Anyone planning on buying one?

The Los Angeles Times (4/3, Milian) "Technology" blog reported that it "seems everybody is buzzing about Apple's new" iPad, "and that includes MDs in between consultations or surgeries." In fact, "one in five doctors say they plan to buy an iPad, according to a survey of 350 clinicians by the San Mateo medical software vendor Epocrates." for information on eye and vision care issues visit youreyesite.com. Doctors of Optometry in Rockville, Maryla … Read More

via EyeInfo's Blog

It is clear that simple mistakes during patient registration can have far-reaching consequences.  Such mistakes can take the form of duplicate records or even erroneous records due to the confused entering of information into other individuals’ files.

The problem begins at registration, which is typically burdened by time constraints.  Most registrars are instructed to enter a patient into the system within two minutes upon arrival so that treatment may be promptly administered.  Erroneous or duplicate file information can be either due to pure accident or, unfortunately, negligence during the registration process.

What is particularly problematic about faulty patient information is that it eventually filters through the larger and more circuitous medical information framework which could potentially cause incidences such as faulty billing, unnecessary treatment (which may prove quite dangerous depending on the circumstance), or wasted time and money in the pursuit of correcting inaccurate file information.

The operational gap between patient registration and HIM departments seems to have led to the exasperation of these problems.  This reality has been recognized by medical professionals and subsequently has lead to the creation of less distance between the two entities, effecting remarkable results.

It has widely become protocol for HIM departments to work more closely with registration staff, providing individuals with feedback and education regarding the consequences of faulty medical recording.  Not only this, but many institutions have set higher standards for the minimization of mistakes during the entrance process, some implementing layoff at three cumulative faulty registrations per year.  Alterations in communication between these departments has lead to vast improvements, the likes of a nearly 60% decrease in duplication rates within some institutions.

Essentially, what was once a considerable problem is now far less of one thanks to the ingenuity of HIM professionals.  The result is less correction, less patient injury, less time, and less money.

Questions: Do you think registration errors are a problem in the facility you work at? Do you have any ideas as to how this process can be improved?

About the Author:  Patricia Heise is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog.

Resources:
Dimick, Chris. “Exposing Double Identity at Patient Registration.” Journal of AHIMA 80, no.11 (November 2009): web extra.

They believed music affected the soul.  Plato said almost 2500 years ago, “Music is a moral law.  It gives soul to the universe, wings to the mind, flight to the imagination, and charm and gaiety to life and to everything.”

Music is universal and despite it being used throughout the ages to soothe the soul, it’s only fairly recently that it became accepted within modern medical circles.  It gained accepted recognition in 1944 when Michigan State University offered the first accredited music therapy program.  Today there are more than 70 colleges and universities offering programs in music therapy and approximately 5000 music therapists.

Hospitals use music to aid patients in many ways, including pain management, to elevate patient’s moods, and to encourage movement in physical therapy.

As of 1994, music therapy services have been identified as reimbursable under Medicare.

But what about music promotes healing?  How does it work?

Every known culture has music.  Music touches us, affecting us physically, psychologically, emotionally, and spiritually.  Has a song ever come on the radio and you find your feet tapping?  Upbeat songs make us feel good.  Our body’s physical responses to music are observable and measurable.  Music can affect your pulse rate, blood pressure, respiration, temperature, and even your brain waves.

There are four types of brain waves; beta, alpha, theta, and delta.  Beta waves occur when we are alert and active.  Alpha waves occur when we are relaxed.  Theta waves occur when we are meditating or drowsy and falling asleep.  Finally, delta waves occur when we are in deep sleep.  Music can affect these brain waves.  Calm, relaxing music can induce theta or delta waves, whereas loud, fast music will put the brain into an alpha state.

Everyone has heard of “runner’s high”, it’s what happens at a certain point during physical exertion when the body starts to release endorphins, a group of peptide hormones that increase the body’s threshold of pain and can affect mood.

Many activities besides running can cause the release of endorphins, for example, eating spicy food, time spent in the sun, intense pleasure such as sex, strong emotions like laughing or crying, and listening to music.

Studies have shown that listening to half an hour of classical or instrumental music has the same effect as taking a Valium.

Many have heard of the exaggerated and unsubstantiated claims surrounding the so-called “Mozart Effect”, that listening to classical music, for example, will make you smarter or will turn your unborn infant into a genius.  Despite these fallacies, however, what the actual study showed was just as amazing without the hyperbole that has since been attached to it.

In 1993, at the University of California, Irvine, Gordon Shaw and Frances Rauscher conducted a study of 36 college undergraduates.  They listened to 10 minutes of a Mozart sonata, then immediately took a Stanford-Binet IQ test to measure their spatial-temporal reasoning.  The results showed an improvement in spatial IQ of eight to nine points, but the effect only lasted for 10-15 minutes.

Despite the fact that the “Mozart Effect” only improved spatial-temporal reasoning and that the effect was temporary, the study still showed the kind of power music has upon the mind.  Other studies have shown that students who study music in high school have higher grade point averages and physically develop faster than those who don’t.

Music has amazing powers in its ability to affect our body and mind and is becoming an effective healing tool.  As author Berthold Auerbach said, “Music washes away from the soul the dust of everyday life”.

Questions:  Do you feel music has the power to heal?  Have you or a loved one experienced music’s healing power first hand?

About the Author:  Ed Pahule is a Staff Writer with the Clear Medical Solutions Communication Team.  His work is regularly shared on the Clear Medical Agency newsletter and the ClearHIMMatters.com blog.

 Schwartz and Woloshin profile three drugs, Zometa, Lunesta, and Rozerem as examples of how drug labels are missing information.  All three drug labels were indeed missing information.  In their review of Lunesta and Rozerem however something stands out, both Lunesta and Rozerem had intense direct- to- consumer advertising campaigns.  Lunesta is reported have spent more than $750,000 a day in its 2007 advertising campaign and to have sales reaching almost $800 million last year.  Rozerem is described as being “aggressively promoted to consumers.”  This information could easily be omitted from the article without detracting from the issue of drug information not reaching clinicians; the inclusion of this information is interesting.

In 1997 the FDA issued new regulations governing television advertising of prescription drugs; following this change direct- to- consumer drug advertising soared.  Prescription drugs became commercialized; direct- to- consumer advertising repackaged drugs into a shiny product to be sold to the public.  In this light, is it surprising that drug companies would over exaggerate the benefits of their drug and down play the risks?   The purpose of advertising is to make consumers think they need a product and make them want to buy it; drug companies are no different.  Consumers have learned to be skeptical of the dubious claims made by advertisements but direct- to- consumer drug advertising is new.  Consumers have more faith in the claims made by drug companies because the idea that drug companies might manipulate information at the risk of the consumer is so unsettling.

By including information on the direct- to- consumer advertising campaigns of Lunesta and Rozerem, Schwartz and Woloshim provide further insight into the motivations (money) behind excluding certain information from drug labels.  It also highlights how for years the public has accepted and believed the claims of drug companies without question despite numerous incidents of drug companies being exposed as less than forthright.  You can be angry with the drug companies for omitting information or mad at the FDA for not making it easier to access the information.  But isn’t it time we as consumers start to demand more from drug companies?

Questions: Do you agree with the above statement that as consumers, it is time to start demanding more from drug companies? Have you experienced any type of negative side effects to your medication that was not listed on the label?

About the Author: Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team. Her work is regularly shared on the Clear Medical Agency newsletter and the ClearHIMMatters.com blog.

References:
Lost in Transmission- FDA Drug Information That Never Reaches Clinicians
http://healthcarereform.nejm.org/?p=2126&query=home

“This is a vast improvement,” said Ron Dix, the foundation’s executive director.

Gains in efficiency of the region’s health care systems played a huge contributing factor to the improvement. 

Bruce Kruger, executive vice president of the Medical Society of Milwaukee County, says “What’s occurring in Milwaukee is physicians and hospitals are doing a better job of all working under one payment system and offering more integrated care”. 

“As well, members have been given more financial responsibility while employers generally have made their plans ‘less rich’”, says Dianne Kiehl, executive director of the Business Health Care Group, an employer coalition created to help bring health care costs in southeastern Wisconsin in line with other cities in the Midwest.   

While changes are trying to be made, payments to physicians are still 24% higher than the Midwest average. 

There are currently larger physician practices in Milwaukee compared to other areas of the Midwest, says Kiehl.  Compared to if there were many smaller practices, larger physician practices make it more difficult to negotiate rates.    

The Wisconsin Health Information Data Mart has information provided by all the large health plan administrators that will help drill down into where the highest costs are. 

The Greater Milwaukee Business Foundation on Health is planning to commission another similar study to analyze 2009 health care costs.  It hopes to make the results available by early 2011, Dix said.   

To read the full article visit http://www.jsonline.com/business/68879872.html 

Questions: Have you experienced high health care costs in the Milwaukee area?  Do you think the employers should continue to make their plans “less rich”?

About the Author: Joan Speelich is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

Title II, Administrative Simplification (AS) provisions, calls for and prescribes the establishment of nationally cohesive standards for all health care transactions, or rather, the use and dissemination of health care information.  Its primary intention is to help protect and retain the privacy of such health care information.  (I.e.: medical records, payment history, etc.)  The AS is comprised of five sets of rules, two of which are relevant to our purposes.  The Privacy Rule pertains to both paper and electronic health care files, and prescribes regulatory measures for both the use and disclosure of protected health information (PHI), being “any information held be a covered entity which concerns health status, providers of health care, or payment for health care that can be linked to an individual”.  This particular rule also requires the training of all individuals working within a medical establishment with regard to the proper procedures concerning both PHI and HIPAA.

Another relevant aspect of HIPAA, with respect to privacy, is a subsection of the Security Rule, a rule that is concerned only with electronic data, known as the Physical Safeguards. This facet of the Act itself attends to the control of physical access in order to protect against any inappropriate entrance into classified data.

HIPAA violations are far from uncommon.  Many are reported, but few are actually prosecuted.  This was not the case, however, in a recent incident involving a nurse in a midsize regional medical establishment.  This individual, Ms. A (whose actual name shall not be disclosed), had been employed by her respective clinic for 5 years and, as of late, was married to a man who had been involved in a car accident for which he was being sued.  She came upon the file of her husband’s plaintiff at her office during the course of the lawsuit, took some notes that had been kept in the plaintiff’s medical file, and brought them home to her husband.  In turn, Mr. A contacted the plaintiff urging him to drop the lawsuit given certain facts regarding what had surfaced in his medical record.  The plaintiff immediately contacted the clinic as well as his attorney.  Ms. A was subsequently and instantaneously fired from her job.  The couple were indicted a month later and charged with violating HIPAA, with “conspiracy to wrongfully disclose individual health information for personal gain with maliciously harmful intent in a personal dispute”, and with witness tampering (which was charged to her husband exclusively).  The charge against Mr. A was dropped after negotiations.  However, Ms. A still faces up to 10 years in prison and up to $250,000 in fines.  Not only this, but the nursing board in her respective state is attempting to have her nursing license revoked.  For the full story, visit http://www.renalandurologynews.com/Staff-Nurse-Faces-Jail-Time-for-HIPAA-Violations/article/119854/

This case is a blatant and highly perceptible situation in which a health care employee violated the boundaries of normative ethical privacy practices in the pursuit of personal gain.  However, no malicious intent need be present in order to carry out such violations.

Though HIPAA has undoubtedly protected innumerable individuals’ health care privacy, it has also raised certain complications as well as costs.  Training with respect to HIPAA has proved to be insufficient and toilsome as a staggering majority of health care workers report being uncertain of its scope and needless to say, its more specific mandates.  Not only this, but costs for medical institutions have significantly increased in tandem with the increase in paperwork required by the Act.  Due to the deducible detriments that have, and may very well continue to occur as a result of such confusion and costs, it is imperative that these matters are resolved by both legislators and by those who manage health care institutions.  

Questions: Do you think Mrs. A and Mr. A faced a fair punishment?  Should Ms. A be subject to high fines and 10 years in prison for her actions?

About the Author: Patricia Heise is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

References:

“Staff Nurse Faces Jail Time for HIPAA Violations.” Ann W. Latner, JD. October 1, 2008. http://www.renalandurologynews.com/Staff-Nurse-Faces-Jail-Time-for-HIPAA-Violations/article/119854/

“Health Insurance Portability and Accountability Act of 1996.” 104^th Congress. August 21, 1996. http://aspe.hhs.gov/admnsimp/pl104191.htm

“Health Insurance Portability and Accountability Act.” http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act

 I teach English in Korea and have lived here for little over a year.  During my stay, I have had several encounters and experiences with the health care system.  Korea has a National Health Insurance Corporation (NHIC), which guarantees health insurance for all Korean Citizens.  Foreigners are also covered by the National Health Insurance (NHI) provided they meet the necessary requirements.  My status as a registered, employed alien, with a proper visa (E2 for me) grants me access to the same NHI benefits as those for Korean nationals.

I am by no means an expert on the NHI; most of my knowledge about the NHI and health care in Korea comes from experience.  However, I do know the basics of how it works, the benefits, and what is covered.  Only properly documented and employed foreigners are eligible for NHI.  A monthly contribution is deducted from each pay check.  The contribution is determined by the monthly wage multiplied by the contribution rate (currently 5.08%).  The employee pays half of the contribution and the employer is responsible for the other half. 

The NHI has a co-pay system; patients pay 10- 20% of the total cost for inpatient care. Outpatient co-pay varies between 30- 50%.  General hospitals require 50% co-pay, while hospitals require 40%.  The co- pay for clinics and pharmacies is 30%.   There is mandatory minimum payment of 3,000 Won for visits when the charges do not exceed 15,000W. 

Currently 1 USD equals about 1,164W or .85 USD equals about 1,000W.  It may be easier to think 1 USD equals 1,000W, since I will be quoting all prices in Won; just remember the actual cost in U.S. dollars will be slightly less.

In my experience, the quality of health care in Korea is equal to the U.S.  The major difference is NHI makes the healthcare vastly more affordable and accessible.  The costs for doctor visits and prescriptions are literally pocket change.  Appointments are unnecessary for small clinics.  Hospitals and dental offices usually require (or strongly recommend) making an appointment, but there is rarely more than a two day wait for an appointment.

Recently, I severely burned my feet in a few places.  I tried treating them myself at first but was unsuccessful.  On my way home one night, I sought the advice of a pharmacist.  I showed the pharmacist my burned feet and he sold me a box of Band-Aids and a tube of Silmazin Cream (1% silver sulfadiazine cream; the Korean equivalent to Silvadene or Flamazine).  The total cost of the cream and Band- Aids came out to be around 6,000W.  The next morning I went downstairs to my regular pharmacist and bought gauze and medical tape; 3,000W.  A few hours later, I noticed one of the burns was developing a red circle around it, was warm to the touch, and was increasingly uncomfortable.  I headed back downstairs to the pharmacist hoping she could help me and she sent me to the doctor on the second floor.  The doctor examined the burns, cleaned them, put an ointment on them, dressed them and wrote me a prescription for antibiotics; 4,000W.  Back downstairs at the pharmacy, I filled the prescription, a 2-week course of antibiotics; 7,000W.  The total expenditure for treating my 2^nd degree burns was 20,000W; I did not have to make any appointments nor sit idly in the waiting room of a doctor’s office. 

All foreign teachers must undergo a yearly physical.  These are usually performed at bigger hospitals opposed to clinics.  The physical includes but is not limited to a chest x-ray, vision and hearing test, urine test, CBC, and HIV/ AIDS STD test.  You change into a hospital gown/top and you are pushed from one room to the next for each test to be performed. The most jarring aspect of the physical for me was the urine test.  The nurse handed me a Dixie cup, which I thanked her for and used to get a cup of water before proceeding with the test.  As I turned back from the water cooler and saw her face, I realized the Dixie cup was meant to collect my urine, not for me to drink out of.  I do not think it matters how many times you do it, walking out of a bathroom holding a Dixie cup of your own urine and placing it on a tray next to other cups urine always feels wrong.  Dixie cups aside, the physicals are easy to get and it usually does not take more than 30 min from when you walk in the door to when you walk out.  I paid 60,000W for my physical this year, but the cost can vary from 55,000- 70,000W depending on where you go.

Dental work also costs much less in Korea than in the U.S.  Friends of mine have had root canals, cavities filled, and crowns made (all things covered by NHI);they all rave about the price and how the quality of care was the same (some said better) as what they were used to back home.  I have not had dental work of that nature done.  However, I am currently undergoing Invisalign treatment for cosmetic purposes, which is not covered by NHI.  Even without the benefit of NHI, I am saving a great deal of money by having it done here rather than in the U.S.   Invisalign performed in the U.S. by an American doctor costs on average $5,000.   My Korean dentist received her degree from Tufts University, is an ADA member and is licensed to practice in several East coast states. I am paying 3,500,000W for my treatment (note: at the time of payment the exchange rate was different so 3,500,000W was about $2,800USD).   And my experience with Invisalign in Korea far surpasses the one I had with braces in the U.S.

The health care system in Korea also has some differences which are cultural.  Confidentiality, which is paramount and a cornerstone in health care in the U.S. is pretty much non-existent here.  I read warnings about this before I came here so I was prepared for it to be a little lax, but I was beyond shocked when my co-teacher showed the parking attendant the results of my physical in order to get her parking validated.  When I recovered from my shock and asked her about it, she did not see anything wrong, strange, or inappropriate with sharing the test results with a stranger whose job it was to monitor a parking lot.  As it turns out, it is not uncommon for doctors or nurses to discuss one patient in front of other patients or for the pharmacist to talk to other people about what medication you are taking.

Koreans typically do not play an active role in their health care.  For the most part, they believe in their doctors, trust them completely and never question them.  As a result they are often less informed about their treatment.  Experience has taught me not to question a Korean on the specifics of any treatment they are receiving because the answers alternate between “Because the doctor told me to” or “I don’t know.” 

I on the other hand like to know about my treatment.  I want to know what’s wrong with me.  I want to know what medication I am being given and why and I want to know the possible side-effects of this medication.  All this proved to be too much for one doctor.  My questioning of him during the examination and then disagreeing with his initial diagnosis that I had an STD (an unfortunate assumption sometimes made about foreigners, which is why a test is included in our physical) did not go over well.  I think I pushed him too far when I asked him for a translated version of the prescription he was writing so I could know what I was taking (or could at least Google it).  He was taken back by this request and stunned for a moment before he ordered one of his nurses to do it and shut the door on me.  The other doctor I have seen did not have a problem with this request and in addition to writing the English name of the drug he also wrote its purpose.

The physical manner in which prescriptions are filled is another difference between health care in Korea and the U.S.  Instead of the nice little orange bottles, clearly labeled with a patients name, drug dosage, and instructions; prescriptions in Korea come in rows of sealed little bags.  Each bag represents one dose.  When I filled my prescription for two weeks of antibiotics, the pharmacist handed me 14 little rows with three bags to each row (take 3 times a day for 2 weeks).  My qualm with the bag system is the loss of control I feel by not being able to control my own medication and again not knowing what I am taking.  However, I see how this system might have its merits for older patients taking multiple pills a day and how it could help prevent them from missing a dose or taking the wrong medication.

Korean pharmacies bare little resemblance to the big corporate owned pharmacies like Walgreens and CVS found the in the U.S.  The wide florescent lit aisles with rows upon rows of cold, flu, headache, stomachache, heartburn, etc., medicine are replaced with surprisingly small shops, stocked floor to ceiling with foreign medication, most of it behind a counter and controlled by the pharmacist.  When you have a cold (or any other ailment) in Korea you go talk to the pharmacist and s/he supplies you with the proper medication (in baggies) based on your symptoms; opposed to going to the drugstore in the U.S. and matching your symptoms to a box of cold medication.  I prefer the U.S. system and so do most foreign teachers, which is why there is a cabinet stocked full of Advil, DayQuil, NyQuil, Imodium AD, etc., in most of our apartments.  The benefit of the Korean system is that more drugs are available over the counter than in the U.S.  The Silmazin I bought for my burns would have required a prescription in the U.S.  More significantly, birth control does not require a doctor’s prescription and can be obtained from a pharmacist.

Health care in Korea has its pros and cons; it has been an adventure for me to experience and has given me numerous stories to tell.  In the end, what has surprised me the most about health care in Korea is how even as a foreigner who does not speak the language; I have never had a problem accessing the health care.  Come January 1, 2010 I will no longer be covered under my mother’s health insurance (which was very good insurance).  With that date looming I have actually started to think about health insurance and health care for the first time in my life.  I know the high quality health care the U.S. is capable of providing because I am used to receiving it; however, as of January 1^st I am not sure how to access that care.  I am dismayed by this fact; the fact that accessing healthcare in a foreign country where I am temporarily residing may be easier than accessing healthcare in my home county where I am a citizen. 

Questions: Based on the above story, how do you feel about the health care system offered in South Korea? Patient confidentiality is a huge focus point for health care in the U.S.; would you be willing to give up patient confidentiality for more available and affordable health care?

About the Author: Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

References:

NHIC- National Health Insurance Corporation
http://www.nhic.or.kr/eng/

 Invisalign Payment Options and Treatment Costs
 http://www.invisalign.com/WillFit/Pages/PaymentOptions.aspx

Home health care allows patients to receive the necessary care in the comfort of their own home by trained professionals.  It reduces hospitalization time and opens more beds in the hospitals.   Both patients and their families benefit from home care and it reduces the strain put on the hospitals.  The services provided by home caregivers are diverse and are suited to match the patient’s needs.  Home caregivers do more than tend to the medical needs of the patient.  They can help with housekeeping, cleaning, washing/ bathing, transportation to appointments, and any other duties that help the patient return to a level of independence.

Patients prefer the comfort of their home to the impersonal sterile hospital environment.  They also recuperate better and faster in familiar home settings.  Patients develop a more meaningful relationship with their home caregiver that is not possible in a hospital setting.  This relationship provides the patient with a sense of security that can aid in the recovery process.  Many elderly patients are resistant to moving into nursing homes or assisted living centers because they feel like they are giving up their freedom; home caregivers are the perfect solution for individuals who need assistance but do not want to lose the independence living in their own home gives them.

Home caregivers help more than just the patient; they give the families of patients the security of knowing their loved one is being taken care of.  Illness of or the assistance required by an elderly relative or parent can be both stressful and overwhelming.  Families do not have to worry about whether or not their loved one is eating properly or taking their medication when a home caregiver is hired.  Nor do they have to worry about if their loved one is lonely or feeling isolated.  Home caregivers provide companionship to their patients and help them stay connected to the world.

Patients, families, and hospitals all prefer home health care to long hospital stays.  It gives patients more personalized care and lessens the stress put on families. Home health care is usually cheaper for the patient and more cost effective for the hospital.  As a result of the strain the baby boomers are putting on the health care system, the home health care industry is booming.  In light of all the benefits home health care offers, one has to wonder why it has taken so long to catch on.

About the Author: Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearNursingMatters.com blog. 

References:

“The Benefits of Using Home Health Care” http://ezinearticles.com/?The-Benefits-of-Using-Home-Health-Care&id=1892252

 AHA: Press Release: “Baby Boomers to Challenge and Change Tomorrow’s Health Care System” http://www.aha.org/aha/press-release/2007/070508-pr-boomers.html

Tinie Riggs, Gene’s wife, waited hopefully while the tests were performed only to find out later from Gene that he’d have to spend the night at the hospital. He told her he might need surgery, but that the hospital would call before any plan was sent into action.

Tinie Riggs, middle, sits by her children, Melissa Riggs and Steve Riggs. Tinie lost her husband in 2006 after he went into BAMC for stomach trouble. A feeding tube was inadvertently put in his right lung instead of his stomach. The family is claiming in a lawsuit that the feeding tube misplacement killed him, although lawyers for the government dispute that. June 23, 2009. ( Photo by Billy Calzada / San Antonio Express-News ) Stoeltje story

By the next morning Tinie still hadn’t heard anything. She called the hospital and was taken aback to discover doctors had performed a procedure, an exploratory laparotomy, which allowed doctors to examine Rigg’s abdominal cavity. Doctors found no signs of the ailment they thought Riggs had. Following the procedure doctors complained that Riggs wasn’t getting the proper nutrition, so they threaded a feeding tube down his throat, into his lung.

Following the insertion of the feeding tube, an X-ray was taken which evidenced the mistake. According to the family’s lawsuit complaint, the nursing staff continued to administer feedings all night. Allegedly, a nurse twice told a doctor, but she insisted that the feeding continue despite nurses having to suction out a “milky pinkish” fluid, consistent with the color of liquid food, from the tube which maintained his airway.

The following morning doctors removed the feeding tube and performed a bronscopy, a procedure that allowed doctors to view Riggs’ airways and lungs. In his lungs, doctors found liquid food and an infection-caused fluid.

After the procedure, Riggs’ health began deteriorating. Riggs was put on a ventilator, and for 24 hours a day, seven days a week, Riggs had his own nurse. Shortly before Riggs died, the Brooke Army Medical Center discharged Riggs to Kindred Hospital.

While at Kindred, doctors performed a dialysis on Riggs and discovered that he had injury to his kidneys. The doctors at Kindred believed it may have had something to do with Riggs’ dopamine IV running out, which falls in the hands of the doctors at the Brooke Army Medical Center.

Lawyers for Brooke Army Medical Center have said very little about the case, however they admitted that the feeding tube was indeed misplaced, but claimed it didn’t’ cause any infection. The antibiotics Riggs was on would have prevented any infection. They also contend that Riggs death was a result of other health problems, including chronic leukemia.

What’s quite disturbing is the family was never notified that the feeding tube was misplaced. Instead, Tinie Riggs was lead to believe that he had inhaled food while he was eating. It was only after she and the rest of the family reviewed boxes of medical documents that they discovered Riggs’ feeding tube was placed in his lung.

Doctors kept telling Trinie that there wasn’t a whole lot she could expect because he was 78 years-old, and dealing with this problem would take a lot. After a while she began to feel that there wasn’t any hope for good care unless you were in your 30’s or 40’s, which isn’t fair.

The Army has since offered Trinie $15,000 to settle the case, which she felt insulted by. If she wins, she could get around $1.7 million for wrongful death and at least $120,000 in non-economic losses.

What do you think? Would Gene Riggs have lived longer if it wasn’t for the misplaced feeding tube?

About The Author:

Todd Michalek is a Staff Writer with the Clear Medical Solutions Communication Team.  His work is regularly shared on the Clear Medical Agency newsletter and the ClearManagementMatters.com blog.  

Link to Full Article: http://www.chron.com/disp/story.mpl/deadbymistake/6555186.html

Let’s take a moment to realize that preferences are utterly subjective – there simply cannot be an exhaustive generalization of what certain people (i.e. physicians) want, insofar as qualities are concerned, in the geographical location that they may call “home”. Regardless, it appears that there may be a common denominator in this situation; personal health. That being the case, the top ten healthiest American cities in which to live are as follows:

1.)   Ann Arbor, Michigan

2.)   Honolulu, Hawaii

3.)   Madison, Wisconsin

4.)   Santa Fe, New Mexico

5.)   Fargo, North Dakota

6.)   Boulder, Colorado

7.)   Charlottesville, Virginia

8.)   Minneapolis-St.Paul, Minnesota

9.)   San Francisco Bay Area, California

10.) Naples-Marco Island, Florida

 This list was compiled by AARP magazine in 2008 and is meant to accurately reflect American cities that demonstrated superiority in areas of “longevity, vitality, and wellness”. Listing the full criteria would prove excessive for our purposes. However, it contains items such as cardiac mortality, obesity, cigarette smoking, and exercise rates.

If one is serious about living in an optimally healthy city, that person is going to have to look well outside of the United States. According to a recent Mercer survey, it has been concluded, given similar criteria, that U.S. cities do not even rank within the top 20 internationally. In fact, this survey did not mention Ann Arbor, MI whatsoever, and ranked Honolulu, HI at 29 on the list. The top ten international cities, in terms of health, are as follows:

1.) Vienna, Austria

2.) Zurich, Switzerland

3.) Geneva, Switzerland

4.) Vancouver, Canada

5.) Auckland, New Zealand

6.) Dusseldorf, Germany

7.) Munich, Germany

8.) Frankfurt, Germany

9.) Bern, Switzerland

10.) Sydney, Australia

As an alternative to going utterly abroad to Europe, Australia, or New Zealand in order to retire with the greatest possible quality of life, there is always Canada – no language barrier, same continent as the U.S. In fact, the cities that ranked in America’s top five healthiest cities are located in Canada:

 1.) Vancouver, Canada

2.) Toronto, Canada

3.) Ottawa, Canada

4.) Montreal, Canada

5.) Calgary, Canada

It is entirely possible that nothing may ever sway someone’s desire to venture to Florida or Arizona for retirement, that nothing will ever prompt the crossing-off of “climate” on one’s list of qualities in a future home. Regardless, I am sure that one’s passion for health will continue to be the determining factor with respect to most of one’s choices as life proceeds.

Is climate a contributing factor when thinking about retiring elsewhere? Or is the health of the area you relocate to a large contributing factor?

About the Author:  Patrisha Heise is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearFinanceMatters.com blog.  

References:

“World’s Healthiest Cities”. March 13, 2008. http://blisterorb.blogspot.com/2008/03/worlds-dirtiest-cities.html

“Quality of Living Global City Rankings 2009 – Mercer Survey”. April 28, 2009. http://www.mercer.com/referencecontent.htm?idContent=1173105

“AARP the Magazine Names the Top 10 Healthiest Places to Live in America”. July 23, 2008. http://www.aarp.org/aarp/presscenter/pressrelease/articles/aarp_the_magazine_names_the_top_10__healthiest_pla.html