Medical Malpractice -- Hospitals Are Killing Us

It sounds as if Dr. Marty Makary, a surgeon at John Hopkins Hospital is fed up.  His new book, "Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care", published by Bloomsbury Press is essential reading for physicians, patients, hospital administrators and anyone who cares about health care in the United States -- yes, it should be read by everyone.

Dr. Makary writes:

"When there is a plane crash in the U.S., even a minor one, it makes headlines.  There is a thorough federal investigation, and the tragedy often yields important lessens for the aviation industry.  Pilots and airlines thus learn how to do their jobs more safely.

"The world of American medicine is far deadlier:  Medical mistakes kill enough people each week to fill four jumbo jets.  But these mistakes go largely unnoticed by the world at large, and the medical community rarely learns from them.  The same preventable mistakes are made over and over again, and patients are left in the dark a bout which hospitals have significantly better (or worse) safety records than their peers."  (emphasis added)

There are a lot of amazingly talented and caring people in the medical care field.  However, as our "medical care field" has turned into the "medical care industry", we have noticed that the industry is more involved in profit-taking and salary than in the patient.  Physician visits where you have to wait over an hour to be seen is all about the maximization of visits to make more money.  Going to a hospital emergency room and waiting many hours for treatment means that the hospital has decided to devote minimum resources to the Emergency Department -- usually visited by people on Medicare and uninsured people and the poor.  Sadly, for the medical care industry it is about the money and quite often, the patient is not viewed as a person in need of treatment, but instead the patient is viewed as a commodity.

98,000 people die each year from medical errors.

U.S. surgeons operate on the wrong body part as often as 40 times a week.

About 25% of all hospitalized patients will be harmed by a medical error of some kind.

If medical errors were a disease, they would be the sixth leading cause of death in America just behind accidents and just ahead of Alzheimer's.

These statistics, provided by Dr. Makary in a recent Wall Street Journal article are chilling enough from a personal safety side.  But Dr. Makary also goes on to note that "...medical errors cost the U.S. health-care system tens of billions a year.  Some 20% to 30% of all medications, tests and procedures are unnecessary, according to research done by medical specialists, surveying their own fields.  What other industry misses the mark this often?"

As long as our medical professionals practice a "closed-door culture", things are going to get worse.  There are two basic reasons that physicians practice this conspiracy of silence when it comes to failing to report or criticize, (let alone self-report or self-criticize) the medical errors of other medical care professionals, (or of themselves.)

The first reason:  Doctors do not like criticizing other doctors.  If they do, quite often they are professionally ostracized.

The second reason:  Medical Insurance Companies who insure doctors -- who are supposed to compensate injured patients when they are injured by the carelessness of a physician -- frown on doctors who report the malpractice of other physicians.

The medical care industry is letting money and insurance run the show.  It is time for change that places the care of the patient first.  There are a lot of great doctors and medical care professionals who do just that.  But there are a lot of professionals in the medical field who won't touch a Medicaid patient nor an uninsured patient.

Are Car Accidents Going to Become A Thing Of The Past?

According to the Wall Street Journal's Monday section, "Innovations in Transportation", the average licensed driver covers 12,700 miles each year, spends about 18 and one-half hours in the car each week and cannot stop being distracted when they drive.  18% of all injury accidents involve distracted drivers.  Moreover about $300 billion dollars is the approximate costs associated with automobile accidents.

And the average time a driver's eyes are off the road is 4.6 seconds.  Lets do the math.  A car travels one and one-half its miles per hour in feet per second.  So, if I am going 50 mph, I am going 75 feet per second.  If I am going 60 miles per hour I am going 90 feet per second.  So, when a person texts, they are travelling almost, on average, 375 feet along the highway, only they are not looking at the highway!  That is fifteen feet more than a football field plus the end zones of the football field.

Coming down the road, surprisingly soon, is the "driverless car".  According to Dan Neil, the automotive critic for the Wall Street Journal, "BMW's TrackTrainer -- an experimental 330i sedan bristling with machine-vision equipment -- uses GPS, track maps and telemetry recorded during a professional driver's model lap to negotiate a racecourse.  "

In his article, Neil opines, "By the time this technology is commercialized, robotically operated cars will be safer, probably a lot safer, than manually operated cars.  Autopilots will never get distracted, sleepy, lost, angry.  There reactions will be instantaneous and in an emergency always the right one.  They will always signal when changing lanes, never tailgate."  So that means that the people who will continue to drive manually operated cars will be less safe.  I wonder how long it will be, then, before the government REQUIRES the use of the driverless car.

Apparently, these cars are inevitable.  About 68% of those polled thought that the driverless cars were a good idea while only 31% felt that the "driverless car" was a bad idea all the way around. 

My wife, however, claims to have already experienced a "driverless car" -- every time I am behind the wheel!

Poverty

Poverty thresholds are determined by the US government, and vary according to the size of a family, and ages of the members. In 2010, the poverty threshold—known more commonly as the poverty line—for an individual was $11,139. For two people, the weighted average threshold was $14,218. Three people: $17,374; Four people: $22,314; Five people: $26,439; Six people: $29,897;Seven people: $34,009; Eight people: $37,934; Nine or more: $45,220.

In 2010, 46.2 million people lived in Poverty USA, up from 43.6 million in 2009. That’s means the poverty rate for 2010 was 15.1%, up from 14.3% in 2009.

2010 marked the fourth consecutive annual increase in the number of people living in poverty. The poverty rate, or percentage of the overall population living in poverty, has steadily increased as well, up to 15.1% in 2010 from 12.5% in 2007.  The number of people living in poverty in 2010 (46.2 million) is the largest number seen in the 52 years for which poverty estimates have been published.

Poverty does not strike all demographics equally. For example, in 2010, 21.7% of men lived in Poverty USA, but 24.1% of women. Along the same lines, the poverty rate for married couples in 2010 was only 6.2%–but the poverty rate for single-parent families with no wife present was up to 15.8%, and for single-parent families with no husband present over 31%.

Between 2009 and 2010, the poverty rate for people living with a disability rose from 25% (in 2009) to 27.9% (in 2010). That’s 4.2 million people living with a disability—in poverty.

In 2010, 22% of all children lived in Poverty USA—that’s over 1 in every 5 children.  In 2009, the National Center on Family Homelessness analyzed state-level data and found that nationwide, 1.5 million children experience homelessness in a year.

In the North Country, Franklin County's poverty rate is 14.4%.  In St. Lawrence County it is 16.9%.  In Clinton County it is 13.3%.

Thinking about the poor is something our government shies away from.  Doing something about the poor is something that we have put on auto-pilot:  Food Stamps, Social Service Assistance, (also known as Welfare), and other public assistance programs.

16.4 Million children living in the United States of America are poor.

It is not just the current state of the economy.  The real problem is how we feel about the poor and giving to them from the surplus.  And, there is a lot of surplus.

16.4 million kids in the United States of America are poor.  If only we had the will to change this.

It's Getting Rough Out There

Question:  How many lawyer jokes are there?
Answer:    Three.  The rest are true stories.

The New York Law Journal on August 23, 2012 gives a little bit of credibility to a lot of the jokes we hear about lawyers.  Clients going through the legal system for do, in fact, have a lot of things to justly criticize.  However, without sounding too much like a cheerleader for the profession of law, for the most part attorneys are pretty great people. They get the job done in workman-like manner; are professional and caring people and quite often are intensely involved in community organizations. But there is that handful of jerks out there that make the rest of all attorneys cringe and become frustrated at how just one idiot attorney can wreck the reputation of the entire profession.

So, here's a brief summary of why I SHOULD NOT have picked up the law journal on August 23rd:

First story:  "A Family Court judge who abruptly resigned in April should be prohibited from holding judicial office again in New York after he acknowledged having sexual contact 40 years ago with his 5 year old deaf niece, the State Commission on Judicial Conduct recommended in a determination released yesterday."  It actually is a bizarre story if you get to read it.  Apparently this sexual contact is alleged to have happened in 1972.  The girl is now 45.  Apparently, the mother of the girl is the sister of the Judge's wife.  The mother of the girl was wired by the DA in Onandoga County, (NY) but recorded in Boulder, Colorado where the mother of the 45 year old victim lives. 

Second Story:  "A State Judge who says he was assaulted by a police officer is accusing the Queens district attorney of orchestrating a cover-up after the prosecutor announced yesterday he will not file criminal charges against the officer who allegedly hit the judge and assaulted a homeless man.  'Everything they say is a lie," Queens Supreme Court Justice Thomas Raffaele said...".

Third Story:  "Employment attorney Matthew Bilt has filed a defamation suit against an adversary who claimed in open court that Bilt files frivolous suits against high-profile figures to extract money from them in a 'shakedown'. "

I am glad that I practice law in St. Lawrence County, Franklin County and Clinton County.  The population of jerks per attorneys is, for some reason, quite lower than downstate.  We do, however, have our share, and you know who you are, but for the most part the attorneys that we deal with, by and large, want to get a great job done for their clients and conclude the matter with the least trauma to the client.

Santa Claus, the tooth fairy, and honest lawyer, and an old drunk were walking along when they simultaneously spotted a hundred-dollar bill laying in the street. Who gets it?
        The old drunk, of course, the other three are mythological creatures!

See...  I love lawyer jokes.

AND

Pedestrians and Cell Phones

There is little question that texting or speaking on a cell phone while driving a car is a hazard.  But the August 2012 Consumer Reports issue speaks to an issue I had not thought about a lot. 

"In a new survey, Consumer Reports found that 85% of Americans had in the past six months seen someone use a mobile device to talk, text, e-mail, or use apps while walking in public.  Of those who had witnesses such behavior, 52% felt that the pedestrians endangered themselves or others."

The article goes on to say that over 1,500 "nonmotorized people", (I guess there are motorized people...), were hurt nationwide in 2010 while distracted by cell phone usage.

According to researches at Stony Brook University of the SUNY system, cell phone using walkers had "significant reductions in gait velocity and an increase in lateral deviation."  In other words, they walk goofily slow and zigzagged distractedly toward whatever destination.   The Consumer Reports article noted that the SUNY Stony Brook study, "...was announced in January -- a few months before a California man nearly walked and texted his way into the arms of a black bear."

As reported by the Daily Mail:

"TV helicopter crews managed to capture an oblivious phone user walking into the path of a 250kg black bear. The video shows the homeowner calmly walking towards the giant animal, engrossed in his mobile.
However, just feet before he reaches it, he notices the huge bear - and turns and runs in the nick of time.
Residents of La Crescenta, California, were warned to be on the lookout for the bear, which was only finally contained in a back garden hours later. Los Angeles County sheriff's deputies received a call of a bear sighting yesterday, KTLA-TV reported.
La Crescenta station sheriff's deputies and the Glendale Police Department responded, according to sheriff's Sgt Mark Slater.  "We did locate about a 500, 600-pound bear in this immediate area,"Sgt Slater said.
"He's been wandering through the residential area for the last several hours."  "Department of Fish and Game is en route," Mr Slater said.
"They have ultimate responsibility over it. Our role right now is if the bear is docile and just hunkering down, we'll let him continue that until Fish and Game gets here."
A police helicopter has been tracking the bear, which is believed to be the same animal that broke into a garage and pried open a refrigerator to snack on some frozen meatballs last month."

The video, which is a riot, is at http://www.youtube.com/watch?v=9Bjhjk2hHZU 

Car Accidents and Medical Bills

New York State, many, many years ago, adopted a plan to provide for mandatory medical insurance for people who are occupants of a motor vehicle or pedestrians struck by a motor vehicle.  It is called "No-Fault" Insurance.

The reason it is called "No-Fault" insurance is because, we are told, the fault of the person in causing the accident does not, in most cases, prevent the driver, occupant or pedestrian from having his medical bills paid by the insurance company that insured the vehicle that everyone is riding in.  You don't have to chase down the person who caused the accident and find him and sue him and win a judgement against him.  No-Fault insurance was designed to simplify the process.  If I am in an accident, the car that I was driving or in which I was a passenger, (or if a pedestrian, the car that hit me), must be insured.  Part of the insurance MINIMALLY must provide up to $50,000 coverage to pay, among other things, my medical bills, lost wages, and other necessary and reasonable out of pocket expenses.

However, insurance companies are in business to make money.  It is hard to convey this to a lot of people that insurance companies are in a business to make money because usually you are dealing with a kind person called an insurance agent or an insurance broker.  And the insurance agents and brokers are for the most part very fine and friendly people who are accesible and answer questions the best they can.  But, at the end of the day, they are agents FOR THE INSURANCE COMPANY and they are NOT AGENTS FOR YOU.

So, because Insurance Companies, including your own insurance company, is out to make money they have stacked the rules against you -- they really, really have -- so that you have to work and do things in order to get coverage after an accident in order to cover your medical bills and lost wages.  THERE ARE FOUR THINGS THAT YOU MUST, MUST DO WHEN YOU ARE INVOLVED IN AN ACCIDENT IN ORDER TO SECURE THIS "NO-FAULT" COVERAGE.  IF YOU DO NOT DO THESE FOUR THINGS - AND YOU NEED THE COOPERATION OF YOUR MEDICAL CARE PROVIDER -- YOU WILL NOT GET COVERAGE.

Here are the Four Things that you have to do to get insurance coverage.

1.  You must provide written notice of the accident to the insurer within 30 days after the accident.  This form must be asked for from the insurance company or agent for the company that insured the car that you were driving, or in which you were a passenger, or the car that hit you if you are a pedestrian.  If you donot provide this "No-Fault Claim Form" within the 30 days you may be out of luck.

2.  Your doctor, or the hospital, the radiologists -- anyone who bills you for services related to the car accident -- must submit the bill for medical services to the insurer within 45 days after the services are rendered to you.  This is important.  This rule means that you must tell your doctor or medical care provider or the hospital the name and address and claim number, when you get it, for the No Fault Insurance Company.  Even if you have personal insurance, it is better for you, particularly if you are contemplating suing the wrong-doer that caused the accident, to demand that they bill the No-Fault carrier and not your personal insurance company.

3.  From time to time, depending upon the nature of the injury, the No-Fault insurance company can demand that you see a doctor to be examined so that the insurance company can determine if you really are hurt and the extent of the injury.  This is where the insurance companies really screw the injured person.  The insurance companies that we have dealt with for our clients use "stable" doctors who, with the rare exception, know that they will continue to get business from the insurance company for these "insurance company examinations" if they minimize the injured persons injuries.

4.  The injured person AND the medical provider, if requested, must submit to a question and answer session, where your testimony is taken under oath, as the insurer may "reasonably require." 

If you fail to do 1 or 2, above, on a timely basis, the medical care claim will not be paid by the No-Fault Insurance Company.

If you refuse to do 3 or 4, if and when asked, the medical care claim will not be paid by the No-Fault Insurance Company.

If you have any questions, make sure you call us at 1800-924-3529

Inmates vs. Pigs

How did an image of a pig — the infamous ’60s-era epithet by protesters for police officers — wind up on a decal used on as many as 30 Vermont State Police cruisers?

Keith Flynn, Vermont's public safety commissioner had to explain how an alteration of decals which are affixed to the Vermont State Police Cars ended up on thirty Vermont State Police Cars.  There was, it appears, an artistically talented inmate who reshaped a spot on a cow -- an animal featured in the Vermont state seal -- in the shape of a pig.  Versions of the altered decal were placed on as many as 30 state police cruisers.

"It is fair to say the quality control will be improved at the Corrections Department and the Vermont State Police," said the executive officer of the State Police.

If you look at the cow's shoulder there is the pig!

“This is not as offensive as it would have been years ago. We can see the humor,” said Public Safety Commissioner Keith Flynn, a former state trooper and state prosecutor who was named commissioner a year ago. “If the person had used some of that creativeness [more positively], he or she would not have ended up inside.”

“We used to play in the Pig Bowl,” said Senator Campbell, the Vermont State Senate leader, and former State Police Officer. “It was the state versus the county and municipal police. While it was derogatory in the ’60s, we used it as a fundraisers for charities.”