DCMedical News: Tuesday, June 7, 2022
DCMedical News is published every day both the House and the Senate are scheduled to be in session.
THE BIG STORY Tuesday, June 7, 2022
Congress returns today. Both Houses are in session twelve days in June.
Vanderbilt “Systemic” Flaws Underlie RaDonda Vaught Manslaughter Conviction, CMS Reported
MedPage Today (here) reports that “Former Tennessee nurse RaDonda Vaught's deadly medication error could have been prevented with a few system-wide fixes that aren't that difficult or costly. Certainly, criminalizing her mistake and charging her or any other nurse with negligent homicide and neglect was absolutely the wrong approach. That's the view of the Anesthesia Patient Safety Foundation (APSF), an arm of the American Society of Anesthesiologists (ASA), whose task force has issued a call to action to hospitals nationwide after studying the circumstances in the Vaught case.
“The anesthesiologists disclosed a 105-page report from CMS (here), which conducted an unannounced inspection of Vanderbilt after an anonymous tip apparently related to the Vaught case, finding that the hospital failed or ignored accepted safety practices that placed its patients in ‘immediate jeopardy’ in numerous ways.”
“Despite the requirement that the county medical examiner be notified in the case of unusual or unexpected deaths -- which many patient safety advocates say would detect fixable hospital errors and provide accountability -- hospital officials instead attributed her death to her brain bleed rather than a medication error. The medical examiner told investigators that the Vanderbilt physician who reported her death said, ‘maybe there was a medication error, but that was hearsay, nothing has been documented. ... We [the medical examiner] didn't see any red flags.’ The CMS report also said the name of the drug Murphey got, vecuronium, was not disclosed to the medical examiner. The hospital's physicians also failed to notify state or federal officials of the error or the unexpected death, which they were obligated to do.”
“The incident and Vaught's involvement did not become public for almost a year, until an anonymous tip the following October prompted an unannounced federal inspection. The agency spent days questioning Vanderbilt personnel and found problems so serious, it threatened to revoke the system's Medicare reimbursement unless it took corrective action. That's when the incident became public.”
“A professor of clinical anesthesiology at the David Geffen School of Medicine at the University of California Los Angeles, said it's important to work on improving systems where 80% to 90% of the issues lie, rather than on ‘outlier individuals’ like Vaught who made a mistake.”
"I don't know too much about the culture at Vanderbilt, but it doesn't help to blame individuals. It creates a culture of fear and inhibits learning and improvement and prevention of errors," he said.
A Warning (and Few Masks) at Davos
The Financial Times reports (here) that “Growing complacency about Covid-19 and politicisation of the pandemic response will cost lives as the world is hit by new waves of the virus in the coming months, Pfizer’s chief executive has warned. “Albert Bourla said people were growing ‘tired’ of the measures introduced to slow the spread of the virus, while ‘politicians want to claim victory.’ Compliance with authorities’ requests for people to get booster shots would fall even among those who are already vaccinated, he predicted. This, combined with waning immunity from previous infections and vaccinations, was likely to lead to ‘constant waves’ of Covid variants and deaths, he said.”
“I feel when I discuss [Covid] with my friends, people are ready to compromise and lower the bar: maybe we can accept a few more old people dying, [rather] than have to work with a mask,” Bourla said. He spoke in Davos, Switzerland, where he noted that few attendees at the World Economic Forum’s annual meeting were masked.
American Birth Rate Up, Slightly, a First Since 2014, But Median Age of Women Giving Birth Rises to New Record
The Wall Street Journal reports (here) that “U.S. births increased last year for the first time in seven years, according to federal figures released Tuesday that offer the latest indication the pandemic baby bust was smaller than expected. American women had about 3.66 million babies in 2021, up 1% from the prior year, according to provisional data from the Centers for Disease Control and Prevention’s National Center for Health Statistics. It was the first increase since 2014. The rebound spanned age groups, with birthrates rising for every cohort of women age 25 and older. Births still remain at historically low levels after peaking in 2007 and then plummeting during the recession that began the end of that year.”
The Census Bureau reports (here), however, that “birthrates have declined for women in their 20s and jumped for women in their late 30s and early 40s, according to a new report from the U.S. Census Bureau. The trend has pushed the median age of U.S. women giving birth from 27 to 30, the highest on record.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
CME on DIE
Policy & Medicine (here) reports that “Beginning June 1, 2022, the Massachusetts Board of Registration in Medicine (BORIM) will require that both applicants for initial physician licensure as well as licensees renewing physician licensure complete a continuing medical education requirement of 2.00 credits on the topic of implicit bias in health care. The 2.00 credits can be applied towards a physician’s biennial requirement of 10 hours of risk management credits and does not result in an increase in the total number of required CME credits. In making the initial announcement, BORIM noted the importance of eliminating racial and ethnic inequities that lead to health disparities in Massachusetts . . . Three courses included on the list are: Diversity in Medicine Matters – The Benefits of a Diverse Workforce, Reflecting on Health Disparities and Moving Towards Anti-Racism in Medicine, and Unconscious Bias in Medicine.”
MGMA Reports Physician Pay Up in 2021
The Medical Group Management Association reports (here) that “Primary care, surgical specialist, and nonsurgical specialist physician compensation, as well as advanced practice provider (APP) compensation, increased from 2020 to 2021. In particular: The area with the biggest percentage decline in median total compensation in the first year of the pandemic — nonsurgical specialist physicians — saw a 3.12% increase from 2020 and a 1.79% increase over 2019’s level. Surgical specialist physicians, who had the second-largest drop in compensation from 2019 to 2020, rebounded with a nearly 4% increase from 2020 to 2021, as median total compensation reached $517,501 last year. Primary care physicians saw compensation gains slightly behind those seen in 2020, with median total compensation reaching $286,525 in 2021.”
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Hospital Revenue Falls in April
“Following a brief rebound in March, hospitals and health systems saw significant decreases in revenue in April, according to a May 31 Kaufman Hall report,” here.
All revenues declined by 7 percent in April, compared to March, due to lower patient volume. Kaufman Hall’s data and analytics head said “"Hospital patients in 2022 are likely sicker, harder to discharge, and more expensive to treat than hospital patients in 2021 . . . Fewer patients who are sicker and more expensive weigh heavily on hospitals' operating margins, putting a strain on both expenses and revenue."
READINGS & REFERENCES
Select Coronavirus Public Health Resources and References may be found here.
The JAMA Patient Page explains the current status of oral anti-viral medications for COVID-19, here.
2022 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
June 8, 9, 10, 13, 14, 15, 16, 21, 22, 23, 24
July 12, 13, 14, 15, 18, 19, 20, 21, 26, 27, 28, 29
August, Congress adjourned, no editions of DCMN
Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org