Medical Research

I did a ton of research before I started figuring out that my bariatric surgeon (and others) didn’t give me a good feel that they knew the current research, especially where it concerns malntrition, neurological complications of bariatric surgery, etc. Either that or they didn’t explain it to me, because a lot of things I couldn’t find an answer for in my records OR in the research. So … in the interests of helping people out to a short/quick/dirty set of links to medical research (so you know when you’re getting someone who is up on the research) … here is what I have.

General guidelines:
American Society of Metabolic and Bariatric Surgery Guidelines.

Bariatric Followup:

Carrying for patients after bariatric surgery Apr 15, 2006 Table of Contents


Bariatric Follow-Up Care


Follow-up of Nutritional and Metabolic Problems After Bariatric Surgery

Iron Deficiency
IDA1
IDA2
IDA3
IDA4
IDA5
IDA6
IDA7
IDA8
IDA9
IDA10
IDA11
IDA12
IDA13
IDA14
IDA15
IDA16
IDA17
IDA18
IDA19
IDA20
IDA21

Neurological Complications:
Neurological disorders associated with malnutrition

Psychiatric Care:

Psychiatric Evaluation and Follow-Up of Bariatric Surgery Patients

Health Care & Money, Bad docs, Medical Research, Obesityhelp.com warning,blogs

I had heard (and of course, always check things out) that obesityhelp.com sends reviews back to the surgeon. If they don’t like it, obesityhelp.com will delete it and not allow you to post. This is the surgeon experience form. When I asked about this, the response I got on 3/18/2014 at 11:14 am from membermail said, “Send us what you want to post and we will review it before you post it. Also let us know what surgeon it’s for.” Now if I have to have it approved, do you feel obesityhelp.com is a fair place to get ALL comments about a surgeon or is it only going to list their good ones. How can you learn if you only have good and don’t see how they deal with the not so good ones?

THE LATEST:
On 3/22/2014 5:32 PM, ObesityHelp Staff wrote:

When a member writes a testimonial on a surgeon, the surgeon receives a notice that a testimonial has been left on their profile. We do not review testimonials before or after they are written. We will conduct a review if a testimonial violates our Terms of Service and is reported to us by a member, a lurker or a professional. Unless a testimonial violates our Terms of Service, is slanderous or involves a potential legal action, we do not remove testimonials. If a testimonial is removed for slander or a legal issue, we do so for the protection of our member. Whenever a testimonial is removed, we notify the member by PM.
Member Services

Here are some recent items that go over money and health care, misbehaving surgeons & other doctors, selling nutritional supplements, and money/healthcare as a business. I also include retaliation that was done to a nurse, a single mom of two who had life miserable made for her due to whistleblowing when she served indigent & low income patients.

Syracuse Hospital Says it may be sued over patient slapping

Hospitals turn a blind eye to bad physician behavior
“Hospitals often turn a blind eye to bad behavior by physicians, especially if the doctors generate a lot of revenue, according to Syracuse.com.”

“Although experts say the vast majority of physicians aren’t troublemakers, bad behavior clearly isn’t an isolated problem. There have been several cases of physicians throwing objects in the operating room, yelling and hitting patients, and sexual abuse, the Association of Health Care Journalists reports. However, in most of these instances hospitals didn’t investigate the claims, according to Syracuse.com.

Hospitals often don’t do anything about the problem because the accused physician brings in a lot of money, Michael A. Carome, M.D., director of health research at the nonprofit consumer rights advocacy group Public Citizen, in Washington, D.C told Syracuse.com. And when hospitals do report cases to state medical boards, it’s rare for physicians to receive more than a slap on the wrist for the misconduct, he said.”

“In many instances, the bad behavior distracts the healthcare team, which can lead to medical mistakes.

“When we allow bad physicians to remain in practice, that can ultimately expose hundreds if not thousands of patients to substandard and unprofessional care,” Carome said.”

*** Just so you know, my blog links to items showing a 45% profit rating

Lawsuit on docs who mocked patient during anesthesia
The suit is emblematic of the decline in doctors’ professional reputations in recent years. “The once-venerable medical profession has taken quite a tumble from its pedestal, with the terms ‘untrustworthy’ and ‘greedy’ used to characterize doctors more often than ‘respected’ and ‘benevolent,'” Linda S. Ellis, M.D., of the Frank H. Netter M.D. School of Medicine at Quinnipiac University wrote in an opinion piece for Live Science.

Pressure on physicians to always be “right” contributes to a mistrustful culture where physicians fear asking questions or conceding mistakes, according to Ellis. “We tell one another and our students to never admit wrongdoing,” she wrote. “[E]ven worse, we model bad behavior to our medical students and residents, training new doctors to perpetuate behaviors that engender distrust.”

Hospitals bullies pose danger to patient safety
This isn’t just psychologically damaging to staff, according to Yurkiewicz; it also affects patient outcomes. For example, an abusive attending physician may discourage residents and nurses from openly discussing a patient’s problems, which gives time for those problems to worsen. “In a system dependent on hierarchy, it works like this: when anger and intimidation flow down, information stops flowing up.”

“This correlation echoes results from a 2013 study in the UK, which found that one in four doctors and surgeons and one in three nurses said bullying has caused them to behave in ways that are bad for patient outcomes”

Johns Hopkins unveils $11Billion hotel/hospital
Johns Hopkins today unveiled plans for a new $1.1 billion hospital with a “hotel-like” atmosphere, The Baltimore Sun reported. As one of the largest hospital construction projects in the country, the 1.6 million-square-foot building will feature 560 private rooms, 33 operating rooms, new adult and children’s emergency rooms and include gardens, artwork, sound-proofing, Internet and food options. The new hospital replaces the East Baltimore campus, constructed in the 1930s and 1950s.

Officials say the upgrades are needed to maintain business by luring patients and keeping doctors and other personnel, the article noted. “Our new facilities will enable us to provide that excellent care with greater comfort and private for our patients and their families in a state-of-the-art environment,” said Edward D. Miller, dean and chief executive of Johns Hopkins Medicine.

*** Maintain business?

Medicaid debt isnt stopping Maine hospital construction
“Hospitals in Bangor, Augusta and Portland found the capital and loans for major construction projects even though they’re owed $484 million in overdue Medicaid payments from the past four years. The construction boom comes as hospitals warn of having to phase out services or lay off workers to cope with the Medicaid debt, the paper notes.
Eastern Maine Medical Center in Bangor, for example, recently resurrected its plans for a $250 million addition, a project the state approved in 2008 but was delayed in part by Medicaid debt–now more than $75 million, according to the paper.”

*** So how much is spent on patient safety?

Patient litagation over insurance billing practices

“St. Luke’s Health System in Kansas City, Mo., will pay $3.5 million and attorneys fees after it refused to accept health insurance from hundreds of patients injured in car accidents in lieu of trying to collect potentially higher payouts from automobile insurers instead.

Three patients sued the hospital after it attempted to recoup payments they received from their automobile insurers for medical treatment. Such payments are often higher than what St. Luke’s can collect from health insurers because the automobile insurers don’t negotiate payment levels in advance, according to the Kansas City Star.

If the automobile insurer didn’t offer a settlement, St. Luke’s often filed liens against patients directly.”

Putting the Patient First
Putting the Patient First — Using the Expertise of Laboratory Professionals to Produce Rapid and Accurate Diagnoses

Doctors & ethics of selling nutritional supplements
Is It Right for Doctors to Sell Nutritional Supplements?

Great blog on how a hospital is facing lawsuits from patients who were lied to on mammograms.
In summary, Perry Hospital technician Rachael Rapraeger lied about the results from over 1,200 mammograms. In her plea deal with a criminal court, Ms. Rapraeger said she got behind in her work and created negative readings for over 1,200 mammograms….mammograms that were never reviewed by physicians. Patients were lied to. Ten patients actually had positive readings, and two have since died. Ms. Rapraeger apologized for her conduct and was sentenced to six months in jail, 9.5 years of probation, a $12,500 fine, and is banned from the healthcare profession for 10 years.
Perry Hospital is currently facing 30 lawsuits from Ms. Rapraeger’s actions, and the hospital issued the following statement after her plea deal: “We are pleased this component of Ms. Rapraeger’s unfortunate action is concluded.”

How rude! Workplace incivility hurts bottom line

CA senator demands hospitals reduce rampant medical errors

“Building a differential diagnosis is in several steps of John Brush’s 12 point diagnostic process outlined that’s been taught for over 100 years. Wouldn’t this help diagnostic errors?”

*** Note that in Virginia, a doctor can “plea bargain” something from the Medical Licensing Board. There is a doc in Va. named as a “top doc” in the DC area that is on the brink of their license. Nothing in the public record for 3 years. Someone mentioned in another list that they should rename boards to something like a Protective Agency. In Florida, the doctor can see your complaint but you can’t see the doctors’ response. So if they lie, the lies are *protected by the state* as the *physician*. It is the same in Va. where you can’t comment on anything. They also don’t consider anything other than their own reports, nor how or where they get specialists to review other specialists, and whether there are conflicts of interest.
Boards of licensing are not transcribed/recorded. The doctors know this. Wonder why they get told that? They’re not sworn to tell the truth either.

Whistleblower lawsuit & what they did to the whistleblower
“Frohsin & Barger Qui Tam Suit Prompts Amedisys to Pay $150 Million
In 2009, Frohsin & Barger client, April Brown was a nurse and single-mother of two, struggling to make ends meet in the sleepy town of Monroeville, Alabama, best known as home to writer Harper Lee and the inspiration for her fictional town of Maycomb in To Kill a Mockingbird. Brown travelled rural Alabama caring for homebound patients: elderly shut-ins and the indigent infirm. What she witnessed about her employer’s Medicare billing, however, eventually caused her to become a whistleblower in the groundbreaking case of United States ex rel. April Brown v. Amedisys, Inc., CV-10-BE-0135-S (NDAL 2009), which today resulted in the largest home health fraud settlement in U.S. history, prompting the company – which denied all wrongdoing – to return $150,000,000 to the taxpayers, according to court documents.”

New WellPoint CEO Swedish Took Home $17 Million in 2013
(with Table: 2013 Compensation Among Five Highest-Paid WellPoint Executives)

General items:

Your rights and responsibilities according to Blue Cross Blue Shield.

Patient Advocacy:

Activated Patient
Patients are people too
Patient Visit Guide
Health Coaching

Protein Issues:
How much protein do I need each day?

Other patients blogs:

Was a bubble butt.
Ad Winters
Bariatric Beginnings
Beauty & the Bypass
Judi’s great spot
Bariatric Girl
What another patient went thru
Another link from Gary

Information on the bariatric surgeries from less than 6 months ago:
BMI Loss Lasting w/3 Bariatric Surgery Options.
Firing of Rex doctor