How is it legal to have an ICU that isn’t staffed by a single doctor?
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This would never happen to people who write the laws so it's not a priority.
It's probably staffed by Nurse Practitioners. They do a lot of stuff that used to be handled by doctors, even my primary care provider is a NP and not a Dr.
For 1/5 of the pay.
More like dr make twice the pay than np because dr requires 10x more hours to be certified over a np. Also the family will be sueing the dr not the np for medical malpractice here.
Oh, not that a doctors pay isn't justified (and still too less, for the requirements). But this here seems a saving money on the cost of quality, only the patient suffers from case.
teledocs, and equity firms have been snatching up doctors all over the place, this hospital is likely part of a firm that does this, they can just staff 1 or few doctors in a hospital, and use teledoc soley.
....wow
That timeline reads to me like he was in withdrawal, vomited, and likely aspirated on his own vomit. All due to lack of actual human care in a supposed ICU. I say "supposed", because that shit shouldn't even be legal for tele-health in the first place.
Marketing be like "this service pairs expert remote monitoring with skilled bedside care" and I translate that bullshit as "we farm monitoring jobs to cheaper labor markets and they watch people die, on Zoom".
I'm willing to bet his family can likely win their lawsuit . Hopefully that will be costly enough to reverse this bullshit.
Unlikely, without regulation against this. Fines are just a cost of business, since they are never, ever costly enough. Either a true penalty fine, or executives in prison, or both, are the only response to ensure change, here.
You mean five percent of the money they make when they decide these immoral choices? Which then gets appealed to a high court and reduced to one-tenth of one percent?
Fun story:
I once got blocked from a flight by TSA because the inspector said my portable hard drive was an explosive device by looking at it via Facetime over an iPad while they were at an Arnold Schwarzenegger's body building conference instead of at work in the airport.
I've been waiting for this since the 1990s, surprised it took so long.
Starting in the 90s, much of the administrative duties of a hospital are now done overseas, including chart notes.
The doctors being overseas? Worst case scenario is just starting.
Why would a hospital pay a US physician 200K a year when they can get a doctor from Pakistan to do the same work for 50K a year? They even have surgical robots that can be remotely piloted from anywhere.
It's not prevalent yet, but it will be.
This should have been such a straightforward case too.
Mr. Hylton's condition deteriorated in the ICU, and despite orders, there are no CIWA assessments, no intake/output monitoring, and no MD assessments for pain and/or change in mental status despite the RN's non-contemporaneous note indicating mental status change in a patient diagnosed with alcohol withdrawal and a history of alcohol withdrawal seizures for which he had "previously been given Keppra."
Hylton, who was admitted around 11 a.m., became unresponsive early the next morning around 4:30 a.m., the complaint says.
"Mr. Hylton slid down in bed, his eyes rolled back and he … exhibited seizure-like activity, vomited, became bradycardic and code was called," the complaint alleges. "He was intubated, but he could not be resuscitated, and he was pronounced dead."
What the fuck were they even trying to do? Some kind of tough love/cold turkey approach? Honestly wouldn't be surprised bc I've heard a lot of ignorant pieces of shit suggest that should be standard protocol for opiate withdrawal.
Aside from that being intentionally and unnecessarily cruel, there's this tricky thing about alcohol withdrawal vs withdrawal from other "more serious" substances, where you can literally fucking die. That's exactly what happened.
See, when I first started hearing of those remote control surgical robots, it was sold to me like "They're for remote places where you can't quickly get to a metropolitan hospital, like the South Pole research station, or Nome Alaska, or the space station. Someone in Nome goes down with gallstones in the winter, getting them to Anchorage may be a problem, this would allow a doctor to remote in care that wouldn't otherwise be available."
That was, of course, bullshit.
See you're just thinking of pro-social applications for tech. Nothing wrong with that. One day the world will be better and we'll need creativity and positivity rather than nihilism. In the meantime, some cynicism is warranted.
Wasn't me doing the thinking, that's what I was told this tech was developed for.
It wasn't. It was designed to kill a dental student in an ICU devoid of actual medical professionals.
No, that was the pitch. I remember it just like you do.
It just...isn't working like that right now.
Doesn't mean the technology can't do that. Just means there's capitalism in the way.
"This is the song that never ends...it just goes on and on my friend"
I shudder to think about my surgeon having to deal with a 400ms ping to the fucking robot cutting me open and how badly that could go...
The US is such a dumb fucking nation, I just cannot believe half this shit
It's like an ongoing slow motion trainwreck and I can't help but stare
People need to be jailed over this
As in the CEO, leadership, management, all involved in setting up and authorizing these procedures, should be jailed
If not, this will just become the norm
And of course it will just become the norm because again, somebody died needlessly and we're not doing shit about it because all the other CEO's still need a gold plated bathtub
Great. We pay into health care that doesn’t offer physical care anymore.
taxes are mostly subsidizing the companies too, and patients never see it being used for them.
Meanwhile in in the rest of the world we've got conservatives telling us how much more efficient it would be and how much quicker you'd see a doctor if we adopted America's for-profit healthcare system.
I know this is fucked up in general, but am I the only one who's slightly bothered by the description of him as a "dental student"? Maybe I'm overthinking things, but I worry that reporting would look different if it didn't happen to a person of high status.
"But people fly here from other countries for healthcare."
If tele-healthcare was the same as in person then no one would need to go to a doctor, much less fly anywhere
People get travel warnings about american "healthcare".
How is is legal to pronounce death without directly checking their pulse in person?
RNs can get the vitals that allows a pronouncement. I do it regularly for hospice folks and it certainly ain't my name on the death certificate. Having an RN verify vitals for an active code is a bit weird though. But so is running a code through telehealth.
Paramedics (at least in NJ) aren't allowed to pronounce, but they're what's called online care (maybe, it's online something), and so they feed vitals to a doc over the phone, and the doc says okay call it.
Boomers will die this way en masse in nursing homes and even the regular hospital system. They are about to learn first hand the correlation between their precious tax cuts and nursing ratios/turnover.
That is fucking horrifying.
Once again the Bigly Beautiful Bill encourages survival of the fittest, puh-raise JEE-zuz-ah!
First thought: "Must be USA". opened the link just to check and was not ~~dissapointed~~ wrong
Non contemporus notes don't really matter (ICU nurse isn't going to write a note while they're peeling this guy off the ceiling) and I'm not familiar with ICU level withdrawal care but I doubt CIWA is helpful in someone like this who's in full blown withdrawal already and going brady with current interventions. CIWA is good for preventing him from getting where he already obviously was.
What does "peeling this guy off the ceiling" mean in this context?
Before he started precedex he would've been essentially highly anxious and fighting everybody. When he wasn't having seizures that is.
