Why Hospitals Turn A Blind Eye To Misbehaving (Mentally Ill) Docs

Dateline April 2014. And if you think anything has changed, . . .

fiercehealthcare

Physicians that generate revenue trump potential for patient harm

April 28, 2014 | By Ilene MacDonald

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

Last week's lawsuit by a Virginia patient who claims doctors mocked and defamed him while he was unconscious during a colonoscopy is just the latest example ofdisruptive doctor behavior.

A Syracuse, N.Y. surgeon allegedly slapped sedated patients' buttocks and called them derogatory names and though staff complained, St. Joseph's Hospital Health Center didn't do anything about it until a formal complaint was filed in December, according to the publication.

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 toSyracuse.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.

Indeed, state boards only disciplined 4,479 of the 878,194 active, licensed physicians in the U.S. in 2012--less than 1 percent, Medscape reports.

Disruptive workplace behavior isn't unique to the healthcare industry, but the stakes are higher because of the negative impact it can have on the patient, William Martin, a DePaul University professor and expert on disruptive workplace behavior, told Syracuse.com. 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.

Last year FierceHealthcare reported that some hospitals are finally cracking down on the problem, particularly the abuse behavior some doctors express toward nurses, trainees, colleagues and other medical staff. Steps hospitals can take include setting behavioral expectations for the professional staff, establishing a behavior event review committee, and implementing a physician health committee.

To learn more:
- read the Syracuse.com article
- check out the AHCJ report
- here's the Medscape report

Related Articles:
Lawsuit: Docs mocked anesthetized patient
Hospitals have had it with misbehaving docs
How to rein in docs gone wild
How rude! Workplace incivility hurts bottom line
Hospital bullies pose a danger to patient safety
3 tips to defuse disruptive behavior in healthcare

Hospitals often don't do anything about the problem because the accused physician brings in a lot of money

Right, that's why they refer to themselves as care "givers". 

You expect this crowd to play by the same rules they clobber everyone else with?

They can't even speak English!

Physician/Nurse, Heal Thyself: Nurses Say Peer Bullying Is Rampant, And Patients Pay The Price

But it's the Patients who get stuck with Incurable Behavioral Illness Government paperwork.

• California Diversion Programs (7)

fiercehealthcare;

Young doctors also often victims of hazing, abuse

April 28, 2015 | By Leslie Small

As the issue of violence directed at healthcare workers gains ever more attention, research shows that nurses and doctors suffer some of the worst abuse at the hands of their own colleagues.

At least 85 percent of nurses have been verbally abused by a fellow nurse, and some expertsestimate that 1 in 3 nurses will consider quitting because of the bullying, Marie Claire reports.

Since the phrase "nurses eat their young" emerged in 1986, it seems as though the practice of hazing, ostracizing and abusing newly minted staffers has become worse, according to Gary Namie, Ph.D., director of the Workplace Bullying Institute in Bellingham, Washington. "Nurses uniformly seem to accept nurse-on-nurse violence as just part of the job," Namie told Marie Claire. "But they're losing nurses by the drove."

This bullying also poses a significant threat to patient safety. One nurse, identified only as Christi, told the magazine that former coworkers once ignored her request for help when dealing with a coding patient, who she said nearly slipped into a fatal coma. Another nurse identified as Megan said she has seen senior nurses at a Virginia hospital assign other nurses patients who need one-on-one care, then watch TV as the nurses struggle to juggle the workload.

A major component of the problem is that victims often lack the ability to stop the abuse, the article states. Christi's manager refused to take action against the alleged offenders. Administrators also often find their hands tied, as same-gender abuse can't be labeled discriminatory and it may be difficult to discipline staff for interactions they didn't witness.

The medical establishment also largely condones bullying of young doctors, argues an article from Medscape. The publication cites a slew of online comments on a previous article about physician suicide, many from people who said they were medical professionals and faced abuse and hazing as residents. Others claimed to have been reprimanded for showing emotion, their supervisors telling them that it's "unprofessional to cry."

Some nurses, however, told Marie Claire that they feel younger staffers misinterpret their often stress-fueled interactions as abusive when they are only intended to improve patient care. "If you come in on your high horse, you need to be knocked off a bit," one nurse told the magazine. "Because it's those nurses who do things wrong and hurt people." Others, however, believe that "arguments such as these run counter to all the data we have on patient outcomes,"FierceHealthcare has reported.

To learn more:
- read the Marie Claire article
- here's the Medscape piece

Related Articles:
Hospital bullies pose a danger to patient safety
Docs, nurses bullied into poor care
Survey: Doc verbal abuse is contagious
Workplace violence is on the rise and nursing staff are in particular danger
Do hospital leaders tolerate violence against emergency staff?
The future of nursing: An industry in flux

Thank You Leslie Small and FierceHealthcare.

How Virginia Employers Enable Nurse Drug Theft

Psychiatrically speaking, these people are - to steal a line from Senator John McCain - 'Wacko Birds'. And their State Diversion Programs violate Federal Civil Rights Statutes.

fiercehealthcare;
December 8, 2014 | By Zack Budryk


Despite a state program in place to keep drug addicted nurses in the workforce, 900 Virginia nurses have been disciplined for theft or abuse of prescription drugs since 2007, according to an investigation by the News Leader.

Based on an analysis of public records, the publication found that the state may actualy enable drug theft. It found:

• Patients across Virginia over the last decade did not take necessary medication due to theft by nurses.
• Employers who discover drug abuse among nurses often don't report them to the state.
• Although state law mandates fines for employers who do not report nurses' drug addiction to the state, they are hardly ever punished for failure to do so.
• Virginia doesn't require criminal background checks for nurses before licensing them to practice and healthcare is not classified as a high-risk sector such as trucking or airline travel, which means random drug tests are not required.

More than 100,000 healthcare workers abuse or are addicted to prescription drugs, making "drug diversion"--the official term for theft of drugs by medical personnel--a major problem within the industry, FierceHealthcare previously reported

"Substance abuse in nursing is the elephant in the room," Pat Graham, a psychiatric nurse and trainer at Western State Hospital in Staunton, told the News Leader. "No company says, 'If you're hired and you have a history, we have a substance abuse program.' We dare not be transparent."

Advocates hoped the monitoring model of treatment, which was added to Virginia law in 1998, would give addicted nurses more options. The model treats addiction as a disease and anticipates relapses, encouraging participants to remain in the workforce, possibly under supervision, while they combat the disease, with the option to get a stay of discipline and keep their record confidential if they enroll in the program.

But advocates admit that this model is risky if not perfectly executed, according to the article. Only about 34 percent of nurses successfully complete the program, compared to much higher averages of about 60 percent for most other states, with the retention rate in Florida as high as 80 percent.

.To learn more:
- read the article

Related Articles:
Rehab programs let addicted nurses seek help, keep jobs
Safety experts: Hospitals lacking in doc substance abuse policies
3 signs healthcare workers abuse drugs
Hospital setting triggers worker drug abuse, theft
Should all docs and nurses receive drug tests after adverse events?
Develop policies to handle doc impairment--before you need them

Thank You Mr Budryk and Fierce Healthcare.

A Few Words. 

License Revocation.

Psychiatric Diagnosis.

Psychiatric Drugging.

State Police Registration.

If it's good enough for the defrauded consumer, it's good enough for Doctor Defrauder's doped up little helpers too. 

$100 M Spent to Defeat Ca. Prop 46 & 45- Making Drinking & Drugging 'Incurably Mentally Ill' Doctors More Accountable

http://www.yeson46.org/dangerous-doctors/

fiercehealthpayer;
October 31, 2014


SANTA MONICA, Calif., Oct. 30, 2014 /PRNewswire-USNewswire/ -- Consumer advocates and victims of medical negligence released a new Yes on 46 TV ad today featuring a sweating, shaky surgeon who runs out of the operating room and dramatizes the potentially deadly risks of physician substance abuse.

The ad, "Need A Drink?" also warns voters about the $100 million that the insurance industry is spending this election cycle to deceive the public about two ballot measures, Propositions 45 and 46, that will hold them accountable for fair prices and patient safety.

View the "Need A Drink?" ad here: 

http://www.youtube.com/watch?v=ZlbgDggl5sg

The ad dramatizes how patients are placed in harm's way when they are treated by doctors with substance abuse problems. Up to 2600 doctors in California have an addiction problem at any given time, yet the Medical Board only disciplines an average of 32 doctors a year for abuse.

"Doctors under the influence place us all at risk but the malpractice insurance companies funding the 'No' campaign don't want to be held accountable when their doctors harm someone. Random drug testing under Prop 46 will identify those dangerous doctors and suspend them when they're found to have been impaired on duty," said Carmen Balber, executive director of Consumer Watchdog.

Malpractice and health insurance companies have given $44 of the $58 million that opponents of Proposition 46's patient safety reforms are spending on deceptive TV ads and mailers. Health insurance companies are spending $57 million against Proposition 45's prohibition on excessive health insurance rates.

"The real risk in this election is letting the insurance industry get away with buying it, but voters know that when insurance companies spend $100 million it's not to protect us," said Balber.
Examples of dangerous doctors across California who placed their patients at risk while addicted to drugs or alcohol can be found at:http://www.yeson46.org/dangerous-doctors/

The $100+ million insurance industry campaign has made California's 2014 November ballot one of the most expensive campaigns in the nation.

Prop 46 requires mandatory drug testing for physicians and suspension of impaired physicians' licenses, mandatory checks of an existing prescription drug database before narcotics are prescribed to first time patients, and indexes for inflation the state's 38 year-old cap on damages for medical negligence victims. Insurance companies are spending so much against it because they don't want to be accountable when physicians cause harm.

For more on Proposition 46 visit: www.YesOn46.org
For more on Proposition 45 visit: www.YesOn45.org

Paid for by Consumer Watchdog Campaign – Yes on 46, a coalition of attorneys, consumer advocates, and patients.  2701 Ocean Park Blvd., Ste. 112, Santa Monica, CA  90405.  Major Funding by Aitken, Aitken & Cohn, LLP.

SOURCE Consumer Watchdog Campaign


Thank You Fierce Health Payer & Yes on 45, Yes on 46.

Prop 46 Ballotpedia:

California Proposition 46, the Medical Malpractice Lawsuits Cap and Drug Testing of Doctors Initiative, was on the November 4, 2014 ballot in California as an initiated state statute. The measure was defeated.

The initiative would have:^[1]

• Increased the state's cap on non-economic damages that can be assessed in medical negligence lawsuits to over $1 million from the current cap of $250,000.
• Required drug and alcohol testing of doctors and reporting of positive tests to the California Medical Board.
• Required the California Medical Board to suspend doctors pending investigation of positive tests and take disciplinary action if the doctor was found impaired while on duty.
• Required health care practitioners to report any doctor suspected of drug or alcohol impairment or medical negligence.
• Required health care practitioners to consult the state prescription drug history database before prescribing certain controlled substances.

Supporters of the initiative refered to it as the Troy and Alana Pack Patient Safety Act of 2014, after two children who were killed by a driver under the influence of alcohol and abused prescription drugs.^[2]

The measure would have created the first law in the United States to require the random drug testing of physicians.^[3]

Supporters of Proposition 46 argued that medical negligence is too common and pain and suffering damage awards are too low. Opponents said the initiative wasn't about protecting patients, but increasing medical lawsuit payouts to trial lawyers.

Election results

---

This ballot measure article has preliminary election results. Certified election results will be added as soon as they are made available by the state or county election office. The following totals are as of 100 percent of precincts reporting.

---

California Proposition 46
Result		Votes	Percentage
No		3,415,996	67.15%
Yes		1,671,163	32.85%

Election results via: California Secretary of State

Proposition 45 Ballotpedia;
California Proposition 45, the Public Notice Required for Insurance Company Rates Initiative, was on the November 4, 2014 ballot in California as an initiated state statute, where it was defeated.

The initiative would have:^[1]

• Required changes to health insurance rates, or anything else affecting the charges associated with health insurance, to be approved by the California Insurance Commissionerbefore taking effect.
• Provided for public notice, disclosure, and hearing on health insurance rate changes, and subsequent judicial review.
• Required sworn statement by health insurer as to accuracy of information submitted to Insurance Commissioner to justify rate changes.
• Exempted employer large group health plans under any circumstances.
• Prohibited health, auto, and homeowners insurers from determining policy eligibility or rates based on lack of prior coverage or credit history.

Overall, the initiative would have imposed on the health insurance rate regulation system what Proposition 103 (1988)imposed on automobile and homeowners insurance.^[2]

Supporters refered to the initiative as the Insurance Rate Public Justification and Accountability Act.^[3]

Its sponsors originally hoped to qualify their measure for theNovember 6, 2012, ballot. They submitted over 800,000 signatures on May 18, 2012.^[4] On June 28, it became evident that election officials would not have adequate time to scrutinize the signatures for validity in time for placement on the November 6, 2012, ballot. On August 23, 2012, it was announced that the measure had qualified for the 2014 ballot.^[5]

Election results

---

This ballot measure article has preliminary election results. Certified election results will be added as soon as they are made available by the state or county election office. The following totals are as of 100 percent of precincts reporting.

---

California Proposition 45
Result		Votes	Percentage
No		3,024,584	59.81%
Yes		2,032,272	40.19%

Election results via: California Secretary of State

Kind of makes you feel all warm and fuzzy inside, doesn't it?

Over $100 Million to keep insurers in the black and drunk and drugged up Docs doing what they do best.

As everybody else gets the Psychiatric Shaft.

Hospital Screw-ups Now 3rd Leading Cause of Death In US, "Why Docs Don't Snitch When Colleagues Make Mistakes"

fiercehealthcare has;

Silent Treatment: Why Docs Don't Snitch When Colleagues Make Mistakes
November 11, 2013 | By Ilene MacDonald


A new report in the New England Journal of Medicine may shed light on some of the reasons hospital medical errors are the third leading cause of death in the nation: Doctors won't tell patients when other clinicians make medical mistakes.

Although there is guidance on how a physician who commits the error should disclose the information to the patient and family members, there are no such guidelines for doctors who discover a colleague's mistake.

Lack of first-hand knowledge about the case, litigation concerns and fear of how a colleague--especially someone who has a higher position or seniority--reacts, are just some physician barriers, according to the report, "Talking with Patients about Other Clinicians' Errors."

Lead researcher Thomas H. Gallagher, M.D., an internist and professor at the University of Washington School of Medicine, told ProPublica that physicians experience a range of emotions when they discover a colleague's error. They may wonder whether they should keep the information to themselves or tell someone, think about what they would want a colleague to do if the situation was reversed or worry about the repercussions if they disclose the error. The result, he said in the article, is leniency toward mistakes.

The NEJM report suggests that despite physicians' worry they may damage their relationship with colleagues, they must remember the patient has a right to know and it's their ethical responsibility to share the information.

"When faced with a potential error involving another health care worker, our conceptions of professionalism should lead us to turn toward, rather than away from, involved colleagues," the researchers concluded. "Although making the effort to understand what happened and ensure appropriate communication with the patient may challenge traditional norms of collegial behavior and involve additional demands on clinicians' time, transparent disclosure of errors is a shared professional responsibility."

Meanwhile, a separate study published in Circulation suggests that there is some truth to the "July effect"--the higher likelihood of patient death when medical students leave the classroom and enter patients' rooms in teaching hospitals.

Researchers at Harvard Medical School, Stanford University Hospitals, University of Southern California and the RAND Corporation, found that in July, the risk of death for high-risk patients who came to teaching hospitals after suffering heart attacks rose from 20 percent to 25 percent. In addition, the difference between patient outcomes in May and July is greatest within organizations that have the highest percentage of trainees.
"The good news for patients is that in most cases, it's very difficult for a physician to make a mistake that results in a patient's death, lead author Anupam Jena, M.D., Ph.D., assistant professor of healthcare policy and medicine at Harvard Medical School and an assistant physician and professor in the department of medicine at Massachusetts General Hospital, said in a the study announcement. "But for severely ill patients, health can be very tenuous. A small error or a very slight delay in care is potentially devastating." 

For more:
- read the NEJM report
- here's the ProPublica piece
- check out the Circulation study abstract
- read the study announcement

Related Articles:
Hospital medical errors now the third leading cause of death in the U.S.
3 caveats to physician apology laws
Should hospitals punish docs for medical errors?
Thousands of docs continue to practice despite misconduct, danger
How to reduce the malpractice threat of ACOs
Hospitals have had it with misbehaving docs
Diagnostic errors: Most costly, common malpractice claim


Thank You Fierce Healthcare and Ms McDonald.

see also;

U.S.C. 18C4 Misprision of Felony

and of related interest;

Arizona Medical Board Nabs Another Drunk Doctor

 Study: 15% Of Surgeons Abuse Alcohol

and the Psych Connection;

http://behavenet.com/search?keys=alcohol


If they're drunk - Two Drinks - just once, . . . EVER, by their own Psychiatric Co-Workers Diagnostic Frippery, they're Incurably, Legally, Insane.

pic cred to phoenixnewtimes