A year after a young amputee left the Hospital of the University of Pennsylvania with transplanted hands and forearms, the lead surgeon calls her progress "nothing less than spectacular." Yet Penn has no waiting list for hand transplants. The distinguished medical center is part of an ironic trend: Availability of the complex reconstructive surgery has been growing faster than demand for it.
A distinguished vascular specialist in his 80s performs surgery, then goes on vacation, forgetting he has patients in the hospital; one subsequently dies because no doctor was overseeing his care. An internist who suffered a stroke gets lost going from one exam room to another in his own office. A beloved general surgeon with Alzheimer's disease continues to assist in operations because hospital officials don't have the heart to tell him to retire. These real-life examples, provided by an expert who evaluates impaired physicians, exemplify an emotionally charged issue that is attracting the attention of patient safety experts and hospital administrators: how to ensure that older doctors are competent to treat patients.
For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law. The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week. Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.
Five patients at Cedars-Sinai Medical Center were unwittingly infected during valve replacement surgeries earlier this year because of tiny tears in a heart surgeon's latex gloves, hospital officials said. Four of the patients needed a second operation and are still recovering. The outbreak in June led to investigations by the hospital and both the Los Angeles County and state departments of public health, the newspaper said. The federal Centers for Disease Control and Prevention was also consulted. The surgeon, whose name was not released, was not allowed to operate again until he healed. He is still a member of the medical staff but no longer performs surgeries.
Aetna and other insurers that initially fought President Obama's health-care overhaul are reversing course, funding a group planning to spend $100 million to help the uninsured get coverage under the law. Enroll America, a nonprofit created two years ago, has gathered support from the insurers that opposed the law and consumer organizations such as Washington-based Families USA that supported it. The new organization plans a broad-based educational campaign to make uninsured people aware of the health-care law's benefits and help them sign up, said Ron Pollack, Enroll America's chairman.
In 2010, Lancaster General Health notched record revenues of nearly $1 billion. But its annual surplus fell for the fourth straight year. Though destitute by no means, galloping expenses and uncertainty in the marketplace were hammering LGH's business model, prompting changes. Two units were closed, some positions were eliminated, and 170 employees were reassigned. Yet even as the bottom line eroded, there was little austerity in the executive suites. In 2010, each of 21 executives systemwide would earn total compensation—salary, bonuses and incentives, benefits and expenses—of at least $250,000, according to LGH's Internal Revenue Service Form 990, the annual financial report that nonprofit health systems such as LGH must file with the federal government.