On occasion, I feel compelled to put in my two cents at Santa Clarita City Council meetings. Recently there was a five hour meeting whether the city should subsidize the artsy Laemmle theatre as an anchor to revitalize business in Old Town Newhall.
This is what I said:
As a physician, my job is to weigh risks and benefits.
Advancing technology and research has improved my ability to practice medicine. We don’t give children cough syrup laced with morphine or heroin anymore. Blood letting has been discontinued. Lobotomies are now only reserved for Washington D.C. politicians.
Instead, we use MRIs, robotic surgery, and will soon have stem cell synovial fluid injected into arthritic knees. Movie theaters are now mostly relegated to our family rooms, in the comfort of our own home through Netflix. Next we will have Laemmleflix.
I disagree with $18 million to be spent on a project which includes a piece that might be a dinosaur. Let’s not do a lobotomy on the Santa Clarita taxpayer.
I’m with TimBen on this one.
TimBen refers to City Councilperson Boydston who is known to dissect material and ask a multitude of questions, typically attempting to get citizens a better deal.
I enjoy going to these meetings because it is democracy at it’s best, and I see and interact with many friends, pros and cons, Leaving the podium and getting a few boos from the crowd didn’t bother me as I knew ultimately our City Council would hear everyone’s voice.
This posting though is not about Laemmle. It is what I heard at City Council from a question asked of me by several friends: “Why are six doctors responsible for $23 million in losses at our hospital?” The source of this misinformation comes from hospital administrators.
Therefore, allow me to dissect this question as they do at City Council…but not for five hours.
With the aforementioned advancing technology, statistics and data are kept on all aspects of hospital care. The payment system is complex, with most coming from State and Federal levels based on DRGs (Diagnosis-related group).
For example, if a patient is hospitalized with pneumonia, the hospital is paid a flat fee of $6,000 for a four day stay to cover all costs. If the patient stays 2 days, they make a profit. If the patient stays 7 days, potentially they lose money. For every day beyond the 4 days DRG allowed for pneumonia, our hospital administration has valued each extra day at $1,000, for a total of $3,000 for the added three days. Throughout the year, the hospital totals these extra days and falsely attributes them to doctors at $1,000 per day, hence their total comes to $23 million for six physicians.
The hospital administrators blame these extra days on “bad doctoring” because the physician didn’t get the patient out of the hospital in the DRG allotted time. What if the patient is 85 year old, suffers from multiple medical problems (heart, kidney, diabetes, etc.) and takes longer to fight off an antibiotic resistant infection, or is too debilitated to eat or go home?
More importantly, what if the hospital does not provide adequate services with staffing of nurses, respiratory care, physical therapy, timely surgery, or other necessary ancillary needs? If the patient does not want to go to a nursing home (where the hospital wants to quickly triage them), who’s fault is that?
So there are far more factors other than “bad doctoring” that play a role in discharging a patient from the hospital.
Why then would hospital administrators ignore these other contributing factors and put the blame on doctors? Obviously instead of looking in the mirror, they want to shift the pointing finger of poor patient care away from themselves, and propagandize against an easy target like physicians who tend not to voice opinions.
As most of you know nowadays, some doctors are just trying to survive while others are contracted and muzzled by administrators. I go to City Council because it is a place of democracy where we all have a voice. This is not the case at our hospital where physicians have had their voice silenced.
The City Council passed the bill endorsing the building of an $18 million theater complex. I am okay with this as long as advancing technology doesn’t overwhelm this artsy business anchor.
As for the $23 million propaganda asserting “bad doctoring”, through my voice and two cents, I won’t let hospital administrators attempt a lobotomy on Santa Clarita citizens.
Gene Uzawa Dorio, M.D.
Which hospital administrator did that to you?
Behind national statistics is a lingering fact healthcare in our country will deteriorate. This will come over the next decade and slowly be recognized by the public as a threat to hospitalized patients.
There is a doctor-shortage in this country. You can reach every doctor in the
country via smart phones and any of several doctors’ web sites, or all of them.
Start with KevinMD aapsonline.org, Sermo.org, aapsonline.org, etc.
I agree 100 percent.!
As an hospitalist I was pressured to kick patients out of the door before or at the 3 day mark even if they were not safe to go home (and refused the regular pressure to be dumped in nursing homes)but I refused to do so because patients care and safety were and are always my priority number one.
Interestingly enough my contract was not renewed…
People need to know what is going on in the health care and please continue your crusade to expose the corruption and greed that drive hospitals and big medical groups at the expense of patients care and emotional well being of physicians!
Dominique