Banner
Home → Last Word

Last Word
New Florida Law You Won't Believe Print E-mail
Written by Michael Sacopulos, JD   
Tuesday, 28 June 2011 00:00

ASK MIKE 

Medical Justice: Medico-Legal Q&A 

Q:         I've recently heard that the Florida legislature has passed a law prohibiting physicians from asking their patients about alcohol consumption and firearms. Is this a joke?

Bill in Tallahassee

A:         Bill, what you heard is partially correct. The Florida legislature recently passed a law (HB 155) prohibiting physicians from asking patients about their firearm ownership. The impetus for this law remains unclear to me. Perhaps there was a fear that patients would be denied access to care if they admitted to owning a firearm.

            The part of your question relating to alcohol consumption is false. No law has been passed (or to the best of my knowledge even been proposed) prohibiting physicians from questioning patients regarding alcohol consumption. This part of your question may have come from someone misinterpreting an article that substitute the term "alcohol consumption" for the term "firearm ownership" in the new law. The article was written as a persuasive piece against the new law. It attempted draw attention and raise emotions to the issue by substituting terms.

            Personally, I've never had a physician question me regarding gun ownership. It is difficult for me to even to imagine where during the history and physical that such a question would be launched. So it would be easy for me to say that the law, while peculiar, is essentially irrelevant. That would be a mistake.

            I think the larger issue is an interference with communication between physician and patient. For centuries, the law has recognized the importance of physician patient communications. Privilege extends over those communications such that a physician may not be compelled to disclose information obtained from a patient without that patient's permission or a court order. The idea here is to give patients confidence and comfort in discussing highly personal matters with their physician. Similar privileges exist between lawyers and clients and clergy (known as the priest/penitent privilege). It seems to me that the Florida law does harm to physician patient communication because it begins to regulate the communication instead of protecting it.

            The timing of this legislation seems particularly poor.  On May 26th, Florida transplant surgeon Dmitriy Nikitin was gunned down by a former patient in a parking garage.  Dr. Nikitin was shot multiple times.  The former patient, Nelson Flecha, then shot himself.  By all accounts, Dr. Nikitin was a young  (41), gifted surgeon that specialized in liver, kidney, pancreas and intestinal transplants. 

              The matter of firearms discussion in Florida exam rooms seems far from resolved. Four different physician groups have joined together to challenge the constitutionality of this new Florida law. It will be some time before this case works its way through the Florida courts.

Michael J. Sacopulos is a Partner with Sacopulos, Johnson & Sacopulos, in Terre Haute, Indiana. His core expertise is in medical malpractice defense and third party payment disputes. Sacopulos may be reached at mike_sacopulos@sacopulos.com

Last Updated on Sunday, 03 July 2011 09:24
 
Using Medicare Claims Data for Improved Outcomes Print E-mail
Written by Bernd Wollschlaeger, M.D   
Sunday, 19 June 2011 09:08

The New York Times recently published an article entitled “Medicare Claims Show Overuse for CT Scanning.”

The authors highlight that according to Medicare claims data some hospitals overuse chest CT scans and, thereby, needlessly expose patients to radiation by scanning their chests twice on the same day. The Medicare agency distributed the data to hospitals last year to show how they performed relative to each other and to encourage more efficient, safer practices. The review of that data found more than 200 hospitals that administered double scans on more than 30 percent of their Medicare outpatients — a percentage that the federal agency and radiology experts considers far too high. The national average is 5.4 percent. The figures show wide variation among states as well, from 1 percent in Massachusetts to 13 percent in Oklahoma. Overall, Medicare paid hospitals roughly $25 million for double scans in 2008. Added revenue may not be the reason dual scans are ordered. But the absence of treatment protocols may explain the variation of CT Chest use among physicians.

Possible solutions should include standardized, evidence-based diagnosis and treatment procedures according to which physicians can tailor their approach to patient care accordingly.

I hope that Medicare will open its database for researchers and health economists to help all of us to make educated and smart medical care decisions which will benefit our patients, too.

 

Last Updated on Sunday, 19 June 2011 09:14
 
CO necessary for locum tenens? Print E-mail
Written by Michael Sacopulos, JD   
Tuesday, 24 May 2011 08:53

ASK MIKE

Medical Justice Medico-Legal Q&A

Q:  I am a locum tenens physician licensed in Florida. Am I required to obtain my own permit for certificate of occupancy in the city and county for which I may have temporary employment or am I covered by the physician for whom I am covering?

A:  Good question.  A certificate of occupancy, or as it is sometimes referred to as a zoning permit, assures that the business is allowed in the zoning district where it is located.  A certificate of occupancy is generally required when a building is erected, altered, or the existing building goes through a change of occupant, name, or type of business.  Thus, in your case, temporary employment would not necessitate the obtaining or transferring of a certificate of occupancy. Just to be sure, I contacted officials in several Florida counties.  While each had slightly different rules, all agreed that you would not need a certificate of occupancy.  It is always prudent to contact the county or city zoning department in which the building is located since there are differences in the local zoning requirements throughout Florida. 

Michael J. Sacopulos is a Partner with Sacopulos, Johnson & Sacopulos, in Terre Haute, Indiana. His core expertise is in medical malpractice defense and third party payment disputes. Sacopulos may be reached at mike_sacopulos@sacopulos.com

 
Reader Response 4-21-11 Print E-mail
Written by Jeffrey Herschler   
Saturday, 23 April 2011 15:33

Regarding FL Docs Monitor Pending Legislation

Democrats have aligned themselves with plaintiff attorneys for years to block any meaningful federal legislation designed to reign in runaway jury verdicts for pain and suffering in medical malpractice insurance cases.  Not only has this hurt doctors and patients but has driven up the cost of defensive medicine to unprecedented levels in the last decade.  Each and every year we could pay for millions of uninsured Americans' healthcare by simply putting reasonable caps on non-economic damages.   

-Matt Gracey, Danna Gracey

Regarding New CEO of Jackson

I am skeptical.  To see two very capable candidates with relevant experience passed over for a county government insider, a banker no less, is disconcerting  As a Dade County taxpayer, I am hoping for the best.  As a realist, I am very concerned.

-Name Withheld by Request

Regarding PDMP to Begin Operations

This is indeed good news and I want to thank all of the many activists and citizens of our great State of Florida who invested so much time and efforts to support this noble cause.

-Bernd Wollschlaeger, MD
 
Why opting out of health care reform is a bad choice Print E-mail
Written by Bernd Wollschlaeger, MD   
Wednesday, 20 April 2011 15:20

In My Opinion

In an excellent editorial published in the Miami Herald, (Click here to see article) Steven Marcus, President and CEO of Health Foundation of South Florida, points out that:

"Florida has a healthcare crisis - and we need to do something. The law is not perfect but it is a giant step in the right direction. The protections under the Affordable Care Act move us forward to a time when citizens won't have to wait until they are so sick that they have to go to emergency rooms for the most expensive care. Rather, they will have coverage to go to a family or primary-care doctor. But before anyone looks forward to a healthier Florida and nation, here's a dose of reality: The benefits from consumer protections increasingly are at risk of being taken away. The actions of many of Florida's elected officials reflect a lack of concern for thousands of our low-wage workers and other citizens who will go without care and instead declare personal bankruptcy over a medical emergency. This leads to community bankruptcy for unpaid, expensive medical and hospital bills. Is this what Floridians deserve? I don't think so. Let's get behind this law and tell our officials to do the same, it will attract businesses and jobs to Florida by reducing costs that are dragging down our economy. Let Florida join the other states in planning by taking the federal money offered to create a brighter and healthier future for all Floridians."  

By blocking and stalling the implementation of the entire healthcare reform package the political leadership in Tallahassee jeopardizes the access to healthcare to four million uninsured residents in Florida. This rigid and ideologically misguided attitude will hurt the business of medicine in Florida, too. Recognizing this problem, Michael W. Garner, President and CEO of the Florida Association of Health Plans, said that Florida should pass bills to keep aspects of its health insurance market in state control, instead of letting the federal government regulate the market under the Patient Protection and Affordable Care Act (PPACA). He is correct in stating that that health insurance companies in Florida will have to struggle to meet the federal guidelines and standards set forth by the PPACA. It is obvious that Governor Rick Scott's ideologically driven policy is not only bad for our health but also bad medicine for big business in Florida.

Last Updated on Wednesday, 20 April 2011 15:30
 
Kick the Can Down the Road? Print E-mail
Written by Michael Joseph Newhouse   
Wednesday, 13 April 2011 15:29

For Crying Out Loud!

OPINION

If one was to receive a message from the future, say twenty years from now, describing the national scene, circa 2030, one would be totally incredulous. Here's a snippet:

We can no longer afford entitlements, diabetes threatens national security, USA is bankrupt and a war is fought on four fronts if one includes Mexico.

All signs point to the classical model of an empire in rapid decline. See video feature entitled Why Great Nations Fail.

How we got here isn't important. What is important is how we are going to get back to prosperity. Here's my plan:

  • No more career politicians. They are dinosaurs. Therefore, term limits on everybody. Every one of these public servants needs to go back into the private sector eventually.
  • No more salaries for these politicians once they are out of office.
  • No more special health plans or other little goodies for them. They serve the people let them be one of the people. Use the same health plans as the rest of us.
  • Simplify the tax code. For example, GE made $5B profit last year and didn't pay a single dollar in taxes! [Editor's note:  This was originally reported in the New York Times.  Since then Fortune.com has reported that GE did indeed pay taxes in 2010.  Fortune estimates GE's effective tax rate at 7%.  See the story The Truth About GE's Tax Bill.] Yet the CEO believes it's patriotic to pay taxes and off shore American jobs. How much did you pay Uncle Sam?
  • US announces to the world that our rules of engagement are reverting back to pre WWII standards so no body better mess with us, our buddies or our national interests. No such thing as civilized warfare. The gloves are off.
  • Everybody that is overweight (i.e. pre diabetes type I and II) must have a comprehensive plan to get in shape and it is incentivized by taxes.
  • Incentivize employers to create jobs.
  • Pull back manufacturing jobs to the US.
  • Allow health insurance across state lines.
  • Bring back all US military bases that are no longer necessary
  • Have all politicians sign the Mount Vernon pledge.
  • Require all politicians to post a weekly and quarterly productivity  report on their time spent, with whom and for what objective along with corresponding expenses and variance report on their operating and capital budgets just like the rest of us.
  • All lobbyists must report weekly and quarterly just like the politicians.
  • Government health programs must send volume to the best value provider; no more sweetheart deals. 

We can no longer afford business as usual. We have come to the perennial fork in the road. And for crying out loud, please remember our government works best when neither party is in control.

Last Updated on Thursday, 14 April 2011 09:37
 
Feedback on Dr. Epstein's Article Entitled: The Price of Certainty Print E-mail
Written by Various Readers   
Sunday, 30 January 2011 14:24

READER RESPONSE

Nice article on health care- not sure I agree with everything he says! (No surprise!!)  It's very complex!

-Jack Wolfsdorf, MD, Pediatrician, Pediatric Critical Care, Editor Miami Childrens International Pediatrics Journal

This is one of the most reasoned and very well written articles on the topic of tort reform!  Many thanks to Dr. Epstein for this very accurate and refreshing article!

-Dan Reale, Medical Malpractice Insurance Specialist, Danna-Gracey Agency, Orlando

I concur with Dr. Epstein’s letter.  However, may I inject the following into his “Susie” scenario:  ER doctor says to Susie’s mother, a CT is not medically indicated and thus will not be covered by your insurance.  Of course if you would like to pay the $700 hospital fee and the $300 Radiologist fee out-of-pocket, then we will be happy to provide that service for you.

You can take it from there…

-James "Jim" Craig, Vice President Middle Market - Healthcare
Fifth Third Bank, Sunrise

This is one of the best articles on the reasons for ordering extra tests that I have ever read.  Thank you!!

-Medical Doctor, Boca Raton

Last Updated on Wednesday, 30 March 2011 16:05
 
<< Start < Prev 51 52 53 54 55 56 57 58 59 60 Next > End >>

Page 60 of 62


Banner
Website design, development, and hosting provided by
Netphiles