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The CMG Voice

UberHealth launches. Perhaps more patients will make their medical appointments.

Posted Thursday, April 19, 2018 by Tyler Goldberg-Hoss

Nearly a year ago, I wrote about how, with the advent of ride sharing companies, some people have elected to use Uber or Lyft to take them to the Emergency Department instead of calling an ambulance.

It appears that Uber was paying attention. It has recently launched UberHealth, focused on helping patients get rides to medical appointments they might otherwise not make.

The UberHealth service is different than the traditional ride sharing apps in that the medical provider arranges the rides for the patient. The patient doesn’t need an app, or even a smartphone.

The benefit to the patient is obvious. For many, just getting to the doctor can be burdensome, particularly for those with limited means and/or without reliable transportation. This service will hopefully provide better access to healthcare.

For medical providers, this service aims to reduce the amount of no-shows, which cost providers money. In addition, with patients receiving better healthcare, hopefully they will in turn be healthier, and need less health care. Consider a patient who doesn’t make it to a doctor’s appointment, or fails to follow through on prescribed treatment plans, including physical or occupational therapy. That patient is less likely to have control over their medical condition, and more likely to need costly care in the future as a result.

You can read more about this new service here:

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Director of shuttered Seattle Pain Centers keeps license after clinics found to have caused or contributed to 16 deaths

Posted Monday, April 16, 2018 by Tyler Goldberg-Hoss

In September of 2016 I wrote about the suspension of Dr. Frank Li, director of a number of Seattle Pain Center clinics in the Puget Sound area.

Dr. Li’s medical license was suspended pending an investigation surrounding deaths associated with patients of his clinics. As a result, a number of opioid dependent patients were suddenly without a medical provider to prescribe them medication. Many scrambled to find other providers willing to do so, often encountering significant difficulty.

Recently, following the investigation conducted by the Washington Medical Commission, an agreement was reached whereby Dr. Li’s license remains suspended for at least another year. Further, once his license is reinstated, his ability to prescribe pain medication will be limited.

You can read a Seattle Times article on the recent agreement here:

In wake of deaths, Seattle-area pain doctor agrees to face a lifetime of restrictions

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The litigation process is particularly hard on wrongful death claimants

Posted Thursday, April 5, 2018 by Tyler Goldberg-Hoss

Hopefully, if you are reading this, you have never contemplated bring a lawsuit alleging that some person or entity wrongfully caused a loved one to die.

For those unlucky few who have and have not yet decided, it is worth a detailed discussion with your prospective attorney about how the process may negatively impact you.

Wrongful death litigation is not a particularly fun endeavor. For starters, the reason you are in such a position is because you have lost someone close to you; a spouse, a parent, maybe even a child. Not only that, the death often times is unexpected, adding another layer of feelings to process.

Through litigation, claimants can feel victimized all over again. The discovery process includes both written questions and often a deposition, where you are compelled to attend, swear before a court reporter to tell the truth, and then you are interrogated about the decedent, your relationship with him or her, and other areas of inquiry. Often such questions can involve delicate or sensitive matters. All of this can be difficult emotionally.

You may learn through the process that the defendants are blaming your loved one – or maybe even you – for causing the death.

Through it all, you are constantly reminded of your loss. It is perhaps primarily because of this that many wrongful death claimants have found that their process of grieving became stunted until the litigation was over.

Finally, claims are not always successful. You could slog through all of the above, and at the end of the trial, you end up with nothing.

Still, most of my wrongful death claimants have also told me, regardless of the outcome, that they were glad to have done it. Bringing a civil lawsuit does not bring a person back to life, but it is one of the few ways we as a society have figured out to hold someone accountable if a jury has decided he or she is responsible for a death.

Although often the focus of the result of a lawsuit – money – is on the family being compensated, don’t forget that the money serves a dual function - compensating the decedent’s family while simultaneously creating a deterrent effect on future negligent conduct. It is always my hope that, through this process, we as a society are safer.

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Doctors Have A "Gut" Feeling About The New Frontier In Medicine

Posted Friday, March 30, 2018 by Gene Moen

A recent article spelled out new interest in the “gut microbome” as an opportunity to control illnesses as diverse as obesity, diabetes, inflammatory bowel disease, and even atherosclerotic disease. Gut microbiome (formerly known as gut flora) is the name given today to the microbe population living in our intestines.

Our gut microbiota contains tens of trillions of microorganisms, including at least 1000 different species of known bacteria with more than 3 million genes (150 times more than human genes). It’s a jungle in there, and new finds are occurring on a frequent basis by those willing to explore.

Experts think that the microbiome affects many aspects of our bodies, including a powerful influence on digestion, the immune system, and the central nervous system. So a new goal of many medical researchers is to find the underlying cause of many diseases and treat them at the source within the gut.

At a recent meeting of the North American Microbiome Congress in February, there was an emphasis on the connection between the gut and overall health. One product of this emphasis is the development of microbiome therapies in clinical trials. Pharmaceutical companies are seeing new possibilities for patenting these therapies in a developing market.

While much of the research is focused on obvious health problems like obesity, diabetes, and inflammatory bowel disease, the new research frontiers will be in areas where there is no current treatment for a disease. But even apart from those possibilities, simply dealing with obesity through this research could save billions of health care dollars.

The bottom line is that there is a huge amount of promise within the gut microbiome, with research in this area just starting to gain attention and momentum within the scientific and medical communities.

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Labor, drug and administrative costs the main reasons why the US spends so much on health care.

Posted Monday, March 26, 2018 by Tyler Goldberg-Hoss

A recent study published in the Journal of the American Medical Association (JAMA) looked at health care spending in the United States and how it compares with other “high-income” countries such as Germany, Canada, Australia, and France.

The study found a number of interest things:

In attempting to answer why we spend so much to get comparable (or worse) health care, the report focused on three things.

First, we pay our health care providers more. For example, we pay general physicians $218,173/year, while in the other countries the range was $86,607-$154,126.

Second, we pay substantially more per person for the costs of goods, particularly drugs. In the US per capita spending is $1443, versus $466-$939 in other countries.

Finally, administrative costs accounted for 8% of all health care spending in the US, versus a range of 1%-3% in the other countries.

In my line of work, malpractice litigation, some focus group participants and jurors have a tendency to believe that malpractice itself – in the form of rising professional insurance or defensive medicine – is a large reason why our health care costs are so high.

The report addressed this indirectly, stating:

“The data also suggest that some of the more common explanations about higher health care spending in the United States, such as underinvestment in social programs, the low primary care/specialist mix, the fee-for-service system encouraging high volumes of care, or defensive medicine leading to overutilization, did not appear to be major drivers of the substantially higher US health care spending compared with other high-income countries.” (emphasis added)

It is clear, not only from this report but also from our collective understanding, that health care is an ongoing issue in our country. On the bright side, this report gives us clues as to how we might fix it.

You can read the full report here:

Health Care Spending in the United States and Other High-Income Countries

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