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2016/03/31 02:06:30
Subject: Re:The Political Junkie™ Thread - USA Edition
Jihadin wrote: Medical Malpractice Insurance I believe is why it takes three to four months. Final authority rest with the "CEO" of the hospital to admit the surgeon name for coverage. I do belive....and I'm not throwing him under the bus that D-USA might have better overview on this. I left the medical field a long time ago
It's more than that. The Medical Staff Office actually vets the MD with background checks... validating DEA licenses (ordering narcs).
Training... No Hospital System is the same. Not to mention the EMR system.
Live Ork, Be Ork. or D'Ork!
2016/03/31 02:07:27
Subject: The Political Junkie™ Thread - USA Edition
So we (and the doc) had to call all around to other hospitals to find some place/doc that would accept her. Which meant that he would have zero responsibility or ability to care for the patient anymore.
Also gonna need some clarification on that. A doctor is free of responsibility if they don't have admitting privileges?
Automatically Appended Next Post:
TheMeanDM wrote: Admitting privileges are a big deal especially for smaller rural hospitals that don't have the capabilities to treat every patient that walks into the ER or comes out from surgery or goes to the clinic.
I'm aware.So how does legislative requirements for very specific procedures help that?
Dr. Smith performed a bowel resection (abortion, extraction, whatever) on Jane Doe. Jane has complications that require advanced teeatment at a larger facility.
Dr Smith has admitting privileges at Bob Hope Hospital. He calls the admissions people (or the floor/unit perhaps) and say "I need to admit Jane for complications of (whatever). I want her to see the doc on that dloor that can treat her. Give her medication A, B, amd C if she needs it." Dr Smith may possibly be able to help the doc that is treating her (as a consultant, depending on the hospital policies, etc).
Or else.....
Dr Smith calls Jerry Garcia Hospital where he has no privileges. He has to speak to their admissions team (usually a special 800#). "I have Jane who is having complications from (whatever). I need to find a doc that will accept her as a patient." The admission person says "OK, I have to see what doc is around and if they are willing to accept Jane. Let me make some phone calls and call you back."
30 minutes later admissions calls back "Ok, Dr Bob might accept her, please call Dr Bob with relavent patient info to see if he will accept." (Nobody at that hospital may accept her...that is their choice)
Dr Smith calls Dr Bob and Dr Bob accepts.
Dr Smith has transferred care to Dr Bob and no longer has ability to consult, order, or care for that patient (so he isn't responsible for what goes on in that hospital after Dr Bob gets her...obviously he is reaponsible for what happened prior to admission).
I destroy my enemies when I make them my friends.
Three!! Three successful trades! Ah ah ah!
2016/03/31 02:07:52
Subject: Re:The Political Junkie™ Thread - USA Edition
Prestor Jon wrote: There's already some variance between states and I don't think many of any states would outlaw it completely.
There are six states with laws already on the books that go into effect if Roe v Wade is overturned. Virginia, Utah, Ohio, Missouri, Louisiana, and Illinois have laws that would outright ban all abortion should that occur. 28 states total have trigger laws in effect that would ban most abortion procedures/make them even more impossible to obtain. This is ignoring that many states, particularly in the South and Midwest, have effectively regulated abortion service providers to near non-existence anyway.
I'm actually shocked that Illinois and Ohio has that...
Live Ork, Be Ork. or D'Ork!
2016/03/31 02:09:16
Subject: The Political Junkie™ Thread - USA Edition
Keep in mind, regarding the admitting privileges, is that here in Texas, nearly every other hospital has the words Baylor or Methodist or Presbyterian, etc., in the name. In theory, yes, requiring admitting privileges is a good idea. In actual practice, it was a backdoor way of outlawing abortion, because of the hospital setup here in Texas.
"Through the darkness of future past, the magician longs to see.
One chants out between two worlds: Fire, walk with me." - Twin Peaks
"You listen to me. While I will admit to a certain cynicism, the fact is that I am a naysayer and hatchetman in the fight against violence. I pride myself in taking a punch and I'll gladly take another because I choose to live my life in the company of Gandhi and King. My concerns are global. I reject absolutely revenge, aggression, and retaliation. The foundation of such a method... is love. I love you Sheriff Truman." - Twin Peaks
2016/03/31 02:09:25
Subject: The Political Junkie™ Thread - USA Edition
So we (and the doc) had to call all around to other hospitals to find some place/doc that would accept her. Which meant that he would have zero responsibility or ability to care for the patient anymore.
Also gonna need some clarification on that. A doctor is free of responsibility if they don't have admitting privileges?
Automatically Appended Next Post:
TheMeanDM wrote: Admitting privileges are a big deal especially for smaller rural hospitals that don't have the capabilities to treat every patient that walks into the ER or comes out from surgery or goes to the clinic.
I'm aware.So how does legislative requirements for very specific procedures help that?
Dr. Smith performed a bowel resection (abortion, extraction, whatever) on Jane Doe. Jane has complications that require advanced teeatment at a larger facility.
Dr Smith has admitting privileges at Bob Hope Hospital. He calls the admissions people (or the floor/unit perhaps) and say "I need to admit Jane for complications of (whatever). I want her to see the doc on that dloor that can treat her. Give her medication A, B, amd C if she needs it." Dr Smith may possibly be able to help the doc that is treating her (as a consultant, depending on the hospital policies, etc).
Or else.....
Dr Smith calls Jerry Garcia Hospital where he has no privileges. He has to speak to their admissions team (usually a special 800#). "I have Jane who is having complications from (whatever). I need to find a doc that will accept her as a patient." The admission person says "OK, I have to see what doc is around and if they are willing to accept Jane. Let me make some phone calls and call you back."
30 minutes later admissions calls back "Ok, Dr Bob might accept her, please call Dr Bob with relavent patient info to see if he will accept." (Nobody at that hospital may accept her...that is their choice)
Dr Smith calls Dr Bob and Dr Bob accepts.
Dr Smith has transferred care to Dr Bob and no longer has ability to consult, order, or care for that patient (so he isn't responsible for what goes on in that hospital after Dr Bob gets her...obviously he is reaponsible for what happened prior to admission).
*This*
Often times, the clockis your worst enemy.
Automatically Appended Next Post:
Tannhauser42 wrote: Keep in mind, regarding the admitting privileges, is that here in Texas, nearly every other hospital has the words Baylor or Methodist or Presbyterian, etc., in the name. In theory, yes, requiring admitting privileges is a good idea. In actual practice, it was a backdoor way of outlawing abortion, because of the hospital setup here in Texas.
Those institutions wouldn't turn down treating a patient post-abortion.
Are you insinuating otherwise?
This message was edited 1 time. Last update was at 2016/03/31 02:10:45
Live Ork, Be Ork. or D'Ork!
2016/03/31 02:14:58
Subject: Re:The Political Junkie™ Thread - USA Edition
Jihadin wrote: Medical Malpractice Insurance I believe is why it takes three to four months. Final authority rest with the "CEO" of the hospital to admit the surgeon name for coverage. I do belive....and I'm not throwing him under the bus that D-USA might have better overview on this. I left the medical field a long time ago
No problem.
Basically, hospitals have zero responsibility or requirements to let any particular physician treat anybody in their facility. The decision to grand privileges basically comes down to "will you make us money". While faith-based hospitals might actually care about what kind of work the actual physician does, most hospitals just see physicians as revenue creators. They don't give privileges to them out of the kindness of their hearts, they give privileges to them because if they admit a patient to their facility, they can then turn around and bill the patient. And that is pretty much it.
The majority of credentialing (the process of granting privileges) are all related to that. Gotta make sure that you can successfully bill insurance and other payment sources.
Verifying education and licensing? Without it they can't bill because they were not legally able to order treatments.
Verifying board certification and specialties? Some insurance companies require that specialists are the ones ordering things, or they will not pay for them.
Verifying history and previous practice? Need to make sure that they don't have a history of malpractice (paying money to settle is expensive and hurts hospital profits). Also need to see if their previous hospital has had any problems with their admissions not meeting InterQual (and other) criteria because those hurt your performance scores and hinder reimbursement.
Verify impact on PR? A doctor is not worth having if bad PR causes a drop in admissions.
There are also often other requirements: like having to take turns to take call, accept new patients to their private practice if it is their turn on the list, perform a certain amount of pro-bono work, etc.
But mostly it boils down to someone deciding "are they worth the risk and will they make us money".
So we (and the doc) had to call all around to other hospitals to find some place/doc that would accept her. Which meant that he would have zero responsibility or ability to care for the patient anymore.
Also gonna need some clarification on that. A doctor is free of responsibility if they don't have admitting privileges?
Automatically Appended Next Post:
TheMeanDM wrote: Admitting privileges are a big deal especially for smaller rural hospitals that don't have the capabilities to treat every patient that walks into the ER or comes out from surgery or goes to the clinic.
I'm aware.So how does legislative requirements for very specific procedures help that?
Dr. Smith performed a bowel resection (abortion, extraction, whatever) on Jane Doe. Jane has complications that require advanced teeatment at a larger facility.
Dr Smith has admitting privileges at Bob Hope Hospital. He calls the admissions people (or the floor/unit perhaps) and say "I need to admit Jane for complications of (whatever). I want her to see the doc on that dloor that can treat her. Give her medication A, B, amd C if she needs it." Dr Smith may possibly be able to help the doc that is treating her (as a consultant, depending on the hospital policies, etc).
Or else.....
Dr Smith calls Jerry Garcia Hospital where he has no privileges. He has to speak to their admissions team (usually a special 800#). "I have Jane who is having complications from (whatever). I need to find a doc that will accept her as a patient." The admission person says "OK, I have to see what doc is around and if they are willing to accept Jane. Let me make some phone calls and call you back."
30 minutes later admissions calls back "Ok, Dr Bob might accept her, please call Dr Bob with relavent patient info to see if he will accept." (Nobody at that hospital may accept her...that is their choice)
Dr Smith calls Dr Bob and Dr Bob accepts.
Dr Smith has transferred care to Dr Bob and no longer has ability to consult, order, or care for that patient (so he isn't responsible for what goes on in that hospital after Dr Bob gets her...obviously he is reaponsible for what happened prior to admission).
To be fair, most facilities that don't have privileges would the patient the same way that any other medical clinic without an admitting physician would treat them: Stabilize, call 911, ambulance to the nearest ER.
If someone walks into a physicians office with a heart attack, they won't play phone tag with various hospitals to get someone to accept the patient. They call 911 and take them to the most appropriate hospital.
This message was edited 1 time. Last update was at 2016/03/31 02:19:25
2016/03/31 02:23:22
Subject: The Political Junkie™ Thread - USA Edition
Dr. Smith performed a bowel resection (abortion, extraction, whatever) on Jane Doe. Jane has complications that require advanced teeatment at a larger facility.
Dr Smith has admitting privileges at Bob Hope Hospital. He calls the admissions people (or the floor/unit perhaps) and say "I need to admit Jane for complications of (whatever). I want her to see the doc on that dloor that can treat her. Give her medication A, B, amd C if she needs it." Dr Smith may possibly be able to help the doc that is treating her (as a consultant, depending on the hospital policies, etc).
Or else.....
Dr Smith calls Jerry Garcia Hospital where he has no privileges. He has to speak to their admissions team (usually a special 800#). "I have Jane who is having complications from (whatever). I need to find a doc that will accept her as a patient." The admission person says "OK, I have to see what doc is around and if they are willing to accept Jane. Let me make some phone calls and call you back."
30 minutes later admissions calls back "Ok, Dr Bob might accept her, please call Dr Bob with relavent patient info to see if he will accept." (Nobody at that hospital may accept her...that is their choice)
Dr Smith calls Dr Bob and Dr Bob accepts.
Dr Smith has transferred care to Dr Bob and no longer has ability to consult, order, or care for that patient (so he isn't responsible for what goes on in that hospital after Dr Bob gets her...obviously he is responsible for what happened prior to admission).
If anything, I find it pretty interesting how things are handled where you live (judging by your ID tag) and where I live in NY. I'm hardly an expert but an attending in a rural area without access to advanced technology that they deem necessary would have no problem transferring out to another doc,legally speaking. I do believe were talking ED right? Cuz if were talking general private practice I'll have to bow out as it's very convoluted to me between CMS medicare/caid insurance etc.
But the conversation was never about bowel surgeries, or breast augmentations, or kidney transplants. It was about a very specific procedure. Abortion. And why that specific procedure should need admitting privileges, legally mandated, when other, more dangerous procedures, don't.
2016/03/31 02:30:32
Subject: Re:The Political Junkie™ Thread - USA Edition
In the poll of 957 likely voters, Cruz received support from 40 percent of likely Republican voters, Trump got 30 percent, and Kasich trailed with 21 percent support. Sanders held a 49-45 lead over Clinton among likely Democratic voters.
The poll was conducted March 24 to 28 with 957 likely voters in the April 5 primary and a margin of error of plus or minus 4.1 percentage points. The GOP sample included 471 likely voters and a margin of error of 5.8 points. The Democratic sample included 405 voters and a margin of error of 6.3 points.
This was taken after Trump's attack on Heidi Cruz... so, that supports the idea that it hurt Trump.
A few months back we had a shoulder scope (completely outpatient procedure...people go home that same day) came out to me on the floor. Doc thought he needed just a couple hours watching and then send him home (due to pain).
Guy developed flash pulmonary edema.
Our doc still had to call to the facility where we normally ship people and get a doc to accept him....while we stabilized and intubated him.
Granted...our clinics and outpatient surgery area is all connected to our hospital...so we don't need to call 911 to have emergency care.
However...if an unattached outpatient service center had a doc with admitting privileges, it can save a great deal of time and potential for miscommunication.
I destroy my enemies when I make them my friends.
Three!! Three successful trades! Ah ah ah!
2016/03/31 03:43:08
Subject: The Political Junkie™ Thread - USA Edition
d-usa wrote: Nuclear warming is the worst global warming. I hate nuclear. We don't need more countries getting nuclear weapons. We can't afford to protect these countries. They need to get nuclear weapons. Japan and South Korea need nuclear weapons. They need nuclear weapons. If more countries had nuclear weapons to protect themselves we would be better. More countries having nuclear weapons are a bad thing. Nuclear weapons are the biggest threat. It's time to let more countries have nuclear weapons.
Yep, those are words alright. You've got my vote!
2016/03/31 04:38:14
Subject: The Political Junkie™ Thread - USA Edition
d-usa wrote: Nuclear warming is the worst global warming. I hate nuclear. We don't need more countries getting nuclear weapons. We can't afford to protect these countries. They need to get nuclear weapons. Japan and South Korea need nuclear weapons. They need nuclear weapons. If more countries had nuclear weapons to protect themselves we would be better. More countries having nuclear weapons are a bad thing. Nuclear weapons are the biggest threat. It's time to let more countries have nuclear weapons.
Our Republican Primary frontrunner...
I am curious though what any of these rallies are like. I feel I should be there myself to judge. In a couple cases I heard the protestors of Trump were pretty brutal. If he truly is that bad i'll see for myself and I'll see him against his opponents at their rallies to compare.
Also maybe I'm crazy but I think I understand what Trump is trying to say. Just along the lines of we need nuclear weapons if our opponents have them but if our opponents get rid of their weapons we should too. At least I think that's what he's going for. I don't think he understands the wording though.
This message was edited 2 times. Last update was at 2016/03/31 04:50:23
I'm actually shocked that Illinois and Ohio has that...
Illinois politics are dominated by the more conservative areas of the State because people living in the Chicago area tend to be far more concerned with Chicago city politics. In fact it's a running joke for a lot of people in the Chicago metro that the rest of Illinois doesn't exist.
Not exactly something you'd want on a potential Presidential candidate...
Nor is continually repeating the notion that carpet bombing would be an effective tactic in a hypothetical conflict with ISIS, while clearly demonstrating that you don't know what carpet bombing actually is.
This message was edited 2 times. Last update was at 2016/03/31 06:26:59
Life does not cease to be funny when people die any more than it ceases to be serious when people laugh.
2016/03/31 11:26:29
Subject: The Political Junkie™ Thread - USA Edition
Tannhauser42 wrote: Keep in mind, regarding the admitting privileges, is that here in Texas, nearly every other hospital has the words Baylor or Methodist or Presbyterian, etc., in the name. In theory, yes, requiring admitting privileges is a good idea. In actual practice, it was a backdoor way of outlawing abortion, because of the hospital setup here in Texas.
Those institutions wouldn't turn down treating a patient post-abortion.
No. The point you clearly missed is that those institutions can refuse to grant admitting privileges in the first place.
"Through the darkness of future past, the magician longs to see.
One chants out between two worlds: Fire, walk with me." - Twin Peaks
"You listen to me. While I will admit to a certain cynicism, the fact is that I am a naysayer and hatchetman in the fight against violence. I pride myself in taking a punch and I'll gladly take another because I choose to live my life in the company of Gandhi and King. My concerns are global. I reject absolutely revenge, aggression, and retaliation. The foundation of such a method... is love. I love you Sheriff Truman." - Twin Peaks
2016/03/31 11:29:39
Subject: The Political Junkie™ Thread - USA Edition
I was using some examples of surgeries from our rural hospital setting to illustrate how provilege is a good thing for the patient that has complications.
There are a number of life threatening complications that can happen with even "routine" or "simple" outpatient procedures that involve little or no anesthesia.
Again....
It isn't the hospital that has performed a "controversial" procedure like an abortion. It was the doctor that is admitting the patient.
So if people are trying to say that Bob Hope Hospital performs abortions....then are patently false and lieing.
Dr Smith may perform abortions in his clinic setting or facility...but all Dr Smith can do at Bob Hope Hospital is admit people that have complications from a procedure that has already been performed..
Seriously...privilege is a good thing to have and I wish more docs had it.
Our general surgeon has it at a larger hospital and one call to tell them "I am admitting this patient" has saved sooooooo much time in a potentially emergent situation.
Automatically Appended Next Post: So....apparently...
" Moments ago the Mississippi Senate voted 31-17 along party lines to approve a sweeping bill that legalizes anti-LGBT discrimination in housing, employment, and public accommodations. The bill’s chief Senate sponsor, Sen. Jenifer Branning [photo], faced some tough questioning, most of all from black Democrats, but the haters once again simply outnumbered the good guys."
A Canadian friend of mine was at a loss as to how this would happen.
I had to explain:
1) southern state
2) former slave state
3) bigotry and racism prevalent until 60's civil rights movement (still thinly veiled)
4) states like this seem to always be looking for an "other" to make their miserable lives a little tolerable
This message was edited 1 time. Last update was at 2016/03/31 11:46:17
I destroy my enemies when I make them my friends.
Three!! Three successful trades! Ah ah ah!
2016/03/31 11:47:06
Subject: The Political Junkie™ Thread - USA Edition
It isn't the hospital that has performed a "controversial" procedure like an abortion. It was the doctor that is admitting the patient.
True, but the problem is that, here in the great state of Texas, that's a point that's lost on a lot of people.
"Through the darkness of future past, the magician longs to see.
One chants out between two worlds: Fire, walk with me." - Twin Peaks
"You listen to me. While I will admit to a certain cynicism, the fact is that I am a naysayer and hatchetman in the fight against violence. I pride myself in taking a punch and I'll gladly take another because I choose to live my life in the company of Gandhi and King. My concerns are global. I reject absolutely revenge, aggression, and retaliation. The foundation of such a method... is love. I love you Sheriff Truman." - Twin Peaks
2016/03/31 11:47:20
Subject: The Political Junkie™ Thread - USA Edition
Of all the threats to global security and peace, the most dangerous is the proliferation and potential use of nuclear weapons. That’s why, seven years ago in Prague, I committed the United States to stopping the spread of nuclear weapons and to seeking a world without them. This vision builds on the policies of presidents before me, Democrat and Republican, including Ronald Reagan, who said “we seek the total elimination one day of nuclear weapons from the face of the Earth.”
Thursday in Washington, I’ll welcome more than 50 world leaders to our fourth Nuclear Security Summit to advance a central pillar of our Prague Agenda: preventing terrorists from obtaining and using a nuclear weapon. We’ll review our progress, such as successfully ridding more than a dozen countries of highly enriched uranium and plutonium. Nations, including the United States, will make new commitments, and we’ll continue strengthening the international treaties and institutions that underpin nuclear security.
Given the continued threat posed by organizations such as the terrorist group we call ISIL, or ISIS, we’ll also join allies and partners in reviewing our counterterrorism efforts, to prevent the world’s most dangerous networks from obtaining the world’s most dangerous weapons.
Beyond preventing nuclear terrorism, we’ve made important progress toward the broader vision I outlined in Prague.
Obviously more than what is above, I just don't want to C+P and entire article when you can just go to the site and read it
This message was edited 1 time. Last update was at 2016/03/31 13:14:30
Verviedi wrote: He said that all abortions should be illegal, and women who have them should be punished, if I recall correctly.
No he was asked 'If abortions were illegal do you think women who have them should be punished?'. Then the media just conveniently edited out the question and only published his response.
JSF wrote:... this is really quite an audacious move by GW, throwing out any pretext that this is a game and that its customers exist to do anything other than buy their overpriced products for the sake of it. The naked arrogance, greed and contempt for their audience is shocking.
= Epic First Post.
2016/03/31 18:23:56
Subject: The Political Junkie™ Thread - USA Edition
Verviedi wrote: He said that all abortions should be illegal, and women who have them should be punished, if I recall correctly.
No he was asked 'If abortions were illegal do you think women who have them should be punished?'. Then the media just conveniently edited out the question and only published his response.
Huh. Didn't know that. Apologies for providing incorrect information.
This message was edited 1 time. Last update was at 2016/03/31 18:26:03
Peregrine - If you like the army buy it, and don't worry about what one random person on the internet thinks.
2016/03/31 18:31:06
Subject: The Political Junkie™ Thread - USA Edition
Verviedi wrote: He said that all abortions should be illegal, and women who have them should be punished, if I recall correctly.
No he was asked 'If abortions were illegal do you think women who have them should be punished?'. Then the media just conveniently edited out the question and only published his response.
Verviedi wrote: He said that all abortions should be illegal, and women who have them should be punished, if I recall correctly.
No he was asked 'If abortions were illegal do you think women who have them should be punished?'. Then the media just conveniently edited out the question and only published his response.
So his response still isn't vile? Good to know
He was asked if something was illegal should the violator be punished, he said yes. The POTUS takes an oath swearing them to uphold the law.
JSF wrote:... this is really quite an audacious move by GW, throwing out any pretext that this is a game and that its customers exist to do anything other than buy their overpriced products for the sake of it. The naked arrogance, greed and contempt for their audience is shocking.
= Epic First Post.
2016/03/31 18:40:00
Subject: The Political Junkie™ Thread - USA Edition
Verviedi wrote: He said that all abortions should be illegal, and women who have them should be punished, if I recall correctly.
No he was asked 'If abortions were illegal do you think women who have them should be punished?'. Then the media just conveniently edited out the question and only published his response.
So his response still isn't vile? Good to know
He was asked if something was illegal should the violator be punished, he said yes. The POTUS takes an oath swearing them to uphold the law.
Verviedi wrote: He said that all abortions should be illegal, and women who have them should be punished, if I recall correctly.
No he was asked 'If abortions were illegal do you think women who have them should be punished?'. Then the media just conveniently edited out the question and only published his response.
So his response still isn't vile? Good to know
He was asked if something was illegal should the violator be punished, he said yes. The POTUS takes an oath swearing them to uphold the law.
So is this the end game of the ProLife movement?
If abortion is ever banned, what should the punishment be for a woman who has one? "I don't know," isn't an answer for this question. If you propose to punish people for having abortions, it's only fair to let everyone know what the
punishment is.
Fines, imprisonment, death, what are we taking about here?
This message was edited 1 time. Last update was at 2016/03/31 18:43:24
