Patient uses E.R. for dialysis treatmentsBy Tim Carpenter
The Capital-Journal
Published Sunday, July 27, 2008
Physical and emotional pain frames Carol Kitzman's delicate face as she rises from the front seat of a car outside the hospital emergency room.
Exhausted by a constant need to beg for life-saving treatment but dedicated to staying alive to watch a grandchild grow up, Kitzman must now rely on a wheelchair to make her way through automatic glass doors leading to the ER at St. Francis Health Center in Topeka.
In these fleeting moments of a hospital visit, she said her anxiety about potentially falling through the cracks in the nation's health system is acute.
Kitzman has been a frequent St. Francis client in two months since denied further care at the Topeka clinic where she received dialysis the past four years. Without a functioning kidney, the 59-year-old Topeka woman must undergo a procedure several times a week to remove toxic fluid from her body. Her torso swells with waste between dialysis sessions, distorting her 96-pound frame.
Her dialysis doctor of many years severed his relationship after clashing with Kitzman and her husband, Ralph Heitt, and the filing of formal complaints on Kitzman's behalf against the doctor. Kitzman's attempts to catch on at another clinic were fruitless, leaving her no option but the ER.
"We had no idea at all that we'd be in a mess like this," Kitzman said.
Life in balance
Kitzman is a medical marvel. She has outlived her poor prognosis. A cancer-ravaged kidney was removed in 1981. The traumatic event intimately familiarized her with the human renal system. Her remaining kidney held out for two decades. When decay shut it down, Kitzman fell under care of physician Dennis Artzer at Dialysis Specialists of Topeka.
Like clockwork three days a week, she went to Artzer's clinic where a vein in her arm was hooked to a machine to extract waste that can no longer be expelled naturally.
Her medical profile extends beyond dialysis. She suffers from diabetes, arthritis, lung damage, high blood pressure and heart problems. She has felt the brush of death many times.
Heitt, 72, holds power of attorney and remains his wife's most vocal supporter. He realizes his brand of advocacy is viewed by some in the medical community as overwhelming.
In May, St. Francis banned him from the hospital. Heitt said it was a misunderstanding about insulin he brought to the hospital for Kitzman, but St. Francis staff won't comment due to patient confidentiality rules. Heitt repeatedly vocalized discontent about his wife's treatment at Artzer's clinic.
"All I'm trying to do is save Carol's life," Heitt said. "How am I supposed to act?"
Big scare
Heitt said he begged Artzer to transfer Kitzman to Topeka's only other out-patient dialysis clinic, Kansas Dialysis Services, which is part of Stormont-Vail HealthCare and employs all five of the city's other nephrologists. Kansas Dialysis Services' doctors, some of whom know Kitzman from working at St. Francis, have declined to take her on.
Nancy Burkhart, spokeswoman for Stormont-Vail HealthCare, said the hospital was obligated to treat anyone passing through the door. Kansas Dialysis Services and similar clinics can accept or reject patients.
"We're here to help people," she said. "If we were to ever limit that, it's a decision that would not come lightly."
Incentive to find an alternative to Artzer intensified in November after Kitzman took medicine prescribed by Artzer to relieve arthritis pain. The drug, methotrexate, relieved her discomfort but sent her immune system into free fall.
"She was half-conscious," Heitt said. "I called an ambulance. She nearly died."
Kitzman was hospitalized three weeks. Physician Michael West helped turn the tide by getting her off methotrexate but noted "the prognosis is very grave." She was hospitalized again in December following a difficult dialysis treatment at Artzer's clinic.
State Rep. Rocky Fund, R-Hoyt, convinced Kitzman to file a complaint in March against Artzer with the Kansas Board of Healing Arts. Neither Fund, Heitt nor Kitzman said they expected harm to come from blowing the whistle.
"It seems as though if you've had any type of complaint it throws up a roadblock," Fund said. "It allows the services and doctors to pick and choose who they'll serve. That's very unfortunate."
Last straw
Artzer dropped Kitzman on May 21. He said in an interview he was limited as to what he could share about her case, but said he withdrew because Kitzman didn't follow medical instructions and filed the complaint. He said state and federal regulators backed his decision to discharge Kitzman.
"I'd love to tell my side of the story," Artzer said. "This is a rare dilemma. It's unfortunate for Carol. I did everything possible to take care of this patient."
Jerry Slaughter, executive director of the Kansas Medical Society, said he sympathized with Artzer's predicament.
"I suspect Doctor Artzer probably felt his relationship had deteriorated," Slaughter said. "Physicians are sensitive about medical-legal issues and the potential of being sued."
Heitt can't convince clinics in Horton, Leavenworth and elsewhere to accept Kitzman, and Heitt and Fund suspect unidentified health professionals in Topeka undercut the effort. "I can't prove it, but I believe this is simply about punishment," Heitt said.
Tracy Westover, Kitzman's son-in-law, said he heard St. Francis staff make insensitive comments about Kitzman.
"It's a bad attitude," Westover said. "She's being penalized."
St. Francis spokeswoman Vicki Estes said she couldn't comment on alleged statements by staff about patients.
"We work to find solutions to anyone, any individual, whose treatment needs are beyond what we provide here," Estes said.
Slaughter said treatment Kitzman receives at St. Francis is inconvenient and inefficient, but the reality is she has been able to obtain life-sustaining care through the hospital's ER in the two months since Artzer severed the doctor-patient relationship.
Kitzman sought help from Heartland Kidney Network, which works on Medicare grievances in Kansas, but nothing came of it. The office of U.S. Sen. Pat Roberts, R-Kan., contacted Medicare officials to assist Kitzman. So far, no new clinic for her.
Carol's fate
Kitzman said visits to St. Francis, which is the sole source of the kidney treatments she needs to stay alive, have been difficult to endure. Uncertainty is agonizing. She received two rounds of treatment at the hospital last week and was turned away twice because her condition was not grave enough to warrant emergency care.
"All I'm asking for is regular dialysis," she said. "Knowing what we do, we should have never filed a complaint."
There are times she wants to crawl into a shell to die. Then she thinks of her granddaughter, 7-year-old Arianna.
"I'd like to see her grow up," Kitzman said. "At least through her teenage years."
Tim Carpenter can be reached at (785) 295-1158 or timothy.carpenter@cjonline.com.
........
Jason Hunter / The Topeka Capital-Journal
Without a functioning kidney, Carol Kitzman must undergo dialysis treatments. In addition, she suffers from diabetes, arthritis, lung damage, high blood pressure and heart problems. Kitzman is a frequent visitor to the ER at St. Francis Health Center.
ABOUT KIDNEYS
What they are:
Glandulary organs, four inches in length, found in the back part of abdominal cavity, normally one of each side of the spine.
What they do:
Filter blood, get rid of waste, control blood pressure, stimulate production of red blood cells and monitor body fluid.
How they work:
According to medicinenet.com:
"When blood flows to the kidney, sensors within the kidney decide how much water to excrete as urine, along with what concentration of electrolytes (such as salt or potassium). For example, if a person is dehydrated from exercise or from an illness, the kidneys will hold onto as much water as possible, and the urine becomes very concentrated. When adequate water is present in the body, the urine is much more dilute, and the urine becomes clear."
When they fail:
Your body retains fluid, blood pressure rises, wastes build up and the body doesn't make enough red blood cells. Symptoms include fatigue, nausea, and loss of appetite.
What dialysis does:
There are several types, but all clean and filter the blood. Complications may include muscle cramps, hypertension and dizziness.
SOURCE: medicinenet.com
.................
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Reader Comments
-2 Rating
Posted by: snailboy at Jul. 27, 2008 at 2:49:24 am
Again, can we do better?
-2 Rating
Posted by: peewees at Jul. 27, 2008 at 4:22:37 am
Making this woman wait repeatedly until her condition is emergent is unethical ... as for the administrators of Kansas Dialysis Services, shame on you!
+ 5 Rating
Posted by: mytopeka at Jul. 27, 2008 at 6:32:35 am
"I can't prove it, but I believe this is simply about punishment," Heitt said.
Doctors, hospitals and other providers aren't in the business to "punish" patients. I highly, highly doubt all of these people are conspiring against her. The doctor is LEGALLY unable to speak about this patient, thus he he isn't afforded the ability to defend himself in a public forum. I feel bad for this lady, but she seems to be very ill, as the only picture of her is one with her holding a basket of pills. The only way for very ill people to get better and hang onto life is to go along with the medical system, something that I suspect this lady isn't (or wasn't) willing to do. If she doesn't want to go along with the system, then she needs to get out of the system and go it alone.
+ 10 Rating
Posted by: hawker1955 at Jul. 27, 2008 at 7:41:37 am
Sounds to me like this womans and her husband have ticked off a lot of people in the medical field. I find it hard to believe that all of these medical professionals are conspiring against her. I wish we could here the whole story
Posted by: TopekaLaugher at Jul. 27, 2008 at 8:24:50 am
Artzer dropped Kitzman on May 21. He said in an interview he was limited as to what he could share about her case, but said he withdrew because Kitzman didn't follow medical instructions and filed the complaint. He said state and federal regulators backed his decision to discharge Kitzman.
--------------------------------------------------------
By the sounds of it there is NO conspiracy here. But to say the US has a health care "system" is wrong. There is no "system", its broken and/or piecemeal.
+ 3 Rating
Posted by: louann1962 at Jul. 27, 2008 at 8:46:17 am
My father was a difficult patient and had his Dr. withdraw from his case. They were not finding the cause of his illness. He resorted to going to the ER because he couldn't find a Dr. willing to treat him. After several weeks an ER Dr. found what was causing his illness, but it was too late. My Dad died of Pancreatic cancer 5 weeks later. It can and does happen. My heart goes out to Ms. Kitzman.
+ 4 Rating
Posted by: ppatrick34 at Jul. 27, 2008 at 8:54:45 am
I wish we could hear the whole story as well. It is sad that in this case, the patient and her "power of attorney" husband are able to use the media, but the Doctor and other health professionals are limited in what they can say because of HIPPA. I am sure that if the Dr responded, the 'power of attorney' would be livid and this would end up in court, which is probably what he was hoping for. There is obviously another side to this story.
+ 6 Rating
Posted by: 122088 at Jul. 27, 2008 at 8:59:42 am
When you are reported to the board of healing arts. that's serious business. And the consequences could be at times they take your privelages of practicing medicine away. No other doctor's are gonna wanna help her after that first complaint is filed.
+ 1 Rating
Posted by: sclemons at Jul. 27, 2008 at 9:01:44 am
When I was 17 years old (1982) I was diagnosised with a kidney disease and started dialysis in 1994. I received a kidney transplant in 2005. As a dialysis patient, I watched others not take their medication as prescribed, did not follow the strict diet required for dialysis, and some did not even follow the dialysis as required by not showing up for treatment. This is considered non-compliant. A patient does have the right to discuss and negotiate their healthcare plan with their doctor but there are some things that are negotiable when receiving dialysis treatment. Dialysis treatment is very costly and there are not enough nephrologist to take care of us all. If a patient is non-compliant with a physican they do have the right to reject the patient. Dialysis is very hard and very strict but the nephrologists in Topeka would not reject a patient as punishment, but would reject a paient for non-compliance. As a patient, I was not always so compliant either but they worked with me and I worked with them...so if they did reject Kitzman my guess would be then it was after trying hard to work with her to follow the minimum requirements.
-2 Rating
Posted by: 1racoon1344 at Jul. 27, 2008 at 9:39:18 am
Without knowing the whole story, she still deserves to
receive medical treatment outside of the emergency room.
If she is a difficult patient to get along with, then she
needs to try to get along with the doctors. By the
same token, doctors should try to give her the treatment
she needs. Unfortunately, the medical profession, such
as it is, is more worried about getting their money than
in the welfare of their patients. Cotton-O'Neil, for
example, stopped taking Medicare patients when it looked
like Medicare money would be cut. The medical profession
in this country definitely needs to be fixed.
+ 3 Rating
Posted by: jeffro at Jul. 27, 2008 at 9:51:13 am
as an employee of one of the above mentioned hospitals, bad talking about patients is absolutly not tolerated, we have to take "customer service" classes every year, this is a one sided story!! so lets not talk bad about your treatment in the er. they are there to save your butt not to kiss it!
-1 Rating
Posted by: homestatekansas at Jul. 27, 2008 at 10:02:24 am
Thank you Jeffro!!!!!
-2 Rating
Posted by: paynequarterhorses at Jul. 27, 2008 at 10:37:42 am
If a doctor refuses to treat a patient in a critical condition like her he should lose all rights to receive any taxpayer money from any patient. If this was the case I bet she would be able to get treatment. If they are willing to go it alone and not take Medicare ect then they should have the right. When they accept the gov't payment then they should also accept treating every American. It is easy to run her down but if you were in her shoes you might react the same way. I lost my boy and many who had never lost a son or daughter was telling me how to handle it. Unfortunately a uncle who had offered advice lost his son several months later and then found out the difference. So if you live in a glass house don't judge too harshly.
+ 1 Rating
Posted by: jswift at Jul. 27, 2008 at 10:42:20 am
At one time, I thought cjonline's reader response was a good thing. Lately, I've concluded it's irresponsible journalism. Day after day, anonymous readers are given the opportunity to publicly disparage people they don't know, based on information they don't have. Often, the integrity of those poeple is attacked based on nothing more than conjecture, assumptions, anecdotes from a 'friend of a friend', and personal prejudice.
+ 2 Rating
Posted by: rdgrey at Jul. 27, 2008 at 11:13:44 am
I have seen times where some patients do nothing but harp on the care thay get constantly but yet they will not follow one step of helping themselves by complying to either medication orders or change of diet. I too see this as a one sided story with the medical profession standing with their hands tied and can not reply due to HIPAA regulations. I feel bad for this patient but also there must be more to the story if the care taker is banned from the hosp.
-1 Rating
Posted by: chasss at Jul. 27, 2008 at 11:14:22 am
Its called free speech, you use it everyday jsswift in making decisions for you and your family. If one knows all the answers to a question then is there a question?
+ 1 Rating
Posted by: ralphralph at Jul. 27, 2008 at 11:19:55 am
What jerks. It's possible to burn all the local bridges.
Maybe she'll get to see her "power of attorney" grow up as well.
+ 4 Rating
Posted by: robobuzz at Jul. 27, 2008 at 11:21:30 am
Jeffro you live in a different world than the rest of us! I have been a patient in Topeka hospitals, with insurance, and I have heard nurses say bad things about other patients ALL THE TIME!! Not tolerated - baloney! Nurse, drs., aides - they talk, they joke about patients, they act like some patients are below them and that caring for some patients is toooo much trouble. I am not saying this woman & her husband are pita's, I am just saying hospitals are not all good! On the flip side, I have met wonderful caring nurses and doctors that truly take great care of everyone they meet. That is what makes up for all the rest!
+ 4 Rating
Posted by: donlilli4 at Jul. 27, 2008 at 11:40:25 am
I've been a dialysis nurse for 11 years. With that said I'd like to tell you how many non-compliant and/or belligerent and/or drug addicted patients that I, personally, have had to deal with over the years. Bottom line is that staff and doctors can only tolerate so much abuse. We shouldn't have to tolerate any of it. We are there for people who want help and want to get better. When patients or their families are verbally abusive,demanding,and belligerent it makes it very difficult for everyone...including the other patients that are there to be dialyzed in the clinic. Many of times "behavioral contracts" have to be signed. Perhaps a dialysis clinic would be more apt to accept her now, if she and her husband were under strict guidelines as expressed in a "contract". If they don't comply with the contract, then they are expelled from the unit and need to look elsewhere...again. I think it's time for the husband to realize that he needs to simmer down, for the good of everyone.
+ 1 Rating
Posted by: purplewally at Jul. 27, 2008 at 11:40:57 am
When an individual is sick with so many illnesses, a lot of times their minds are not functioning properly. And a spouse that is older and concerned about their loved one is going to react negatively when they can't get the help they are seeking. This probably boils down to communication. IF the doctor was not communicating EVERYTHING to the power of attorney (spouse), the communication is broken down because he does not know what the doctor's next move it or his intent. I have and am dealing with this right now as my father's power of attorney.
If they believe she is a difficult patient, maybe due to some mental problems, don't deny her services but help her to get the extra support she needs, such as an advocate, other than her spouse, to help communicate between she and her doctors or even a mental specialist because she probably has some depression or even dementia going on. In either case, a patient this chronically ill should not be denied services and should not have to wait until she is so sick to have to visit the ER because one of these times it will be too late.
-1 Rating
Posted by: fatfairforty at Jul. 27, 2008 at 11:53:48 am
This is unfortunate for all involved. I cettain that had she known that filing a complaint would jeapordize her treatment she would not have done this. I wonder if the drs warned her that if she would this may happen. However, she was in dire strait her life depends on getting treatment. When you are faced with death on all sides, it makes you do odd things. You are desperate and emotions run high. Many times the health professionals seem uncaring - and while they may not be- since they see this day in and day out they don't seem to take it as seriously as the patients and their families would like.
I can see why the she might have a disagreement with her dr.
I know this type of thing first hand because of what my brother endured for years. He just recently died. For the most part he had no complaints against his drs, it was just very frustrating at times as he had so many things wrong that many treatments were off limits to him.
+ 3 Rating
Posted by: jeremyrmeyer at Jul. 27, 2008 at 12:02:00 pm
I've known many of the staff at KDS. They would not arbitrarily reject some one. The reason she was rejected must be pretty serious, such as a very abusive patient, or some one who refuses to follow doctors instructions.
The staff I know at KDS are among the best in the region and have certainly earned my respect for them as doctors and nurses.
That the TCJ has given her voice creates a bias in the community that is just plain WRONG. The TCJ should have obtained a release to print all sides of the argument from her,and then gotten the full story, or refused her story. Shoddy journalism that slanders good medical professionals should not be accepted by the readers.
+ 1 Rating
Posted by: jeremyrmeyer at Jul. 27, 2008 at 12:13:58 pm
fatfairforty, Had Dr. Artzer dumped her because of the complaint, he would be liable and could be sued. He needed to have a legitimate reason for refusing her.
+ 1 Rating
Posted by: blexican at Jul. 27, 2008 at 12:31:41 pm
Compassion abounds in the capital city.
+ 1 Rating
Posted by: rdgrey at Jul. 27, 2008 at 1:35:42 pm
Very well put donlilli4, I have seen with and delt with this for 15 years. Yes it is sad and yes people who are sick are not in their right mind but when the person with power of attorney abusive and screaming about lawsuits everytime you turn around what choices are they giving the care takers? Nurses go into this field to help heal the sick not to turn their backs on people. If it was just one person refusing to give care then I would question that person. But when several agencies are worn out and refusing then maybe we should look at the other side of the story. But I would send someone from social services to get involved and maybe get a contract set up that both sides can agreee on so the patient can get the care she needs. It is very frustrating to try to help someone who will not comply to any advice that is offered to them that will help. The bad part of this story is that noone will know the other side of this story because of HIPAA.
-1 Rating
Posted by: ADifferentOpinion at Jul. 27, 2008 at 1:44:36 pm
It amazes me that someone is going to die if they do not receive treatment - yet those that can provide the treatment choose to let the person die because they don't care for him/her. I am certain that if there was a problem previously, a workable solution for treatment can NOW be found.
Topeka has made alot of incentive funds available for medical purposes with the goal of improving services to the public. Possibly there should be stipulations placed on furture expenditures.
I would hope that either a facility or a physician would come forward and provide this woman with the treatment she needs to stay alive - and I hope it is made public.
+ 1 Rating
Posted by: mcwalker66615 at Jul. 27, 2008 at 2:04:58 pm
If she's on medicare, couldn't she get transportation to Kansas City medical facilities? I'm asking in all earnestness. Surely if she explains the situation, medicare find a loophole.
-3 Rating
Posted by: mcs7584 at Jul. 27, 2008 at 2:14:20 pm
jswift said: "At one time, I thought cjonline's reader response was a good thing. Lately, I've concluded it's irresponsible journalism."
There definitely does need to be some moderation of comments. While it may be a person's right to "free speech" to say what they want, it's also the CJ's responsibility to make sure that the rights of others aren't abused and infringed by someone exercising their free speech. The Wichita Eagle limits the stories its readers can comment on. I think it would be wise for the CJ to consider doing the same.
And while we're talking about responsible journalism, I wonder if the Vicki Estes quoted in the story refusing to comment on behalf of the hospital is the same Vicki Estes who writes a blog for the CJ.
"St. Francis spokeswoman Vicki Estes said she couldn't comment on alleged statements by staff about patients."
http://blogs.cjonline.com/authors/10-vicki-estesIf she is, this is a clear conflict of interest and compromises the appearance of the CJ's ability to impartially report facts, several of which were left out of this article under the guise of "patient confidentiality." Seems to me if the patients speaks to the press, which she did in this case, she's waived her right to privacy and the hospital and doctors should comment.
Posted by: rickkuhlman at Jul. 27, 2008 at 2:27:42 pm
Modern medicine has kept her alive this long. That is amazing in itself. My brother almost died, but due to the help of hospitals and doctors he lived! I personally am very thankful for all the people in the hospital and medicine industry.
Posted by: keithmiles at Jul. 27, 2008 at 3:02:11 pm
There is always two sides to every story. Always.
+ 2 Rating
Posted by: JennyG at Jul. 27, 2008 at 3:53:15 pm
"In May, St. Francis banned him from the hospital. Heitt said it was a misunderstanding about insulin he brought to the hospital for Kitzman, but St. Francis staff won't comment due to patient confidentiality rules."
Maybe he's too old to have power of attorney. Even I know that you aren't supposed to take medicine to a patient without a doctors approval.DUH
I had power of attorney of my mother, I was 36. You have to follow rules. You don't have to agree with every doctor but from what I read , maybe the husband needs to step back or at least have someone else help out when it comes to her medical decisions. My mother gave my sister and I power of attorney BEFORE she got sick.We didn't think that we'd have to ever use it while she was so young. It was really difficult to make decisions or to agree with what every doctor said. I believe that doctors, most of them, are there for us.Being "difficult" doesn't help anyone. I find a lot of this story to be one sided.Too bad we can't get both sides.
+ 2 Rating
Posted by: Hockeygoon at Jul. 27, 2008 at 4:46:18 pm
The headline should read, "Woman receives life saving treatment for free, complains".
Posted by: dwj911 at Jul. 27, 2008 at 5:08:53 pm
I was in the transportation industry for awhile and have had dealings with this family. Very contrary and disrespectful.
Posted by: JennyG at Jul. 27, 2008 at 5:17:54 pm
Hockeygoon, not very nice
+ 2 Rating
Posted by: peewees at Jul. 27, 2008 at 5:39:14 pm
I suspect employees and the attorney for Kidney Dialysis Services have weighed in heavily with responses ... again, shame on you! A "difficult" patient does not relieve you of responsibility to provide care and I know, first hand, that people who work in the medical field are some of the worst patients, so I hope you never experience a chronic, life-threatening illness like Mrs. Kitzman ... and if yu do, I hope your care providers are more compassionate than you have been.
Posted by: eldaremington at Jul. 27, 2008 at 5:48:42 pm
dwj911 you are misusing HIPAA! Talking when you could....still be sighted for giving out info that is not yours to give....Making a judgment that the feds can correct. There are not many medical transports in Topeka....several of them have been audited.
Hockeygoon What is free? She has Medicare.
You never know who might read this....Doctors, Lawyers, Indian Chiefs....KHA, KSBHA, KSNA, even Integriguard.
To all that read the "comments"
Please legally define: non-compliant patient. I'll bet 10 people would give 10 different defintions. And none of them would be correct.
It sounds like the patient's many disabilities may be what is....difficult. Is it alright to discriminate against a person with a disability?
+ 1 Rating
Posted by: urabus at Jul. 27, 2008 at 6:21:04 pm
As someone who has been fired by a doctor, sometimes it is simply that the doctor doesn't know what to do with their patient and it's just easier to refuse to treat them. In my case I got upset with the nurse because no one would return a call - I had called on a Thursday and finally through my own continuous calls, got to speak with the nurse the following Tuesday. When I expressed my dissatisfaction with the way calls were returned, I was greeted with any number of excuses. Two days later I received a letter telling me that the doctor would no longer be able to treat me. Yes, there are difficult patients, but it's been my experience that many doctors have an "I'm God" attitude and that no one has the right to question their integrity. However, it's also been my experience that this is an attitude primarily prevalent amongst traditional medical doctors. Since switching to an alternative medicine doctor, I've been treated with compassion, respect, understanding, and, best of all, this doctor is helping me to get better.
+ 1 Rating
Posted by: peewees at Jul. 27, 2008 at 6:22:00 pm
jeffro, I also work in the industry and I don't expect anyone to kiss my butt or even thank me ... if you do, then it's time for you to move on to a different profession. I'd like for my patients to be compliant, but I understand that is not going to happen as often as I'd like. All patients deserve to be treated with dignity and respect even when they don't return it ... maybe especially when they don't. For those of you who have lost that compassion, I'm sorry, but it's time for you to move on to a job that doesn't require professional ethics or attention to "First do no harm."
Posted by: amesmb at Jul. 27, 2008 at 7:03:05 pm
"Seems to me if the patients speaks to the press, which she did in this case, she's waived her right to privacy and the hospital and doctors should comment."
-It doesn't work that way, mcs7584. Because of HIPAA, this woman can shout anything about herself from the rooftops if she wants to, whereas her doctor can't even tell his neighbor about her unless she signs a release permitting him to do so. I'm surprised Artzer even acknowledged that she was a patient.
On another note, is anyone else wondering why this is on the front page of the paper?...
+ 1 Rating
Posted by: kansascuti at Jul. 27, 2008 at 7:27:21 pm
To all of the nurses, physicians and others that work in the health care field. When I became a nurse over 16 years ago, I had to take an oath to uphold the moral and ethical values of caring for another individuals life. I also, when hired to work in either a hospital or long term care facility, realized that I was there not only as a PROFESSIONAL!!! but as representative of the facility I was working in. If I had a difficult patient, I had to "Grin & Bear It" Bite my teeth and swallow what ever criticism the patient was throwing my way. My understanding as a human being was that the patient, as well as their families, were under a lot of stress with whatever ailment they were dealing with and that people have a tendency to say a lot of things that does not necessarily mean they are picking on me, but rather venting their frustrations over not knowing or being afraid of what is happening to themselves or their loved one. I have, on numerous occassions, had to tell other employees that they did not need to air their comments about a particularly difficult patient in the public areas, but rather wait until they were on their breaks if they needed to vent, when other patients and their families would not be able to hear their comments. I realized that I was being paid by these patients and their families to do a job, and to treat not only the physical ailments, but the emotional as well. If people who are in the medical field are unable to let comments made by those who are under a great deal of emotional stress slide off their backs, then they are in the wrong profession. Also, sometimes patients do not follow their orders to the T, because of many reasons, and yes, some just don't want to, but others perhaps don't take certain medications on certain days because they have some special occassion they want to attend, or perhaps the medications make them feel worse than if they don't take them. There is no law that says an individual has to follow a doctors orders exactly as he wants. The doctor is not God, and last I knew, it was still a free country with an individual able to make decisions for themselves.
And on another note as well, I bet if these same medical professionals went to eat in a public restaurant and were treated to shoddy service and verbal mistreatment, they would complain to the manager about it, so why do they think they are immune to it in their area of work?
+ 1 Rating
Posted by: paynequarterhorses at Jul. 27, 2008 at 8:45:40 pm
Posted by: kansascuti at Jul. 27, 2008 at 7:27:21 pm Very well stated. By far the best and most accurate post on this thread. If I'm ever sick I hope I either have you or a nurse like you to treat me. God Bless. JD
Posted by: butthead at Jul. 27, 2008 at 9:43:08 pm
I guess this lady if full of piss and vinegar.
Posted by: eldaremington at Jul. 27, 2008 at 9:46:51 pm
Several people have mentioned HIPAA but has anyone read it? I don't mean the training material given out at inservices.
Most of the inservices are done with a bias....wanting to nullify & malign HIPAA. The medical industry call it inconvenient or gaging of their speach. If you really want to know:
http://www.hhs.gov/ocr/hipaa/assist.htmlGet rid of the half-truths and myths bout HIPAA. HIPAA does not require patients to sign consent forms before Dr.s, hospitals or ambulances can share info. Does not cut off communications between providers & family & friends of patients. HIPPA does not stop visits to hospitals by frienda, clergy or anyone else unless the patient instructs that their name be unavailable. You can find out more if you wish to talk intelligently about HIPAA. It effects us all one way or another.
The medical information belongs to the patient not to the medical establishment not to the direct care staff.
It is not for sale.... The informtion is valuable to theves who traffic in Medical Identity Information. It can be worth millions on millions of dollars. Rapper DMX was charged with medical identity theft in Phoenix(dateline July 21, 2008.)
HIPAA is about keeping secure....the patients info. Good medical identity theft info can be found at:
http://www.worldprivacyforum.com+ 1 Rating
Posted by: 122088 at Jul. 27, 2008 at 9:57:31 pm
Praise the Lord for Kansascuti comment you could not of explained it any better for people's understanding. I admire you, and hope their is many more like you out their in the medical field.
-1 Rating
Posted by: Dwight_Schrute at Jul. 27, 2008 at 10:24:06 pm
What a poorly written article, full of innuendo and hearsay. Terribly one-sided and ill-researched by Carpenter...who is an award winning writer.
The business by Nancy Burkhart for SV is laughable. They routinely turn patients away and send them to SF. What a joke!
then... kansascuti said - There is no law that says an individual has to follow a doctors orders exactly as he wants.
Yep, you are right, and there is also no law that says a Dr. can't fire a patient. You're not as smart as you think you are cuti.
There is more to this story than has been printed. I hope the reporter continues to investigate further.
+ 1 Rating
Posted by: eldaremington at Jul. 27, 2008 at 11:17:29 pm
Did you know that Angies List has just begun to accept reviews on doctors?
FYI....Tim Carpenter does his homework. kansascuti must have hit your sore spot schrute. Are you by chance doctor?
-1 Rating
Posted by: Hockeygoon at Jul. 27, 2008 at 11:38:47 pm
JennyG at Jul. 27, 2008 at 5:17:54 pm
Hockeygoon, not very nice
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But you can't say its not accurate.
+ 1 Rating
Posted by: peewees at Jul. 28, 2008 at 1:20:38 am
Kansascuti, I have a feeling we have worked together ... you sound like one of the good nurses who has earned my respect. Thank you for being a good example.
-1 Rating
Posted by: brian2225 at Jul. 28, 2008 at 2:33:11 am
eldaremington saud-To all that read the "comments"
Please legally define: non-compliant patient. I'll bet 10 people would give 10 different defintions. And none of them would be correct.
I'll be the first to take you up on that. A "non-compliant" patient is one who does not follow the instructions given to them by their doctor, regularly. It is a patient who does not take their medications as prescribed, regularly. It is a person who does not show up for scheduled appointments on time, regularly.
Just as an attorney would drop your defense case if you told them you were really guilty, a doctor can't treat you if you don't let them.
Posted by: eldaremington at Jul. 28, 2008 at 8:17:52 am
brian 2225
Legal defination, K.A.R.s....K.S.A.s
The point I was making: any defintion that appear to be "clear and well defined" to one person may not be to another. Exmine each word in a set of instructions to a patient. Don't talk down to the patient. Don't interject your own social prejedices. Don't do it by rote, don't do it just because the drug/durable medical equipment company rep. pushes to do it that way.
Patients do read and listen to the media. With a computer you can even search PubMed for answers. Patients are adaqutely aware that the medical estblishment is fallible but yet very expensive. Patients are aware that doctors have become technitions first and Physcians second. The medical profession is under closer exmination. Tests results can be wrong and are....very often(and contine to be expensive). Drugs are withdrawn from the market regularly sometimes weekly. Drug research has been found to be subject to reserchers conflicts of interest. Many drug companies acquire their base ingredients from unregulated and unscrupulous China. Some of the drugs are used with dialysis. A good patient always questions. Dialysis is not a picnic. It is only a stop gap measure at best. Having a repeated procedure over a long period of time....I would make it my business....to become a patient expert of the procedure. That can become a threat to the "professional".
All that said, I do hope that this patient can find the care she should have. At this moment....our medical system has filed her and her family. If not this my become another example of the need for change on a nationl level.
http://cjonline.com/stories/072708/loc_310185285.shtml
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