[Sign Up Now] to Receive Our FREE Daily SCVTV-SCVNews Digest by E-Mail

Inside
Weather
Santa Clarita CA
Clear
Clear
45°F
 
Calendar
Today in
S.C.V. History
February 24
1956 - Baseball Hall of Famer Eddie Murray born in Los Angeles; later SCV resident & car dealer [story]


Commentary by Dr. Gene Dorio
| Monday, Dec 9, 2013

genedorio“Throw grandma under the bus” clearly conveys anger, sympathy and fear when healthcare decisions are made outside the realm of medical professionals. Within the doctor-patient relationship, alignment of physician expertise with an individual’s personal decision should keep insurance company executives, hospital CEOs and HMOs from interfering.

Are we naive to believe interference isn’t already occurring?

A doctor orders a breast MRI to further evaluate an abnormal mammogram, but the insurance company denies approval. Physical therapy after a broken hip must be done at a facility 60 miles away instead of down the street because “we don’t have a contract with them.” The physician-recommended, evidence-based cancer surgery cannot be initiated as it is not authorized by the insurance company. A mid-90s woman is told she must go to a nursing home because her “double” pneumonia is beyond the four days allotted to the hospital for her care.

Yes, we’re already throwing grandma under the bus.

The healthcare role of doctors is to heal, and for some it extends to end-of-life care to assure minimal pain and maximum comfort in the patient’s final days. Somehow, though, unscrupulous profiteers have found ways to intervene covertly, claiming patient benefit, when their real purpose is profit.

I wish to forewarn patients and caregivers of new threats against us and our loved ones, and possibly make you better able to question healthcare professionals.

As an internist and hospice physician, I was asked to see a patient with a “terminal disease” for end-of-life comfort care. She lived with her family on a ranch outside of Santa Clarita, and when I arrived, she was actively sweeping the front porch with no sign of debility or pain.

Being able to access her hospital chart, I found the HMO had not done the usual workup nor staging of her cancer. As Medicare funding is separate, by placing her on hospice, the HMO was able to “wash its hands” of the patient, saving money by not providing any further care.

I reported them to a state agency and advised the family of the problem, resulting in appropriate care and treatment.

In Henry Mayo Newhall Memorial Hospital, I now see aggressive questioning of families and older patients seeking a code status change to DNR (Do Not Resuscitate), coercing them into a lower level of care. Coupled with this, sometimes, is an attempt to place them on hospice.

Under certain circumstances I cannot disagree, but wouldn’t you expect those asking these questions be physicians? Unfortunately, they are not. Sometimes they are nurses, social workers and even case managers, maneuvering under the guise of “palliative care team.”

An unsettling problem at Henry Mayo is oversight of the Palliative Care Team by an administrative hospital committee that formulates policy away from the scrutiny of physicians. “Orders” have been placed by non-physicians asking for Palliative Care personnel to consult patients – which is tantamount to practicing medicine without a license.

Far before hospitalization, I discuss with my elder senior patients their sense of quality of life and expectations of how aggressive they want to be treated at end of life. No one lives forever, and everyone uniquely makes decisions based on personal relations, family, religion, experience, common sense and reality.

But hospitals abide by Medicare rules of payment and might lose money when a patient stays too long.

Reducing care by forcing code-status changes of patients under duress is inappropriate, especially when it is not presented by the physician. A new twist on the problem is at some hospitals, physician care is turned over to a hospitalist who has never met the patient nor the family. If these hospitalists are paid directly or indirectly by the hospital, you already know the tenor of their questioning.

Not to be misunderstood, there are many caring physicians, including hospitalists and Palliative Care Teams, focusing on the best interests of the patient. Again, sadly, who pays them determines the fate of many of our elder seniors.

The present medical system is too vast and complex for most to understand or read between the lines. Being aware of the unseemly profit-making tactics I’ve outlined here might help you and your loved ones ask questions and make better choices.

Personal decisions should not be twisted or coerced by insurance company executives, hospital CEOs or HMO profiteers. Ultimately we must demand to uphold the sacred relationship between doctor and patient.

Throwing grandma under the bus should not be an option.

 

 

Dr. Gene Dorio is a housecall geriatric physician on staff at Henry Mayo Newhall Memorial Hospital and has been engaged as an advocate in many community activities. The views expressed in this column as his alone.

 

 

Comment On This Story
COMMENT POLICY: We welcome comments from individuals and businesses. All comments are moderated. Comments are subject to rejection if they are vulgar, combative, or in poor taste.
REAL NAMES ONLY: All posters must use their real individual or business name. This applies equally to Twitter account holders who use a nickname.

0 Comments

You can be the first one to leave a comment.

Leave a Comment


Opinion Section Policy
All opinions and ideas are welcome. Factually inaccurate, libelous, defamatory, profane or hateful statements are not. Your words must be your own. All commentary is subject to editing for legibility. There is no length limit, but the shorter, the better the odds of people reading it. "Local" SCV-related topics are preferred. Send commentary to: LETTERS (at) SCVNEWS.COM. Author's full name, community name, phone number and e-mail address are required. Phone numbers and e-mail addresses are not published except at author's request. Acknowledgment of submission does not guarantee publication.
Read More From...
RECENT COMMENTARY
Thursday, Feb 15, 2018
There was broad public support for the Desert Renewable Energy Conservation Plan, which struck a careful balance between lands available for large-scale renewable energy development and the environment. Now the federal government is rethinking it - putting the important and much-needed protections at risk.
Tuesday, Feb 13, 2018
You can prevent vision loss by finding and treating problems early. Medicare covers a glaucoma test once every 12 months for people at high risk for glaucoma
Wednesday, Feb 7, 2018
Sierra Club Angeles Chapter SCV Group Chair Sandra Cattell urges Santa Clarita Valley residents to contact their congressional representatives to push legislation to kill the Cemex mining project in Soledad Canyon.
Friday, Feb 2, 2018
Santa Clarita City Manager Ken Striplin highlights the city's customer service efforts in his message for February 2018.
Friday, Feb 2, 2018
If the Department of the Interior is successful in destroying this national monument, the next one slated for destruction is Grand Staircase-Escalante, then Cascade-Siskiyou National Monument along the California-Oregon border.
Friday, Feb 2, 2018
Here’s what is happening on February 24: a rally to organize students in the Los Angeles Unified School District "against" the highly effective Los Angeles School Police Department.

Latest Additions to SCVNews.com
1956 - Baseball Hall of Famer Eddie Murray born in Los Angeles; later SCV resident & car dealer [story]
Santa Clarita Studios debuted their new production offices to industry peers, business leaders and public officials on Friday.
Santa Clarita Studios Scores ABC Show, Debuts New Production Offices
The next regular meeting of the Governing Board of the William S. Hart Union High School District is Wednesday, February 284 at the Administrative Center, 21380 Centre Pointe Parkway, Santa Clarita 91350.
Feb. 28: Hart District Governing Board Regular Meeting
California State University, Northridge’s Criminology and Justice Studies Department will host a discussion titled “Does More Immigration Mean More Crime?” on Tuesday, Feb. 27 from 5:30 p.m. to 7 p.m.
Feb. 27 CSUN Discussion: ‘Does More Immigration Mean More Crime?’
Santa Clarita Valley Sheriff's Station deputies arrested a man and a woman on multiple weapons and drug charges in Castaic early Thursday, according to station officials.
Tip Leads to Arrest of 2 on Multiple Gun, Drug Charges
The California Department of Education has released new guiding principles for teaching social and emotional skills, to help educators ensure students have the skills for success in school, careers and in the community.
State Education Department Sets New Social Emotional Learning Guidelines
Spring 2018 is an exciting time for composer, sound artist and CalArts alumna Ellen Reid (Music MFA 11) as two of her works make their debut with the Los Angeles Chamber Orchestra and Los Angeles Master Chorale.
LACO, LA Master Chorale to Debut New Works by Ellen Reid
LA-based artist and CalArts grad Edgar Arceneaux (Art MFA 01) performed his award-winning, critically acclaimed theatrical work "Until, Until, Until…" in three sold-out shows this week in San Francisco.
Edgar Arceneaux’s ‘Until, Until, Until…’ Sells Out 3 SF Performances
CalArtians were out in full force at last month's 33rd annual Sundance Film Festival in Park City, Utah, which ran January 18-28.
CalArts Well Represented at Sundance Film Festival 2018
Four furry, four-legged detection devices assigned to the LA County Sheriff's Department's Operation Safe Streets Bureau have been selected to receive tactical body armor.
LASD ‘Safe Streets’ K9s to Get Protective Vests
Gael García Bernal, Mary J. Blige, Andra Day, Natalia LaFourcade, Miguel, Keala Settle, Sufjan Stevens and Oscar winner Common will perform this year's nominated songs at the 90th Oscars ceremony on Sunday, March 4.
Academy Unveils 90th Oscars Song Performers Lineup
Democratic gubernatorial candidates vying to replace Gov. Jerry Brown in November debated in San Diego Thursday night how to maintain the Golden State’s strict gun laws and reduce poverty.
California Gubernatorial Candidates Take on Poverty, Gun Control
"SCVTV Presents: An Evening With New West" Friday, February 23 at The MAIN in Old Town Newhall as the award-winning trio brings their signature brand of Western ballads, story songs and cowboy swing to entertain fans in the Santa Clarita Valley.
Feb. 23: SCVTV to Present ‘Evening With New West’ at MAIN
Santa Clarita Valley Water Company officials will hold a meeting of the company's Outreach and Legislation Committee on Wednesday, March 21 at 5:30 p.m.
March 21: SCV Water Public Outreach, Legislation Committee Meeting
The 40th annual St. Clare Lenten Fish Fry charity fundraiser continues at the Canyon Country church on Friday, February 23 from 4:30 p.m. to 8 p.m. and for the next four Friday evenings.
Feb. 23: St. Clare 40th Annual Lenten Fish Fry for Charity
A 17-year-old West Ranch High School student was arrested Thursday and charged with making criminal threats on social media.
West Ranch Student Charged with Making Criminal Threats
California's and New Mexico's Attorneys General, together with the California Air Resources Board, have secured a preliminary injunction against the U.S. Bureau of Land Management's suspension of the methane gas Waste Prevention Rule.
Judge Blocks Feds’ Suspension of Methane Waste Prevention Rule
Deputies from the Santa Clarita Valley Sheriff's Station pulled over a vehicle on Castaic Lake Road for a traffic violation on Tuesday afternoon and discovered the male adult passenger had a $30,000 warrant out for his arrest.
Man Arrested for Warrant, Alleged ID Theft in Castaic
DMV investigators issued 29 misdemeanor citations during an enforcement operation in Sun Valley and Pacoima on February 22 aimed at combating unlicensed vehicle dismantlers.
DMV Cites Unlicensed Vehicle Dismantlers in Sunland, Pacoima
The 10 year anniversary of the Val Verde African American Heritage Celebration will take place Saturday Feb. 24th, from 12:00 p.m. - 5:30 p.m. at Val Verde Park.
Feb. 24: Val Verde African American Heritage Celebration
1998 - Worst day of record-setting 1997-98 El Nino storm season [story]
A Spring Concert with the Golden Valley High School Jazz Band will be held at the school's theater Sunday, Mar. 25.
Mar. 25: Golden Valley High School Jazz Band Spring Concert
Hidden cultural gems from Mexico and El Salvador will be uncovered during a lecture series at California State University, Northridge, hosted by the Tom & Ethel Bradley Center.
CSUN Lecture Series to Highlight Hidden Cultural Gems
The Santa Clarita Valley Water Agency's Engineering Committee will be meeting on Thursday, Mar. 1, at 5:30 p.m.
March 1: SCV Water Agency Engineering Committee Meeting
The Santa Clarita City Council will hold its Regular Meeting, Tuesday, Feb. 27, at 6:00 p.m.
Feb. 27: City Council Regular Meeting
The Sulphur Springs Union School District was recognized Wednesday evening with the Operation School Bell Award given by the National Assistance League.
Sulphur Springs Schools Lauded by Assistance League
Earlier today, the Santa Clarita Valley International Charter School was on lockdown as deputies from the Santa Clarita Valley Sheriff's Station investigated an unconfirmed threat. The lockdown has since been lifted and a 15-year-old suspect was charged with making Criminal Threats. The following is a breakdown from the Facebook page of the SCV Sheriff's Station:
SCVi Charter Student Charged with Making Criminal Threats
Carousel Ranch Raising Funds for “Carousel Wishes and Valentine Kisses” Annual Giving Campaign Carousel Ranch, a place where children with special needs discover and experience some of their greatest achievements through equestrian therapy and vocational training programs, is reaching out to the donor community during its “Carousel Wishes and Valentine Kisses” annual giving campaign.
Carousel Ranch Seeks to Fund Scholarships for Wait-List Students
College of the Canyons has added more than 100 late-start classes to its spring 2018 semester class schedule to accommodate the needs of working students.
Spring Brings More Late-Start Class Options to COC
Deputies at the Santa Clarita Valley Sheriff's Station are currently investigating an unconfirmed threat at the Santa Clarita Valley International School.
Lockdown Lifted at SCVi Charter School
The kids are back for Season Six of Masterchef Junior, featuring award-winning chefs Gordon Ramsay and Christina Tosi, as well as the return of fan-favorite judge Joe Bastianich.
Newhall Student Vies for Apron on Masterchef Junior
The William S. Hart Baseball Complex was vandalized early Sunday morning. The Santa Clarita Valley Sheriff's Station was able to apprehend the suspect with the help of surveillance video. Here is the breakdown from the Facebook page of the SCV Sheriff's Station.
Suspect Detained in Connection with Vandalism at Hart Baseball Field
LOS ANGELES – The County Interim Health Officer is issuing a Cold Weather Alert due to the National Weather Service’s forecast for low temperatures. Wind chill temperatures are expected to be below 32 degrees Fahrenheit.
Cold Weather Alert Issued for SCV
1983 - Armed robber taken out at Alpha Beta supermarket on Lyons [story]
The Master's University Mustangs baseball team added to their recent string of come-from-behind wins with a 9-5 comeback win over the University of Antelope Valley at Master's.
Mustangs Rally Again, This Time Against Antelope Valley
A driver lost control of her vehicle in the parking lot and crashed into the outdoor dining area at Stone Fire Grill on Cinema Drive in Valencia Wednesday afternoon.
No Injuries in Accidental Drive-Through at Stone Fire Grill Restaurant