header image

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

Inside
Weather
Santa Clarita CA
Mostly cloudy
Mostly cloudy
56°F
 
Calendar
Today in
S.C.V. History
October 2
1945 - Cattle-rustling "Phantom of Vasquez Rocks" captured [story]
Phantom suspect


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, Sep 29, 2022
We began our Equity, Diversity, Inclusion and Anti-Racism (EDIA) journey nearly two years ago, and while the path ahead was not clearly defined, Health Services leadership was enthusiastically joined by workforce members across our health enterprise in a united commitment to creating a more welcoming, inclusive and proactively anti-racist health care system for our patients, staff and the communities we serve.
Wednesday, Sep 14, 2022
Recent media reports about overcrowding and lack of exercise for dogs at some other Los Angeles area animal shelters has prompted discussions about animal shelter population management. This is a key operational issue for animal shelters and deserving of the public’s attention.
Tuesday, Sep 13, 2022
As summer comes to an end, we can only hope that the extreme heat will also be ending soon! Crazy weather! The hospital is preparing for a very busy remainder of the year with many exciting ways for our community to get involved, from our Breast Cancer Awareness Month, including Bingo or Bust, to the Holiday Home Tour Gala and Boutique.
Tuesday, Sep 13, 2022
Since the city of Santa Clarita’s incorporation in 1987, your City Council has made protecting our local environment a top priority.
Monday, Sep 12, 2022
As one of the busiest freeways on the West Coast, Interstate 5 is a key component in goods movement and a major source of commuter traffic.
Friday, Sep 9, 2022
As the seasons change and we welcome cooler weather, the city is excited to bring new programming to all of our residents this fall, whether that’s at on our fields, out on the trails or at our pools.

Latest Additions to SCVNews.com
1945 - Cattle-rustling "Phantom of Vasquez Rocks" captured [story]
Phantom suspect
1842 - Proof of discovery: New York Observer (newspaper) reports on gold in Placerita Canyon. [story]
New York Observer
Sixteen William S. Hart Union High School District 2022/23 Teachers of the Year were recognized by the Governing Board on Wednesday, Sept. 28.
Hart District Teachers of the Year Honored by Board
The Los Angeles County Department of Public Health confirmed six new deaths throughout L.A. County, 1,682 new cases countywide and 100 new cases in the Santa Clarita Valley.
Friday COVID Roundup: Seven Day Average of County Case Counts Declines 8 Percent
The HOV, High Occupancy Vehicle, or carpool, lanes are open on I-5 in both directions between Magnolia Boulevard and Buena Vista Street.
I-5 Corridor Improvement Work Continues, SR-134  to Buena Vista Street
Two recent graduates of CalArts’ MFA Experimental Animation Program, Moon (Yuezhu) Wang and Dairys Escoto De León, have been selected for the 2022-23 Association for Independent Colleges of Art and Design Post-Graduate Teaching Fellowships.
CalArts Alums Selected for AICAD Teaching Fellowships
Join Route 66 Classic Grill for the longest monthly Classic Car Show in Southern California history. The last show of 2022 will be held Oct. 8 from 5 p.m. to 9:30 p.m.
Oct. 8: Route 66 Classic Grill Classic Car Show
Los Angeles County’s new Veteran Suicide Review Team met for the first time Thursday, Sept. 29, kick-starting an innovative and collaborative approach to reducing veteran suicide in the county.
L.A. County’s New Veteran Suicide Review Team Begins Work
Agua Dulce Winery will host StompFest on Saturday, Oct. 1 at noon.
Oct. 1: StompFest at Agua Dulce Winery
Do you want to create a post on Facebook and Instagram at the same time? Learn to schedule posts, respond to comments and inbox messages from one place by attending this free Small Business Development Center webinar, "Manage Your Social Media Platform, Meta Business Suite."
Oct. 5: SBDC Free Webinar Helps Businesses Manage Social Media Platforms
On Saturday, November 12, 2022, the Santa Clarita Veteran Services Collaborative and Curtiss-Wright Defense Solutions will host a Veteran Career Fair on Saturday, Nov. 12 at the Curtiss-Wright facility.
Nov. 12: Veteran Career Fair at Curtiss-Wright in Valencia
A strong first half turned into a great start of the second half, but it ended going against Master's men's soccer team as they lost the Golden State Athletic Conference opener to Arizona Christian 3-1 Thursday in Glendale, Ariz.
GSAC Opening Win Eludes TMU Men’s Soccer
Motoko Shimoji earned medalist honors for the third straight week and Carla Menendez placed runner-up to help lead the College of the Canyons Golf Team to a 15-stroke victory over Bakersfield College at the Western State Conference event hosted by Moorpark College at Los Robles Greens on Sept. 26.
Cougars Win Again, Shimoji Medals for Third Straight Week
1955 - Actor James Dean, 24, drives through Castaic Junction en route to his final resting place [watch]
James Dean
Chelsea A. Kay, 37, an insurance operations manager living in Saugus, was honored by JCI USA (United States Junior Chamber) as a member of the 2022 class Ten Outstanding Young Americans.
United States Junior Chamber Honors Local Operations Manager
October is fast approaching. To help embrace the haunted season, we are happy to announce the return of the Santa Clarita Valley Sheriff’s Station Haunted Jailhouse after a two year hiatus.
SCV Sheriff’s Station Haunted Jailhouse Returns After Two Years
The Los Angeles County Department of Animal Care and Control would like to remind residents within unincorporated county areas and participating contracted cities that the pet license amnesty period is almost over.
County Reminding Residents Pet License Amnesty Period Ending Soon
Four individuals and one writing team have been selected as winners of the 2022 Academy Nicholl Fellowships in Screenwriting.
Academy Announces Winners of Nicholl Screenwriting Fellowships
We began our Equity, Diversity, Inclusion and Anti-Racism (EDIA) journey nearly two years ago, and while the path ahead was not clearly defined, Health Services leadership was enthusiastically joined by workforce members across our health enterprise in a united commitment to creating a more welcoming, inclusive and proactively anti-racist health care system for our patients, staff and the communities we serve.
Message from County Health Services Director Dr. Christina Ghaly
College of the Canyons student-athletes Brianna Botello (women's volleyball) and Sam Regez (men's cross coutry) have been named the COC Athletic Department's Women's & Men's Student-Athletes of the Week for the period running Sept. 19-24.
COC Names Botello, Regez Athletes of the Week
Detectives at the Santa Clarita Valley Sheriff's Station need your help. On Aug. 13, 2022, the individuals pictured shoplifted items from a retail store in Valencia at approximately 6:15 p.m.
Detectives Seek Help in Identifying Shoplifting Suspects
Are you hiring? Looking for a new career? The Santa Clarita Valley Economic Development Center has partnered with College of the Canyons, the city of Santa Clarita and America's Job Centers of California to host a valley-wide job fair at the Canyon Country Community Center Thursday, Oct. 20, from 9 a.m. - 1 p.m.
SCVEDC, COC, City Partner to Host Job Fair
The Los Angeles County Department of Public Health confirmed Thursday no additional deaths and 49 new cases in the Santa Clarita Valley, with a total of 12 deaths and 1,517 new cases countywide.
Thursday COVID Roundup: 49 New SCV Cases; No Additional Deaths
1969 - College of the Canyons opens with first class of students in temporary quarters at Hart High School [story]
COC
SCVNews.com
%d bloggers like this: