Disruptive behavior by doctors, nurses persists a year after crackdown

From amednews (AMA):

… disruptive behaviors that persist among physicians and nurses at hospitals, group practices and other health care facilities, according to anonymous responses to a national survey of 13,000 physician and nurse executives conducted by the American College of Physician Executives.

The survey comes almost one year after the Joint Commission began requiring health care facilities to implement zero-tolerance policies that define intimidating and disruptive behaviors. The commission also required that facilities establish disciplinary procedures for medical staff and other health care professionals who violate the standards.

With increasing concern over the impact of bad behavior on patient care, the findings renew questions about how to curb the problem effectively.

Paramedics Extricate 800lb. Man from Recliner; Patient Dies of Cardiac Arrest Enroute to Hospital

From JEMS (Quoting the AP):

COLUMBIA, S.C. — When an ambulance brought Daniel Webb home from the hospital after he hurt his knee in March, paramedics warned the then 550-pound man he probably wouldn’t be able to get up from his recliner if they put him there, his wife said.

Webb told them to leave him there anyway. He would sit in that recliner, slowly dying, for the next eight months. Finally, paramedics were called back to his Greenwood home on Wednesday because he was in a lot of pain.

Webb’s body was physically stuck to the power recliner and firefighters had to cut him from the chair to take him to the hospital. He died a few hours later, his body covered with sores and a “very bad odor,” according to a police report.

Forbes: Primary care physician shortage and international physicians

From Forbes:

Primary care physicians, essential to keeping chronic conditions like diabetes and high blood pressure from escalating into expensive hospital visits, are in short supply: The American Academy of Family Physicians predicts a shortage of 40,000 general practice docs within ten years as U.S. med school grads favor higher-paying specialties. (At the moment 32% of the 941,000 U.S. doctors are in primary care.) That shortfall will only get worse if the federal government expands coverage. “If 40 million people come online with access to medicine, the system won’t be able to accommodate them,” says Dr. Russell Robertson, chairman of the Council on Graduate Medical Education and a professor at Northwestern’s Feinberg School of Medicine.

One solution would be to import doctors from other countries, but a combination of tight licensing rules and a limited number of residency slots holds down their numbers. Last year 10,000 foreign-trained docs applied for slots in American residency programs, a necessary first step to practicing in the U.S.; 7,000 got in. “They are turned away all the time,” says Carl Shusterman, a Los Angeles immigration lawyer who specializes in representing medical professionals.

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