Health Care – Should Your Doctor Decide?

In years past, a doctor had the authority and power to decide what treatment and/or modality was appropriate. Each health care provider chose the remedy, relief &/or intervention based upon the following: (1) a specific diagnosis; (2) a tentative diagnosis [provisional]; &/or (3) a differential diagnosis [generally, that which relates to multiple conditions or causes that are based upon probabilities].

As medical insurance, Medicare, Medicaid and now Obamacare (officially entitled the Affordable Care Act) have intervened, their coverage for treatment rendered by a physician has been strictly refined and restricted, as well as subject to interpretation more often than not by lay individuals. These current business and regulatory systems in place seek to justify their role by pointing to, among other things, the nature and amount of waste, and their goal to make our health care better. In doing so, they often perceive medical treatments as increasingly suspect. As such, the scope of coverage of the third party payer system has continued to place limits on physicians, hospitals and other health care providers, along with using monetary incentives to achieve their political and business goals.

 Clearly, there are many who support the current scheme and, therefore, contend it is designed to produce an effective health care system, albeit conceding it is far from an ideal one. The opponents assert this system will inevitably lead to the rationing of medical care with a much smaller group of health care providers who choose such a career and, therefore, less available to serve the public, fewer innovations, and eventually far less medical research. In addition, they cite other countries that have socialized medicine and the inherent problems therein, including but not limited to the increasing waiting time before one can obtain an examination or evaluation; the length of time until one can obtain certain procedures and treatment; the inability of the physician to choose the nature and extent of care deemed appropriate; and, the growing trend to depersonalize the health care system as a whole. The debate continues while the ability to produce a better result is limited as each side remains polarized, and at times vilifying the other.

Nevada state psychiatric hospital to lose accreditation

A Nevada state psychiatric hospital is being stripped of its accreditation, but is choosing not to appeal.

It seems a conundrum here: The hospital loses its accreditation and that means they will not be paid by the government, patients will have to be released, transferred to another facility if available and/or others will not be admitted until they apply for and receive a new certification.. There are many who believe the 72 hour hold is sufficient to protect the patient as well as society because psychiatrists and staff are required to determine if there is a present danger to the patient and/or society and only if that does not appear to exist is the patient released.

If the patient does not have any family or caretakers, they are released into the community. Unfortunately, there are an insufficient number of places for community housing and/or locations that can provide an appropriate, albeit temporary period of time for such patients to be sufficiently stabilized to be on their own. It is clear that we have far too many members of society that fall into this category and need ongoing care and treatment. While some pundits will claim we cannot provide appropriate and adequate transitional care for psychiatric patients who are medically challenged, others who are more enlightened including myself passionately believe the billions of dollars we send to foreign countries should first be used to fix this and countless other problems in our own country.

Commentary by Sam Spital, California State Board Licensing Defense Attorney & San Diego Personal Injury Lawyer: