Medical Malpractice

Everyone pretty much agrees that "SOMETHING" needs to be done to reform our current health care system.
The question is "what", and "how soon"?

Well, I'm sure most will agree that "the sooner, the better".

The problem is that too many are "rushing into" all kinds of "major surgery" whereas I believe a series of corrective operations need to be performed. There are too many policies, rules & restrictions in place which prohibit cost-effective operation of the current system. Here are just some of the steps needed which will give you a sense for the necessary way we need to make corrections in our Healthcare System.

First, we need to transfer ownership of all health insurance plans directly into the hands of the individual. That means eliminating control of employer-held policies for their employees. Employers simply PAY their employees for whatever costs they are now paying. This will force individuals (employees) to now "comparison-shop" for the BEST policies, thereby introducing the "competitiveness" element into the health care marketplace! Enrollment requirements for group policies would be modified or eliminated.

Second, we need to allow individuals the freedom to purchase ONLY the coverage that they need (want) and can afford. For instance, if one wanted coverage for a pregnancy, it would certainly cost less than one with all the other "bells & whistles". Likewise, there is no reason that a non-smoker, drinker or drug user would need to pay for coverage which would include alcohol and drug abuse, etc. (unless, of course he or she just wanted it).

Third, we need to eliminate many of our "built-in" cost producing restrictions. Examples are: Many reasonable healthcare services can be handled by qualified nurse-assistants (practitioners) instead of requiring the more expensive visit to a higher paid physician; adopt a "loser-pays" system for malpractice suits; re-vamp FDA restrictions and availability of drugs....including availability of more reasonable "over-the-counter" drugs; deny federal medical funds to any organizations (including states) who restrict competition in the medical field; modify laws requiring Emergency Rooms to treat ALL persons regardless of condition; i.e. prevent free-loaders from using emergency rooms for non-emergency injuries (colds, abrasions, etc.), and there are many more!!

Fourth, we need to allow tax-free Medical Savings Plans for all "Citizens"

Fifth, we need to eliminate coverage for illegal aliens.

Sixth, we need to adopt the FAIR TAX H.R. 25 & S 296

Marie Jones is a 73-year-old woman who lost her husband last year after almost 50 years of marriage. Her complaints are memory problems, poor appetite, and low energy. Mrs. Jones told her physician that her children think she should move into a retirement community, but she is hesitant to give up her home. If Mrs. Jones or someone like her was referred to your practice, would you be prepared to treat her? If you are like many other providers in the helping community, the answer is most likely no. As the 20th century draws to a close American society is graying. Life expectancies have increased dramatically during the past 75 years, and the number of community dew willing seniors is steadily rising. The stressful associated with aging, such as environmental changes, retirement, loss of partners, and coping with Illnesses are all issues that could be addressed in psychotherapy. Yet very few graduate programs offer training opportunities in clinical gerontology.

Even when training is available, ageism may lead some therapists to assume that emotional growth and change among seniors is limited, and therefore not worth professional pursuit. Counter transference, often based on personal fears of aging or family issues with parents/grandparents, can also pull people away from treating seniors. Whether the reasons are personal or professional, treating older adults when you are I'll prepared leaves the door wide open for ethical dilemmas and potential malpractice.

*Before the Work Begins*
Psychotherapy is an intensive exploration of personal values. Understanding your own value system and how it Impacts your work is the cornerstone of ethical practice. Your beliefs drive the counseling process forward, even in the most non directive of therapies. As Christians, it is easy to underestimate the Importance of values clarification. Loving God, loving our neighbors as ourselves, and believing in the healing power of Christ are all values that would appear to be self-evident within the Christian counseling community. But there is tremendous diversity within the Body of Christ as we will as many different understandings of health, healing, pathology, and change.

Assessing and articulating your values in the field of gerontology will involve prayerfully considering difficult questions. For example, what are your beliefs regarding the ending of life? If your client wanted to die by stopping painful medical treatment, how would you decide what to do? Would your decision be different if your client was 65 or 85? Would your behavior place you in conflict with accepted community standards of practice or with state regulations and laws? Values guide us, and they guide our clients. Once you have taken the time to identify your values about the aging process and about older persons, you will be better able to see how thesis will Impact your work. Being aware, being clear, and being open respects both the process of therapy and the individual client. It also helps you steer clear of many ethics-related pitfalls.

*Common Ethical Dilemmas in Gerontology*
Mrs. Jones has now been referred for counseling by her family physician. He is concerned about her memory problems and wants a second opinion. He also thinks that Mrs. Jones is isolated and could benefit from talking to someone about the relatively recent loss of her spouse. Are you the appropriate referral? Even with the limited information we have about Mrs. Jones, there are many clues that can direct her mental health treatment. Her complaints may indicate the onset of a dementia, but they can also suggest other problems, such as depression, uncomplicated bereavement, failing health, or even elder abuse. Psychological assessment, individual therapy, and family therapy may all be appropriate parts of her treatment plan. As a provider, you must first evaluate your own level of training and expertise. Just as you would not think of treating children without adequate training, the same standard applies to gerontological practice. If you feel that you are under trained, you will need to access old_resources such as supervision, continuing education, and consultation to assist your work. The most ethical decision may be to refer this client to a colleague and take the time you need to develop your skills.

*Consent to Treatment*
Many older adults are unfamiliar with the process, demands, and expectations of psychotherapy. Although the senior community is rapidly becoming more psychologically sophisticated, there are many older persons who believe that counseling is only for really crazy people. They may be more comfortable with a traditional doctor/ patient relationship and may not know what to expect from a therapist or from therapy Itself. Once you have decided you have the skills to treat Mrs. Jones, she must be fully informed about the process of therapy, including your therapeutic style, fees and billing practices, confidentiality, and the risks and benefits of treatment. She may need additional information about potential recommendations such as psychological testing, bereavement groups, or a medication consultation. Once Mrs. Jones is given the information she needs to understand your work with her, she will then be better prepared to give informed content. If you have any doubts about her competence to give consent, further evaluation will be needed before you begin treating Mrs. Jones. This is Important for the provision of ethically sound therapy and for the clients own safety. If Mrs. Jones does not appear to understand the therapeutic contract, she may have problems outside the therapy room that need to be quickly addressed. Memory loss or decreases in functioning do not equal incompetence, but they can serve as red flags for a comprehensive assessment.

*Release of Information*
You have been meeting with Mrs. Jones for about two months when her son comes to visit from another state. He is very impressed with the Improvements he sees in his mother's mood and self-care but continues to wonder whether his mother should move into a care facility. He also believes that some of his mother's problems relate to the physical abuse she endured during most of her married life. He calls and leaves you this information and asks that you return his call without telling his mother he has been in touch. This phone message presents many problems for you. First, Mrs. Jones has yet to mention that her husband was abusive. She has presented her marriage as happy and stable. Second, Mrs. Jones decided not to sign releases of information for her children, because they worry enough about me and this would just make it worse. Her son learned about her therapy from the family physician, who reported to the son that Mrs. Jones memory problems and depression seemed to be decreasing. When faced with this turn of events, you must remain focused on your client. You do not have access to Mrs. Jones son, as much as he would like to be helpful. In addition, you now have Important therapeutic information that must be sensitively addressed with your client. Honesty within the therapy demands that you let her know what has happened and work with her to reach a plan of action.

*Limits of Confidentiality*
When told about her sons call, Mrs. Jones states that her husband had been an active alcoholic for most of their marriage. During that time, he was physically abusive. His eventual failing health led to his sobriety, and they spent the last 10 years of their lives together in a peaceful and relatively happy relationship. Mrs. Jones also reveals that her youngest son, who lives next door, is also an alcoholic and sometimes becomes so angry that he hIt's her. An essential aspect of ethically sound gerontological practice is having a thorough understanding of elder abuse. It is possible that some of the depression and cognitive problems observed in Mrs. Jones could be attributed to the abuse she has been experiencing. The shame associated with being abused by their children leads many adults to keep the violence hidden, but the stress and trauma are often exhibited indirectly. It is your responsibility to know the laws in your state regarding the limits of confidentiality and the reporting requirements for suspected elder abuse. This information should be shared with your clients when treatment begins, so they have the power to decide when and how to share this information with you. Online Christian Counseling is a nice way to get suggestions.

*In Closing*
The best way to avoid ethical problems in psychotherapy with any population is antecedent control. Recognizing the limits of your training, participating in continuing education, making sure you have safety nets in place to assist your practice, and staying in touch with colleagues are all Important safeguards against ethical violations. As Christian therapists, we have made a commitment to be Gods instruments of healing in a broken world. This demands not only that we practice with the highest ethical standards of our profession, but that we constantly remain open to the work that God can do through us. Knowledgeable, we will-trained, and self-aware clinicians who know their values, strengths, and limits are going to be best equipped to meet this higher standard of care.

Computers are a necessity today. They not only simplify our lives but also help make our work easier and save us unnecessary wastage of time. The medical industry is now realizing the importance of technology and is focusing on doing away with cumbersome files, loads of paper, and hand written records. The shift is now towards using computers to keep a track of medical records.

In a normal scenario when an individual approaches his doctor with some ailment the doctor seeks a whole lot of information from the patient about his medical history, previous medical conditions, radiological images if any, laboratory results and other such details. The doctor uses this information as well as details of some tests he may order to diagnose your problem and provide a course of treatment. Things are different today. What the doctor now does is put all the information you provide in a digital format. This digital format is also known as an electronic health record. In the case of bariatric patients these records are known as bariatric EHR (Electronic health records)

Be it a regular EHR or a bariatric EHR, these systems have some advantages and disadvantages. The advantages of having an Electronic health record are:

1. Effective documentation: Doctors are known to have illegible handwriting and this can very often lead to information being misunderstood by some other health care provider. If you go in for ehr this problem will disappear.

2. Cost effective: The use of EHR will lower costs in the long run and help you save resources. Information is easily available and the patient's sick period is reduced as information is easily available at the click of a button.

3. Storage: Files and paper documents take a lot of space and a backup needs to be created to take care of calamities such as fire. On the other hand a lot of information when stored in a digital format can take up very little space and creating a back-up is not too difficult as well.

4. Insurance companies usually reduce the malpractice premium for hospitals that use an EHR system. This is because they have access to documentation that is legible and accurate as compared to notes that are scribbled by your doctor. In case there is litigation it becomes easier to follow an information trail in the case of institutions that use an EHR system.

5. The care that is provided to a patient is also improved as the health care provider can easily access the patient's medical information.

Are you a plaintiff or an attorney involved in a lawsuit and need more money to continue your case? Lawsuit funding may be the way to go. Since this service has only been available for a few years now, most attorneys and hardly any individuals are aware of the fact that they can receive cash advances for pending lawsuits.

What Is Lawsuit Funding? Lawsuit funding - often referred as lawsuit loans, litigation financing, and legal finance - is a new segment of the cash flow industry. But, it is growing very quickly. Essentially, a funding company provides a cash advance to a plaintiff in a lawsuit against the favorable outcome of the case.

In other words, based upon the strength of the lawsuit, the lawsuit funding company will provide an advance (normally, in the range of 10-15%) on the amount of money the plaintiff is expected to receive, should he win his case. This advance is non-recourse. This means, that should the plaintiff not win the case, he does not owe the funding company any money in return. Lawsuit funding is not a typical loan because the money does not have to be paid back, unless the case is won or settled.

Why Lawsuit Funding? It levels the lawsuit playing field. Typically, lawsuit defendants (insurance companies, large manufacturers, banks, etc) have deep pockets. The plaintiffs are normally average, ordinary citizens. These large companies tend to string the process out, hoping that the plaintiff will run out of money and quickly settle the case for a small sum of money.

Take for instance, slip and fall cases and auto accidents. These cases account for more than 3 million injuries each year in the US. Many result in job loss, severe injuries, paralysis, and head traumas; some are permanent and irreversible. Many require continual, expensive medical care - the cost of which can easily bankrupt a family. This is where lawsuit funding can help.

A lawsuit cash advance will allow the plaintiff to pay his or her medical bills, mortgage payments, and other household bills. The problem is: Most lawsuit plaintiffs do not know they can get a lawsuit loan. They can qualify for funding, ranging from $250 to over $1M for an individual case and up to $10M for a commercial case.

How Does Lawsuit Funding Works? It is very simple and straightforward: The plaintiff fills out an application and submits it to the lawsuit funding company. The company contacts the plaintiff and his lawyer and asks background questions about the case. The funding company sends the plaintiff a contract, the plaintiff signs and the company transfers the money into the plaintiff's bank account or FedEx's the funds directly to the plaintiff (whichever the plaintiff chooses).

Advantages of Lawsuit Funding. Lawsuit funding offers many advantages: it is confidential, prompt and discreet; there is no risk to the borrower; applications are free, and without obligation; there are no upfront fees, nor any processing or monthly fees; there are no credit or employment checks; bad credit - even no credit - is okay; the underwriting process is quick - as little as 6-8 hours; a client can have money in hand the very same day; funds can be for any purpose; plaintiff pays back the advance, only if he or she wins; if the client loses the case, he or she owes nothing; all information is kept confidential; you do not need your attorney's approval; and its available for all types of civil and commercial lawsuits.

Who is eligible for Lawsuit funding? If you are involved in any type of lawsuit, such as: personal injury, product liability, auto accident, patent infringement, malpractice (medical, legal, construction), employment discrimination, fraud, breach of contract, Mesothelioma, negligence, workers compensation, class action, civil rights, whistle blower (qui tam), workers compensation (not in all states), wrongful death, commercial litigation etc.; and you are represented by an attorney, you may qualify.

Spread the word! You can get an advance against your lawsuit. If you have a friend, family member or business associate going through a lawsuit, let them know about this new service.

You've spent years in medical school and residency dreaming about the time when you could care for your patients and start settling down into a regular life. For many people, working in traditional physician jobs is the perfect solution for enjoying life outside of medical school. For other doctors, however, who find that graduating from medical and completing their residency is a completing liberating experience, the prospect of being tied down to a full-time job just isn't a thrilling idea. Many new doctors who have been stuck inside a classroom or doing residency inside a hospital for years may be ready to break out of the traditional mold and see a little bit of the world.

For these doctors who find traditional physician jobs unappealing, a job as a locum tenens doctor may be the perfect solution. Locum tenens doctors are traveling positions who work on a contract basis to cover for full-time doctors when they go on vacation or take another type of leave of absence from their positions. Their services are vital to hospitals, medical centers, and even family practices that otherwise would not be able to care for patients adequately when members of their medical staff are away for an extended period of time.

Most professionals working as a locum tenens doctor will find employment options through a servicing company, which can negotiate your compensation package, and make your travel and housing arrangements for each of your jobs. Often the compensation received for locum tenens services are superior, and many medical facilities will cover housing, travel, malpractice insurance, and even licensing fees. These jobs are available for doctors who have chosen not to specialize such as family practice physicians as well as others who have specialized in any number of areas, including surgical specialties. The jobs are a great way for doctors to travel and see different parts of the country while still working in their profession.

Perhaps it shouldn't feel like suffering a personal wound when learning about the state of healthcare coverage in Dallas, Houston and throughout Texas, or anywhere else in this country – but it does. In fact, for most of us, it really does.

It tends to shatter the ideals we were taught as American children—that everyone is equal, no one suffers unwillingly, and working hard will get you somewhere—when we learn that approximately 18,000 uninsured individuals ages 25 to 64 suffer “excess" deaths annually.

Health insurance premiums have increased by 15% per year over the past five years, more than triple that of the inflation rate, 2.5% . Medical costs are through the roof, quality of it often below sewage level, and an average citizen might feel that he/she has to overwork him or herself into a coronary just to get it.

One third of firms did not even offer health insurance coverage to their employees in 2004 , most of them citing high premium costs. It does not seem a coincidence then, that one-third of uninsured adults did not fill at least one prescription, and/or receive at least one recommended test, due to cost .

In Texas alone, 9,787 deaths in 2002 were attributed to lung and bronchus cancers, arguably the most preventable cancers with proper screening and smoking cessation programs. Perhaps it shouldn't be personal, but when young adults consider the reality of an impending personal health crisis, or their children not receiving the absolute highest quality of care available because of poor or non-existent coverage—and perhaps not even knowing the difference—yes, it tends to chafe. This is a biologically-based life, after all, and those lungs and hearts keep us in the game.

In order to address the problem, it is important to attempt to understand why this is happening. It's not just that premiums are increasing; it's that the economy is shifting. Texas and the rest of the United States is no longer manufacturing-based; it's service-based, and small businesses – which cannot afford large, corporate healthcare packages – in turn, cannot offer coverage to their employees. Three-fifths of all workers provide their labor to small businesses, and less than two-thirds of these companies offer health benefits .

Even if they could, their employees might not be able to afford group health insurance; employee spending for healthcare coverage increased 143% between 2000 and 2005 . To many, it's simply unrealistic. So what we have, without exaggeration, is a healthcare crisis—lack of or inadequate coverage, which leads to lack of or inadequate healthcare.

But let's not be entirely gloom and doom about this, shall we? After all, whiners with no solutions are a bit like well diggers in the desert with no shovels. We can analyze the situation for days at a time ("yep, that's a lot of sand") —but then, of course, we die of dehydration. There are, in fact, solutions, and perfectly logical options at that.

(1) Introduce revamped, affordable health insurance plans addressing the uninsured's actual needs.

Sounds obvious, right? Well, evidently not. Approximately 58% of uninsured adults in 2004 reported having changed or lost their jobs in 2003 , while only 7% of the unemployed could afford COBRA insurance (an extension of former employers' health plans), at an average of $700 per month, per family. While it's also easy to blame insurance companies for high premiums, they, too, are absorbing higher hospital and clinic bills, the consequences of malpractice suits, and a surge of baby boomers growing older. It may be more productive, for now, for the public to demand new plans that are reflective of today's needs, than to try to tear apart the industry as a whole. This is not at all unrealistic, and pushing for such changes could make a big difference.

Many of us, for instance, need affordable interim or basic coverage while we build our careers, and would gladly pay a reasonable premium for a reasonable policy. We need these policies to cover the millions slipping through the cracks—students, entry-level workers, those in between jobs, on leave of absence, or those just starting out in their professions (and who may not be able to afford buying into group health insurance). Similarly-crafted policies need to also address the growing number of workers in contract, freelance, self-employed, and full-time positions, in which benefits are self-provided through individual health insurance plans.

These plans need to be accessible and affordable to the increasingly independent, young individual with middle and lower-middle class budget constraints. Obviously, the market is there.

(2) Purchase "portable" individual health insurance plans.

Considering the majority of the uninsured in 2004 had changed or
lost their jobs, and considering that there are many who stay in their current
positions simply for the health insurance coverage, individual health insurance may make more sense, as they are "portable," that is, they can follow a worker from job to job. With individual health insurance policies, workers are no longer tied to a position just for the sake of health insurance, nor do they need to worry about the exorbitant cost of COBRA in the case of job loss. Many companies, in fact, are willing to offer an allotment to cover all of their employees for the purpose of purchasing individual health insurance. In this way, insured individuals can relax, knowing they will still have coverage if they switch, or lose their jobs, even with pre-existing conditions.

(3) Increase coverage of preventative care.

According to the American Cancer Society, an individual's risk of getting, or dying from, cancer greatly decreases with prevention, early detection, and proper screening programs. Smoking alone causes 30% of all cancer deaths, and lifestyle changes can also dramatically reduce cancer risks . Yet, those lacking insurance receive less preventative care, are diagnosed at more advanced stages of disease, and tend to have higher mortality rates than the insured . Even many of the insured do not have access to these programs. Obviously, standardizing affordable packages that offer preventative services would not only reduce incidences of disease, but also dramatically reduce treatment costs. Even basic plans need to include an allotment for preventative care, in addition to some version of basic dental and eye coverage—like annual exams.

So, yes, my sense of good citizenship has been a bit wounded by the current state
of healthcare coverage. We used to worry about the retirees and children who could not provide their own health coverage; now we worry about almost everyone. Most of us are hard-working, helpful members of society who would pay a reasonable premium if we had access to it. But, if this system is to be revamped, citizens must speak louder for the necessary changes. We may be in the desert of healthcare, after all, but we are not without shovels.

If you’re interested in high-quality individual health insurance at affordable rates, specifically created for young, healthy individuals, you should take a look at Precedent. Visit our website, [http://www.precedent.com], for more information. We offer a unique and innovative suite of individual health insurance solutions, including highly competitive HSA-qualified plans, and an unparalleled “real time" application and acceptance experience.

In the early 1990s, when brainswitching, was first proposed as a cognitive behavioral method to halt a depressive episode, there wasn't much scientific research to support it. Anti-depressants were touted as the best solution.

Also there was the little matter, of which not everyone is aware, that anti-depressants were the treatment of choice for depression according to the DSM IV. This is the legal standard for the diagnosis and treatment of mental illness. That meant if a psychiatrist or medical doctor did not prescribe medication for depression, they could be subject to a malpractice suit for having made that "contrary" decision. Contrary as far as the DSM IV was concerned.

However, because of new questions raised this year about the efficacy of anti-depressants, there may be some changes in the DSM IV when it morphs into the DSM V at the next publication. Newsweek's cover story on February 8, based on the research of Irving Kirsch and Guy Sapirstein of the University of Connecticut, claims that placeboes are just as effective as anti-depressants in the treatment of depression,

Kirsch and Sapirstein saw that patients did improve on anti-depressants. "This improvement," says Newsweek, "demonstrated in scores of clinical trials, is the basis for the ubiquitous claim that antidepressants work. But when Kirsch compared the improvement in patients taking the drugs with the improvement in those taking dummy pills-clinical trials typically compare an experimental drug with a placebo-he saw that the difference was minuscule."

Brainswitching was ahead of its time in recommending mind exercises over anti-depressants. There is now much more support for brainswitching, and other alternative methods, in the research of the last 5 years. For instance, Rafael Malach and Ilan Goldberg of the Weizmann Institute of Science reported in 2006 that the "self-related" function of the brain, that part of the brain involved with introspection, actually shuts down during an intense sensory task.

Or, another way to put it, the brain can actually "lose itself," lose its power of self-focus, when engaged in some demanding task. The research involved getting subjects to classify animal picture cards, or name selections of musical pieces, while at the same time indicating whether or not they had a strong or weak emotional response to what they were classifying.

The researchers found that the regions of the brain involved with processing something in the environment, such as classifying the animal or music, was distinctly different from one's introspection about it, whether or not one felt strongly or neutral about one animal or the other, or one piece of music or the other.

The parts of the brain activated during either the classifying or emotional response to the animals or music were quite distinct and segregated. To make this judgment, the researcher used magnetic fields and radio waves to scan blood flow in the different brain areas, which would indicate brain activity going on in the different parts of the brain.

The conclusion of the research is that the self-focused "observer" doesn't seem to be present when one is involved in some intense task. Or, you could say, as the researchers did, the brain actually switches off "self." This research is very support of the cognitive behavioral techniques involved in brainswitching.

In the first place, in order to be depressed, a person has to think their depression. The person has to be self-focused on the pain they are feeling. The "observer part,"" the "self" of the brain must be present and functioning in order to experience the pain of the depression. Brainswitching, like the experiment of Malach and Goldberg, actually separates the message from one part of the brain to the other that depression is being produced. Some relief is immediate.

The whole idea of brainswitching is to do some intense mental task, such as thinking a nursery rhyme like row, row, row your boat over and over. The point being that the brain, in concentrating on thinking the thought repetitively, loses the "observer" of the depression. The observer disappears, the "self" disappears, it goes "offline," and therefore the depression cannot sustain itself.

Depression depends upon anxious thinking to produce the stress chemicals that cause the chemical imbalance that causes depression. When the depressed person uses a simple brainswitch exercise first, to separate the message from one part of the brain to another that depression is ongoing, and then immediately gets intensely busy with chores or work, the person's brain temporarily "loses" the "self" that was suffering with depression. The chemical imbalance now has a change to stabilize.