Articles Posted in Surgical Complications

A new study suggests that doctors are more likely to skip screenings and otherwise make mistakes with patients later in the day. According to a JAMA Network Open study, doctors ordered fewer breast and colon cancer screenings for patients with an afternoon appointment – despite the fact that all patients were due for a screening. According to the study, the doctor was most likely to order a medical screening for his patient with an 8 AM appointment. By 4 PM, the likelihood that the doctor would order screens for their patient had dropped by 10 to 15 percent.

Other studies have confirmed that poorer outcomes for patients are more likely in the afternoon. A 2014 study, cited by The New York Times, found that doctors were more likely to dole out unnecessary antibiotic prescriptions in the afternoon. In fact, the likelihood of an unnecessary antibiotic is 26 times higher for a 4 PM appointment compared to an 8 AM appointment.  Other studies located by the New York Times found that patients were less likely to receive the flu vaccine and more likely to receive prescription opioids for back pain. Even the amount of hand washing by doctors fell during the afternoon hours.

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A disgraced doctor pleaded guilty to three charges of manslaughter last week in Queens, according to The New York Daily News, Indicted on felony charges last year, Dr. Lawrence Choy ran a ‘pill mill’ out of his Queens office from 2012 to 2016. The former doctor routinely prescribed the so-called ‘Holy Trinity’ of drugs to his patients – an opioid, a benzodiazepine, and a muscle relaxer. All three medications are both extremely addictive and extremely dangerous because of their ability to suppress breathing and cause an overdose. Tragically, Dr. Choy’s reckless prescribing habits caused three of his patients to fatally overdose.

After the deaths of his patients, Dr. Choy closed his medical practice and fled to Wyoming. The long-distance move did not matter to federal authorities who charged Dr. Choy with 231 crimes last year in a complaint detailing the doctor’s recklessness and indifference to his patient’s suffering. According to prosecutors, Choy’s pill mill in Queens was popular across the entire northeast – patients from New Jersey and Pennsylvania routinely made the trip just to visit Choy. According to federal prosecutors, Choy began doling out oxycodone prescriptions beginning in 2012 when Choy received a tax bill for more than $1 million. Once word got out that Choy would exchange prescriptions for cash, addicts would travel to the Queens doctor to get their fix and drug dealers would travel to get their supply. A single oxycodone pill prescribed by Choy could be sold for $30 on the street, less than the cost of a month’s prescription without insurance.

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According to The New York Times, long-term care hospitals continue to provide poor care to elderly Americans. Long-term care hospitals, also called long term acute care hospitals, provide care typically after a person is being discharged from intensive care and is too sick to return to their nursing home. Close to 400 long-term care hospitals exist in the United States, a number that has dipped in the last decade after skyrocketing in the 90s from just 38.

The proliferation of long-term care hospitals during the period is now largely regarded as unnecessary and many elder care advocates say they harmed individuals while enriching their owners. Because patients at these hospitals are so sick, the hospital receives hefty sums performing multiple procedures and diagnostics on their patients. In 2017 alone, Medicare – which pays for two-thirds of all long-term care stays – paid out an eye-wateringly high 4.5 billion to these several hundred hospitals.

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The New York Medical Board is slow to punish doctors who lose their license to practice in other states. According to The New York Post, the state licensing board for doctors took between “a few weeks to several months” to stop 14 doctors who had lost their ability to practice medicine in New Jersey over the last six months. Perhaps even more worrisome, the local newspaper found that two of those doctors were still practicing medicine despite being deemed unfit to practice just across the river. New Jersey did not perform much better at ensuring potentially dangerous doctors stayed away from the state’s patients – five doctors with their New York licenses suspended in the last six months were still practicing in the state.

Perhaps overstating the obvious, Patient-safety advocate Betsy McCaughey told The Post that licensing board’s slow movement on incompetent doctors “could lead to unnecessary additional harm to patients.” The founder of the Committee to Reduce Infection Deaths then harped on the unnecessary risk to patients by stating “all you have to do is send an email.” McCaughey correctly notes that the New Jersey Board of Medical Examiners receives a daily alert for doctors whose license has been suspended or permanently revoked. With this information delivered each day, it is not unreasonable to expect a prompt investigation.

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