Specialty Focus   
Volume VI | Issue 13                                                                                   
March 28, 2017  
        Practice specific news, analysis and commentary 
      for Florida's Medical Specialists
                            From the publisher of FHIweekly & FloridaHealthIndustry.com

The Emergency Department and Access to Care
William F. Paolo, MD

The redefinition of a potentially functioning medical system in which each individual is able to utilize financially non-prohibitive care into a disjointed balkanized realm of income-based insurance tribes is aided by the protean definitions of the political buzzword "access." Access to medical care does not entail the ability to reliably obtain medical care much as medical insurance reform is not, in point of fact, healthcare reform. Regardless, the conflation of one's potential ability to access a broken system with the delivery of a reliably accessible holistic system is never more evident than in the discussions surrounding emergency care.

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More patients choose to stay awake during surgery
Matt Kuhrt
Fierce Healthcare

Some surgeons find themselves under increased supervision during their procedures these days, as patients elect to stay awake and watch them work. High-profile stories about concurrent surgeries and surgeon misconduct could be driving the trend.

A recent New York Times article examined this increased willingness among patients to become more engaged with and involved in their own care, as well as a way to retain control over their care and guard against mistakes.

Other benefits include reduced complications compared to general anesthesia, as well as speedier recovery times-both of which could save money, noted the Times.

Alexander Langerman, MD, of Vanderbilt University Medical Center, noted that some surgeons can look to their own conduct for one motivating factor for patients.


OIG Opinion Applies Access to Care Exception
Can a hospital system provide free or reduced-cost lodging and meals to certain financially needy patients, or would such an arrangement (a) constitute either a violation of the federal anti-kickback statute or (b) constitute grounds for the imposition of civil monetary penalties because it would violate a provision of the Social Security Act that prohibits remuneration to a federal healthcare program beneficiary that might influence the beneficiary's selection of a particular provider?

That was the question recently answered in an Advisory Opinion issued by the U.S. Department of Health and Human Services Office of the Inspector General (OIG).

The requestor, whose name is redacted, owns and operates an academic medical center consisting of four hospitals and a number of hospital-based clinics. One of those hospitals operates a Level I trauma center and provides care to patients, some of whom live in rural and medically underserved areas.

Beware of Joining a Clinical Trial - Medical Research Must Come Clean   
MD Whistleblower

From time to time, friends, patients and relatives ask my advice on participating in a medical experiment. My response has been no. More accurately, once I explain to them the realities of research, they don't need to be persuaded. They back away.

Here's the key point.  When an individual volunteers to join a research project, the medical study is not designed to benefit the individual patient. This point is sorely misunderstood by patients and their families who understandably will pursue any opportunity to achieve some measure of healing for an ailing individual. I get this. In addition, I believe that these research proposals are often slanted in a way to suggest that there may direct benefit that the patient will receive. I am not accusing the medical establishment of uttering outright falsehoods to prospective study patients, but there are two powerful forces that may incentivize investigators to recruit patients with undue influence.


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