If patients in the ER are unattended and desperately ill, you're not supposed to ignore them,

[MtnMan]

"POINT OF CLARIFICATION"​

If patients in the ER are unattended and desperately ill, you're not supposed to ignore them, Mission medical bosses inform staff​

The highly unusual internal email, obtained by Asheville Watchdog, was sent Dec. 2 to hundreds of doctors, nurses, and other medical staff in the midst of several state and national investigations into safety practices at Asheville’s flagship hospital. The email was unprecedented, current and former Mission physicians told The Watchdog. But it was also confusing to some doctors who work in the emergency department, and infuriating to others, because it seemed to assume providers who worked there were purposefully ignoring patients or family members who were raising alarms about patients in distress.​

Also, a POINT OF CLARIFICATION about how fucked up "for profit" hospitals and healthcare are turning healthcare in the US into a clusterfuck.

In 2019 a very highly ranked hospital was purchased by a greedy, and probably corrupt for profit healthcare company, HCA, out of Nashville, TN. And here we are, with hospital care so poor and lacking that the chief of staff of a major hospital has to remind over 800 doctors and nurses of what their fucking job is.

In unusual email, Mission leaders inform medical staff that they are expected to care for desperately ill patients in emergency room • Asheville Watchdog

Mission Hospital leadership sent a highly unusual email to hundreds of medical staff earlier this month to remind them of seemingly obvious expectations for patient safety in the Emergency Department: They are to respond when alerted to a patient’s loss of consciousness or “emergent” condition...

avlwatchdog.org

 

[MtnMan]

The North Carolina AG is suing HCA Healthcare, things are so bad.

https://ncdoj.gov/attorney-general-josh-stein-sues-hca-healthcare/

 

[MtnMan]

Nurses know what their job is... but profits of the greedy HCA don't care about anything but the stockholders.

Nurses unite in protest against HCA's handling of Mission Hospital staffing issues

Nurses from the National Nurses Organizing Committee/National Nurses United rallied in front of Mission Hospital on Wednesday afternoon.

wlos.com

 

[MtnMan]

The profit before patients is impacting a lot of neighboring counties EMS systems, who have as few as 3 Paramedic level trucks, as the patients and Paramedics are "parked" in the ER, because there is not enough staff in the ER to take responsibility for the patient. Some are taking action, such as not transferring non-emergency patients to Mission.

My county has put on 2 or 3 additional EMS units at considerable expense to taxpayers to try and provide the level of service needed. Still listening to the scanner, there are times when there are no available EMS units to respond.

Fortunately, the new ER area at the hospital has lots of parking for ambulances.

McDowell EMS Enacts 45-Day Pause on Non Emergency Transfers

McDowell EMS leaders have taken a decisive step by implementing a 45-day pause on non-emergent transfers between McDowell Hospital and Mission Hospital in Asheville. Emergency Services Director Will Kehler sent a letter to HCA Leadership on Monday,

www.ourlocalcommunityonline.com

 

[sandorski]

We provide Healthcare, mmmmkay.

 

[Torn Mind]

It's standard practice in hospitals to create enough misery so that memories fade or are utterly deleted upon exit. Faded memories equals witness testimony that is lost. That's why some sections are drafty and fucking cold. They might hook you up with two IV ports if you're young.

Malpractice, negligence, etc all require actual damages. So neglecting someone but they don't die or have any legally provable issues and damages from those issues, can be given less than the bare minimum.

The letter is issued for the obvious reason: legal heat, not any sort moral wake up call.

Don't expect a government based system to be too much better. Finances are still a concern and driver of behavior and there will be methods developed to cut costs even though up front, there is supposed be "better" care and access.

The populace holds very naive assumptions about doctors, hospitals, etc. Where they think it's populated by individuals who "care" in the sense of an ideal parent, sibling, or romantic lover, the actual relationship is strictly business and you're just a another head to deal with.

Proof of illness is more akin to trying to prove a case before a judge. They ask questions, you answer, info beyond the learned books gets discarded even you think it has relevance or context. But, there are no formal ways to appeal diagnosis, which is a judgment, not of law but of health. Ambiguity in the "proof of facts" is the pathway to profit at the expense of the patient.

There is a time lag of 10-30 years between update of protocol and the actual manifestation of waves of illness. Now, insurance companies have lowered the age for colonoscopies to the mid-40s. That's because, the first wave of young guinea pigs either died too soon or had to experience delay to the point that they had stage IV colon cancer instead of an earlier, less advanced stage.

 

[BoomerD]

My wife just spent 9 days in a skilled nursing facility following a mini-stroke. She was (and continues to be) a severe fall risk because of balance issues. One night, she called for an aide to help her to the bathroom. The aide told her, "don't fall. It's not my job to stop you from falling or to help you up if you do." Da fuq? I filed a complaint with management the following day, but of course, it's a "she said, she said" thing...so nothing was done.

 

[Red Squirrel]

Damn that's brutal. As much as the system here in Canada is a mess and super bloated and inefficient, it's still not as bad as the US system.

 

[SteveGrabowski]

Damn that's brutal. As much as the system here in Canada is a mess and super bloated and inefficient, it's still not as bad as the US system.

I love how our system is so bad broke ass Cuba has a higher life expectancy than the US. And you can't blame antivaxxtards because Cuba crossed past the US on life expectancy in 2019. Though the antivaxxtards look like they have helped Cuba pad that lead in life expectancy out to three years.

 

[BoomerD]

I love how our system is so bad broke ass Cuba has a higher life expectancy than the US. And you can't blame antivaxxtards because Cuba crossed past the US on life expectancy in 2019. Though the antivaxxtards look like they have helped Cuba pad that lead in life expectancy out to three years.

But...but...but...PROFIT!

It's like our medical system is run by Ferengis.

 

[Torn Mind]

Damn that's brutal. As much as the system here in Canada is a mess and super bloated and inefficient, it's still not as bad as the US system.

Your system has nurses or other checkup bots that are incentivized to not behave in doing the bare minimum checks?

They're generally paid worse in Canada than the U.S.

You guys haven't gone down the slippery slope too far yet, but eventually, euthanasia will become fully legal there.

 

[Muse]

Code Black is a 2013 documentary (NOT the subsequent CBS TV series that was based on it, which I have not seen) that highlights ER and hospital healthcare. It was made by one of the principal participants, a resident M.D. who had studied cinematography previously. I've seen it 3+ times, I highly recommend seeing it if you can. It does speak to this thread title directly and in detail.

 

[sandorski]

Your system has nurses or other checkup bots that are incentivized to not behave in doing the bare minimum checks?

They're generally paid worse in Canada than the U.S.

You guys haven't gone down the slippery slope too far yet, but eventually, euthanasia will become fully legal there.

Euthanasia, as a personal choice, is a good thing.

 

[WilliamM2]

Damn that's brutal. As much as the system here in Canada is a mess and super bloated and inefficient, it's still not as bad as the US system.

Must be why so many Canadians travel to the US for timely care...

 

[Fenixgoon]

But...but...but...PROFIT!

It's like our medical system is run by Ferengis.

The best healthcare latinum can buy!

Ferengi Rules of Acquisition

For other uses, see Ferengi. The Ferengi Rules of Acquisition are a collection of two hundred and eighty-five sayings that form the basis of Ferengi philosophy. (DS9 episode: "The Nagus") The Rules of Acquisition were written by Gint, the first Grand Nagus of the Ferengi people. According to a...

memory-beta.fandom.com

 

[sandorski]

Must be why so many Canadians travel to the US for timely care...

Almost everyone is doing Medical Tourism these days. Many even come to Canada for certain surgeries. These are the top destinations for Canadians: Costa Rica, India, Israel, Malaysia, Mexico, Singapore, South Korea, Taiwan, Thailand, Turkey and the United States[list is alphabetized]. Approx 70k did this in 2016, although there are no hard numbers on it.

 

[dave_the_nerd]

Stop killing people, you twats.

 

[Torn Mind]

Code Black is a 2013 documentary (NOT the subsequent CBS TV series that was based on it, which I have not seen) that highlights ER and hospital healthcare. It was made by one of the principal participants, a resident M.D. who had studied cinematography previously. I've seen it 3+ times, I highly recommend seeing it if you can. It does speak to this thread title directly and in detail.

The first 45 minutes come off as sympathy propaganda for a small community of Los Angeles doctors. Very little in terms of facts, especially detailed facts, are actually put forth at all. Restricting the analysis to the "four corners" of the documentary, there's a dislike for paperwork, and constant, frequently bald assertions of "wanting to care", along with shock value footage with no relevance or even factual context.

I find it exceptionally concerning they whine about having to do paperwork. The medical record is one of the most important documents a patient(and their potential lawyers in certain cases) can get.

The general impression is that "our intent differs from the usual doc", but only self-serving testimony and irrelevant footage of the most extreme situations are put forth as grounds. I get they get plentyof incident come straight out of Compton, but not every ER is situated near a Compton for gunshot and stab wounds to constantly filter in.

The worst thing is that this doc might have influenced juries the wrong way(in favor of docs at the expense, suffering, and victimization of patrients), which COVID then renewed.

Some regulations help misconduct while others deter it. HIPAA assists misconduct and negligence because the "pattern of conduct" is exceptionally hard to establish when everything is protected by privacy. Doing reports is bare minumum keeping track of the bare minimum work being done. It is not mere bureaucrary, but because doctors are a legitimate threat to health and safety that such tracking is in place.

Touchy feely "relationships" don't mean shit if they are not doing their job of accurante diagnosis and proper treatment based on that diagnosis. Doctors are not psychologists nor cheerleaders dealing in the "intangible".

Despite the ending message wanting more "county hospitals"...one must wonder how one of the wealthiest locales were making due with a 1930s facility all the way until 2010......and only an "earthquake code" force the construction of a new building.

Crying about having to shut down a section of ER....not saying the reason why. Having to bring facts out of the documentary, it's because even if they pay nurses, it's just such a bad job that they'll still quit.

And good god, true to LA, the women going in with their hair down, showing little regard for cleanliness.....even pizza places have rules to make sure food doesn't get contaminated.

 

[Torn Mind]

L.A. supervisors OK $1.5-million medical malpractice settlement

The Los Angeles County Board of Supervisors on Tuesday agreed to pay $1.5 million to settle a medical malpractice lawsuit stemming from a 2011 surgery at County-USC Medical Center.

www.latimes.com

Well, whaddya know. They were dealing with a couple lawsuits at the time of the documentary's release.

Two-faced conduct by docs.

Most probable scenario:
Top doc "boss" charged young underling to put this shit forth to blunt public opinion amonst the "impressionable" general populace, who take narratives at face value with little ability to think like lawyer or skeptic.

The campaign was clearly successful, given high ratings of the documentary, wose 90 minutes of video literally can be reduced into five meaningful sentences at most.

 

[Muse]

The first 45 minutes come off as sympathy propaganda for a small community of Los Angeles doctors. Very little in terms of facts, especially detailed facts, are actually put forth at all. Restricting the analysis to the "four corners" of the documentary, there's a dislike for paperwork, and constant, frequently bald assertions of "wanting to care", along with shock value footage with no relevance or even factual context.

I find it exceptionally concerning they whine about having to do paperwork. The medical record is one of the most important documents a patient(and their potential lawyers in certain cases) can get.

The general impression is that "our intent differs from the usual doc", but only self-serving testimony and irrelevant footage of the most extreme situations are put forth as grounds. I get they get plentyof incident come straight out of Compton, but not every ER is situated near a Compton for gunshot and stab wounds to constantly filter in.

The worst thing is that this doc might have influenced juries the wrong way(in favor of docs at the expense, suffering, and victimization of patrients), which COVID then renewed.

Some regulations help misconduct while others deter it. HIPAA assists misconduct and negligence because the "pattern of conduct" is exceptionally hard to establish when everything is protected by privacy. Doing reports is bare minumum keeping track of the bare minimum work being done. It is not mere bureaucrary, but because doctors are a legitimate threat to health and safety that such tracking is in place.

Touchy feely "relationships" don't mean shit if they are not doing their job of accurante diagnosis and proper treatment based on that diagnosis. Doctors are not psychologists nor cheerleaders dealing in the "intangible".

Despite the ending message wanting more "county hospitals"...one must wonder how one of the wealthiest locales were making due with a 1930s facility all the way until 2010......and only an "earthquake code" force the construction of a new building.

Crying about having to shut down a section of ER....not saying the reason why. Having to bring facts out of the documentary, it's because even if they pay nurses, it's just such a bad job that they'll still quit.

And good god, true to LA, the women going in with their hair down, showing little regard for cleanliness.....even pizza places have rules to make sure food doesn't get contaminated.

Well, there's a review. To respond intelligently comprehensively, I'll have to watch it again. I do have the sense that you approached it with antagonistic attitude. The paperwork issue seems obvious to me right now. They were forced to spend tons of time on paperwork (when the new county hospital was finished) but they wanted to hands-on help suffering people instead, like they did before the HIIPA regulations. The new facility and regulations didn't allow them to feel like they were helping particularly, but were forced to spend inordinate time/effort in fulfilling elaborate documentation protocols, so they were frustrated.

I had a hospital experience 6 days ago, an outpatient orthopedic hand surgery. My hand doctor wasn't able to it endoscopically, so he referred me to this guy without elaboration. He didn't respond to my request for assurance that this other guy knew what he was doing. The surgeon calls me 2 days before our scheduled phone initial "meeting," I ask him which type of endoscopy he does for this condition (carpal tunnel release) and he says single incision, "state of the art." On that he does not elaborate. Asked if he will honor our scheduled phone interview 2 days later (when I will have a list of questions at hand) he says no, but I can email him with further questions. His answers to those were typically (for my HMO) very brief and incomplete.

I met him in person after I was in gown with IV applied. His "about me" online said nothing about his practice other than that he did a vast array of orthopedic procedures (nothing in particular) and that he was quite into instructing his lesser colleagues (residents). So, I put to him something my surgeon brother told me about 15 years ago, who said that teaching surgeons are by and large not the best surgeons. My surgeon responds that I should tell my brother he's absolutely and completely wrong. I tell him he died 10 years ago, and he reiterates I must tell him he's wrong. He makes no effort to convince me that he's going to do a good job on me. Not a word.

Now, 6 days later, I'm forced to wonder if he did an adequate job. I have watched a few of these on YT. I have to wonder. When he came to me after I woke up his first words were "you were really tight in there." I now have to wonder if that didn't prevent an adequate decompression. If I ask him now (i.e. by email) I figure if he didn't he'd not admit it or admit to not being sure. He might not even know what he should have done to ensure that he achieved adequate decompression. How well trained was he? How many of these has he done? I have no idea. He wasn't personal with me, he rushed off to his other business, which is not unexpected at my HMO.

I did look at the "summary" for the procedure online. It struck me as boiler plate. It's a small paragraph. There's not a word in there that suggests it pertains to my particular operation. I suppose it's there to satisfy HIIPA requirements but it appears useless to me.

I've had a few other outpatient surgeries, 15-20 years ago, about which I was much more confident, had much better communication with the doctors, one of those with my HMO. I had relationships with them prior to the operations, met them in person afterward as well. I want to have the other hand done in a month or two and don't know if I will have a chance at a more satisfactory experience. Fortunately, the other hand isn't in as bad shape, that's my only consolation.

 

[MtnMan]

It's only getting worse as the corporate greed of HCA has destroyed what was a highly ranked hospital before they bought it out.

The finding of immediate jeopardy is the most serious deficiency possible for a hospital, issued only when federal and state investigators determine there are severe threats to patients’ health and safety.

Watch: Officials, nurses hold news conference on Mission Hospital's immediate jeopardy • Asheville Watchdog

Elected officials, nurses, and advocates held an hourlong news conference in Asheville on Tuesday to talk about the U.S. Centers for Medicare & Medicaid Services’ finding of immediate jeopardy at Mission Hospital. The finding of immediate jeopardy is the most serious deficiency possible for a...

avlwatchdog.org

Medicare and Medicaid coverage are in jeopardy, meaning 10s of thousands of locals will need to travel out of county or out of state for hospital care.

My wife and I have already aligned ourselves with physicians that are associated with non HCA hospitals in neighboring counties.

Of course, our local repugnant republican representative is all too eager to blame this corporate criminals (HCA) greed placing profits over patients on "obamacare"

Chuck Edwards: “Failures of Obamacare” Led to Mission’s Decline in Care - Asheville.com

Congressman Chuck Edwards said he is “acutely aware of the problems” that patients have had at Asheville’s Mission Health since the hospital system was purchased by HCA Healthcare, but said he sees no need for his office or the federal government to offer a solution.

www.asheville.com

God, I fucking hate republicans... they are really trying to kill all but the elite.

The only thing this ass wipe has to his credit is he is the repuke that primaried the shit stain Madison Cawthorn.

 

[MtnMan]

As grandsons are firefighters, I frequently have a scanner listening to fire dispatch channels.

Just heard an Engine dispatched to the ER entrance to assist a patient from their car into the ER. WTF

 

[MtnMan]

RANT - RANT - RANT

OK, long story, short.

I ended up in the hospital for 4 days, admitted through the ER. I probably should have called EMS, but I know full well that based on where I live, I would be taken to the closest ER, which is a fucking mess, as it is with a for-profit hospital system, specifically HCA based out of Nashville, TN.

I drove 20 miles to the next county to another hospital. Walked in, and explained why I was there. Since I have been there before, and have several doctors associated with them, I'm in the system, and check in was quick. Told me to have a seat, they would be with me soon. I barely got my butt in a chair before a nurse showed with a wheelchair and took me back. Two nurses, and a PA were immediately giving me care, more than I realized I needed at the time.

Spent the night in the ER, and admitted early in the morning. Three more days "in" the hospital, with excellent care. The ER doc, and the hospitalists that managed my care in the hospital, were great. Huge improvements in my health during the stay. When they (and I) felt I was ready for discharge, they made sure I had everything I needed, and arranged for home aids, i.e. home oxygen, and I was discharged.

Hospitalists, doc, told me he was sending all the info to the specialists I have seen for years, and they should contact me within a day.

Got home about 1:30 on Wednesday in the afternoon, no call from specialists practice.

• Thursday, called specialist's office because I had not heard. Told "their scheduling nurse will contact you", confirmed contact info.
• Friday, called specialist's office because I had not heard. Told "their scheduling nurse will contact you", confirmed contact info.
• Monday, called specialist's office because I had not heard. Told "their scheduling nurse will contact you", confirmed contact info.
• Today, Tuesday, called specialist's office because I had not heard. Told "their scheduling nurse will contact you", confirmed contact info. Read them the damn riot act, and they promised they would send an "urgent" request, and I will hear from them today.

Today, 3 PM, I'm over this shit. (I'm actually feeling great, pretty sure I'm OK for now... but), I call the specialists department associated with the hospital I was actually in. No referral, just explained my situation, and that I really would like to be seen by a specialist there. Being I was in "the system" they are part of as due to being a patient there.

I have an appointment to see a specialist in a couple of days.

The specialists I have seen for perhaps 6 or 7 years is great (and before HCA took over the local hospital system). Easy to work with, talk to, helpful in even helping me interface with the VA for benefits. However, she is apparently sequestered in the current "we are a for profit ONLY system", and we will cut staffing to the point that Medicare threatens to cut us off.

Footnote:
Staff, RN's, CNAs, Therapists, dietary, PAs, were all great. It is a hospital, but given the circumstances, I'd be hard-pressed to find something to criticize.
There are horror stories about the closer HCA hospital, not because of the people, but because of the lack of people as they habitually understaff every department for one simple reason, profit.

And it is after 5 PM, and guess who I haven’t received a call back from...

Ask me opinion about "for profit" health care, I dare ya...