When crisis — big or small — strikes in Passaic County, there's a special medical unit ready for action, akin to the mobile Army surgical hospitals made famous in the "M*A*S*H" television series. St. Joseph's Regional Medical Center has gathered a group of professionals from all levels of the medical field into a team equipped to respond to any type of disaster or emergency imaginable. The team's paramedics, physicians, respiratory therapists and nurses are available to the city and the county 24/7. "The goal is to respond to things when the need is critical," said John Pruden, MD, an emergency physician at St. Joe's for more than 28 years. He gave as examples a person trapped in a car in need of an amputation; evacuation of a senior citizen complex because of a power outage; and standby at a power plant because of fume inhalation by the workers as scenarios where the team would be dispatched. "This is not a 'pick them up and take them to the hospital' kind of truck," said Pruden.
The five acute care hospitals in Monroe County, NY performed charity care and absorbed bad debt at a rate that ranges from approximately 3.6% to 6.5% of their total expenses, according to new data required by law. All are nonprofit hospitals, which by New York public health law must provide medically necessary care to anyone who shows up, regardless of ability to pay. The Democrat and Chronicle calculated the charity care and bad debt for Strong Memorial, Highland, Rochester General, Unity and Lakeside Memorial hospitals based on cost data that each hospital provided on its Internal Revenue Service Form 990 Schedule H for 2009, the first year that such reporting was required and the latest available.
The American Medical Association disclosed it lost 12,000 dues-paying member physicians last year, which some blame on the national doctor group's support of the health overhaul law that is subject of intense debate among AMA members this week in Chicago. The disclosure this morning during the AMA's annual policy-making House of Delegates meeting comes as member doctors consider withdrawing support of a key tenet of the health overhaul law that requires Americans to purchase an insurance plan. The AMA is also debating scores of other issues, including whether to support state taxes on sugar-sweetened drinks, Medicare payment polices and public health issues. The Chicago-based national doctors group disclosed this morning in testimony about a continued deterioration of its membership, that it has "just under" 216,000 member doctors, which is down about 5 percent from the 228,000 members at the end of 2009. The bulk of the 12,000 members who left the AMA last year pay the full $420 annual dues, AMA delegates said this morning. The group said about one-third of its members are younger doctors, residents and medical students who pay less than $50 compared to the $420 paid by full dues-paying members the AMA is losing.
Hundreds of hospitals are routinely performing a type of chest scan that experts say should be used rarely, subjecting patients to double doses of radiation and driving up health-care costs. In a double CT scan, patients get two imaging tests consecutively: one without dye and the other with dye injected into their veins. Providence Hospital in Northeast Washington and nearly one of every six hospitals in Virginia were among those performing double scans particularly frequently, according to the most recently published government Medicare data, from 2008. The government is taking a closer look at scans because imaging tests are among the fastest growing procedures in health care. Medicare's Hospital Compare Web site publishes individual hospital rates of double chest scans, along with rates for several other kinds of imaging. Medicare doesn't restrict the use of double scans or penalize those who perform lots of them. "Just making the information public is a fairly strong incentive" for hospitals to examine their rates, says Michael Rapp, director of quality measurement at the federal Centers for Medicare and Medicaid Services.
With medical research accelerating and doctors chasing not only treatments but also outright cures for terminal illnesses, research centers are increasingly forced to make the hard decision between helping current patients and focusing on research for the future, especially when the two missions conflict. Though Vanderbilt-Ingram Cancer Center's choice not to participate in compassionate use frustrated the director of the melanoma program there, the lead investigator of the drug's trials in New York said the decision is understandable. "It takes money; it takes resources away from what you normally would be doing. So, each hospital would have to make that decision," said Paul Chapman, MD, lead investigator of the vemurafenib trials from the Memorial Sloan-Kettering Cancer Center.
The United States spends around $30 billion a year on the National Institutes of Health, an agency that has been called the "jewel in the crown of the federal government." The NIH is by far the nation's most important single funder of medical research — the scientific work that drives our university labs, our drug companies, and our major hospitals — and its budget amounts to an enormous bet that by advancing basic medical science, we can reap improvements in national healthcare. In one arena, at least, that bet is paying off: America has become the unquestioned global leader in biomedical science. But biomedical science is not the same thing as health, and in a very important sense, our investment in the NIH is not fully paying off. The agency's own mission statement holds that its ultimate goal is applying knowledge to "enhance health, lengthen life, and reduce the burdens of illness and disability."