. Levinson, HHS OIG, followed up umpteen times with his staff, and got a letter from Jennifer Trussell of his staff telling me to sit down and shut up.""If only I had filled out a brochure instead, I am sure they would have listened..."immediately what hit me as i read this article was the fact that doctors and hospitals are finding a new way to 'game the system'. my god! when is enough going to be enough. is there no end to the greed? seriously! "The taxpayer gets the same amount of respect as the medical injury victim. Once they have started to game the system, they feel entitled to do it even more." "We���re overdiagnosed, overprescribed and undereducated ��� the best thing for medicine may be having less of it"If any of you have loved ones suffering from cognitive issues you may be interested in this"""New York Times article about my friend Jennifer In Memory of Jennifer C. Jaff. The swellin fof support and sharing of her tremendous accomplishments is helping me, and many who knew her cope with the devastating news of her passing. On September 30th at 11:00 PST we will be lighting a candle Merced Gardens & Nursery in solidarity with many people across the country to celebrate her life and legacey. Please join us if you can.""4. If I prescribe a newer, more expensive medication, it may be because a drug rep just left my office. They constantly bring us presents and flatter us, and their only goal is getting us to prescribe the latest medication, which is usually no better than the older ones.""1. ""We're not going to tell you your doctor is incompetent, but if I say, 'You have the right to a second opinion,' that can be code for 'I don't like your doctor' or 'I don't trust your doctor.'""""a nurse saved me when i was in the hospital about a year ago. a doctor misdiagnosed me and my nurse knew it. he ordered me to take a dangerous drug for a disorder i did not have. my nurse came into my room and handed me information on the drug, looked me in the eyes and said 'read this. by the way, you can refuse to take that just so you know'. i knew what she was telling me.. 'don't take that!' i'm very thankful for that nurse!" that's good to hear veronica... i'm quick to say the doctor who performed my surgery acted criminally but i'm also quick to say i've had some good doctors and nurses along the way too."I dido that, I had a amazing nurse after the surgery.." "6. Even though I tell you to let your baby cry himself back to sleep once he's older, don't ask me if I always followed that advice with my own kids. I didn't." Please help support Jocelyn.terrible story out of the colorado chiropractic board awesome mary-lou! so proud of what you're accomplishing in the midst of your terrible loss.."I am asking for prayers. We have been working with a reporter for over six months on what happened to mom. He has a kick butt story from what he has told us. But it keeps getting kicked back and kicked back and we are getting discouraged. Bluntly put. Its been on the ""verge of being released' since mid-July. We have so little faith in anyone at this point and we can't be think that it is politics. Can you pray or send white light or whatever floats your boat that it will make it to press this week?""Thank you so much Jennie. Although I have never met you, I often think of your sister and I am so sorry that you have had such an awful loss.""Empathetic: ""The doctor tries to understand what I am feeling and experiencing, physically and emotionally, and communicates that understanding to me.""""The avoidable death of Albany Times Union reporter Mike Hurewitz is described in a chapter on med errors in the new book ""Unaccountable"" by Dr Marty Makary. The paper ran many stories about the tragedy in a New York City hospital but over the past 12 years has ignored dozens of lawsuits alleging negligence filed against hospitals in its circulatation area.http://www.northeasthealthclaims.com""Living donors die every year in the US within 12 months of surgery (4.4 living kidney donors. and PS. 2 liver donors died in 2010). Even though the transplant centers are supposed to report it to OPTN (UNOS' is only the contractor), but there is no mechanism of quality control to ensure they do. Since there is no transparency for either the hospitals nor OPTN, the media and public very rarely find out about the deaths. To this day, btw, the transplant center responsible for Hurewitz' death lies to prospective living donors about why he died. www.livingdonor101.com"interesting site cristy! i have many issues with organ donation..."Ok, not a great article to read before bed, I have only 1 kidney left."so sorry georjean... i thought about you as i read this."As you might have guessed, I only have one kidney myself. I realized, after my donation, that my experience didn't jibe with the public conception of living kidney donation. I searched for support groups or resources and found none, so I began reading journal articles. With each new revelation (How can they have no data? What do you mean my blood pressure will go up? Chemotherapy is nephrotoxic?!? Now I'm at greater risk of cardiovascular disease?!?!?), I was thrown into a new panic and depression. It'd be neat and tidy to say I've gotten over all of that four years post-donation, but it'd also be a lie. Like you, I have to live with it every day, so it's impossible to get over. But I have taken the approach that it's better to know my risks so I can try to prevent as much as possible. I don't do everything I should, but I'm much more aware than I ever was before, and I consider that a step in the right direction."very sorry cristy... cases like yours and georjean's are the reason i have serious issues with organ donation - living or otherwise. your cases need exposure! thanks for sharing... "Important topic and quotes by The Empowered Patient Coalition. http://www.chicagotribune.com/news/local/ct-met-surgeon-switch20120923,0,3844888.story"Deborah Shelton is one of the few reporters who has given attention to the neglect and deficiencies in the transplant system regarding living donors.She was wonderful to work with - we spoke on the phone for several hours. She is one of the most devoted and thorough reporters I have ever encountered.I agree. We need a couple hundred more just like her "http://www.chicagotribune.com/news/local/ct-met-consent-form-tip-box20120923,0,999198.story"We picketed our hospital yesterday. mostly to get public awareness and to get support for an inquest into Josh's death. While I was there I had three people come to me with their horror stories from this hospital. It is the worst in the area. I am praying for an inquest so they have to change the way they treat people like my son.good for you mary-lou! hoping with you for a good result here.."Brick by brick the wall of silence is coming down. This article by Robert Pear is in Saturday's New York Times, about a proposal for a way to let people report medical mistakes to the government.http://nyti.ms/PMGvVZ"Six thousand plus dollars for a single insulin shot - described in this multi-item posting at http://www.answersforlisa.blogspot.com"david, i disagree on one point. i don't believe hospitals make billing 'mistakes'. i believe they overcharge on purpose.""I think some do yes. What is amazing in this case is that the insurance paid the claim. It wasn't until I asked the hospital for an itemized bill that it responded with the letter, a letter that makes it sound as if it had discovered the ovecharge.""david, i haven't been able to read all documents but i'm working on it. there's so much information... it's great you are blogging about this! somebody needs to hold their feet to the fire... it is amazing that insurance companies seem to blindly pay out on these claims. united health care told me that they pay any claim submitted to them as long as it's covered under the patient's plan. when i asked them how they know a claim is legitimate, they told me that they trust that doctors don't lie. that's nearly incomprehensible!"And people wonder why health care costs are rising so much. This is one reason why.you're so right david and there's no excuse for it!Call in number is (646) 716-4367glad you're talking about tort reform deirdre.... pursuing a medical malpractice complaint is next to impossible. i filed a complaint in 2008. i've been through several lawyers and i'm now representing myself due to no other choice. my trial date has been moved many times and is now set for 2014. tort reform has created a very very dangerous medical environment for all of us. doctors know they can't be sued so they have little incentive to 'first do no harm'. the judge over my case actually told me at my last hearing that his own wife filed a malpractice complaint but she didn't win. he went on to tell me 'you just can't win a medical malpractice case in this county'. what does that tell you?great show deirdre! thank you for talking about what very few are willing to talking about!you are welcome-we will continue this show until we get justice. thanks for tuning in. please call in and talk we would love to hear your stories.Is this radio show archived? I would like to go back and hear it.In New York the task is how to interest one independent state politician in legal change. Where in god's name can we find one independent(sans lobbyist money) state politician??http://www.blogtalkradio.com/kingdomview/2012/09/21/life-radioshowher next show will be on at 8 p.m. est on thursday... she has a great guest lined up for that show!"Excellent article on prescribed drugs. http://www.guardian.co.uk/world/2012/sep/14/french-doctors-drugs-useless-dangerous" "New article on overbilling. The article misses one consequence of this aggressive, falsified billing. Incorrect medical records. In the second ER record, Mom had recorded a ""normal"" neurological exam. Never happened and mom had preexisting conditions that precluded one. In the first ER, the doctor recorded that Mom had had a Coronary Arterial Bypass Graft surgery that she had never had. That erroneous history was cloned probably a dozen times, and resulted in misdirection on diagnosis and incorrect medicines that caused harm to her. Not a single doctor questioned the inclusion of this item of the history, even though moment's view of her chest (and lack of scarring) would make it clear that this surgery never happened. She was also incorrectly recorded as having a history of pulmonary embolism, which resulted in unnecessary procedures. Billing cheating can cause serious patient harm.http://www.nytimes.com/2012/09/22/business/medicare-billingrises-at-hospitals-with-electronic-records.html?hp""errors in medical records can and do cause great harm and even death as in your mom's case debra. and getting those errors corrected can be next to impossible; even when you find them. after one of my e.r. visits, i noticed that the doctor i saw wrongly noted that i had an alcohol abuse problem. i don't drink - never have. i contacted the hospital many times to try and get this corrected. the process for getting this one thing corrected was unbelievable! to make matters worse, the doctor who made the notation was no longer working at the hospital. my efforts to get my record corrected were all to no avail. so my e.r. record from university hospital in cincinnati says i have an alcohol abuse problem.""Which means that if you ever go in with severe abdominal pain or the like, the ER doc will decide that you are a ""drug seeker"" and that you are faking it, and therefore decide not to treat you. There really should be a better remedy for slander in medical records.""It's one of the things the integrated EHR folks did not factor in. How to get rid of the info from the crazy docs that can screw up a patient for life. with paper docs, when you run into one, you just switch docs and ""forget"" the name of the old doc. With this new system one vindictive doctor can kill you by lying in your record and there is not a darn thing you can do.""The new HIPAA (2003) and HITECH (2009) acts have provisions for improved patient access and amendment to their Protected Health Information. Google, ""45 CFR 164.524"". Plus, this link: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_048587.hcsp? dDocName=bok1_048587""Another proactive way to know what is in your record is to ask for a copy of todays information before leaving the facility. If you get a push back, produce the following from your back pocket: http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/healthit/eaccess.pdf" "Doug, thank you for that information, but this is another theoretical ""right"" that everyone believes is true because earnest reporters and medical professionals tell us its true, but it is not. There is no real enforcement of HIPAA. A hospital is more likely to burn down to the ground than have a serious fine for violating HIPAA. If you try to get a serious medical error fixed in your medical records, it is more likely that you as a male will give birth. The medical facility will stonewall telling you that they refuse to change the information because it was accurate -- to do otherwise would mean that they made a mistake. A medical provider is not going to admit in writing to a mistake, and the intransigence will be worse the more serious the mistake -- meaning the likelihood of harm to the patient goes up. If you try to put your own correction in the record, you will brand yourself as a problem patient, so there is no winning. The solution is that medical records belong to to the patient, not medical providers. But that is not going to happen. If laws do not have working enforcement mechanisms, it does not matter.""Pre-2003 HIPAA was poorly enforced. HIPAA HITECH does enforce violations and non-compliance with huge fines. The facility may refuse your request to amend your record if your request includes one of the terms for denial. The old ways are changing, slowly. If you take a copy of the law with you and speak to a department director you may have better results. See: 45 CFR 164.526(a) Right to Amend -http://www.law.cornell.edu/cfr/text/45/164.526""And I don't mean to be picking on you, but i have fought many battles with medical providers to get records. Almost all have only been settled with me pulling out my bar card. One ended with a family member scheduling an appointment and walking the records when the doctor left (after months of requests) In one instance, however, even that did not work. The hospital mom was in refused for two months to give us mom's current medication (with signed paperwork) even after there were multiple overdoses. Then they refused to give us the CTs that showed she had lung cancer. All of which is sitting up on the desk of a Regional Administrator at Medicare who refuses to enforce one ounce of the law. All of my complaints stem from post-2009 and I will tell you I fail to see a single glimmer of change. The problem is that one of the ""exceptions"" is that ""the records are accurate."" If the provider does not want to admit a mistake, its a loophole the size of Missouri. And truthtelling is not the strong suit of the medical profession.""And it has been sitting on that administrator's desk for more than half a year, with a congressman's office intervening, a teleconference with the regional adminstrator, promises of ""immediate action"" and it resulted in a patient death. Can you hear the crickets? They have died of old age.""It seems like there also needs to be laws that keep hospitals from suppressing some of the medical records that they feel aren't pertinent. When a medical records system is setup with flags for suppress y/n and patients can't get everything and have no clue what is missing and have no say in what is suppressed it should be considered fraud, tampering and premeditated intent to do harm and above all HIPAA violations. Doctors and facilities that do harm and then are allowed to cover it up by suppressing records need to be stopped.""Your not picking on me - I can appreciate all you've been through. These issues are difficult to resolve after the fact. I encourage a different approach to the healthcare community by enlisting a professional or family Patient Safety Advocate to monitor care for best-practices 60 minutes per hour and to review everything that is documented within 12 hours of it's entry. If you have evidence that is documented, yes, res ipsa loquitur."Suppress y/n?? There are 10 reason why a Covered Entity may deny access. See: CFR 164.524. There may be state laws that are more restrictive but the facility should be able to show you the state laws. The facilities can no longer make up their own rules. http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_048587.hcsp? dDocName=bok1_048587"what doug is saying might work if all things were equal but they clearly are not as most of in this group know too well. i obtained a copy of my record immediately after my surgery in 07. by the time i filed a malpractice complaint a year later, my record had been altered. so even if you ask to see your record after each visit, your record can easily be altered after that. and even if your doctor freely admits they've altered your record, there's not one damn thing you can do about it. i sent my doctor's testimony to the state medical board for review; along with my altered records. they responded with 'maybe your doctor gave false testimony'. there is no way to win. the deck is stacked against you in a big way! specifically, my former doctor defended altering my record by stating ""this chart is my record. this is my remembrance of events. this is for me"". further, in reference to me merely inquiring about a note in my record, he said ""i thought it was odd that she would be 'rifling' through my record..."" there are many doctors who believe your medical records belong to them; not you. therefore, they have absolutely no problem altering them.""We contacted patient advocacy. They were part of the problem. The hospital refused to allow us ANY access to records for two months. It's not a matter of a different approach. It is a broken system.This not the only patient related group I am in. I have multiple rare diseases and I have close network of other patient sites I am on. Access to records is a horrific and continuing problem. Misrepresentation of patient information and status is a terrible problem. Doctors sending out ""poison pen' letters to colleagues and other blackballing techniques if a patient does not ""comply"" with unnecessary and expensive testing, to the detriment of the patient, is not infrequent.""I have seen dozens of poison pen letters posted by other patients -- usually they get them from a decent doc who warns them. I have been the victim twice -- luckily my insurer got copies and gave them to me. But trust me, mine were not in my medical records when requested and others have found the letters to be missing also.We actually did two data dumps from hospital radiology for mom. One was very early and surprise, surprise, a very incriminating image showing the spine clearly broken went missing from the records when provided several months later. there needs to be some recognition on the part of regulators and ""advocates"" that much of this is not a matter of people not getting along, there is a serious degree of malice in some instances, which will not go away no matter how nicely or professionally one addresses the matter. Dad was mom's advocate in the hospital for 15 years and very successful at it. It is not that we did not know the medical system. It was that there are some very evil people out there.""The examples on this forum are the reasons why HIPAA HITECH 2009 was written. Yes, facilities had the attitude that it may be your data but it's our paper. Electronic Health Records and this new law will actually benefit patients and patient advocates. See 45 CFR 164.502, 164.510(b), 164.514, 164.520. Plus, complaints of violations and non-compliance can now be made directly to your state attorney general because they are violations of your Civil Rights.""Um our state attorney general has told us to go screw ourselves. The hospital in question provides 15,000 jobs in our state. He frankly does not give a damn.""Three weeks after that letter, he issued a press release about his tireless multi-agency, federal/state efforts to protect roosters from abuse."45 days until election day.same here in ohio debra. the attorney general does not care about any of this. try reporting a hipaa violation and see how that works out for you. nobody gives a damn about hipaa. i'm disabled for the rest of my life due to blatant violation of hipaa privacy laws. nobody cares - nobody that is except the person whose privacy has been violated."Unfortunately, this appears to be a bii-partisan effort here where I am.""Thank you for your presentation Partnership WITH Patients. I support your work. You presentation is wonderful." http://www.propublica.org/article/now-on-nursing-home-inspect-140000-plusinspection-reportsThank You for posting this."well i've heard it all now. i just got off the phone with someone from the state medical board of ohio. i called to check the status of my complaint filed in may. the woman i spoke with was christa. christa told me that it can take months to complete an investigation, blah, blah, blah... i told her that it shouldn't take months in my case because i submitted the sworn testimony of my doctor wherein he 'admitted he alters medical records and obtains illegal consent for surgery'. you know what she said to me? she said ""well, maybe he lied."" i said ""excuse me, what do you mean well maybe he lied?"" she said ""i've personally given false testimony before."" i said ""why would you do that?"" she said ""to get someone off my back."" i was speechless... when an investigator from a state medical board defends a doctor's illegal/criminal activity by stating ""maybe he lied. i've personally given false testimony before'"". well, i don't know where a person does with that information....."Wow hang in there - all I can say is some people just won't get it until it happens to themshe called me back as they were leaving today. i think i am going to try to call back tomorrow though. it's almost impossible to get through to someone but i can write to them if i can't get through via the phone.i meant on monday....This is what I would do. Write the board. Put the conversation in writing. Unbelievable. Except it isn't. Nothing like admitting to perjury.Karen what state are you in? Also I would love you Tonkin our group Citizens for Patient SafetyThat is truly pathetic....they make it impossible for any of us to get help I am so sorry"This comment/clinical note should have been shared with us. This topic of conversation was never ever discussed. I/we were told I had Advanced stage of kidney cancer TCC. I make my own medical decisions NOT my surgeon on a Presumption. the beginning of the lies and deceit my surgery was the morning of 112/17/2008. Now tell me what shouldn't be shared, wait till you see all the NO cancer testing results between 10/2008 and 12/17/2008.""Looking at documents under Files and see some medical records posted.As these documents are posted by individuals not hospitals, those documents may not be applicable to the HIPPA requirements that hospitals are under but some redaction of personnal identifable information may be in order. Even if not required legally, this forum should practice the same guidelines that we would consider patient harm in a clinical setting.""I don't believe that we need to hide whom doctors have hurt or caused some death. This is not a clinical setting and this is what I believe needs to be done. Date of birth, social security number I wouldn't do that, but if they are dead because of medical negligence, really does that matter. If they are showing it, it possible they don't care. The main concern and purpose here is to let others see what some are trying to cover up.""I want to say to the community of people who have lost hope. I urge you not to let someone take your voice. Your voice is going to be the very voice of change. Some may not understand because they haven't experience what you have and never will, but never allow the doubts of others or their insecurities make you not do what is right."thank you deirdre! thank you for being courageous in the face of such personal tragedy. and thank you for being a voice for change! "since individuals are the ones posting, why would HIPAA privacy laws apply here? the only way this becomes an issue is if pro publica posts medical documents without consent; which i'm sure they would not do. i see this as an non-issue." "While the documents being posted imply the consent of the person who has posted it, there is no signed consent documenting this. Also if the document is not posted by the individual who's record it is they may not be legally entitled to post the document.While Propublica isn't doing the direct posting, they are hosting the post and if said document are there w/o consent then they can possibily be held liable for the posting. Not trying to cause trouble. Trying to keep this forum out of trouble.""And I am a firn believer in practicing what you preach. If we feel that exposure of medical records to the public by medical facilities is harmful to patients, then we ought to live up to that same standard.""Hipaa does not prevent me from doing anything I want with my medical records. I can post them in Times Square if I want. The ""guidelines"" of scrubbing all useful information about medical wrongs is part of why we can't get the problem fixed. Who, what, where, when, how. I refuse to be treated like a 1950's rape victim where being mistreated is supposed to make ME feel ashamed and the whole social fabric is set up to protect the evil-doer from facing what he did. I refuse to be stigmatized by someone else's wrong. I refuse to live my life having people trying to make me feel ashamed of what someone else did and saying I can;t talk about it. I agree, no socials, but other than that, what did you think needs to be taken off? Names? the doctors, nurses and institutions that did wrong. The embarrassing personal information? The ugly pictures of what was done to people that make others cringe?" "agree with debra completely! having said that, marshall do those of us who have uploaded/posted medical docs need to sign a consent of some sort to keep this forum out of trouble? please advise...""The documents can and should be posted. And any redaction I referred to was the patient involved. Only the patient. Staff, institutions should be fair game.""The point, Cary, is who is charge. A nurse has no right to decide what should happened to my information or my body. I do. It's a question of patient autonomy and rights. Hipaa has nothing to do with a fear that the public might actually find out what medical professionals are doing. Why should the patient info be pulled out? It happened to them. If they want to share why not? Or is it that you are afraid the doctors and nurses and hospitals will be embarrassed about their conduct? if someone posts something they have no right to post, the owner can sue the publisher. The law is very clear on protecting the rights of board owners.""Hi Cary Parks, thanks for bringing up such an interesting point. But I do have to disagree with you. Members of this group own their own medical records, so they have every right to do what they want with them. The privacy laws prevent exposing these records without an individual's consent, which is a much different thing than a person deciding to post their own records to verify their story. I would say that people should be careful about posting any medical records, and should definitely redact private info that could be compromised. But there is no legal problem with someone posting their own records. And it also doesn't violate the principles of patient privacy because the whole point is that a patient has the right to do what they want with their private information. Do you disagree?""How are we going to guarantee that the person posting the records was indeed the person directly giving the consent. If I have a copy of your record somehow and posted it to this forum without your consent, is that proper? And should that be moderated?If you read my post in this forum about my brother's radiation tradegy, you would see that I have no compunction at all with exposing my brother's story via the New York Times, Congressional hearings and now this forum. But if I were to post any of his medical records, I would seek a signed consent from his widow and redact any information identifying him. I would not redact the instution or the clinical staff involved.""The law is that if you invade privacy rights of a third party, it is between you and the third party. It is of no interest to the board owner. In fact, I think that if the board owner tried to regulate it, and did a poor job of doing so, it there would be more possibility of liability than by doing nothing. but I am sure Propublica has good lawyers.""Cary Parks, you can see the name of the person who uploaded the file, for one thing. But the bottom line is that you are asking for a standard here that is impossible to maintain. Do you think that we can verify anything that is said in this group? It's very difficult when there are nearly a thousand members, and that's not a standard that we are trying to set. I would say that this forum -like any social media forum -- is limited by the fact that it's pretty much impossible to verify the things that are said in it. That's sort of understood with social media, I think. But that doesn't mean it's flawed. It just is what it is." "By the way, Cary Parks, do you see medical records that appear to have been uploaded by someone who does not have a right to upload them? If so, please be specific. But it sounds like you just don't agree with the principle. And that's OK, too. We can agree to disagree. I understand your concern. It's certainly valid.""Another very timely post for me. Thank you for this information. If I did get a response from the 'watch dog' gov't agencies - they all state confidentiality must be strictly observed - no mention of hospital or physician names. My reply was always I wanted to be totally transparent - they found this rude.... - I intend to send several documents from my records as well as all correspondence on their stationary marked as Exhibits - no redacting. I have not uploaded any online todate. I won't upload anything here if that is PP's wish. IF we go silent, we can help no one. That is not an option for me."a agree with michelin... going silent is not an option for me either!"I agree with the difficulty to monitor this but document posting recommendations may be in order.All, pleaes understand that I am not trying to cause trouble. I think this forum will be a wonderful resource for all involved and may provide Marshall with material for publishing in ProPublica. I am a big believer in activism via social media (BTW Marshall PP is one of the best!) and it is time for patient safety to harness this resource. I just wanted to insure that we were addressing this issue as a group before it became a potential problem.""Michelin, Robin,If you read my earlier posting about my brother, I can assure you I am not the silent type.""I understand your concern, Cary Parks, and we'll discuss it with our team here again. But you also have to realize that there is tremendous value in allowing people to post their own medical records, because it can verify their story. That adds a lot of weight to what that patient is saying, and makes that story much more difficult to dismiss. Also, let's pretend we did try to set a standard where we would ""verify"" each person had a right to post any records that were posted. How would we do it? The point is, we cannot verify these things with absolute certainty, nor is it necessary for us to do so. And we're transparent about that fact. So far we have not seen a case where someone seems to be posting records that they have no right to post. (You'll also see that very few people have posted any records at all.) That doesn't mean that the issue couldn't arise, but also realize that we've been doing this for a little while so far and it hasn't become an issue yet." http://olenderfeldman.com/privacy/how-can-they-post-that-understanding-thecommunication-decency-act"cary, i went back and read your brother's story. i'm very sorry for what your family has endured... thanks for sharing here. when one of us shares, it benefits all. now that i've read your posts, i'm even more perplexed by your posts here regarding posting of medical records and privacy issues.""Thanks Debra.. ""websites that post only user submitted content (even if the website encourages or pays third parties to create or submit content) are protected under the CDA, and immune from liability, with two major exceptions. The CDA does not immunize against the posting of criminally illegal content (such as underage pornography), and it does not immunize against the posting of another���s intellectual property without permission.""""You are not a silent one Cary - I was needing this guidance you have provided and did not read all before I posted. I am not medically trained - only know patients really do have stated rights, but, I have been told just the opposite by several Federal and State agencies. When one is conscientiously lied to by so many - one hesitates - momentarily only but you do get the heebie geebies and it is good to see daylight here. You can relate your experience to people, but, if they have not experienced something similar - it is hard for them to accept medical professionals lie. The proof is in one's records and staff who sees what is going on. Thanks for what you have shared earlier that I have not read and for your comments in this thread. Attorneys do not want a client sharing too much. You have caused me no trouble Cary - sorry if I made you feel that way.""This has been a good discussion, and I'm glad that Cary Parks raised this issue. There is much confusion about patient privacy laws, including within the medical profession itself.""Cary Parks - I am so sincerely sorry for you and your family's great loss. I have no words to express my gratitude for your sharing your story so that others may be more aggressive, careful . Unfortunately, lobbyist/marketing has taken a great deal of time to smearing certain big legal cases - the victim, not the one charged. People tend to only read and semi comprehend what has truly been done. It's really hard to read these stories and know it can happen to anyone.""I'm ok and encouraged by this discussion.Robin, sorry for perplexing you but I point back to those NYT articles as an example of what can be exposed and lead to monumental improvement in the safety of patients while guaranteeing the privacy of my brother's medical record. While my family had multiple discussion with the NYT reporter (Scott's widow could not discuss anything with NYT due to litagation), no records were ever released.Lack of the records was never a limitation. Diligent journalistic investigation led to a series of articles (links are posted) that led to congressional hearings that led to FDA oversight and vendor improvements to not only insure that the equipment would be modified to not ""stick wide open"" as it did in my brother's case but also to add radiatio dosage measurement devices to xray and ct devices. These dosage records can be included in the medical record and monitored for cumulative exposure. An enourmous impact to all of us and didn't require any release of my brother's medical records beyond immediate family.While we lucky that NYT took an interest in this issue and the subsequent exposure led to important national action, I believe social networking such as this forum and socially responsible organizations such as Probublica can lead us to the same goals but believe me it is a long hard road and takes committment, courage and time to get there. But every time i visit my parents and see their wall of Scott's pictures and a picture of my Dad testifying in front of congress, I know it was all worth it."thanks for the further explanation cary. i understand your concerns better... it's nice to see where something good and worthwhile can come from something so tragic. glad you shared here."One thing that this is really useful for is that it seems that the process of getting information out is really broken. So, a reporter who wants to talk about this either has to hope the right person will find him/her and that official sources come clean. As family, we have found it a very hard to find people who are interested in a story. and many reporters say, well, if I had two stories that were the same... well the likelihood of that happening is like lightening striking. So having a ""clearning house"" that has real names and gives reporters some idea of who really has ""the goods"" is a help to making things better.""I think that finally medicine is getting to the level of every other type of business, If you refer to something like ""Angie's list"" consumers are able to voice good and bad and name employees and businesses. We are healthcare consumers and when things go WRONG we need to be screaming it to the world. My medical records my story. All 40lbs will be published if for nothing else but a learning tool for patients (consumers) and the medical profession. There was no reason to be in the ""BEST HOSPITAL"" (per consumer reports) and go through what I went through, Unacceptable and Unaccountable. Plus if all these Doctors and Hospitals can advertise their GREAT achievements I can advertise the HORRIBLE achievements, I AM PROTECTING the next innocent victim. Silence is allowing someone else to possibly be placed in harms way.""that's right georjean.. silence is not golden when it comes to speaking out about dangerous doctors, hospitals, medicine, etc."May I need to start a service like Angie's list for healthcare and tell the good with the bad. "www.ratemd.com is good, but the docs try to do gag agreements and threaten litigation""My bigger question is how do we have animal rights groups the protect animals from research studies, but we don't seem to have that for Humans..."yeah they have Health Grades-I sent a letter in and I want you to start writing to this entity as well.To Marshall please read the letter I sent to Health Grades because this is the entity that is being used for doctors and hospitals. I attached it in an earlier post."We review all submissions. The purpose of review is to ensure that procedures discussed are ""on-label"" meaning the US Food and Drug Administration (FDA) has cleared the treatment(s) discussed; that privacy of friends and family is protected; to ensure that stories are about da Vinci procedures and to ensure content is appropriate for a general audience. http://www.davincistories.com/web/davincistories/about"this site will never tell of patient harm.interesting site georjean! i can see that they only post positive stories about the robot. i read one woman's testimonial where she said she only had three puncture wounds - only three. this woman was 73 and underwent a hysterectomy. how sad that this poor woman let a doctor looking for practice with his robot perform a surgery on her that she didn't even need. many of the testimonials are sad..."Thought you all would be interested in this: Now On Nursing Home Inspect: 140,000-Plus Inspection Reports http://www.propublica.org/article/now-on-nursinghome-inspect-140000-plus-inspection-reports"Nice work! Anyone interested in the quality of care in nursing homes will be blown away by what this tool reveals."Wow, you all amaze my with what you are doing. Thank you all.""Wow, I looked at the inspection reports for the two snfs mom was at and boy, are those inspections a world different than the inspection done at the hospital.""One of the places got written up because the inspection report wasn't in the main waiting room. I hate to say it, but it just made me laugh."It is great to have all of these available.A doctor advocating transparency. And a newspaper practicing suppression. Who would have thought it would happen? http://bit.ly/R3l30l"As I have been scanning all my medical records I just came across something of great concern. Up until this very minute I was told I had a Laparoscopic left nephrourecterectomy. Why did I just find an Operative Note like this - ""She underwent a ROBOTIC ureteral nephrectomy with lymph node dissection."" My doctor never ever discussed ROBOTIC with anyone and I NEVER gave consent for ROBOTIC anything. From my research I know now,this is something Dr Castle promotes and is very very involved in."Talk about UNACCOUNTABLE Excellent book"Marshall Allen just interviewed Dr. Makary about the book, and his thoughts on the system. Check it out: http://www.propublica.org/article/qa-martymakary-m.d.-author-of-unaccountable""Um, we're not in Kansas anymore? More like down the rabbit hole and through the looking glass.""What a fantastic article, it gives us all Hope for a better system. I also applaude Dr Makary, we need so many more like him to break the silence.""Using robots allows doctors to do complicated surgeries less invasively meaning many patients can get back to their lives faster and with fewer complications. LOL... http://kaaltv.com/article/stories/S2594905.shtml?cat=10799"We need discussion on the patients that get severely injured and lay for 2 days in a hospital and go into SEPTIC SHOCK..."those robots cost a fortune! guess how they pay for them? they do surgery after surgery after surgery using them. sometimes they inform patients they are using a robot and sometimes they don't. often, when they do inform patients about the use of a robot, they don't tell them the risks involved. there are many patients who have been seriously harmed via these 'miracle robots'! stories of harm are all over the net.""You know, that is a good question. How do you actually clean one of those. I mean if NIH is pulling plumbing apart to get rid of Klebsellia, how do you clean a robot for the next patient, who might be in the next 15 minutes."why is that because they don't have the training themselves"just one of the many comments i found on the web regarding robotic surgery... ""has anyone had one of the surgical tools fall off this robot? in my surgery, a tool fell off in me the dr. had to look for 1 hour to find it in my body she found it using x-ray but from all the poking around i am extreamly painful!""""Two more comments... Angela said ""The Da Vinci surgery ruined my life - lets see it this gets posted - if so I will elaborate in detail the training these surgeons receive is hardly enough to prepare them for how to deal with the possible occurrence of complications - the vaginal cuff failed three times and I had two intraabdominal abscesses then following that two bowel obstructions from the scar tissue that formed and now reoccurring formation of scar tissue in my abdominal cavity I had a minimally invasive procedure that lead to 11 follow up surgeries - four of which were emergency life saving following MY da vinci hysterectomy..."" Then, Lauren said ""Angela...I am glad I read your comment. My mom had her davinci hysterectomy November 29 2011 and she is still having complications. Her doctor brushed his hands of her. I have taken her to like 35 doctor appointments since then for help. WARNING do not have it done!""""the following article discusses the cost of the da vinci robot and also the risks of robotic surgery, etc. http://online.wsj.com/article/SB10001424052702304703104575173952145907526.html"DOMO ARIGATO MR. ROBOTOI actually had 14 surgeries and 4 or 5 blood transfusions and still need more surgery for multiple hernia repairs."georjean, that is nearly incomprehensible! i'm so sorry!!!!""http://www.escapefiremovie.com/I just heard about this film, which takes its name from a book by Don Berwick. I sure hope it elucidates what's really wrong with American healthcare and why we do not have the ""best healthcare in the world"" and rises above the political noise. Some of the subjects (Berwick, Shannon Brownlee, Dean Ornish) will be familiar to those in the patient-safety movement."Thanks for posting; looks like an interesting film.IS THIS A FILM BY THE TEA PARTY GROUP D.P.M.A?No. They certainly wouldn't be featuring Berwick. They torched his nomination.Are there any new york residents on this facebook group? Are there any families that have had bad experiences with the giant medical fortress known as new york presbyterian hospital in New York City? "Steven, please read my earlier posting about my brother. Happened at St. Vincents though not NYPH."how far back is the post12 -13 posts below yours."There are approx. 95,300 metal on metal recipients out there, and i believe it is time to organize all of us before we start dying off of cobalt/chromium poisoning. i already have written myself off as there is no help out there for us. I am planning to donate my body to science so others don't have to suffer as I have. Cobalt/chromium has no place in the human body""Hence forth I should be addressed as ""lab rat"".""That is so sad. I don't know if this is acceptable, but I listen to Ring of Fire on the radio, and one of the host's, Mike Papantonio is a lawyer whose firm is working on the hip implant case: http://www.levinlaw.com/ There is a lot of info on their website.""Been there as a matter of fact i have applied to his law firm. the problem is they only take depuy asr and i have a pinnacle. my acetabular component that has subluxed the day it was put in to almost 20 times/dayshearing cob/chrom. and as a result i have large amounts of ions in my blood and there is no medical data on the effects. i, however am under attack at every level and i am sure this is killing me."METAL SCREWS ARE MADE OF TITANIUMTHE PROBLEM WITH COB/CHROME IS SHEARING OF METAL IN THE TISSUE AND IONS IN THE BLOOD. UNLESS THEY ARE LOOSE TITANIUM IS RELATIVELY SAFE."TITANIUM IS AN ALLOY, COB/CHROM IS A HEAVY METAL POISON""I WANT TO MAKE A SMALL CORRECTION; TITANIUM IS GENERALLY INERT, HOWEVER, TITANIUM SHOULD BE CLOSELY LOOKED AT WHEN USED IN DENTAL WORK. AND FOR ANYONE THAT HAS TO HAVE METAL PLATES ATTACHED TO THEIR BONES, THERE IS A FAR LESS PAINFUL ALTERNATIVE, TRUE FLEX RODS WHICH ARE A STAR SHAPED ROD THAT IS DRILLED IN TO THE BONE AND IS INSIDE THE BROKEN BONE. AND ONCE HEALED IS REMOVED EASILY. FOR BACK SURGERY I RECOMMEND B.A.K. CAGES. THEY ARE IMPLANTED THROUGH THE ABDOMEN AND DON'T REQUIRE CUTTING THROUGH THE DEEP MUSCLES OF THE BACK.""I have another topic. What standard of proof does your state require before imposing discipline upon Medical professionals? I recently received a letter from the Virginia Board of Nursing positing that the standard is ""clear and convincing evidence"" which is a really high standard-- nearly the standard you would need to convict someone of murder. I have spent the evening going through the regs, the laws, the case law. There is absolutely no legal basis for that high standard. I also looked at the Virginia FOIA laws and once a case is closed, its fully subject to public disclosure. Letter saying I could not get the info I requested was wrong. Here is a good court case explaining why the lower standard of proof is appropriate. http://caselaw.findlaw.com/wa-supreme-court/1368417.html"In Texas the standard of proof is high. It states that we must prove that the healthcare provider did what they did with willful and wanton negligence and that we had to prove the mental state of the physician or healthcare provider at the time of the injury or death. The Fort Worth Court of Appeals notes that it is doubtful that an expert report would ever be able to contain an opinion regarding whether the doctor or healthcare provider acted with willful and wanton negligence. It also states that this standards effectively codifies a lower standard of healthcare for emergency medical care.Is this for malpractice or for removal of license? It's just crazy. Don't these legislators have kids that might get brought to the ER? "this is for malpractice but if you can't prove it or if they don't report the adverse action then the removal of license is not going to happen. this is the problem with the National Practitioner Data Bank which is this secret data base that keeps all these doctors histories secret, but it is the responsibility of hospitals to report the doctors but they don't. In my daughter's case they did not tell anyone she had died. It has become a web of deceit.""that seems to be just the heart of the problem. Everyone wants reports but nobody wants verified data, so the hospitals just lie with no consequences"You don't irradiate loose metal. It can fry things."That's why the consent forms ask if you have any loose metal. But oh wait, this whole darn thing was done without consent.""debra, you hit the nail on the head!""It just seems to me that having a license to practice as a medical professional should not require ""clear and convincing"" evidence to revoke. It's a privilege and if anything, continuing fitness should be the onus of the licensee, rather than the onus to prove conclusively not on the licensor. Can you imagine if the same standard was for revoking the licenses of drunk drivers?""Marshall Allen, In the patient harm questionnaire, I said No/Uknown to medical records altered, I have just now Validated that my medical records have most definitively been altered.""My angel Dr had updated her records to reflect this - As I have been scanning all my medical records I just came across something of great concern. Up until this very minute I was told I had a Laparoscopic left nephrourecterectomy. Why did I just find an Operative Note like this - ""She underwent a ROBOTIC ureteral nephrectomy with lymph node dissection."" My doctor never ever discussed ROBOTIC with anyone and I NEVER gave consent for ROBOTIC anything. From my research I know now,this is something Dr Castle promotes and is very very involved in."UGH! Sorry I don't know her name but a health journalist from the Chicagi Tribune has been investigating some of the surgeries that fudged about informed consent. With some searching might be able to find her.Claudia Kim Nichols Is it Deborah Shelton? Possibly. Or she might help direct to the individual investigating."OK - I'll make that change, Georjean."Interesting google search term - davinci robotic surgery erik castle"Here are some more questions. The Medicare State Survey Manual indicates that complaints should be elevated if the patient is able to get publicity. Is that fair for those who are less well connected? ""If a complaint is especially significant, sensitive, or attracting broad public or media attention, the SA informs the RO immediately. PFW `""http://www.cms.gov/Regulations-andGuidance/Guidance/Manuals/Downloads/som107c05.pdf. So, if you are an owner of the Sun Times and a friend of the president, you get immediate justice. If you are a regular person, you don't. http://articles.chicagotribune.com/2011-0414/business/ct-biz-0415-uofc-tyree-20110414_1_medicare-and-medicaid-servicesmidwest-business-group-medical-facilities.""Dennis Quaid, do you think that it would be right that because you are famous, something would be done about what happened to your kids, but if it were someone who was poor, uneducated and without resources, Medicare would pay less attention to it? How would your feel if you knew the hospital had made the same mistake many times but because the victims were not connected with the media, it went unaddressed?""I guess that when we have problems with a hospital, we don't need to hire a lawyer, we need to hire a publicist. Anyone want to ask kathleen sebelius about that one. email address is [email protected].""I'm just glad I am not driving people nuts. The hospital Mom was at made us take care of her 24/7 in the ICU, I got the night shift, so between moments of terror when the oxygen tube would fall apart, I would try to be quiet. So, I started reading the Medicare regulations, and the guidances and the manuals. I think I have read most of it -- doesn't mean I remember it all. So, I am posting what I remember that I think folks would like to see. We get the same response from Sebelius too, but sometime we also get a letter from the person we complained about asking us not to bother the secretary. So, at least someone at Medicare is experiencing some momentary annoyance.... Gotta take your wins . I bet that if Marshall Allen or Charles Ornstein emailed her, they would get a response, because they are important people. The manual says so. I bet that if Dennis Quaid emailed her, he would not get just the form letter. I bet he'd get a real letter. Who thought that when you went to the hospital, you needed to bring your own publicist with to deserve being kept safe?"the immediate jeopardy one I just posted should have much fodder.It would be interesting to see if there is a single person with a serious injury who has had a positive experience with this process.I removed my comment - I am too tired tonite and will attempt again tomorrow. Thanks for all the info. I don't suffer from cognizant dissidence I suffer from PTSD - it's been like a war to survive the insults heaped on top of injury."Big hug Michelin Anderson, it is a WAR innocent victims abused by the medical system.""I am very interested in this subject as my brother Scott was diagnosed with stage 4 tongue cancer after working at Ground Zero. He elected to be treated with targeted radiation via linear accelerator. A risky undertaking under any circumstances. A computer error and inadequate monitoring allow the machine to blast Scott with Chernobyl level radiation; not just at the cancer but his whole head and neck. After several year of brave survival, Scott passed away in 2007. His autopsy was attended by Army surgeons who were interested in the effects of such devastating radiation and it was a rare opportunity for them as this level of radiation doesn���t occur very often.His plight (and that of many others) was documented by a series of New York Times articles. These articles led to Congressional hearings and subsequent reaction from the FDA and the radiation equipment community.I have pulled together a list of articles collected during our family���s (and Scott���s last wishes) to see that some good came from this tragedy. While benefits are slow in coming, I do believe some improvement have been made but there is much left to do." http://www.nytimes.com/slideshow/2010/01/24/us/20100124RADIATION1_index.htmlMy Dad testifying in front of Congress. http://www.nytimes.com/2010/02/27/health/policy/27radiation.html?ref=waltbogdanich# "Hi Cary Parks, thanks for sharing your story. So sorry to hear about your brother's tragic death. That was an important series of stories about radiation in the NYT.""Thanks, Marshall. Will continue to post the library of articles for resource material for this group."FDA and equipment manufacturer reaction to Congressional oversight."Radiation Bills Raise Question of Supervision http://www.nytimes.com/2010/02/26/us/26radiation.html?ref=waltbogdanich&_r=0"Sorry that the links aren't embedding properly but they will go to the appropriate article."As Technology Surges, Radiation Safeguards Lag http://www.nytimes.com/2010/01/27/us/27radiation.html?ref=waltbogdanich""F.D.A. Toughens Process for Radiation Equipment http://www.nytimes.com/2010/04/09/health/policy/09radiation.html?ref=waltbogdanich" "Safety Features Planned for Radiation Machines http://www.nytimes.com/2010/06/10/health/10radiation.html?ref=waltbogdanich""A Pinpoint Beam Strays Invisibly, Harming Instead of Healing http://www.nytimes.com/2010/12/29/health/29radiation.html?ref=waltbogdanich""Hi Cary Parks - another way to house these more permanently, would be to put them in a single document and then post them in the ""files"" section of this page. This post will get buried as other people post and comment on things, but having the links to the stories in the files section is a good way to keep them more permanent."How about both? I agree with it getting buried and the file section is a good repository but I was hoping to stimulate some good conversation but posting en masse right now. Is that okay to do both?"F.D.A. Urges Two Steps for Safer CT Scanshttp://www.nytimes.com/2010/11/09/health/policy/09scan.html?ref=waltbogdanich" Assorted articles about overuse of radiation."Medicare Claims Show Overuse for CT Scanninghttp://www.nytimes.com/2011/06/18/health/18radiation.html? ref=waltbogdanich""Bad X-Rays Found Again at a Brooklyn Poor Patients Rights Connecticuthttp://www.nytimes.com/2011/04/13/nyregion/13radiation.html? ref=waltbogdanich&_r=0"One more to post but hit my NYT limit at work. Will post the last article from another PC and also post to Files for long term resources. "Marshall, thanks for starting a valuable social project. I believe that this resource can give rise to a constuctive dialog that can include the public and the medical community for the common good of us all.""Also, I am prepared to go outside this country for care.""who would have thought this necessary... i know so many people, including myself, who are right there with you.""The bottom line is that you (patient) has to be completely involved in the entire process from care....and post surgery. I was left in a post op room after surgery and was trying to talk for help, the nurses were discussing the night before when they partied, what they wore, etc. I couldn't believe it, they acted annoyed when they heard my request for help....scary I say to be prepared for all aspects of your care.""Another good reason to enlist a professional or family Patient Safety Advocate to monitor for best-practices patient care 60 minutes per hour. And have your comfort, safety and involvement given the priority it deserves as a paying consumer of healthcare services.""Doctors need to make room for disagreement with patientsby Ishani Ganguli, MD on September 17th, 2012in PhysicianWhile our dad was in the hospital last winter, my brother shared with me his strategy for talking to the doctors we encountered ��� an approach honed over ten years of marriage to an internist and dozens of pediatrician visits for his two little boys. He asked smart questions that used medical terms to earn their respect, he told me. He was appropriately deferential, admitting his lack of clinical experience. If he disagreed, he gently offered empirical evidence to support his argument and then hoped that the doctor listened and didn���t get defensive.That���s a tall order, even for the savviest of patients.I���ve written before about shared decision making: the idea that for medical decisions in which there is no clear right or wrong answer, doctors and patients should collaborate on choosing a path that best fits the patient���s preferences. The success of this approach rests on the ability of patient and doctor to have a frank conversation. But this has been historically difficult and a study that was published last week in the Archives of Internal Medicine helps explain why.California-based researchers surveyed 1340 adult patients about a hypothetical scenario of deciding on a treatment for heart disease. Almost all of them reported that they���d be comfortable asking their doctors questions about the options (93%) and stating their preferences (94%). Good news so far. But only 14% said they would tell their doctors if their preferences clashed with the doctor���s advice ��� not because they couldn���t express this disagreement, the survey results suggested, but because they felt it was socially unacceptable to do so and wouldn���t end well. Many feared being seen as a difficult patient; others worried that they would hurt the doctor-patient relationship or would get in the way of their care.The part that most struck me was that factors like age, income and education level didn���t predict a patient���s willingness to disagree (neither, for the record, did the existence of true heart disease, extent of their medical issues, or race). The only predictor of voiced disagreement was a general preference for making one���s own medical decisions.In the clinic where I practice, most patients are Massachusetts General Hospital employees. While their jobs range from cashier to cardiologist, their education levels and health literacy tend to be above average. Yet, I���ve seen many of my patients fall into the same traps described in the study. Though they often have the background to say ���I���m sorry, I don���t mean to be a difficult patient,��� they still worry about being one.It���s an important reminder to myself and other doctors to make room for disagreement: To ask, explicitly, what is your preference? And then to say, explicitly, it���s truly up to you.What have your experiences been? How do you make your preferences known, especially when they are at odds with your doctor���s recommendations?Ishani Ganguli is a journalist and an internal medicine-primary care resident who blogs at The Boston Globe���s Short White Coat, where this article originally appeared. Tagged as: Primary care""Yes I agree with letting go of doctors who can not and will not treat what needs to be treated. One of the advantages that I had was that I had a background in medical coding and billing. I knew the medical terminology that was being used and if I didn't I looked it up. Having knowledge of what is going on is going to protect you and your loved ones. I had a doctor to tell me that my daughter did not have seizures by simply tapping her on her knee. I asked him did he get that from medical school because he did not even take an Cat Scan. This is the problem we are facing. You know more about you or your loved ones more than the doctors and I made the doctor understand this is not about your degree but it is about my daughter's life. I know what she need and since you don't pay for it, give her what she needs. If that was not accommodated, I found someone who would." "Our Governor was joined by Senator Jane Nelson and State Representative John Zerwas. Would you think this is a conflict of interest since he works for Memorial Hermann Hospital, a board member of Memorial Hermann Hospital making over $850,000 a year and he was appointed by the Governor over the Appropriations Committee who funds any bill, resolution or state agency, and the Health and Human Services who are supposedly protect public health. How is that possible when you have this web of deceit.""This is what they call Agency Capture-John Zerwas is one of our State Representatives, but he also sits on board of a hospital in Houston as well as being appointed over two state agencies. Appropriations Committee who is responsible for funding any bill, resolution or state agency and The Health and Human Services who is responsible for the protection of public health. He is a board member, an employee of the very hospital that was responsible for my daughter's death. But look at the convenience of him being friends with the Governor who supports the ""Tort"" Reform."they don't want you to see this I guess. Sounds like an interesting movie.If we can get 5 funders in the next 2 hours we will break the record for the most backers on Medstartr and help pay for food and transportation for patients at the Partnership with Patients Summit! http://www.medstartr.com/projects/35-the-walking-gallery"Whoo Hoo even patients need to eat..Glad to help How did we do? I pushed it out to my 5000 followers on twitter and it looks like we go over $10,000"Great Work!!!!Now lets see who can figure out the million dollar question: HOW DOES SOMEONE RECEIVE HEART SURGERY by MISTAKE? Examine the medical record"I wanted to share this with you: https://www.ctlanet.org/index.cfm?pg=Case%20of%20the%20Year"please watch the first video."watched the first video. it's good that this family was compensated with money as they certainly deserve it. however, no amount of money will ever make up for the horror and injustice of what was done to them! this did not happen via a mistake. it was intentional and so was the cover-up. those responsible should be behind bars!""Oregon got $1.9 billion federal funds to revamp its Medicaid program. One foundational idea: pay doctors for the quality of health care they provide, rather than the quantity, and eliminate expensive care that doesn't improve health. The article below has more from Oregon's governor on how they plan to do it.What do you think: will it work? What kind of obstacles might they face? Do you know of other states with similar models?""It's interesting that they hope to make their biggest savings in reducing hospitalization of people with chronic conditions that can be managed at home. Not a bad idea if the planning is done right and the necessary resources are in place -- an important ""if."" I do feel a lot safer at home than in a hospital, especially from infection. And I get a lot more rest. Very hard to sleep in hospitals!""Very interesting policy proposal. One item that might be difficult for them to address is rare diseases. It is one of the really weak areas of having Medicaid coverage because most state medicaid programs limit coverage to providers within the state. If you live in NY, that might not be a big deal. If you live in Rhode Island.... not so good. While rare diseases may sound like not a big deal, about 10 percent of the population has one, and they tend to burn through money like wildfire. Expensive drugs, lots of missteps in management. Lots of fancy tests. And avoiding them is often a function of traveling to someone who is highly specialized. A second issue is access to diagnostic services. If you are poor and on Medicaid, you can get access to diagnostics are hospitals, and hosptials tend to have easy access to public transportation. Lab Corp, Quest, not so much. An easy area for cost control is using lower cost, high volume, often not accepting of insurance, radiology centers. A head MRI at a no-strings MRI center is $350, at a hospital the same one is $6000. i wonder if they will be able to shift people to lower strings and therefore lower cost medicine providers. One of the reasons why you need to go to the hospital is to get access to the better radiologists, but then you gotta have the high cost scan there.""Another tough issue to address is the high cost of infrastructure. Every hospital has to have the latest and fanciest of every piece of equipment, even if they aren't very good in that specialty and someone else across town (or across the state) is. how do we stop the arms race -- not ever hospital in town has to have the most fancy heart surgery equipment -- it would be more efficient to have the patients who need it ambulanced or air lifted to the place that is good. but that would mean that hospitals have to admit what they are good at and what they are not...""Please call in and join in on the conversation tomorrow 7:00 PM CST. The number is (646) 7164367. You can also go to www.kingdomviewnetwork. com and scroll down to ""LIFE"" Radio Show."http://www.sunnewsnetwork.ca/video/swiss-health-care%3A-a-model-thatworks/1847969109001"Congratulations! Today we���re launching a section of our ProPublica website that���s a direct outgrowth of the success of this Patient Harm Facebook group. Your ongoing conversations about the harm you or your loved ones have suffered while undergoing medical treatment are generating a lot of interest. We can see that by the more than 900 members that have joined the group, among other things. This group has raised important issues that warrant further investigation and brought a much-needed patient voice to the discussions about holding health care providers accountable and protecting patients. This Facebook group is not going to change. It will continue to be a forum for people who care about patient harm to encourage one another, share their stories and offer resources and advice. The ProPublica site���s Patient Safety section -- named in part to be search engine friendly -- brings the conversation about this crisis to a wider audience. We���ll feature topics that arise in the Facebook group, a blog that examines relevant topics, interesting stories and studies and interviews with patient safety experts. Some of the posts came straight out of this group. See Helen Haskell���s recommendations on what to do if you���re harmed, your Q&A with Rosemary Gibson and Patty Skolnik���s recommendations on ���how to play in the sandbox with others.��� (As we move forward, you���ll notice additional cross-posting of content between the Facebook group and the ProPublica site.) We appreciate your participation in both venues. We hope that you���ll continue to contribute to the Facebook group, and also offer your insightful comments on the ProPublica Patient Safety site.""I can see the next thing I do is donate money to help support your good works. Bravo, guys.""Thanks much, David Eric Hancock!"by the way... excellent interview with marty makary marshall allen!"Thank you, Robin Karr.""From the book ���Unaccountable: What Hospitals Won���t Tell You: and How Transparency Can Revolutionize Health Care,��� by Marty Makary, M.D.���If you want to see a hospital jump to enact large-scale reform, just watch when a journalist cracks open the story of bad medical care. I���ve never seen hospital administrators move as far as they do when their public image needs repair. It���s the code blue for hospital administration.���""Too bad that's the situation! With the education prevalent in the medical community, one would think they would understand the concept of proactive being better than reactive." This looks like an interesting story. Something I'm adding to my reading list.Oh my god!truly despicable."From the doctor who wrote this book: ""All doctors make mistakes. Some are preventable and some are not. But when every doctor knows a doctor who should not be practicing, it speaks to the closed-door culture of medicine.""""you know as much as i am angered by what my former doctor did to me on purpose, i'm also reminded of the many good, decent, caring and ethical doctors who have helped me during my life. i guess it takes one bad apple... having said that, reading portions from 'unaccountable' has also reminded me that there are ethical doctors among us because one wrote 'unaccountable'. it's a shame that the many good doctors are all but helpless when it comes to reporting those doctors who harm. the 'good ole boy' system in place in the medical world needs to go! and it needs to go yesterday!"I am happy with all these people speaking up and all the new jobs being created to provide statistics but it also angers me because it just seems like a lot of talking right now and a new business being created but I see very little help being given to people who need it and very little change...... Albany Times Union reporter blogs on how transparency reduces med errors - while for years her paper has ignored 100s locally http://bit.ly/U8DP9B"The manuscript regarding setting standards for MRSA Surveillance (published in the Journal of Patient Safety) is now FREE ACCESS. http://journals.lww.com/journalpatientsafety/Fulltext/2012/09000/A_Perspective_on_t he_Evidence_Regarding.6.aspx""���Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help.��� 1"agree shannon that the importance of good communication between doctor and patient cannot be overstated!Medical professionals are oftentimes accused of having poor bedside manner due to unintentional nonverbal cues that are sent to patients."Amanda JointCommission, here is another question for you, in the hopes of a meaningful dialogue. The premise of the Joint Commission is that hospitals are better served by having a third party provide a thorough review of what hospitals do -- to audit, inspect, to make recommendations, and see if those recommendations are implemented. Why then does the Joint Commission not release its data? Using that same logic, would not the Joint Commission do a better job of oversight if academic patient safety researchers, the press, patients and the government could review what the Joint Commission is doing, what its strengths are and what its deficiencies are? Wouldn't it be a better, stronger organization if it adopted the same transparency that it expects hospitals to provide to it?""The Joint Commission is only concerned about their self serving accredition . They are a Joke and lacks any sort of mediation or transparency. You make your claims, the provider answers them and the case is closed. As a patient or surviver, you have no opportunity to see their response or contest it. This agency is just the chior for medical malpractice and Hospital Acquired Infections caused by providers.""Marshall Allen. Given that the Joint Commission has ""deeming"" authority, and there has to be medicare approval of that authority, has anyone ever done a FOIA on Medicare's approval? Has anyone argued that the Joint Commission is exercising an inherently governmental responsibility (determining which contractors quality for contract with Medicare) and therefore should be viewed as a federal agency for the purposes of FOIA?""Here is the FAR regulation defining what actions must be done by government employees (not contractors). https://www.acquisition.gov/far/html/Subpart%207_5.html. By giving the JC ""deeming"" authority, I think that the JC is perfoming the inherently governmental functions of acting as a source selection board, awarding contracts, administering contracts, and terminating contracts (if the JC were ever to do so). I believe that their authority could also be covered by the following: (14) The conduct of administrative hearings to determine the eligibility of any person for a security clearance, or involving actions that affect matters of personal reputation or eligibility to participate in Government programs.(15) The approval of Federal licensing actions and inspections. It seems to me that if the JC is performing government functions, it should be subject to FOIA."We so often minimize listening by saying we ���just��� listened. "http://www.bloomberg.com/news/2012-09-17/superbug-vaccine-tested-by-pfizer-glaxozap-deadly-staph.htmlWe need new ways in which to prevent MRSA infectionsand I hope that there will be a vaccine some day. I was interviewed for this article.""I'd like to share my story to see if this happened to anyone else. I have suffered from GAD and panic disorder since I was 12. I have been on and off meds since that time. My husband I decided to try to get pregnant and I was weaned off of what I was taking at the time. Panic attacks started to resume 3 months later and I spoke with my obgyn to see if there was anything I could take. He suggested Wellbutrin. After 1 week of taking the drug, I experienced the worst panic attacks of my life, constant shaking, a fear of eating, leaving, the house, even just a fear of my house. Completely irrational thoughts. This began almost 2 months ago. I spent 3 times in the ER and was admitted for one night. Every medical professional I have spoken too has said that someone with my medical history should never have been prescribed this medication. I am recovering now taking several medications but lost over a month of my life to complete terror. I'd be interested to know if this happened to anyone else and what they have done about it.""anne marie, i'm very sorry for what you'e going through... you might want to contact a psychiatrist (who can be trusted) and ask about this. i've had my own issues with xanax and the like but don't know how to advise you. i would suggest writing to dr. peter breggin. i've been following him for quite a while. he's written some excellent books on the subject of psychiatric drugs/withdrawal. https://www.facebook.com/pages/Peter-RBreggin-MD/290410539778"http://breggin.com/index.php? option=com_content&task=view&id=296&Itemid=129Yes with the help of a psychiatrist and counselor I am recovering. Thank you for the comment.You WILL get better with proper medications...are you still pregnant?"Question 2. These are the instructions for State Surveyors and Medicare to assess Immediate Jeopardy. http://www.cms.gov/Regulations-andGuidance/Guidance/Manuals/downloads/som107ap_q_immedjeopardy.pdf. The rules are very clear that only ONE patient has to be affected. Starting at page four, there are listed the triggers for immediate jeopardy. Mom's medical records unambiguously document Triggers A, B, C, D, E, F, I and J. What does AHRQ propose to ensure Medicare follows its own rules? What remedies should there be?"Noel Eldridge isn't going to answer. We are little people."But I will say this Marshall. We have been working with a reporter and our congressman for some time. Probably one of the most maddening part of the process has been that we would call and call and call and write and write. Not even people who were that high up. Most of the time, they would not ever return the communication. For months. In the rare instances where they did, the response was venomous that we would expect accountability, that we would question what had been done. Literally, why are you bothering us because this won't bring your mother back (that one is in writing, from one of the organizations responsible for helping us get her out). And our letters were always professional, filled with citations to legal authority, and with reference to included medical records. The reporter would get instant responses. People called him back. they were polite to him. the same exact people. Things we had been asking for for months would be addressed in hours. Same deal with the congressman's office. the person in reference was tagged for a response and dropped the group within 24 hours, without providing a response. i have worked through many other questions with federal and state agencies. Usually, I find regulators to go out of their way to be nice. Usually, the higher up you go, the more responsive people are. Not so with the medical community. A while ago, you wrote about all the nice doctors etc. Keep in mind you might get treated differently because you are a reporter.""Hi Debra Van Putten, you're absolutely right that reporters are treated differently than patients. It's not right, but it's the reality. That's one of the fundamental reasons that we created this Facebook group -- to bring attention to the injustices suffered by patients, bring attention to the issue of patient harm and give patients a voice. This also underscores the importance of engaging the media on these stories. It's sad that sometimes it takes media attention to get medical providers to do the right thing, but it's common. I am certainly aware that reporters are not treated the way patients are and would guess that other journalists know this, too.""Actually, I am going to amend that. About a year before mom's death, mom changed part D providers and there was a problem with one prescription. We tried 1-800 medicare and that was useless, but we contacted the same person who we contacted later. In that instance, there was a problem with the computer programming with a subcontractor that could not be easily remedied. It was discovered, an interim fix was implemented and dad never had a problem with getting that med again. So, Medicare is capable of managing its contractor and subcontractors. It's just hospital oversight is the third rail.""when I was able to talk to someone from the Regional Office in Philadelphia, the officer responsible for Mom's investigation said to me that I shouldn't be complaining because after all I was a Republican (my contribution history is shown on HuffPo) and after all I was in favor of small government and this is small government. And then she told me i could hire an attorney, call my congressman or talk to a reporter, it didn't matter, this hospital would be held accountable over her dead body. I understand how the world works. But it really seems to be that it is one step too far when government employees are crystal clear that justice is for sale to the highest bidder.""So, we called our congressman and called a reporter.""the congressman's office made the Regional Administrator talk to us. She claimed that she thought mom being starved was ""new information' and was promptly disabused of that. She promised to make this her ""top priority."" That was May 31. Radio silence except for the letters we get when we complain to Sebeliius. We're up for our third run at the administrative editor today on a news story. The story keeps getting longer every time it gets kicked down with more questions, so we guardedly have our fingers crossed. Prayers are always welcome. We had seven findings of immediate jeopardy at the state level, and that is the only report in the official state files. The only version of the report in the records at CMS has those findings mostly scrubbed with no action being taken. Don't know who changed the findings, but I sure have my beliefs."And medicare sure was perturbed that we got both versions of the report. How that happened was priority one for them coming off of the phone conference.We (and the reporter) filed Freedom of Infornation Requests both with the state that did the investigation and with Medicare. This describes the Medicare FOIA process: http://www.cms.gov/center/freedom-of-information-act-center.html. The state agency should have a similar request page.QIO is not subject to FOIA. That is the really bad thing about this system is that it is set up to bury any negative finding. "there are basically three entities that do reviews. The Joint Commission, QIOs and State Survey Agencies. The Joint Commission publishes no information (even while flogging patients that they need to take charge and promoting patient involvement) and the QIO is also a black hole. Only the State Survey Agencies are accountable. What is really bizarre is that QIO can make decisions on what care is reimbursable, yet the patient has no due process rights. In our instance, if Mom had lived, that would have posed a very serious problem for them. Mom had run through about half of her compensable days in rehab taking care of hospital caused conditions. She had alot more need for rehab and only thirty days left -- not enough time. We would have had to keep her out of any health care facility for sixty days to have that reset. Otherwise, Mom and Dad would have had to pay out of pocket. So, Mom and Dad actually had a probably six figure interest in the resolution of our complaints, but ZERO due process -no right to be heard, no right to contest.""Going back a half dozen or so posts - to the phone conference with CMS Regional Administrator and staff - I think Debra's characterization of ""perturbed"" is kind and generous. In actuality, both during the conversation and subsequent review, it was obvious that CMS was FAR more concerned with how it was that we could have gotten copies of the disparate versions of the onsite hospital inspection than they were of the actual allegations of patient abuse, torture and denial of civil rights.""I would also ask for the Form 2567 (I don't know if they are the same). We sent in a letter, but the system is automated and there is no reason that I know of not to do it electroncally. In fact, it might be faster.""Here's the Medicare sample FOIA letter. I think we asked for all records related to a complaint about X hospital pertaining to [Mom's Name]. and then we asked specifically for the Form 2567, and you can ask for the citation notice and anything else you want/. The email address is [email protected]. If you are asking about a http://www.cms.gov/Regulations-andGuidance/Legislation/FOIA/Downloads/FOIARequestLetter.pdf If you are asking for a deceased person, you need to include proof that you are the executor and there is a different letter: http://www.cms.gov/Regulations-andGuidance/Legislation/FOIA/Downloads/FOIARequestLetterDeceasedBene.pdf. We used this letter and the first time we got a denial because they said they did not think the form of the request was appropriate. We wrote them back and told them it was their form letter, so fix the letter. So, if they are stupid, don't be surprised.""In fact, there is a really good reason to send it to the national center (ie. email). When we did the FOIA, apparently the PA Regional Office has a policy that program officers (not FOIA officers) have the authority to answer FOIA requests on their program. Of course, the investigator I had had problems with got the FOIA request and once we made them answer it, it was short alot of information. When we insisted on a national office review, we got more information.""Still again I ask how do people get a reporter to listen and look at all tje documentation. I have tried with no luck, and everytime I try on my own all I get is road blocks because it is Mayo the great. If they are so great how does a patient have surgery and lay in pain for 2 days in the hoapital and noone helps or monitors anything until I look my husband in the eyes and tell him I am dying and he finally got the attention of general surgery to help but I was already in septic shock. Pretty sad. I also was released way to early after being in ICU on life Support because urology didn't want me there over 30 days. I remember being so sick at home but scared to death to go back to that hosp. My husband talked to the general surgeon that saved my life and she promised she would handle my care if he brought me back and she (my angel) would not let anyone but herself release me home again until she was confident I was ready to go. She was also the one that contacted CDC. She immediately had me back in surgery to open my left flank to drain more stuff. Thankfully my angel had small hands to get into the small spaces no one else could have. She explained everything to me so clearly and always held my hand. Ok this is were the tears start and I can't see to type."You would think I would be remembered well as the topic for discussion was I was only the 2nd person to be in the hospital so long the 1st longest was the man on a heart machine that my family got to know well. I was actually referred to as Lazarus and stayed in the room Barbara Bush stayed.Maybe someone could pull the stats for longest hospital stays and reasons why it was so extended. Also look for concurrent stays with admit/discharge within 2 week or 30 day period. Review billing codes and start flagging in payer systems."Yes, Veronica James?"I figured that's what you meant. The truth is we read and take into consideration all of the things that are posted on this site. But I'm also pretty consumed with the things we're working on so don't have the time to pursue every idea. Hopefully the other reporters on this group are tuning in so they can pursue the many good leads."Veronica, working with a reporter has been an eyeopener (and we don't know if we'll make it across the finish line.) This has been a seven month process. We were fortunate because we knew someone because my nephew had been the subject of a human interest story a couple years ago. We were fortunate because we had a distant relative working in our congressman's office. The reporter we have worked with has easily put in 500 hours on the project. The guy is a local beat reporter and he has completely busted his butt. He has reviewed all of mom's thousands of pages of medical records. He has talked to every organization several times. It is not a small project. We have extremely clear medical records. As unhappy we are with some people for not stopping things, they did leave an unambiguous paper trail. Even with that, it is a tough story. Lots of complicated concepts. I used to be a writer by profession and I could not put something this complicated together in such a short space. It has been an emotionally difficult process for us, because it has been a roller coaster. It's part of why I took such offense to the rule that says that if you have gotten press attention, we will pay more attention. And we will answer press questions, but not family questions. We should not have to have the press basically do the investigators' work for them in order to get justice or to get basic questions answered. That is not the role of the press - to do a first cut on the government's job. Maybe they do it once in a while, but justice should not depend on it. It is a huge amount of work to make something a publishable story.""'We should not have to have the press basically do the investigators' work for them in order to get justice or to get basic questions answered. That is not the role of the press - to do a first cut on the government's job. Maybe they do it once in a while, but justice should not depend on it.' agree debra... i'm glad there are sites like this one but we should not have to look to them for remedy/justice for patient harm.""I most certainly appreciate it as well. And I really appreciate the help we have gotten thus far. but it is certainly no substitute for a functioning system. The hard thing is that it seems nearly impossible to get the hard questions about why the system isn't working asked, much less answered. At this point, we don't want an ounce of sympathy. the person who deserves it most is gone and will never hear it. And she got zero from anyone when she needed it most.""This morning I was at work when this series of posts started. My experience with patient safety topics is mostly from working in the Department of Veterans Affairs for almost 10 years, and the CMS rules don't pertain there so I don't know much about them. You might want to contact the HHS Office of Inspector General at www.oig.hhs.gov or Hotline Number: (800) 447-8477 & Hotline Email: [email protected]. AHRQ does very little regulation and has no authority over CMS. I'm not avoiding responding to anything I might be able to provide an informed opinion on. One way to understand what those topics might be is to Google my name and the phrase patient safety, as follows: Noel Eldridge ""patient safety"".""Been there, done that. got chewed out by Jennifer Trussel at HHS OIG that she didn't have time for this whining after she went to the extraordinary lengths of calling the lady in the Regional office who tanked the investigation in the first place. That lady of course said she had done an exemplary job and Jennifer thought that constituted an ""investigation"" on her part. she had 250 pages of medical records contesting the original ""investigation."" Thanks for responding though. It's nice to see someone from HHS pays some attention."And I have now looked at your published stuff and its right on. The roadblock being serious implementationLooks fantastic!"A reporter at the Albany, NY Times Union defends the newspaper's noncoverage of medical-malpractice lawsuits. http://www.answersforlisa.blogspot.com" http://www.nationofchange.org/how-doctors-and-hospitals-have-collected-billionsquestionable-medicare-fees-1347804104I just want to let everyone know that one should never give up hope. I just spent the weekend with the NYS hospital trustees from 175 hospitals. They were so engaged and thankful for having a face put on their work...these are the influencers wea are all making a difference.that's all many of us have left... 'hope'"Robin,Please try not to lose that. Thinking of you. Patty""i decided to tell my own story and not worry about waiting until i get to court one day or until a reporter somewhere writes about it. i'm redoing my web site now to reflect my true story and my real name and the real names of those who purposely harmed me. i've spent the last five years of my life connecting the dots..... those who harmed me weaved quite a tangled web of deceit and lies. i untangled it though - piece by piece. it does no good to untangle the web and connect the dots unless i reveal what i've learned. please take the time to read 'my story' and the supporting evidence i've posted which substantiates it. i'm not done but i have a good start at least. also, please share my web site with women you know and care about. thank you. http://www.hysterectomyconsequences.com/my_story"I am SO PROUD OF YOU!!!! <3"I AGREE ROBIN - I just told my husband a couple hours ago that is probably the only option we have. It not only is my story it is also my husband - Mike Parrish, my father,brothers and sisters, children - Christopher M Monarrez Sr., Thomas , Daniel and Angela Marie Jones, and many grandchildren - That have been through this with me since that awful day DEC 17, 2008 - They have all had a tough time with no answers or accountability. And the anger of finding out in my medical records that all the days the doctors lied and told them I was in a medically induced coma, BUT THEY FORGOT TO MENTION THAT I HAD DAILY A 3 HOUR ""MEDICATION VACATION"" from 5am 8 am - right before visiting was allowed in the ICU. I remember waking up daily and seeing 5 on the clock but it was dark and I didn't know if it was day or night and kept asking for my family and they said they would be here later, but for me later never came day after day, until one day my husband said we had a good conversation the day before new years and he was looking forward to a GREAT NEW YEARS until he came back to see me the next day and the meds were turned up - he immediately went to complain to my general surgeon and problem was solved I have been awake since. UROLOGY Dept was running the show thank goodness again for my angel Dr.- I hear from lawyers over 2 years kick rocks, BUT CRIMINAL BEHAVIOR and ASSULT SHOULD HAVE NO STATUTE OF LIMITATION EVER....""AND the medical records themselves will name the names, and tell the HORRID story...""I was also restrained tightly to my bed, and my husband had to keep loosening them because he said they were too tight when he came in yes I was awake just before that trying to get help... All I could see was a nurse sitting through a little window to my left."Then when my husband got there I was in a medicated coma again.i agree georjean.. there should be NO statute of limitations on assault and battery.Most impressive presentation - thank you for your thoroughness and for sharing. I have just started reading and intend to read every entry. It was not just one error - it was a series of criminal actions perpetuated by professionals. The number of these would crush most - that is what I learned from my own experience with 'today's' heathcare system. The depth of lies and deceit has to have cover from many systems - not just the medical and it is all done for only one reason. Hint - it's not safe effective healthcare. It's a business."yes michelin, you're exactly right... in my case and many others, it's not just one error - it's a series of criminal actions perpetuated by 'professionals'. it is 'crushing'! what a good word choice! there are many days, many times i feel the weight of what's been intentionally done to me via a place where i should have been safe and i feel 'crushed' by it all. if this had happened to me in a walmart parking lot, i could accept it i think - at least on some level. but to know for sure that what was done to me was 'planned' and 'done on purpose' is - to use your word *CRUSHING*! to have so much evidence of criminal activity and for nobody to look at it or care is also 'crushing'. that's why i decided to post the whole ugly truth on my own site' along with all my substantiating documentation. i realize that by doing this, i most likely will have to dismiss my malpractice case but i don't care at this point. silence is not golden for harmed patients. in fact, it's just the opposite! when we remain silent, we remain *CRUSHED* thank you for your very insightful post and thank you for using the word 'crush' to help describe the tremendous impact of 'intentional' medical harm.""You have done a noble and outstanding job of not being crushed. Very courageous and self-less. Anyone with an ounce of compassion for a fellow human being who has been medically mutilated that can lie for monetary gain is sub-human in my book - but for in the case of the supposed givers of health to perpetrate this on the entire population - no gender, age- group nor even really wealth - protects us. There is no accountability and it has gotten much worse. Those of us who have first hand knowledge and try to warn others are sometimes shunned because the facts are reprehensible, unthinkable. We are black balled by medical professionals, etc. I neglected to say to you how sorry I am that you have had this happen to you. I really admire your strength and self-less actions to save others."thank you michelin for your kind and encouraging words. we are all so broken by what has been done to us by those we trusted most - those we trusted to 'first do no harm'. http://www.youtube.com/watch?v=41yOxQu2Qdghttp://www.youtube.com/watch? v=thaAVwMJPms&list=FL5CMYoktO7rnah9eSscnpUQ&index=9&feature=plpp_video"thank you for sharing shannon. I'm very sorry for what you've endured. i've thought a lot about your story since you first posted it. what happened to you is truly horrifying. major surgery is horrifying when you 'need' it. when you don't... well, no words come to mind. it's very difficult for me to believe this was done to you purely by 'mistake'. how does a doctor perform 'heart surgery' by mistake? i don't believe it was a 'mistake'. did the surgeon who made this mistake give the money back? if he did, then i might consider that it was a 'mistake'. your story needs to be told everywhere!"the bigger problem is the INSURANCE companies keeping and promoting their Preferred contracted providers and basically mandating that if you want the better benefit you MUST use their CONTRACTED providers - when do we start to hold them accountable too."Complaining to BCBS about their doctors, and the lack of documented diagnosis/ test results, to legitimately AUTHORIZE a surgery(Left Laparoscopic nephroureterectomy,left aortic and interaortocaval lymph node dissection, right iliac and obturator lymph node dissection) prior to it being done, seems to be none existent in my case, and yes, I also have a copy of the submitted/billed diagnosis's by Mayo Clinic AZ, and never was Kidney Cancer nor any other cancer submitted until approx 1 year after the fact when I started questioning all that had happened. Then to think the people that really are sick and need surgery have to fight all the time to get services covered."Please share with your friends.sharedthe picture of you and jocelyn at the end of the video is *beautiful*"Please forward to your friends and family-Start this same petition in your state. You can use the same information, but send it to your Governor."signed deirdre! good for you by the way... please sign my petition at change.org regarding the unnecessary castration of women. http://www.change.org/petitions/help-stopunnecessary-hysterectomies-and-castrationsignedthat's the surgery that was performed on me:( it's brutal..."Agency capture has been the topic of recent media reporting. Agency capture is when people high up in certain industries go work for the government agencies that regulate the industries they are from. From the inside, these infiltrators prevent meaningful regulation and oversight of the industries those agencies are supposed to oversee. This has been used to explain why the FDA has allowed dangerous drugs and devices through without proper testing. However state medical boards are made up entirely of doctors. State medical boards have been entirely captured from the beginning. They have been able to prevent any action under the practice of medicine from being viewed as a crime. And in the actions doctors do that the public would be shocked to find out, doctors have made it very difficult to shine a light on. If a doctor rapes children or steals money from a patient's bank account, that is disciplined because those things are already crimes. Doctors have been given complete control of the classification of anything they do in medicine, and they have made sure no action under medicine is considered a crime. They have made their profession of medicine a world unto itself,and they control perceptions and prevent legislation that would punish unethical and immoral acts from entering their world.""'they have made their profession of medicine a world unto itself'... this is so true it's downright scary. i never really considered just how much the medical world is a 'another world'. it's a world where doctors do seemingly have complete control. their world operates by their rules and anyone who enters that world must submit to those rules or pay the consequences. and often, those consequences are beyond devastating.""the video is not mine veronica. i like enya too and i understand what you're saying about how the music does not seem to 'fit' with what's taking place in the video. that was my first thought as well. however... after some more thought, i decided it was probably a good choice in some ways. enya had trouble with stalkers for a portion of her life. in fact, she had stalkers actually break into her home and attack her staff. consequently, she spent a fortune trying to 'protect' herself via securing her home. i think if anyone would understand the horror and victimization women feel after having their body so brutally assaulted, it would be enya.""i understand veronica... that's how everything is for me though since hysterectomy. when a woman undergoes this surgery, nothing is ever the same. there have been many books written about how women lose their ability to create and be artistic. one gynecologist from cambridge spoke about this at a hysterectomy conference i attended in new york. he said he quit performing hysterectomies because he saw that women were never the same afterward... grass wasn't as green for them, skies weren't as blue, music wasn't beautiful, etc. and women who could sing, dance, paint, etc. before the surgery couldn't afterward. the creative desire and energy is gone forever... this is very sad but it's the truth. that's why i warn women about the consequences of hysterectomy. most doctors will never tell a woman this. a new book came out about the vagina that i believe helps to explain the connection between the vagina and the brain. if i didn't know before, i know now that there is most definitely a connection - a strong one. you really don't know until you no longer have it: ( http://www.harpercollins.com/books/Vagina-Naomi-Wolf? isbn=9780061989162&HCHP=TB_Vagina"Attended the Virginia Board of Health's Meeting today. it was a full board meeting with everyone there because the issue was whether abortion clinics should be held to the same standards as Virginia hospitals. I said my piece about what 'virginia hospital standards' mean to me. Sitting next to me was the Dept of Health staffer who has been sitting on our complaint about mom's care. He had no idea of who I was. It was the tiniest bit of satisfaction to watch his face as my name get called and see him have this bemused look on his face -- how do I know that name. and then see the blood drain from his face as he realized."More than 40 cases brought against this plastic surgeon. Daily News reports: A teacher was blinded in one eye in 2005, and a Health Dept report said the doctor tried to stop an ambulance crew from transporting a bleeding patient to a hospital. His license is finally, finally, finally revoked. Finally. http://www.nydailynews.com/new-york/staten-island-cosmetic-surgeon-robert-cattaniloses-medical-license-slew-malpractice-complaints-butchered-patients-article1.1159301""New book by Hopkins surgeon makes me even more afraid to go to a doc or a hospital than I was before. Spotlight on ""Dr. Hodad"" surgeons nicknamed for their ""Hands of Death and Destruction."" A scary read. My column today. http://www.healthleadersmedia.com/content/QUA-284447/Hopkins-Surgeon-BlastsHealthcare-Safety-Ethics"Available in book or Kindle on 9/18 - available now for pre-order at: http://www.pulseofflorida.org/BookStore.html"Wow, this looks like a great book!"Wow excited to read a must buy"Test your knowledge: See how much you remember from the Institute of Medicine's report on waste and misuse in healthcare, with the New York Times' new quiz. (Hint: You can find one answer in Marshall Allen's summary of the report! http://on.fb.me/U9pyVw)"The IOM Report makes it even more clear of the state of healthcare. Even with $750B in wasteful spending per year the average hospital still operates at -0.7% profit margin."Push back from the healthcare industryhttp://mcclearymrsaprevention.com/""This is an important post, Kathy. We need to speak up when abuse happens, not ""swallow"" it. My thinking -applied from my days of working on family violence issues -- is to stop the conversation in its tracks at the first instance, and to deal with the abuse and misaligned relationships before resuming. Reason for this is that if the abuser ""gets away with it"" the abuser no longer has to credit anything the abused person has to say -- which means, in patient safety terms -- if the advocate is abused, the advocate cannot be effective.""MRSA has a new champion!!! Richard Branson of Virgin Unite will help raise awareness for MRSA and he is producing a video with his personal meesage about MRSA and hospital-acquired infections that will be shown during the 4th Annual World MRSA Day Kickoff Event, Sept. 29th in Chicago - join us at this important event! More info at MRSAsurvivors.org and www.worldMRSAday.org" That's what you call a heavy hitter!"Ted Chabasinski is an American psychiatric survivor, human rights activist and attorney who lives in Berkeley, California. At the age of six he was taken from his foster family's home and committed to a New York psychiatric facility."just goes to show that the human spirit is capable of enduring much and overcoming much...Great amount of accurate information on Medical Malpractice.Thank you for sharing"What do you all think of this? The Agency for Healthcare Research and Quality is seeking approval from the Office of Management and Budget to test a patient reporting system for health care safety eventsRead more: http://www.ihealthbeat.org/articles/2012/9/10/ahrq-seeks-permission-to-testpatient-safety-event-reporting-system.aspx#ixzz265upd0PM""There is already a reporting system, at least for hospital events. The problem is that they don't do anything.... In point of fact, there are myriad places to report. QIO, state licensing, board of medicine, Joint Commission. If you call one, they will give you ten more numbers to call and you could spend days making complaints. The problem isn't a lack of places to report. It's the lack of anyone who will *do* something." "Debra Van Putten, I could not have said it better myself! Truth: ""There is already a reporting system, at least for hospital events. The problem is that they don't do anything.... In point of fact, there are myriad places to report. QIO, state licensing, board of medicine, Joint Commission. If you call one, they will give you ten more numbers to call and you could spend days making complaints. The problem isn't a lack of places to report. It's the lack of anyone who will *do* something.""""Could one of you reporters ask AHRQ how many deficient hospitals have been closed, have lost medicare contracts, have been seriously fined in an amount equal to the long term harm caused and hospital executives been fired and excluded from medicare as a result of patient harm in FY 2011? How many doctors and nurses have lost their licenses permanently? With 180k Medicare patient deaths per year due to preventable medical error, how is it that pretty much EVERY hospital in this country passes inspection without so much as a wimper of concern. That is 30 preventable deaths, per hospital per year -- or more than one every other week. How is it that the Joint Commission holds itself out as a quality seal of approval yet 90+ percent of hospitals get that stamp of approval with that death rate.""How many health providers get into trouble for misbilling vs. poor quality? How many chargebacks does Medicare do for coding errors vs. quality errors? How many enforcement people in OIG investigate fraud vs quality failures? Isn't the message given, you can do whatever you want to the patients but don't mess up the coding???""And here is another one for Noel Eldridge. Instead of burdening us with more complaints to make, why not have every other entity that accepts complaints make them public? Why not publish ALL of the quality related data that the government has? Why not require the Joint Commission to publish its inspection reports. why not require state licensing boards to publish complaints on their websites as well as all inspection results. Why should be have to be subject to care that would cause us to complain when you all probably know who the bad apples are already?""Today the FDA conducted a meeting (including webinar) on post-market surveillance of medical devices. Harmed patients were poorly represented. The usual suspects of industry, providers and regulatory sphere took the mic during public comment periods. The mission of the meeting was to get public comment. Short notice and the cost of travel prevents real representation/advocacy. Of course, the MedWatch #5009052 report of a failed elbow implant has never gotten an investigation. Why bemoan the lack of 'patient engagement"" when reported patient harm is ignored by the registry and there is no enforcement? Avoid medical implants to protect your civil liberties."I find the lack of engagement with the patient community puzzling as well. Was there anything sent by way of notice to the Arthritis Foundation and did the Foundation advertise it on its website? Most surely they would have a community that would likely have a strong interest. Was it advertised on facebook or other patient sites for people with arthritis. I doubt it. How about folks with heart dieseae -- another major area for implants. Bet nothing on those websites. Its not like it is hard to find the patients."Charles Ornstein, here is the AHRQ website on who to call. when mom was in the hospital, I called every single one of them to try to get mom out of the hospital that had intentionally starved her. the quality of ""help"" I got was basically to wheel her $50,k hospital bed out of the facility, hitch it to the back of my car and drive her home. And a year out, nobody has the moxie to say that intentionally starving a patient, not terminally ill, with no advance directive, is wrong. Not even the theoretically pro-life Ken Cuccinelli. Trust me, if we had wheeled the bed out with mom in it, someone would have gotten us arrested and I would sitting in jail for major theft. But when we called 911 and adult protective services, it was so sorry, we can't help you. http://www.ahrq.gov/consumer/cc/cc031709.htm. So, ""file another complaint"" is really irritating.""charles ornstein, you have been doing this a long time, what do you think of this?""Responding to note above. I don't know the details on this, sorry I can't help shed more light on it.""The comment period is open until November 9, so there is plenty of opportunity to make inputs on what has been posted. Either as individual citizens or from groups.""well, thank you for joining us!"I hadn't been looking or posting on Facebook for a few days...There is this new crabby lady who has posted tons of new stuff. Most of it is junk. But some of it is ok. ;) Thanks for returning. http://www.kickstarter.com/projects/mercuryexposure/you-put-what-in-my-mouthToday a little thought occurred to me which may have profound implications. I reflect on it at http://www.hospitalpatientadvocate.com/?p=1772http://www.youtube.com/watch? v=svvzESoMnI0"I am looking for others to join me on ""LIFE"" Radio Show to discuss those issues that we need the world to hear. Bart Windrum will be my guest on September 27th, if you are interested in telling your story, inbox me. I also have the 20th available and October 4, 11,18,and 25. Let me know, I am trying to get this out via the show."This is my story.....Please take a moment to read it and share it. Thank you in advance!! http://mymedicalsurvivalstory.blogspot.com/2012/09/khristina.htmlDeirdre GilbertDicksonHow do u inbox youI went to the URL address at the bottom of the flyer you posted. It took me to a webpage for starting an online talk show. I did a search for ProPublica and found a list of past shows. I am not sure how to listen on the day you specified."FDA 4-day public meeting on medical device post-market surveillance9/10/12-9/13/12 Harmed patients are the 'elephant in the room' and 'he who should not be named'! I tweet at JjrkChJoin the webinar tomorrow using this link: http://www.fda.gov/MedicalDevices/NewsEvents/WorkshopsConferences/ucm300724.htm" "FDA 4 day public meeting on medical device post-market surveillance9/10/12-9/13/12 The patient harm community is poorly represented but you can join now and participate by webinar. Email your questions/comments to: [email protected]""A local blogger with a large and influential following here in Albany, NY posted comments and a link to my page listing unreported lawsuits against hospitals.the blog is New York Citizen One. Read the post at: http://bit.ly/NlfY3F""Check out this site. Tell your story of medical error and sign up to be a speaker. Together the medical community can learn from our stories, and we can reach the goal of healthcare helping not harming. http://www.speakerlink.org/home.jsp"I can't get the link to work...."I just clicked and it worked, try www.speakerlink.org"Thank you Shannon Koob :) http://bc.ctvnews.ca/health-canada-mum-on-plant-inspections-researcher-1.949889 "Thank you for accepting my request, Here is my story, This news story was done 5 months after surgery.http://www.youtube.com/watch? v=thaAVwMJPms&list=FL5CMYoktO7rnah9eSscnpUQ&index=6&feature=plpp_video""Just one story, my story of a medical mistake. Thousand of people are harmed by the healthcare system. I share my story to make you aware of the dangers of Americas Healthcare system��_��_��_Shannon Koob storyhttp://www.youtube.com/watch? v=41yOxQu2Qdg&feature=my_liked_videos&list=LL5CMYoktO7rnah9eSscnpUQ""And this is breaking today too: A national project targeting central line-associated bloodstream infections has lowered overall rates of such infections by 40% among participating hospitals, according to government data released Monday. http://www.modernhealthcare.com/article/20120910/NEWS/309109950#ixzz2664Qnsm2? trk=tynt"This is as result in part of using a CUSP BSI Checklist and Best-Practices every time the central line is accessed. The Patient Safety adage is right: No one is hurt by doing the thing right.Happening now: FDA public meeting/interactive webinar on medical device post market surveillance. http://fda.yorkcast.com/webcast/Viewer/?peid=af65cdee620e418196e780a4b3f76a9c1dIM ON IT!!!we are going to picket the hospital on Sept 22."This is the same thing that happened to me and I have the same feelings as this person. http://csn.cancer.org/node/148182"scary!"i hate to say it but i think most of us who have read this story can see the elephant in the room here... this was no miracle. it's not a miracle when a doctor removes a perfectly healthy kidney! personally, i believe they needed a healthy kidney and they found one. using the 'C' word to scare a patient into agreeing to surgery they do not need is unfortunately fairly common these days. the first thing my former doctor said to me after he removed all of my healthy sex organs without my consent was 'the good news is you don't have cancer'... even though i was 'out of it' on morphine, versed and had lost a lot of blood, i knew that the bad news was *I DID NOT HAVE CANCER IN THE FIRST PLACE* so sorry georjean that you had to endure the same... :("Did you know the Corrupt group of UROLOGIST also have now created a New Profession called UROGYNOGOLOGY so the can get to more innocent women.this is another story that needs to be told far and wide - the story in the article and your story georjean... "I had conversation with a the tech at Mayo Florida and she informede that everything they see is always labled ""renal mass"" and they have no information relating to amy cancers. And directed me back to Dr Castle in AZ because he is the owner and principle investigator if Castle Labs which also has an interal kidney registry.""We need professional advocates to tell us what the doctor doesn't and ask the right questions. My hindsight is 20-20: did you consider getting a second opinion? That doctor seemed so certain your kidney had to come out. No biopsy needed he said. I agree with the last comment, ""You are better off having an objective doctor review your charts before you talk to a lawyer.""But it is a pretty naive comment. How hard would it be to find a doctor to tell YOU the truth?" "The ironic thing in my case is they did a biopsy of a lympnode becauss they told us they thought the cancer had spread to lymphnodes and lungs ghey told us I had a very advanced atags of TCC of the kidney but all biopsies before and during surgery show negative for cancers. The final biopsy of the tumor per our consent was to be done prior fo removal ic nothing came back positive they did not have permission to removs the kidney and there was never a mention of removing ureter and lymphnodes tbat they had confirmed negative biopsies for prior fo surgery. When my husband and finally got to talk to a dr (not the original surgeons) we were told the dr made a medical decision on his own to procede to remove my kidney, and his notes state he presumed it was TCC of the kidney.""while this doesn't help those here, there is actually a fair amount of good information that is available to use as a touchstone as to whether the doctor's recommendations make medical sense. Mayo has good website, NIH does. Sometimes they cover recommended treatment courses, sometimes not. One source is the AHRQ website, which has a catalog of guidelines http://www.guideline.gov/browse/by-topic.aspx. Not user friendly, but its there. Now. Some of them are really tough slogging and most are not written with patients as an audience, but you can learn alot. Pay attention to the date and who is issuing it. This is the one for kidney cancer http://www.guideline.gov/content.aspx?id=36891&search=kidney. If you look at it, partial nephrectomy is always an option. If the surgeon you see doesn't offer that as a option (or explain why it isn't), he or she may be not up to date, short on the surgical skills needed for a partial, or just wants to schedule alot of surgeries. In any case, this is a red flag for a second opinion. If you go in with some idea of what the doctor *should* be talking about, even if you don't understand it 100%, it should help weed out people who are really outside the medical mainstream.""although it may seem overwhelming, you don't need a professional advocate to help; it just takes work and patience. For me, patient support groups have been very helpful in weeding out the less ethical doctors (everything with a grain of salt of course). I know moms with only high school degrees who can go toe to toe with the top researchers in the field in a very complex field of medicine. There is much that you can do on your own hook without spending money on so called experts.""Most people including myself are overwhelmed with the idea that I will need surgery. My mind is focused on subjects about how will my life change, what arrangements to make with my employer, what will I tell people, how much will it cost, etc. Most people are not experienced surgery patients, and don't know to think to check on all these things. And if someone would have recommended I check around to see what I need to know regarding the doctors diagnosis, it would seem like a mysterious task. I would quickly forget. There should be something in place to protect the masses. How about a magazine in the grocery, ""Surgery Patient Magazine"" that would go over some of these things every month? Anybody here in the magazine business?""the problem is no matter how much you research, no matter how intelligent and savvy you may be, etc., there is just no way you can be completely sure 1) your diagnosis is accurate/correct 2) you need surgery 3) you can trust your surgeon to perform only the surgery you agree/consent to. so even if you're not completely overwhelmed for all the reasons garrick listed (which i think most patients would be) and even if you had the where-with-all to do your own research, etc., (and those are some pretty big if's), there is still simply no way you can know your surgeon will 'first do no harm'. so at best, you take a chance. you take a 'gamble' as it were. is it worth it? not to me... never again will i subject myself to the trauma of surgery and all that goes with it. like so many others, i learned a very hard lesson.. a lesson no human being should ever have to learn inside a hospital."please go back to the story on the kw record and read the comments. there are a couple that will make your hair stand on end "read the comments mary-lou... as difficult as it is, try to ignore the senseless and cruel comments. the person who continued to say such nasty things to you about wanting sympathy, etc. is filled with hate and that comes through loud and clear. having said that... most of the comments are fair and supportive of you and what you're trying to accomplish. i went through this same type of thing when my story regarding the abduction of my children was on tv in texas. everybody has an opinion..... if i were you, i would not waste my time and energy responding to the nasty comments. i would thank the people who left supportive ones. i learned a long time ago that you can't overcome evil with evil. what you are doing is honorable. there can be no question about that. keep telling josh's story. you are making a difference for *GOOD*"actually this person helps stir up interest without knowing itagree mary-lou... let them stirCannuckCol clearly has no idea of the amount of unnecessary deaths caused by the use of restraints in hospitals and by police. Its not hard to look up the information but instead he states its not a problem."I predicted this would happen. Many people would read this article as a one-off misfortune, and the character to responded negatively thought it a cheap plea to feel sorry for the victim. The message communicated should have been that hospitals are dangerous because of how they are run, the lack of coordinated communication, the erroneous assumptions, and here is an example.The journalist who wrote this article did good to expose the public to another incident of medical malpractice. But I think the author does not comprehend the seriousness of the situation is nationwide. In his attempt to look as unbiased and middle of the road, he concentrated on reporting the facts in minutia and the complexity of the close up view. The author missed the big picture.""ATTENTION: Fluoroquinolone drugs have been linked to numerous and widespread devastating and systemic side effects. Toxic side effects to the Central Nervous System, Peripheral Nervous System and the Autonomic Nervous System have been reported. If you have taken Levaquin, Cipro or Avelox and experienced any of these or other side effects lasting longer than 3 weeks after discontinuation of the drug, please contact the FQ Lawsuit Registry. One experienced Southern California law firm would like to represent you regarding your adverse drug reaction. In order to be considered for compensation for your injuries, in this class action lawsuit, you must fill out the information form provided. No information will be shared outside the legal firm. This is time sensitive. Law firms gauge interest by numbers of responsive victims affected. These forms need to be submitted by Thurs Sept. 13th. Please take 3 minutes and register NOW in order to obtain financial compensation.https://docs.google.com/spreadsheet/viewform? formkey=dGtXRnVhcjZXRzU4VGh6OEcwckJRX2c6MQ&fb_source=message"Is this site really open as free advertisement??? Please....It is not an advertisement. This is organized by people who have been damaged by Fluoroquinolone drugs. We are attempting to remove them from the general market. I need victims to register in order to include them in a litigation. It benefits the victim."I am not an attorney, I am a victim of Fluoroquinolone Toxicity."Done!Thank you fellow FQ victim."you do realize that even if you aren't a lawyer, this likely comes under the CA Bar rules on soliciting clients... And without disclosures would this would likely not meet muster. I'll tell you, I wouldn't want such a law firm representing me. Just sayin..."No need to exchange medical malpractice for legal malpractice...Debra Van Putten. are you always this nasty? Is that your medical problem?"Erin, sorry if you took offense, but this looks like an attorney ad to me. It seems that if the group is open to attorney ads, that's all that would be on here. Not much room for discussion. If you think I am being unfair, this is the relevant rule from the CA Bar: http://rules.calbar.ca.gov/Rules/RulesofProfessionalConduct/CurrentRules/Rule1400.a spx. It's a client solicitation, even if its related to patients and not sent out by the law firm itself. And it is misleading: ""In order to be considered for compensation for your injuries, in this class action lawsuit, you must fill out the information form provided."" If it were a court ordered class-action notice that really was a cut off of plaintiff rights, it would not be in this format. If it were a proper law firm solicitation, the law firm would be named and there would be disclosures and there would be tons of other information. For all you know, this is a website run by the manufacturer. The California rule is a consumer protection rule intended to keep people from getting ripped off by unscruplous attorneys. Like the plaintiffs in the phen-fen disaster. http://www.fbi.gov/louisville/pressreleases/2009/lo040309.htm. Marshall Allen?"This is accurate information on the status of Levaquin litigation. I hope it helps. http://www.mnd.uscourts.gov/MDLLevaquin/current-developments.shtml"Hi Erin - insults are not at all welcome in this group. Please refer to our guidelines in the ""files"" section. The document is called ""How to participate..."" Also, I think that Debra Van Putten was asking a legitimate question. Your post does sound like a solicitation of sorts and she was inquiring about it."google kw record to see my story"Here's the link: http://www.therecord.com/iphone/topstories/article/795298So sorry for your loss." "An Institute of Medicine report released today is an expansive indictment of American healthcare, and I wanted to get your thoughts on it.The ���Best Care at Lower Cost��� report says that waste, fraud and other inefficiencies are costing an estimated $765 billion a year ��� an amount greater than the entire budget of the Department of Defense. The report also said too many patients are suffering harm, and it���s now recognized that infections and complications that were once considered routine can now be prevented with an evidence-based approach to medicine. Those findings are alarming, but also widely known, particularly to members of our ProPublica Patient Harm Facebook Group. I wanted to get your thoughts on one of the report���s conclusions. It said the structure, incentives and culture of health care result in a lack of engagement with patients and their families, even though patient engagement leads to better outcomes across the board. Health care providers offer scientific expertise, the report said, but ���patients, their families, and other caregivers bring personal knowledge regarding their suitability ��� or lack thereof ��� of different treatments��_Information from both sources is needed to select the right care option.��� So here���s what I wonder: How does it make you feel that some the top health care minds in the country ��� the committee that produced this report ��� acknowledge the shortcomings that have been discussed at great length in this group? Do you find it encouraging? Or is it depressing that experts and reports keep verifying the problems, but the culture is so slow to change? And what do you think needs to happen to spur meaningful improvement?""I just read it. and interviewed one of the authors. It tries to foster a sense for providers, patients -- all stakeholders ��� to see fraud, abuse, unnecessary care in the context of electronic medical records, patient engagement and complications. in effect, it is the kitchen sink of what's wrong with healthcare. unfortunately, imho, it does not pave a path to assembling the pieces to fix the problem. Only payment reform, again imho, will get that done. Until providers are not paid by click, and until they can monitor in real time what's going on with patients right now, in their hospital, will a dent be made.""Veronica James, they do make a push for transparency in the report, too, urging for actual quality outcomes to be made public. Many studies have shown that transparency spurs providers to improve. But meaningful public reporting is hard to find.""IOM published, ""To Err is Human"" in 1999. They did an extensive study on errors in 2007. There has been no significant change, and the cost of medical error wasn't even whispered in the national ""debate"" related to PPACA. HHS is gutting what little there is helpful in PPACA in response to the lobbying efforts of the AHA. The federal government pays for half of medicine in the US and has zero effective quality controls. It can't even say that starving a 67 year old grandmother, because she is a paraplegic -- due to medical error -is wrong. And we are federalizing the rules for the health care for millions. And in doing so, making it impossible to contest bad insurance decisions and even further limiting visibility on oversight. Corporate payers of insurance (a soon diminishing species) continue to buy the unproven ""preventive medicine"" sales job of the AMA and big pharma, instead of demanding quality as well. If you go on any medical blog, it is clear that the medical community has nearly zero belief in the proven medical error rate. Try to make a post on Kevinmd.com -- you will get bullied. Or if you want a real idea of what medical ""professionals"" think, try nurse K's blog: http://crasspollination.blogspot.com/"Nurse K has a heck of alot more readers in the medical community than the IOM"Look at the trashing Atul Gawande got on kevinmd.com for a pretty middle of the road article that espouses management theories that were new in like, 1911 (see Frederick Taylor). I think Kevin is actually a nice guy, but his audience is often beyond the bend and they seem to not understand (or don't care) that they bring their profession into disrepute. Unfortunately, I suspect the audience represents the majority of the medical community.""Most doctors who read this, most administrators who read this will say (1) this is how it is, it can't be fixed, the people who write this is pie in the sky; (2) they are talking about someone else (3) they are overestimating the problem, these people calculated it wrong. Why, to come to terms with the body count is just too horrifying. look at doctor responses in the NYT Well column. anyone mentions something bad and its a doctor pile up. the solution is YOU (Dr. X, administrator X) did Y, which caused Z harm in a way that can't be rationalized away. And when something is public, it is much more difficult to rationalize.""We also need to realize that there are limits to jawboning. ""Don't steal"" is a great thing to teach kids. But there is a certain set of the population who will steal anyway. It's great if we can get people at that point to realize what they have done and have them stop, but the reality is that there is a certain percentage who will need to see the unpleasant side of the criminal justice system to change their minds and some percentage never will and will only stop when locked up. For people with security clearances, there is much that is voluntary, but people can and do lose clearances all of the time for even minor infractions, and it can and does affect one's livelihood. And nobody really cries a river for those folks.""i agree with you debra... there is a certain percentage who will need to see the unpleasant side of the criminal justice system. if we were merely talking about medical errors, medical negligence, etc., then maybe this report would give me some hope for change. however, far too often, this is not the case. in my case and so many other cases, doctors are harming patients with intent for profit. as ugly as that is, it's the truth. until harmed patients have legal remedy via the criminal justice system, i don't believe there will be noticeable change. if and when doctors begin going to jail for their crimes, i believe we will likely see at least a hope for change. at present, doctors have zero incentive to 'first do no harm' because they know full well there is absolutely no consequence awaiting them if they harm by mistake or even on purpose. they are free to commit unthinkable crimes against humanity. and not only do they not face consequences, they are paid for what they do - even if they harm and kill.""I don't think its even just jail (although I think that is the appropriate remedy in my mom's case), it's consequences. Oh, so sad the doctor might lose his livelihood if he loses his license. Oh, so horrible if a doctor is humiliated with a lawsuit. Please. First, if someone is smart enough to make it through med school, he or she should have enough smarts and ambition to earn some other living. Maybe not so plush, but something to put food on the table. Second, if that ""livelihood"" is made at the cost of imposing wanton destruction on others, well, maybe subsidizing that ""livelihood"" with a body count is just too expensive. If you are an airline pilot and if you show up drunk, you are not going to fly. If you are a neurosurgeon about to cut millimeters away from someone's carotid artery and you show up three hours late, guess what -- you get to operate because the hospital is not going to give up the revenue you bring in. And yes, I know someone who had brain surgery from a DRUNK neurosurgeon.""Going through medical school is probably not dissimilar to learning to be a member of a cult. Not a religion based cult, but a very insular group non-the-less. There is sharp line dividing inside and an outside. There is an us and a them. Loosing lawsuit isn't just about money, as recent reports have told us many times they just don't pay anyway. Losing a lawsuit is a great humiliation. Like belonging to a cult, to be kicked out is like annihilation, a death of a selfconcept. Come to think of it, going through medical school, through internship, and becoming a doctor is probably very much like becoming a priest. A doctor who looses a license to practice medicine is like a priest defrocked. See how tightly priests have stuck together to protect any member accused of the crime of pedophilia." "garrick, you bring up a good point by way of comparing doctors and priests. i see similarities there. i think one reason (probably the biggest reason) i've had such a unbelievably difficult time pursuing my medical malpractice complaint over the past four years is due to the fact that I was harmed in a catholic hospital namely 'mercy'. also, there's the issue of the specific type of surgery that was performed on me - removal of all six of my 'healthy' sex organs. catholic hospitals do not want cases like mine 'advertised' in any way because they are not supposed to be in the business of removing women's sex organs - especially healthy ones... that this happened to me in a catholic hospital just adds another layer of difficulty. i suspect this adds to the difficulty in other cases as well for the reasons you already stated.""Robin Karr I agree with all you said. Once I found out what had happened to me and found others in yhe same situation I posted and.still post. Amazing information has seemed to allow me to connect the dots and believe me it show exactly how doctors are profiling and placing innocent patients in harms way. I have the dots connected and with EHR it become a reality to stop this nightmare for patients and monitor and authorize realtime all patients info in one place. The key is to have superior quality control of the data so more harm doesn't come from incorrect information in files. This has to be a partnership between patients, providers and clinicians""Since the discussion seems focused on the problem of enforcement -- making sure the bad practitioners are not harming patients -- I thought I would mention that most of the doctors and nurses I speak to (who are obviously the good ones with nothing to hide) are willing to talk to the media because going through the established system of oversight has been so frustrating for them. The vast majority of doctors and nurses are good at what they do, are ethical and put patients first. But some seem to be greedy, sloppy, incompetent, etc. The good practitioners know who the bad ones are, but, from those I've talked to, have an almost impossible time stopping the harm that's being done. The medical boards are often conflicted trying to discipline their peers, who lawyer up and fight tooth and nail to defend themselves. And those who turn in their peers often get targeted for retribution.""marshall, i know what you say is true in regard to how the retribution factor makes it very difficult for good practitioners to stop the harm they see and know is going on. to some extent, i understand that... however, to a larger extent, i don't or at least i don't accept it. i gave up two careers (one in 1984 and one in 2004) due to the fact that i was not willing to look the other way in order to make a good living. is it fair that i had to lose all i worked for due to the unethical actions of others? maybe not... but at the end of the day, i have to look myself in the mirror - i have to live with robin. when i chose to walk away from my first career, my supervisor told me that he wished he had the courage to do the same. since this man was directly responsible for molding the lives of many children, i wish he had had the courage to walk away too. debra brought up the issue of security clearances and how people lose those (along with their livelihood) for even minor infractions. i know this is true because i lost mine due to my reporting a high government official (working under president bush) who was sexually harassing women. i should mention that two women who worked for this man died under suspicious circumstances. i knew the risk i was taking in reporting this official. and my worst fears were realized when my clearance was suddenly taken without warning and i was escorted out of dhs headquarters in our nation's capital. my ride home on the subway that day was very very long. i lost everything..... even my home. i paid a very high price for doing the right thing. i could easily have justified looking the other way. after all, i was a single mother just trying to survive. i chose to do the right thing regardless of the consequence. i taught my son that it's 'always' the right thing to do the right thing. how could i choose not to do it then? i couldn't. i made a conscious choice to do the right thing. in the same way, those in authority consciously chose to take my security clearance and ruin my career. those in authority consciously chose to do the wrong thing. my point is we all make choices. the choice to do nothing is still a choice. that's what people often don't understand or consider. i suspect the admitting nurse who worked with me the morning of my surgery in 07 was let go for not going along with what was done to me. i know she no longer works for mercy hospital in cincinnati. i felt badly for her (in a way) when i first learned she was no longer employed by mercy. but then i thought about how she can at least know she does not have my blood on her hands. she did the right thing the morning of september 27, 2007. she made a conscious decision to not be a part of what ultimately happened to me that day. in my opinion, there's a lot to be said for that. maybe i'm a idealist or a dreamer, but even today, i still believe it's always the right thing to do the right thing.""I see your points, Robin Karr. I'm not justifying the lack of action by the good nursing, docs and hospital officials. I think if they decided, as a group, to speak up and refuse to accept the bad care that they see, it would be revolutionary. But I am trying to explain the very real reality that those who speak up seem to be in the minority, and the risks that they face are real. But you're right -- we all face this in various aspects of our lives. No one has an excuse to stand by and do nothing when they see something that's wrong.""love what your mom used to say veronica ""when you see a wrong, right it -- put on your gloves and fight it."" you obviously took what she said to heart...""Two posts, both long. In the security clearance system, if you know someone is doing something wrong, and don't report it, you can lose your clearance too. I got yelled at once because the guy in the office NEXT TO ME left classified out one night. It wasn't even my office.The processes were designed to remind you that you were not dealing with something casual every day -- logs, handling instructions, etc. It was so rote after several years that on 9/11 when the plane came in at the pentagon, flying 50 feet over my office, I pulled the hard drive out of my computer, gathered up the classified and got it in the safe, with completed log, before I evacuated. There were real random audits. There were scheduled audits. There are security guards on the way out of facilities and they check your bag on the way out. And I have had coworkers get caught forgetting to follow the handling procedures, head to a meeting and getting caught in a random bag check and lose a job. The penalties were real and enforced at senior levels -- in fact harder at senior levels. I had one boss -- very senior -- who has not handled his hard drive correctly and he was forbidden to use a computer for a year. And, he was denied the right to touch anything classified, for a year. So, his employees had to bring everything to him and take it away. They had to log on and get his emails. He got to wear his humiliation with him to meetings without outside agencies, explaining his misdeed. Trust me, he had a different view of following the rules after that. I had another boss lose safe privileges because he left a safe open overnight. So, the employees had to log every classified document he got and he had to hand it back. He got to tell every employee that he got caught and trust me, it gave the security officer fodder for years. So, real professionals, if entrusted with something really important, can be subjected to serious rules and the community can be accepting of it and collectively can enforce. If someone saw something go wrong, they would say something. Like, if the guy next door leaves his safe open, you give him a hard time to be more careful, and if you leave after him, you check his office, fix the problem and tell the supervisor, so you don't get blamed. Sure, there was training. But what kept you motivated was the penalties. Very public penalties that were meted out to all. And the whole system was premised on oversight and regular feedback, at a low level, for minor infractions, to prevent larger, more painful punishment. If you were an airhead about what you did with paper and were deluded that you were not, trust me, you figured out quickly that you had a problem and changed.""Post, two (and I suspect there will actually be three). When what happened to mom happened, one of the things that was most upsetting to me was that the medical staff behaved as if this was normal, if not exemplary behavior. The abuse and failure of the hospital was horribly visible. A black eye. Emaciation with pictures of a healthy person only weeks before. A stage Iv pressure ulcer. Fear of hospital personnel. Inappropriate medications designed to restrain, rope burns on her arms, open, untended wounds on her arm, paralysis due to delayed treatment, a lack of basic physical therapy, lack of access to equipment needed for movement and communication. Pretty much every red flag of elder abuse. Hospital personnel admitted that if mom had been brought in by us to the ER in her condition, they would have called social services on us and had her removed from our custody. The head of the hospital admitted this and then turned around and emailed us that mom was ""getting great care."" Not a single one made a report to adult protective services, even though they were mandatory reporters and even though such reporting is anonymous. there are probably 60 -70 nurses and doctors, plus some administrators, who could be fairly prosecuted for elder abuse or derogation of their mandatory reporting duties -- felonies at this level of abuse. Trust me, if the Virginia board of medicine had some spine and yanked their licenses en masse and the Virginia attorney general were to prosecute every single one, and there were even a few more cases like it, every doctor or nurse in the country would have the excuse of ""I'm not going along with that, I have too much invested in my license and I am not risking going to jail to cover your butt."" If there were a credible and somewhat predictable threat of serious penalties, there would be much more social acceptance of lower level enforcement of standards -- it would change the calculus of individuals as to where their self interest lies."and so what does it take to instill the values required to fix the problem? Or perhaps the difference is between government and business."And now back to, ""the established system of oversight has been so frustrating for them."" That is because the established system of oversight in the health care industry is essentially one of enabling. If you look at the literature, there is this belief that if you impose penalties, you will cause nobody to talk about failures and therefore the ""system"" won't find out what is wrong. The belief is that all information has to come from voluntary disclosures. The belief is that health care providers are emotionally fragile entities that if told that they, personally, are screwing up, they will collapse and be unable to function, therefore harming even more patients. It's silly.""Let's look at that oversight system. More than half of health expenditures are paid for by the federal government, directly or indirectly. So, that is where the ""money"" is on oversight. Medicare has NO entity that has the necessary authority, training and independence to enforce quality requirements. Period. There are plenty of organizations with enforcement for coding errors, but nothing to ensure that we are paying for competent care. it's like Dod counting how many bullets it has received and not checking if they work. Let's posit this. After every hospitalization, Medicare sends out a survey to the patient based on the billing codes submitted by the hospital. And instead of a bunch of fluffy questions, the survey asks alot of hard questions based on the diagnosis codes. Is the billing code what you went to the hospital for. Did you experience any other problems. Was medication delivered timely. did you get a pressure ulcer. how bad was it. Were your blood sugars checked before meals if you were a diabetic. Etc. Pay people $20 in the SS checks to fill out the surveys. I guarantee alot of surveys will come back. If a problem shows up in the survey response, cut the reimbursement for that visit by a certain percentage. If its something that causes harm, offset reimbursements by the cost of the anticipated harm Medicare is going to have to pay over the lifetime of the patient. And maybe add a multiplier for how many of similar incidences are likely missed. Use the survey data in guiding inspections and do real, random audits of patient files, with real penalties. Go behind the files and interview patients to validate the data being provided by the contractor. If there is some real penalty that is attached to non-performance for both hospitals and doctors, information about what is not working then becomes something of value to the organization, not something that is a potential liability (lawsuit). Have the overall survey information available publicly, so that people can choose which hospital they wish to go to and so that boards have independent data as to the performance of the executive staff, who, under the current system have no real accountability for quality failures -in personal liability or medicare exclusion. The worst that can happen to a hospital executive for a quality failure is being fired. Everything in the oversight system is designed to hide information to prevent it from being used in a lawsuit because ""the system"" believes consequences are evil. Can you imagine how many taxes would be collected if there were no penalties for non-payment, but only public service announcements about all of us ""paying our fair share."""Mothers against drunk driving had significant effect by penalizing federal transportation funding if the drinking age was below 21. How about penalizing Medicaid block grants if a state does not have an effective medical licensing program that is fully public? How about tying federal funding for residencies position to demonstrated low rates of infections and never events. How about tying federal funding for building projects to proof of effective management and recognition and compensation of medical errors. How about extremely stiff penalities for failure to report and failure to document. I don't see why we are putting all of the onus on people who are at the bottom of the food chain."Veronica, I am well aware of the Medicare survey division and the state inspection process. Our experience is that the state survey personnel had absolutely ZERO technical skills, ZERO knowledge of the legal requirements (they did not even know what the phrase ""conditions of participation"" referred to) and ZERO understanding of the investigative process. Quite frankly, they weren't able to string a sentence together in a report. They are also the people who had ZERO problem with a 67 year old grandmother being involuntarily starved for a week. The State inspectors could have shut the hospital down while mom was there and did not-- even though the found substantiated seven immediate jeopardy level violations. I am also familiar with the medicare survey folks. The woman from the Philadelphia Region who was responsible for these state inspectors told me that, over her dead body, would the hospital in question be held accountable, and somehow, the state inspection report got altered, without documentation why, to fit that viewpoint. And by the way, that alteration constitutes obstruction of justice under federal law. HHS OIG refuses to do anything because after all, they talked to the lady from Philadelphia, and she told them she did not do anything wrong. That we have the starvation documented in the hospital's records means nothing. When our Congressman's office required the Regional Administrator to meet with us on a conference call, the survey division was more pissed off that the state had given us, as required by law, the original version of the inspection report and the altered inspection report, than they were about the fact that mom had been starved and otherwise abused. The state isn't going to impose penalties on a major employer in the area (in fact, they sponsored a $350 mil bond for them). And apparently CMS isn't going to be bothered either.Ask Ms. Barbara Capers-Merrick MS, CD/N for the actual survey report and the CMS form with its findings and the record of what penalties were actually imposed. And then come back and let us know if you are happy with how it was handled.""i agree that tying federal funding for resident positions to demonstrated low rates of infections and never events would likely help matters. any time you tie money to results, you can expect things will change. blindly paying money (via gov't funding or otherwise) no matter what the result is not only dangerous, it can be deadly. i'm still dealing with united health care and the complaint i filed with them regarding my surgery in 07. uhc says they've done nothing wrong in paying for my surgery because it was covered under my plan. using that reasoning, my former gynecologist could have done any number of things to me (all unnecessary and without my consent) and uhc would have paid for it so long as it was covered. seriously? when i asked uhc how they know a patient needs or consents to surgery they pay for, they said that they trust that doctors do not lie. i said 'that's nice..... but what do you do when someone like me alerts you to the fact that a doctor did lie (by his own admission no less), that a doctor altered medical records and performed surgery without consent (again by his own admission)?' i told uhc point blank that they are funding a criminal doctor who they now know is altering medical records and performing surgery without medical need or consent. finally, i told them that there is no way that my former doctor would be operating without medical need or consent if he was not being 'blindly paid' (for whatever services are rendered) by insurance companies like uhc. what incentive does my former doctor have to 'first do no harm'? he gets paid no matter what happens and nobody questions him. not a good system.....""In addition, if you look at this HHS OIG report, even if state inspectors find something, they don't do anything about it: http://oig.hhs.gov/oei/reports/oei-01-08-00590.pdf. They did not impose penalties and they did not verify that proposed changes were actually implemented. CMS does not inform accreditors of substantiated problems""Just because they ""cited' them doesn't mean that Select had anything happen to them. They can be ""cited"" but no fine, no requirement to change.""If the QIO found ""substandard"" what are they going to do about it? Cut payment? Refer to HHS OIG (our state QIO told me they have NEVER made a referral to HHS OIG, even though it is supposed to be the standard for any sort of serious patient harm). Again, nice to hear words, but what teeth is there to that finding?""Trust me, if a materials provider gave us something that got ""substandard"" by the inspectors, it would go back, there would be contract penalties assessed, etc. Where's the beef in this system?""Are they going to provide you with proof of implementation or is that going to go back into the super secret, we can't tell you because it will make someone look bad file. Are they going to publish on their website what they found and what the changes are and how they are to be implemented, so that if someone else has the same problem, they can contact the same person at NJDHHS to let them know that the fix did not work. An effective oversight system needs to have that closure and monitoring. QIO is legally precluded from publishing that data. Individual complainants are not allowed to get even the information you received without permission of the investigated health care provider.""marshall, can you perhaps also encourage some of the folks in this group who are from the hospital oversight community (esp the folks from the Joint Commission) to perhaps chime in.""Veronica, what the regulations required is that the ""nice honest lady"" from Survey and Certification send you the entire inspection report, plus the completed Form(s) 2567, Statement of Deficiencies and Plan of Correction. email her back and ask for them. and if she doesn't, make a FOIA request.""And, there is supposed to be a verification survey done to ensure that the fixes were implemented. Ask for the Form 2567 for that too.""Look at the OIG report I just cited. For all of the 100 Immediate Jeopardy complaints, half of which were found to be substantiated (ie. complaints of serious errors resulting in patient disability or death), ""Only one hospital was required to submit data to the State agency showing longer term compliance."" One hospital in the whole darn country. That's it.""To put a finer point on it. 180,000 deaths per year due to avoidable medical error for medicare and ONE hospital got sanctions such that they were required to show long term compliance. ONE."'...one hospital in the whole darn country. that's it' ... well that says a lot now doesn't it!good you rec'd some information helpful to you veronica... thanks for sharing so much debra. and thanks to marshall also for posting his original question that prompted all of us to begin this discussion:)"Veronica, this is the state survey process for dealing with complaints: http://www.cms.gov/Medicare/Provider-Enrollment-andCertification/SurveyCertificationGenInfo/Downloads/som107c05.pdfthis is the QIO manual: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/InternetOnly-Manuals-IOMs-Items/CMS019035.htmlThis is the Appendices for the State operations manual, which includes what standards are to be applied: http://www.cms.gov/Regulations-andGuidance/Guidance/Manuals/Downloads/som107_appendixtoc.pdfNow you have enough to be moderately dangerous ;). Or at least smother them with paper.""This is an interesting story, and not one of the usual ones heard over and over again.""very interesting remark buy someone who posted a comment on ""inquest for Josh"". go to the website http://www.justiceforjosh.com/ and click on sign petition and click on signatures and check out #70.""mary-lou, i read #70's comment. sadly, i believe many people are driven to say and do things they would never say or do because of the very dangerous influence of 'prescription' drugs. i've been on that road. i somehow managed to get off. others are not so lucky:(" http://www.webpronews.com/tom-brokaw-hospitalized-blames-it-on-ambien-2012-09"I understand with you about the medical examiner being part of the problem, they tried to claim that my daughter died from a narrow esophagus and CHARGE Syndrome. You don't die from your disabilities. I did the same thing in writing a complaint against the medical examiner as well, and the Medical board is trying to keep this all covered up, but you keep writing until they turn blue and you don't stop. I am working on some things in Texas and when I finish I will share with everyone how we intend to bring this mess to an end. It is sick and it nothing short of Genocide." you're absolutely right deirdre.. it is nothing short of *GENOCIDE*when our son died the medical examier tried to say our son died because he was alcoholic and this caused his major bleeding from his TBI..His physical he had just before his injury proved he was not a alcholicThe truth was he had a major tear in his artery from a fractured skull.Brain truma guidelines recommend evacuation which he never got but they told us he did get.His attending wrote us a letter saying surgery wouldnt have done him any good.A very conflicting story in writing and the medical board did nothing.. Keep the pressure on the ME and youll get the truth.When guilty doctors rely on bashing the innocent patient it just goes to show what they realy are.true john... blame the victim"Here are Michael Moore's mailing addresses: Michael Moore Dog Eat Dog Films P.O. Box 831 New York, NY 10101 Michael Moore Endeavor Agency LLC 9701 Wilshire Blvd Fl 10, Beverly Hills, CA 90212 Michael Moore's Agent: Ariel (Ari) Emanuel Endeavor Agency LLC 9701 Wilshire Blvd Fl 10, Beverly Hills, CA 90212"is there a city and stateclick on see more at the bottomthanksI actually think there is merit in doctors having a government-sanctioned place to go if they are struggling with addiction. Consumers Union's Lisa McGiffert has a different take. http://bit.ly/UmYIvfI'd be interested to hear other folks weigh in on this. Does a doctor have a right to privacy if s/he is struggling with mental illness or addiction? Should doctors who have struggled in the past be allowed to be 'rehabilitated' if they successfully complete treatment and are sober? Or should they be banned permanently?What information would you want as a patient?"The information readily available now includes: Name of medical school, if that medical school is accredited, the date of graduation, date and location of beginning of residency, license status and history, advanced speciality certifications, national background check.""Healthcare workers are people too ~ 12% of the population is addicted to something. Is anyone aware if pilots, nuclear plant operators, soldiers, police, truck drivers and others are required to have a drug screen and to renew their license?"Do they have mandatory regular pee tests to keep your medical license? We most certainly had those to keep a security clearance."""I hired a pathologist and brought in the coroner to consult��_[they] determined that Lloyd���s death was caused by surgical errors, and infection untreated which led to severe sepsis.""Is this something people should consider when the hospital doesn't give an adequate explanation? This man got the truth this way.""garrick, i think this is something patients should consider... a woman i know in california learned her breasts and muscles were removed for no reason after she hired a pathologist to re-examine her tissues. she did not have cancer as her surgeon told her she did. i doubt she would have ever learned the truth any other way - sad to say...""Thank you everyone for entering the discussion on this issue. I am Michele and Lloyd (mentioned in the article ) was my husband-to-be. In response to Olga Pierce's question. I believe that if a physician chooses to abuse drugs or alcohol, then we as patients have a right to know about it. I have spent five years on this issue up against the most powerful lobbying groups in the state. I have testified at Senate hearings where I have heard others say that physicians have a right to their livelihood. My response to those comments in my testimony was that Lloyd had the right to live. Lloyd had the right to his livelihood which was empowering Californians. So, in response to your question. No, physicians should not be guaranteed privacy. If doctors do not pay their child support or do not pay their taxes, they face potential suspension and real discipline. Yet, if impaired, they were able to avoid discipline and even now without a program most doctors receive probation over and over again."A lot of the physicians who have these issues are repeat offenders. They relapse over and over. Some of them receive probation 3 times over while still practicing with their patients having no idea their doctor has such a problem. There are many examples. Here is an example of a mentally ill physician. Jose Maria Montenegro was a pediatrician who had to surrender his license a couple of years ago because there was no program. His public records list many years of disturbing information yet he kept receiving probation over and over again http://www2.mbc.ca.gov/LicenseLookupSystem/PhysicianSurgeon/Lookup.aspx? licenseType=C&licenseNumber=35541Here is a recent example of a physician who was abusing drugs in his office while on duty and on call at the hospital. He is an OB GYN. It was the janitor who discovered items in the doctor's trash can. It was the janitor who reported his findings to the Chief of Staff of the hospital because he was concerned for patient safety. http://www2.mbc.ca.gov/LicenseLookupSystem/PhysicianSurgeon/Lookup.aspx? licenseType=G&licenseNumber=86782"Garrick, I think it is something more people should consider. In my case, it was the only way that I was going to get any answers."thank you for sharing so much insight and info michele'lloyd died three days following 'elective surgery' with no reason given for his death.' this is tragic on every level! so sorry for the horror you faced via the unnecessary death of your *husband-to-be*. the 'elective' part of this story especially upsets me. so many innocent and unsuspecting people sign up for 'elective' surgery unaware of the many hidden dangers. lloyd is a perfect example of this. and so am i..."'i decided that I was going to get to the bottom of it if it was the last thing I ever did.' you did get to the bottom of what happened to your mom veronica. thankfully, it's not the last thing you ever did though.. you uncovered so much! and you went on to share your mom's very important story, what you uncovered and also how you uncovered it.""The solution to cognitive dissonance is feedback with consequences. A lawyer who goes to court and loses every time figures out pretty quick that he stinks in the court room. Someone who sells a product nobody buys figures it out pretty quick, too. The politician who thinks nobody cares about his private life but gets outed in the paper will rethink that position. Public disclosures and consequences do wonders for self-delusion.""I don't believe that all doctors need that system. One time is rehabilitation but multiple charges of drug and alcohol abuse is reason for revocation. We can not drive and drink and not go to jail, even if we go get rehabilitation. I am concerned because the first doctor that perforated my doctors esophagus and colon, overinsufflated with CO2, and disappeared after he did it leaving my daughter to die has no right for keeping a secret. That is what is wrong now, too much secrecy. Why is it the doctors claim that revelation will ruin their business, but what about the doctor killing or injuring a person? Something is wrong with that picture. It is time for change and we can no longer sit idle and allow the systems to dictate morality." http://www.amazon.com/Blind-Eye-Medical-Establishment-Doctor/dp/0671044214"""If there's a lesson here, it's that authority figures, such as doctors, suffer pride, envy and lust just like the rest of us but unlike the rest of us, too often fail to acknowledge their fallibility. It highlights the patriarchal and sexist nature of the American medical profession which, like other parts of society, is not hermetically sealed off from that society.""""by the way... the reviews of this book are almost as interesting as the book and many indicate that this book and non-fiction story of a serial-killer doctor has served as a wake-up call for hospitals. the following review indicates just that... A compelling wake up call for hospitals and our government., September 11, 1999By A CustomerThis review is from: Blind Eye: How the Medical Establishment Let a Doctor Get Away with Murder (Hardcover)As a medical staff coordinator (basically we do the background checks on physicians for the medical staff) I found this book quite interesting. I read it straight through. I want to assure you that there are now many checks and balances in place that would not allow Swango to fall through the cracks. This includes the National Practitioners Data Bank and Federal of State Medical Boards. Unfortunately, I am not familiar with residency and internship programs processing so I do not know if they utilize these sources. Our government has also instituted a new data bank (HIPDB) going into effect in just a few days which would include criminal background information. Unfortunately, hospitals are not allowed access to this information. How tragic. I urge each of you to contact your state representative about this matter as soon as possible.I shared the content of this book with my administrators, Credential Committee and Board of Trustee members. They were astonished. They are now passing the book around and buying their own copies. We are even buying a copy to put in our Medical Staff library for the rest of the staff to read.My hospital has toyed with the thought of performing criminal background checks on all physician applicants. This book was instrumental in making in reality. It is now a policy to do this on every physician applicant.Many of those in my profession have been following this story for some time now. My thanks goes to James Stewart for opening the eyes of the rest of the country to this monster. Unfortunately, the monster is not just Swango, but also the process that allowed him to go from residency program to residency program with such ease. It is comforting to know that there were those out there that attempted to stop him but frightening to know that others, such as those in Ohio, were more concerned about their own problems than stopping a murderer.I urge everyone to read this book and to encourage others, especially those in medicine to do the same. With people like Swamgo in the world today, it is a must that hospitals, training programs and licensing boards go much further in working to protect the patient.My prayers will continue for the families of the victims to bring this killer to justice. I am frightened to know that he may be out on the streets in just a few short months but thankful that the government found some way to lock him up for at least a little while."That book is a fascinating read."You know all those Immediate Jeopardy fines against California hospitals? They total $9.25 million, but almost none of it has been spent. It's supposed to be spent on patient care improvement projects. But after four years, one $825,000 project administered by UC Davis is just getting off the ground. The state is sitting on the rest of the money. My column today. http://www.healthleadersmedia.com/content/QUA-284154/925M-in-Fines-for-MedicalErrors-Goes-Largely-Unspent-in-CA"Nice work Cheryl Clark."Chicago is the Place to Be!!! 4h Annual World MRSA Day & Global MRSA Summit - Sept.29th at the Hilton Garden Inn, OakBrook Terrace, IL from 10:30am-12pm. Free admission & free parking. Help us raise awareness- leading MRSA and HAI's experts along with MRSA survivors and families sharing their personal stories. Also speaking is Illinois Senate Pres. John Cullerton. Short seminar on how to become a 'MRSA Champion' and a balloon release after the event. Bring the entire family!! Downloadable posters and materials for World MRSA Day, Oct. 2 and World MRSA Awareness Month, October available at www.worldMRSAdayorg. RSVP at 630 325-4354 to MRSA Survivors Network. Media Sponsor - NBC5 Chicago."http://www.kevinmd.com/blog/2012/09/die-lightly.html "'of all the wishes in our lives, the wish for how we die seems as important as any, something to plan for deliberately and carefully.'""Very interesting discussion...http://csn.cancer.org/node/151960""Notice the comment "" I had a healthy kidney removed"""hard not to notice that... literally jumped out at me and made me queasy.This is the same thing I experienced. I truely believe I survived so these corrupt UROLOGIST would be exposed. UROLOGIST are using humans for research subjects without disclosing to the patient.This is the same thing I experienced. I truely believe I survived so these corrupt UROLOGIST would be exposed. UROLOGIST are using humans for research subjects without disclosing to the patient.i too believe that so many of us have survived so we can help to educate and expose.good news. My story is set to run in the kw record on Saturday. Unless something major happens and I get bumped. Pray for me and check it our. "Sorry wrong linkwww.unaccountablebook.com""Get your registration in by tomorrow, September 5 if you want to attend this FDA September 10 webinar!"Make public comments!http://www.ofr.gov/OFRUpload/OFRData/2012-21434_PI.pdf?source=govdelivery "clearly, the motive here was 'donor organs'...""How do these doctors look themselves in the mirror? I hope that Texas right to life and the ACLU join together and picket this place with the same gusto as an abortion clinic. The law most certainly cannot be constitutional -- its deprivation of life without due process, which requires at a minimum an impartial arbiter and opportunity to confront evidence and present a differing side.""Surely, prisoners at Gitmo can't have more rights than a twelve year old kid.""you bring up a good point debra... i just read a great article on michael moore's site regarding a call to pro-life people to care about life 'outside the womb' too. i'm not pro-abortion or anything BUT i believe we need to also care about the lives of those who are already here; lives on those on our streets, in hospitals, nursing homes, etc., etc.. i can't help but wonder what would happen in a case like this one if pro-life people would rally behind these poor parents..... i can't begin to imagine their devastation on every level. my heart is overwhelmed for them. this story needs to be reported far and wide in my opinion!""We called right to life and they would not answer our phone calls. It's a pro-life governor and in Virginia here it was a pro-life governor. I'm not a fan of michael moore, and I know Texas right to life intervened in a similar case, but you're right. But you will never get this administration to get the civil rights division of its department of Justice to go after Texas for this law. Which is what should be happening.""Two things:1. I'll go out on a limb and suppose that since the victim was a drug deal bystander that this family is lower class. I wonder how treatment decisions would have unfolded for a middle class family.2. My book contains an entire 30-some-odd page chapter on resuscitation matters. Issues around DNRs and life support technology LST abound yet are nowhere, as far as I know, presented to us in advance in a cohesive whole (nowhere except my 2008 book, that is ��� tho writing this may prompt me to do a google search). The 3 most problematic moments in my parents' ~6 weeks of terminal hospitalizations were directly and 100% about LST. Especially relevant are provider inclinations and hospital DNR policy during surgeries and post-op. Of course we're not advised in advance; the surgical release form is where we encounter such things, but it's provided very late in the process (in Robin's case to devastating effect). Our first two ""DNR Snafus"" as I call them were during Mom's intubation treatment and completely decimated the family's ability to function, including my then 83yo father, Mom's proxy. Way to go: tell people to bring a proxy, then undermine them, especially when elderly. The 3rd DNR Snafu led directly and unnecessarily to Dad's death due to clinical disinterest in investigating his stipulation. My sister and I became inadvertently complicit due to our naive inability to advocate at a full level on Dad's behalf (""we are part of the system""). It was specifically because of our DNR Snafus that I made a call in the book's reform proposals section for Communication Algorithms, a phrase I coined to communicate the fact that effective professional communication is a repeatable skill that can be learned according to some set of parameters. DNR issues must be understood in advance of confronting them. Investigate doctor, facility, and first responder and be prepared for several things: facilities and their policies differ; be alert for overrides to your wishes; if your wishes are liberal (right to die) complete a Compassion & Choices ecumenical form for removal to a facility that'll honor your wishes, should you end up in one that won't (hint: these days even facilities with non-Catholic names may be governed by Catholic organizations, even crossing US state boundaries); and that anything related to DNR or AND (allow natural dying) including POLST and MOST forms are doctor's orders; US citizens are not legally empowered to execute forms on their own behalf."thanks bart for your input here... you are unfortunately somewhat of an expert on 'end of life' issues now - including but not limited to dnr and lst. i was shocked to read where it's legal in texas (other states too i suspect) to place a 'dnr note' in a patient's chart without disclosing this to the family. i usually have no trouble verbalizing how i feel about almost anything. i'm rather speechless here..... i agree with you about how the class status of the family most likely sealed the 12 yr. old's fate. and i completely agree with you on this *dnr issues must be understood in advance of confronting them*"Very good point. I also wonder why the doctors in this case are not being prosecuted for attempted murder. And by the way, our family is nowhere near poor ... happened to us. Mom was a retired bank executive. Dad a bank executive, daughter a licensed attorney. the problem is that if you are on medicare, the receiving facility gets stiffed on a transfer, so nobody will agree to receive.""Another important point: when a DNR is appended to a patient chart, that chart ought to get flagged in a highly and immediately visible manner, esp. in the ICU. This is so that nurses don't end up calling code should the patient arrest. Advocacy 101 includes that the chart is available to the pt. and their proxies, so regularly ask for and examine it. This assumes you've got all your paperwork ducks quacking. AND points to the necessity for either an ironclad HIPAA authorization and release as part of the durable medical power of attorney or via a standalone document. Without the HIPAA angle covered it's conceivable that a legally assigned proxy might have access to their patient's chart withheld under the guise of HIPAA compliance."i'm on medicare now even though i'm not elderly. i'm on medicare due to being disabled by surgery i didn't need or consent too. the cycle of trauma is unending..... precisely why one simple post on here is likely to prompt in-depth discussion. a good thing!"bart, you bring up a good point regarding the hipaa laws.... actually, you bring up several good points. in my opinion, hipaa laws have unnecessarily complicated things for all involved. hipaa laws were blatantly violated in my case and yet there is seemingly nothing i can do about it. my hospital medical record clearly notes that nobody was to be given my medical information. i made certain of this because my family has very different religious views from me and i knew my mother would be present the morning of my elective surgery. even though i was proactive on this, the hospital o.r. nurse shared my private medical information (including type of surgery i was scheduled for, etc.) with my mother who, in turn, agreed to sign a consent for surgery i refused to sign. i assumed that i would have legal remedy - at least on this... i was 'dead wrong'. hipaa violations are many and there's really nothing a patient can do. having said that, i suspect that hospitals turn the tables when necessary (for them) and claim 'privacy' due to hipaa laws. in other words, i can see where it would benefit hospitals in many cases, to not allow a patient's legal representative to have full access to all pertinent information and then claim 'hipaa laws'...... not sure at this point what to make of the whole 'hipaa thing'. just wondering if you've done much research on enforcement of hipaa laws bart...""I've done zero research. This whole empowered patient patient advocate/advocacy thing scares me to death. No two situations will every be alike and whatever lessons we learn may or may not apply the next time. We have to do it all, and the best we can, anyway.""you're right bart... lessons we learn may or may not apply the next time. that scares me. and at the end of the day, all we can do is 'do it all' and do it 'the best we can'.""I think it's all a mess and we are so far from seeing a real change... there are too many issues, too much wrongdoing, too many coverups, too much to lose.....sorry stupid IPad typing again""melissa, i agree with you that a very tangled web has been weaved...""I am a fan of being an empowered patient. It means being educated about your condition, it means understanding how the health care system really works and it means having your own information so that you can make your own decisions and not have someone make them for you. in this case, the family's decisions were not respected and the family wasn't informed. In my mom's case, the hospital actively hiding information greatly contributed to her death, as did the doctors' constant refusal to listen to the family. We were right, time and time again, and it is particularly grieving to us to know that if we had been listened to, things would have turned out differently.""yes debora, what you describe as far as what happened in your mother's case, does make it much much more difficult... it's not that you were not proactive and/or didn't do the right things. and when things are hidden, what can you do? that's an utterly impossible situation.... honestly, that's what gets to me the most regarding my own case. i educated myself and i took all of the proper precautions, etc. but at the end of the day, i was dealing with a criminal doctor, who does not play by any rules. i have a new saying... all's fair in love and war AND MEDICINE. like bart said, lessons i learned may or may not apply the next time. knowing this has caused me to reject breast surgery that could be life-saving. i'm just not willing to take a chance again - not knowing what i know now. i can apply the lessons i've learned but there is just no way i can know the next surgeon will 'first do no harm'. i think the story i posted is a perfect example of this. and, so is your story and my story and so many other stories.... unfortunately, many of us make the same scary point.""I 'self' diagnosed myself with a very rare disease a couple years ago. Correctly, stuck to my guns, over doctors telling me I was wrong, and it undoubtedly saved my life. In that journey, I ran across more than a few bad apple docs and I am part of a larger patient community and that helps. Dad was very active in mom's care all along. So, we have learned to go with our gut about medical decisions. By and large, we KNEW that something was going wrong and in most instanced we KNEW what was going wrong, days ahead of the doctors. Knowing yourself and knowing about your own condition, having savvy family members is the best insurance. In your situation, there was not much to do, except not let your mom be next of kin. Having worked with alot of doctors, you get an idea of who is weak, who shaves the truth and who plays it straight. If you have an idea of the underlying medicine, you can also more easily spot folks who claim to know what they are talking about but are wholly clueless. But the best armed patient can't do anything against a doctor in a hospital that is damned and determined to do wrong.""Debra you are so right.....I see it in my case and the longer it takes the more damage is being done to my health....I am the educated one in my situation and am alone most of the time at the hospital and it's been a field day for them...I am sorry what happened to your mom I can totally see where they would ignore you, they ignore the patients completely most of the time, sometimes it helps more when you have educated family members such as yourself but your case shows they don't even listen sometimes then...... so where are our solutions?....what I hear repeatedly is that the problem is the doctors, the hospitals, etc but nothing changes ....all that changes are the amount of errors and deaths...they increase....."". But the best armed patient can't do anything against a doctor in a hospital that is damned and determined to do wrong. .....Due to agendas that are anything but the safety of the patients? Why - because they can and have done and will continue. Since the year 2000 - the biggest budget in the Federal government has been Health and Human Services each year.. That is more that the military. Regulations that are established have zero accountability. Statistics are being scrubbed annually quite boldly., but, really the people who generate the data - control reports of events so they are not accurate anyway.They stopped doing the WHO reporting in 2000 - said it was too expensive to do. That last year's 'overall' report - 2000 - rated the US as #37 - right below Costa Rica and above Slovenia. The US was #1 in cost. In checking all the different departments for Health and Human Services - they all pretty much do the same thing. I am wondering how many employees they have. I am wondering what these employees do besides write 'policy' manuals and go to training seminars, and deny any errors. In 2011 - HHS - funding was 909.7 billion. Military was 739.7 billion. The year 2000 seems to be a pivotal year for HHS - tort 'reform'. I want to thank ProPublica for providing so much information to us. It is very hard for the general public to understand that THEY are responsible for their own SAFE medical care. We are all told to consult your physician - that is no longer a good thing to do without researching on our own. Health and medical care is certainly not an example of American 'exceptional-ism'. It does generate big bucks though. I am speaking from recent personal experience and a little research. I keep reading the same remark .....for the good of the community...compromise....why do people accept this?""Michelin Anderson, it can be a non-starter for many people to consider that authority has the capacity to betray them. Most people grew up with parents that were good enough, and by good enough I mean that they were instilled with the idea that there is some kind of contract between the world and themselves that they could rely on which says official authority would always take proper care of them.When presented with evidence of official betrayal, either second-hand or their own personal experience, cognitive dissonance occurs. Cognitive dissonance is the nagging feeling that something isn't right with the facts. Such as one might have when dealing with a fast talking usedcar salesman. Cognitive dissonance feels like an anxiety. A skilled salesman is trained to notice the uncomfortable feeling of a customer, and to try to disconnect the person from their cognitive dissonance to facilitate the sale. The customer may then be sold something that they later realized they regret buying.To overcome cognitive dissonance one must examine the differences in the information, and this can take considerable patience and determination, especially if the result could change one's world view. And that is what happens. If the result of examining the facts could lead to a shakeup of one's world view, the facts are avoided. Denial sets in as a symptom solver. Denial is the solution to allow life to continue as if the facts never happened.I think the way to cause people to be less accepting of medical abuse is to make it more difficult to deny cognitive dissonance. To make it less rational to believe in a lie.""Garrick, what a lucid presentation re: cognitive dissonance. I never applied my mind to that phrase or even recalled it; the best I could muster were things like ""I couldn't believe what was happening and couldn't believe what wasn't happening"" and, upon figuring a few things out, ""I'm not nuts...I'm not crazy.""""I agree -- Garrick Sitongia, that's a great explanation of cognitive dissonance. With regard to some of the discussion lately about the media telling these stories, one of my main goals in telling these stories is to break through that cognitive dissonance. That's a big reason for this Facebook group, in fact, to acknowledge the problem and encourage discussion about it. Denial has been, and is, a big part of the problem."it is also a major factor in my story as well. Once they do something wrong or back out of helping they tend to turn it towards the patient."Exciting news from The Empowered Patient Coalition! We have optimized our website for the iphone and ipad. You can bookmark our site and an ""EPC"" icon will show on your screen to give you access to our free resources right at your fingertips exactly when you need them. Please share with others.www.EmpoweredPatientCoalition.org""Information for Patients http://privacyruleandresearch.nih.gov/patients.asp""Here's more evidence the US does not have the ""best healthcare in the world"" (despite what NJ Gov. Christie said on national TV the other night). We'll never make it better if we don't acknowledge the problem. http://consumer.healthday.com/Article.asp?AID=668084"you can't heal a wound by saying it's not there...."'even if misdiagnoses in the ICU do not lead to patient death, they can lead to unnecessary surgery, a longer hospital stay and reduced quality of life for patients'. and that's something most don't stop to consider... death, unnecessary surgery, a longer hospital stay and reduced quality of life... all bad!"And more income for the hospital. Fee-for-service needs to go.What is the solution if not pay for service?"Fee-for-service, not pay for service. Bundled payments for managing entire cases. No reimbursements for preventable readmissions within 30 days of discharge. It's in the Affordable Care Act (though politicians and the MSM only want to discuss the insurance aspects, which have zero to do with actual care).""Fee-for-service means you get paid for each service you provide. The incentive is for volume, not quality and safety. You make more money when people are sick and you can run all kinds of tests, whether or not they're necessary." "neil, for some reason i knew what you meant. but... thanks for explaining. i agree with you."Welcome. It was Doug I was trying to explain this to.I haven't read the 1990 pages of the ACA. I don't follow the logic of bundled payments for managing entire cases? Will each diagnosis and treatment regime be assigned a dollar value and facilities expected to deliver services within that value?"Yes. And they will be expected to coordinate care with other providers, such as primary care physicians, physical therapists, LTC facilities, etc.""Each diagnosis will be provided a list of approved treatments and if you need something off of that list, you are out of luck. Current medicare for hospitals does bundling by diagnosis group. The bundling rules meant that we could not get a transfer out from the hospital that decided to starve her for a week, just for kicks.""'we could not get a transfer out from the hospital that decided to *starve* her for a week, *just for kicks*.' no human being should ever have to utter those words. *beyond chilling* and *very wrong*""We have it in writing from Medicare that starving a patient, on purpose, because she is a paraplegic is not a violation of Medicare's condition of participation. AFTER an email to the General Counsel of Medicare, WHILE the Mom was still in the hospital. By that point, the hospital had turned mom away from the ER twice with a spine fracture, left her without surgery for 31 hours after she couldn't move her legs. Only got surgery by calling the head of the hospital system. they overdosed her with steroid for two weeks, caused pneumonia and CAUTIs, pumped, caused a stage IV pressure sore. She was illegally restrained for 20 days. To top it off, they knew she had lung cancer but did not tell us, her or the hospital we were trying to get her to and scrubbed all of the transfer records of any mention of lung cancer. Of course, by the time another hospital figured it out, it was too late. Head of the hospital addressed our concerns by writing that Mom was getting ""great care"" and Medicare has refused to levy a single penalty. Medicare's explanation is that not penalizing the hospital is for the ""greater good' of the community. If we had done this to her, we would be serving decades long sentences. Oh, and the day after the Medicare inspector came through, mom was catatonic and somehow got a black eye. No problem to medicare -- they refused to investigate that too.""Debra, you might want to start a separate thread for that." "Here is why patient safety is ignored by the government:""explanation is that not penalizing the hospital is for the ""greater good' of the community.""The real reason is cash flow is all that really matters to the government and the legal industry.""The government isn't ignoring patient safety any more. Medicare is cutting off reimbursements for certain preventable hospital readmissions starting Oct 1, based on data collected since last Oct 1. It's in the ACA.""Neil, that is verifiably untrue. The hospital in question miscoded the second of three admissions so that it would get NO bounce back penalty. If the administrators REFUSE to enforce the law, it does not matter how many laws are written. And to make things absolutely clear, the state investigators found that the hospital had seven immediate jeopardies. The report got altered. The response of both medicare and the HHS OIG, in writing, is ""we don't care."" If you think Medicare is watching out for us, you are sadly, sadly deluded. And to make it clear, Medicare had the specific opportunity to save my mom's life from a situation that unambiguously would lead to her death (since the pressure ulcer was progressing) and it specifically chose not to. What happened to Mom should have resulting in the hospital losing its medicare contracts without immediate and serious changes and Medicare took a complete pass.""Furthermore, the AHA has been crabbing to Sebelius about lack of specificity in the definition of Immediate Jeopardy. Because the 75 page appendix explaining what it is, isn't enough for them. So, did Sebelius push back? No. Did she request better regulations. No. She changed the regulations so that a hospital has to have TWO immediate jeopardy findings before having the contract terminated. That's right. A hospital is allowed to have one major contract provision unfulfilled that imperils the life, health and safety of every patient or visitor to that hospital, and that is OK and they don't have to comply." What is verifiably untrue?The government isn't ignoring patient safety any more. What is untrue about it?"neil, you made debra's point really.... 'here's more evidence the u.s. does not have the ""best healthcare in the world"" (despite what nj gov. christie said on national tv the other night). we'll never make it better if we don't acknowledge the problem.'""the government most certainly IS ignoring patient safety. Writing regulations means nothing. Doubling, tripling or quadrupling the number of regulations that are not enforced is not ""paying attention to."" Writing regulations that exempt huge swaths of the problem (eg for bounce backs, people who are so harmed that they die before going back to the hospital or are so disgusted with the quality of care they go elsewhere) isn't meaningful. Quality and consistent enforcement of the regulations is what makes the difference. And as you can see by what happened to my Mom, even with everything documented in the hospital's records, with the state investigators finding the hospital seriously in non-compliance (with more never events by four fold than HHS IG could find as his worst example), and with a patient's life on the line, Medicare intentionally CHOSE to do NOTHING. I don't know how one could be more clear about it. PPACA's ""quality improvements"" are anemic and lack the regulatory enforcement mechanisms/organization framework to make a serious difference. For goodness sakes, we have a report dismissing our complaint that mom lacked necessary pain medication by quoting a doctor who said it wasn't true because mom had been receiving a steroid. Steroids are not pain medication. A statement that should have shown the doctor to be completely incompetent was something the state investigator and Medicare oversight couldn't even recognize was a serious medical error.""""The government"" is a broad statement. Check out www ahrq gov. I will have an interview with AHRQ director Dr Carolyn Clancy posted online in the next few days. And please take your rants to another thread." Politicians like Christie certainly are ignoring the problem."agree neil that 'the government' is a broad statement or term. but you didn't really qualify what you meant in your original post when you used christie and his rnc speech as a way of supporting your statement 'here's more evidence the us does not have the ""best healthcare in the world'.' since christie is a gov't official, he does qualify as 'the government' in the stricter sense. i agree with your original post/statement. i also hope your interview goes well by the way. however, i also see where debra is coming from... i don't view debra's posts as 'rants' or even unrelated. (i assume you were talking to debra when you said 'rants' since you already suggested to debra that she start a new thread). i think the word 'rant' is unfair in this instance. like you, debra has given us some good information and insight. debra is helping to make your original point. i totally don't 'get' you saying 'and please take your rants to another thread'....."The evidence is the study I linked to. "Neil, I think you are missing the point. Great that AHRQ is doing studies. Lovely that we have a bajillion more regulations. The most salient problem is that none of it is flowing down to where reality exists, which is Medicare's writing and enforcement of its contracts -- its acquisition management (and I am an expert in that-- used to audit and reorganize problematic federal programs). Medicare's contracting authorities allow for only the most tepid of quality enforcement. For example, Medicare cannot refuse to pay for substandard services unless they are ""totally worthless."" This is an unimaginably higher standard than I have seen in any other federal agency. It is contrary to good acquisition oversight. Any other agency I have reviewed can terminate a contract with a contractor ""for the convenience of the government."" It's a fast way to get rid of an errant contractor. Medicare's processes to remove a contractor are rococco. there is no way they could get rid of a health care contractor on a fast basis -- it would take years and a major prosecutorial effort. Most of Medicare's oversight function is delegated to entities with ZERO public oversight or accountability, over which Medicare has limited oversight itself, and which have other, complex relationships with industry-- QIOs, the Joint Commission and state health agencies. All of the lovely research on how to improve quality very poorly flow through to Medicare's contracting efforts, if at all, especially for hospitals. Those who are responsible for enforcement have clue as to what they are responsible for doing -- the people I talked to at the QIO, the state agency and the regional office had no idea what the regulations are, what the appropriate medical standards are, and what consequences should flow form a violation. The pay dirt in government oversight and patient protection is the federal government. And it is not happening. Neil, that is not a rant. That is an analysis from someone who has taught federal acquisition oversight and developed acquisition oversight curriculum.""Neil, since you think my criticisms are unfair, I thought I would add some folks to the conversation. Jerod Loeb Terry Terri Dickerson Tye Both list their organization as the Joint Commission. The Joint Commission had no problem with the care my mother received either -- and it was did a pre-announced inspection while we were there . ICU nurses were spending their time washing windows, rather than turning mom, contributing to the pressure ulcer. It doesn't appear from what others have posted, that many, if any, patient complaints receive any sort of satisfactory resolution -granted this is a small sample, but... There are no statistics on the Joint Commission Website as to its responsiveness to the patient community or how the patient community is involved in its accreditation process/standards. Anyone from the Joint Commission want to join in and explain why patients and their families find the Joint Commission less than useful?"What does any of this have to do with my post about quality of care? It really does sound like you have an axe to grind on a totally unrelated subject."You said, ""We'll never make it better if we don't acknowledge the problem."" I am agreeing and saying what I think is the cause of the problem, which by your comment doesn't seem to be what you think the is the cause of the problem. And since my complaints relate to undiagnosed conditions in the ICU, it is 100% on point. What do you think is the cause of the problem, and thus sources for a solution?"I think it's a culture of silence and a lack of accountability exacerbated by poor communication and coordination of care."so, with that assessment, maybe an intervention could mean providing patient's families handout of what should be expected for care for a particular condition, so that the family has more of a roll in monitoring quality. A detail phone treat of who to contact in case of problems, 24/7, with real people on the phones and execs at to, would be great. Maybe even the ability to TEXT the nurse so that if she is AMA, you can let her know its serous and the coffee break is over.And to have them text status updates back. IS that what you are thinking about or at least in a neigboring ball park?""I just want to chime in here. It sounds like Debra wants to manage the medical staff to make sure her relative gets proper care. The problem is that multiple patient family/advocates would be bossing the staff around all at once. I think there should be a specific staff person who should be the manager. The patient's family would contact that person with their concerns and that staff person would integrate the care request into the tasks the staff is doing. I don't think we have that now.There should be a staff organization chart that is posted for patients and visitors to see.""Without having read the comment thread, and where ""staff"" equals ""nurse,"" and in a world of chronic understaffing that understaffedly ebbs and flows with patient census, is it realistic to even conjecture about an additional staffing layer (staff mgr)?""A manager trained for the job would keep track of the big picture in order to reduce mistakes and errors and improve efficiency by making sure tasks are done in time, facilitating important communication and prevent erroneous assumptions, coordinating actions when emergencies arise. If you wonder if this good idea, I can point out that it is already being used. Just check any other moderate to large private business from restaurants to manufacturing or any other service industry besides medical businesses. If you were to suggest they could save money by letting everyone run around doing things as they thought it was needed without a manager, I'm sure they would laugh and say it would be a disaster.""What I personally vote for is better for it better contract management and oversight so that there is quality management at the hospital. And that means tying quality very closely to payment, rather than coding accuracy. This requires serious validation of quality (and by that I mean no errors) and investigations of reports of non-quality, not the potemkin village inspections the Joint Commission does. (The only serious validation of data that is done is of billing data, not quality of care data). The new ""quality measures"" and ""quality penalties"" are too small and too remote from actual care instances to make a difference. We need real and serious penalties, including not paying for schlock work on a case by case basis -- just like we do for miscoding. Trying to micromanage how a hospital achieves quality, in a top down fashion, is an impossibility, very expensive and will result in people doing stupid things like waking patients up at 3am to see if they need a flu shot. It's how the department of defense ended up with $700 toilet seats. Can you imagine how long serious errors would last if Medicare refused to pay for the entire care event and offset the total medical cost projected to be caused by the event -- ie made the hospital pay the other providers, not Medicare. If hospitals bore the cost of sloppy work, serious medical errors would be gone in a year.""The other thing Neil is that you posited that ""bundled payments"" would facilitate better quality. My Mom's experience is that bundled payments made it 100% impossible to get her out of a hospital that was providing criminal care and had every incentive to have minimal care and to die. Severely bundled care, such as what is going to be implemented with ACO's, is what resulted in the HMO crises, where places like Kaiser deprive people of access to care for diseases it knows will be expensive to treat. I have one friend who has been trying to get a needed brain surgery out of Kaiser for years (and most certainly can't speak out because of fear of retaliation) and there is another person on this site I know who lost her sister due to a delayed diagnosis of a brain tumor with Kaiser. Jennie Whitehead Brick. Another lady I know had to have her church pay for brain surgery because of a plan with severe restrictions to ""reduce costs."" I know several ladies from Canada who have had to pay out of pocket for brain surgery in the US because of problems with the Canadian system. Every person I know of who has been denied access to medical care for my medical condition has been denied care -- not because of a lack of insurance -- people get free care-- but because of being in a highly restrictive insurance plan.""You have a right to move to another facility, though insurance coverage tying you to one place is another factor.""The thing is, too many Americans believe insurance is the same as care. Just thinking out loud here, but maybe our employer-centric insurance system needs to go away. It's a relic of WWII wage controls. Instead of offering raises, companies increased benefits.""Good point about insurance doesn't equal care. Even today we see more patients, sicker patients, staff shortages, healthcare workers bailing to different careers and fewer students starting healthcare training. See the Affordability Care Act time-line to see your referenced employer-centric insurance system going away in 2014 - www.healthcare.gov/law/timeline/"I just started a new thread mentioning that the Sept issue of Health Affairs is dedicated to payment reform."FYI, the September issue of Health Affairs is looking at payment reform's effect on quality and cost.""From the press release:Profiles in Payment Innovation Featured in Health Affairs' September 2012 IssueComplex patients responsible for $319.5 billion in annual spending under federal programsBethesda, MD -- The September 2012 issue of Health Affairs, supported in part by grants from WellPoint Inc., the WellPoint Foundation, and the California HealthCare Foundation, focuses on changing the way US health care is paid for to shift incentives away from fee-for-service medicine and produce better health and health care at lower cost.Together with other articles in the issue, a series of ""Innovation Profiles"" highlight promising pilot programs in which payments to doctors, medical groups, and hospitals were at least partially based on quality and other metrics--and in some instances moved broadly away from fee-for-service toward other, very different payment models. Innovations featured include patient-centered medical homes, accountable care organizations, bundled payment projects, and others.Other articles in the issue carefully analyze the development of different payment models and show that, despite early signs of success, there are many challenges to their widespread implementation.Ruth Raskas, vice president of clinical health policy at WellPoint, and co-authors provide encouraging signs that medical practices participating in patient-centered medical home pilots are meeting goals for higher quality of care, lower use of hospitalization, and cost savings. WellPoint provided incentives to participating physicians for greater care coordination and preventive activities to improve patient health.In New Hampshire, for example, WellPoint paid primary care physicians fees based on services provided, plus a monthly care management payment to support comprehensive services. Additionally, physicians who met certain quality and utilization targets were eligible for a bonus.Early findings show patient-centered medical home participants in New Hampshire saw costs increase just 5 percent, compared to 12 percent in traditional practices. Patient-centered medical home participants had a greater decline in emergency department visits than the control group, and the pilot had a positive influence on utilization of health care services.""We know that we need to drive fundamental changes in primary care in order to improve the lives of the people we serve,"" said Raskas. ""Payment models that improve both access and quality are scalable, and they encourage the type of patient-centered care that's needed to transform the US health care system.""Thomas Claffey, medical director of NovaHealth, president of Intermed, and director of the Infectious Diseases Division at the Maine Medical Center, and co-authors report on a collaboration between Aetna and NovaHealth, an independent physician association based in Portland. The model focused on shared data, financial incentives, and care management to improve health outcomes for approximately 750 of Aetna's Medicare Advantage members. Patients in the pilot had 50 percent fewer hospital days, 45 percent fewer admissions, and 56 percent fewer readmissions than unmanaged Medicare populations statewide. NovaHealth's total per member, per month costs for its Aetna Medicare Advantage members were 16.5-33 percent lower than costs for other members. Clinical quality metrics were also consistently high.Marjie Harbrecht, CEO of HealthTeamWorks in Lakewood, Colorado, and Lisa Latts, principal of LML Health Solutions LLC, in Denver, share their experiences from one of the nation's first voluntary, multipayer medical home pilots. Six health plans, the state's high-risk pool carrier, and sixteen medical practices with approximately 100,000 patients participated in the pilot over a period of three years. Preliminary results show that the pilot significantly reduced emergency department visits and also reduced hospital admissions, particularly for patients with multiple chronic conditions. One payer in the pilot reported a return on investment of 250-400 percent.Despite such success, participants in Colorado also ran into numerous obstacles. Many practices had to provide extra services to patients whose employer-sponsored insurance plans declined to pay the extra fees needed to cover the cost of the patient-centered medical home expansion. The authors say this outcome shows how important it will be to have strong commitments and collaborative efforts among multiple stakeholders in order to make the model viable over the long term.Rachel Werner, a core investigator at the Center for Health Equity Research and Promotion at the Philadelphia Veterans Affairs Medical Center and an associate professor of medicine at the Perelman School of Medicine at the University of Pennsylvania and R. Adams Dudley, a professor of medicine and health policy and an associate director for research at the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, calculated hospital performance scores and projected payments for all eligible hospitals. With a projected bonus pool of $850 million, it's the largest Medicare quality improvement initiative to date, but dividing this pool among more than 3,000 participating hospitals will produce small bonuses for individual hospitals, even those with the best scores. Almost twothirds of hospitals will experience payment changes of just a fraction of a percent. Even after a projected doubling in size of the bonus pool in 2017, only eight hospitals would see payment changes as large as 1.5 percent, and the authors say it's unclear whether such small amounts can influence care.Related articles that profile early payment innovations include:A Global Budget Pilot Project Among Provider Partners And Blue Shield of California Led to Savings in First Two Years, Paul Markovich--president and COO of Blue Shield of CaliforniaHorizon's PatientCentered Medical Home Program Shows Practices Need Much More than Payment Changes to Transform, Urvashi Patel--head of research and development at Horizon Healthcare Services, Inc., and co-authorsPayers Test Reference Pricing and Centers of Excellence to Steer Patients to Low-Price and High-Quality Providers, James Robinson and Kimberly MacPherson of the Berkeley Center for Health Technology at the University of California, BerkeleyMichigan's Physician Group Incentive Program Offers a Regional Model for Incremental 'Fee for Value' Payment Reform, David Share and Margaret H. Mason of Blue Cross Blue Shield of MichiganRelated articles that analyze past changes in provider payment and the viability of early payment pilots include:The Lessons of Medicare's Prospective Payment System Show that the Bundled Payment Program Faces Challenges, Stuart Altman--economist and the Sol C. Chaikin Professor of National Health Policy at the Heller School for Social Policy and Management, Brandeis UniversityBeyond Capitation: How New Payment Experiments Seek to Find the 'Sweet Spot' in Amount of Risk Providers and Payers Bear, Austin Frakt--health economist with Health Care Financing and Economics at the Veterans Affairs Boston Healthcare System and Rick Mayes, a faculty research fellow at the Petris Center on Healthcare Markets and Consumer Welfare, University of California, Berkeley.Fee-for-Service Will Remain a Feature of Major Payment Reforms, Requiring More Changes in Medicare Physician Payment, Paul Ginsburg--president of the Center for Studying Health System ChangeMedicare Postacute Care Payment Reforms Have Potential to Improve Efficiency of Care, But May Need Changes to Cut Cost, David Grabowski--a professor in the Department of Health Care Policy, Harvard Medical School, and co-authorsMany Large Medical Groups Will Need to Acquire New Skills and Tools to Be Ready for Payment Reform, Robert Mechanic and Darren E. Zinner of the Heller School for Social Policy and Management, Brandeis University" http://www.deathbymodernmedicine.com/"US research lags most of the world in medical ethics. ""Not a single academic medical center in the United States makes it a policy to compensate injured subjects or their families for lost wages or suffering. These policies do not change even if a subject is injured in a study that is scientifically worthless, deceptive, or exploitative."" http://www.nejm.org/doi/full/10.1056/NEJMp1205623"Thank you Garrick for reposting "Someone had posted it in a different forum, but I see you posted it here first. Great find!""After reading this, I truly believe this is the type of practice in UROLOGY at Mayo Clinic Arizona by Dr Erik P Castle (Castle Labs) & Dr Shane Daley. No Confirmed Kidney Cancer before or during surgery, per pathology reports and Dr Castle had in his notes ""Presumed Transitional Cell Carcinoma"". The problem is we were told, I had a very rare Advanced Stage Kidney Cancer. I would NEVER voluntarily participate in a RESEARCH PROJECT... This is so wrong, we protect animals better that people."The ideas Marshall Allen shared about how to work with the media prompted this post: http://bit.ly/SPe3oC and this one: http://bit.ly/Rv6WBC"As mentioned in the article, is there a possibility of meaningful change as a result of going to the press? If meaningful change was the result, our hospitals would have the safety record of the airline industry (no preventable deaths in years). Meaningful change more likely comes from an internal champion to make changes (Dr Pronovost at Johns Hopkins after the Josie King tragedy). A post-event disclosure may uncover information for the patient and facility. A proactive measure to avoid having a story to tell is to enlist a professional or family Patient Safety Advocate to monitor for best-practices 60 minutes per hour and record everything.""Without reading the article, and since the central line here regards our stories: before telling your story be sure to be sure why you're in the game. The media still seek out, turn toward, and like to quote as solution providers mainstream institutions and people in them who probably have degrees awarded that support their livelihood. Reporters then find plain folk with sad stories to tell. An article or section will lead with said story as a foil (example setback) for the subsequent presentation of potential solutions by mainstream professionals.If you are a harmed patient-family member whose sole aim is to share your story in order to publicize and help grease these rote wheels, that's perfectly fine. If you happen to also be an author or lay person offering some product you've developed and have not acquired, through hard work or good fortune, enough notoriety to be already known and sought after, beware���the great likelihood is that the reportage will fail to acknowledge your expertise, solution, value, or credibility (even if you're an author, around which conventional book-sheparding wisdom says that author = expert).Some years ago a major metropolitan business journal/newspaper did it's annual healthcare issue. A, or the, main article was about dying with dignity. It lead with my story for a full four paragraphs. The reporter knew of my book (which was mentioned), bona-fides, endorsements, speaking, website; all of it���and especially the hard-won meaning I'd made over years of reflection and engagement, and the unique solutions I'd developed for what's requisite to die in peace. The article never included me in that phase; only the other interviewees, representing facilities and disciplines, were asked for and had reported their solutions. Peppered throughout the remainder of the multipage print edition were sidebars presenting every other entity's pictures, business name, offerings, contact info, logo, website URLs. I alone did not receive this treatment, despite being in business. And, let us note, that the always and ever present, unspoken context/frame was that tired paternalism that medicine, alone, held the answers to the poor citizenry's troubles.I felt very used.I don't know about you but I always have a dual purpose. Yes, this is heart work. Yes, I was and remain driven. Yes, I have gone further than some in writing and then publishing a book���at great dollar cost. Yes, I would be overjoyed to with regular paid speaking gigs. Yes, I would like to recoup the cost of my efforts and even make more than occasional spending money from them.In whatever corner of healthcare harm you have crawled out from under and now work, it's probably the same: you have some solutions that remain outside the bounds of everyday reportage. I don't think that reporters collude with corporate medicine (we somehow have to reach and educate them), but would understand if our megalomanic harmed patient cohort did.When I challenged the reporter about being excluded he absolutely could not get on my wavelength, seeing nothing at all wrong with his reportage.And even recently, on these pages, I've seen links with little verbal ""hurrahs"" to halfsentence mentions of even the most prominent of our patient-advocate colleagues within an article from, enviably, some huge media outlet.I'm no marketer, but do wonder if we're kidding ourselves about the amount of value received from such exposure. Yeah, something's better than nothing. Or, is it?Lesson: whenever I go on record with a reporter I now make it a point to say that I offer a range of value: story, unique insights, books, and a nascent speaking career. And that I expect to be fully represented. I know that I (and you) have no muscle over national reporters and reporting. But we've already been through the wringer with whatever has brought us to a page like this. Be very clear about what you are, and want to offer the media, and what you want from your media encounters.""as usual, bart speaks much wisdom.... he said 'but we've already been through the wringer with whatever has brought us to a page like this. be very clear about what you are, and want to offer the media, and what you want from your media encounters.'""All righty - I'll weigh in here, since we're obviously talking about what I do for a living! ;) Doug Hall, it's true that no one article or series of articles is going to bring about radical reform of the health care system. But that's also an unfair and unrealistic standard of ""meaningful change."" I would argue that ""meaningful change"" is the result of many stories of patients that are told by journalists. It brings accountability to providers. It brings a modicum of justice to the patients. And it brings important exposure to the problem of patient harm, which spurs health care leaders to bring about change. Of course there are still problems. Major problems. But the public is much more aware of them, at least. But yes, there's much work to be done. And there have been instances I've seen where the public exposure shames the providers into doing the right thing by the patient. I would say this is meaningful. At the same time, I don't disagree with what Bart Windrum is saying, and would need to caution that reporters and media outlets are all individuals. You can't just lump them all in together. Each has its own unique mission. Not every reporter is going to want to take on stories of patient harm. As some journalists have explained in this forum, they are difficult stories to publish. They're difficult because they can be extremely challenging to verify, for one thing. It's a painstaking process that doesn't always fit with the deadlines of many media outlets. I won't go into all the other reasons these stories are a challenge, but will just post a link to the article we wrote about it in this forum.""Just to be clear: my entry above refers to when reporters do engage in in writing stories on topics about patient-family harm and needlessly rough dying, and seek us out to write about. I and Marshall are writing about two different issues; me, how we're portrayed and treated by the media (with the example being in print); Marshal about whether our interests are topics of interest and do-ability for the media.""I think my main point is that telling patient stories does bring about meaningful change, on many levels.""This is an edited of the comment I put on the article comment section.After a lifetime of believing normal people ""trust your doctor"" which implies your doctor is trustworthy, and everyone you know believes it, and you are part of everyone, to find this is all wrong because after your doctor injured you he lied about it. And other doctors cooperate with the lie and deny the injury. The victim knows most people believe doctors are high minded moral do-gooders who would of course own up to their mistakes.Prior to this experience, a victim would have assumed a person relating this very experience might be diverted to the rubber room. The victim realizes he has information he can't tell, for fear of not conforming to general wisdom. That is traumatic. The nature of trauma is not knowing how to trust anyone to tell what you know. Now the victim still believes in his sanity, so his world view must change.If his world view must change, he must inform everyone else. The victim can't tell his story fast enough, but only to the right person. Journalists play a large part in what people believe about the world. It is no wonder that when someone has new information about he nature of the world he goes to report it to a journalist. It is the responsibility of the journalist to report changes in the world view we all hold in common.To the victim, the injury is not a story of one lone patient versus a doctor. A deceit was foisted on him and he realizes his experience not unique, everyone must be warned. The author must try to understand the enormity of an experience for the victim is a huge world-view change that contradicts ""trust your doctor.""The victim wants the author to see the big picture, which is doctors really do have a Mr. Hyde that comes out when the doctor makes a mistake. This real-life Mr. Hyde comes out not to kill the patient, but silence the victim just as brutally with legal tactics devised to prevent litigation. The doctor disappears and Mr. Hyde deals with managing reality for patient and loosing any patient records containing evidence. Seeking ""good"" doctors, the victim finds out all doctors have Mr. Hydes who come out and cooperate together to prevent the victim from obtaining truth and healing. This is what the victim experiences. This shocking experience is about the entire world, it is much more than a personal slight.""Like I have said., I WAS IN DISBELIEF when I dound out I couldnt talk to any of my doctors many month after the fact becauae I spent months in a hospital fighting the fight fory life because after removing my left kidney for PRESUMMED TCC OF THE KIDNEY and the doctors that promised this was a routine procedure that they do very well no explanation of side effect or possibility of puncturing an intestine and going septic and on life supportor with Zero percent survival. THEN since i have worked in health and requested my records numerius times and only got a few things and i knew spending 3 months in a hospital had to have more I went to the IT dept and asked for a dump cover to cover of all my records from 10/08 to current and quess what i found in internal phone records and also print stating parts of my record are archived because resident is no longer on site well to this day i still cant get those records but i have many pages of their internal conversations that show premeditation to do harm. I pray for my story to be told only for purposes of saving lives we have corupt urologist in the USA and have a certain doctors timeline by good fortune and evweything is documented. My doctor now calls me Lazareth and I truely beloeve I survived for the purpose of sharing my and my families story of MAYO CLINICS dirty little secrets.""And, since we're all in this sandbox together, I was just telling my story, not dissing Marshall's good efforts!""garrick said... 'this *shocking experience* is about the entire world, it is much more than a personal slight.' indeed, this experience is about the entire world and it is shocking on every level!""Doug, My experience is that very little meaningful change comes without media coverage. And media coverage of an issue always has less impact without a human story. I know what you mean about internal champions, and they are hugely important. But when you have internal pressure and external pressure (from the media and readers) you get meaningful change. It can happen without media coverage, but it's not as common.""I can appreciate your theory - There is no shortage of stories of hospital acquired conditions that result in injury or death - yet in the last 10 years the IOM Reports show no reduction of the estimated one hundred thousand preventable healthcare deaths per year. How does the media or readers affect the quality of care? We are in the midst of a perfect storm in healthcare: More patients, sicker patients, staff shortages, MDs and RNs leaving for different careers, fewer students entering the career, hospitals closing, increased antibiotic resistant bacteria to name a few. What is your idea toward a solution?" http://www.therecord.com/news/local/article/791372--west-nile-nightmare-forcambridge-family http://preventdisease.com/news/articles/hysterectomy_operation_not_needed.shtml http://www.kevinmd.com/blog/2012/08/stop-paying-mcdonalds-wages-cheesecake-factorymedicine.htmlhttp://www.nejm.org/doi/full/10.1056/NEJMp1205623"Yet another reminder that the medical negligence crisis is not a crisis of lawsuits. It's a crisis of medical negligence. ""If [the deaths from hospital errors] happened in aviation, they would shut the airlines down."" That quote in the story below comes not from a lawyer but from a former hospital CEO."...number of preventable deaths in the aviation industry in the last several years = 0"And not be a green eye-shade about it, but medical errors can be horrifically expensive in terms of additional medical care, disability, and loss of life. Given the error rate, it would not be surprising if a quarter of health care spending, or more, is caused by preventable error. Can you imagine what the benefit would be minus those errors. Doctors would not be so harried, the would be room for scheduling more patients, we would not have to spend so much for new medical facilities, people would spend less time at the doctor and have more time for living their lives. Health insurance premiums could drop 25% or more. Medical malpractice insurance would be low and our courts would not be clogged with malpractice litigation.""Not sure if you are being sarcastic or not but, medical malpractice litigation makes up very little of state courts' dockets. In 2011, the National Center for State Courts found that ""despite the widespread prevalence of medical negligence,"" in 2008 med mal case filings ""represented 2 percent of all incoming civil cases, and less than 8 percent of incoming tort cases.""""Yes, that last part was more than sarcastic." "Professional engineers build all sorts of things, like massive factories, bridges, airplanes, nuclear reactors, rockets. etc. You never hear them crying in their beer about the raging design failure liability crisis that is preventing them from getting rich and functioning properly. It's because engineering pays serious attention to processes, failure potential, and peer review (the real kind). Anyone trained as an engineer is trained to assess risks, costs and process times. Engineering schools have, for decades, emphasized performance in teams as part of the educational process. Engineers have no special protection from lawsuits and don't need it. And I guarantee you, 99% of doctors would look down their nose at an engineer. The risk of a lawsuit against you as a doctor is minuscule if you are a decent human being (not a jerk) and reasonably careful. The people who get sued are the ones who are so arrogant, they have no clue that they are professional failures. It really disturbs me that people whose job it is to assess risk and cost every day are so irrational about this risk."interesting comparison between engineers and doctors debra and good points... especially this one 'the risk of a lawsuit against you as a doctor is minuscule if you are a decent human being (not a jerk) and reasonably careful.'Kirpal Singh is quite right. The number of medical malpractice cases is minimal. The largest single group of personal injury cases are motor vehicle accident cases."Debra Van Putten, I like your comparison between doctors and engineers. The difference is that engineers design a single product such as a bridge or a toaster that lots of people use. So a design failure gets multiplied by the number of people affected by a single engineering flaw. A doctor does a one-off each time. If a doctor makes a mistake it is easier to hide it within the population. The people injured by doctors do not know of each other. But the people who go down in a plane crash know how many of them there are. Also the culture is vastly different. Engineers have to work in a team. In engineering culture are no ""stars"" who get special treatment. Engineers are rewarded by achievement of their design. Doctors are rewarded by reputation bestowed on them. Any engineer who has an idea or a safety alert must speak because a bad product that gets recalled can cost the company it's existance. On the other hand, bullying is a part of medical culture starting in medical school. Doctors who do a single act of whistle-blowing by telling the truth to a patient of another doctor may end their career, at least in that state. Teamwork is really only important when they are protecting one of their members from legal action. I could go on and on.""The principals of engineering could in many instances be applied to doctoring. And I do not think patients, in terms of care, are as ""one off"" as made to be especially when you get to the specialist level. (and that is from someone with multiple rare diseases). And engineers rarely face the exact same problem time and again. Because I am very much a 'zebra,' I have been all over the country for various aspects of my care. There is a night and day difference with a place that takes care with its processes than one does not. The real driver in the difference in the culture is how legal liability is allocated and how the system responds to it. I have always said, if you are doing anything important, you need to have two sets of eyes and two people working on it. Why, because we are all prone to mistakes. Medicine seems to think that what it does is not, in the end, important, or that doctors, despite ample evidence to the contrary, are infallible.""My husband was part of the team that designed the landing gear steering control on the Boeing 747 - so I know about the team work -There is no ""I"" in Teamwork and I all too late realized the lack of teamwork in healthcare in Canada and the US!"It wouldn't surprise me to learn that some medical malpractice suits are selffulfilling prophesies brought on by medical providers trying to prevent one. Victims of error hate the lie more than the error. Victims sue the lie.Love all the discussion and all so very true @poor patient nailed it.I have just submitted to Michael moore again as well as Nancy Grace and Oprah. I have suggested a story about all the people that have been killed and harmed by doctors. Heres hoping! Thank you"This is about the $29,000,000 CEO of Davita Dialysis. Is this how we ought to be spending our healthcare dollars? This guy is getting rich (and so are his stockholders), from taxpayer funds for dialysis patients.I think the money should be put where the dialysis patients are....into improved quality of care and a safer experience. http://www.5280.com/magazine/2012/09/strangest-show-earth? page=0,1""It's an article that makes one cringe. Long, but worth the time because of the questions it raises.""To those who don't know, Davita is the company that is trying to purchase Eastern Maine Medical Center's dialysis services, here in Central and northern Maine. A colleague in Patient Safety warned me about the corporation and some of their history. She also connected me to a dialysis patient advocate. The advocate steered me to Dialysis patient who bravely shared their stories of harm and sometimes dismissal from Davita clinics. This was the basis of my campaign against the acquisition. I testified with several others at a Maine Certificate of Need hearing. Because I stood up for patients who had been harmed, gave them a voice and dared to expose some of Davita's questionable past and practices, I drew fire from their attorneys. All in a day's work when you are a Patient Safety Activist. This is the letter of support from my trusted and admired Patient Safety colleagues.""Date: August 17, 2012To: Phyllis PowellAssistant DirectorPlanning, Development and QualityDivision of Licensing and Regulatory Services Department of Health and Human Services State House Station #11 41 Anthony Avenue Augusta, ME 04333-0011Re: Letter in support of patient safety activist Kathy Day, RN concerning proposed DaVita acquisition of Eastern Maine Medical Center dialysis servicesThe Centers for Medicare and Medicaid Services (CMS) has designated patient safety as a top goal in reforming our healthcare system, reducing costs, and improving public health. Across the nation federal and state agencies, hospital systems and research institutes, auditors, advocates, and activists are working to protect patients and especially vulnerable populations from preventable medical harm. Given this sea change, speaking up and out about patient safety failures is hardly an act of revolution, yet one courageous activist in Maine has drawn fire for doing just that. We write to you today in support of patient safety activist Kathy Day in her quest for serious deliberation of the DaVita acquisition of Eastern Maine Medical Center dialysis services. We know of Kathy Day's work as an advocate for patient safety in Maine. Because of her compassion, caring, and advocacy, patients in Maine are receiving better care with less risk from hospital-acquired infections. Her advocacy for dialysis patients is consistent with the growing national concerns reported in the press about the quality and safety of patient care at DaVita dialysis centers. Ms. Day has no personal financial stake in the DaVita matter; her interests lie solely in the outcome of Maine���s dialysis patients. We urge Maine to reject the proposed DaVita acquisition pending a more thorough review of patient quality and safety concerns. This action has precedent. The State of Vermont recently rejected the out-of-state-for-profit acquisition of dialysis centers by Fresenius Medical Care because it reportedly failed to pass their patient quality and safety muster. Additionally, it appears to be statutorily prudent to require regulatory investigations and whistle-blower lawsuits regarding DaVita operations be concluded and prescribed corrective action taken before giving further consideration to a business transaction that may negatively impact the quality of care for Maine���s dialysis patients.While healthcare is delivered one patient and one community at a time, national coalitions support the grassroots work of state advocates and activists like Kathy Day to promote policy action that recognizes patient safety as not only a moral highground, but also as a financial necessity for program sustainability.Sincerely,*** Please note that all supporters are non-conflicted individuals and organizations. ***(signed by 25 Patient safety advocates and activists)" http://www.cbc.ca/fifth/donoharm_multimedia.html*FIRST DO NO HARM* a documentary filmed in canada...http://www.thestar.com/news/gta/article/839648--127-women-seekseparate-suits-against-scarborough-doctorthanks kariann for sharing the above link...such a good show"Do you know of someone who should be nominated for the Hope Award? It's a great way to recognize and spotlight someone (patient/family/clinician) who is doing great work supporting those who have been harmed by adverse events. The winner will receive $5,000. Past winners have included patient advocates. Link is below. http://us1.campaign-archive2.com/? u=c1b1ae9f20456f800ad6e62cd&id=bcf689a205"Me! ;)"Christine, they have selfnominations--go for it!"Julia Hallisy of the Empowered Patient Coalition."Claudia, great suggestion. Maybe you can nominate her."I will!"This painful article about a needless cancer death exposes some confusion about citizen eligibility for highrisk-pool coverage right now, before full implementation of the Affordable Care Act. Worth reading for that purpose. http://goo.gl/y1Aqi" http://www.michaelmoore.com/words/mike-friends-blog/dead-woman-working-im-no-robinrobertsthe article bart posted above made me think of 'dead woman working' posted on michaelmoore.com"Although Stein relinquished his license, he can reapply for a new one in two years. In a final agency order the Board of Dental Examiners accuses Stein of saving unused drugs in syringes, and then combining the medications into another syringe to be used on another patient.""Of course....why should their lives be affected any longer than the bre minimum while they leave us with the impossibility of getting better, getting help or getting back on our feet....I want my six figure job back too..... Unbelievable""Herein lies the evidence that the Dental Boards keeping incompetent, dangerous, unethical and drug/alcohol addicted dentists licensed impose the negligent/incompetent licensing practice on patients paying exorbitant dental fees...too many of us becoming victims of both of their dangerous conduct/misconduct."It is far worse the patients lieing in the chairs of Dentists On Probation are not informed at the dental appointment the dentist has a history of harmful conduct only the Dental Board and Probationer Dentist knows of http://www.medscape.com/viewarticle/769999?src=nldneGood information on how to get money back from insurance collectors. WOWgood for you deidre! *don't hush say a word* may god bless your efforts for speaking out...Has anybody from the US tried to send your story to Nancy Grace or Oprah. May be a way to get noticedI haven't been able to get it to them. any ideas let me know.Hey guys - we have some tips on dealing with the media here: http://www.facebook.com/groups/209024949216061/doc/255361274582428/ and here: http://www.facebook.com/groups/209024949216061/doc/255749517876937/"try michael moore. go to his website www.michaelmoore.com and go to the bottom and click on the word ""contact""""interesting mary-lou... thanks for posting. i like michael moore but haven't kept up with him too much lately. looks like his site has lots of information on it. if i was inclined to contact anyone at this point, it would probably be michael moore.""Last year today, Mom was in her second day of being intentionally starved, with no advanced directive and no terminal illness diagnosed. She did have a stage III pressure ulcer, which was degrading quickly from her previous ""visit"". The evil restraints were again applied, in lieu of appropriate medications and to hinder any self care. Oh, and she was septic from a wrongful discharge a week earlier and the massive overdose of steroids she had received in visit 1.""I don't know if others have the same problem, but every morning I wake up and relive what happened a year ago. It's hard to not be there and be here."We who take action as a result of harm experienced are destined to relive it. Comes with the territory. In my experience it ebbs and flows. 1 year is a brief time. Best we can do holding it all close is figure out how to prevent it for our (remaining) families and others going forward."Thanks for sharing. Somehow we need to get people to understand that these are crimes. It's criminal abuse. If a family member would go to jail for it, caretakers should go to jail for it. Why should professionally trained people be held to a lower standard? Adult Protective Services folks somehow believe that if it happens in a facility, it's not abuse or neglect. There are multiple federal statutes that would make altering a medicare recipient's medical records a serious crime (forgery statutes and obstruction of justice statutes), yet such prosecutions are never done. If its a public company, this kind of incident should have to be reported in disclosure statements." "'altering' a medical record is a felony in most, if not all, states but it's only a felony if the state decides to prosecute and files charges. my former doctor 'admitted' via sworn testimony that he 'altered' my medical record. *ADMITTED* he went on and on about how it's 'his record' and about how 'he can do what he wants with it'. nobody cares. *hush don't say a word* to use deirdre's phrase... he admitted that it's his 'practice' to have his patients sedated before he arrives for surgery and then obtain illegal consent. nobody cares about that either... not the state medical board, not the joint commission on hospitals, not the insurance company that pays for the illegal surgeries, not the police and not the media. *hush don't say a word* i was 'crazy enough' to think the police would file charges once my former doctor actually 'admitted' what he did to me and others like me no less... i was wrong. i was told point-blank by the police that if a thug on the street drugged me and stole my organs, they would file charges but, since a doctor did this to me, it's considered *CIVIL* it's considered *CIVIL* debra is correct 'such prosecutions are never done'. when a doctor can 'boldly admit and declare they alter medical records' and 'order patients to be knocked out so as to obtain illegal consent for surgery' and NOBODY cares, that makes for a very very dangerous medical environment - a deadly one in fact! but wait... *hush don't say a word* right? if it sounds like i'm mad... you know what? I AM MAD! and you know what else? I SHOULD BE MAD! the trauma purposely inflicted upon innocent and unsuspecting patients by those who we believe take an oath to 'first do no harm' is beyond overwhelming! the trauma never ever ends..... i just learned tuesday that it looks like i may need breast surgery. the current issue with my right breast is most likely due to my taking hormone replacement therapy since the unconsented removal of my own vital hormone-producing organs five years ago. the breast surgeon believes surgery is necessary. it took me exactly one day to decide that there is no way in hell i will agree to surgery and take a 'chance' on further unnecessary mutilation of my body. been there done that. not going back for more.....""Gordon and Betty Moore Foundation aiming for a new approach, announces Patient Care Program that seeks to eliminate all preventable harms to patients.""The web page Albany 2 Cents has a piece on its front today about my web page listing unreported medical-malpractice lawsuits. It's at:http://www.albany2cents.com""that's great david! i too am outraged that the media, whose function is to *inform the public*, routinely ignores lawsuits alleging harm while receiving hundreds of thousands of dollars in advertising revenue from those providers. that's a huge problem... i've learned this first-hand. for this reason, i post various media sources that refuse to 'inform the public' on my website. i even post my e-mails/letters to them and their responses or non-responses. it's no accident that hospitals advertise via local tv and newspapers. silence is bought and paid for....."Exactly. Here in the Albany area it's been going on for a dozen years and the newspapers are still filled with ads for the hospitals."by the way david, i think what you're doing is much needed. the more people i meet via this site and similar sites, the more i realize just how many intelligent and passionate people are advocating for patient safety in a variety of ways.""Thank you, Robin. There were times during the past eight years when I felt I was in this alone. But now the truth is getting out. David""!!!Excellent!!! By reporting the lawsuits, you are reporting the truth. The truth does not need legal defense (Bradley Manning aside). I didn't download the pdfs because it would take awhile on my Internet connection. But I don't know how they could sue you for that unless it is frivolous. It seems NY has an anti-SLAPP law (Strategic Lawsuits Against Public Participation) so they would end up paying for their own frivolous lawsuit."agree with garrick. the truth is the truth... and 'does not need legal defense'"Yes, Garrick, NY does have an anti-SLAPP but it only applies to government entities. So while the lawsuit the hospital filed against me is clearly intended to shut me up, it is not covered by that law.""The truth is a defense, but it does not defend your bank account from your legal costs. Mr. Baker, if you are not already situated, I recommend the Electronic Frontier Foundation for finding legal resources for bloggers threatened with lawsuits. They are the preeminent clearinghouse in this area and have a comprehensive website"How about sending your stories to Michael Moore. He seems to like exposing corruption"One of the reasons given for medical malpractice damage caps is that if Colorado didn't have them, physicians would leave the state and costs would go up. Texas has a similar cap. This study shows that there has been no effect on physician supply or costs in that state.""Yesterday was an extremely busy day. In the morning I spoke at CareFusion's Town Hall Meeting, a live webcast to all of their employees around the globe. In the afternoon, Eric Cropp and I gave another presentation to The San Diego Patient Safety Council at CareFusion's corporate headquarters. The following is some local news coverage about my beautiful daughter Emily and what we are truly trying to accomplish through The Emily Jerry Foundation!""Johns Hopkins study of autopsies finds 1 in 4 in ICU had a missed diagnosis, 8% of which could have caused or contributed to the death of the patient.""That's a similar finding to the story I wrote last year about the lack of autopsies in American hospitals, and what that means for identifying incorrect diagnoses: http://www.propublica.org/article/without-autopsies-hospitals-bury-their-mistakes" "not only do they bury mistakes they falsify documents. they sent a fraudulent cause of death to the medical examiners office. they said she choked, but she had sepsis and six sponges left in abdomen. how does that happen"Presentations from the August 9th National Priorities Partnership Meeting (regarding the Partnership for Patients) are now on-line at: http://www.qualityforum.org/Setting_Priorities/NPP/Partnership_for_Patients/Quarter ly_PFP-NPP_Meetings.aspx"Dear All,Please join our open group as well on FB Citizens for Patient Safety."Please share http://reginaholliday.blogspot.com/2012/08/calling-all-patient-advocates.html Shared.http://well.blogs.nytimes.com/2012/08/27/overtreatment-is-taking-a-harmfultoll/?src=me&ref=general Another aspect of the patient safety problem..."What do you do when you watch your father's dignity & health get eaten away by a hospitalacquired infection...and finally lose him? I put all my energies and personal resources into creating a Patient Pod, and now want to give them away. Please check out link below and help me have an impact on other families. Would love to hear ideas from you!http://beta.medstartr.com/projects/46-saving-100-lives-with-thepatient-pod"Do I do this one too?"No, my dear, you have done quite enough:) Wonderful post today about playing in the sandbox.""Robin,I totally feel your pain and know your anger. This didn't happen with a magic wand for me but as Michael was in nuring school and it was the profession he loved I found it in my heart to take my grief an dthe tradgedy of losing my only child and one day at a time tried to get wherw I am. I think of all the Robins and Michael's out there and say we have to do something to save others.""i know patty... as i said, i saw your heart and focus in your words. i'm thankful for you and for what you have the courage to do. i was merely sharing my thoughts... that's all. i'm behind what you're doing 100%. just not there myself.""Robin, I didn't mean that you need to be there just something to think about maybe someday. My husband is not near where I am and I don't believe he ever will be that's ok we understand one another. Sometime when you feel like it and want too I would like you to share your story with me." http://www.cbc.ca/player/Shows/ID/2273210665/Check out this site. I placed my complaint on this site concerning the medical negligence of my daughter Jocelyn. http://wwwcomplaintsboard.com. Read the article about Memorial Hermann Hospital. "The site you mean seems to behttp://www.complaintsboard.com/But I do not see a category for medical"Look at Jocelyn Y. Dickson foundation for Life where i filed a complaint for medicalGreat Veronica glad you did"This is why I keep pushing for Justice! The Fight will continue............HUSH DON���T SAY A WORDJocelyn Y. Dickson a small framed 22 year old CHARGE Syndrome little girl was taken to the Emergency Room of Memorial Hermann Hospital for a piece of corn dog lodged in her throat. On that fateful day of February 14, 2011, the supposedly most loved day of the year, she becomes the victim of medical negligence.Two doctors, who were found to be friends as well as colleagues decided to commit a crime-cover-up of the death of my daughter Jocelyn. HUSH DON���T SAY A WORDThe core value of the medical profession is centered on the duty to help sick people and to avoid harm, but on that day, one of medicines most cherished commandments, First do no harm was not honored.Imagine, Jocelyn lying there while the first doctor forces the GI tubing down her throat. The thrust of the tubing perforates her esophagus but he continues to force the instrument further inducing too much CO2 in her abdomen causing abdominal compartment syndrome. Her abdomen continues to swell until her colon erupts releasing toxins in her body. Limp and helpless she goes into cardiac arrest, but he proceeds with placing her on a ventilator. This is part of the horrific experience I had to watch and endure. No one including the nurses said a thing. They witnessed this ���serious��� medical error and did nothing. HUSH DON���T SAY A WORDThough that wasn���t enough the second doctor operates on what we found to be true later a totally brain dead patient, also leaving six blood soaked sponges in splenic region of her abdomen. No one including the nurses said a thing. HUSH DON���T SAY A WORDCompounding the problem, they roll her little body into ICU as if she was alive, hook her up to IV���s and continued to give her blood transfusions. During the second surgery her blood coagulated and she began to bleed out. Blood streamed down her face from her eyes, ears and nose. Every opening and every wound seeped blood until every drop of blood ran onto the floor. Seven (7) hours my family and I watched my daughter die. No one including the nurses said a thing. HUSH DON���T SAY A WORD.Edmund Burke made a profound statement that ���No one could make a greater mistake than he who did nothing because he could only do a little. Just one whisper would have done. Just one word would have sufficed, but instead they said HUSH DON���T SAY A WORD.In a survey of 1,600 physicians by Columbia University���s Institute of Medicine as a profession revealed that 46 percent of the doctors in the survey had witnessed ���serious��� medical errors by their colleagues without reporting them. (DC Medical Malpractice Law Blog). This was even true though 93 percent said they realized they should turn doctors in. HUSH DON���T SAY A WORDOur governor Rick Perry, legislators and the Texas Medical Board has failed us and has not protected us from this repulsive demon ���medical negligence���.How does one ignore and deliberately conceal this most hideous crime and get away with it? The answer is the ���TORT��� Reform, Proposition 12, and House Bill 4. This horrid ���demon��� has become an undercover agent that is out to destroy. It protects doctors, hospitals and other medical personnel, a matter of fact it is the only entity that allows someone to injure or even cause death and suffer no consequences. Even if doctors are sanctioned, they usually keep practicing. Both doctors who caused my daughters��� death are still allowed to practice medicine. HUSH DON���T SAY A WORDSocrates felt that it was necessary to create tension in the mind so that individuals could rise from the bondage of myths and half-truths, so it is now necessary that I create tension in society that will call the American people to action and to raise their voices in protest for change. I will never be able to recover Jocelyn hugging me, never recover her sitting on my lap, never recover her combing my hair, never recover her saying Hi Momma, I���m Momma���s baby. Jocelyn���s last words to me as she kneeled on the side of the bed was Momma Help Me Please and the ringing of those words will forever haunt my soul, for my family and I trusted the doctors, doctors who Americans have trusted for centuries.This sick sordid game on life ���medical negligence��� has taken innocent lives and the world has turned their heads and just simply said HUSH DON���T SAY A WORD.No more HUSH DON���T SAY A WORD, Jocelyn had the right to breathe. Texas has found a way to legalize Murder.���All that is necessary for the triumph of evil is that good men do nothing���Edmund Burke""deirdre, i'm so sorry for what was done to your daughter and you. 'hush, don't say a word' is a very sobering phrase..... it packs a *punch* as it should. thank you for sharing with us. most in this group get exactly what you're saying. and most of us are there with you."Heartfelt sorry for your terrible loss xoxoxo you have whatever support you need"apparently ontario has also found a way to legalize murder. Your story is horrendous, just like my son's"yes mary-lou... deirdre's story reminded me of josh's story:( good for both you and deirdre for having the courage to speak out in the midst of so much pain and injustice.So sorry for the loss of your daughter. Cover up goes on everywhere. Very sad!!Deepest sympathy for your terrible loss. Thank you for posting each salient fact - so many different agencies are in on the cover up. It is with great sorrow that I discovered so many people simply will not - can not accept the deplorable machinations of our healthcare principles. When it happens to them they may - but it will be too late then. http://www.modernphysician.com/article/20120823/MODERNPHYSICIAN/308239974? AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMVGJYUDhDRWxYek9UY ktwUGZUamg5b1g4WFFERmhzbHh0THNUYk9XNlk9&utm_source=link-20120823-MODERNPHYSICIAN308239974&utm_medium=email&utm_campaign=mpdaily#'the texas medical board has not disciplined 459 doctors who were sanctioned over a 21-year period by hospitals or healthcare institutions where they practiced'... that says it all....."I would love to sit in one of his lectures ans ask ""Have you ever harmed a patient?' Robotic Bladder Surgery Complications: Preventionand Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . .553Erik P. Castle, Rafael Nu��ez-Nateras, Michael E. Woods,and Paul E. Andrews http://www.scribd.com/doc/54594129/Robotics-in-Genitourinary-Surgery""Dr Erik P Castle article is on page 553, but the whole document is very Scary and amazing.""i posted several articles regarding the dangers of robotic surgery (hysterectomy in particular) on my hysterectomy web site several years ago. the most wrong, twisted and sickening article i ran across was related to high school kids being shown robotic hysterectomies via schools in northern ky and cincinnati oh. comments the kids made regarding the robotic removal of women's vital sex organs were nothing short of 'alarming'. the very idea of doctors pushing robotic surgery to the point of demonstrating it for high school kids is... well in a word... *EVIL* as far as the kids were concerned, it was like playing a video 'game'. planting that idea in young minds is so wrong.....""Great article: http://www.nejm.org/doi/full/10.1056/NEJMp1205623""That is an excellent article Georjean. Thanks for posting. I hope, I hope ProPublica writes articles on these important issues facing heathcare today and those injured by the very people that are supposed to be taking care of us and have a ""first, do no harm"" oath. And lastly we simply have to do a better job of educating people about why their premiums will continue to increase if the issue of responsibility is not dealt with. I have no love for health insurance companies but they should not have to pay when others injure. And why should SSDI or Medicare and Medicaid have to pay when others injure? Something needs to change and those that are responsible for injury must pay not us through higher premiums and our tax dollars.""It's time to walk into your doctor's office and sing ""Gimme My DaM Data!"" http://www.acmimimi.org/2012/08/gimme-my-dam-data.html""Love the video! I think the many members of this group who have not even been able to get ahold of their medical records would agree. And the battles for data are also taking place on a much higher level that relates to health care quality, as I wrote about here: http://www.propublica.org/article/health-care-reform-rules-would-restrict-publicreporting""Hey Ross - checking out your website, which is hilarious, I'm interested in the way you're using your creative talents - humor and music - to try and accomplish a greater goal. Can you tell us a little bit about that? How did you come to this point? Have you found this to be effective? You could do a guest post for this group, perhaps, or just respond here. I'd love to hear from anyone else who's had success using humor/satire/unorthodox methods to bring attention to these issues.""I wrote up a fairly brief explanation of this odd place I find myself just last night and posted it to the ""About Us"" page on the ACMImimi site. http://www.acmimimi.org/p/about-us.html A deeper story of how love and uncertainty have mixed to create our family's approach to healthcare can be found in a threepart post on my personal blog, starting with http://rossmartinmd.blogspot.com/2012/01/shall-we-dance.html. The shortest answer, though, is I do it because I must. I can't imagine not creating stuff that makes people go hmm or laugh or tap their toes -- preferably all at the same time. Since my careerish passions are in transforming healthcare through IT, a subject that keeps growing in importance, I've been forced to blend the two to keep some remnant of sanity/balance in my life. That I am working feverishly on a proposal on a Sunday (no kidding, I have a fever and the flu), while posting this video with my family out on their own today shows that balance is not working so well. As for recommendations on what works, I don't post works that often and, when I do, I really try to make them of high quality--funny and edgy maybe, but not so much to cause offense. It's a delicate balance. Like with this video, the original was ""Gimme My Damn Data"" and there were folks who weren't all that comfortable swearing--even for a good cause. Rather than just saying ""so what,"" a little creativity modified it to DaM--Data about Me--and made a good idea even better.It took me a while to learn how to leverage social media. I'm still learning really. Not that I'm a novice at it, but I don't have the time to get really embedded in all of the nuances. There's not much money in medical informatimusicology (especially when you give it all away), so the day job rules for now. Instead, I rely on a group of folks who are much more closely tied to the SM world, like EPatient Dave deBronkart, Regina Holliday and Brian Ahier. Once something goes out that they like, it doesn't take much for it to go viral (or at least as viral as something as geeky as my stuff can go). Hope this helps! Back to the proposal... sigh..."Very interesting. Thanks - and I hope you feel better!To Marshall-please contact me so I can talk with youhttp://gma.yahoo.com/kidney-ohio-transplantthrown-trash-174711282--abc-news-health.html"Because of tissue ownership laws, the living kidney donor has no rights or recourse in this case. A significant number of living donors whose recipients experience an 'adverse event' (in the literature this is usually defined as either the recipient dying, the transplant failing, or the recipient not regaining health post-transplant, but I think something like the above situation applies as well) will experience grief, depression and/or PTSD. Yet no transplant center in the US has structured aftercare or support services or living donors, nor mental health professionals adequately trained in living donor issues. For more about how living donors are treated, see www.livingdonor101.com." "This may be of interest. Health Canada.http://canadianawareness.org/2012/08/fdaand-health-canada-corruption-rampant-whistleblowers-agree/" http://martineehrenclou.com/2012/08/communication-strategies-for-physiciansbenefits-for-physicians-and-patients/"Right on M. I coined the term Communication Algorithms for the training I suppose is required for providers to acquire and prove communication skill. It's actually quite challenging, I found, when serendipitously role-playing during an IHI conference session on initiating ""The Talk."" The session leaders had a (decent) model, and boy did those very seasoned doctors and nurses struggle. Quite humbling to witness.""Thanks, Bart. I wish I could have been in that IHI conference. Sounds very interesting!"10 years of training may not be enough to be a doctor. The lack of skill sets in communication and conflict resolution compromise health care quality."You bet they do, Claudia. Lack of communication with patients compromises quality of care, patient safety, patient satisfaction and patient adherence to treatment plans. Just spoke on this today at PFCC Partners.""As I review the completed ProPublica Patient Harm Questionnaires (http://bit.ly/KeQ9h8) I'm seeing that most people do not complain to regulators about the harm they or their loved ones suffered. I can imagine that the trauma and urgency of a patient harm event would make it difficult to immediately report it a medical board, Medicare quality improvement organization, or state licensing agency. And I could also see a barrier just being not knowing how or where to complain. But you all would know about this better than I would. What do you see as the barriers to notifying regulators and oversight agencies about patient harm?""Marshall, thanks for asking about these issues and for investigating them. I think that your invitation to contribute to the Patient Harm database may yield important information. Unfortunately, even doing the Patient Harm questionnaire may be too painful for some of the most damaged patients/families to complete until they have somehow begun to come to terms with the damage.In my case, I knew where and how to complain, but I didn't always do it when circumstances dictated a complaint. I have written about several noncomplaint incidents in my book, The Last Collaboration.http://www.amazon.com/TheLast-Collaboration-Not-very-funny-modernization/dp/061564595X/ref=sr_1_1? s=books&ie=UTF8&qid=1341258273&sr=1-1&keywords=%22The+Last+Collaboration%22On Pp. 12-20, I describe a disastrous ER visit which my daughter endured with me as her advocate. A nurse misdiagnosed and mistreated an eye problem. The errors occurred in my presence, but I had no idea that she was making mistakes. My daughter became blind in both eyes within a few hours, and she was admitted to the hospital as a result. Although she eventually recovered usable sight, her vision remained unpredictable for the rest of her life. We were so busy dealing with the psychological trauma of her sudden blindness, the additional medical care caused by the nurse's mistake, and the drastic increase in her caretaking needs that neither she, nor I had the energy to make the appropriate complaints, let alone initiate litigation.I don't live comfortably with this. A year later, we saw this same nurse during an ER visit in another hospital. At that point, I simply approached the ER clerk and asked her to make certain the nurse wasn't assigned to my daughter or I would tell her why.So, one barrier is the harmful consequences caused by the medical error. Another is difficulty obtaining records. As I write this, I am in the midst of assisting someone toin obtain records of his surgery-gone-wrong. The materials he received from the hospital 4 weeks after requesting them (in a state that requires producing records within 10 days of the request) included someone else's records along with his ��� and omits the surgery report, the admission and discharge physicals ��� and even a copy of his consent form for the surgery. The papers he did receive were primarily illegible, dates missing, id's of authors missing. Some papers were actually missing all of the headings and labels.I have been on my state's Access to Patient Information Program provider panel for many years. I have never seen records like these. The patient (if able to persist in his pursuit of the records) will need to make a considerable effort even to obtain his records, let alone file complaints or sue for his injury.Many people whom I meet tell of terrible experiences with the medical system, but they have never even obtained their records, let alone filed a complaint, because they are too traumatized to do so.Filing a complaint takes a lot of time. Even if the screeners are kind and helpful, the results are usually disappointing. In my daughter's case, I filed a complaint that resulted in a nursing care citation. The citation was certainly warranted, but the doctors were exonerated. Because the hospital's response to the first investigation contained alleged facts that contradicted the medical record I had already obtained, I was permitted to file a second complaint, which included an allegation about the records.Again, a nursing error led to a second citation. Again, the doctors were exonerated. As to the distortion of facts in the course of the first investigation ��� I will never know the outcome as this comes under the ���quality control��� issues which, by law, are kept confidential.Many people who attempt to file complaints with regulatory agencies are disappointed by the results as I was. And yet, I am one of the ���lucky ones,��� because the state health department hospital complaint liaison actually talked to me and apologized for the inaction. I was treated as the grieving parent I was throughout the experience, and I had the satisfaction of learning that the nurse investigators are much more willing to apply applicable regulations than the doctors are. The medical investigators in my state still appear to be more concerned with maintaining doctors' and hospitals' reputations than protecting patients.Again, I have laid out how I investigated my daughter's death, the barriers I encountered in keeping up my efforts until the investigations were concluded, and even the long road I have traveled attempting to heal after my daughter's autopsy revealed the medical errors that had caused her death. The Last Collaboration contains many of the primary documents to and from the state health department, so readers can learn about how the regulatory agencies I turned to function. I assumed, in writing The Last Collaboration that the challenges I faced could apply to people in other states.""I'm a nurse and I have reported communicable diseases to my state. So, when my father contracted MRSA in his tiny community hospital, after 2 others had and died, I called my State Public Health office. I was promptly told that MRSA is not a reportable disease in the State of Maine. Nothing else was offered, like a referral to licensing or regulatory offices. I proceeded to call the Joint Commission. The tiny Maine Hospital he was in was not JC accredited. In hindsight I should have kept going with the Department of Health and Human Services here in Maine, but by that time I was well on my way with my campaign to stop MRSA in Maine Hospitals. To tell you the truth, I don't think it would have made one bit of difference. The DHHS defers to the industry and my complaint would have likely gone into a black hole.""Kathy...did you ever work at Brotman Memorial in Culver City, CA?""No, I worked mostly in Maine and a few years in VT.""This is a bit of an aside but the Jayco 100 hospital my dad contracted urinary tract MRSA in in 2005 and died of, as my 2nd parent's 3-week terminal hospitalization within 15 months played out, flew a banner off the side of the building so large as to function effectively as a billboard toward the 6 lane arterial roadway fronting the facility. I identified this as one manifestation of a positive communication stream (that's towards us) intended to advertise and promise patient-families things. And I experienced a negative communication stream (as we all here have), the many things withheld from us, the vital things we really need(ed) to know. Now, this stuff is not directly about Marshall's query in this thread but the twin streams are at the least an undercurrent atop which we bob (and, apparently, medicine weaves)."We need national news attention to this conspiratorial sabotage of our health and safety. :/"My father's Hospital did disclose that the infection came from there (surprise surprise), but they punctuated that disclosure with ""well, it happens and there isn't much we can do about it"". That really got me.....they obviously had no plan to stop the small outbreak that had infected 3 patients and killed 2. Dad died 11 weeks after his infection was diagnosed....he was about 50lbs lighter and he never walked again after his infection. When I asked the hospital's Med surg manager if they did any MRSA screening, he looked at me like I had two heads. I still think Maine would be in the dark ages about MRSA prevention if I hadn't raised such hell about these preventable infections. They were killing vulnerable patients...every single day in Maine Hospitals. Sadly, I think they still are, but not at such a high rate.""I asked the medical examiner who did my mother's autopsy whether or not her case would be reported to the state health department. Her response was that my mother's case (a 56-year-old otherwise healthy woman who died from C. diff after only 5 day of symptoms) ""wasn't the unusual"" and wouldn't be reported. She also said something like, ""we see C. diff deaths all the time."" I was disgusted and horrified at the casual callousness of such a statement." "Christian, I dont' know what the NY laws are, but that callous response might be considered way out of line now. I hope NY is now reporting all C Diff, and deaths because of it. We have just started this year in Maine and only nosocomial (infection started after being in the hospital a few days). It all has to be reported and tracked, or we will never lick it!""Christian, I am so sorry. We are so vulnerable when dealing with autopsies. The person who did my daughter, Millie's autopsy, started the conversation by asking me if I was angry about her death. I said (not yet knowing what caused her death), ""No."" The pathologist replied, ""You will be."" But the point is -- at the moment when we are utterly helpless with grief, we are at the mercy of whoever comes along. Your story horrifies me.""christian's post raises a good point... the attitude concerning her mother's death via c. diff indicates that the more 'common' the cause of death, the more likely it is to be overlooked and not reported. i have run into the same attitude regarding the surgery that was performed on me. even though i was healthy, didn't need surgery and did not consent to it, it's considered no big deal really since it's a 'common' surgery. we should never consider surgery 'common'. and... we certainly should never consider 'death' brought on by a mistake or infection via a hospital 'common'. the medical examiner's callous comment is truly *HORRIFYING*"I reported an infectious disease cover up and their was no investigation and further cover up."They do not answer the phone and when you leave a message, they do not call you back. Letters of complaint are not acknowledged unless sent certified mail......for starters. Marshall, I'll give you a challenge. Call the various state health departments and leave a complaint (message on a machine) and see how many return the call. Send in complaints to the medical boards regular mail and see how many are answered."Ditto! Same with the Sate Attorney General OfficeDoes anyone know if there are any groups that offer Patient Advocates to help Injured Patients "georjean, i wondered the same as you... i checked into it and found a few groups/resources that appear to assist with healthcare issues but not in the context we are talking about here. it appears there very few, if any, groups/resources that assist with medical 'harm' and the aftermath - including filing complaints, etc....""bart said 'the twin streams are at the least an undercurrent atop which we bob (and, apparently, medicine weaves)'. bart is correct here and he makes an excellent point actually. for lack of a better way to say this just now... bart fell into a trap most of us in this group have fallen into - the trap of trusting a doctor and/or hospital based on a 'misconception' (a scheme) - one they purposely project on us though. in bart's case, he believed the large banner hanging off the building which housed his parents at the end of their life was a sign (quite literally) that the hospital staff cared about communicating with patients and patients families. bart said 'I identified this as one manifestation of a positive communication stream (that's towards us) intended to advertise and promise patient-families things'. that's a reasonable assumption in my opinion. i chose the surgeon who ultimately performed surgery i did not consent to and who severely compromised my sexuality and health for similar reasons. we absolutely must remain guarded at all times when it comes to matters of medicine and our health. we have to be very careful not to be lulled into a false sense of security. martha said 'at the moment when we are utterly helpless with grief, we are at the mercy of whoever comes along'. this is *exactly* what happens... everyone who has posted here in response to marshall's query about filing complaints has found themselves in the position both bart and martha describe. what bart and martha pointed out is extremely important because it may help explain how so many of us find ourselves in similar horrifying medical 'situations' if the first place. we are at our most vulnerable when we make decisions that will affect health and life forever. add that to the many 'misconceptions' we succumb to... well, you have a recipe for disaster as many of us NOW know. it occurs to me that if we knew 'then' what we know 'now', many of us would not be in a place where we would have to concern ourselves with filing complaints. bart said ' this is a bit of an aside'... while it may be a bit of an aside, it's a very important one in my opinion.""First off most of what is coming out about the FDA does not inspire trust even if it was reported. Second many feel without validation from doctors that they have no standing and their injury is being vehemently denied by doctors that protect their pay masters, pharma. Third because many of us have relied on disability to sustain us we worry that our LTD insurer will deny us benefits on a whim which they have already done to me. My LTD insurer is Liberty Mutual which is in the top three deniers of legitimate claims for LTD. They are equally as bad for Workers' Comp. This puts patients on an endless treadmill of protecting their rights and constantly worried that they will lose their benefits should the insurance spies find out they can do something that they said they couldn't on the endless questionnaires they have you fill out. My insurer asks who takes care of your child. And as in my case I'm also fighting Freddie Mac and Ocwen from an illegal foreclosure. Our loan was with TBW, you remember the ones that multiple pledged the notes to up to 13 times. I'll be fighting phantom notes until I die because of what they did. I���m going to send you a letter a recent doctor sent to my treating doctor. It was nasty and inaccurate. Doctors can���t be bothered to help their patients it interferes with their profits in my opinion in a healthcare system that has very little health in it. I think the only way anything is going to change is if the insurance companies and Medicare and Medicaid get a clue about the inverse relationship they have with their profits to that of pharma and predatory doctors (faulty products or medical malpractice). Because the doctors lie for one another it becomes impossible to get those responsible to pay and because now insurance companies can���t kick you off their rolls they will pay and pay for pharma and medical malpractice while the doctors and pharma are able to privatize their profits and socialize or privatize their losses onto the backs of policy holders and insurance companies. The only chance we have is if insurance companies wake up to what is being done to them in the name of healthcare. As ProPublica embarks on this series you might want to hit the insurance companies up for donations. It would greatly benefit them and would be doing society a public service. I hope the health insurance companies see the opportunity here and don���t have to be told to donate.""sharon made an excellent point also... 'this puts patients on an *endless treadmill* of protecting their rights'. what a great metaphor - *ENDLESS TREADMILL* i think that's what we've all been trying to say here... after being harmed, we are put on an 'endless treadmill'. every comment in response to marshall's query has been eye-opening if anything - at least in my opinion. i've learned a lot from all the comments. hopefully, all the responses here have helped marshall to better understand the many many reasons patients don't file complaints regarding medical harm and/or negligence with various agencies. it's *COMPLICATED*""veronica brings up the question in georjean's post regarding the need for patient advocates to assist in filing complaints. @veronica... you did do an excellent job filing the appropriate complaints on behalf of your mother. you know exactly what to do and how to do it. maybe you could help others in this regard? i agree with you about the 'need' to document... i think most of us agree with that in theory. i was able to easily obtain my records and i'm a writer by trade. yet, i still had a very difficult time filing complaints. i came to the point where i simply had to focus what energy i had left on my health. i couldn't focus energy on filing complaints that may or may not be taken seriously. there is no doubt a very real need for advocates like yourself. until marshall posted this query, i never really considered how much advocates are needed in regard to helping harmed patients file the appropriate complaints.""I reported a HIPAA violation to the state medical board. After a year of silence, I received a form letter saying they conducted an investigation, but they couldn't tell me about the investigation, but they determined there was no violation. Really? Because they certainly never talked to any of the people involved, so how thorough of an investigation could it possibly have been?""exactly to chisty's point regarding HIPAA... there is no question that HIPAA laws were violated in my case because my mother was told to sign 'my' ELECTIVE surgical consent form. AND... my hospital record indicates that nobody was to be given medical information concerning me. (my mother was not even supposed to know what surgical procedure i was having done that day). regardless, my lawyers all told me that although HIPAA had been obviously violated in my case, there was nothing i could do about it since violations are rarely ever addressed. i researched the matter myself and came to the same conclusion so i didn't bother filing a HIPAA complaint.""The opacity around all of this (ex: Cristy's post above) is spirit-crushingly awful.Trisha Torrey: I wonder if you'd be interested in looking into complaint filing assistance as another category up at AdvoConnection, or writing it up on About.com..." http://www.consumerwatchdog.org/node/13777#disqus_thread"Powerful, Joleen. Thanks for posting this.""Joleen Chambers & Marshall Allen if the health insurance companies would provide assistance to patients for filing the complaints they would benefit in the long run by: 1) getting more reports completed, 2) by ensuring that they are followed up on and 3) their only true concern; it would improve their profits. We have a small window of opportunity here to get the health insurance companies on the consumers' side and in the process help to clean up a broken reporting system. The result would shine a light on treatments, drugs or procedures that shouldn't be on the market in the first place.""Whew - Joleen Chambers that's a powerful article you posted. Sharon Hanson - you make a good point. But when I've talked to insurance folks they seem concerned about maintaining a good relationship with providers, so that the providers will continue to be on their panel. Someone who knows more about insurance could enlighten me about this, I'm sure. But do insurance companies do much in this regard? I know they do some things internally. But I'd like to know all that they do if you know.""I receieved a Subrogation letter from my Health Insurance company months/year after they finally identified a submitted diagnosis code of Injury. If an Accident code is billed it will trigger the questionaire. Of course as the patient I will never get the results, but they do try to recoup their money. In the case of Employers that are self-insured and, in actuallity, the money paid to providers is the employers money, I would think they should have some responsibility to their employees to make sure the care received is Quality Care. Employers and Health Insurance Companies need to stand behind the Injured patients' and family. If Health Insurance Plans offer a PREFFERED PROVIDER ORGANIZATION (PPO) and a patient uses their CONTRACTED PROVIDERS and they are continuing to do business with providers and facilities that are doing harm and not taking actions they become a major contibuting factor in patient harm. When I choose a healthplan, sign a contract and pay premiums with the expectation of QUALITY CARE, that is what I should get. I fought endless hours with my healthplan and offered to partner with them and asked for their help in keeping their policyholders safe. Of couse, that hasn't happened."I also have suggested to CMS Medicare/Medicaid they need to be more dilligent in reviewing members that have medicare/medicaid because of a disability/injury that was originally caused by a provider/facility and now medicare/ medicaid has to pay out huge dollars of long term care that should remain the responsibility of the provider/facility at fault."A Healthcare consumer advocate that I work with suggests that we all call our insurance companies if Hospitals or other providers screw up badly. We need to make them aware and tell them we do not want our insurance to pay for harm to the patient. Keep asking up the line of supervisors until you get someone who will actually refuse to pay for healthcare harm. It's an interesting idea, but I haven't tried it yet. She has and she succeeded....charges as a result of harm to her husband were not paid by her insurance to the guilty Hospital."What about letters and radiologic studies that would identify the harm would that be enough to file? I had contacted almost every organization and agency out there but never filed an official report?"marshall, i had united healthcare at the time of my surgery in 07. they paid for the surgery even though i let them know that i did not consent to it. then, after i filed a medical malpractice complaint, they turned around and put a $10,000.00 lien against any settlement or jury award i could possibly receive. i filed a complaint with united health and the ohio dept. of insurance - to no avail though. i provided both of them with a transcript of my former doctor's deposition wherein he stated that it is his 'practice' to obtain illegal consent for surgery. i assumed that united healthcare would be interested in knowing about a doctor who makes it his 'practice' to obtain illegal consent. united healthcare was not at all interested. the ohio dept. of insurance sent me a letter advising that their hands are tied when a provider pays for any surgery or procedure covered under a patient's contract - regardless of whether they consent to it or not. my efforts to enlist united healthcare in assisting me with reporting my former doctor went nowhere. i seriously doubt insurance providers would 'rock the boat' for the reason you stated... 'they seem concerned about maintaining a good relationship with providers, so that the providers will continue to be on their panel'.""@Kathy -- I think your friend's experience in persuading an insurance company not to pay a claim when medical care was deficient is highly unusual. My daughter had a Medicare Advantage Plan through Blue Cross/Blue Shield. When she was made blind in a local ER due to an NP's multiple mistakes, I was told (tho I phoned the next day) that the hospital had already been paid and that BCBS would not pursue the issue. When my daughter left a different ER shortly before midnight AMA because she had waited more than 8 hours for results of a CT scan to determine whether she was bleeding internally (she assumed if she was bleeding internally she would already have died) we called the insurance company and got the same response -- the scan wasn't read until the next afternoon because it was the weekend and there were no radiologists on duty in the entire hospital system (5 hospitals, 1200 beds).""I agree, my friends experience is probably rare and unusual, but if a lot of us strarted a trend, who knows. She got her company to with hold payment...maybe more of us can do the same. I do plan to give it a try in the future if I feel that something should not be reimbursed. At one time I did find a medical device (endotrachial tube) charge on an intemized bill and I contacted the insurance company and the Hospital...it did not get paid for. It wasn't used...I had a spinal block...no need for an ET tube. a bit of bill padding perhaps?""Another item of concern is the non-compliance with Prior Authorization and case management services. I actually was able to get copies of all my bills submitted to BCBS and found that the Kidney cancer diagnosis that was given to me verbally and documented in my pcp records and indicated as PRESUMED TCC OF THE KIDNEY in Dr Erik Castle's (my surgeon) notes was never submitted to BCBS until many months after the surgery only because I kept asking how they never had any kidney cancer diag submitted to BCBS. MILLION DOLLAR QUESTION ""How did my surgery for kidney removal ever get authorized and paid"" . My medical record clearly show NO CONFIRMED CANCER PRIOR TO OR DURING SURGERY. I will never understand how it is not assult with intent do do harm for a Dr to procede to cut into a person and then the removal of a left kidney and other organs on a PRESUMPTION and he is not required to have any docummented pathology prior or during the procedure.??????????""georjean, i had a woman from california e-mail me recently and tell me that she went into the hospital for a lumpectomy breast surgery to determine if she had cancer or not. she woke up to find both breasts gone and even her muscle gone. her doctor told her she had invasive cancer. she didn't believe him so she asked for her tissue to be re-examined and it turned out she had 'no cancer whatsoever'. of course, she was completely devastated. long story short... she learned that her doctor's partner was overseeing a study regarding muscles in women who undergo a double mastectomy. she filed a med mal complaint which she didn't win and she filed all the appropriate complaints with various agencies. this woman is older and on medicare but extremely savvy. like most of the rest of us, she was unable to find any closure or remedy via a med mal complaint or complaints to various agencies. and... medicare paid for the mutilating surgery she didn't need or consent to.""Well I would think that BC/BS would love to jump on mine then because I would think they would like their five million dollars back....if its possible and a viable option then I would be a perfect candidate especially since my issue can still be resolved or hopefully most of it with the proper surgery......remove the foreign body and maybe my body will heal .....i would think maybe if the insurance company contacts the individual specialists that felt that the problems in their area were due to a retained foreign body .....i am also a prime example because of what they paid and are still paying to maintain unnecessarily.....wow now u understand why I continue to try and speak out..... not just because I need help but also because here's a perfect example of an error that was made and then after the error there were years of not diagnosing it and suggesting other illnesses, of treating other illnesses then ruling out all those diseases then after years of medicine, treatments, tests etc and not getting better, increasingly getting worst....finally a doctor tried to resolve it suggesting an infection and possible foreign body nope......too easy then on to still more years of hospitalization, tests, medicines..... expensive ones mind you , then out of state visits, more attempts at surgery only to confirm they couldn't get to the foreign body..""....now on to more expensive hosp stays, new things wrong, more tests etc and now now now the patient should just get the laparotomy to remove the foreign body the one the doctor suggested should be done four years and half the healthcare cost earlier...... My situation looks at the unnecessary costs of healthcare, the errors made during a surgery, the unwillingness to look at medical error before u rule out every natural disease in a patient who was completely healthy before surgery, it also shows all the organizations, agencies I attempted for help and truly how unavailable or unable to handle true error resolution (in English how alone patients are when errors happen), whats worst is it shows the true inability every person had not just te original doctor, not just the medical personnel but everyone that came along rather than think they missed something, rather than believe or admit that human error could have been involved or maybe even they missed something they would much rather turn it around to look as if the patient made it up or they have something oing on they cant figure out even after its being shown as what it truly is and documented in my case a foreign body but for others it can be different......instead of work to resolve they would rather trn te patient back into the system to start over, for more coats of testing, hospitalization and more temporary high cost bandaid pills and this is why its so messed up. Patients nowadays are not worth much as humans they are worth much more as a human error. In addition, my case can also help u look at patients who didn't have strong relatives or family advocating for them, i myself was a very educated person but it didn't matter""........it shows how little they listen or receive the patient....if u need help in looking to resolve one, multiple or all issues within our system I am an open book and a classic example as I am sure many of us are......I also stand to prove that even when u want to try and fix it or resolve some of the problems there are not many real options....I have to say I don't really believe we are there yet......we are on our way but not there yet.....most patients who died from error I would bet tried to fight or get help first and no one listens or there's nowhere to turn that works......I will try the insurance company route again I did try years ago and they were more interested with me being in a wheelchair when they thought it was due to a car accident or something similar they reaced out to me"".......when i told them my situation and asked if they could help they said oh sorry we can't help..... Sorry this was messed up I just edited and tried to fix ....I typed it on my iPad and it replaces the words and it doesn't make sense half the time.....""Robin Karr you just left me speechless"".......no cancer both breasts removed can prove partner was involved in study that would benefit from it, she tried te law it didn't work tried appropriate agencies didn't work......God I don't know how people live with themselves and just watch this crap happening.....""Marshall Allen ��� I see your point. This is what I mean by a small window of opportunity. First we must educate them as to how much money they lose from faulty products and medical malpractice especially when the provider or manufacturer doesn���t pay. Medical errors are generally serious with life-long consequences. I know insurance companies know this. And now they have access to the data to prove it. We are not talking pocket change; we are talking trillions of dollars. I cannot speak for insurance companies but with the new ACA they no longer can kick people off their rolls, deny insurance for preexisting conditions or limit life-time benefits. Marshall, what does that leave for insurance companies to reduce their costs? They must keep us healthy and prevent injuries; it is the only way they will survive. We need to alert the health insurance companies to this financial reality so that we as consumers can get them to do the right thing. How can a business model like this work for health insurance companies without jeopardizing their relationships with the providers? By ensuring that there is a well-funded non-profit watchdog group that assists those injured to report and track the injuries and maintain a database of those reports. That way the insurance companies will have more accurate information as to which treatments, procedures, drugs and/or scans are causing the injuries. The health insurance companies can and should be our best ally in keeping us healthy. It���s a win/win situation and they should embrace a model like this. Otherwise I don���t see them staying solvent for long.""melissa, i don't know how they live with themselves either... they obviously find a way because we are here sharing basically the same story of medical harm and/or abuse.... and we are all here trying to find ways to cope, to survive and find some sense of justice and/or closure.""Most victims don't immediately recognize the damage that's been done and when the damage results in pain most victims are more interested in seeking immediate relief. My experience with reporting and filing a complaint with the Dental Board was highly disappointing. They conspired with the dentist and ""lost"" my records and probation monitor's reports. They simply apologized to me and after a 2 yr investigation they didn't find my dentist negligent even though my current dentist wrote to the Department of Consumer Affairs and the Dental Board my former dentist didn't know the mechanics of the procedures he performed and practiced below the standard of care."The majority of filed complaints with the Dental Board of California have resulted in no action taken against the dentist or if they revoke the license of a grossly negligent/fraudulent/drug and alcohol addicted dentist they almost always immediately license the dentist as a PROBATIONER DENTIST- a status of licensee the patient is purposely not informed of at the dental office.agreed robin and tina...... veronica mom is smiling on you"The Texas Medical Board as I found it is very lenient with notorious repeat offenders who commit medical negligence. I am astound to see that doctors are murderers, rapists, have felonies, commit sexual assault, falsify documents and are still allowed to operate and practice medicine. In my research I found that people were impersonating doctors and were told just to cease and desist. What is that? There was not legal actions and I guess they went home and figured out where they could go next. We will have to step up and take our lives back because a life today is not worth a penny. One thing I found out as well is that people don't know that crimes are being committed because doctors and hospital personnel are manipulating and falsifying documents. Some don't even tell you that medical negligence have occurred. My daughter had sustained three perforations and they left six sponges in her abdomen and they tried to cover it up. They said she died from an asphyxiation of a hot dog. I had an autopsy done but I am still having to fight the system even with the evidence. That's crazy.""Pharmacy malpractice and dispensing errors may be responsible for tens of thousands of hospitalizations and untimely deaths each year. WWW.Ultimedhealthadvisors.com""I have a question - What does a patient do when you take a rx to the pharmacy and the pharmacist enters it in the system and receive alert that drug does is too high and conflicts with current medication patient is taking - pharmacist calls dr and explains alerts but dr instruct pharmacist to overide and fill. WHEN I discuss my concerns of this with my dr he got an attitude and makes the statement ""I cant help you if you dont follow my orders"" well as I know now he never had my best interest at heart." "Georjean, Unfortunetly many Pharmacists will just hit the override button on the computer and fill the Rx. Some RPh's will call the MD first to alert them about the drug interaction, and then document the MD wants the RPh to dispense it even knowing the risks, and fill the Rx. Your MD's response was very inappropriate. Most MD's have very little training in Pharmacology, yet precribe copiuous amount of medications they know little or nothing about. An MD or an RPh should also take the time to explain everything about the medicine, the action /indication, proper dose, possible interactions, side effects, how to best take it, possible risks, and if possible adjunctive therapies and/or possible alternatives. As Voltare once said:���Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing���"USA Today followed up last week's story featuring the foundation with an editorial outlining solutions to combat C. diff.When you sit on your hands instead of enforcing your rights it has a huge impact on how a Judge decides and how others harmed by medical professionals can find restitution and rightful retribution. GET THE FACTS.already signed it tina. a worthy endeavor.....me as well......http://www.nature.com/news/india-shakes-up-rules-on-clinical-trials1.11223"now, if we could just shake up the rules on clinical trials here in the u.s.""���Selling Records for Profit Alleged - Hospital Staffer Targeted Accident Victims' Records, FBI Says���http://www.healthcareinfosecurity.com/sellingrecords-for-profit-alleged-a-5054?rf=2012-08-22eh&elq=b18adb7bc1ba4eb6ab38ca4091ca943a&elqCampaignId=4279���A former staff member at Florida Hospital Celebration was arrested last week for allegedly inappropriately accessing more than 760,000 electronic health records with the intent to disclose, transfer or sell certain information for personal gain.���I started warning about the black market value of stolen medical records years ago, and have been mostly ignored by the dental community. As a matter of fact, there are still a few industry leaders who would silence me only for the sake of appearances. When dentists complain about even lousy products it somehow seems unprofessional."Not a happy story."Veronica James asked me to share my little story this morning. While it is not a serious medical issue, in it's small way, it highlights simple things we can do to better advocate for ourselves. Thanks Veronica, for letting me share this.From Kim Lynette (Sandstrom) Hawksey Ok...here is a new patient safety advocacy story. When I went to the VA in Gville on Tues, with my complaints of back pain, the ER triage guy was quick to say, ""Oh it's muscle pain, and muscle strain is worse you know."" I looked at him and said, ""It is not muscle pain."" I wanted to say, ""I have lived in this body quite a long time and I have learned to tell when it is a muscle issue and when it is not."" But I held my tongue. He then ordered xrays. Fast forward 4 hrs of waiting on results and being sent to the Urgent Care section of VA. The Urgent Care specialist, looked at me, listened to me and then told me that my lumbar xrays showed no breaks, but significant degenerative changes. I then asked him why it hurt where it hurt, which was not in my spine. He was good to stand me up, and finally, someone actually asked me where it hurt. I showed him. He said the ER triage guy didn't order enough or the right xrays. Because I insisted this was not muscle pain, and the Urgent Care guy, listened and paid attention, I was sent back for the appropriate xrays. The results came back that I have 3 fractures on the right side of my back. My point is this: when you know that you know that you know, persist and insist until you are satisfied that the right things have been done. It took 8 hrs that day. Also, I had to call for the radiologist report or I might not have received it. Fortunately, the Ocala VA doc knows me, knows how I feel about medical care and called me back twice yesterday and when he couldn't get me, made sure he reached me this morning. I always get my tests and reports in hand as well, as should everyone who receives medical care...it is more important than getting a receipt when we go shopping, yet many do not even do this important thing for themselves and for their health. Always get your results. Make copies and keep them. Always ask questions and do not be satisfied until you are satisfied with the answers. Trust your instincts.""Thank you, Kim Lynette. Good advice - and never, ever assume that the doctor knows best.""Amen, Heidi...we need to come together as experts...I will respect my doctor and his/her education and medical experiences, when he/she respects what I know about my body, health history and experiences." "This is an important story -- not only was the outcome good for the patient, which is the most important part of the story -- but the writer emphasized the importance of acquiring medical records as soon as they are generated. Saves a lot of time later and makes medical care more efficient. It's good to hear a ""good doctors"" story once in awhile, because they surely do exist.""Thanks Martha...I consider my story fairly insignificant in the scheme of things, however it is representative of many common experiences for us as clients of modern medicine. I am the mother of Diana Brookins (Fatal Care by Dr. Sanjaya Kumar), who lost her life to a routine gall bladder surgery at 25. The good outcome, by the way, is only because, I listened to myself and respected what I was ""hearing"" and a new ""eye"", the Urgent Care guy, later in the day, was a listener too. This is the new paradigm I preach: mutual respect brings positive results.""Just wondering what your Vitamin D level is - bone fractures a- one of the symptoms of deficiency along with malabsorbtion in the gut (allergies) - if MD's were working with ND's health care would not just be sick care! Keeping records is important but getting the right answers too might be difficult because ""not in their scope of practice""!""Hi Margaret. I live in the Sunshine State and my D levels are excellent, but I have other issues that mitigate my bones and joints. Thanks for your input.""@Kim-- I am deeply sorry for your loss, which seems similar to mine (although no loss of a child is ever the same as another mother's loss of a child. I hope that your daughter's story in Kumar's book will at least raise patient safety issues that can help others. This is my hope for the loss of Millie as well. BTW-- I just ordered a copy of Fatal Care. Don't know how I missed it when it was first issued. Thanks for mentioning it -- and for writing about your daughter.""Kim, did you mean to say ""exacerbate"" rather than ""mitigate""?""no, I meant mitigate. Thanks for the clarification though, what I meant, was, I have other issues that make it harder for doctors when they treat me. Not feeling so hot today!""@Martha...I wrote a full length play called Damselfly about my darling Diana. Helen Haskell of MAME also helped me with this. Damselfly is dedicated to all affected by medical harm, but especially our children. Damsellfy had it's world premiere at HART Theatre in Portland, Oregon last month. Helen and I flew out there to attend.""Kim, great example of being the best advocate for yourself. You know your body best! Love what you wrote. Thanks for sharing your story.""Wonderfully well written and true, true, true!!!""Psychiatrist Keith Ablow and member of the Fox News Medical A-Team says, ""Given the available data, I would recommend that children with learning disorders, attention deficit disorder, depression, attention-deficit disorder or other psychiatric illnesses refrain from drinking fluoridated water http://www.foxnews.com/health/2012/08/22/does-fluoride-in-drinking-water-hurt-yourbrain/#ixzz24K2CKJ5J""Dear Friends, If you are attending the Partnership with Patients Summit in KC please register http://partnershipwithpatients.eventbrite.com/ If you cannot attend please share this with your larger network of friends."Will be a wonderful and important event. Looking forward to it!'imagine patients coming together to plan how to make a real impact in the healthcare industry'. that is our hope... wish i could attend....."I am very familiar how it works,you file a complaint with Medicare,the joint commission ,and in Nevada, the Health care Quality and Compliance.The Joint Commision sides with the hospitals And virtually does nothing and is a waste of time.Medicare contacts CMS to do an investigation once you have denied the CMS billing requests,CMS contacts the QIO(quality improvement organization?),in the west it is subcontracted to a company called Health Insight,in the Midwest it is a company called Stratis Health .These company's are made up of Doctor Surveyers who are mostly tainted to side with hospital facilities as is evident in their websites which show a ,in Nevada,83/17% decision ratio for outcome decision in favor of the health care facilities.The investigations are based on medical records,hopefully they are accurate and have not been altered or deleted.Then a decision is made by the Doctor/ surveyor as to the ""quality of care"" ,regardless of whether or not your loved one was indoctrinated with Hospital acquired infections or as they like to call it 'conditions', as long as we turned the patient and gave meds on time,Quality of care was given.In Nevada the facility does not have to tell your or your loved ones that you even have an infection until five days have passed,by law.That gives them time to fix the problem before you know you have one.So, the QIO studies the records, the Health Care Quality and Compliace inspects the facility to respond to the complaint,all is well protocols are followed according to policy,The QIO confirms with the HCQC that everything is shipshape,and they respond that the multiple infection that killed your love one happened because they had pre existing conditions and that HAI'S do not matter because it s your loved ones fault for having these conditions and hey,Our opinion is ;quality of care was given so your claim is UNSUBSTANTUATED,there for we the tax payers !Oh I Mean CMS/Medicare are going to pay the $800,000 to the facilities/medical personal. Only when Senatorial pressure and bad press were instigated did these institution start to re review their decisions,because you must complain,especially if needless suffering or death occurs.And you must follow up.If you want to get results,take the money away give the press( great job USATODAY) they deserve"Ditto...Ditto... Ditto...Ditto...Ditto...Ditto...Ditto...That was an internet problem...not me:/ "Although...did I mention ""Ditto""? :D"the last post was submitted by Steve Winters.http://www.cbc.ca/player/News/Canada/Windsor/Audio/ID/2238327667/?page=9 i've read stats which state that more people die in hospitals than die in car accidents each year in the u.s. something to think long and hard about for sure... especially if faced with being in the hospital for any reason.During cervical spine surgery in Oct 08 I contracted MRSA. It almost killed me. It was a long 2 month battle that ended up forcing me to retire on SSD."Could anyone here kindly help me figure out if there are any long-term patient studies on the survival rate, the quality of life, the disability rate, and the numbers and kinds of repeated Thoracic Outlet surgeries for patients who have had Thoracic Outlet Syndrome surgery, with a 1st rib resection?? I am a suffering survivor of T.O.S. surgery in 2004 with a 1st rib resection, and I get worse every year living disabled since surgery, with decreased function, more restricted mobility, and more pain. It is hard to find doctors to diagnose or even treat the problems I have including trouble walking, breathing, and severe shoulder atrophy, bilaterally with pain, and more. I have some information from patients who have contacted me over the years via my website www.tossurgerynightmare.com but, at this rate-I'm concerned about my own survival. I wonder each day how much longer I have until I'm completely bed bound, and living as a ball of restricted pain. I still have NO power wheelchair though I was approved for one over 4 years ago. Having a hard day today. best, Bobbie Jenke""bobbie, i don't have the information you're asking for but just wanted to let you know i saw your post. i had one of those days yesterday. our lives completely change after we've been harmed by a surgery we didn't need or one that went wrong somehow. there are many days i feel completely defined by what's happened so i understand... and i 'get' your concerns about the future. you're strong or you wouldn't be here seeking answers. take one day at a time when you have to...""thanks Robin!! Now, if only I was not so blacklisted in this ""Kaiser town."" I have over 30 years residency here. There are x-Kaiser doctors--or current Kaiser HMO doctors starting to fill the low-cost clinics and more. This concerns me--because I was blackballed from Kaiser after the first surgery, that they paid for. I led a Patient Rights rally with several of my students/friends whose family had been harmed at Kaiser, here in Santa Rosa, CA. We handed out fliers about Patient Rights--and carried signs and I was spokesperson on local channel. But, soon after, I got a letter stating that I could no longer be a patient at Kaiser Santa Rosa, because I ""complained"" too much about my care there. The DMHC did nothing--Glad I was still teaching a bit then--so I switched to Blue Cross--or I would have been in trouble.""we all pay a price for speaking out bobbie. it sounds like you are paying that price. your only other choice though would be to remain silent. from what you stated above, i doubt you have the personality to remain silent. good for you for speaking out. i'm going through similar issues where i live due to my filing a medical malpractice complaint. i knew after the my surgery in 07 that i would either have to remain silent about what happened to me and continue to receive medical care or speak out and warn others and not receive medical care. like you, i chose to speak out.""Dear RobinPlease feel free to email me if you'd like to--it is on my website.(I would like to give you my phone # to perhaps discuss more of what we have in common and learn more abt how you cope as well.) Typing is hard for me as is a lot of speaking, even on the speaker phone, but it helps to know other damaged patients-in similar situations.--I've been diagnosed by some specialists I've written to with RSD-which causes SEVERE delayed pain with any use of my body-especially the upper (affected) parts. Even typing this amt., will create severe contraction in the surgery site later, and more, with increased pain. It is a weird, hard life to have one's nerves neurolyzed(sp?) 3 times via surgery--in the brachial plexus, and more--only to have them scar over afterwards and to lose their natural protective fat layers via surgery. It creates such painful chaos that affects my sympathetic system. All done for profit with little-to-no evidence of need. Thanks for caring Robin. You are right, I can't ""shut up"" as this is so egregious!!! to do to patients--and then dump us!!........ I wrote many poems in the years after surgery- and hope someday--Someone? might publish poetry by"" Patient/victims of Medical Crimes."" very best to you too! b.""keep writing poems about your experience bobbie. date them and keep them in a notebook. some day, you will have enough to submit them for publishing yourself. that's a very creative way for you to cope with what you're going through and, at the end of the day, it's a great way for you to share your experience with others. good for you for finding a healthy way of coping:)""Over a period of six months, six children each said they were paid $10 to get into an unmarked vans, taken to a southeast Dallas dental clinic called All About Dentistry, and drilled without their parents' permission. One child's Medicaid records, obtained by News 8, show $2,000 worth of dental bills from All About Dentistry without parental consent."Horrible.I cannot believe the lengths some dentists will go to make a buck...it's torture on so many levels for the victims to try to recover from shoddy dental work and still have to pay physically and financially for a lifetime to recover from this greedy assault."this is horrible... on a good and different note though, i'd like to say that some dentists do volunteer their services and don't charge for it. diane sawyer did a special a year or two ago about dental issues in appalachia (exactly where i'm from). she talked about the problem of no access to dental care ( especially for children) and she interviewed a dentist in appalachia who volunteers his services via a mobile dentist office/unit. i just happen to know the dentist because he rented a garage from my mother in which to store his mobile dentist office/unit. after the abc story aired, pepsi bought him a new mobile unit which greatly helped this dentist make his services available to even more children. i'm glad i knew this dentist personally. it's good to know there are still decent doctors who care about true need in their community and 'volunteer' their services. in a world where we see so much healthcare for profit... this is refreshing." http://abcnews.go.com/Health/story?id=6899312&page=1#.UC_M1qmPVGQWhat the heck. Why is Medicaid covering dental care when working people have to pay out of pocket with separate policies and it isn't covered by Medicare?"Medical Errors from White Coat, Black Art www.cbc.caIn 1999, the US-based Institute of Medicine published a report on medical errors at American hospitals. The report was entitled .Like �� �� Share �� 21 minutes ago ��""JUST TYPE IN WHITE COAT, BLACK ART IN THE SEARCH" "Most Hospital Mistakes Never Reported :: Halifax Medical Malpractice Lawyer Blog www.halifaxmedicalmalpracticelawyerblog.com Most Hospital Mistakes Never Reported :: Halifax Medical Malpractice Lawyer Blog .Like �� �� Share �� 29 minutes ago ��""Why 98% of Canadian Medical Malpractice Victims Never Get a Penny in Compensation! www.articlesbase.comA review of Canadian medical malpractice claims and how they differ from similar claims in the U.S..Like �� �� Share �� 13 minutes ago ��""I immersed myself in the topic for today's column, and will be writing more to be sure. What there were a structure that helped patients understand all the risks of the procedures their doctors persuaded them to undergo? Or which they thought they wanted? I mean really appreciated what they would endure, whether it would help, and whether there were less invasive alternatives. 'Informed Decision' May Irk Surgeons as it Cuts Costs, Improves Quality http://www.healthleadersmedia.com/content/QUA-283486/Informed-Decision-May-IrkSurgeons-as-it-Cuts-Costs-Improves-Quality""Hi Cheryl-i left a comment on your article--meant constructively only. Thanks for writing it. I've seen too much harm sneak in the back doors of medicine in this Fee of Service country--and living the result of my own harm done by surgeons and flawed reviews of surgical outcomes by TOP medical journals. So, what really IS ""informed consent"". very best, Bobbie Jenke""Comments ��� good, bad or indifferent ��� are always welcome as long as they're thoughtful and not mean spirited. I envision informed consent as that one would give after being told everything the doctors and hospitals know about the chance of you having a good outcome, not getting infected, and that your health status will have improved as a result of the procedure. Imagine if you were set to undergo a procedure, and found out that the surgeon knew it only resolved the issue completely in 25% of the patients, resolved it partially in another 10% and the rest, 65% got no benefit at all. and then, imagine you were told that you'd be in a world of hurt for at least three or four weeks, unable to walk or drive a car. Would you still have the procedure? Then imagine that you were informed that physical therapy or some other non-invasive strategy would worked for 25% of the patients. I want to know the surgeon's track record as well as the hospital's I want to know what they know. I want to know what they should know. Sorry if this is rambling.""Cheryl, no rambling at all, just explicating the valuable facts of the case for straight talk by medicine to citizens. For those of us who are not babies requiring paternalism it'd be fruitful for the default to switch to that described in your writeup.""I think it's a good treatment of an important issue. There are other strategies. For instance, I blew out my ACL a few years ago. I first asked a physical therapist I know to take a look at the list of surgeons that are on my insurance plan. She said none of them did good knees. So I asked her, an orthopedic surgeon that is an acquaintance, and anyone I know who had their knees done. The doc I ended up going to was the team surgeon for some NY sports team (for my other knee, some years prior, I used the surgeon for a ballet company). He thought, because I don't do sports that involve pivoting on the knee, I might be able to go without surgery and suggested that I see how stable the knee is. I am physically active, etc. and the knee has been fine. But: in researching this issue, I figured that 5 years after the injury I wouldn't remember what the procedure cost, but I would remember every day if I walked with a limp. That was my criteria.""I have had 2 recent encounters with institutional medicine, both unfortunate. 1) My mother had a TIA and while in the hospital was prescribed depakote, theoretically because of agitation (she was nervous, not epileptic or psychotic). I reviewed her chart in the rehab facility, saw the problem, and had it corrected. The attending hadn't noticed. She recovered and is fine now. 2) my father fractured his hip and was in rehab. He was nearing completion of recovery when he developed a URI. He had, it seems complained of difficulty swallowing to his regular physician, who didn't visit that facility and turned my father's care over to his wife's practice. She apparently had limited knowledge of his history. The URI got worse, and she decided to discontinue visits to that facility as well, so a new team took over. I was very insistent that this be sorted out (he has CLL, but has been in remission for many years), so he was discharged to the hospital, where it was finally determined that he was aspirating into his lungs. The hospital chose a narrow interpretation of his living will, left him to die on palliative care. I got it straightened out, and requested a PEG feeding tube. Because health care providers don't collaborate/interact on a regular basis, I had a delay in getting the tube scheduled and done. The hospital maintained they had 24 hours for a consult and I disagreed. I won, and the procedure was done quickly, but the hospital did not have rehab for dysphagia, so he sat there with no appropriate care for a couple of days. He is now in rehab and doing very well. It is very upsetting because the hospital's basic position was that he would die, when all he needed was a 20 minute procedure under twilight sedation and rehab. Very discouraging. Fortunately, I've learned a lot about rehab centers, and dad is in a good one. It does require frequent follow up (daily with him and every few days with the staff) to make sure that everything goes as it should. My condolences to anyone who has to navigate the system.""Cathy Herbert, I have no idea what your TLAs mean (three letter acronyms). You seem to be much more of an expert about proper medical care than I am, and I am of average layman knowledge. My take is that unless a patient his or her own competent person monitoring and correcting mistakes in his care, the common place institutional incompetence could kill the patient who is left alone there. Your post is quite an eye-opener.A recent article in the NY times compared the success of a restaurant food manufacturer with the failures and problems with institutional medical care. One that caught me was in manufacturing, there is one person who is ultimately responsible for the quality of the product. He is at the top looking down at the process. In the medical industry, several doctors and caretakers are involved and must communicate horizontally with each other. And often they fail to. There is no one person coordinating and keeping track of the big picture about the patient. In the medical industry, incompetence is financially rewarded just as quickly as incompetence. The final result doesn't rate a high priority. Your post certainly verifies that situation to me.""Veronica James, so sad to hear this. CMS has indicated that hospitals/rehab/hursing homes etc should decrease their use of antipsychotics by 20%.... it's a good move.""Sso true, Garrick Sitongia and I suspect there is no other industry in which the people who make the profits (lots of tests, procedures, billable hours) are the same ones responsible for all decisions with no accountability. (TIA=mini-stroke) Also, people talk about malpractice suits as a possible safeguard, but lawyers won't take cases re: old people, so the docs know there is a steady and continuous stream of old people to take the place of those that die or become too unprofitable (Medicaid) to continue to care for. Oh, and one thought that bothers me somewhat: I pushed really hard to get my father's PEG procedure done immediately, which meant a Sunday. I got a lot of grief because there were several procedures already scheduled but I insisted that he be fit in.""That was on Saturday at arouand noon. By the time the procedure was done (Sunday at 1), the other 3 procedures were cancelled. I didn't ask (no point in alienating anyone), but I can't help but wonder if those patients died. That's not an optional procedure and aspirating into your lungs will kill you." "Thanks, Veronica (don't know that I'm knowledgeable but I am persistent and work in the healthcare industry, which is certainly a help). Will be happy to look over the weekend. Thanks!""If Massachusetts can do this, why doesn't New York?Because too many people are making too much money.http://bo.st/PiVQOM""I wonder if a doctor won't admit to a mistake, if this law releases other doctors to tell the truth to the patient without causing the original doctor to be legally threatened. Because I think big ego doctors won't admit to their own mistakes no matter what. The patient should be able to find a truthful doctor. Would this law make that more likely?" "Thank you for the comments and kind words. I had hoped my website www.tossurgerynightmare.com would be the one displayed here. Ahh....there it is! Yes, the terrible rolfing injury started my search for answers--and when I got NONE at Kaiser Permanente, CA HMO for profit, and, in fact, I got misdiagnosed there by their neurologist, I had to start paying ""out of pocket"" to go our of plan. I was getting more disabled by my ""rolfing-induced"" injuries--so had the first surgery in my life at age 42 to try to fix my ""winging scapula."" I fell victim to surgeons who were far overconfident, aggressive, and took my insurance money or cash to ""fix"" me at Hospitals and Private Surgery Centers. They ""fixed"" me alright. Now, sadly--I am a train wreck of scar tissue, half a neck, spine problems, breathing problems, still have the winging scapula injury-and more. The T.O.S. Surgery, my LAST surgery in 2004 was the WORST. Cutting out my first rib-and my neck muscles--my surgeon LIED (grossly) on his pre-op form that I signed, then abused me after his surgery made me obviously worse--and the Medical Board in CA did not care--so just let him off. But, the truth is very clear in the documents of my complaint to the Medical Board! He LIED!.... about all of the risks of Thoracic Outlet Surgery saying the risks were only between 1-7% (at most)-- He and I both signed his pre-op form. But, the Medical Board in CA stated he was not at fault because T.O.S. surgery was so risky??? How do they get away with that? A more accurate representation of T.O.S. surgery is that it almost always makes people worse--not better. Yet, they continue to allow it--and it is BARBARIC! As so many of you here know, Medicine is a dangerous world when one is desperate for answers. There were and are NO watchdogs for greedy, reckless, abusive surgeons and their hospitals/HMOs. What they can get away with, they will. That is why I'm so glad to find like-minded people here--maybe we can start to raise awareness together and change this medical industry.""unfortunately bobbie, they get away with a lot. most in this group have stories of medical harm and/or know someone with a story of medical harm. so sorry for the reasons that brought you here but welcome..."thanks Robin!thx veronica--I did--tho-thought of more to add to it recently....thanks!"Hi all, ProPublica's social media producer here! We're compiling a round-up of great accountability journalism on nursing homes. Do you know any good articles, or journalists doing good work? Let us know in the comments. (And just for reference, here's one example of the kind of work we'll be including: http://californiawatch.org/node/1583) Thanks!""Thanks, Veronica!""I would suggest reading Jack Schroder's book ""Identifying Medical Malpractice"" for some more insights into Medical Crimes in those types of facilities.""Blair-do you remember Ila Swan out of Sacramento? She may have retired or passed away?...(sorry Ila, if not) but she used the millions she won in a lawsuit against a nursing home for her (mom?) to do research, travel to across country to many nursing homes--and was a ""pit-bull""(in a good way) for exposing dangers in them. She may have many journalist contacts,or her relatives might. Here is one link to her. She was very approachable on the phone years ago.. lives (lived in Sacramento, CA-http://www.hospicepatients.org/ilaswan/index.html""Are HIPAA-covered dentists any more compliant with the Rule today than five years ago?In 2008, the results of an informal 2007 survey measuring HIPAA compliance among dentists was published in the Medical Executive Post.""-----------���HIPAA Rules and Dentistry ��� A Survey of Dentists��� By Darrell Pruitt DDSABSTRACT:A survey of 18 dentists was performed using the Internet as a platform. The volunteer dentists��� anonymity was guaranteed. The dentists were presented with ten HIPAA compliancy requirements followed by a series of questions concerning their compliancy as well as the importance of the requirements in dental practices.The range of compliancy was found to be from 0% for the requirement of a written workstation policy to 88% for that of password security. The average was 49%, meaning that less than half of the requirements are being respected by the dentists in this sample.Frustration with the tenets of the mandate, as well as open defiance is evident by the written responses. In addition, it appears that a dentist���s likelihood of satisfying a requirement is related to the dentist���s perceived importance of the requirement.Even though this is a limited pilot study, there is convincing evidence that more thorough investigation concerning the cost and benefits of the requirements need to be performed before enforcement of the HIPAA mandate is considered for the nation���s dental practices.----------------As far as I know, almost 5 years later this remains the only published study of HIPAA compliance in dentistry. It goes without saying that the profession���s continued evasion of the topic can only increase the harm that data breaches cause dentists as well as their patients. What���s more, it is simply counter to the tenets of the Hippocratic Oath to hide avoidable danger from patients. Americans have a clear obligation to demand more transparency in dentalcare. D. Kellus Pruitt DDS" http://www.kevinmd.com/blog/2012/08/health-care-doctors-lead-change.html"If the cap can be overturned in Missouri, let's hope it can be overturned in Colorado!! Spread the word!"incredibly sad story but wonderful ruling..."Hi Patient Harm Site--I'm glad I'm not alone--well sort-of glad. Hope Medical Boards start investigating sham unnecessary surgeries, like mine-- Thoracic Outlet Surgeries. (they cut out my 1st rib, lots of my neck and more--all for NO reason--NO proof it was needed! UNECESSARY mutilation! Thank you Pro Publica!! for initiating this site and VERY important PROBLEM in this greedy US Medical Industry. Please see my website at www.sonic.net/bjj and www.tossurgerynightmare.com I hope to get to know some of you over time--but OUCH!! typing hurts me..so might be slow to respond. It's time to OVERHAUL our Medical System and our phony State Department watchdogs--who simply exist to protect the hospitals/HMOs and surgeons making all the extra bucks.""Hi Bobbie. Reading your site I see the Rolfing manipulation as an initiator of your problems. I'm curious what you learned about that and if you pursued it, or the Rolfer, in any way. I ask neutrally, with no guidance to offer, out of curiosity because I've benefitted mightily from Rolfing. Although it's been probably 20 yrs since engaging in pure Rolfing (I think in the first 10 yrs I had the basic 10 sessions and 2 rounds of 10 advanced sessions; and occasionally I do a session of ""rolfage,"" massage by a Rolfer who works some in), and remembering how challenging some of the work can be, every practitioner I worked with was sensitive and excellent... that could be because a major and early training center is nearby."thank you for posting you story and web site bobbie.thanks all---just getting the hang of face book--kinda nice!"bobbie, it is helpful to know you are not alone in your situation. reading articles posted here and reading about others who have been harmed by medicine helps to 'validate' what you've been through. doesn't make things better especially but it helps to know you're not alone." http://collateral-damage.net/"notice the comments on this web site. several people attack the victim of medical harm and even state that there must not be enough evidence of medical malpractice since the case was lost. as most in this group know, not being able to file medical malpractice or being able to file and then losing your case does not equal not enough evidence. sadly, this is often the perception...""Robin, I don't know about this case, but I do know that the Chief of Johns Hopkins, Dr. Julie Frieshlog (sp?), has been promoting Thoracic Outlet Surgery on You Tube--you may want to take a look- (She came from the Vascular surgery Dept at UCLA where many Thoracic Outlet surgeries were being done by her and by Dr. Samuel Ahn in early 2000---This surgery has a very poor overall outcome--but the Vascular medical journals and many of the surgeons doing the procedure lie about the outcomes--so the mutilation, the unnecessary cutting out of first ribs, sympathectomies and more continues. The surgery supposedly is used to relieve the repetitive stress injuries of keyboarding, etc, or other brachial plexus injuries--but in fact, it carries very high risks, and often causes scarring of same damaged nerves, and more, the blood vessels, more tightness and pain, and loss of structure and more compromise of that area--and leaves many many patients disabled and in pain for life. Just FYI re: Hopkins and Thoracic Outlet Surgery. I'll look up your article. thank you!""bobbie, many of the surgeries performed these days are unnecessary, mutilating and don't make for a better quality of life. gone (i'm afraid) are the days when doctors 'FIRST do no harm'. with all the new technology come many new complications and dangers. for this reason, patients absolutely must educate themselves as much as possible about any surgery they are considering and especially learn about related risks/consequences.""A Harvard meta-analysis funded by the National Institutes of Health has concluded that water fluoridation significantly lowers IQ scores in children, and may be a neurotoxicant that affects brain development Fluoride has immunosuppressive effects at low dosages, which can raise your risk of chronic disease, including cancer. http://lewrockwell.com/mercola/mercola218.html""In fact, there have been over 23 human studies and 100 animal studies linking fluoride to brain damage3. Fluoride can also increase manganese absorption, compounding problems since manganese in drinking water has also been linked to lower IQ in children.""USA Today attributes 30,000 deaths a year to C diff in this story today and alleges that not enough is being done to prevent the bacteria and protect patients. Sadly, I know that a lot of you have experiences with health care acquired infections. They are indeed rampant. I'm wondering what you think about the allegation that health care facilities are not doing enough to protect patients from them. Whether you're a patient or provider, please tell us what you know. Are health care facilities doing enough?""Thanks for posting this, Marshall.""My latest article for ProPublica examines the problem of unnecessary stent procedures, and touches on the problems of money-driven medicine, appropriate treatment of stable heart disease and informed consent. It's well known that it's often just as effective to treat patients with stable heart disease with medication, rather than stents; and yet one recent study found that only 6 percent of Medicare patients who received stents said that their doctors had presented medication alone as an option. That raises some thorny questions about the nature of informed consent. The story also plugs our Patient Harm Questionnaire, which is a huge help for our reporting and to help other journalists tell these stories. If you have not yet completed it, please do so here: http://bit.ly/KeQ9h8.I'd love to hear any of your thoughts and observations about the problem of unnecessary stents or other procedures. Have any of you experienced this?""I wrote about this last fall after that paper came out and interviewed the PI. ""Don't have a flat tire in front of that hospital, you'll likely get cathed."" Inside Cardiology's PCI problem. http://www.healthleadersmedia.com/content/QUA-269942/Inside-Cardiologys-PCIProblem""Marshall: Is it possible that some teaching hospitals are putting in unnecessary stents because they need their residents to fulfill requirements for passing boards or procedures to move to next level? I have a friend who believes that is what Kaiser Permanente HMO did to her carotid artery here in California-and she seems to have documents to prove it. She was going in to have her parotid gland removed and didn't know a resident was going to work on her--and she says she has evidence and films showing a stent in her carotid artery--they also ruined her entire neck-R shoulder by killing the nerve function to her R trapezius ""Spinal Accessory Nerve"" That is not even near the parotid gland, i don't think. Ck. out ""Kaiser Crimes"" on You Tube.""That would be an interesting thing to examine, Bobbie Jenke. Would you please ask your friend to complete our Patient Harm Questionnaire? That helps us keep track of people's stories so we have the info we need to follow them up: http://bit.ly/KeQ9h8""This article shows the risks taken when for-profit hospitals seek to maximize profits. Perhaps medicine really should be, as it once was, part of what Lewis Hyde called ""the gift economy:"" run as a public service, or a charity, or a religious vocation. http://www.nytimes.com/2012/08/15/business/hca-giant-hospital-chain-creates-awindfall-for-private-equity.html?pagewanted=all"Healthcare Entities should never have been allowed to go FOR-PROFIT. THAT IS WHERE THE PROBLEMS BEGAN."My comment is about this: ""Earlier this year, a jury awarded Mr. Chandler and his family $178 million in damages. This month, Memorial and HCA, which had appealed the jury���s verdict, reached a confidential settlement with Mr. Chandler���s family.""For every one of these, there are probably tens, or hundreds of thousands of victims with severe injuries who get nothing. Mr Chandler was probably very rich to begin with, and had excellent access to legal resources, and was able to show his injury would result in reduced income of a whole lot. Our legal system takes care of people like him very well. The rest of victims can rot and die. Our legal system is extremely inadequate for the majority of victims. And the medical system takes full advantage of that."Papers in Samaritan Hospital negligent-credentailing case will show details that prompted last-minute settlement. http://bit.ly/pAb3jb wow... the gynecologist in this case had obvious issues"MRSA infection rates double in US academic hospitals yet the CDC has not released MRSA infection rates since 2005. The government continues to hide the MRSA epidemic from Americans and the genocide continues. NO public awareness campaigns, PSA's etc. by state health departments. The only public awareness campaigns and PSA's are run by MRSA Survivors Network. http://www.eurekalert.org/pub_releases/2012-07/uocpmci072612.php"Same goes for C- Diff!My late husband was infected with MRSA during one of his hospital stays. We were not informed until two hospital stays later when he was placed in isolation because of his MRSA. Surprise! Same hospital. HealthLeaders magazine's August issue features a story about how hospitals react to data that makes them look bad. and quotes ProPublica's Charlie Ornstein."""More reporters are realizing the treasure trove of information they can find,"" he says. ""For decades, hospitals fought to keep this information out of the public domain. But now that it is public, we as journalists have an obligation to make it relevant."" EXACTLY...""We all have an obligation to get this right. Pumping out data, while being transparent, isn't being useful. I hope ProPublica's tools are helpful to everyone."Amazing stories and some very scary truths.IHI's launched this new end of life conversation-starter initiative. Useful guidance and resources. http://theconversationproject.org/"this is really a good resource. i never gave this much thought until my father passed away suddenly from a massive heart attack in 12/2009. i don't feel that anything was done the way he would have wanted and i will forever regret it. my father always wanted to be cremated. he did not want a public viewing or funeral. my brothers had a public viewing and funeral anyway. and, even though my father was not an organ donor, his organs were donated including his eyes. my father's organs being donated really bothered me so i contacted a friend of mine who runs a funeral home and asked her how my father's organs could be donated when he didn't want to be an organ donor. she told me that in most states there is a law now that forces hospitals to contact the state's agency over organ donation anytime a person dies in the hospital. she said that the family is then pressured to donate the organs of their loved one who passed. i then learned that this is exactly what happened in my father's case. according to my friend, most of the bodies she receives now are missing most of their organs. i would have never known about this law if my father's organs had not been donated. none of us really want to think about death but what happened to my father has taught me that we need to think about it.""Robin, organ donation is another very important topic. On the one hand, much good comes of it. OTOH: there is great debate over the practice, apparently, of not anesthetizing the body of the person donating and that it's possible, if not brain-dead, for pain to be felt. Then there's the issue of donate vs harvest, which is the operative term (not to be cute about it). Next, harvesting may or does also include tissue, bone, skin, etc. from the cadaver, all of which are used ��� and well used ��� in medicine. Finally, I must acknowledge the issue that various entities to profit from harvesting, but of course not the deceased's family (that'd be crass, wouldn't it? ���not).At the moment I'm not an organ donor. I might (re)consider it if (a) a system of guaranteed anesthetizing were enacted and (b) my family received significant monies for my bod.""Bart in this country and many others, the anaesthesia is very well controlled and administered.. and I believe that it is in all countries.. with pain come different receptors and the harvesting of organs, needs all to be well as they need to obtain a good vein and artery system to that organ..... so unless you have real proof that it is not happening. I would agree to disagree with you. It is very easy to get chinese whispers going.. YES the anaes team leave before the surgical, but then the patient has died and no longer needing support they were dead prior but on life support to keep the organs alive. In Robins case it seems that her brothers did not get a family consensus, which is the sad part.""Hi Brenda, esp. on this topic and in these forums I'd like that we take care in our statements. I did not declare that harvesting took place sans anesthesia. I wrote that there ""is great debate over the practice, apparently..."" Reference: http://goo.gl/XeEpV . What's behind my closing paragraph above is that, after experiences during all 3 of my family of origins' hospitalizations, I no longer naively trust medicine. I'm not to the point of saying, like some of the harmed, that the harm is willful; my experience is that it's been systemically inept. That however doesn't change how we experience it, or that medicine says ""adverse event"" when we feel shocked and harmed. Knowing how fast events can move, and how absent real communication can be in hospitals and at end of life, I'm personally disinclined to potentially subject myself or a loved one to harvesting misadventures. Again, because donation can do so much good, it's a very challenging place to be, at heart.Ever contrarian, and acknowledging the awful aspects of Robin's family's situation, I have a hard time reconciling the notion that individual's are supposed to be noble (donate) yet many other entities get paid for body parts and their implantation. Again, sensitive stuff, and my approach to broaching these topics is straightforward, as I believe it must be.""i would never agree to be an organ donor for the reasons bart stated. six healthy organs were stolen from my body without consent as it is. there is just no way i would agree to organ donation now that i know what can and does sometimes happen. brenda is right in that the sad thing about what happened to my father (after death) is that his organs were donated when he did not want them to be. i will never forget the way my father looked after this and unfortunately it will forever be my last 'picture' of him. i don't know what use my father's organs could have been anyway since he was almost 75 and he had heart issues, among other things. what could his organs have been used for except maybe medical students to practice on?""Robin, it's either in Teresi's article or...actually, in a video report I subsequently watched online. Skin is used for burn victims, bone and tissue have a variety of uses. I guess we're all a bit of a treasure trove! I don't know how age plays out in assessing the usability of any parts.Interesting ""conversation"" we're having given how innocently this thread started!""innocent post bart and a necessary conversation following in my opinion. 'end of life issues' include organ donation or no organ donation. i guess that was really my point. i thought if a person wanted to be an organ donor, they signed up for it making that the end of it. my father's death highlighted this issue for me and my family and i learned it's not quite so simple. i had no idea that my family could donate my organs when i don't want to be an organ donor. now i know that so i can put in writing what i want. end of life issues are something we will all face at some point. why not be proactive and make preparation? again i will say that your post is a good resource...""bart, i also watched a video about the use of donated skin for burn victims. we are every bit a treasure trove - even after we die. for that reason, we need to ensure what we want at the end of our life is known and that it will be honored... at least as best we can.""Speaking of med student practice, Mary Roach wrote, probably in Stiff but I don't recall which hilarious and educational book of hers, about a plastic surgeon's convention she sweet talked her way into. IIRC, for one practice session, essentially, attendees (plastic surgeons) entered to heads on platters. I might be embellishing the visual slightly, or perhaps not. Mary's description was memorable. Just sayin'; it ain't like they practice on Barbie dolls."Reliable answers about HIPAA and dentistry ��� at last"You may have heard a rumor that dentists are ���mandated��� to purchase and use electronic dental records. As a matter of fact, you might have read the rumor in the ADA News, followed months later by the ADA���s denial of the rumor. Such conflicting information about a mandate have co-existed in the leaderless dental industry for almost a decade. Bottom line: Regardless what the ADA, EDR vendors and other stakeholders tell dentists, there is no mandate ��� not even for dentists whose practices are more than 30% Medicaid.A few days ago, I asked well-known experts on the HIPAA 411 Linkedin group about the Rule. Our unprecedented discussion even spilled over into other questions, including what determines if a dentist is a HIPAA covered entity. As far as I can tell, many of the answers I uncovered have never before been revealed to dentists:According to the official definition from 45 CFR 160.103, a covered entity includes:- A health plan.- A health care clearinghouse.- A health care provider who transmits any health information in electronic form in connection with a transaction covered by this subchapter.Another expert offered:a) Sending facsimiles doesn't count as electronic communications for purposes of making a health care provider a HIPAA Covered Entity. There are a number of reasons for this, but one of the biggest is that the data being communicated via facsimile never actually exists as discrete data elements.b) Patient registration and patient scheduling electronic transactions are not among the list of HIPAA transactions presently spelled-out starting with Subpart K in 45 CFR 162. Thus sending or receiving them does not make a health care provider a HIPAA Covered Entity.c) A health care provider who only receives electronic remittance transactions, but never transmits any transactions is not a HIPAA Covered Entity.d) The electronic transactions that most often cause a health care provider to become a HIPAA Covered Entity are:- requesting eligibility or benefits information from a health plan- submitting a claim or encounter report to a health plan.���Generally speaking, if a health care provider initiates -- i.e., transmits -- any of these types of transactions via a computer, that health care provider is very likely either using the ASC X12 transactions itself or via a business associate / health care clearinghouse, or using Direct Data Entry. Either way, that health care provider is now transmitting a transaction spelled-out in Subpart K or Subpart L in 45 CFR 162, and is, therefore, a HIPAA Covered Entity.���e) Once a health care provider becomes a HIPAA Covered Entity, all of the HIPAA regulations -- transactions, code sets, identifiers, security, privacy, enforcement, etc. -- apply to that health care provider.Another offered this:���Also, pursuant to Section 3 of the ASCA, PL107105 (2002), many providers are required to submit Medicare claims electronically making them covered entities. In this case, though, dentists were specifically excluded from this requirement. Per CMS guidance (Related Change Request (CR) #: 3440, reissued January 27, 2005), dentists and small providers are specifically excluded from electronic submission requirements related to Medicare claims. There may be states with additional requirements that would push more into the covered entity category or even force adoption of HIT but that would be state by state. It is not a national requirement today.���I wish to thank the members of HIPAA 411 Linkedin group for their generous help. I would also suggest to ADA leaders that when they sell membership information about an EDR mandate that contradicts itself not once, but three times, they harm the organization���s credibility for years. You leaders need to get your act together quickly because the ADA is on the verge of becoming increasingly irrelevant at a time when our patients need strong representation the most.D. Kellus Pruitt DDS"Question - In my medical records there are several mentions of contacting CDC and my husband remembers they were involved. How does a patient get those medical records and what is CDCs responsibility for reporting."Today, ProPublica introduces a new feature that goes right to the heart of patient safety.Nursing Home Inspect, http://projects.propublica.org/nursinghomes/, allows you to easily search through thousands of recent government inspection reports from around the country, most since the beginning of 2011.You can search by state or by the severity level of the deficiencies cited. The default search ranks results by the severity level of the problem found.Here is a link to a story I wrote with Lena Groeger (who put together the app): http://www.propublica.org/article/our-latest-news-app-nursing-home-inspectHere is a link to a tipsheet on how to best use the app: http://www.propublica.org/article/how-to-search-nursing-home-inspectHave any of you had any experiences with a nursing home? Please comment below. And let us know what interesting things you find using the search.""A study notes that dental expenses are among the highest out-of-pocket health cost to consumers, second only to prescription drug expenditures...the government as a factor too, citing the statistic that only 6% of dental nationally is paid through government sources.""New York authorities say a Brooklyn dentist has pleaded guilty to fraud, admitting he paid recruiters to solicit homeless Medicaid patients with cash. http://www.myfoxny.com/story/19266705/brooklyn-dentist-admits-fraud-in-medicaidprobe""This is one shared from childhood friend who used to be a girl, but is now a man. The varieties of misuses of drugs never ceases to amaze.""The American Dental Associaton���s Dental Quality Alliance ��� Quality control, cost control or simple tyranny?""���The ADA was asked in 2008 by CMS to be the lead agency in forming the DQA, with an initial charge of creating programmatic measures for children���s dental Medicaid plans. It is comprised of multiple stakeholders from across the oral health community who are committed to development of consensus based measures.��� (See ���DQA accepting proposals to test measures��� by ADA reporter Kelly Soderlund, ADA News, August 13, 2012). http://www.ada.org/news/7480.aspx Actually, in the 2008 address to the ADA House of Delegates, HHS Secretary Michael Leavitt put it much more bluntly than Soderlund leads dentists to believe: ���If you don���t get a handle on quality control my MBAs will.��� The government official���s threat to US citizens reminds me of a quote by Thomas Jefferson: ���When governments fear the people, there is liberty. When the people fear the government, there is tyranny.��� Not unexpectedly, our spineless ADA leaders capitulated to DQA cost control measures as quietly as they surrendered my profession to HIPAA and EHR vendors ��� once more favoring stakeholders over dues-paying members, the Hippocratic Oath and the ADA mission.Dr. Christopher Smiley, DQA chair, tells ADA News: ���Quality measurement has been present for some time in medical care and it���s evolving in oral health care. This is going to impact not only public pay programs such as dental Medicaid and federal Children���s Health Insurance Programs but it will likely extend into private pay benefit plans through regulations of the health care exchanges.��� Must American dentists fight against ambitious ADA bureaucrats in addition to the other self-serving stakeholders they invite to interfere with doctor-patient relationships?When the ADA-approved online report cards appear, dentists will be identified by voluntary but permanent NPI numbers which were promoted by ADA leaders and Delta Dental. It will be interesting to compare stakeholders��� favorite dentists with patients��� favorites as listed on doctoroogle.com.Doc, who would you really prefer to determine your value to society ��� patients you have pleased for years, or ���multiple stakeholders��� armed with your dental claims and a national report card? Since dental patient���s opinions have already been discarded as unreliable by the DQA, how do you feel about Dr. Smiley, Delta Dental and Leavitt���s MBAs determining your pay scale instead of the free market? I cannot think of a quicker way for the American Dental Association to become even more hated by a growing number of American dentists. What a disappointment to the profession.D. Kellus Pruitt DDS" please visit my website www.justiceforjosh.com to see what is going on in canada What a travesty of medical malpractice without accountability. USA is already here.http://www.huffingtonpost.com/dr-peter-breggin/electroshocktreatment_b_1373619.html"A test for behavior is all that matters. Sitting quietly in a chair and calmly answering simple questions about who the President is and what your birthday is the test to determine mental health. Either a lobotomy or electroshock can consistently produce this outcome, therefore they are ""therapeutic.""I might be exaggerating or over-simplifying some, but that's what it comes down to."@ garrick... that is what it comes down to http://www.naturalnews.com/036787_chemotherapy_medical_freedom_alternative_medicine .html"The ADA adapts to climate change - slowly at firstFor years, I���ve pointed out that the ADA Facebook continues to attract increasing numbers of fans, yet the only information offered is the increasing numbers of fans. Recently, that changed. The ADA Council on Communications cracked opened the door ever so slightly, and quietly invited ���recommendations��� from the public." "Surprisingly, it���s still open to comments. Not surprisingly, out of 21,739 fans, the invitation has only attracted 2 responses in its first week. That���s what happens when an organization disrespects 21,739 fans for years.The first recommendation is from a very dissatisfied customer complaining about a dental clinic. The second is mine:Maybe someone can help me with this question: Are electronic dental records mandated? in a 2008 interview for ADA News, ADA President-elect Dr. John Findley told ADA reporter Judy Jakush: ���The electronic health record may not be the result of changes of our choice. They are going to be mandated. No one is going to ask, ���Do you want to do this?��� No, it���s going to be, ���You have to do this.��Ȋ�� http://www.ada.org/members/resources/pubs/adanews/081006_findley.aspBut then, in January of this year, the ADA News reported: ���Dentists and their employees may have heard rumors of federal mandates requiring dentists to adopt electronic health records (EHRs), or implement ���paperless��� offices by 2014. Another rumor implies that dentists must be able to create and transmit digital radiographs (which are important EHR capabilities) by 2014. There are no such mandates or deadlines for dentists who do not submit claims to Medicare, or who do not see large numbers of Medicaid patients.��� http://www.ada.org/5348.aspxHowever, as recently as May, the ADA appears to have reversed itself again on the question of a mandate: ���Dentistry has joined a growing list of domains, including cardiology, eye care, patient care devices, radiation oncology, anatomic pathology and several others, in preparing for the legally mandated transition from paper records to electronic health records.��� http://www.ada.org/news/7087.aspx So which one do we believe?----------It was Friday when I brought the contradicting statements to the attention of the ADA using their Facebook. Then on Saturday, I discovered that the ADA has evidently reversed its opinion about the mandate a third time. http://cdaonline.org/index.php? option=com_content&view=article&id=564:aredentalofficesrequiredtousedigitalxraysystemsby2014&catid=1:latest-news&Itemid=129 On June 24, the Colorado Dental Association announced that there is no mandate for EDRs and that ���vendors��� (not the ADA) are responsible for the rumor. Considering the ADA���s notoriously poor internal communications, do you think I should warn someone or let them find out on their own someday��_ or not?I think the ADA���s small, diffident step towards openness on Facebook reflects disruptive forces just under the toughened surface. I may be reading too much into it, but I imagine very private, traditional ADA leaders were perhaps recently shocked by discouraging news: For the not-forprofit to stay relevant as well as viable, ADA leaders must personally become part of the community they serve. What���s more, they must interact with consumers they can no longer evade with layers of protective bureaucracy. Community leaders can���t get away with that in a small town. Those who demand special conditions for interaction are called hermits. For my part, by patiently prising at small, quiet openings, I���ll eventually succeed in bringing transparency to dentistry. Sit back and watch. This will be fun.D. Kellus Pruitt DDS""Electronic dental records are mandated ��� True or False? I learned today that the American Dental Association leadership changed their answer to this question for the third time just two months ago.""On June 24, dentists were told in a Colorado Dental Association online news article that contrary to what ���vendors��� have been saying, electronic dental records are NOT mandated. The CDA���s opinion directly contradicts 2 out of the 3 articles about the mandate that have been published by the ADA in the last 4 years. Confusing? You bet! But it���s coming to a head. The truth will soon emerge on its own.For those keeping track of the ADA���s argument with itself, the count stands at 2 apiece and we are awaiting a tiebreaker opinion from ADA Headquarters, or perhaps another courageous state Association. I���ve found it fascinating to observe this awkward development of national embarrassment from a safe distance. It���s sort of like watching an undisturbed zit achieve its inflamed, indurated potential. MandatedSeptember, 2008 - ADA President-elect Dr. John Findley: ���They are going to be mandated. No one is going to ask, ���Do you want to do this?��� No, it���s going to be, ���You have to do this.��Ȋ�� http://www.ada.org/members/resources/pubs/adanews/081006_findley.asp (Note: The link is no longer valid. Dr. Findley���s interview with Judy Jakush is now only available in print editions of the October 2008 ADA News).Not MandatedJanuary, 2012 ��� ADA News: ���Dentists and their employees may have heard rumors [see September, 2008 above] of federal mandates requiring dentists to adopt electronic health records (EHRs),��_ There are no such mandates or deadlines for dentists who do not submit claims to Medicare, or who do not see large numbers of Medicaid patients.���http://www.ada.org/5348.aspx MandatedMay, 2012 ��� ADA News: ���Dentistry has joined a growing list of domains��_. in preparing for the legally mandated transition from paper records to electronic health records.���http://www.ada.org/news/7087.aspx (Note: It���s my opinion that this link could one day become a dead end).Not MandatedJune, 2012 ��� CDA online News: ���Electronic health records are not required ��� not now and not in 2014. The American Recovery and Reinvestment Act of 2009 (commonly known as the ���stimulus bill���) offers some incentives to encourage healthcare providers to switch to electronic records systems, including grants of stimulus money for the purchase of electronic records systems. However, the legislation explicitly states that participation in the installation of electronic records systems is voluntary.���http://cdaonline.org/index.php? option=com_content&view=article&id=564:aredentalofficesrequiredtousedigitalxraysystemsby2014&catid=1:latest-news&Itemid=129Contrary to what the CDA would have members believe, the ���vendors��� are not the ones responsible for hatching the rumor of a mandate ��� not directly. As anyone can see, it was the ADA. Considering that I arguably uncovered a policy of deception in a national healthcare organization, can you think of a more convincing reason for demanding transparency in the dental industry?In defense of Dr. Findley���s abject surrender of my profession to vendors, HHS and other stakeholders who don���t care for my patients, he is otherwise known as a smart, capable leader and is wellrespected by dentists I respect. That is why I think the man was pressured into promoting others��� ambitious interests rather than his own. Nevertheless, he knew before running for the highest office in the profession that the ADA���s traditional business model is designed to strip vetted leaders of apparent intelligence. The notorious unresponsiveness of ADA officials hints that their freedom of openness and even self-determination are forfeited for the good of the organization. It���s an increasingly rare command-and-control business strategy out of the 1950s that still thrives deep in dentistry���s hidden niche. That���s my opinion. What���s yours?D. Kellus Pruitt DDS""""the notorious unresponsiveness of ADA officials hints that their freedom of openness and even self-determination are forfeited for the good of the organization"". for the good of the organization says it all in my opinion...""Transparency, adequate notification and accurate information is owed to the patients/consumers of dental services and products...the ADA is known to deviate from the basic human rights to the dental patient/client. It is so grossly unethical and has caused so much suffering for patients and the professional committed to the paying customer in the dental chair."It's all about transparency.Absolutely...when I contacted the Pres of ADA a few years ago to discuss the merits of Tina's Bill Proposal and to gain the ADA's support they agreed that ethically the Dentist On Probation should inform the patient about their changed licensing status and the fact that the dentist is on probation for being non complaint or for repeating gross negligent conduct. They didn't take any action however and didn't follow up."@ tina... i've learned that you can report and file complaints but they are rarely addressed for real. i filed a dozen or more complaints regarding my surgery in 2007 and nothing has truly been addressed. i think the most ridiculous response i received was from the joint commission on hospitals wrote to me and told me that they don't investigate any matter more than three years old. forgetting the fact that i filed my 'first' complaint with them before three years was up... i wrote them back and told them that they should follow up on any complaint as serious as mine - especially when the doctor testifies that it is his 'routine' to obtain illegal consent for surgery and it should not matter if the complaint is three years old or thirty. of course, they never responded after my last letter. regardless of whether our complaints or reports are taken seriously or not, we need to file them for many reasons. one thing is for certain. if we don't file reports or complaints, nothing will be done.""Sorry you're yet another person suffering with the frustration of being ""stonewalled"" after filing a complaint Robin Karr . You know the investigators collect hourly fees for years from just investigating the dentist after you file that valuable complaint...the dentist they keep licensed pays the investigation fees and as soon as they are placed on probation for non compliant and negligent behavior they also pay the hourly monitoring fees. If the Attorney General's office is participating in the investigation they can also charge for their hourly investigative fees as long as they keep the non compliant dentist licensed. The ""money wheel"" is the conflict of interest that doesn't prevent a dentist's harmful conduct from repeating and harming a patient irreparably or provide a victim with proper restitution or rightful retribution. The damage a victim suffers is a physical and financial burden we endure after a Dentist On Probation repeats a harmful pattern the Dental Board acknowledges may repeat""The answer to commandand-control stonewalling by unaccountable entities is to complain broadly and loudly. About 7 years ago, when Dell Computer's deceptive warranty pissed off Jeff Jarvis, he started a website called ""Dell Hell."" He had no idea that so many thousands of Dell customers were just as disappointed, and also willing to publicly complain. Dell Hell brought the computer giant to its knees. In the end, Dell became a better company. I'm not saying you must open an aggressive website (but you could). Post your complaint on Yelp, Angies List or any and all other ratings sites you can find. It might not help you, but it could prevent someone else from being a victim."I've participated on so many levels to prevent other dental patients from being fooled or deceptively coerced by a dentist the Dental Board licensed after they acknowledged he harmed several patients with a harmful pattern and the Board failed to competently inform the public on their website - a duty they owe the public and consumer of dental services. I'll never get my damage repaired but hopefully others will learn from my experience. Dental professionals need to educate the public about the difference in a dentist licensed as a Dentist On Probation.You'll get no argument from me."If all dentists that are not on probation would educate their patients about the different licensing status and condtiion of a Dentist On Probation the consumer of dental services could actually choose a dentist they want to invest in. All patients are trying to avoid any increased risk of harmful products, patterns and conduct.""Hackers��� ransom ��� another important I told you so from years ago���Hackers Encrypt Health Records and Hold Data for Ransom��� was posted today on BloombergBusinessWeek.com by Jordan Robertson.""Today, Robertson revealed a growing liability for HIPAA-covered entities - extortion by hacker: ���Unlike many other data breaches, the hackers made no attempt to keep their presence a secret. In fact, they all but fired a flare to announce the break-in, taking the extreme step of encrypting their illicit haul and posting a digital ransom note demanding payment for the password.���Almost four years ago, my reaction to this budding crime wave was, ���Dentists must lose this danger or lose their computers.��� (See ���Extortion ��� The newest argument for de-identification,��� Pruitt���s Platform, November 22, 2008). http://community.pennwelldentalgroup.com/forum/topics/extortion-the-newest-argument If one is counting, this is my third unpopular I told you so this week ��� even as dental leaders we depend on for representation continue to affect a stoic, professional image by remaining above such concerns of common dentists. Am I right or what?D. Kellus Pruitt DDS""I expect the efficiency of EHRs to improve and even surpass paper records' in emergency rooms.... let's hope so. However, if an unconscious patient is brought in, and his or her EHR has been altered by a medical identity thief, the victim could be quickly injured or killed. I think biometrics should be included in EHRs as a second item of identification.""Unecessary sedation with Versed/Midazolam should stop. Most people don't need it, it can add THOUSANDS of dollars to each procedure and it's dangerous to your mental health. Medical workers want to use it because they can hide behind that amnesia that the drug USUALLY causes and take advantage of the extreme obedience the drug creates. Too bad for you when you get PTSD from being tortured while under this amnesia drug. BAN IT!"@ jackie... thanks for posting this. i experienced ptsd after being injected with versed in 2007. versed allowed my former doctor to perform surgery on me that i didn't consent to. this drug should be banned! it's not a true sedative nor is it a pain killer. it causes conscious amnesia! it's often given to patients who don't even know about it nor the serious side effects associated with it.My medical records have verced they told us it was for anxiety before my surgery. Another point to add is I thought general anesth didn't include propothol??? I found in my records they used it"Propothol is used a lot for minor surgery.... it has reduced the side effects and allows for faster recovery, in that sector of the surgical/anaes outcomes""@ georjean... versed is most often given to patients to make them more 'compliant'. without question, when versed is given, patients should be told why and also be told about the possible consequences. in my case, like you, i was told that i was being given versed for 'anxiety' and/or to 'relax' me. in my case, i refused to sign my surgical consent due to the wrong procedure being listed on the consent. i told the nurse that i wanted to speak with my doctor. while i was waiting to speak with my doctor, a crna came into my pod and told me he was going to give me something to 'relax' me. i advised him that i did not want to be given anything since i was waiting to speak with my doctor about my surgery. he injected my IV anyway! that was my last waking memory. my family told me that the o.r. nurse rushed into my room as soon as i was given versed and she told my mother to sign the consent i had refused to sign and i was immediately taken to the o.r. and the wrong surgical procedure was performed. my life was forever changed and in ways i could never have imagined. i suffer mental anguish that i've never known and also complex ptsd as well as many negative health consequences from the surgery. to this day, i panic when it's time to sleep. i cried out that i wanted to die when i woke up and learned what had been done to me. this is noted in my hospital record. i would think that this should serve as a *red flag* in more ways than one. why would a patient wake up from an 'elective' surgery and cry out that they want to die? the o.r. nurse who was deposed in my case stated that i raised red flags because of my behavior. you think????? the whole ugly picture became all too clear once i obtained my hospital records - especially the anesthesia report. interestingly, my pre-anesthesia plan did NOT include versed. versed was ordered by my doctor at the moment of his arrival at the hospital for my surgery - 7:38 a.m. my mother's illegal consent was also timed at 7:38 a.m. very interesting... the 'new' anesthesia order states my doctor ordered versed due to 'anxiety'. however... the admitting nurse noted in my pre-op assessment report that my mood was 'calm'. she noted this only minutes before my doctor showed up and ordered versed. it is beyond clear why this was done in light of my records. my doctor arrived at the hospital and learned that i did not sign off on the wrong surgical procedure (the one he intended to perform though) and he ordered me to be knocked out. the nurse obtained illegal consent from my mother and i was taken to surgery. my doctor performed the most expensive surgery he could perform on me and the most dangerous. he botched the surgery i did not consent to and i lost so much blood that i needed a transfusion. if i had not come out of my sedation and been able to advise my nurse that i was pouring blood, i would have died. i was taken back to the o.r. and the bleeding was stopped. although i needed a transfusion, i was not given one because my doctor did not want the seriousness of what he did to me to be documented. he told me the next morning that i needed a transfusion but that he decided to instead prescribe iron pills for me to take for a few months. versed allowed for all of this to happen to me. i was not anxious when i was given versed. however, i will be anxious for the rest of my life..." http://healthland.time.com/2012/08/09/antipsychotic-prescriptions-in-children-haveskyrocketed-study/I have also seen children have a rapid weight gainy daughter tool her child of them and she lost the weight@ garrick... peter breggin m.d. of new york continually talks about this issue in particular. he has been sending out alarms about this for years.http://www.sacbee.com/2012/07/22/4648415/2-uc-davisneurosurgeons-accused.html?storylink=lingospot_related_articlesEXACTLY!!!!!"Those of us who have received deceptive psychological management when we seek answers to our medical injuries are left to wonder how these people can sleep at night. Here is one answer. ""It suggests that the thrill of pulling off a deception outweighs the negative feelings associated with immoral behaviour.""""good article and it rings true. i always say follow the money. but, it is equally true that people 'get off' by being bad or deceptive just for the sake of being bad or deceptive and... getting away with it. sick people that is..."It's sad.... http://video.search.yahoo.com/video/play? p=death+by+medicine+movie&tnr=21&vid=4997366887481570&turl=http%3A%2F %2Fts3.mm.bing.net%2Fvideos%2Fthumbnail.aspx%3Fq%3D4997366887481570%26id %3Df717a4d6a7578a8baf5982b63799f05c%26bid%3D45pK5RArkTzWjw%26bn%3DThumb%26url %3Dhttp%253a%252f%252fwww.imdb.com%252fvideo%252fimdb %252fvi228433177%252f&rurl=http%3A%2F%2Fwww.imdb.com%2Fvideo%2Fimdb %2Fvi228433177%2F&sigr=11b9krpdn&newfp=1&tit=Death+by+Medicine+Trailer+-+IMDb "according to gary null's death by medicine, there are approximately 800,000 deaths each year caused by conventional medicine - making medicine the leading cause of death in the u.s. both the book and movie are an excellent resource..."thanks veronica. i found that one and a couple of others after i posted mine. glad you posted the link you found:)"���The Insurance-Free Dental Practice.��� This sounds interesting. Can you say, ���concierge dentistry���?""""The most important thing to remember is that Quality Dental Plan isn���t dental insurance. Rather, patients pay a simple, set annual membership fee directly to their local dentist, bypassing the third party entirely. In return, they receive a preventive dental care package for the whole year at that dental practice. There���s also a further savings for additional family members, and patients also save on any treatments (restorative, cosmetic, implants), with no limit, and no deductible.""What do you think? I'm sincerely interested in your opinion.""@ veronica... the most important point you made in my opinion is 'i have been blessed with a very good and honorable dentist'. that's the key to a successful outcome always. i too have a wonderful dentist who i truly trust and have known for at least 25 years. i'm more thankful for doctors like my dentist now more than ever... having lost faith in medicine, it certainly helps to have a doctor/doctors i can trust to do what is best for me. i saw my dentist several times this past year which is unusual and everything went perfect each time. good experiences help to balance all the bad ones to some extent...""That's good to hear, Robin. If you feel like doing so, you could help others in your community by visiting one of the many dentist ratings sites and put in a good word for your dentist. Encouragement of good ethics always improves the treatment patients receive."i think i did that darrell but i'm going to check now that you mentioned it:)"Now more than ever before, consumers control quality in the marketplace. And that's wonderful."and that's the way it should be...Demand it!"From NYrs for Patient & Family Empowerment - new report urging hospitals to have patient-centered visiting policies and to respect the patient's right to decide who can visit! It's called ""Sick, Scared and Separated from Loved Ones"" - produced jointly with NYPIRG. http://www.nypirg.org/patientandfamily/default.html""Great work, Suzanne. While a 24/7 family advocate can't prevent all medical errors (and could exhaust said family advocate), it certainly would be a major help in reducing errors. Most of the mistakes that harmed my daughter and led to her death happened when I wasn't in the room. She could email me at night and if I was awake, I could raise an alarm from home. Obviously, that was not sufficient."I'm so sorry to hear about that. Best thoughts to you."On the one hand medicine advises to us to accompany a loved on as their advocate. It does an inadequate job of telling us why (too scary) and how (too complicated). Additionally, it hampers us with arbitrary ""visitation"" policies (the ICU where we spent the last 3 wks of my mother's life disallowed visitation before 11am, when a horde of family members queued up. Of course we missed 6:30-7:30 MD rounding, often the only time the GPs/admittings would round. This article's suggestions are good. I'd say timely except that I'm surprised these conditions haven't already been remedied. Mom died in 2004."@ martha... very sad that you had to raise an alarm from home. so sorry..."i agree with bart about being surprised that these conditions haven't already been remedied. if they were addressed and corrected this minute, it would be too late..."A Greenburgh dentist was sentenced to 10 years probation Wednesday for pleading guilty in April to a felony charge of possession of an obscene sexual performance by a child."Patients and partners who plan to go to the Partnership with Patient Summit in KC Sept 2123, please register here: https://partnershipwithpatients.eventbrite.com/?nomo=1 please look for rooomates here: http://www.advoconnection.com/PWP-roommates/ please book your hotel room here: https://resweb.passkey.com/Resweb.do? mode=welcome_ei_new&eventID=10013915""Moreover, lawsuits are playing a previously unconsidered role in hospital patient safety efforts - as a source of valuable data about weaknesses in hospital policy, practices, staff, and administration. These new and counterintuitive observations should inform open and pressing questions about medical malpractice reform and the best ways to improve patient safety." Electronic medical records have selling points for everyone"The question of whether EMRs will increase or decrease physicians��� billings depends on who is asked. Kelly Kennedy, writing for USA Today suggests that better oversight by insurers and government will help eliminate unnecessary charges:���Also, the [2010 health care] law and 2009 stimulus act will change payment incentives and allow physicians to use electronic records to limit unnecessary medical testing. Private insurers will also be able to work with government agencies to combine billing data to spot trends in overused procedures.��� (from ���Health care law may cut down on excessive procedures,��� August 8, 2012).http://www.usatoday.com/news/health/story/2012-08-08/excessive-medicalprocedures/56875996/1On the other hand, if one asks Alok Prasad, the President and CEO of RevenueXL, an EMR and Practice Management consulting firm, he tells physicians:���Electronic Medical Record Software improves charge capture: When traditional paper charts are used, many services performed in a physician���s office are lost and never billed. The billing staff may either completely leave out an E&M Code or may erroneously enter fewer units, all resulting in lower billing and therefore lower reimbursements to a physician. Electronic Medical Record software can increase revenues by facilitating capturing of charges for all services provided by the physician thereby avoiding lost revenues. In a case study (Nick Fabrizio, July 2005, QIO Presentation quote), a family medicine physician while seeing same number of patients increased revenues by $3000 per month due to timely visit documentation and automated charge capture.��� (from ���Does an Electronic Medical Record / Electronic Health Record Software system increase revenues?��� February 13, 2009). http://www.articlesbase.com/medicinearticles/do-electronic-medical-records-increase-revenues-768294.html Bottom line: Will the improvements in government and insurance oversight enabled by EMRs save more money than improvements in charge capture will cost?D. Kellus Pruitt DDS" "Redemption at last - The ugly truth emerges about the true cost and safety of EHRs. Again, I told you so, long, long ago.""If EHRs arguably create more problems for physicians than they solve, how can they possibly provide a return on investment for far simpler dental practices? If you haven���t yet heard the news, they can���t.���Electronic Medical Records: Their Time Has Not Yet Come,��� was posted today by Dr. Dennis Gottfried, Associate professor, University of Connecticut Medical School.http://www.huffingtonpost.com/dr-dennisgottfried/electronic-medical-record_1_b_1749795.html���The theoretical benefits of an electronic record are not matched by its actual performance - a performance that increases costs but detracts from clinical efficiencies and does nothing to improve patient outcomes. Although the adoption of EMRs is one of the few health care measure to enjoy bipartisan support, the technology is not good enough to warrant that enthusiasm. In health care, the lawmakers have yet to learn that new is frequently not better and change is rarely improvement.���For years, shady businesspeople with selfish interests in healthcare IT misled not only physicians, but also dentists into purchasing expensive, dangerous EHRs. I confidently proclaim that those days are over in the dental community. Not long ago, when I pointed out the lack of a return on investment on EDRs, as well as the epidemic level of digital data breaches, defenseless leaders in the dental industry chose to censor my warnings before blocking me from access to their intentionally uninformed customers. In spite of the dentalcare stakeholders��� aggression against this dentist, I successfully shut down their favorite lies. My pleasure. I would point out that while virtually everyone else in the dental industry remained ���professionally��� silent about the true cost and safety of EDRs compared to paper, I alone stood up and demanded honesty from stakeholders. I just hope the sleazy leaders who tried to silence me never forget my name. In case I forget theirs I���ve got them listed on my Google Alert. Should they pop up on the internet pushing software, I���ll be right there to remind them of business ethics.Six years ago, when I first noticed the absurdity of HIPAA in dentistry, I never imagined this adventure would lead me to become this disappointed in our elected leaders on all levels. Their ineffective representation of dental patients��� needs before lawmakers truly saddens me.D. Kellus Pruitt DDS" http://healthimpactnews.com/2012/doctors-at-hospital-chain-giant-performedunnecessary-cardiac-surgeries-increasing-profits/"A Perspective on the Evidence Regarding Methicillin-resistant Staphylococcus aureus Surveillance.This article by HW USA tells part of the story of the behind the USA not setting standards for MRSA Surveillance. ""The publication in prominent journals of 2 studies, the STAR*ICU Study and the MRSA-Swiss Study, seems to have had a disproportionate impact on health-care policy, which has stymied the widespread adoption of MRSA active surveillance testing in hospitals."" -- Journal of Patient Safety, Aug. 2012. http://journals.lww.com/journalpatientsafety/ Abstract/publishahead/A_Perspective_on_the_Evidence_Regarding.99853.aspx""How many of you would like to know ""How to Play in the Sandbox With Ohers"" to move your agenda forward?"Great I will be putting something together for you :)I think it's a safe assumption that any advocate would be interested in guidance from those who have succeeded at scale.Yes!It will be coming so keep a watch out for it!! Bart I miss you!!"aw shux, Patty! xo""One way or another, transparency with dentists and their patients is inevitable. After all, it���s only dentistry.""While reading this year���s ADA candidate statements in the ADA News, I recognized signs that the ADA can no longer hide the financial squeeze caused by the loss of dues from a declining membership ��� including dues from members suspended for unprofessional conduct. On the good side, the candidate statements hint that the disruption is forcing a return to basics: The Hippocratic Oath and the ADA���s mission.A second vice president candidate says, ���Strong leadership across the tripartite that allows for open communication and transparency in our deliberations is a must in formulating answers to our challenges.��� This is the first time ���transparency��� has been mentioned by any ADA official in at least 3 years. The last candidate who trotted out the modern idea lost.One president-elect candidate states, ���Members are the ADA���s lifeblood���the heart of our organization and inclusion of all dentists is mandatory. To enhance member value, it is essential that the ADA be proactive and shed the reactionary mode of the past. We must create an ADA where all dentists want to be members.���At first, I was alarmed by his call for dentists��� ���mandatory��� inclusion in the ADA. But since the candidate concludes with a goal to create an ADA that nonmembers want to join, I think it���s clear that it was just a poor choice of words. That���s understandable. Since ���mandatory��� is used so liberally these days by ADA officials, it���s become a buzzword that can mean almost anything ADA leaders need it to.Another president-elect candidate, perhaps the sharper of the two, also acknowledges problems with the ADA: ���Today, the evolving economic, regulatory and communications environment leaves the American Dental Association at a crossroads. As an organization, we must adapt to the changing realities or face the prospect of becoming less relevant. To succeed, we need strong leadership and innovative thinking.��� Sound familiar yet, Texas Dental Association? It will. He continues: ���People outside of our profession have questioned our credibility as the voice of dentistry and as the policymakers for our profession. The weak global economic and aggressive regulatory environment could strain the health of our organization and the reputation of dentists. In addition, we are losing membership market share vital to the ADA���s financial stability.���If the ADA keeps moving toward transparency, I may see if they���ll have me back. It sounds like they need customers��� financial support bad enough to cause them to become more humble. And that���s the way the free market is supposed to work. The customer is always right.D. Kellus Pruitt DDS" "Thanks, Veronica. I was pretty certain that in the land of the free, customers are still always right. Nevertheless, the moderator for Dental Technology Geeks Linkedin group, Dave Greenfield, censored the very comment which happens to admonish dentalcare stakeholders like him for censoring customers like me.If you or any others in dentistry feel like it, please drop Dave a line and see if he���ll offer you a reason for hiding my comment from at least one member who invited me to join his group ��� a fellow dentist. http://www.linkedin.com/groups? viewMemberFeed=&gid=2396260&memberID=98333897&goback=%2Egmp_2396260 Mr. Dave Greenfield has been given the power to censor, yet the ���Social Media and Community Architect at Objet Geometries��� won���t tell this dentist why. Maybe Object Geometries just doesn���t need business bad enough to show common respect for customers.""When Wal-mart employees treat customers rudely one should always notify their supervisor. Why shouldn't Dave Greenfield be held accountable for his rudeness as well.Dear Objet Geometries, Ltd. I wish to complain about the rudeness of your employee, Dave Greenfield, who serves as moderator for the Dental Technology Geeks Linkedin group. After censoring my comment without warning, your ���architect��� not only refuses to tell me why he chose to hide this dentist���s information from his readers, but he then ignored my demand to speak with you, his supervisor. In Wal-mart, when a customer is treated with aggression by an insensitive employee, management pays attention. How about you, Objet Geometries? Just what kind of business do you run that encourages your employees to show such disrespect to customers?Please help me correct this misunderstanding as quickly as possible. Otherwise, I feel it is my obligation to warn others in the dental industry about Dave Greenfield and Objet Geometries, which is ���engaged in the design, development and manufacture of photopolymer 3D printing systems.���Who knows, perhaps US dentists need your company���s services so desperately my public complaints on dental technology venues may not affect your sales at all.Please don���t encourage your employees to disrespect US dentists, Objet Geometries.Sincerely, D. Kellus Pruitt DDSCc: Dave Greenfield, spamgroup"Those who don't demand honesty from salespeople always pay more for disrespect."It all comes down to accountability through transparency, Veronica. What do you think Dave Greenfield, Social Media and Community Architect at Obet Geometries, is trying to keep hidden from dentists? What is he afraid of?""Here's my wild guess: Since Dave's boss, Objet Geometries, sells 3-D imaging devices to dentists, there might be an underlying justifiable fear about the security of dental patients' PHI maintained by their equipment. And now that Objet is soon to become a HIPAA-covered Business Associate, you can bet that Dave's boss doesn't want to attract the attention of the Office of Civil Rights in the Department of HHS - which determines who gets audited. Just a guess. He certainly is acting strange.""""People in networked markets have figured out that they get far better information and support from one another than from vendors. So much for corporate rhetoric about adding value to commoditized products."" - Thesis number 11, The Cluetrain Manifesto""""There are no secrets. The networked market knows more than companies do about their own products. And whether the news is good or bad, they tell everyone."" - Thesis number 12.""""Most marketing programs are based on the fear that the market might see what's really going on inside the company."" - number 28""""Companies that don't realize their markets are now networked person-to-person, getting smarter as a result and deeply joined in conversation are missing their best opportunity."" number 18""""Companies can now communicate with their markets directly. If they blow it, it could be their last chance."" - 19""""Public Relations does not relate to the public. Companies are deeply afraid of their markets."" - 26"See new book Unaccountable trailer http """Unaccountable"" is an excellent book."Wow and thanks."the sad thing is that dangerous doctors are allowed to 'continue'... even when they harm and even when they kill their patients and even when those working around and with them 'know'. dangerous doctors 'continue' because the danger is kept secret and because there is 'no accountability'. defense counsel for the doctor and hospital who knocked me out and performed surgery which i did not need nor consent to stated in their answer to my medical malpractice complaint that what happened to me was my own doing and that it was through my own negligence that i'm damaged - if i'm damaged. additionally, they added that if i did not cause my own damage, then it was an 'act of god' for which they cannot be held accountable. i don't have words to express how i feel about such a simple and arrogant response. how exactly did i cause my own damage? i checked into the hospital for an elective surgical procedure. i refused the procedure once i learned that the wrong procedure was listed on the consent and asked to speak with my doctor. upon arriving at the hospital and learning that i had refused to sign the consent, my doctor ordered that i be knocked out with versed. (this is all documented in my hospital record). i did not agree to the versed but it was injected into my iv as i was protesting. that was my last waking memory. when i woke up a couple of hours later, six healthy organs had been removed and i was bleeding badly even though i consented to NOTHING. i lost enough blood to require a transfusion. i had to be taken back to surgery to repair damage caused by surgery i did not consent to. i went on to develop so many complications from this surgery that i was too disabled to work within three years. i still need two additional surgeries to repair damage done. what exactly did i do that caused my own harm? and... what did god have to do with it? NOTHING! the defense response in my case reminded me of my young niece who scribbled all over the living room wall with crayons and blamed it on my brother (who was grown) even though he wasn't home and even though she had the crayons in her hand. she blamed someone who was not even there. this might be acceptable behavior for a child but it is not acceptable behavior for a doctor or hospital! there is NO ACCOUNTABILITY! therein lies the true problem..."As an RN...have seen this type of behavior and everyone plays along for fear of losing job or being blackballed! I remain outraged!@christine... i know what you say is true. the only nurse who told the truth regarding what happened to me is no longer employed by the hospital. it's good to know there are nurses like her and you who are outraged by this type of behavior...I tried to get an attorney to protest and was told that I would be blackballed from working in any hospital in LA. The time will come when I can join other activists and stop these licensed psychopaths!I left nursing as soon as I was financially able and have PTSD.@ christine... so sad you had to leave for the reasons you did. beyond sad that you now suffer from ptsd like many of the harmed patients... you should not have to leave your profession. the 'licensed psychopaths' should have to leave. and they would if they were held accountable"I must interject, that there are some terrific professionals available...but the psychopathic professionals must be weeded out somehow!""i agree veronica. but how sad? if people with a conscience avoid the medical field, what do we have other than a very dangerous medical community? agree christine that we must find a way to weed out the bad... hopefully groups like this one will help toward that end in some way.""@ veronica... i was pre-med in college until i decided the same as you... i first wanted to go into medicine because of the wonderful, caring treatment i received from my endocrinologist when i had a brain tumor at fifteen. he inspired me. however, i came to realize that ones like him are few and far between as they say and i made the decision to use my talents in other ways as you stated.""@ veronica... i am a classic example of how even when you go with your gut and do all the right things, things can still go horribly wrong. i got a second opinion and that is the reason i even agreed to any surgery in the first place. how was i to know that two doctors would lie to me? i took a witness with me to my pre-surgery consultation only to have my doctor swear that nobody was with me and that me and my witness lied. i read the consent once i arrived at the hospital and informed my nurse that it was for the wrong procedure and i refused to sign it. how was i to know that my doctor would order me to be knocked out once he learned that i wanted to speak with him? omg! this is so wrong... what happened to your mom is beyond words... what has happened to so many of us is beyond words...""The report about your mom's care is very sad. I am so sorry for your suffering. People such as we, will help to make changes in the system. X"@ Veronica... i just finished reading your entire account of your mom's story. i could feel your incredible pain as i read... what you said about treating the whole person is so important and so on target. doctors often look at someone who is older or poor or divorced or depressed or the like as someone who does not necessarily matter. i watched a movie recently which drove this point home. a plastic surgeon operated on a woman who ended up dying from complications from the surgery. the woman's husband sued. the doctor was angered by the lawsuit and set out to talk to the husband of the dead woman. the husband asked the doctor one question. he asked him what color his wife's eyes had been. the doctor looked down because he could not answer. the husband cried and told the doctor they were a deep and intense beautiful brown color- full of expression. the doctor got his point as did i. i cried as i thought about how often patients are viewed 'in parts' and not as 'a whole'. the doctor who ruined my life actually stated that he did not think what he did to me mattered since i was depressed over previous trauma in my life such as the loss of my two youngest children. i mean we know that doctors often think this way but how many admit it? my doctor actually admitted this. very shocking and beyond sad..."@ veronica... did not finish my thought before posting. i wanted to add that the most disturbing part of your mother's story is the part about how graceful and intelligent your mother was and how she communicated via her body (dance) and how she took such extreme care of her body and health. the medical people who harmed and killed your mothers did not know or take the time to know these important aspects of your mother. equally disturbing is the fact that your mother was not alone when this all happened to her. you were there, and yet, this happened. my mother, son and boyfriend were all there when i was drugged against my will and taken from my room. they did not fully comprehend the horror unfolding before them. at times, i want to blame them for not doing something but then i remember that they would have had no way of knowing what my doctor would do to me. how could they? my boyfriend is very very bothered by this til this day... hindsight is always better vision though. we can all look back and see clearly what we could have done differently. that get us nowhere. all we can do 'after the fact' is speak out and tell our stories so others will not have to endure what we have had to endure. i'm sure your mother would be very proud of what your doing because you are doing what you can do in order that your mother's death not be in vain.""Kerry OConnell, one of the members of our ProPublica Patient Harm Community, shares his saga of botched surgeries, infections, engineering his own solutions and hope in this Health Affairs article.""Kevin-- This is a terrific article -- well-written and persuasive. I am sorry you have had the experiences that gave you the reason for the piece, but this is really helpful -- should be required reading for anyone considering a fixator, whether that person is a patient or a surgeon."what's wrong with the american health care system 101... very very sad but good article."This long new article by Atul Gawande describes new implementation of fundamental process improvements in hospitals. It's a very interesting read, and potentially raises a new question to ask providers when parsing the need for medical services, a query into whether or not the procedure has been standardized. http://goo.gl/EBfVT . The descriptions of Cheesecake Factory vs ""typical"" hospital goings-ons is almost amazing.""""The biggest complaint that people have about health care is that no one ever takes responsibility for the total experience of care, for the costs, and for the results.""Lots of good observations in this article.""""defensive medicine"" in light of today's incredible front page NY Times story about testing by HCA's cardiologists.http://www.thepoptort.com/2012/08/anopen-letter-to-sanjay-gupta-and-america.html""A lawsuit filed by two former dental clinic employees accuses a Wichita dentist of viewing pornographic videos in front of child patients while they were sedated. The lawsuit, which alleges sexual harassment and racial discrimination, also says the dentist gave inadequate sedation to Hispanic and African-American children.""This brings to mind a few feelings:1) Encouraged because the intervention worked and the infection rate went down by 1/3.2) Sad because even afterwards the rate is more than 1 in 6 of these patients (colorectal surgery patients at Johns Hopkins) getting a surgical site infection. JHU has been rated the best Hospital in the country for years so it shows that this is a tough one to make vary rare.3) Strange because I saw one of the co-authors (Dr. Efron) two years ago when I was considering major colorectal surgery (I'm still considering it). (Long story.)4) Glad because the agency I work for (AHRQ) is funding the JHU people to begin to spread nationwide an intervention to reduce surgical adverse events based on the ""CUSP"" methods used in this study. 5) Perplexed that some in Congress have submitted a bill to terminate AHRQ as of October 1, 2012 despite the fact that AHRQ funds projects like this. (Although the rumored budget deal if passed in September will put off that argument until March 2013.)""AHRQ is a great resource. In my position I use their information at least weekly. Noel, what do you do there?""Noel, would you mind if I used some of your comments for a post on www.reportingonhealth.org about the Hopkins study?""Sure, go ahead. :)""Another I told you so���Medical ID theft: Double danger for doctors,��� by Pamela Lewis Dolan was posted today on AmedNews.com." "���Medical identity theft is very much on the radar of Medicare and other agencies responsible for investigating identity theft. In recent years, it has become the fastest-growing type of identity theft in the world, according to reports. An estimated 2 million people become victims of identity theft each year.���I started questioning dental leaders about medical identity theft from EHRs in 2006. I���m still waiting for a response.���Physicians also face repercussions when their patients��� identities are stolen. Patients report losing trust in their physicians after a medical ID theft has occurred. There is also the potential for medical errors and bad outcomes caused by two patients using the same identity. Physicians also potentially could be subjected to violations of the Health Insurance Portability and Accountability Act [HIPAA] if they did not adequately protect the data from being stolen.��� Sound familiar? Why does it seem less unprofessional for an AMA reporter than for a dentist to say such bad things about EHRs?While the AMA and the nation���s physicians have been working hard to protect practices and patients from the devastating consequences of identity theft, the expression of such concerns in dentistry continues to be censored as ���unprofessional behavior.��� What���s more, if an ADA member persists in questioning the safety of EDRs beyond the approved chain of dissent, the unprofessional behavior can be upgraded to ���unethical behavior,��� which includes the loss of membership and forfeiture of any dues refund for the unused portion of the year. I say risk some dues money, Doc. Be like a physician and demand more transparency concerning EHR dangers. You don���t want to find out the hard way that I���ve been consistently straight with you for years.D. Kellus Pruitt DDS""While the Missouri Supreme Court threw out their cap on pain suffering in medical malpractice cases, unfortunately it still exists in Colorado as seen in this verdict: ""Walters will receive only a portion of the $15 million awarded to him by the jury. Under Colorado law, he can receive only $300,000 of the $10 million portion of the award for pain, suffering, impairment and disfigurement.""" Absolutely disgusting!"Has anyone in this forum compiled a list of these caps? I've written about the Illinois cap and the California cap, but it would be interesting to do a state-by-state comparison. What happens to you if you are injured in one state and someone with the same injury sues in the state across the border? Seems millions are in the balance.""William Heisel, just for medical malpractice or all damage caps?"Click on the pdf link on this page.http://centerjd.org/content/factsheet-caps-do-not-lower-insurance-premiums-doctors-and-insurance-insiders-admit-it0"in california the $250,000 cap hasnt changed since 1973"You���ll never believe who controls dentistry in the nation: Dental office designers."Tim Fichtner is a dental facility designer from Lancaster, Pa who also serves as an anonymous supervisor for Dental Geeks Linkedin group. Days ago, he had his not-anonymous moderator block me from Dental Geeks. Like any consumer should, I demanded to speak to the rude employee���s supervisor. Days later, after repeating my demand for the supervisor���s name, Mr. Fichtner finally came out from behind an employee to admonish: ���Posting on Dental Geeks is a privilege and not an unassailable right.��� He added, ���What we expect of contributors is that their communications display a professional, non-emotional, pleasant, civil, winsome, non-confrontational, didactic tone.��� Yes, he said ���winsome.���Yet another stakeholder���s determination that professionalism for good little dentists is not unlike convenient oppression. I first learned about the flexible, controlling qualities in a similar situation involving the Texas Dental Association - which also couldn���t prove unprofessional conduct. In spite of encouragement even from the Austin BBB, they still beat me out of a $200 refund in prorated dues. Dear Tim,You said, ���As long as you remain professional & respectful to the opinions and egos of others, your posts are welcome and will be approved. I believe you understand me quite clearly.���Even though you claim I understand you ���quite clearly,��� you���ve been less than transparent starting long before yesterday���s vague accusations of sarcasm and bullying. In spite of my repeated requests, you haven���t once offered evidence of the unprofessional conduct which resulted in the loss of my membership privileges. How am I to learn anything from that?I���m happy to learn your name. Until yesterday, you had anonymously directed a not-anonymous employee to censor me many times. The disregard you show for employees��� reputations means you can put your lecture on ethics back in your pocket. ���I look forward to reading your professional contributions. Good luck.���Even though you continue to be sarcastic as well as evasive, I still trust the sincerity of your invitation to contribute content to the tightly-controlled Dental Geeks Linkedin group. I often get invited to join forums in the dental industry, and as a result, I belong to several. The invitations come mostly from dentists who cannot themselves publicly mention issues dentists other than me only discuss privately ��� such as the known dangers of EDRs that some would hide. In fact, after witnessing misleading HIT ads that stakeholders successfully post, it was a concerned hygienist who invited me to become a member of Dental Geeks. If you will be honest with me from now on, I prefer not to let my friend down.Let���s start with yesterday. After you wished me luck, I attempted to post ���EHR-related malpractice suits could threaten HIT adoption,��� in which renown patient privacy rights attorney Jim Pyles offered important insight to EHR liability dangers. Even though it was immediately picked up by the Medical Executive-Post (a widely-respected source of healthcare news with a readership of over 400,000), you chose to protect your readers from seeing it. Can you explain why you censored my comment ��� even after wishing me, ���Good luck���?���When someone disagrees with you on a post, I have witnessed you respond with innuendo and subtle insults.��� Prove it or apologize, Tim.I have to say, you���re trying my patience, but I haven���t given up on you or Dental Geeks yet. If you really want me to help provide safe content for your group according to your rules, you will just have to reveal the innuendo and subtle insults you witnessed. If you consider them too unprofessional to repeat, simply provide the date and time I posted them and I���ll nail down what you feel Dental Geek members shouldn���t read. That���s the best offer I can make. Let me know how I can help.D. Kellus Pruitt DDS""Will Dental Geeks turn the corner with me?I offered Tim Fichtner���s Dental Geeks Linkedin group the same news I posted elsewhere, but without the sarcasm (per his request). I���m told my comment has been ���submitted for review��� by the moderator to make sure it is safe for group members to read before it���s allowed to be posted. If you recall, yesterday, Tim wished me luck.---------Theft of a ���password-protected��� computer from a California doctor���s office exposes 2500 patients to increased risk of identity theft. ���Stanford alerts patients to potential privacy breach after computer theft��� by Robert Salonga, MercuryNews.com.http://www.mercurynews.com/breakingnews/ci_21229475/stanford-alerts-patients-potential-privacy-breach-after-computer ���Stanford medical school officials are alerting 2,500 patients that their private health information may have been breached following the theft of a computer from a doctor's office in July, the university announced Friday.The theft occurred between July 15 and 16, according to a news release. The password-protected computer is said to have contained patient names and medical records, and even Social Security numbers in some cases.���In my opinion, ���passwordprotection��� is false hope and that should have never been mentioned by Stanford. For anyone whose technology skills are sophisticated enough to steal and alter patients��� medical identities (which sell for $50 each), passwords are meaningless. Without a doubt, industry misrepresentations like Stanford���s cause uninformed dentists to under-report data breaches ��� exacerbating Americans��� risk of medical identity theft. Unlike a breach which only exposes patients��� de-identified or encrypted personal information, HIPAA requires dentists to notify patients whose PHI is only password-protected ��� and for good reason. Dental Geeks moderator, you are to be commended for posting this important, if unpopular information. Your editing exhibits the professionalism dentistry needs.D. Kellus Pruitt DDS""Theft of a computer from a California doctor���s office exposes 2500 patients to increased risk of identity theft. But don���t worry, it���s ���password protected.���""���Stanford medical school officials are alerting 2,500 patients that their private health information may have been breached following the theft of a computer from a doctor's office in July, the university announced Friday.The theft occurred between July 15 and 16, according to a news release. The password-protected computer is said to have contained patient names and medical records, and even Social Security numbers in some cases.���Concerning Stanford���s hopeful reassurance of ���passwordprotection,��� I would assume that for anyone whose technology skills are sophisticated enough to steal medical insurance, password protection is as obsolete as the Maginot Line. Since stolen medical identities contained in removable hard drives sell for $50 each, that makes the heist potentially worth over $100,000. With that kind of money on the line, there���s a good chance that the thief might find someone with a small Phillips screw-driver and working knowledge of ���righty-tighty, lefty-loosey.��� Is it unprofessional to sarcastically reveal risks others would hide?D. Kellus Pruitt DDS""Based on the story, my theory is it seems in order to access the records on the computer, the computer has to go online and access a password server to decrypt the records. The password server it what tracks the computer if it had been contacted.""Regardless, unlike deidentification, or even encryption, HIPAA considers password protection is inadequate security for stolen computers. That's good enough for me.""Furman allegedly prescribed both narcotic and nonnarcotic drugs to the girl���s mother, brother and to the girl between 2009 and 2010, but failed to keep treatment records for them, the department said. Based on the commission���s decision, Furman cannot practice in Washington or seek reinstatement of his license for 10 years." His license may have been suspended in Washington but he can move to another state however and be licensed there without the patients in his office ever being informed of his actual harmful conduct before agreeing to sign an Informed Consent DocumentThese kinds of people need a dark cloud hovering over them 24/7!I'd love to hear what people think about this. There are some fierce opinions out there about Seroquel and people seem to want to punish doctors like Steven Balt who have admitted prescribing a lot of it. Do the patients helped by drugs -- even with side effects -- matter? http://bit.ly/NebwRh http://truththeory.com/2012/08/05/individualized-medicine-fda-approved-ingestiblemicrochip-tracking-device/"I was a little critical of the claim that a pill could monitor heart rate. The pill can detect what you eat or what pill you take, and it passes through the body in the usual time. A patch on the skin receives the weak radio signal from the pill. The patch also has additional capabilities that can monitor heart rate, temperature, etc. The pill only detects and communicates the chemical environment around it.http://proteusdigitalhealth.com/technology/"wow"I'm pleased to say that, after 13 years, I settled a case for my daughter and it was very successful. It CAN be done - but everything is stacked against you. The most important step, without exception however, is the first step. That first step was 13 years ago and it was worth every minute, day, hour and year."Congratulations. Maybe you could provide coaching for the one I need to file?"It's good to hear a positive outcome Drew Gorman, congratulations. I was forced to settle my case because my former dentist threatened to file bankruptcy and retire if I didn't take a crappy settlement. The Dental Board is at fault and they will have to take responsibility now for impeding my ability to seek rightful retribution and proper restitution. They failed to supervise their licensee they placed on probation and failed to post his Probationer Dentist status all the years he was on probation...I should have been informed before I agreed to surgery or signing an Informed Consent Document."Hi Drew Gorman - thanks for sharing this. Would you mind starting a new post on this topic and giving some practical step-by-step instructions so others can learn from your experience? It sounds like you've gained some valuable knowledge that could be beneficial to the group."Kelly, you know I would be happy to help you Angel...""Veronica, you did a great job with severability - all the best on your next quest!""Marshall, after 13 years I'm not quite sure where to start regarding your request. You're right, I learned so much during this process but the most important lesson was to get started immediately. Each case is completely different and I'm not sure general advice would be helpful. Perhaps oneon-one Q&A is the best way to go - as is being done on this site...""Drew, How do you find an attorney to represent you when you've spent all of your money seeking competent care and then become disabled because you couldn't find it in time? All the lawyers I've contacted including those who say they will work on a contingent basis still want $25,000 upfront for ""expenses"" -- you know, expert witnesses, administrative, etc.""Anna, I can truly relate to your situation. Though time was my greatest challenge, finding a lawyer was the hardest. There was also an additional problem-there was a local statute that had expired and I had to get that thrown out before I even had the 'right' to sue. Since my daughter was an infant, I separated myself from the case and became a 'trustee' rather than a 'participant' and was able to 'win' the right to sue-but gave up the right to make any personal financial claims. My story goes on and on (as you can imagine-13 years!). I have a FB page if you'd like to contact me there for more info. I would not want to take up that much space here. I don't mind helping in any way if I can, so feel free to contact me. I send you Blessings and Light!""Sorry I am a bit behind with reading these and catching up.....first I would like to congratulate you Drew Gorman for succeeding it sounds like you had a really hard time but you stuck with it ...... i want to thank you for sharing some of the details esp in the last post because you gave me a lot of hope....i think sometimes our statutes run out because the injury was not discovered whether it was doctors who should have diagnosed it and didnt accidentally, it could be intentional there are so many factors and they just put these blanket statutes on there.....also when its more involved it may be more difficult to find people who know how to represent your scenario....anyway thank you for letting us know the different things you had to go through and i am sure that was just the tip of the iceberg but hearing you had to overturn the statute then become trustee, etc it lets those of us still in the thick of it know that no matter how hard or impossible it may seem there are still options and to never give up i dont know how and if I can do anything time will tell but thanks for the insight."https://www.facebook.com/photo.php? fbid=300055666758327&set=a.258335754263652.54360.156003164496912&type=1&theater "According to a recent survey conducted by Xerox, only 26% of Americans want their personal information stored in electronic medical records.""Considering that this is discouraging news for those who profit from the sale of reportedly dangerous EHRs, what���s your opinion of the ethics of stakeholders in the business who hide information from consumers for selfish reasons?David A. Feinberg, the moderator of HIPAA 411 Linkedin group, is president of Rensis Corporation ��� an EHR consultant firm located in Seattle. He is one of three Linkedin moderators who blocked readers from witnessing findings that might hurt his business. How Hippocratic is that?Another biased moderator with selfish motives is Mary Yakas, who makes her living as executive director of The Dental Advisor out of Detroit ��� an EHR consultant company which markets digital records to uninformed dentists. She shields members of Dental Geeks Linkedin group from viewing results of studies that don���t serve her employer���s needs. She���s devoted.The third moderator to censor the link to the discouraging findings is Christy Choi from Washington DC, who is the protective moderator of the HIT Linkedin group. While David Feinberg and Mary Yakas are employed by private industry, Ms. Choi serves as the Web Manager at the Office of the National Coordinator for Health Information Technology (ONC) ��� her salary is paid by the taxpayers she censors.While censorship by private business to protect profits is repulsive and clearly unethical, censoring US citizens by government employees is not only tyranny, but it���s against the law. As a taxpayer, it���s my opinion that Christy Choi should be fired from the Department of HHS immediately.D. Kellus Pruitt DDS""Even as HIT stakeholders continue to evade this dentist���s questions about EDRs systems��� increased risk of identity theft over paper dental records, it���s already been a bad week for HIT security.���Personal information for more than 1,000 Newfoundland patients compromised��� http://www.thestar.com/news/canada/article/1235198--personal-information-for-morethan-1-000-newfoundland-patients-compromised CORNER BROOK, N.L.���More than 1,000 patients in western Newfoundland have had their privacy violated after an employee inappropriately accessed their personal records, a provincial health board said Wednesday.Western Health said it fired the employee after discovering that 1,043 people had their privacy breached.���Hartford Hospital and VNA HealthCare Notify Patients of Computer Theft��� http://www.harthosp.org/Portals/1/Images/6/PR-VNA-Data-Incident.pdf HARTFORD ��� On June 26, 2012, the leadership teams of Hartford Hospital and VNA HealthCare learned that an unencrypted laptop computer containing personal information of some of their patients was stolen from the home of an employee of a firm called Greenplum, which is a subsidiary of one of our vendors, EMC Corp. Greenplum was performing data analysis for EMC on our behalf as part of a qualityimprovement project related to hospital readmissions. ------------Why does it seem to be unprofessional to share this information?""As someone who has work in or with hospitals for 35 years, you would be suprised to see how many paper records go missing. And it's not like they were trying to hide them. The HITECH proposed structure and security would, IMHO, would be much safer.""I agree, Julie. Even though the risk of identity theft is higher for EHRs than for paper records, I don't think hospitals and busy physicians' offices can afford to depend on paper records these days - especially considering the non-productive, tedious documentation required by insurers for doctors to get paid for work already completed. The longer the delay, the more insurers profit.But instead of the millions of active patients treated at a hospital every year, busy dentists might treat around 4000. Computerization is simply overkill. And when one considers the additional cost and danger of digital over paper dental records, it's a no-brainer. Dentists who have electronic dental record systems have an expensive and dangerous hobby.""What do you think of the following. All medical businesses must send your records to be stored in a central government agency, within 2 weeks of creation. Any medical business that wanted access to your records would be required to get them from that agency, not another medical business. And what they get is strictly controlled by patient authorization.""It's a worthy goal for Americans to have complete control of their own medical histories. That is what most Americans want, and that is how it should be. However, my first concern is that if the government controls the data, can they be trusted not to snoop into Americans' privacy themselves? If you recall, it wasn't that long ago when the FBI got spanked for snooping through Americans' phone records.""Secondly, considering the market value for medical data, stakeholders in the insurance industry are unlikely to want to let go of the asset, and they have much more power over Congress than you or me, Garrick."Paper records could not be sent to a government agency. They need to be readily available to the hospital if the patient returns for care."I'm no fan of insurance companies. That said, and supposing that if I were to get screwed it'd happen with or w/out eRecords, and having lived with the hassles of paper records, and knowing how other nations have advanced healthcare systems utilizing eRecords: on the whole I'm for them. Seems to me that the # of crowns and root canals in my mouth is all of very little consequence, esp. when dental insurance is separate from medical. Darrell, why are you so adamantly opposed to dental eRecords?""I'm glad you asked, Bart. It so happens that only minutes ago, I responded to Ron's similar question on Dental Speakers Linkedin group:It���s good to hear from you, Ron. I���ve read your stuff. I like it. I appreciate your courtesy and fully understand your point that dental offices, costing hundreds of thousands and even millions of dollars, are being built to accommodate paperless practices of the future - yet the future of EDRs has yet to be determined. Sometimes drastic changes occur with even the largest federal projects. For example, several years ago, billions of dollars were spent digging a hole in Texas for the Supercollider before it was abandoned for becoming too expensive. What���s more, in contrast to those supporting the unquestioned adoption of EHRs in dentistry, stakeholders promoting the Supercollider were armed with evidence-based research proving its potential value to Americans. All EDR stakeholders have are guesses and advertisements. Am I wrong?According to a recent survey, only 26% of Americans want their medical information stored on EHRs. That���s not my fault. http://eon.businesswire.com/news/eon/20120731005334/en/Xerox/Electronic-HealthRecords/SurveyAs more and more dental patients become aware of the epidemic level of data breaches from healthcare organizations, they could certainly start choosing dentists with paper records. Consider this: If dental patients prefer EDRs, why are dentists not advertising them? Time and again, I have revealed indisputable evidence that EDRs are not only more dangerous than paper dental records, but they are more expensive as well. Sharing these unpopular findings has certainly attracted more personal attacks than friends, but that���s simply how it is. Those who sell EDR systems to dentists hide evidence that paperless is a dangerous and expensive hobby��_. Perhaps it���s the way I explain things that aggravates people. �����_in this ���electronic and virtual��� world what do you feel is a reasonable solution to integrating paper and cloud?��� I���ve said it many times: One day, the solution to almost all security problems in dentistry will be de-identification of EDRs. If a hacker exploits a computer belonging to a dentist and/or cloud server, and nothing more than patients��� dental histories are revealed, it is not a data breach according to HIPAA. That means nobody has to be notified, and news of the breach doesn���t have to be issued as a press release in the dentist���s community. Eventually, most will agree that de-id is the simple, logical solution.���Lastly I do know of many reps working for the Schein/Pattersons/Bencos, etc. who do a great job and have become members of the dental office team.��� Name for me just one who can prove EDRs offer dentists a return on investment like they advertise, and I���ll believe you, Ron. Nobody can prove they are safer than paper dental records, and that���s also not my fault.Thanks, Ron.Darrell""Darrell Pruitt, Regarding my suggestion of a law that medical businesses submit patient records to a central government agency. I understand your concerns about government snooping into private records. My main concern is medical businesses pretend to lose records to hide evidence of medical malpractice, and this evidence is the only way the victim can get help for their injury. It is a severe conflict of interest for a medical business to be responsible for records when they are liable for injuries exposed by those records. And also, other doctors become part of the problem because they will not produce a truthful examination of the patient, because a doctor will not tattle on another doctor. With a legal requirement to deposit records, the doctor guilty of a malpractice injury will have to either obey the law, violate the law by not submitting records, or violate the law by submitting a false record. Any of these is more to work with than the excuse of no records found.""Garrick, in light of another conversation I had yesterday concerning unavailable EHRs, it was with special interest that I read your opinion that medical records are sometimes intentionally lost to protect doctors from malpractice accountability. I cannot argue with your frightening points. Allow me to share a related concern from another point of view: According to patient privacy attorney Jim Pyles, the malpractice liability caused by unavailable EHRs arguably threatens the future of healthcare IT. Yesterday, he sent me a law question: ���Darrell, you will have fun with this. My question is, who gets sued when the patient dies because the doctor could not get access to the current medical record?���I guessed that the treating doctor would be held accountable. ���He or she would at least be a co-defendant, I would think. But then, I���m a dentist.���Jim writes, ���I think the answer is (a) the doctor, (b) the hospital, (c) the vendor, (d) the power company, and (e) anyone else the plaintiff���s attorney can think to drag in. Great law school exam question. This will make the malpractice insurance industry pucker up. I have said before that the thing what will bring down the HIT industry will be when the malpractice insurers pull out. No one will want to go bare. HIT is like the nuclear energy of health reform. It has the potential for some advantages if we carefully control it, but it presents a clear and present danger when (not if) it goes out of control.���It seems HHS promised too much too early.""Darrell - who gets sued when the paper record is lost? The answer is nobody. That's a tactic they use to avoid a lawsuit. I am not saying they have to discard their own paper records they themselves have generated.I agree with you and I do not want to have individual medical businesses responsible for holding their own EHRs, and being able to conveniently transmit those EHRs to other providers. Each of those becomes a weak point in losing medical records. I conceive a central, highly specialized agency that does nothing but maintain records, and police their disbursal.""I question the survey, who did they ask?? and how did they ask it. and what sort of health consumer got to be asked.... one who hasnt had to fight the system, or even be within the system...""I cannot argue against the Utopian idea of a secure national vault for every Americans' medical records. But there is no cyber-security. That's why the limited mobility of paper is still the gold standard in safety from data breaches. Give it some time, Garrick. It's going to become even more tricky as our DNA codes are more commonly stored in EHRs. Social security numbers only last a lifetime. DNA codes last generations.We have a responsibility to our descendants not to take privacy concerns too lightly. Yet today, I just read that Stanford medical school fumbled 2500 patients' PHI through a stolen computer. http://www.mercurynews.com/breaking-news/ci_21229475/stanford-alerts-patientspotential-privacy-breach-after-computer""The Xerox survey is already 3 days old. The number of Americans who don't trust the security of EHRs may have already risen to 27%, Brenda.""The word is spreading quickly now. The Medical Executive - Post, which has a readership of over 400,000, picked up my conversation with Jim Pyles. He's very well known in the healthcare IT industry. http://medicalexecutivepost.com/2011/09/25/the-legal-ehr-extreme-cautionahead/#comment-13052""The interdependency of doctor medical business to other doctor medical businesses has to be reduced. This will open communication that is in interest of patients who have been victims of doctors. I have two ideas:1. Doctors should be independent of other doctors for your medical records.2. Doctors should not depend on other doctors for referrals to their business."An Albany Times Union story about a hospital accused of negligent credentialing a doctor! But the hospital is in Connecticut; not a TU advertiser that the paper protects from bad news. http://bit.ly/MX87tE"We want to be sure all the new members know about our non-profit, The Empowered Patient Coalition. We have many free resources for patients, caregivers, and advocates. Please visit our website at http://www.EmpoweredPatientCoalition.org.""As always regarding end of life this story has the wrong headline; ""assisted suicide"" is a prejudicial phrase. That aside, the compilation of state laws regarding self-directed dying (as assisted) is nice to have in one file. http://www.patientsrightscouncil.org/site/assistedsuicide-state-laws/""Actually, I only now perused the site; yesterday I perused the state's legalities compilation page. I don't like the site because I completely disagree with their viewpoint. Regardless, the site offers some useful resources." ...some dental clinics are literally picking kids up off the street and taking them straight to the dentist's office without letting parents know.insanity http://www.youtube.com/watch?v=Jhj3u3LoooM&feature=player_detailpageCheck out The Peggy Lillis Memorial Foundation's latest op-ed at AlterNet on how investing in patient safety can save lives and create jobs. Please share to help spread the word."Excellent article, Christian!""Yeah, Christian. A well-reasoned and very well-written piece. Hope it gets lots of hits.""Thanks, ladies! Please do share it with Facebook peeps.""Christian, I commented on your article, and talked about needing more nurses at the bedside with more1 to 1 contact with the patients.""I again question whether EDRs are more reliable than paper dental records. A couple of weeks ago, I was once again busting the surprisingly durable myth that paper dental records are more likely to be totally lost than EDRs. I���m still unsure if some readers were emotionally ready to believe it, so today, when I read ���Patient data outage exposes risks of electronic medical records,��� by Chad Terhune, I felt it was important to share the link to the LA Times article." "���'Human error' is blamed for a five-hour computer outage last week. It highlights the risks of a nationwide switch to electronic medical records,��� Terhune writes. ���Within minutes of the outage, they said, doctors and nurses reverted to writing orders and notes by hand, but in many cases they no longer had access to previous patient information saved remotely with Cerner. That information isn't typically put on paper charts when records are kept electronically.���Ross Koppel, a sociology professor at the University of Pennsylvania who has studied the safety and effectiveness of electronic medical records, told the LA Times, ""As vendors and the federal government push for totally electronic systems the vulnerabilities of these hospitals to this kind of outage increases exponentially."" He added, ""The lack of access to previous patient records means that doctors were flying blind.""For those who are still concerned that my patients��� paper records are at significant risk of turning to ashes in a fire that would have to last for days, metal filing cabinets will always be unaffected by internet outages. And even in power outages, paper records can be read using a flashlight.When EDR vendors exaggerate the risk of paper cuts to improve sales, it does nothing improve EDRs. It only makes vendors appear desperate to improve sales. D. Kellus Pruitt DDS"New York State keeps thousands of hospital mistakes secret like a C-section on a woman who wasn't pregnant. http://bit.ly/M7NVnwI wouldnt be surprised that this is happening all over the place"Is it a good business practice, or even ethical, for HIT salespeople to ignore dentists��� concerns about patients��� safety?���Does e-service create a higher risk of identity theft than transactions that don���t involve digital PHI?��� The question I asked Dr. Larry Emmott yesterday following his advertisement for e-services was finally posted a few minutes ago. Perhaps a response will follow.""From a customer���s point of view, mine is clearly a straightforward, logical safety concern about transmitting dental patients��� identities over the internet. If Dr. Emmott had any intention of respecting this dentist���s question, he could have answered it with a simple yes or no hours ago. But who can blame him for taking his time? Since it is impossible for anyone to provide a vendor-friendly response to the question, and since in the traditionally quiet dental community, I���m still commonly perceived as unprofessional for speaking out, that creates a huge disincentive for him to react at all. He shows courage as well as wisdom in not censoring my question. Outside the dental industry, unresponsiveness as default protection from accountability became obsolete at least seven years ago when Jeff Jarvis brought Dell Computer to its knees with his purpose-built, ���Dell Hell��� website. So why does it somehow seem unprofessional for me to inconvenience a dental consultant with questions about the safety of his favorite products? How can patients and dentists possibly be protected from harm when the profession���s 1950���s command-and-control habits now stand in the way of modern marketplace transparency? In my opinion, evasion became an acceptable business practice due in part to the very barriers the ADA erected to protect its leaders from accountability to membership. Other stakeholders naturally stepped in to fill the resultant leadership vacuum. Who couldn���t see that coming? If the niche weren���t so well hidden by consumers��� preference not to think about dentistry when given a choice, the ADA���s dysfunctional problems would have been resolved long ago. For those out of the loop, I���m revealing nothing that dentists don���t already discuss in private.While dentists weren���t paying attention, ambitious entrepreneurs took control of our profession - enabled by well-meaning, stoic leaders with blind faith in the magic of a ���one-voice��� PR strategy. Come on out, Doc. The air is fine.D. Kellus Pruitt DDS""This debacle involving the ""serial infector"" raises questions about the regulatory effectiveness of state and federal laws regarding reporting of disciplinary actions against hospital contractors or employees. It also raises bigtime questions about the inadequacy of the National Practitioner Data Bank to stop drug addicts from traveling through 12 hospitals in nine states, eventually (allegedly) infecting at least 30 patients with Hep C by the time he got caught in New Hampshire. My column today. http://www.healthleadersmedia.com/content/QUA-283001/Serial-Infector-InvestigationPoints-to-Need-for-Federal-Registry""As a result, he was the first doctor in Illinois required to have a chaperone present during all ���patient encounters��� because of a new state law enacted in response to a Tribune series on doctors accused of sexual abuse. Sue Hofer, a spokeswoman for the Illinois Department of Financial and Professional Regulation, said Panos��� license would be restored once regulators receive a court-certified copy of the disposition of his cases.""The Board is also going to remove his disciplinary action from public view so his patients aren't able to see he required a ""chaperone"" to practice." https://www.facebook.com/photo.php? fbid=508066219207692&set=a.293794393968210.89115.248783301802653&type=1&theater https://www.facebook.com/photo.php? fbid=299050076858886&set=a.258335754263652.54360.156003164496912&type=1&theater Thought-provoking points. Have seen these basic themes/findings before in other write-ups.I had to comment over there. At the moment it's awaiting moderation. "Essay on the value of AHRQhttp://newsatjama.jama.com/2012/07/26/jama-forum-billwould-gut-patient-centered-outcomes-research/""There will be another fight in March, assuming the 6-month budget extension happens in September and the Republicans keep the House in November. If Romney wins, it will up to the Senate (assuming the Dems keep it) to negotiate the continued existence of of AHRQ and other groups like CMS's Center for Medicare and Medicaid Innovation...""The Missouri Supreme Court today ruled the $350,000 flat cap on noneconomic damages in medical malpractice cases violates the Right to Trial by Jury in the Missouri Constitution."This is wonderful!A good article! http://www.pharmatimes.com/Article/12-0731/Some_US_pharmacies_selling_entire_inventories_to_gray_market.aspx?"Read the Congressional report, ""Shining the Light on the Gray Market""http://commerce.senate.gov/public/?a=Files.Serve&File_id=dcc81e66-09ae4650-ab06-c590ae284c4e""The following picture was taken a few weeks ago at the grand opening of SEA Medical Systems new facilities in Silicon Valley. Thanks again to all of our friends at SEA Medical who are putting their ""hearts & souls"" into the development of their technology and systems that will save thousands of lives and prevent IV compounding errors like the error that ultimately took the life of my beautiful daughter Emily.""Thanks for posting this, Christopher Jerry. Can you explain a little more about how compounding errors have been occurring and how this technology works to prevent them?"This is another one that causes a lot of accidental overdoses and bad consequences for patients."via Captain C.B. Sully Sullenberger: In the proposed 2013 spending bill for the Departments of Labor, Health and Human Services, Education and related agencies, the House Appropriations committee terminates the Agency for Healthcare Research and Quality (AHRQ). This agency funds research and programs that improve health care quality, enhance consumer choice, advance patient safety, improve efficiency, reduce medical errors, and broaden access to essential services.The bill also eliminates funding for patient-centered outcomes research done by any agency. You can find out more about it and how you can take action here:""Terrible. Thankfully, it will never pass the Senate."Kind of funny. Kind of not funny.Hahahahaha - not!"I recently spoke to the FDA investigative panel June 27,2012 in Washington, DC re: metal on metal hips. Joleen Chambers was instrumental in helping me prepare for this event. Her belief in honesty, patient education and care, accountability etc are genuine and sincere. We the tenacity Joleen Chambers and 10 more folks like her, if we are evergoing to rid the ongoing corruption in the medical device world and see truth and justice is served in order to protect and ensure the quality of our lives.Howard Sadwin""Hi Howard Sadwin, so nice of you to praise Joleen Chambers! I'm curious what you shared with the FDA investigative panel. Can you tell us?"Video of patient Howard Sadwin testifying at FDA begins at minute 1:52. Each patient had 4 minutes. http://fda.yorkcast.com/webcast/Viewer/?peid=12f84ea095b445d78e9b115f495392731d "Thanks, Joleen Chambers.""Whew, just watched the testimony, Howard Sadwin. You really spoke from your gut, and that is some painful stuff. Thanks for sharing it with our group.""We have to check if a drug or implant released under the FDA preapproval because that means it is untested, and the manufacturer cannot be held legally responsible for defects. Our medical-legal system is becoming such that each patient needs to bring a patient advocate who is an expert at knowing when to ask such questions to every appointment. Or perhaps a business can be started that patients can go to check what the doctor has prescribed for important negative information. No, the doctor cannot be trusted anymore. Drug and device manufacturers have shortcuts through the regulatory agencies like this.""I wrote my July 5 column on MoMs hips. What should patients who have them do now? How did these reactions and toxicity problems escape notice? And why is David Langton's research not being taken as seriously as it probably should be? (By the way, i didn't write this headline but here is the column.) http://www.healthleadersmedia.com/content/QUA-281987/MoMs-Hips-a-Grinding-Dilemmafor-Hospitals-Doctors-FDA""I have been listening to the above video on computer while I work. It has been quite interesting. After the patient horror stories, they had industry representatives speak. Then they have the AMA equivalents of various countries speak. At about 3:30 hrs there is the speaker from England showing their collection of statistics. It shows the metal-on-metal with over twice the revision rates of other types.http://s12.postimage.org/g7wc5wov1/MED_metalonmetal.jpg" Cautious Patient Communities starting in Albuquerque New Mexico! You can host one too! Visit www.cautiouspatientcommunities.org"In a truly startling decision, an Illinois coroner���s jury investigating the heart attack death of 49-year old Beatrice Vance while she sat, ignored for hours, in a hospital E.R., didn���t just cite the hospital, but declared her death a homicide. The jury found that the death was ���a result of a gross deviation from the standard of care which a reasonable person would exercise in the situation.��� Illinois State���s Attorney Michael Waller said at the time that this was the first time in his 30year career that an emergency room heart attack death was ruled a homicide. Read more of this case at: http://myheartsisters.org/2012/01/20/beatrice-vance/"Yay Carolyn Thomas is a member of the group! ((I follow your blog.)) :)"Thanks for that nice welcome, Holly! <3"I mean Holle - sorry about the spelling...."Sure Carolyn. :) For those not familiar with Carolyn's blog, see: http://ethicalnag.org/ . I don't mean to hijack your post. I had not heard of this case. I assume Beatrice Vance was profiled on arrival to emergency as not a likely heart attack victim because of her age. It's very sad. She wasn't taken seriously. Good to hear her death was called for exactly what it was - negligent homicide." "Newspaper dodge a bullet - for now; Samaritan Hospital negligent-credentialing lawsuit over without a trial. www.answersforlisa.blogspot.com""tried to share this using the share button but it did not work, so heres the direct linkIts a documentary, focusing on the alternative cancer treatment known as Gerson therapy, another film i believe by the title of ""the forbidden cancer cures"" had some similar footage, but this movie is very interesting to see the conventional doctors talk about how ""alternative medicine"" is a scam, or doesnt even exist!Check it out, hope you enjoy watchinghttp://www.youtube.com/watch? v=DoUl7F7dWdE&feature=watch-now-button&wide=1""Consider the benefits for consumers if dentists and patients were provided interactive Facebook access to the ADA's recognized experts in dentistry. Currently, in the absence of evidence-based, reliable information in dentalcare, the nation depends too heavily on vendorfriendly advertisements ��� which may or may not warn about harm their products cause. In fact, I���ve found that numerous dental industry vendors aggressively hide the danger of their products by censoring dentists��� concerns. Tell me how unaccountability can possibly improve the care of dental patients?""This is so like what my sister went through at University of Michigan. We thought at the time that her story was unique. This is not the case. Who could ever believe that a hospital would throw out a sick, dying person? Now we know, it happens all the time."Yes it does!This is a very important story. Cindy Chapman died in 2009. Has there been any follow-up? E.g. was there an investigation of the hospital? Any outcome?I really do not know?http://truth-out.org/news/item/10524-former-fda-reviewer-speaksout-about-intimidation-retaliation-and-marginalizing-of-safety"The above article explains just how the FDA used it's spy program to defeat the the good people working for the public health, for the benefit of industry profits. For anyone who still believes that anyone who has risen to running government agencies are moral and righteous, and our government avoids corruption because of ""American Exceptional-ism"" and all that, should read the above article.'On another occasion a company clearly stated in a meeting that they had ""paid for an approval.""'About half way down, we see pyridostigmine was up for approval but did not work against the nerve gas that Saddam Hussein was using, and in fact increase mortality rates for the nerve gas he was using. But the reviewer who made objections was replaced before he could make his report with someone who would approve it, and a waiver for informed consent was approved so it could be used without telling providers of the dangers.""Of late I have been thinking a great deal on social media etiquette for patient advocates and our colleagues. I addressed quite a few point in this blog post. Please read and consider commenting and sharing. Thank you. http://reginaholliday.blogspot.com/2012/07/media-and-message.html? showComment=1343333251609#c7987502032909145173""Those are both poignant and practical suggestions about social media use - and they're particularly relevant for our group. Thanks for the post, Regina."I had Scarlett Fever when I was 5. Luckily it was in the 1970s when they had much better treatments.PS: Very good blog post. Capture many things I've struggled with particularly in terms of tone and managing my reactions to advocates who haven't reached the 6th stage."I had not heard of the so-called ""6th stage of grief,"" that Regina Holliday referenced in her blog post. Here's the link to the column by Trisha Torrey, where she apparently coined the term: http://patients.about.com/od/medicalmistakessafety/a/ProactiveSurvivorship-The-Sixth-Stage-Of-Grief.htm."Regina's excellent guidance is the tool with which to temper our contributions.I am glad I can help this incredibly vibrant community do its good work!"I agree with the 6th stage of grief. After you have taken care of yourself (as much as possible), it's time to take care of others and others in the future by doing something! Don't just quit processing the bad event when you can go no further for your own healing. There is more to be done that one can do for others. Don't let anybody advise you to retire and fade into the woodwork like an old stain.""Thanks, Garrick Sitongia. I'm curious what others in the group who have suffered patient harm think about this 6th stage of grief. It might be constructive for people who are in one of the other five stages of grief to hear your thoughts. Anyone willing to share?""I think the concept of the 6th stage of grief,describes how I live when I am at my strongest, and most involved in medical reform. When I am able to tell my story in a way that empowers people, not in a way that frightens them, or causes them to feel pity for me, I am living the life my daughter would expect of me. That is when I can get people to listen, and feel strong enough to tackle they system, even with baby steps. I think its a wonderful concept.""On National Patient Safety Day, please take 61 seconds to watch the Peggy Lillis Memorial Foundation's public service announcement and then click ""Share"" below to help prevent other families from losing a loved one to preventable Clostridium difficile infections.""A beautiful piece, Christian. I remain very sorry that you have had the occasion to learn about C. Diff. As you have said, The price is unacceptably high for many of us, including you, who have joined the ranks of patient safety advocates.""Very nice video, Christian John Lillis. Thanks for sharing it. Sorry for the loss of your mom.""This is one welldocumented but rarely-discussed-with-patients risk factor for C diff: overuse or misuse of proton pump inhibitors (drugs like like Prilosec, Prevacid and Nexium...) this is a blog entry but there are numerous papers on this issue: http://skepticalscalpel.blogspot.com/2012/06/overuse-of-proton-pump-inhibitorsis.html""Thanks, Noel. I've been looking to update our site with more information about PPIs. Oddly, my mother never took them.""There are lots of ways to get C diff. These PPI drugs are just one risk factor. Most inpatient cases of C diff are preceded by an antibiotic and many outpatient cases are too. Some C diff cases are mysterious and it's hard to know why they occurred or what could have been done to prevent them or catch them early. The most interesting right now to me is potentially focusing on early and effective treatment in addition to prevention. This treatment seems odd, but there are indications that it may work better than anything else in the current armamentarium: http://vitals.nbcnews.com/_news/2011/10/24/8419332-sounds-gross-works-great-fecaltransplants-cure-nasty-c-diff-infections?lite Getting over the ""ick"" factor may be the biggest barrier to widespread use." http://kingvalley.wordpress.com/2012/07/25/second-opinions/An anonymous Patterson Dental representative has had just about enough of me."���Dr. Darrell Pruitt, to answer your question, we have stated several times that there are many factors which need to be taken into account on the topic of safety of both paper dental records and electronic dental records.���OK then, Patterson Dental. I���ll bite. Please share with me and my friends the factors you say must be taken into account when comparing the security of electronic dental records to paper dental records.���""We started our Facebook page to bring our community together online to discuss advancements in dentistry and issues facing the industry today."" Prove it. ""We would like to keep our community open to all view points and for everyone to be able to participate. However, if you can't respect the community we've created here with our employees, vendors, customers, and other industry leaders, we will block you from further participation.""Remember. This started out as a simple question about the safety of your product. But rather than address dentist and dental patients' concerns, you would rather hide the danger of identity theft in dentistry.Now let's have a look at those other factors that make the risk of identity theft from paper dental records greater than from Eaglesoft products.Cc: Dental Geeks Linkedin group and others. (Block me if you want, but the discussion will continue without you).And what is the name of the anonymous Patterson employee who is threatening me?""Patterson chooses censorship over truthRather than reveal mysterious factors which an anonymous Patterson employee promised would prove that paper dental records put patients at a higher risk of identity theft than Eaglesoft EDRs, she chose to simply block me from the Patterson Dental Facebook. I guess I didn���t realize Patterson Dental was such a sleazy company.""What I find humorous about being kicked off Patterson Dental's Facebook was their reason: ""We would like to keep our community open to all view points and for everyone to be able to participate.""Isn't that a hoot! Did anyone notice people standing in line to comment on the Patterson Facebook? I had no ideal I was in their way!""Dr. Larry Emmott, do electronic dental records expose patients to a higher risk of identity theft than paper dental records?""In the wake of the death of 12-year-old Rory Staunton at a New York hospital, I collaborated with my ProPublica colleagues Charles Ornstein and Tracy Weber to ask why medicine can't seem to fix simple mistakes.Would love to hear your feedback on the topic!""...another reason to enlist a professional or family Patient Safety Advocate to check lab values and escalate the need for attention if the patient exhibits signs & symptoms of Sepsis. To help prevent wrong-site surgery, insist that a Time-Out Confirmation is part of the Informed Consent.""This is a good suggestion to follow IFthe doctors will listen to the advocate. In our case, not only would no one listen to me (the advocate), but the medical records showed they wouldn't listen to their own doctors who recognized the need for action.So, it's a good suggestion IF someone is in charge of the case.In our situation, the hospital was not in compliance with having a patient complaint policy and procedures in place, which is a condition of participation for Medicare. This gap was identified in a top-bottom survey conducted on Medicare's behalf in 2010, a year after my daughter died of sepsis from an undiagnosed spinal infection.So, it's a good suggestion IF the hospital has a mechanism to interact with the advocate and to respond to the advocate's concerns.I become concerned with the emphasis on civilians being encouraged to believe that their advocacy can save their loved ones' lives. Under limited circumstances, an advocate can make a real difference, and there were times in other hospital episodes where I, as advocate, did make a difference and perhaps my actions did extend my daughter's life, e.g. my noticing a drop in oxygen sats before the staff did and my finding a nurse led to a Code Blue and successful rescue during a medical emergency in another hospital.But ��� advocacy failed in the end, because the culture of that last hospital was to placate, not act. Even when those speaking up were their own staff members. No advocate will succeed under those circumstances.We can advocate for change in hospital culture, but, in the end, it is the hospitals that must take responsibility, and my experience is that while some hospitals will respond to gaps in care with making changes ��� at least on paper ��� most will need outside pressure to become safer. It's a situation similar to what happens in the airplane industry or the automobile industry: safety weighed against profit.And my impression is that hospitals are not even as responsive as the airplane industry when it comes to safety issues." "Congratulations on your success as an Advocate. Enlisting a professional or family Patient Safety Advocate is not a guarantee of perfect outcomes but does positively affect outcomes, as you found. If your physician and hospital do not provide services to your standards find the ones that work for you."Some interesting feedback and robust discussion taking place on this story on the ProPublica website: http://www.propublica.org/article/why-cant-medicine-seem-to-fix-simplemistakes#comments"Thanks to Marshall Allen and the other writers. It ALWAYS helps when those not intimately involved in the errors report on this ""phenomenon."" It's always more useful---more believable to the public. So thank you, and I'll save this article.""Too many hospitals still use the old hook-and-toss method to lift and move patients rather than invest in proper lifting equipment and training. Bad for patients, bad for nurses (who have many times more musculoskeletal injuries than construction workers). NIOSH has been on this for years. Using proper lifting equipment prevents injuries and saves hospitals money (reduced lost work days, workers comp). The failure of hospitals to change is a disturbing indication of institutional resistance in the face of strong, consistent evidence in study after study. Shouldn't nurses' backs matter?""for us laypersons, what's the hook and toss method?""Grab the patient under the arms to haul them from one location to another, such as from a chair to a bed. For more info, here's the CDC webpage on it: http://www.cdc.gov/niosh/topics/safepatient/""Patient Safety Day World National Globalwww.patientsafetyday.comWorld Patient Safety Day Moment of Silence July 25 annually safe quality health care medical error prevention reduce cost of health care save lives Lucian Nightingale Codman award..""Patterson Dental employees Jamie Vee and Jim Sieg evade questions about the safety of Eaglesoft:Isn't there anyone from Patterson Dental who can answer this dentist's simple question? Are dental patients more likely to have their identities stolen through electronic dental records than paper records. It's a simple question that doesn't require a paragraph of evasion, Jamie Vee and Jim Sieg. Yes or no. Quit hiding. https://www.facebook.com/pattersondental""This statistic in records security breaches is understandable considering a medical culture which considers errors and accidents ""risk factors."" It isn't a stretch then for medicine to consider general incompetence in everything to be just a risk factor."I know of no other business in the nation which can point-blank ignore customers' questions about the safety of their product."I continue to question Patterson Dental���s ethics, Facebook to Facebook��_Dear Patterson Dental officials: I know of no other business in the nation which is allowed to ignore customers' concerns about the safety of their product. Since EHRs are arguably medical devices, I think the FDA should be informed of your carelessness. And if you cannot provide evidence that Eaglesoft offers a return on investment for dentists, I think the FTC should be informed about deceptive advertisements as well.Please answer the question: Are dental patients more likely to have their identities stolen through electronic dental records than paper records?""So what is your response, Patterson Dental? This customer is waiting.""Still able to practise despite the NSW Supreme Court today ordering him to pay more than $1.7 million in damages and finding him guilty of professional misconduct. Mark Phung, whose practice is in the south-west suburb of Beverly Hills, saw patient Todd Dean 53 times in one year after Mr Dean was struck on the chin by a piece of wood in a workplace accident in 2001. http://www.smh.com.au/nsw/17m-fine-for-cheating-dentist-patient-had-75000-ofunnecessary-work-20120725-22q04.html""Today is National Patient Safety Day. Please remember those who have died or been harmed because of unsafe healthcare, and at the same time honor those health caregivers who give their all to provide safe high quality care every day.""So many more ""patient safety soldiers"" are now on the front lines of helping others protect themselves from avoidable harm...I commend everyone that continues to discuss the somber and sometimes embarassing issues in an effort to educate and keep the dialog going.""So it's never considered good form to get too controversial online, especially when the controversy's centered on group participants. Rather than post my reflections herein, I'll link to them: http://www.hospitalpatientadvocate.com/?p=1666"If your goal is change then you need engagement and good medical professionals should be considered allies. Some of you discuss the House of Medicine like it's a single entity worthy of disdain. That's a simplistic view. The system is broken but the people involved in health care are overwhelmingly caring and competent."You make a good point, Tom Bouthillet. I talk to doctors and nurses all the time who realize the system is broken and are doing what they can to bring about reform. Much of the time they're frustrated because there are so many things that impede their efforts. And you're right that we do need to ensure that comments in this forum are not painting medical providers as a whole in a negative light. I think it's a challenge when so many people have been harmed, then ignored, shunned, etc. But it is possible to do and important to remember in a forum like this, which includes members of all different backgrounds.""Just a reminder that you can find our guidelines about the constructive tone we're trying to set in this facebook group in the ""files"" section of this page. The document is called ""How to Participate...""""I agree and have said to others on here that we need to be careful not to paint with too broad a brush regarding the medical community. That said, my mother's death makes me enormously empathetic toward those who feel like the system as a whole is against them and, in far too many cases, there is collusion within and between bad actors. For that reason, I think it's important that we are all sensitive to the very real pain and suffering that contributes to some patient advocates' hostility toward the healthcare system writ large. This is made worse by the very real power imbalance wherein the healthcare industry is overwhelmingly more powerful than patient advocacy groups. While we do not want to perpetuate or amplify such generalizations, I also worry that we might overcompensate and reinforce the belief that those who are harmed are being ignored or dismissed.""As a victim of fraud,cover up and abuse I have a different view. I no longer see medical professionals as people who should ever be trusted.""I would advocate ""trust but verify"". The best patient advocates I know are medical professionals.""Patient advocates are hired by hospitals to protect the hospital. During my illness none of them did a thing. In fact, they were bent on protecting the hospital.""KariAnn Having three doctors and two nurses in my family as well as many other docs and healthcare workers among my friends, I can assure you that there are many physicians who are trustworthy. OTOH, the experience of my mother's death makes me very sympathetic to your feelings. I think that's where Tom's urging that we ""trust but verify"" is the way to go. Another patient advocate that I know recently said that she thinks most harm (not all but most) is the result of mistakes, errors, and omissions not purposeful. To me, that means that we have to be clear that all the HCWs that we interact with are fallible (yes, a few are malicious or sociopathic) and for both reasons we have to vigilant about our and our loved ones care.""You've had bad experiences and I'm sorry. But I'm not talking about the job title ""patient advocate"". I'm talking about the Atul Gawandes and Peter Provovosts of the world."Christian John Lillis Exactly. We need to learn from industries like aviation to reduce error. Human beings aren't perfect but we all expect perfection from medicine."Kariann, what were the patient advocates who you engaged titles and roles? For instance, social worker, RN, risk manager, chaplain, mission director?""Christian, at some point in a hospitalization gone bad due to omissions, commissions, errors, and the entire systemic experience turns a corner, like a ship flipping over or a theatre gone dark. The patient-family experience seems/becomes systemically purposeful, and we then may have trouble working through the causes. For instance, I distinguish between people who might deal with me honestly as their own person, distinct from dishonestly as a cog in or representative of a system. Huge difference what I may be faced with in some moment as an advocate for a hospitalized loved one. My sister, a retired Newborn ICU nurse, was more outraged and devastated by the details and totality of each of our parents terminal hospitalizations than I was. I see our jobs more as calligraphers, needing to paint bold strokes with strong brushes that spell out clear messages without smearing the canvas.""Bart - I don't disagree and have had my share of bad experiences with hospitalizations in my family but I do think we need to distinguish between sick systems where we need to pressure externally and provide support to individuals who share our vision for reform, and individual bad actors who through incompetence or evil intent cause harm.""Overall the system is inherently and in fact quite good! It saves and adds decades to lives. The trouble is in risk management; twice bitten, a zillion times shy.""I think the system allows individual bad actors, and cadres of bad actors to co-exist with the good with the two rarely crossing paths. The medical system is a case of the right hand not knowing what the left hand is doing. The system should be reengineered specifically to make this situation difficult to create or exist.A patient who was medically injured and who represents the possibility of a large financial threat will be handled and not be told the truth. They are funneled to specific doctors who are the cover-up patient experts. Or if the injured victim chooses a doctor independently, that doctor will recognize medical malpractice and will find out the story behind the injury, and will use a technique to manage the patient and not tell them the truth. The techniques doctors use to manage us are what we victims perceive as abuse.""The system from my standpoint becomes very flawed once damage is done through error, finding people willing to help is beyond challenging and even if you do then finding resolution becomes an impossibility it seems or at least that's what it feels like.... there are a lot of factors involved and from what I noticed even the best attempts do not succeed when there is a lot that was done to keep mistakes hidden or at bay. I believe advocates truly care and want to see help or change come and I am sure there's several things that can affect resolution whether the hospitals or doctors involved are more powerful than the team you have trying to get resolution, it can be frustration, it can be intentional ..... There are so many factors that leave patients who are injured not knowing where to turn who to trust who will really help and not give in due to pressure or if it's too challenging.....this whole healthcare system, process, structure scares me....we need to start seeing real changes while the patient is still alive, while there is a chance to help.....we need to believe in hope, of possibilities , of options, a way out or up, errors being fixed, voices given to the silenced, we need to see change.....all of my life I believed you can change your circumstances, you could work our way out, think a solution up, make phone calls write letters, you could fix the wrongs, I have tried everything I could do with my own ability and they ( a combination of doctors, hospitals, etc who make the mistakes and much worst the ones who don't fix or turn a cheek) in my opinion rule the arena, control the market, own the playing field.....I pray for the day when there are more ways to help or change the system or level the playing field. There are so many good doctors, honest healthcare personnel, etc but there's so much of the opposite and so much damage being done that its hard to see it. Nothing should be painted with a broad stroke that is correct it's just a very rough situation for so many of us especially if you are one of the ones that can still be helped. We are constantly reminded of the good Samaritan story in the bible there are so many good Samaritans out there now we just have to get them together with the patients/ injured and try to change the damage hopefully in time when possible and for when it's too late implement the change that could have fixed the error.""Garrick Sitongia, I assume you mean that if a patient chooses a doctor independently, and that doctor will find out the story, the story will be told by the injured patient to this doctor. What if the patient chooses to not say one word about the circumstances that lead to the injury or about the previous doctor? How would this silence affect the technique used to ""manage"" (I really dislike this word and the implication) the patient?""This is the flip-side to a litigious society. When the lawyers get involved you're not going to get cooperation. I'm not saying that malpractice doesn't happen, and errors most certainly happen, but process improvement doesn't generally involve the injured patient unless it's part of a settlement. It's not ideal, but that's the reality when scumbag personal injury attorneys advertise on T.V. I personally think it's helpful to involve patient advocates before an error happens at the policy or system building level. For example, Jan Vick from SC Voices for Patient Safety is actively involved with the SC Hospital Association and the SC Chapter of AHA Mission: Lifeline. Her twin sister died from a medical error. Having a patient representative in the room helps cut through narrow turf wars, political barriers, or business interests that do not necessarily align with patients interests. I'd like to see more transparency as far as how hospitals address clinical quality and error prevention. This would accomplish two things. First, more people would know that there are a lot of very caring and competent people working in clinical quality already, and second, hospitals would have to invest more in solutions and commit to implementation beyond what is required from JCAHO, CMS, and state regulatory offices (which already require a lot of reporting, including sentinel events).""Malpractice injury is quite a different in diagnosis than natural disease or accident. The patient may not say anything, but the doctor is not naive that litigation might happen if the patient is given evidence of malpractice by the doctor making a correct diagnosis. It doesn't matter how many caring competent medical people are in the room with the injured patient. Each of them is caught between conflicting loyalties. Their wish to help the patient and the real consequences if they betray their profession. I have read a few stories of medical people having their careers cut short from helping the patient. The hospital opens an investigation on them, exaggerates or manufactures claims of incompetence against them, and lets them go. They now have that on their employment record. A few weeks ago there was someone in this group who related how that happened to her. Here is a re-post from one of these forums. http://www.wvrecord.com/news/225508-former-employee-sues-select-specialty-hospitalcharleston-for-unlawful-termination""For every horror story posted on the internet there are a thousand stories of compassion, caring, and curing that you don't hear about. It matters very much how many competent and caring medical professionals are in the room. You may think a monstrous, health care boogeyman lurks behind every shadow but the reality is that nurses advocate for patients every day and most of the time the people working in the clinical quality department are nurses who will not automatically take the physician's side if the physician has acted inappropriately or incompetently. This is why physicians derisively speak about the ""brief case nurses"" who are ""taking over health care"". There are two sides to every story but in health care there are probably a dozen sides to every story. To put it another way, the truth is complicated. Nurses complain about staffing all the time (and I agree with them most of the time). That doesn't mean that a nurse who complained about staffing was fired unjustly.""Garrick hit the nail right on the head....even when you dont have a lawyer even when the patient just wants the situation resolved, the threat of or the possibility that somethig could be done actually inhibits getting help, I have tried not telling them what is wrong, I have gone in with a blank slate after being seen by 30 doctors when we knew what was wrong and couldnt get help....it still didnt work, whether they dont want the risk themselves to get involved or they dont want to be the one to confirm the injury further I have seen and heard more than I ever would want to or any patient ever should. I think if we had people who could and would tell our stories (of course after they can be verified) I think people would be shocked to see sometimes what is allowed to go on...we hear after the fact we hear after death how about follow someone going through it? how about see it happening maybe that would help........its not only the injury its what occurs for years after that its like a bad nightmare you cannot get out of.......there are so many good people and doctors out there, so many good advocates its a matter of bringing it together........I did everything I begged for help I didnt scream I let them figure it out I went through years of being told I had anything and everything else, most people dont want to sue most people just want help. I am in the process of hopefully telling my story and I pray that it opens some eyes but does good; first is to get me help thats going to be a hurdle itself its been attempted several times but theres always politics or something that interferes with resolution but my dream is to bring patients and the healthcare personnel.system together, open our eyes to whats not working. There is so much good out there .....there are so many amazing doctors but there is so much preventable illness injuries occurring that if they dont kill the patient are slowly taking their lives. We can meet in the middle both sides just have to open their eyes and see it from both sides....and want it to change" "Thanks for the comments, Tom Bouthillet, but I do have to wonder how the wonderful care provided by many doctors and nurses, and their advocacy on behalf of patients, relates to the hundreds of thousands of cases of preventable harm suffered by patients. I'm not sure if you saw my recent post on the OIG investigation into Medicare harm, but their review of records found harm to about one-in-four Medicare patients. And then they followed up to find that a mere one percent of those cases was reported to state sentinel event and HAI reporting systems, because hospital administrators said the preventable harmful events were considered mere complications. I'm not sure how one would define a ""monstrous, health care bogeyman,"" but a reasonable person could say that this ongoing, systemic situation would qualify. Your thoughts?""The devil is in the details. I'm a big fan of both Atul Gawande MD and Peter Pronovost MD who have helped reduce preventable harm. See ""The Science of Safety"" on YouTube for example. Do you remember in the 1980s when aviation started reporting near misses? You couldn't turn on the news without hearing about two jets that almost collided. You'd think aviation was incredibly unsafe! As more patient safety experts start redefining what preventable harm actually means, and more reports come out showing infection rates, the more conspiracy theorists will equate doctors and nurses with Jack the Ripper. In a perfect world no one would get sick and no one would die. But human beings do get sick and they do die. Human beings are prone to making mistakes (Pronovost makes the comparison to pilots -- they get tired and pull the wrong knob). The difference is that in aviation this still happens a lot -- but they catch it. Building safe systems is definitely on the radar in health care and there is a patient safety movement that builds momentum every day. I agree with those who have said this is about risk management. Whether we call them ""complications"" or ""adverse events"" or ""preventable infections"" doesn't matter as long as it is being measured. I did not intend to take the position of ""defender of the health care system"" because the reality is that I am a critic. Friends of the health care system cannot afford to be flatterers of the health care system. Having said that, change can only come by working within the system, however much we would like to dream of tearing it down and starting over from scratch."Preventable deaths in the aviation industry in 2011 = 0."Tom Bouthillet, you are right, the aviation stories were in the news. Each one of them. And it worked. But in the medical industry I doubt 0.1% of preventable deaths make it into the news. The aviation industry had to improve because of the bad publicity. When an accident happens in the aviation industry, perhaps hundreds of people may be seriously affected. The medical industry has a different situation. The preventable death of a single person spread out and multiplied over the country 250 times a day isn't reported. The medical industry safety record hasn't noticeably improved over the last 10 years, because unlike the aviation industry, there is little real pressure in the form of publicity to make it improve."Garrick well said. We are all looking for change and truth be told yes medical error is occasionally being reported but nothing compared to how often it's happening. The medical error/mistake is one point what happens after I believe is a whole other entity."If you want better public reporting of errors then you should advocate for tort reform. A lot of the reporting is done internally through the quality assurance process and is not discoverable in litigation. That's different, you will note, from not reporting errors at all."Tom - Tort reform as a solution to medical errors is a red herring."Where did I suggest that? It's not a ""solution to medical error"" but the constant threat of a medical malpractice lawsuit is a barrier to transparency which is indispensable for process improvement. Human error is complex but there are tools to deal with it (for example, the Human Factors Analysis and Classification System or HFACS). In any other enlightened industry human error is decriminalized to encourage reporting and solutions are non-punitive. It's a real problem and calling it a ""red herring"" does not make it so."I didn't say you suggested it. It's a time worn talking point for those who want to protect large corporations and institutions from legal action by individuals - one of the few options left in a political system largely run by corporations. Your position assumes that transparency should be a choice rather than a function of regulation.Here's a reality check. If you punish people for making mistakes they will become really good at hiding mistakes and deflecting blame. If you think you can change that through regulation you are sorely mistaken. "That's not a ""reality check"". That's perpetuating a series of myths that are really good for institutions, really bad for people. There are mistakes and then there are patterns. In Infection Control, it's not a mistake that 50% of doctors don't wash their hands between patients, that's a cultural problem that needs to be addressed not by removing the right of patients to sue for harm caused to them by individual's poor hand hygiene but by making the costs of not washing higher than the taking the 20 seconds between each patient to do so. There are many, many problems with our healthcare system none of which tort reform will fix.""That problem is being addressed in a much more effective and constructive manner than lawsuits. Tort reform is not a panacea but process improvement must be non-punitive to create the kind of culture that lends itself to patient safety. In other words, there are many problems within our health care system that lawsuits will not fix, and many more that lawsuits make more difficult to fix.""Process improvement should not be related to lawsuits at all. It should be done to prevent deaths, injuries and billions in extra health care costs. I have three doctors in my family. None of them wants to infect a patient or leave a sponge in a patient. In far too many states, tort reform has already severely limited patients and their families ability to get justice and compensation for harm. That it takes lawsuits to spur improvement is a more stunning indictment of the status quo than I could levy." "There are times that a legal remedy is appropriate and an injured party's only course for justice. On the other hand, malpractice lawsuits are often a source of significant injustice for doctors and hospitals. Feel free to consult the doctors in your family on this point. I'll be astounded if they don't agree. Defensive medicine is expensive for patients and health care in general. The rights of patients have to be balanced against the rights of health care professionals and justice should be served for everyone involved to whatever extent possible. Health care is in need of reform but no one wants to give an inch. In my opinion, tort reform does not (or should not) mean that patients ought not be allowed to sue but that judgements should be based on medical science and not emotion, and damages should be reasonable. I don't blame physicians for getting out of medicine or talented students for choosing other fields. It can be adversarial and demoralizing and people expect perfection. It's easy to judge. So easy.""I am going to get a lot of slack for saying this but hey what the heck......today compared to 10 years ago there are less errors reported, less malpractice suits and even when they are filed the percentage where the patient wins is disgustingly low i believe the reported percentage was under 5%- it feels like we are unprotected, un American definitely not the land of the free and brave and thats when the system is in the doctors/hospitals favor but years ago there were more errors reported, more lawsuits were allowed and patients won more.. there were less complications....I get what you are saying that if you punish someone for mistakes they will report them less but truth be told the evidence supports something else...when they were punished it actually was more effective,,, I think its a direct link to being given more freedom to do what u want...sorry sounds terrible who would want to believe that human beings could live with themself or operate like that but dont shoot the messenger analyze the facts........ when they changed the laws in 2002/2003? all they did was make it almost impossible to see any kind of justice done, give freedom to doctors with little governing body or authority over them, basically the only ones that make out are the patients who get the doctors that truly love what they do live and breathe it and are amazing at it....listen its not just doctors its that way for everything in life we just pay a higher price with doctors....if you go to a subway and order a sandwich and that person is tired or having relationship problems or arrogant or just there because they need a job and dont care what they are doing you are likely to get a crappy sandwich and if he had a boss that didnt care or see that their duties are met it kicks off a series of adverse reactions...they dont clean the store up, wash their hands, make proper sandwiches, etc so you get a sucky sandwich, you get treated poorly when you are ordering, the food in the sandwich may not be fresh and you can get sick and if they dont wash their hands you may get bacteria, etc etc etc see the point ????? I just pray something works and soon......""A study by the Office of the Inspector General for the Department of Health and Human Services has found that doctors and hospitals are reporting only 14 percent of their mistakes when caring for Medicare patients, raising disturbing questions about accountability and quality of care in the nation���s medical facilities.A Clear Attempt To Avoid ResponsibilityTo err is human. The problem is, unlike most professionals, when doctors mess up, people die.""Also like most people, doctors don���t like to admit their mistakes���and the stakes of taking responsibility for negative outcomes are much higher than for your average office drone. Doctor error can expose health workers to millions in liability for malpractice and wrongful death, so they have even greater incentive to brush their ���oops��� moments under the proverbial rug. Indeed, last week���s survey results made it clear that under reporting of error has reached epidemic proportions.""Unfortunately, it���s not just the victims who suffer and die when mistakes get covered up. Ultimately, anyone who might pass through the hospital in the future is put at risk. ���The reporting of medical errors leads to corrective action to prevent future similar mistakes,""Actually, KariAnn, the OIG found that hospitals were only reporting about 1 percent of cases of patient harm. I wrote about it a few days ago on this site. There's a link to the study, too. The problem, in part, was that hospital folks considered the preventable harm to patients complications of the procedures.""The numbers are dropping if people start doing accurate reporting and investigation....it all goes back to its just people talking until someone dives in does the research and reports on it. the numbers thrown out there were 10 percent and then like Marshall wrote in his article when they did the study and researched further they were reporting only 1 percent of errors do we get the magnitude of that? One out of a 100 that's unimaginable, unacceptable, unthinkable but yet it exists How is it our fault that they are not reporting or lying 99 percent and does that finally show people how unsafe it is. Something else to show its not the patients/people's fault someone had suggested it could be because of the threat of legal ramifications well I had seen an article someone had posted recently and I am not exact on the numbers but close without having it in front of me but the percentage of patients that were injured by error/malpractice that were able to bring a suit was 10 percent or under and only 4 percent are successful so 96 percent of allowed reported malpractice got away with it and 90 percent of injured patients as a whole are unable to do anything about it.....do u have any idea what it does to a patients life? Their family? The patients after them......if I had the money if I had a dream I would do a documentary right now, a tv show....there's a major epidemic going on and the affects it has moving forward is unimaginable what about the children in those households of the ones who died? My household others households where the children have to suffer from it or where the children are injured and the parents have to watch the person they love most suffer.....this isn't just mistakes.....mistakes happen and I do know here are amazing doctors, nurses, etc but in my opinion it is the minority or that's what it seems like I don't know what the answer is but I do know more focus needs to be put on it, eyes need to be opened, education needs to occur, if u re confident in life u would want to know if u are doing something wrong, should want to improve, what happended to being the best at what u do, striving for excellence, putting smiles on people's faces? Medicine has changed and it can't be taken lightly we need doctors we need nurses we need surgeons......we need help.....""I agree with Tom Bouthillet that legal liability is a major reason for hiding data, falsification of records. I am sure it is why my own medical pathology report about my injury was ""lost."" And it is why I get a ""wall of silence"" when I try to get help from doctors about my injury. But the lawsuit is the only remedy our culture provides victims with today. If there is to be tort reform, there darn well must be something else in addition to the lawsuit to help victims get access to medical repair and compensation than they get today.""Actually we don't need ""tort reform."" And that phrase is misinformation. What they want is more accurately termed ""litigation discouragement."" What the public needs is an easier, more sure path to discovery, diagnosis, and recovery due to medical malpractice. Victims will get what they need without using the legal system. And then the legal business will have fewer cases to cherry pick from, without restricting lawsuits.""Has anyone ever shared an experience with you about their medical care and asked: What can I do to make the system better? Have you ever felt helpless or vulnerable at the doctor���s office? Have you ever thought: If you could just get together with others and learn what has worked for them, you would feel more in control at the doctor���s office and in a hospital?Well now you can! Start a Cautious Patient Community and become informed and involved! Here's how http://www.cautiouspatientcommunities.org"Samaritan Hospital defends disgraced former doctor as negligent-credentialing trial nears. http://www.answersforlisa.blogspot.com"""banned from performing medical research on humans after he and a colleague were accused of experimenting on dying brain cancer patients without university permission.""""Just answer the question, Patterson DentalJamie Vee, Patterson Dental territory representative out of the Minnesota branch, this dentist has no more patience for evasive representatives. So please don't attempt to brush me off with dead end links again. All I ask of you is an answer to this simple, straightforward question: Will electronic dental records put my patients at greater risk of identity theft than paper dental records? Yes or no?""You can read the introduction and the book from this link. Powerful. http://www.furtherfield.org/friendsofspork/tlc.html""Thank you for posting this. I wanted any interested person to be able to read this book, whether or not they had money to buy the book. For those who prefer to hold a book in their hands, The Last Collaboration is available at"http://www.sporkworld.org/Deed/tlc.htmlThank you for writing this book with Millie and sharing it with everyone. I could not stop reading it and was shaking my head throughout. All healthcare workers should read this book."Demanding transparency in dental careIt���s my opinion that when ANYONE advertises their electronic dental records to attract new patients, ethics as well as the Hippocratic Oath demand that potential customers be warned about the increased risk of identity theft over paper dental records. From my experience, I don���t expect anyone to attempt to argue against such common sense in dentistry. Not long, anyway.""Metro Dentalcare, a huge dental franchise corporation which operates more than 40 offices in Minnesotahttp://www.metro-dentalcare.com/, purchased four internet press releases advertising the franchises��� electronic dental records. Only one of the paid venues, GNT (Generation of New Technology), permits comments following Metro Dentalcare���s ad. Andrea Goodall is listed as the company���s contact person, so I contacted the PR specialist hard:Dear Andrea Goodall, Metro Dentalcare in Minneapolis, Minnesota:I just read your article ""Transition to electronic dental records and digital x-ray improves efficiency and accuracy, providing seamless patient care across locations.""http://us.generationnt.com/metro-dentalcare-transitions-electronic-record-keeping-digital-press3667961.html Isn't it true that Minneapolis dental patients are at a higher risk of identity theft from electronic dental records than from paper records?Since this is an important question, I'll email it to you in case you don't notice it here, following your article.D. Kellus Pruitt DDS""We in this group have a particular focus borne of real experiences. Here in Colorado many of us find ourselves tangentially touched by the Aurora Theater Shooting, suddenly in the company of people whose friends were among the victims. Here's a more uplifting medical story from that place: http://wp.me/pvbjj-aa"CJ&D on apology and early offer programs... "4th World MRSA Day Kickoff Event & Global MRSA Summit Sept. 29th in Chicago. Keynote Speaker Dr. William R. Jarvis - leading world renowned MRSA expert and ID specialist, formerly with the CDC. An event that brings the community and healthcare industry together to unite in raising awareness to the global epidemic. For more information: http://www.worldMRSAday.org""Amid reports the actor/producer accidentally overdosed on pain medication, his mother has spoken to the New York Post, revealing she tried to talk her son out of having five teeth removed in a day, two weeks before his death""My letter to the editor is the second one down. I am hoping to get the message across that Davita does have a history of harm and dismissal of patients. Why would we want them in Maine? http://bangordailynews.com/2012/07/22/opinion/monday-july-23-2012-lepages-commentsdavita-and-gay-marriage/""A really strong letter, Kathy. It is concise, yet includes all of the essentials. Finger crossed here for a positive outcome to your efforts."Patient advocates like Kathy Day willingly stand up to protect our family members and our community against profiteers that are tone-deaf to patient harm. Support Kathy Day and insist on healthcare that is affordable and responds to human need."Thank you for establishing this much needed group, for myself personally, for the million women who have contacted the HERS Foundation about medical abuse they experienced at the hands of doctors who were enabled by hospitals.One in three women undergo hysterectomy by age 60 in the US, and 73% of hysterectomized women's ovaries are removed during a hysterectomy. The ovaries are the female gonads. Removal of the ovaries or testes is castration. Watch the informative 4:45sec trailer of HERS Conference to hear what hysterectomized women, doctors and lawyers talk about the outrage everyone should feel that this is being done to another woman every minute of every day. Rarely - if ever - are women provided with the information required for 'Informed Consent'."It is also important to know that of those women who need to have a gyn surgery for cancer almost 35% will develop PTSD and of those who have gyn surgery for a benign condition up to 15% will as well. This surgery is traumatic emotionally as well as physically."I had no idea the stats were so high. On another group, we're discussing how uterine bleeding is caused by serotonin drugs and their increased use since 1987, esp in women. Excuse if this was covered in video." http://www.alive.com/articles/view/23507/bridging_the_divide"Lawyers in Samaritan Hospital 'negligent-credentialing"" lawsuit battle over prior cases against former doctor. http://bit.ly/LsDlr8"This is exactly the kind of information people need to have. Thanks for posting this."After reviewing x-rays and patient charts, that dentist concluded Duyzend had done ���fraudulent root canals on almost every patient in the practice��� and that many were done poorly. More than 200 patients have filed malpractice claims against Duyzend."IF NO ONE STOPS OR AT LEAST INFORMS PATIENTS OF DENTISTS THAT ARE ON PROBATION FOR REPEATED GROSS NEGLIGENT CONDUCT YOU MIGHT BE JUST ANOTHER VICTIM OF A DENTIST'S HARMFUL PATTERN. http://www.thepetitionsite.com/1/Pass-Tinas-Bill/"PPPHC folks: Like Joleen I sent an essay to the Mayo Clinic to enter their forthcoming healthcare social media conference scholarship. If anyone's so moved I'd appreciate your ""like"" and tweet or other broadcasting the effort to qualify. First round based on social likeability and commenting; final round judged on the essay's merits by Mayo personnel. Mine's up at http://socialmedia.mayoclinic.org/?p=2642""to Like, go to the essay link and use the like button below the essay :)""Nice job! I was fortunate to be able to advocate for my mother and was the one who initiated the hospice process, not the hospital staff or physicians, when she had metastatic lung cancer. I was able to bring her home where she was able to make decisions regarding her care and was able to die on her own terms. Although helping her through the dying process was difficult for me, it made her happy. I will never regret having her at home on hospice when she was finally at peace.""BTW - you got my ""LIKE""!" "Thanks Julie! I think I can understand the difficulties in helping a loved one die at home. Altogether, tho, magnitudes easier than the stuff of a hospitalized demise.""Lots of new info on CMS' Hospital Compare and Nursing Home Compare websites. Inappropriate imaging usage in outpatient settings, inappropriate use of anti-psychotic drugs in nursing homes, and nursing home deficiency reports are all now posted. Likewise, there's updated infection, adverse event, readmission and mortality data posted for each hospital. There's still a (long) ways to go to improve the site to my liking, but it looks like the agency is trying to broaden its attention to transparency.""Cheryl Clark - there are plans in the works to migrate the individual ""Compare"" websites to an even easier, integrated format on data.medicare.gov""Have you ever seen a ""Top Doctor"" plaque on your doctor's wall? It's a sham! They paid for the plaque! There was no vetting, no look at that doctor's track record. Even criminal doctors have them!""DON'T BE FOOLED BY ""BOARD CERTIFIED"" EITHER...DENTISTS THAT ARE BOARD CERTIFIED CAN ALSO BE PROBATIONER DENTISTS on probation for harming several patients with repeated gross negligent conduct."http://abcnews.go.com/Health/top-doctor-awards-deserved-abcnews-investigation/story?id=16771628#.UAVgE7Se6S_Interesting Johns Hopkins Walls are covered with TOP DOTOR PLACQUES. Some of those doctors are so stupid it is a disgrace that they are allowed to call themselves doctors."Did you research your cell phone plan more than your surgeon? The information is now easily obtainable: Medical school accredited? Time from graduation to start of residency, advanced certifications, history of licensure, admitting privileges ever suspended, history of malpractice filings, national criminal background check. This is about the same level of vetting for any new employee.""Did you know my former dentist's actual history of repeating gross negligent conduct to several patients and fraudulently billing patients and Medicaid was NEVER even on a website...I was supposed to just accept an apology from the Dental Board executive now that I'm irreparably damaged facing surgery 5 and with no hope to restore. Corruption and conspiracy keeps incompetent, drug/alcohol addicted, grossly negligent dentists licensed in my experience. Sorry Doug Hall not every dentist is forthcoming and the Dental Board fails too."Again: it does no good to research the information on any surgeon if you are having surgery in a teaching hospital because you are NOT going to be operated on by that already-practicing surgeon. You are going to be operated on by a resident trainee."When discussing your procedure with your surgeon make it a point of your Informed Consent that you want only your physician to perform the procedure and that no students, interns, residents, manufacturer's representatives or lookyloo's are to be present during the procedure.""and this must be done in writing, with signatures and dates."This is exactly why I believe cameras should be rolling at the place of treatment during the treatment...I will never ever trust a dentist again and no matter what the Informed Consent Document represents the fact remains too many professionals I've trust failed to be honest."In my sub-section of healthcare, dentistry, it is the recommendation of a crown when a filling will do. It is the intent to ""find"" a maximum amount of work on each patient. It is the diagnosis for deep cleaning where a regular cleaning would do. ""Aggressive diagnosis"" is also a survival response""I'm not endorsing this type of up-selling, especially in healthcare, but healthcare is a business and the doctrine of caveat emptor applies - the buyer has a responsibility to understand the terms, need and outcome of the transaction."So you believe selling irreversible dental procedures is equal to the caveat emptor used in the process of selling a car Doug Hall? The law clearly states ethical reasons why caveat emptor is not acceptable...Patient and public safety measures are written into law so that professionals don't abuse their position by deviating from the paramount interest for patient and public safety.I tell them what I will accept...or I don't go back...end of that story!I am always learning - can you cite about that which you are referring??"If some greedy professional deviates from the priority of patient/public safety measures they lean on their financial ability to ""lawyer up"" and find an ""apparatus of compromise"" to keep them licensed and no matter what...they act in concert to deviate from the law as they conceal their actual misconduct from the public."Senate B&P 1601.2 "Marshall asked me to describe my work to the group, specifically my book, Notes from the Waiting Room: Managing a Loved One���s (End of Life) Hospitalization, and how it relates to harm. I���ll make this a two part post. First the backstory, then the book. I prefer shorter posts in these forums but don���t know how to do this as a soundbite.Notes from the Waiting Room���BackstoryNotes is based on my experience as a patient-family member and proxy during each of my parents ~3-week terminal hospitalizations: Mom (80) January 2005 and Dad (84) April-May 2006. The book���s genesis occurred during these events. Dad happily scootered himself in for elective pacemaker eligibility testing, thinking to return to Colorado to finish his life near us (today I���d question the whole notion of pacemaker from a range of perspectives; then I didn���t know enough). Medical harm was part of Dad���s demise; he had crashed medically associated with pacemaker eligibility testing and contracted nosocomial urinary tract MRSA due to wrong-size catheterization. His bloodstream became infected; it lodged in his wrist. The worst aspect came when we abandoned treatment; draining the wrist infection required general surgery due to his greatly compromised heart (two bypass op���s starting 19 years prior). We viewed the procedure as logical and nonheroic. Dad stipulated no intubation (Mom, suffering sudden respiratory failure, had lain intubated for her entire hospitalization (ICU) and he didn���t want to end up that way). The several anesthesiologists declined but failed to fully explain why, citing only ���it���d violate our principle of ���do no harm.��Ȋ�� Too stunned and naive in advocacy, I failed to say ���you���ve just handed me Dad���s death sentence.��� The lead, who acted as liaison for his colleagues, failed in other ways: not asking what was behind the no intubation stipulation���senseless on the face of it assuming one knew that intubation was standard operating procedure���which we didn���t know. Nor did we know that DNRs are suspended for surgeries and that post-op SOP stipulates reintroduction of life-support technology for anywhere from 2-48 hours post-op depending upon the facility. We didn���t know these things because we���d not been presented with a surgical release form, which I would have read closely and questioned. The doc failed to inform us and failed to offer a post-op time-based trial approach (a phrase I encountered only months later while researching and writing Notes). Neither the unit nor the facility asked why we were leaving. Nor were we asked, during the otherwise careful 3-hour hospice intake, why we were entering hospice. All the players failed to go the distance, myself included (I was, and we are, part of ���the system���). I feel unendingly stupid, retrospectively. On the other hand, by the time a patient-family has endured the day-in day-out nature of a critical hospitalization where, for example, your loved isn���t being fed and watered because of insufficient monitoring, and 10 days in you google ���end of life symptoms��� out of curiosity about the odd behaviors your loved exhibits (but have not been seen nor mentioned by staff) and find them listed on hospice websites as associated with dying���well, weeks of this sort of stuff takes its toll on a patientfamily���s acuity. So Dad lucidly enrolled in the on-site hospice and more quickly than expected became unavailable, so I never got the opportunity to say goodbye; he died after 4 days. He was one of the 35-45% who are hospice patients for only 4-7 days, a period of bodily active dying.And I���m not even going to detail the nature of Mom���s hospitalization in a very callous ICU. The litany spanned a gamut from small but annoying (slamming doors and too-loud nurses in mom���s ICU) to medically dangerous (dropped items placed back in service) to emotionally brutal (ill-timed, inept physician ���communication��� around treatment and resuscitation choices in the context of making immediate decisions with life and death implications that could, and should, have been discussed days earlier, and which blunted the family���s ability to act as proxy in those moments. And more���but members of this group are familiar with the type and range of commissions and omissions that together form a hospitalization.We were a small (the folks, my NICU-nurse sister, and me), cohesive, advance-planned family who wound up in these circumstances regardless due to chance, naivete, and normal human impetus."very sad that these are your last memories with your mother and father. beyond sad really. thanks for sharing with others..."Yes, Robin, I carry sadness over the overall nature of my parents' demises. It's tempered, however by: ��� it's nearing a decade since their demises��� we brought our own baggage to the party (this in no way accommodates systemic/provider failures)��� I learned a wealth of lessons to apply personally and at least try to share with the world (see my related thread below, Notes from the Waiting Room���The Book) and offered me a new direction in life��� it could have been far worse; as rough as those sets of ~3 weeks were, at least neither my folks nor the family endured months to years of decline.""It will recede to a regret, and who knows what else after that. Ultimately, V, it's a seed.""@ veronica, i know the pain of what you went through to some extent. my father dropped dead instantly with a massive heart attack and i never had the chance to say goodbye. but in the case with your mother, i just can't imagine how you deal with such pain; especially since the hospital caused the injury. i am so sorry. your wound will never heal completely. i think bart is correct in that your sadness will change over time. it will never go completely away and probably shouldn't. you will always have the scar to remind you of the wound...""V, painful as it is, remember all the conversations you *did* have with her. I'd bet, as with me and my father, they far outnumber the several that we might have had. Outlook rules. Budget your energies."budget your energies is good advice. that's how i've make it through many traumas. i always think of the 'prayer of serenity' and i try to focus what energy i have on those things i can do something about and not on something i cannot change."How effective is the security of encrypted, cloud-based electronic dental records?Stolen medical identities sell for $50 each. That makes $25,000 for 500 EDRs a tempting heist, which takes a hacker or dishonest employee only a few minutes to silently download.""Even though offsite, encrypted storage of EDRs is arguably safer than the dentist transporting a backup to and from the office every day, it���s still not as secure as deidentified dental records. Before handing over patients��� records to a cloud or Software as a Service (SaaS) Business Associate, dentists should be ethically warned that the Ponemon Institute recently reported that third-party mistakes account for 46 percent of data breaches. http://www.healthcarefinancenews.com/news/ponemon-study-says-data-breaches-cost-ushealthcare-65-billion-annually Because of federal and state breach notification requirements, if a BA hires a dishonest employee who steals over 500 patients' identities from a dental practice, the unfortunate incident must be reported in local media. From the perspective of the dentist���s pissed off (former) patients, it might as well be the dentist who negligently entrusted their welfare to a thief.As far as I can tell, the very best in encryption software is provided by all SaaS providers. Now the bad news: None of their encryption is secure. According to John Markoff���s article ���Flaw Found in an Online Encryption Method,��� published in February in the NY Times, ���A team of European and American mathematicians and cryptographers have discovered an unexpected weakness in the encryption system widely used worldwide for online shopping, banking, e-mail and other Internet services intended to remain private and secure.��� http://www.nytimes.com/2012/02/15/technology/researchers-find-flaw-in-an-onlineencryption-method.html?_r=1 James P. Hughes, an independent Silicon Valley cryptanalyst, worked with a group of researchers led by Arjen K. Lenstra, a widely respected Dutch mathematician and professor at the �_cole Polytechnique F��d��rale de Lausanne in Switzerland. He told the NY Times: ���This comes as an unwelcome warning that underscores the difficulty of key generation in the real world. Some people may say that 99.8 percent security is fine.��� It turns out that the cryptanalyst and I consider 2 chances out of 1000 risky. If it were your family���s privacy at stake, I���d guess that you probably tend to agree. If even encrypted identities in my family are fumbled, ethically, I deserve to know the details as soon as possible. I don���t want to hear afterwards that HIPAA doesn���t demand accountability from those responsible for encrypted losses. I cannot imagine anyone preferring not to be bothered about a breach, even if encrypted��_ Two out of 1000. On second thought, I ESPECIALLY want to know if encrypted PHI is fumbled. False security is always worse than no security because it favors the cleverest of thieves. Eventually, most dentists will come to the common sense conclusion that de-identification of EDRs is the only security solution which will make digital records safe enough for our patients. So what are we waiting on? ADA leadership? Hell. In the last 2 minutes you���ve learned things about EDRs that ADA Delegates and Trustees won���t hear about for another 3 months. I���m telling you, this is the ONLY internet venue where EDRs are being openly discussed. It���s certainly not happening through the ADA. What a shame. What a waste of talent and resources. By the way, Doc. The ADA recently announced that there will be a dues increase in January.D. Kellus Pruitt DDS""the attorney who i thought was going to take over my case telephoned yesterday to advise me that he will not be. he says there is no question that my doctor stole my organs without my consent so i can prove liability easy enough but... i cannot prove damages. is appears that most people are of the mind-set that women's sex organs are disposable even though they support all other pelvic organs, even though they produce life-sustaining hormones that tell every other organ in a woman's body what to do and when to do it and even though they define a woman's very gender, identity and sexuality. anyone have an idea how i can prove damages? it would seem to me that the fact that i was knocked out and all six of my healthy sex organs removed would be damage enough on many levels. it is not - at least not in the legal world of medical malpractice. looks like i will have to turn to you tube for justice... i can't allow the monster who stole my organs and ruined my life and health to get away with what he did. there is no way i can live with what's been done. any suggestions regarding proving damages would be appreciated."I am so sorry for what u are going through.....it seems I possible or beyond difficult for many of us to get help....this is insane I am going trough hell too and they just go on with their loves like nothing happened.yes they do... they go right on leaving a trail of utter destruction behind them"Your experience -- which is truly horrific -- provides a perfect example of how flawed the malpractice area is. In many instances, suing is a blunt instrument that does little good. And often, the regulatory agencies aren't a lot better. Nonetheless, if you haven't done so already, you might consider filing a complaint with your state's medical board and/or state department of health. If your complain is founded there, it might at least inconvenience the surgeon.""Even in Buffalo, NY, where legal fees are often modest by NYC standards, few -- if any -- lawyers will accept a case worth less than $1 million."Even then it's hard.....I have a foreign body pathology confirms its. Foreign body and it appears ome is still in there.....my case for an attorney would be high money I had a six figure income it's made me disabled the medical bills are close to five million but between what the doctors lie about and how they play with time anymore the whole burden falls on the patient......robin we are in very similar situations a bunch of us are on here and we are trying to go at it with media avenues....I need a surgeonto do a laparotomy they send me to a hospital they run tests confirm its a foreignbody set up surgery nd cancel last minute that's happened multiple times last one was for June 28th the others try to say there's no foreign body for years we didn't know it was there even though it started righ Afer my csection they convinced us I had an autoimmune caused by pregnancy then treated then ruled it out then said it was MS then sarcoidosis this was for 7 years then someone suggested an abdominal infection retained from the csection then they ruled it out then we found my records and one said foreign body so we started getting tests and it said no....to make a long story short in January 2011 we picked up a ct scan and it said retained surgical material like cotton or gauze and metal products my life has been hell they went in we're supposed to remove and didn't and another one went in for an hour removed a clip and what he said was suture and scans show the foreign body still in there and metal no one will do the laparotomy and even if they say they will they cancel. Robin and others keep fighting it makes a difference.......the doctors right now seemcovered by politics and most lawyers seem just to give up......it's sad"Hi Melissa DelMastro Seminara, so sorry to hear your difficult story. I was wondering if you are uninsured, or if the $5 million is after what insurance paid.""The 5 million is what the insurance paid, then my loss of income totaling 8 years out so far I was up for a vice presidency position had signed the contract and then ended up back in the hospital and had to go out. It's been hell" "Ah, I see, so there has been a lot of lost income.""@ Rachel...i have talked to probably no less than 50 medical malpractice lawyers since my surgery in 2007 so i know how difficult it is to get one to take your case. ohio is one of the worst states in the country due to tort reform. and, t...he particular county i had to file in is the worst in the state. the plaintiff rarely ever wins no matter how obvious the malpractice so lawyers are not inerested in my case for that reason alone. @ melissa, i am so sorry for what you're going through. i had something similar happen to me but everything worked out. when i had my first child in 1985, my doctor was in a hurry to get to a golf game and let a sponge or packing in me. i went home and developed a fever and began to go into toxic shock. luckily, my mother insisted i go back to my doctor's office and they removed the packing. if i had not been living with my mother, i would have died. i have a feeling that if that happened today, i would be dead; especially after hearing your horrible story. what is happening with you is beyond wrong or unethical. it's criminal or should be. like you, i lost my income too and have to depend on others to pay my most of my bills. i worked from the time i was fifteen until january 2010. i finally had to give up because it got to the point that i could only work maybe 9 hours a week or so. also, the loss of estrogen to my lenses caused me to develop cataracts so i can't see to drive; especially at night or in bad weather. my bladder dropped to third degree prolapse after the surgery so i was in the restroom every ten minutes at work which cause an issue. plus, i sitll have the original condition i sought treament for in the first place. i look like i'm 8 months pregnant and have to wear maternity clothes - going on five years now. my stomach suddenly grew from 29"" to 48"" within a matter of a week in july 2007. people are alwys asking me when my baby's due and if i've picked out a name, etc. that gets very difficult to deal with for many reasons for me. it's still that way and no doctor has any clue why. i've even been to cleveland clinic... i just live with it now. i won't go to a doctor or hospital for anything or any reason. the only doctor i will go to is the one who puts in my hormone implant. that's it. i don't know how you even have the courage to keep going to doctors melissa. @ Martha, I did file a complaint with the medical board, the nursing board, the joint commission on hospitals and even with the hospital where my surgery was performed. additionally, i filed a comlplaint with the oh dept. of insurance and with united health care and with the governor of ohio. i know from my ast experience of having my two youngest children abducted by their father that filing complaints with various agencies does little good. it was not until my story was on tv that anybody cared that a tx judge helped my ex take my children. she was removed from office at least.. @ Rachel... what happened to your mother is beyond words. i don't know how you dealt with it or even deal with it now. so wrong! your poor mother. thank you for responding to my question about damages. the problem is that, in ohio at least, you have to have an expert to testify about each and every damage. in my case, that will cost anywhere from $50,000 to $100.000; making my case not worth it for a lawyer and any lawyer i've talked to wants me to pay for the experts. i have .72 in my bank account right now. obviously, i can't nor should i have to pay all that money. in ohio, very very few lawyers will 'front' the money for med mal cases. sometimes in the case of death they will... it's very sad that a site like this even exists. none of us should have these horror stories to tell. this is so wrong. the media is our best hope of putting pressure on the system. even then, it's so big and so protected, i'm not sure the media can help. thank all of you for sharing what you've been through and are still going through.See More56 minutes ago �� LikeUnlike""btw, sorry for not using paragraphs. the computer i'm using is from 2004 and is so messed up i can hardly use it. it often does its own thing - like posting my comment before i'm ready or deleting it altogether. the keyboard is the original too and many of the keys don't work. if i decide to make videos for you tube regarding my case and what is going on in general, i will have to borrow money to purchase a new computer." "Sometimes damage can be concealed...Be careful in trusting your radiology reports people. It's a little game that can be played and most people don't know what is happening. You have pain from the damage but the reports may be coming back as normal or past reports are changed. I had 4 radiology reports changed and the original reports were gotten rid of.. Not a coincidence. Look for wording on the changed reports like ""possible"" ,""questionable"", ""incidental findings"" etc.. or if the report comes back as normal then you may want to get the tests done in a different country. If their is fraud involved then concealment may follow.." "records are often changed or altered too. i ordered a copy of my medical record within a couple of weeks of my surgery. by the time i hired an attorney eight months later, my record had been 'altered'. i have both copies. don't need them though because my doctor boldly admitted he altered my record. he said that he alters records all the time and he also said that he has never timed or dated a late entry or alteration. my doctor's depo should be published.""Yes Olga luckily we have really good insurance I pray to God that continues because my medical bills have been insane....lost income was great, even now with the drastic reduction of incoming money we still put between 500.00 to 1000 extra a month on top of what the insurance covers.....its just been devastating. I consider myself one of the lucky ones because some have no money coming in and n insurance my heart goes out to them. I had an idea for a show kind of like they did the extreme makeover home edition and the body edition maybe eventually someone will do it but theres so much out there especially help but if the stories are not heard the help doesnt come..... hopefully we can get this right soon or at least help some.""I imagine short videos condensing the years events into 10 minutes, of people who get treated with obvious denial and coverup by doctors for the injuries they caused. The videos would tell the story to the public. Maybe they would be classified under both horror and documentary, and that would be correct.""Robin your story is devastating and its actually puzzling me you say you had the sponge removed now the interesting part is mine is still in there or lets call it a a foreign body for now since thats all that has been confirmed its a presumed sponge but it could be a towel or gauze.....anyway so my body is still doing all the horrible things and its attacking its invader but a lot of what you said is currently going on with you is the same as me my abdomen in larger than when i was pregnant i am double my normal weight and completely malnourished my weight is and was normally 120 to 130 i even lost all the baby weight but then in 45 days my body swelled so large i gained 80 lbs and the damage to the liver and surrounding organs is increasing i guess inflammation....have you had any scans or anything done to see whats going on in there? i just have a feeling there may be something left in there maybe even a piece see i know at this point especially in the last few months more than i care to and unfortunately not many doctors in the US know much about this theres a chance that sponge broke into 2 or actually 3 or when he went to remove it a piece could break off and despite what they tell you that it wont do much damage thats crap it could go without having adverse affects but you are having symptoms so something is happening mine is actually now in either 2 or 3 pieces and once they break it apart and dont remove it it spreads it throughout your body not always blood it can be via other fluids or tissue just research intra abdominal infection. I pray you get better and if you want there are things natural i am taking to try and keep the damage at bay or trying to do homeopathic things until i am able to find a surgeon who knows what they are doing to remove it or one that doesnt keep backing out. I am completely disabled and quality of life is poor but i am alive...... i am shocked when they pulled out and confirmed sponge no lawyer would take it but then i guess nah not shocked.....it shows how little they know they think retained sponges are minor cases but depending on the damage its done to your body what its cost you , the medical expenses they took your life.....that shouldnt be a minor settlement.....sad very sad.....i am so sorry you are in my prayers God willing i want to tell my story and get better and hopefully help so many others.....there is a company that created these sponges that are supposed to prevent this from happening and it didnt do as well as they had hoped because people in politics or healthcare managed to convince them its not necessary therefore not mandatory if they could get a high profile case and see how 10 to 15 hospitals 100 radiologic studies missed it on one patient how many doctors failed to diagnose or misdiagnose and this could be out there for everyone to see i would think that company and maybe another one could make it mandatory for a major change to be incorporated. surgeries are done everyday and many people can ignore it but at one point their mother brother sister or child will need a surgery and as long as its in its current state a sponge a towel a clip anything can be left behind and with our methods of finding it that are in place good luck and once its not found right away even if the patient lives their life is changed forever and chances are they will be diagnosed with everything else but whats re4ally in there and a simple fix could be done to remove it unless its in there for a long time the surgery is more involved but instead of putting patients through sepsis and organ damage or involvement heart failure kidney failure etc from infection they say is not there....etc anyway i hope people get my point this is huge issue in our country right now how many people do you know that were sick after a surgery whether it was weeks months or even years and they never knew what was wrong???????""Dear Robin-- Well, obviously you have been through the mill with your health and also your children. And you are right that sometimes there seems to be nowhere to turn except to the media. I hope that the support you are getting here gives you at least the comfort of knowing you aren't alone and -- who knows? Maybe someone will have an idea or know of some leverage which could be used. I really appreciate your telling your story here. Thank you.""melissa, i have been to well over 200 doctors and no doctor has been able to figure out what's wrong with my abdomen. i went to every type of doctor i could think of. i even tried acupressure and i cut wheat, dairy and gluten out of my diet. i've tried everything but sell my soul to the devil and i still look pregnant. wearing maternity clothes is very dpressing; especially after five years as i'm sure you can relate to... i did not consider suing the doctor who left the sponge in since i ended up being ok after taking many doses of antibiotics. while giving birth to my second child (one of the ones who was abducted in 1998), i was given too much spinal block and i could not push my baby out or even breathe without oxygen. the doctor had to pull him out with forceps. we didn't know if he had any brain damage or not at first and the feeling didn't come back in my legs for a couple of months. very scary... i ended up back in the hospital. again, i ended up being ok and so was my baby so i didn't consider suing. my oldest son who is a write in new york now was run over by a police car while walking home from school when he was in the 7th grade. he ended up getting ok. i could have sued the city for all it was worth but didn't give it a thought. i'm not the kind of person who just wants to sue. but after being knocked out and having all of my healthy sex organs stolen... i'm the kind of person who just wants to sue. if i could get my organs back and get well again, i wouldn't sue. but, that's not the case. what was done to me is irreversible and it has disabled me for life in many ways; mentally, physically and financially. there is no way i can let this one go... i will be praying for you too. we are all on this site due to much suffering; either suffering ourselves or due to the suffering of someone we love.""Robin, I live in Ohio so I know what you are talking about. This is the organized crime capital of the midwest. Lawyers are only interested in accepting cases that will make themselves a bunch of money. Selecting cases has nothing to do with truth, merit , or justice. It is about money. Certain groups of people do not tally up enough ""damages"" on the scale lawyers use to determine what a case is worth financially: housewives, single over the age of 25 with no dependents, the elderly retired, prisoners, people on public assistance, etc. That is why doctors target people from these groups for their worst violations: we are essentially ""free kills"". Anything at all can be, and is, done to us because the doctors know something essential about our assigned place in life that we don't: no matter what they do to us there will be no consequences. Anything goes. Too, the lawyers get paid not to accept certain kinds of cases. It is free money they do not have to do a lick of work for. From what you have written about your case, it appears to me that your case probably falls into that category. Ohio has a Statute of Repose; until it expires the doctors will ""see nothing"" no matter what manifests.""you are exactly right about ohio being the organized crime capital of the midwest and about lawyers not taking cases unless there is big money and about doctors going after certain people. i agree with everything you said. i've personally seen it for myself. another thing i've learned about ohio is that it is mainly catholic. even the police dept. is catholic. the police near where i live when i'm in ohio came to my home last august and arrested me for being depressed. they said someone called them and told them i was depressed. since when is being depressed against the law? over half the country is depressed and on medication for it. i was taken from my own home against my will to middletown oh to the atrium. i went through pure hell for 24 hours. it's a miracle i got out. a doctor talked to me for five minutes and decided i was delusional; among other things and he tried to force me to take a very dangerous drug. my nurse told me to refuse it. she said that she knew there was nothing wrong with me (except mental 'injury'; not mental 'illness') and she and my social worker looked up my web site and articles about the taking of my children on the net and they went up against the doctor and forced him to release me. they helped me get out and they both thanked me for my web site warning othes about what's going on. my nurse cried when she thanked me because she said she had been praying for god to show her whether or not to have a hysterectomy. her doctor had been pressuring her to have one. my nurse was black and that's a group that is targeted for hysterectomies. she was my same age. she told me that meeting me was an answer to her prayer. so i guess something good came from my being in a living hell... i filed a complaint against the police dept. but it went nowhere of course. anyway, i know that something very strange went down with that whole ordeal. when they arrested me, i was fine. i told them that they could contact my doctor and he would tell them that i suffer from ptsd from what happened to me at mercy hospital in 2007. they would not listen to me even though i was rational and articulate, etc. they were determined to take me and they were cruel to me beyond reason. they would not let me change clothes (i was still in pj's) or take anything with me or even leave a note for my boyfriend and let him know what happened to me. he came home and saw my things and could not find me so he knew something happened to me. he called my mother in ky and she was worried sick of course. he ended up calling 911 and learned where i was. they would not let him see me though. i have seriously wondered if the police were told to do this to me. i truly believe all of my lawyers have been paid off due to my surgery taking place in a catholic hospital. i have been very outspoken about what happened to me and about how catholic hospitals are the worst offenders in regard to performing hysterectomies while they publicly pretend to be pro-life. if i told you what i've been through with my case since 2008 and how many lawyers i've been through, you wouldn't believe it. something is going on. that much i know. the atty in dayton who hasn't agreed to take my case did go to the hearing this morning. i looked online and saw where there is an august 20 date set to either dismiss my case or set it for trial. i have not spoken to the atty yet, so i don't know the details. he emailed me and said he planned to phone me tomorrow morning. i'm curious to hear what happened and what was said. i can only imagine what the judge in my case must think at this point. he's seen lawyer after lawyer come and go. from what i've been told by everybody in the legal world in ohio, i have the best and most fair judge i could have gotten. that's good but it doesn't help me if i can't get my case to trial:(""""He who passively accepts evil is as much involved in it as he who helps to perpetuate it. He who accepts evil without protesting against it is really cooperating with it"" - Martin Luther King Jr""Evil has no problem finding willing cooperators. Evil couldn't exist without its cooperators. When I first began researching this L.C. atrocity I was amazed at how many willing, dedicated, ice-cold cooperators there were. Some even reveled in it. What the cooperators don't know is that evil considers them the most disposable of all because evil knows that the same warped personality/character defects that make them willing cooperators with evil are the same defects that will cause them to change sides when the power base shifts. They are also the most easily replaceable...""Robin Karr: A well-known lawyer from Kentucky called me one day, said he had to be in Ohio for business and asked if, after his meeting was over, could he spend the afternoon at my house because he wanted to talk to me about something. He drove two hours to my house after his meeting. He told me a few interesting things but the most interesting of all was that Ohio is controlled by two mob factions: One controls from Columbus upward and the other controls from Columbus downward--organized crime divided the state in half and each faction has its own portion. One of the factions you have already mentioned. I believe what you have said about the police here because they have put me and my family through the wringer too. Sometimes a squad car will sit outside my house for hours at a time. Another time they arrested my son and extorted around $1,000. from us--money I had saved over a period of months to get something I needed. Long story. When I said ""bile duct injury"" in front of my surgeon for the first time he sent a psychiatrist pal of his into my hospital room, without my permission, and she verbally abused me and wrote up a false psychiatric report saying I was ""psychotic with somatic delusions""--something that cannot be determined in one short visit without proper testing. The liar. Then she prescribed a drug it is well-charted I am allergic to under it alternative label hoping I wouldn't recognize it. One of my associates was sent to prison for two years on trumped-up drug charges when she would not obey the medical mafia's order to shut up about a hospital killing her husband. I was told ""shut up or get locked up"" and only because an insider tipped me off months in advance did I manage to thwart a plan to have me arrested too on trumped-up drug charges. What you say about Ohio is true.""The sad thing is that we're not talking about a rogue pervert physician here and there. Rather, we're talking about an institutionalized psychopathic power trip that hints at the way conventional medicine is carried out across the United States and the world. It reminds me of the Milgram experiments where students were very easily trained to apply deadly levels of electroshock jolts to innocent victims merely because they were ordered to do so by an instructor. Those experiments served to substantiate that 70 percent of people will torture other human beings if encouraged to do so by someone in an apparent position of authority. A great book about evil and even 'group evil' is 'People of the Lie' by Scott Peck. We have seen throughout history via wars and the holocaust (for example) how entire groups of people will go along with evil. Why would the medical field be an exception?""Ohio has no laws, no actual laws--not for murder, not for anything. It is all a facade. A homicide detective told me this years ago but I didn't understand what he was talking about then. I do now. We only have fiat administrative codes. A signature makes the contract and gives them authority they did not otherwise have before; sign nothing.""i did not KNOW this about ohio but i felt strongly that i should not sign anything at the hospital before reading it completely. i read the consent form completely and realized that they had changed the surgical procedure i agreed to in my doctor's office two days prior. (that consent curiously enough is not in my hospital record even though there is a written note on it which says it was faxed to the hospital that same day). i refused to sign it. it's blank where my signature should be. and yet, they went right ahead and performed surgery anyway. they didn't even perform the surgery listed on the consent. they took out an extra organ. but who cares right?""by the way, i agree. sign NOTHING!""i went up against this same kind of thing in texas when my children were taken. i was arrested for crying in court. front page headlines the next day... the court-appointed psychologist said i was border-line retarded even though i graduated from college with honors. the judge presiding over my case started a rumor that i was a drug dealer. a local newspaper editor told me this. there was literally a whole group of court-appointed individuals who all attacked me in every way you can imagine. i was afraid and i wanted to run but i didn't. (you know tx if famous for killing people right and left via the death penalty). i began to document everything and i recorded conversations with these gov't people. finally, i gathered enough evidence that channel 8 in dallas was prompted to flew to ky and film my story. after my story aired on tv, the judge who took illegally took jurisdiction of my children was removed form office. i never wanted to go through anything like this again. then i met the surgeon who would change my life forever. once again, i find myself really too sick to fight. but, my personality is one that just won't quit. i have to speak out no matter what the cost to me personally. unfortunately, i find myself in yet another state which seems like the 'twilight zone'. i've lived all over the country but tx and oh are bad bad states to live in. i've written to governor kasich about tort reform and about what's going on in ohio with regard to medical malpratice, etc. his office says they are investigating my claims... i'm sure they are. not really... nevertheless, i can't say that the governor is not doing something about this issue if i can't at least show he knows about the issue. that is my reason for writing to him. at least tx warns people... all throughout the state, you see signs that say 'don't mess with texas'. believe me. they mean it. ohio doesn't have such warning signs. i found out about ohio the hard way. i know that the evil and greed which has taken over medicine is widely spread throughout the u.s. but there are some offenders worse than others i think...""Patients can anticipate being attacked, discredited and demonized.To avoid taking any responsibility for their errors, actions or behavior, doctors--and their governing bodies--will often employ the same tactics that communist countries use to quash political dissent. The patient will be labeled ""difficult"" or ""psychiatric."" Such pejorative labels are given to divert attention away from the negligent, incompetent or malpracticing doctor or doctors.In attempting to pursue justice through the legal system, patients often find that the door is closed to them. Additionally, doctors are protected by the government, as well as by their professional and legal associations. Patients do not have any protection. Because of the medical profession���s CODE OF SILENCE, the public is often unaware of physicians��� corrupt practices of covert rationing and blacklisting patients. Many patients are afraid to speak out about these abuses, because they fear RETALIATION by the medical community. Retaliation is a legitimate fear. It is imperative that there be legislation requiring full disclosure and mandatory reporting of all medical error, injury and/or harm to patients and that patients be informed of such and receive proper redress.""It is all one big happy ""club"". Doctors and lawyers are not adversaries no matter what mainstream media tries to project. Everybody has their hands in each others' pockets and work to keep the big money circulating at the top, within their own ""club"" membership. The ""club"" works to keep us outsiders under control and each part has its role to play: the lawyers/courts protect the doctors from consequences and in exchange the doctors don't use the lawyers or their family members for experiments, student training, drug testing and such. They place their own membership in key position in government. Mainstream media helps hide all their dirty-work. We are livestock to these people. They call us: ""cows--to be milked dry"" and that is what they do.""i was prepared for corruption in medicine after my experience with the family court system. otherwise, i think it would have taken me a lot longer to 'get it'. it is truly horrifying when you think about it. i try not to... i was totally prepared for the 'good ole boy club mentality'. unfortunately, not my first rodeo. the doctors and lawyers are not enemies by any stretch. they are laughing all the way to the bank. i agree completely elizabeth. @ kariann... the games have already begun in my case. just as you have described, i have already been called every name under the sun. they have brought up what happened with my two youngest children. and what exactly does that have to do with my sociopath doctor operating without medical indicatio or consent? of course it's my fault my organs were removed. my doctor went as far as to state when asked if he believed it was below the standard of care to operate on somone in the way he did in my case, he said 'on anyone else yes, but not her'. he then looked at me and chuckled. what an evil b*****d. it's my fault i showed up at the hospital that fateful day in september 2007. i get it. nobody forced me to walk through the hospital doors. that much is true. it's like hotel california though. you can check in but you can't leave. at least you can't leave until you have been destroyed in a variety of ways. best not to ever check in."I found in my records made up trash to try and make me look bad. This is the kind of stuff we are subject too once negligence has occurred."Something similar happened to me: a strange and unusually verbose entry that mischaracterized both the conversation I had had with the author of the entry and also falsified the facts. This entry was present in the medical records when I requested them several days after my daughter's death. However, the records weren't made immediately available. (In New York State, providers have ten days to act on any request.) The medical records clerk actually told me that all records had to go through a risk management office before being released. Really. And to what purpose? Pages weren't numbered in that section of the record, so a page could be inserted at a later time if someone wanted that to happen."so sorry martha for what you've been through with the death of your daughter and then with trying to obtain the 'real' medical records. that's so wrong..."Thanks, Robin. What was particularly fascinating about this is that I am a psychologist and have served on the Psychologist panel to settle disputes over medical records in NY state for many years. My training on access to patient records made me pretty effective in obtaining Millie's records for previous hospitalizations. If she was inpatient, we generally were able to leave the hospital with records in hand especially if follow-up care was needed (it often was) in another city. The important point, though, is that no one should need special training in order to persuade a medical provider to follow both state regulations and safe patient care.""Robin Karr, your comments here return to me during the time in my day I have to spare. Many of us have had the same patterns. I really appreciate and I am impressed your tenacity and determination at what you are doing in response to the injury and abandonment the doctors and the legal system have piled on you.""Marshall Allen my son is a MRSA Survivor. Here is the article published by our local paper, we were able to get Front Page. I'd like to talk with you more as we are trying to get a Bill pass here in Michigan for Hospital Acquired Infection Mandatory Reporting pass thru Legislation. We need reporters like you that can help us keep the awareness. I hope you call me 269363-6953http://www.heraldpalladium.com/news/local/an-end-tosilence/article_dfce31d4-fc89-50c4-b527-b6431d902464.html#.UAV2KXemr9k.facebook" "Skin and bone donated by relatives of the dead are turned into everything from bladder slings to surgical screws to material used in dentistry or plastic surgery. ""We are more careful with fruit and vegetables than with body parts,"" said Dr. Martin Zizi, professor of neurophysiology at the Free University of Brussels." "There is big money in human tissue. ""The Body Brokers"" was a famous series on the subject from the Orange County Register years ago. Funeral home staff has been in the news often in recent years for trafficking in human tissue removed for sale without consent. What people don't know is that tissue and organs removed at surgery is also sold to tissue companies. The ones who do not respect us and our rights in life will not respect us after we are dead either. No surprise there." "Yes, be certain about the origin and certificate of the bone grafting material a dentist may suggest is necessary prior to any dental implant procedure. It's a hard lesson to learn after the bone grafting fails.""my father died two years ago with a massive heart attack. he was not an organ donor. yet, my brother donated all of his organs - even his eyes. when i saw my father, he was unrecognizable. i will never be able to get that sight out of my mind. anyway, i wondered how my brother could donate his organs when my father was not an organ donor. i called a friend of mine who owns a funeral home and she told me that there is a law in most states now that requires hospitals to contact whoever in the state handles donor organs and let them know that they have a patient dying or dead. then, these people talk grieving family into donating organs. my friend told me that at least half of the people they receive at the funeral home now are missing most of their organs. i had no idea that this was going on until my father died. there seems to be no end to snatching organs in every way possible. this is so wrong. i will never forgive my brother for donating my father's organs. we have not spoken since the funeral. my poor mother is terrified that my brother will donate her organs. i have promised her that he won't as long as i'm around. it's really sad that my sick mom has to worry about something like tihis...""Here is a video on the subject below the article. One of the reasons I suspect that is possible for my medical malpractice, in which 1/2 cm of my nasal septum was removed, not part of the operation, and without my consent, is that it was donated or sold to someone else. http://www.dailymail.co.uk/news/article-2175006/Skin-bones-tissue-sale-How-deadused-grisly-trade-human-body-parts.html"what have we become? what is even more disturbing than the article are the comments... it appears that most people have lost sight of what's right and what's wrong. reminds me of 'situational ethics' which became popular when i was in college working toward a degree in education. nothing's absolutely right or absolutely wrong. it all depends on the situation. that's a dangerous slippery-slope..."As with so many things made, or kept, black and white, organ donation ought to be graded. As always, the terminology confuses from the start. So, we all ought to distinguish between various levels of donation from skin to organ, tissue, and body. Next, the sacred cow of donation ought to be finessed, with levels, perhaps only two: donation and sale. All these distinctions illuminate what controls would be required at the various levels.""What people are not told in those organ-donation pleas in the mainstream media is that the socalled brain-dead living organ donor is NOT ANESTHETIZED. They strap them down and cut. The donors squirm, grimace, show signs of distress and pain, pull away, etcetera. Those profiting write these responses off as insignificant and call them reflex but who really knows but the people it is being done to? People who are truly brain-dead would not respond to pain. Of course nobody comes back to tell. New Medicine's utilitarian ethic can justify anything, always seem to have a ready answer on hand. The nurses and such are debriefed after. The experience is so traumatic to some that they have quit nursing, suffer PTSD from what they witness. Hospitals collect placentas and sell them to the cosmetics industry. The plasma centers sell plasma to the cosmetics industry. So much goes on that the public is not aware of."criminal minds..."I left my comment in the Dailymail article, and it is this:The problem with money in harvesting body parts is this: A patient has become a financial liability due to medical error and malpractice. The choice is to save the patient and face the possibility of getting sued for the patient's brain damage or other medical injury, or let the patient die and thereby cover up the malpractice, and turn a financial profit by selling the body parts. Of course, the larger the profit the more likely the second situation will occur. For those naive people who think the morality of doctors is next to God and Christ, I've got news for you. Doctors have less moral development than average people do, and studies have shown this.""Garrick, pls cite the studies.""Garrick Sitongia: New Medicine's half-baked utilitarian ethic of ""eat what you kill"" supposedly cleanses them of wrong-doing when they turn their dirty-work to any kind of good after-the-fact. They believe this conscience-salving feel-good crap is just as good as having the restraint to not commit the crime in the first place. Left completely out of consideration is their victims, of course--the victim's rights, wishes, feelings, losses, damages, suffering. Anyone who thinks they can turn the heart of a sociopath is naive; these people are hard-wired with a ""me-first"" mentality that will not be denied. See, want, take...After we are injured another of New Medicine's half-baked utilitarian ethics kick in: ""you can't break what is already broken"". This ethic gives them blanket permission to use up, until there is nothing left, of the people they have injured and vacuum up as much of the victim's resources as possible.""Bart Windrum, Google medical school morality decline. Example:http://www.ncbi.nlm.nih.gov/pubmed/12668541""There was a case of a woman in California, I think, who woke up from surgery without her nose. Of course nobody present had any idea what happened to it. She claimed ""they stole my nose!"" but nobody seemed interested--it didn't happen to them.""At one point I noticed stories in the mainstream news detailing the number of doctors, nurses, and other medical professionals who, instead of just getting a divorce, would simply murder their unwanted or irritating spouse--I started collecting these cases and came to the conclusion that some people cannot reconcile the depersonalization skills they have learned and practiced in the workplace and then turn it off at home. At work if someone gets in their way they have blanket permission and support to abuse into submission the irritant by whatever means necessary and if nothing works, kill it. Eventually some lose the ability to compartmentalize home from work. In July of 2000 the problem of doctors killing their irritating spouses caused the Massachusetts Medical Society to send out information packets to its members offering free councelling. A friend of mine who worked in a hospital told me he knew a doctor who took in unwanted horses, not because he was an animal-loving humanitarian but because he would relieve stress by shooting them. I also collect information on Pavulon death clusters and the so-called ""mercy killings""--not what people are misled to believe. Deadly Depersonalization is an insidious and unpredictable process.""this is the problem. nobody is interested or gives a s**t unless it happens to them. this happens more than people would imagine. i get so many e-mails from women via my web site wherein they tell me how they wake up to learn that extra organs were removed; organs they did not consent to having removed. who cares? i remember after my surgery when i began contacting law firms, i was told by one lawyer that once you give a surgeon permission to cut you and go in for any reason, they can take any organ they want and there is nothing you can do about it. (of course she didn't even give me a chance to tell her that i did not consent to any surgery at all...). i hung up in total disbelief. much to my horror, i've come to learn that what she said is more than true. my friend who committed suicide a couple of years ago due to the aftermath of hysterectomy did so largely because they took organs she didn't agree to which caused much damage. due to nerve damage caused by a hysterectomy she didn't even need, she was going to have to have her leg amputated. that was the end for her. she killed herself. she could not lose one more piece of herself. she sent me her story to put on my web site before she took her life. sometimes i wonder how her doctor sleeps at night. he had been her doctor for 19 years. she trusted him... unfortunately, i'm guessing her doctor sleeps just fine." "@ Elizabeth... i know that what you say is true. i've read many accounts regarding how medical students are trained to do what they're told and what they 'have to do'. and, they learn to keep their mouths shut too. it becomes second nature. very scary but true. you can go on nurse blogs and nurse anesthesia blogs and read what they say to each other and you can clearly see this is what they become.""When a person signs a medical consent form only their signature is on it; the other party doesn't sign. This is called a unilateral contract. Type unilateral contract into your browser and look at what comes up--very educational. In a unilateral contract the person signing agrees to perform every word on that contract BUT since the other party did not sign they have promised NOTHING. We promise everything; they promise nothing. When we are admitted into a hospital we sign an admission form; since it was signed first it trumps anything else we sign while under their roof. On the consent forms there is usually a piece that says something to the effect of we give permission for the doctors to do ""whatever they deem necessary"". But they never specified ""whatever they deem necessary"" is necessary for US, did they? What if, on that day, they are training green residents and ""whatever they deem necessary"" is bringing in a green trainee who has never once performed your surgery and will be starting with you? Or that someone is doing a study of some kind and needs a snip of this or that? I know a man who went in for back surgery and came out missing one kidney and half a lung...I know another man with epilepsy who agreed to a ""brain biopsy"" and awoke to find they'd removed half his brain because the doctors were doing an experiment on that and knew if they told him up front what they really intended to do he would not have agreed to it. They also knew something he didn't know beforehand: that they would get away with it."i had a pituitary tumor when i was fifteen. i was referred to an endocrinologist in lexington ky. this doctor was a wonderful caring doctor. he told my parents that many doctors would opt to perform exploratory surgery but he said that he looked at me as if i was his own daughter. he said that brain surgery is much too serious to 'explore'. he opted to wait until a medication was available in the u.s. that would shrink my tumor. i was one of the first people in the u.s. to take this medication and it did shrink my tumor. i realize today just how 'blessed' i was to find a doctor like that. omg! i could have been operated on and i could have ended up a vegetable or worse. those doctors do not exist in conventional medicine today."I had one for a short while but he was in his 80s, old-school doctor who actually cared what happened to me. Then he died and the world lost one of the last real doctors it had left. He asked me to do what I am doing right now: expose them, tell people the truth. I have done what he asked me to do to the best of my ability."my doctor is dead now too. those doctors who took their oath to 'first do no harm' seriously are long gone. we have doctors now that take an opposite oath... 'first do harm'."I got my first taste of what kind of people are working in the health care system when my first child was born: she was born breech because she had hydrocephalus and spina bifida. Agonizing birth experience and the doctor used no anesthesia whatsoever for the cutting, not even a local. I am on the table moaning ""no, no, no..."" and the nurse starts laughing! Yes, laughing like a hyena and can't seem to stop. Like this is the funniest thing she has ever seen. Idiot. At the time I wrote it off to one person's craziness shining through but have since met many just like her--and worse.""omg elizabeth! that is so tragic. that nurse sounds purely evil. how cruel! hopefully, she will reap that. you stating that the nurse actually laughed hits close to home. the nurse who told me that i was in recovery after the surgery that was performed on me in 2007 stated very coldly 'you have nothing left' and walked away. i told my first attorney what she said and he didn't belive me. and, he told me not to tell anyone else what she said because it makes me look bad; not credible. he said people want to believe nurses care about us and that they are good. well... it is what it is. i want to believe in santa claus too. and your point is...""Hi Elizabeth Eugenia LaBozetta - I'm the social media producer at ProPublica. As you may have seen, someone flagged your story about med students beating dogs with hammers. We like to give everyone here the benefit of the doubt, but this isn't a place for unfounded rumors; it harms the constructive tone of the group. If you have any more questions, feel free to message me privately or email me at [email protected].""If the post offends people I will take it down (the part about the dogs). But I stand by the statement that it was a doctor who told me this. As for ""unfounded rumors""--I suppose anything any of us say here could qualify if the only criteria is that it offends someone and we don't have a video of the perpetrators actually performing the act we speak of. The Tuskeegee Syphilis Study was an unfounded rumor until the perpetrators themselves decided it was time to address it--decades after, of course, they'd already gotten what they wanted from the people they'd damaged. But I have a question here and would be interested in receiving an answer: why is it, when I have worked day and night for 20 years collecting concrete evidence of an atrocity of Buchenwoldian proportions (people used up training laparoscopic cholecystectomy)--supported in mainstream media and in the medical trade journals written by the perpetrators themselves no less, collected hundreds of victim's stories, and it gets no more than a yawn...but interest ignites when I mention dogs. Solid evidence involving people...nothing. ""Unfounded rumor"" involving dogs...NOW people are interested. Why?""ADA leadership opens MouthHealthy.org to answer their favorite dental questionsIf Americans want trustworthy information about their dentists��� electronic dental records, who can they turn to? One naturally assumes the American Dental Association would be a logical choice ��� arguably less biased than patients��� dentists who might have invested tens of thousands of dollars on their electronic dental records.""Today I visited MouthHealthy.org - the ADA���s new public-accessible website specifically intended for consumer questions about dentistry.http://www.mouthhealthy.org/en/aztopics/d.aspx When one searches ���electronic dental record,��� here is the sum total of what the ADA has to offer: ���Today, many dentists are making use of computerized systems to maintain patient dental records. Electronic records have great quality and patient-safety benefits.���The anonymous ADA employee adds, ���If you have a question about dental records, ask your dentist.���Dentists, as you can see, ADA experts appear to be surprisingly incapable of answering even basic questions about the safety of EDRs. So if a patient were to ask you, ���Are digital records more dangerous for me and my family than paper records? ��� what would you say? ADA leaders are telling them that you know the answer. So what is it, Doc?Let���s end anonymous leaders��� need for evasion. Deidentify EDRs now.D. Kellus Pruitt DDS""Unintended Conseq. dept. PPACA may hurt hospitals it was supposed to help. Safety net providers may have a tougher time. Mitch Katz weighs in too. My column today. bit.ly/Qd5UKU"A decent JAMA article ostensibly about hand disinfecting but actually about a countermeasure to medicine outsourcing its responsibilities to patient-families. http://jama.jamanetwork.com/article.aspx?articleid=1148155"Very interesting article, Bart. I think most patients can relate. I'd ask the nurse to wash her hands anyway, I think....": )"1. We like to think so, don't we?2. Wrong, wrong, wrong! Martine. The correct request is to ""disinfect"" not to wash. Language matters, everyone. It frames everything."...it's always the patient's faultYou're right Doug!"I've actually done it--took my daughter to pediatrician, pediatrician in with two coughing kids across the hall. She walked directly into our exam room. I waited for her to wash her hands. She didn't and went directly for my daughter. I stopped her. I asked politely if she would wash her hands before touching my daughter. There was eye contact between us for a second too long. She washed her hands. Was it worth the discomfort? YES!""M, thx for reminding us that it's not just in-hospital that matters, it's in any clinical environment.""When I received this from one of my Patient Safety colleagues today, I wondered...how many more articles will I read about asking health caregivers to wash their hands before they touch me or other patients. TONS of money has gone into the effectiveness of handwashing, and it alone will never stop infections. But, it is the #1 method and the easiest of all to help prevent them. It does not take an MD or a BSN or any other degree to know this. Yet, patients are still instructed to ""ask your caregiver to wash their hands?"". Asking that question can set a patient up for retaliation, anger or worse. Even if the request is from one healthcare colleague to another it is often not well recieved. IT IS THE RESPONSIBILITY OF CAREGIVERS TO DO THIS WITHOUT PROMPTING FROM ILL AND SOMETIMES IMPAIRED PATIENTS!How about this idea.....GREEN FOR KLEEN. If patients or their advocates started handing out $1 bills for clean hands....would handwashing compliance improve? Money talks, bacteria walks...on the hands of health caregivers.Suzan Gordon will be the keynote speaker at the 2012 Patient Safety Academy in Portland ME on Sept. 7. I look forward to meeting her.""Hospital asks judge to exclude testimony about former doctor's license revocation, criminal conviction http://bit.ly/LsDlr8"that's nice..."Thank you for establishing this much needed group, for myself personally, and for the million women who have contacted the HERS Foundation about medical abuse they experienced at the hands of doctors enabled by hospitals.""Just FYI. This bill would defund the part of CMS that funds the Partnership for Patients (the Center for Medicare and Medicaid Innovation mentioned in the article) and eliminate (so I'm told) the Agency for Healthcare Research and Quality, which is identified in the Affordable Care Act as the agency that is supposed to work on quality and patient safety improvement as the law (""Obamacare"") is implemented. Go figure.""Your daily vote/comment/Twitter/'like' until August 4, powers my advocacy for safer implanted medical devices. Many thanks! http://bit.ly/PakhxV""I recently filled out a Patient Harm Survey on behalf of Millie Niss, my daughter, who died of an undiagnosed spinal infection in a community hospital ICU while recovering from Swine Flu, November 29, 2009. Millie was 36 years old and had been chronically-ill with Behcet���s Disease for many years. Behcet���s is an inflammatory disease that attacks blood vessels anywhere in the body. Behcet���s is rarely a fatal disease, but treatments often leave patients immune-suppressed and vulnerable to infection.But Millie was not defined by her illness, although her illness, with its unpredictable emergencies, did teach us to be patient advocates. Millie was primarily a web artist and poet, widely published, and we often collaborated on installations.So when Millie���s rheumatologist, who was not involved in caring for Millie at our local hospital, reviewed Millie���s autopsy report with me several months after her death, both he and I were astonished to discover ��� actually, I was devastated to discover ��� that Millie���s actual cause of death was a spinal infection that had gone undiagnosed, and hence, untreated. Had it been discovered, it was a treatable infection.My book, The Last Collaboration, began with that revelation and was undertaken as the book Millie would have written, had she been here to do so. Millie���s notes, emails, treatment logs, and conversations are a prominent feature of this multimedia fatality review. About me: I am a retired psychologist with experience in governance and social action ��� and a full-time writer and poet. Member of Consumer Union���s safe patient advocacy network. Further description and excerpts of The Last Collaboration are available on the website Millie began in 2001 and that I continue: http://www.sporkworld.org/Deed/tlc.html""I'm looking forward to checking out the book, Martha Deed!""Thanks, Marshall and Robin. You and many others, I hope [smile].""as i researched the drug 'versed', i came across a nurse anesthesia blog site at www.nurse-anesthesia.org it's quite the eye-opener. everyone should go on the site and read what these anesthesia nurses have to say about their patients. i suggest going to one place in particular. Type in 'Crazies' in the search box. then click on 'Crazies' thread. you will find that these nurses joke about wanting to 'smack their patients in the head since they won't remember it anyway' and they joke about 'wanting to use duct tape on patients' and also about 'placing a pillow over their patients face and pushing down"" after reading just this one blog site about those who administer anesthesia, i won't be going to any hospital again for any reason - at least not voluntarily.""There have been many published cases where women (and men) have been molested and raped when under anesthesia; I am sure many more go unpublished. One of my friends who worked in a hospital told me this one doctor used to call his name as he was passing by, then would flip down the draping on anesthetized/sedated women and flash their breasts real fast ""as a joke"". Then there is always student pelvic and rectal exam practice, without informed consent, on anesthetized patients: students line up, gloves on, and one after the other violate your privacy and practice exams you never consented to. Depersonalization reduces patients to an object and as it slips down the slope people stop asking the question: ""Is this the right thing to do?"""i have decided that m.d. stands for 'medical degenerate'And it is only going to get worse. http://opinionator.blogs.nytimes.com/2012/07/14/dont-get-sick-in-july/"The administrative law judge initially recommended that the surgeon���s medical license be revoked but instead placed the surgeon on administrative probation for three years. The surgeon had at least eight medical malpractice claims filed against him from September 2009 to May 2012. Also unknown to the woman was another case in which the Medical Board of California, through the findings of an administrative law judge, decided that the surgeon had committed gross negligence, had failed to maintain adequate and accurate records, and had failed to obtain the written consent of a 66-year-old woman before removing her uterus."YET ANOTHER PROBATIONER DOCTOR THE MEDICAL BOARD REFUSED TO ADEQUATELY INFORM THE PATIENT ABOUT AT THE PLACE OF TREATMENT...SHE WOULD HAVE CHOSE SOMEONE ELSE IF SHE HAD KNOWN THIS DOCTOR HARMED SEVERAL PATIENTS AND A JUDGE STATED HE REPEATED A GROSS NEGLIGENT PATTERN."I check the license of every doctor I see AND I Google them. This won't always protect us, but it's the best we can do right now. I think it's a shame we cannot see who has had complaints filed against them via the medical board, even if they were found to not have done anything wrong. I think a pattern of them would be quite telling."I checked my former dentist's license too but the Dental Board failed to post his Probationer Dentist status and I'm now on surgery 5 still trying to work on his repeated gross negligent pattern - the suggested treatment this time is remove some of my hip bones to replace bone and teeth.The bottom line is if you are going into surgery its at the place of surgery/treatment that adequate/proper notification should be provided prior ot signing an Informed Consent Document...we don't have surgery or treatment on a website or over the phone so its ridiculous a fact sheet isn't at the place of treatment if the Board is placing a dentist on probation for harming several patients with a pattern.I found out the doctor who did my csection and left this foreign body in me had 29 counts of malpractice against him and he is the chief of the department"Those titles (chief or head of the department) mean nothing as far as quality goes, just like it doesn't matter where they went to med school. Those titles are all based on internal politics, not anyone's skill as a clinician."I know now it means nothing as far as skill and quality......to make it worst I just had a chief of a hospital 9 months ago say he was going to go in remove the foreign body clean it up etc I got sick again after the surgery we found out he went in for an hour removed a clip never took the foreign body out the scans show the two areas that were in there before he went in are still there it was like oops I forgot or I couldn't reach it but now you are on your own too bad.....a chief at a major hospital? I just don't get it and yes the politics are worst because they are being protected for their title it's like a free pass to do what's want.....for my daughters sake I am determined to find a good surgeon who is willing to do the right thing and help me and more importantly the skill set and ability.....doctors in two other countries have the knowledge and offered to help but due to my health I can't make that far of a trip and he's not licensed to operate in the US it's just sad the difference between our doctors and other countries."One other thing....why aren't hospitals expected to have a doctor on staff in intensive care units, 24 hours a day?""Umm in this country they do, they dont have to be in the room itself but certainly within the confines of the hospital. so can be in the unit within 1-2 min"There is a difference between acute care hospitals and long-term acute care hospitals."I am specifically referring to acute care hospital intensive care units (medical and surgical) where a doctor is not required to be on staff and working the shift with nurses. These units have the illest patients. It is where a doctor should be all the time. As a result, nurses make huge life changing decisions constantly. And, especially during the midnight shift, they hate to call the doctor at home to wake them up...So, many are resistant to make late night, early am calls. I think a doctor should be a part of the full time staff 24 hours a day on every intensive care unit. What do you think?""As an RN who worked ICU for 20 years, most of them on the night shift, I always had a physician in house if I needed them. Critical Care nurses are trained to notice subtle changes and act swiftly to intervene and contact the physician with those changes. Most physicians that I know hold Critical Care nurses in the highest regard because they are so knowledgeable and experienced.""Yes, I totally agree with you, and I am absolutely positive one of the critical care nurses saved my father to live at least another week. Plus there was a great team of other professionals there as well, including respiration therapists, people from the labs, and some other experienced nurses who all did an amazing job. But, that wasn't the case everyday. And when the not so good nurses were there, and there were a number of them, I felt my father was at high risk for dying. I am just saying a physician should be an active and integral part of the staff in any ICU 24 hours a day. The ICU's require constant and intensive response to critically ill people. I don't think it is enough in a hospital to know you can call a doctor from somewhere else. There is always a doc in the ER,...there should always be a doc in ICU, 24 hours a day....as a procedural requirement.""Choose a hospital with 24/7 intensivists or at least hospitalists - and not a student, intern or resident as a fill-in.""Keith and I discuss the danger of electronic dental records to patients on Dental Geeks Linkedin group:I���ve been beaten up on the internet enough to be aware that few dentists ��� especially those who have invested in electronic dental records ��� are ready to consider that HIT in dentistry was poorly planned. I contend the naivety is not the fault of colleagues who actually treat disease. It���s the fault of well-meaning leaders who hastily grabbed stake in the popular EDR ���mandate��� - basing reckless decisions on the future of dentistry on political correctness and CDT royalties rather than common sense and the Hippocratic Oath.""Long ago, Ponemon Institute studies began revealing the growing number of data breaches from providers��� offices. Perhaps because of leaders��� pride and/or investment of careers into HIT, they resist transparency about the products they promote. In the absence of a trustworthy source of information, pervasive vendor-friendly bias makes my opinion very unpopular on a (decreasing) number of dental industry venues. It���s also why your assumptions concerning EDR security are wrong, Keith.���The only thing a thief could want from a dental chart would be the financial information. If you have a password protected system and all the other safeguards in place this should be almost impossible for someone to steal.���Impossible to steal? Ponemon estimates that 96% of healthcare organizations have experienced reportable data breaches in the last two years. Between 2010 and 2011, the number of breaches doubled, and may double again by the end of 2012. Medical identities go for $50 each on the black market while financial identities only bring $5. This means thieves are targeting health insurance coverage. And when a medical history is altered to suit an imposter, it can easily put the victim���s life in danger.���With paper records someone simply has to break into the office and copy that info down from records.��� Identity thieves of course prefer digital over paper. For one thing, nobody has to decipher bad handwriting before entering it on a computer. Secondly, filing cabinets make far more noise than hackers. What���s more, if a burglar steals a computer from a dentist���s office, passwords are no better protection than the Maginot Line.���The biggest problem in our area has been vandalism of the office after the thief did not find money or drugs(what most of them are after) Imagine coming in to the office and having a couple thousand charts tossed around the office.��� That���s the first time I���ve heard that one. Don���t forget the danger of paper cuts.���With the electronic record if they did steal this information there is a good chance of knowing which records were accessed and when, you can not look at a paper chart and tell this.��� When a computer is stolen, usually ALL the dentist���s patients are instantly involved. Once again, nobody steals paper dental records.James Pyles, a widely-respected attorney who has fought for patient privacy rights for years was quoted in a FormTek.com article yesterday. He describes the difference between paper and digital: ���We now have electronic disclosures of patient privacy that are entirely different from disclosures of paper records. You can get a paper record back; you cannot get an electronic record back. You can disclose millions of electronic records simultaneously; you cannot do that with paper records.��� http://www.formtek.com/blog/?p=3099Want a solution? De-identification of EDRs is far better than even encryption. If dental patients��� identities are not present in a stolen computer, nobody has to be notified, and a computer is all it costs ��� not lawsuits, HIPAA fines and one���s reputation in the community. Once we take ownership of our blunders, corrections can be made and we can move toward safer, real advancements in dentistry. Remember: Patients��� unnamed dental histories have no black market value. D. Kellus Pruitt DDS""From ProPublica's charts is a $9.69 billion reminder (just since 2009) of fraudulent pharmaceutical activities - that the AMA and FDA will *never* be capable of policing their own ranks. From Natural News, another source in addition to ProPublica wrote, ""According to court documents, GlaxoSmithKline had actually developed a network of 'speakers' (i.e. primarily doctors receiving kickbacks for writing prescriptions) totaling 49,000."" There's systematic patient harm for you." "For more on this topic, check out ProPublica's Dollars for Docs project. http://projects.propublica.org/docdollars/. The stories detail the influence of the drug industry and the database allows patients to look up the $761 million in payments and gifts made by 12 pharma companies to doctors.""Thanks, Marshall. Very helpful!""Notes from the Waiting Room���The BookThe experiences of my patientfamily backstory lead me to recognize and espouse a different view, or type, of harm beyond medical error. Our ~6 weeks in hospital with my folks dying were filled with what I came to characterize as extrinsic shock and harm. ���Extrinsic��� means ���not part of the essential nature of something.��� In other words, a loved one���s dying is intri