Patient Records Up For Auction?

This ad appeared in a local newspaper about a month ago:  Up for auction in Norton, Ohio:  Physician’s office furniture, patient files and records. It was an advertisement from one of those “store your stuff” places; apparently Sophia Coen, retired Ob/Gyn, hadn’t paid her rent. 

My sister-in-law (a hospital credentialer) showed me the ad.  We talked about who should contact the owner of the storage business to advise them about HIPAA, etc.  Her supervisor called.  She was quickly assured that none of the doctor’s records would be auctioned and that he had received “many calls.”

Now there’s a follow up article in the Akron Beacon Journal (even commented on by Compliance Monitor, a national healthcare publication from HcPro.)

And it appears that Dr. Coen may end up with more problems than back rent.  Patients have been requesting, and in some cases even paying for copies of their records, but haven’t received them.  This issue is one of real concern for retiring physicians: 

Under the Health Insurance Portability and Accountability Act (HIPAA), patients have the legal right to get copies of their medical files, as well as to keep others from viewing the information.

In most cases, the law calls for patients to get their records within 30 days after the request is made, or within 60 days if the files are stored at an off-site location.

Anyone who violates HIPAA rules can be fined a maximum of $25,000 per year and face possible criminal charges.

Read: Women waiting for medical files now have hope from the Akron Beacon Journal:
http://www.ohio.com/mld/ohio/living/15323561.htm

Improving Hospital-Physician Relationships

When hospital leaders and physician leaders don’t trust or respect one another, working conditions and patient care throughout the hospital are negatively affected. 

A Mitretek Healthcare study found that “73 percent of the participating CEOs rated their hospital-physician relationships quite positively, only 44 percent of the participating physicians shared this view.”

Want to know how your hospital/physician relationship rates? Talk to the people who work in the Medical Staff Services office.  MSSPs work closely with both sides of the house and often have significant insight as to how the relationship is faring.

Robert A. McGowan of Mitretek Systems offers this advice on strengthening the bond. “For optimal relationships with physicians, hospitals need to combine a strategy to align economic interests and share revenues with strategies to communicate better, build trust, and include physicians in decision making.”

Study participants also commonly noted that “volunteerism is dead” and that physicians expect to be paid for time spent on hospital business.

Read the full text of Mr. McGowan’s article:
http://findarticles.com/p/articles/mi_m3257/is_12_58/ai_n8574803

Leadership and Style

A few years ago I worked in a fairly small community hospital, which grew exponentially during the time I was employed there.  When I started the administrative offices, admitting, ER, and several other services were housed in the originally-donated red brick house.  It wasn’t terribly functional, but it certainly had a charm of its own.

Eventually the house was torn down and replaced by a modern, more efficient structure, and in time the CEO made the decision to retire.  Because he’d been CEO for nearly three decades, he had a special relationship with the community and the employees.  He knew most of our names, and would often stop to chat for a moment to ask how things were going.

At his retirement dinner employees were invited to say a few words, tell a story, etc. 

I told the story of getting on the elevator with him one day and noticing that he was holding two empty coffee carafes.  “Did they send you out for coffee?”  I asked with a grin.

I still remember his response.  “I’m in a planning meeting with some employees and the energy is great, we’re really getting a lot accomplished.  We ran out of coffee so I’m just taking these down to the cafeteria to be refilled.”  He smiled and added “I don’t want the creative thought process to drop off due to lack of coffee.”

What an excellent example of leadership and style.  It apparently never occurred to him that as CEO he was “above” getting coffee for his employees. 

Upon his retirement I presented him with a framed version of the poem below, which he told me hangs in a place of honor in his den.

Here’s to you Mr. Hall. 

The Journey 

You’ve led us on a journey
Spanning twenty-seven years
It’s been a grand adventure
Filled with laughter, smiles, and tears

And during all that time
You’ve impressed us with your style
Always ready with a greeting
And a warmly gracious smile

There’s been quite a transformation
Since you came upon the scene
Of  a quiet small-town hospital
Nestled peaceful and serene

In a charming red brick house
With a switchboard in the hall
A lobby in the living room
And patches on the walls

With an office in the attic
And a tunnel underground
An ER in the basement
And hallways curled around

But for everything that’s changed
In the time you’ve led the way
The heart of who we are
Has stayed the same from day to day

For the people here are caring
In buildings old or new
And much of who we are
We are because of you

So as our paths now part
And you head a new direction
We send you with best wishes
And our genuine affection

Rita Schwab
for
Edward A. Hall
President & CEO

June, 1993

 

Things to do in Atlanta

Atlanta Welcomes NAMSS – September 16-20, 2006Arrive early; stay late. Here are a few local attractions you may want to take time to see while you’re in the Atlanta area for the 30th Annual NAMSS Conference and Exhibition in September: Check the attraction’s web site for the latest information.
  

The Georgia Aquarium
The Georgia Aquarium, which opened in November 2005 and is the world’s largest aquarium, is less than ½ mile from the Marriott Marquis. With 8 million gallons of fresh and marine water, and more than 100,000 animals representing 500 species from around the globe, you’re sure to see things you’ve never seen before! Hours of operation are 8:00 a.m. to 6:00 p.m.

Due to overwhelming response, the Aquarium is selling out many time slots far in advance, and advance reservations are recommended. Tickets can be purchased online at http://www.georgiaaquarium.org/

 The Atlanta Zoo
 Approximately 2.5 miles from the hotel you’ll find lions and tigers and (panda) bears, oh my! The Atlanta Zoo is the wildest place in town, and the grounds are open from 9:30 a.m. to 5:30 p.m.

Tickets can be purchased online at http://www.zooatlanta.org/home.htm

 Centennial Olympic Park
 
Just five blocks from the hotel is 21-acre Centennial Olympic Park. This unique park serves as Georgia’s lasting legacy to the Centennial Olympic Games, as well as being the anchor to Atlanta’s downtown revitalization. http://www.centennialpark.com/
 The World of Coca-Cola
 Less than one mile from the hotel, visitors can tour the World of Coca-Cola and visit the Everything Coca-Cola store. More than a century of Coca-Cola history is on display, including memorabilia and interactive video stations. The Real Thing Gallery highlights classic television commercials spanning over fifty years.

At the end of the self-guided tour, Club Coca-Cola offers a “Taste of the States;” favorite soft drinks offered throughout the U.S. In addition, the International Lounge offers “Tastes of the World,” a sampler of over 20 exotic beverages made by The Coca-Cola Company around the world that are not available in the U.S.
http://www2.coca-cola.com/heritage/worldcocacola.html

 CNN Studio Tour 
Lights, camera, action! CNN’s Atlanta Studio is about one and a quarter miles from the hotel. Fifty-minute tours are available 7 days a week between 9:00 am and 5:00 pm, and depart every 10 minutes. Reservations are highly recommended – tours tend to sell out hours and sometimes days in advance.

Tours include a recreation of CNN’s main control room, as well as an interactive exhibit area where guests can view video clips of the top 100 news stories that CNN has covered during the past 20 years, log on to CNN.com, test their knowledge with the journalism ethics display, and trace the growth of CNN as it parallels world events.
http://www.cnn.com/tour/atlanta/

 Stone Mountain Park
 If you can spend an extra day or two in the area, Stone Mountain Park is just a few miles from downtown. The park is located on 3,200 acres of natural beauty. Stone Mountain features a wide variety of fun family activities and things to do. Find out more at http://www.stonemountainpark.com/
 Hospitality Team Members will be on site at the conference to help you with any questions you may have about the area.

See you in Atlanta!

Grand Rounds Number 100

The 100th edition of Grand Rounds, a weekly collection of the best of the medical blogosphere is up at The Examining Room of Dr. Charles. 

Find out more about Dr. Charles in his Medscape interview with Nicholas Genes, M.D.:
I think every healthcare worker feels the enormity of their task and the impossibility of perfection. We need to have an outlet, some cathartic "generativity" that helps us remember why we enlisted in this often heartbreaking field to begin with, or at least allows us to poke fun at ourselves. For me that has been writing.

Grand_rounds

Healthcare Overhaul Needed According to WebMD Survey

I spoke the other day with someone who is attempting to change culture in a large healthcare organization.   

To say the least, it’s an uphill battle. 

He speaks passionately about process changes that he believes can save the organization a considerable amount of money.  The major stumbling block is control.  Lots of people control little pieces of the puzzle, and no one feels inclined to toss their piece into a communal pot for “the greater good.”

A common human frailty.  Why is that?  Do we feel that we have so little control in our lives that when we get some we hang onto it at all cost?  Is it because we feel we worked hard for our little piece of the pie and no one is going to take it away from us?

Are we skeptical that if we give up some control to “the greater good” it will end up being “not-so-good” after all?

Lots of questions, few answers.  In the meantime, healthcare is spiraling up in cost, and often down in quality.

It will come as no surprise to anyone who works in medicine, or even anyone who has recently been treated for a serious illness or injury, Americans are growing increasingly concerned about the affordability and quality of their healthcare.   

WebMD is reporting on a Harris survey of 1,023 adults, where 42% reported an instance of receiving inefficient, poorly coordinated, or unsafe health care in the past two years.

More than three-quarters of those surveyed said the U.S. health care system is in need of fundamental change or complete rebuilding.

Read the article:
http://www.webmd.com/content/article/126/116369.htm

Kate’s Fate – A Progressive Story

Kim from  Emergiblog
Barb from Barbados Butterfly
Aidan from The Examining Room of Dr. Charles
and me

Each of us completed a section and then sent the story on to the next blogger, so none of us knew “Kate’s Fate” until the end.

Part One – Rita from MSSPNexus: http://msspnexus.blogs.com

Kate stood, gazing up at the imposing glass and brick building silhouetted against the quickly darkening sky. The wind whipped her hair, and she absently pushed it back from her face. She watched as dark clouds rolled and tumbled ominously toward her, ravenously swallowing up the retreating azure sky. A single fat drop of cool rain landed on her cheek; she brushed it away like an errant tear.

It was time. She needed to move forward, to face whatever awaited her behind those glass doors. Yet even as that thought coalesced her feet remained motionless, as though mired in wet concrete instead of resting firmly atop it.

She had insisted on coming here alone, had been quite firm about the matter actually. Kate remembered the look on her husband’s face as he’d held her hand the night before and told her they’d face whatever the future held together. She’d squeezed his hand and smiled, “No need for anyone to make a fuss” she had said.

“What did you tell Amanda?” he had asked.

“I told her that a certain highly-placed official at Microsoft has decided to give Robert Scoble a run for his money and that I was jetting off to Seattle to meet with him about becoming a ghost-blogger.”

She grinned, remembering her husband’s laughter, and his request to see if she couldn’t snag a copy of Vista for him while she was there.

This morning she had kissed him on the cheek and breezed out the door as though she hadn’t a care in the world. To come here; to find out what comes next.

Kate began to walk briskly forward, toward her future.

Part Two – Kim from Emergiblog: http://www.emergiblog.com

Two days before, that Friday, she had seen her primary physician for a routine physical. Ironically, she had been able to schedule her yearly mammogram for late that same day. Thank goodness she didn’t have to take another day off of work. Things just seemed to pile up if she wasn’t there.

She caught sight of herself in the glass window as she passed. She looked at least ten years younger than she was. She jogged regularly and had the metabolism of a gazelle.

The epitome of a healthy woman and she felt every bit of it.

So she was just a bit concerned when her doctor called her after hours with the news that the latest mammogram was somewhat different than her previous film. Not to worry, the doctor told her, it might be nothing.

But it would require follow up. In the form of a biopsy.

She pushed the obvious into the depths of her subconscious.

Oh great, Kate thought, another day off of work. When did this need to be done?

Soon.

Monday.

Today.

And so it was that Kate found herself in front of St. Bernadette’s Health Center for Women.

She took one last look at herself in the glass door, smoothed out her skirt, threw back her hair…

…and prayed.

Part Three - Barbados Butterfly http://barbadosbutterfly.blogspot.com

Kate changed quickly into the white cotton gown, placing her clothes in a blue plastic bag before exiting the cubicle. Hurry up, she thought to herself. Let’s get this over with.

Kate was greeted by a rotund, flaxen-haired woman when she emerged. “Hi, Kate,” the woman said pleasantly. “I’m Jodie and I’ll be your ultrasonographer today. You’re having a biopsy of your right breast, yes?”

Kate opened her mouth to speak but ended up nodding instead as nervousness overwhelmed her. She followed the ultrasonographer into the room. A tall man wearing a white shirt and brilliant blue tie stood up from his chair when she entered.

“Good morning Kate,” he said cheerfully. “I’m Dr Shand, one of the radiologists here. I’ll be performing your core biopsy today.”

Dr Shand explained the procedure. Kate nodded intermittently as he spoke, barely hearing a word. She understood that there would be a biopsy taken. She had no questions about what it involved.

“We won’t get the result of the biopsy today,” Dr Shand continued. “It will take 2-3 days to get a result and you will need to make an appointment with your physician to find out the results.”

Explanations over, soon Jodie was pressing the cold grey ultrasound probe against Kate’s breast, scanning for the abnormal area seen on the mammogram. The first needle was for the local anaesthetic; Kate stiffened as the needle pierced her skin, trying to ignore the discomfort.

Kate glanced down as the radiologist brought the biopsy needle toward her, then quickly raised her gaze to the ceiling upon seeing the needle’s huge size.

“Snap!”

The loud noise of the biopsy needle firing made Kate jump. There was a burning pain within her breast. Kate stared at the ceiling and hoped it would be over soon.

Part Four - Dr Charles http://scienceblogs.com/drcharles

It was like déjà vu. She remembered the same piercing pain in her breasts ten years ago. Feeling inadequate and finally bowing to societal pressure, Kate had flown down to Miami to see the top cosmetic breast surgeon on the east coast. Make them big she had said. The surgeon had obeyed her command, and for ten years she had forgotten that pain, awash in the dubious glory of her new anatomy.

“I’m finding some strange resistance in the tissue,” Dr. Shand said. He looked worried. “I’ve never felt this sort of thing before.” With a look of concern Dr. Shand pulled out the anesthetic needle again. “I’m going to numb this up a little more and see if we can remove it.” 

Kate felt the pain again, followed by numbness and tugging. “Dr. Shand, you know that I had breast implants, right?”

“Of course, of course,” he replied. “Wait a minute . . . Yes, I have it! Here it comes now, hold still.” Dr. Shand carefully withdrew his instrument from the core site. Stuck to the end of the puncturing tip was a piece of pale red tissue.

“What is that?” Kate asked.

Dr. Shand looked troubled. “This is very serious. Did you have your surgery in Florida by any chance?” He recalled that in the late 1980′s the field of cosmetic surgery was booming in Miami, and plastic surgeons from all over the world had set up shop. It got so out of control that licensing boards couldn’t keep up with the clinics or the credentials of the doctors. There had been one charlatan in particular who had forged his medical degree and training certificates, and eventually gained notoriety as one of the best surgeons in the land. But like all villains he had a dangerous hubris, a self-destructive streak that compelled him to sneak foreign objects into his surgeries and try to implant them.

Years later he was found out, tried, and locked away for life in Folsum County Prison.

“What is that?” Kate repeated desperately, still fearing that Dr. Shand was about to tell her that he had surely found cancer. The story that had begun with her abnormal mammogram was about to end tragically.

“Kate, I regret to inform you of a terrible thing that’s happened to you,” Dr. Shand said with all sincerity. “This piece of tissue was planted in you years ago without your knowledge. It is called . . .”

“What is it?!” Kate screamed, coming apart at the seams.

“There is no medical term for it. It is called Hubba Bubba.”