Medical Practice Board panel member Russell Davignon held up a 5-page document detailing 153 prescriptions for opiate medications that a former University of Vermont physician assistant had written for 12 patients at the student health center in 2008 and 2009. What Davignon, a Montpelier surgeon, wanted to know was why so many of the lines designating the supervising physician for the prescriptions had been left blank. He said he believed the blanks should have contained the name of the center's director, Dr. Jon Porter. Davignon, the only physician on the three-person panel, also said it looked like a newly hired interim medical director, Dr. A. Evan Eyler, was in some cases identified as the supervising doctor before she was actually given that task. Bennett at first tried to explain how he had put together the document, but soon retreated as Davignon held his ground. "If there is an error there on a date, that is our fault," Bennett said. The exchange Monday afternoon came at the end of more than six hours of testimony in a hearing about the quality of oversight by one of UVM's top officials, Porter, who is director of UVM's Center for Health and Wellbeing.
A new company's proposal to build an ambulatory surgical center in Kenai, AK has caused uncertainty in the local medical community and Central Peninsula Hospital officials to ready their defenses. Kahtnu Ventures, LLC recently filed an application for a certificate of need with the Alaska Department of Health and Social Services for an 8,365 square foot "ambulatory surgical center." According to the application, the company hopes to build the estimated $8 million facility by spring of 2013 and service the Kenai and Northern Kenai Peninsula area. Ryan Smith, Central Peninsula Hospital CEO, said the origins of the company are somewhat mysterious. Smith said if the center is approved after the required lengthy public process, it could spell financial troubles for CPH.
Rising from a 60-acre field of old cypress swamp and cattle pasture near the Orlando airport, the 7-story Nemours Children's Hospital will be a monument to "best-in-class" care, its leaders boast. That may be the case. But at a cost of about $400 million, the equivalent of $4.2-million for each of its 95 beds, Nemours will also rank among the more expensive children's hospitals ever built when it is completed next year. Some people believe construction never should have begun. Florida health planners twice rejected Nemours' applications for a new hospital, noting that Orlando already had two children's hospitals; most cities have only one. A third hospital could duplicate existing services, driving up costs for insurers, employers and policyholders.
Obama administration lawyers face a decision by Monday that carries a high political risk and will probably determine whether the Supreme Court decides on the constitutionality of the healthcare law before next year's presidential election. The Justice Department could ask the full U.S. 11th Circuit Court of Appeals in Atlanta to reconsider a 2-1 decision in August that declared the law's mandate that all Americans must have health insurance unconstitutional. But seeking the full court review could take weeks, or even months, and probably push back a Supreme Court ruling until 2013. Or government lawyers could opt to skip the full review in the lower court and appeal directly to the Supreme Court this fall.
Donald Berwick, MD, doesn't know what he'll be doing after Dec. 31. The Harvard pediatrician who runs the federal Centers for Medicare & Medicaid Services needs Senate approval by the end of the year, or he's out of a job. No confirmation hearings have been scheduled. Berwick, who met with editors and reporters at The Boston Globe Friday morning, said he doesn't think often about his future after Medicare, both because he's prohibited under ethics rules from interviewing for jobs and because his current work is so intense. "This is the best job I've ever had and the best job in American healthcare," he said. During his visit to the Globe, Berwick repeatedly hit on the theme of improving care and saving money by "making care coordinated, seamless, and scientifically-based." He spoke of curing the American health care system of its "addiction to volume" rather than to quality.
Vanderbilt University Medical Center has partnered with three other not-for-profit hospitals across Middle Tennessee in a still-evolving project the hospitals say will boost medical services in suburban markets. Affiliation agreements with Williamson Medical Center in Franklin, Maury Regional Medical Center in Columbia, TN, and NorthCrest Medical Center in Springfield could lead to a joint approach in areas such as cancer treatment, cardiovascular services, high-risk pregnancies, diagnostic imaging and perhaps medical office development. Specific services could vary by location and are still being discussed, officials said. "It will let us be partners instead of competitors," said Dennis E. Miller, CEO of the 185-bed Williamson Medical Center.