State of Healthcare in the US

[Wino]

Hard to believe the State of Minnesota does not revoke this doctor's liscense.

MINNEAPOLIS – A urologist has been indefinitely barred from inpatient surgery for removing the wrong kidney of one patient and taking a biopsy from another's patient's pancreas instead of a kidney. Dr. Erol Uke has signed the disciplinary ruling from the Minnesota Board of Medical Practice, agreeing that his actions justify the board's discipline.

The ruling said Uke could regain surgical privileges if the board later determines he's competent to do so.

The Star Tribune reported the ruling did not say where the errors happened, just that Uke removed the wrong kidney in March 2008 and performed the erroneous biopsy about four months later.

Uke declined comment when reached at home by The Associated Press.

http://news.yahoo.com/s/ap/20100117/ap_on_fe_st/us_odd_wrong_kidney_removed

[Beer Chang]

When I had some minor knee surgury in the States, about three or four different docs and nurses asked me whether it was my right or left knee. The surgeon informed me, not to worry, that's their procedure.

[Wino]

I bet this patient wishes the doctor and nurses would have asked him which kidney was bad. This doctor must have had some major problems in his life.

[lvdkeyes]

After the lawsuits are filed and money is paid, I am sure his malpractice insure will be raised so high he won't be able to afford it, which will effectively prohibit him from practicing medicine.

[Beer Chang]

The constituency that gets ignored in the healthcare debate are those living abroad where very often medical insurance does not cover one overseas.

[lvdkeyes]

Right BC, including those of us who had paid into Medicare from inception and now can't use it overseas.

[Wino]

This doctor's malpractice insurance will be sky-high, but I would feel better if the state would pull his liscense.

[Bob]

When I had some minor knee surgury in the States, about three or four different docs and nurses asked me whether it was my right or left knee. The surgeon informed me, not to worry, that's their procedure.

It absolutely is their procedure and required to double and triple check that they're going to operate on the correct knee. If your answer was any different from what their records showed, there would have been a grinding halt until that was straightened out. And it's also standard procedure for them to use a dry marker and write on the correct knee something to the effect "yes, this is it" and on the other something to the effect of "don't even think about touching this one, you bonehead!).

The various people didn't ask because they didn't know.....they were just trying to make sure they knew 100%.

[Bob]

Most surgeons are very capable guys and the vast majority of surgeries are properly done.

But, it doesn't make good news to print: "200 successful surgeries" were done at "x" hospital today." So, what they print is the odd bad one (yea, there are stupid and incompetent surgeons out there) and, because that's about all we see in print, one gets the false notion that the incidents of medical malpractice are more common than they actually are.

Sorta like reporting car accidents in my dinky city. They report the two accidents - they don't report anything about the 200,000 safe trips made that day. Human nature.

[Beer Chang]

The various people didn't ask because they didn't know.....they were just trying to make sure they knew 100%.

I know and a damn good idea!

[Wino]

Bob stated, "Most surgeons are very capable guys and the vast majority of surgeries are properly done."

There are just a few bad apples that spoil the whole bunch. Plenty of good surgeons around but some bad. I wonder how many surgeons push a patient towards a surgery in which they could do without?

[Bob]

I wonder how many surgeons push a patient towards a surgery in which they could do without?

I'm sure it's happened but I've not known of a case personally. I suppose circumcision might be an example of an operation (albiet, small) that we don't need but it's not the surgeon pushing for it.

Most surgeons follow protocalls that suggest you operate if "X" happens or if "X" is the condition. But I'm sure a few don't (and/or screwed up the diagnosis in the first place).

When I was working as a law clerk in a big firm during law school, I reviewed about 50 files involving defense of medical malpractice lawsuits. And, to be honest, every single case I (Mr. Fairly Ignorant About Medical Issues) was convinced right away that even I knew better not to do what the dumbass surgeon or doctor did. Two examples only: you simply don't leave a pair of pliers in somebody's chest or you don't take out his kidney when he's there to get his appendix out. Oh, and you don't sexually fondle a patient on the operating table or during a physical examination in your office.

None of the lawsuits I saw involved somebody suing a doctor or surgeon just because the result was bad or because the doctor or surgeon didn't do a perfect job. All involved things that any reasonably intelligent non-medical person would have known not to do.

[Wino]

I know of a case in which a cardiologist did a procedure on an 86 year old woman. A camera was placed through the groin to the heart to look for blockages. She had an advance directive stating she wanted no extraordinary procedures. The woman made the mistake of saying to this asshole doctor, "I can't take being tired and short of breath anymore." He took this as voiding her advance directive and did the procedure. She coded on the table. She was on a ventilator for ten days until the niece convinced the hospital to discontinue it. She died shortly thereafter.

[Bob]

I know of a case in which a cardiologist did a procedure on an 86 year old woman. A camera was placed through the groin to the heart to look for blockages. She had an advance directive stating she wanted no extraordinary procedures. The woman made the mistake of saying to this asshole doctor, "I can't take being tired and short of breath anymore." He took this as voiding her advance directive and did the procedure. She coded on the table. She was on a ventilator for ten days until the niece convinced the hospital to discontinue it. She died shortly thereafter.

I'd bet a nickel (or more) that the old lady and at least one of her relatives signed written releases which pointed out the obvious fact that any medical procedure on somebody that age is dangerous and could be fatal. That alone, of course, doesn't excuse bad judgment by a doctor or surgeon (but, frankly, I don't know if we know enough about the case to make a good judgment about that).

I've known people (people who were long-time friends and not mere passing acquaintances) that have had elective surgery well into their eighties and, while most of them turned out well, I too wondered at the time if the danger outweighed the possible benefit. But, you know, as long as I'm semi-competent, I sure as hell hope that I can get a doctor to do what I want done when I'm 80 or 90 too (and damned the consequences!).

[Beer Chang]

I wonder how many surgeons push a patient towards a surgery in which they could do without?

I think in case where it's really 50-50 whether the surgery is the best option some surgeons will be clouded ny self interest.

A dentist once encouraged me to have wisdom teeth removed despite my not having any problems with them. I declined and years later still no problem. Had they been removed there'd also be no problem but the dentist would be richer.

[Wino]

I think sometimes doctor's self-interests cloud their judgement. I had a dentist say I needed a root canal even though I had no pain or problems with the tooth. Maybe he was behind on his mortgage payment?

[Beer Chang]

I think sometimes doctor's self-interests cloud their judgement. I had a dentist say I needed a root canal even though I had no pain or problems with the tooth. Maybe he was behind on his mortgage payment?

I had the opposite experience as I kept complaining to my dentist about a particular tooth and he told ne there was no problem. Turned out the tooth eventually degraded and I needed an extraction and a very expenisve implant rather than a simple root canal.

In fairness, I did not push the dentiat too hard as he told nme what I wanted to heart which was no root canal.

[Beer Chang]

One big problem with USA medical insurance is that an unhealthy American is covered as long as he stays at his job but if he leaves he's only covered under COBRA for 18 months.

Being trully insured means you'll always be covered.

[Wino]

Even some employed US citizens are not covered. Seems you need to be employed by a good-sized company, have a COBRA policy, or poor enough to be on medicaid.

[Bob]

Even some employed US citizens are not covered. Seems you need to be employed by a good-sized company, have a COBRA policy, or poor enough to be on medicaid.

Correct.....although I trust you know that Cobra only applies in those situations where a company has 50 or more employees (the vast bulk of the small businesses in the US have less than 50 employees) and the company provides health insurance (and, as noted, not all do).

And Cobra really is only for those with a significant pre-existing condition. Cobra, when it applies, allows an ex-employee to continue the coverage for 18 months but at the single-payor rate (a cost that is much higher, often double or more, than what the employer had to pay for the same coverage). So, if you're fired while you're getting cancer treatment, you really have no choice but to pay the higher rate for the continued coverage (for 18 months anyway) as no other company will cover you for your pre-existing coverage. So, effectively, Cobra coverage is only worthwhile for those with pre-existing conditions (other than that, the terminated employee can usually find cheaper or more suitable health insurance coverage elsewhere).

[Wino]

I always thought COBRA was your same insurance you had while employed, but you pay the total cost of the policy.

[Beer Chang]

I always thought COBRA was your same insurance you had while employed, but you pay the total cost of the policy.

That's correct. But COBRA is meant to be a convenient short term gap between jobs. Insurance that only lasts for 18 months needs to replaced because insurance that expires has limited value.

[Bob]

I always thought COBRA was your same insurance you had while employed, but you pay the total cost of the policy.

Yea, it's the same coverage but you pay for that coverage as if you were a single-payor (one person) policy - which is why the "Cobra" rate is so much more than what the employer paid.

[Beer Chang]

What I was paying for Cobra was reasonable but not being guranteed renewable diminshes its value.

[Wino]

In certain circumstances, I think Cobra is extendable beyond the 18 months.