Drugs for epilepsy, bipolar illness and mood problems double the risks of suicidal thoughts and behavior, and patients taking them should be watched for sudden behavioral changes, according to drug regulators. The Food and Drug Administration undertook a combined analysis of 199 clinical trials with 43,892 patients and found four suicides and 105 reports of suicidal symptoms among the 27,863 patients who were given the drugs compared to no suicides and 35 reports of suicidal symptoms among the 16,029 patients treated with placebos.
Around much of Florida, neurosurgeons are becoming increasingly scarce. They pay the highest rates for malpractice insurance among specialists, yet reimbursements for the care they provide are low. Solutions also are being sought statewide, and many in the medical community say the answer is protecting doctors from frivolous malpractice lawsuits.
Efforts to bring more specialists into Florida hospital emergency rooms has hit a major snag now that hospital officials have rejected a possible solution to the crisis. Doctors and hospital executives crafted a plan for Palm Beach County's 13 hospitals to voluntarily join a regional system to provide specialists to the facilities. Hospitals would pay into the system because they would not have their own full complement of surgeons, and an online call schedule was envisioned.
The Commonwealth Medical Center in Aliquippa, PA, has received a full two-year license from the state Department of Health. The hospital had been working on a provisional license because of problems during summer 2007 inspections at the hospital. The license was released after the state accepted the hospital's plan of correction, which included submission of financial reports and a plan to have an independent audit.
Florida Gov. Charlie Crist has recommended a repeal of the certificate-of-need process for new acute-care hospitals in the state and replace it with a licensing process. Ending certificates of need would "increase competition and efficiency in the healthcare marketplace and provide Floridians with greater access to quality services," Crist's said in his budget message.
Details of an agreement to bring a third children's hospital to Orlando, FL, have been made public. The working draft of a settlement agreement reached by the Nemours Foundation, Orlando Regional Healthcare and Florida Hospital was released by the Florida Attorney General's Office. The draft agreement includes a commitment by Nemours to set up in-hospital and outpatient programs for pediatric rehabilitation and adolescent behavioral health.
Ft. Lauderdale, FL-based Holy Cross Hospital is buying one of its main rivals, the financially struggling North Ridge Medical Center in Oakland Park. The Catholic-owned Holy Cross is acquiring the 332-bed North Ridge from Tenet Healthcare Corp. in Dallas. The entities did not disclose a purchase price, saying the transaction must still be approved by state regulators.
When Donald Trump unveiled Celebrity Apprentice, a star-studded twist on his popular television reality series, my skeptical side said, "Great, yet another show where virtually unknown D-listers try desperately for a shot at real fame." But the inner optimist (and reality junkie), screamed, "A business competition with big stars and huge egos? Where's the remote to my TiVo?"
Given the serious premise of the show--uncovering a business guru savvy enough to be the next Donald Trump--I hoped the show would attract some high-caliber celebrity contestants. That was unfortunately not the case (you know America's in trouble when a detox-based show called Celebrity Rehab attracts bigger names than a business competition), but the show nonetheless is a fascinating case study in business strategy and leadership style.
Take the recently fired Gene Simmons, for example. Metal music fans remember Simmons as the painted-face lead singer of KISS, a 1970s metal band, but today he may be better known as Trump's bossy former employee. As a leader, Simmons was arrogant, unwavering, Machiavellian. In one episode, he proudly dubbed his leadership style a "benevolent dictatorship." He manages with an iron fist, and he wouldn't know the meaning of teamwork if it knocked off his ever-present sunglasses.
As far out as it seems on reality TV, Simmons' style typifies what was until recently the traditional American leader. Twenty years ago, Simmons would have been elevated to the ranks of CEO or physician leader. Today, he's one of the first to be fired.
Simmons' firing reinforces the research of Harvard Business School professor Linda Hill. Hill's studied leadership around the globe, including in emerging markets like China and Eastern Europe. Her research points to the changing face of leadership. Leaders of the future, Hill says, will no longer fit the Simmons-esque style of management. Instead, they must be collaborative, flexible, and open-minded if they want to be successful.
The same is true in hospitals. Earlier this month, I wrote a column Docs Are People, Too. Unfortunately, they don't always act it. The traditional physician leader is often portrayed much like Simmons--inflexible, dictatorial, and a tad sexist. Physicians are perceived as all-knowing, and up until a few years ago, neither nurse nor patient dared question the authority of a physician--even if he was clearly wrong.
Beth Israel Medical Center in New York City has adopted the OR Empowerment Program to overcome this way of thinking. Under this system, anyone in the operating room has the power to stop a procedure at any time by calling an "OR stop." The person who called the stop, their supervisor, the attending surgeon, and the anesthesiologist then have an immediate discussion about why the stop was called, what might be wrong, and what can be done about it. "We want to get over the time where surgeons were the gods, the kings in the room that everyone's afraid of. That doesn't breed the environment where people will talk up or say something's not right," explains Dr. Donald Kastenbaum, the head of Beth Israel's OR.
A few weeks ago, I was talking to a friend of mine about healthcare. She's a successful executive--confident, outspoken, and opinionated. She wouldn't think twice about challenging her boss, but she said she's still not comfortable asking her doctor if he's washed his hands. Her comments reminded me that all the patient education posters in the world won't overcome the traditional image of doctors as indisputable experts. It's up to healthcare leaders to monitor the culture of physician-patient/physician-staff relations and to implement programs like OR Empowerment to ensure that necessary, life-saving questions are asked (and heard).
Business strategy experts say the Gene Simmons style of leadership stifles growth and holds companies back. In healthcare, however, heavy-handed leaders can have a much graver effect.
Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.
Doctors keep licenses despite lawsuits, sexual assaults, even patient deaths thanks to Wisconsin's lax system of oversight that favors doctors over patients. A Journal Sentinel review of five years' worth of disciplinary action found that the board is slow to look into complaints, keeps many of its investigations secret and rarely imposes serious discipline, even when patients die.
In a move that has been fiercely debated by legislators and the hospital industry, Mount Sinai Medical Center opened a stand-alone emergency room Monday less than a mile from Aventura Hospital. The money-losing hospital is gambling $5 million that it can attract Aventura residents to a 'round-the-clock ER and, if needed, rush them by ambulance to their half-empty facility in Miami Beach for surgery or other extensive care.
