Socialized medicine kills patients...Oh...I mean...Socialized Medicine "un-blocks" beds for others to use!

Universal Care (read Obamacare) has ways to "un-block" hospital beds. Ready for....Just unplug the ventilator and pull the feeding tube!

 

Killing patients who are difficult to manage is wrong, but who would want to go on living as a vegetable?

By Robert Lefever

PUBLISHED:07:52 EST, 21 June 2012| UPDATED:11:13 EST, 21 June 2012

Old people are difficult to care for in hospital. They tend to have multiple medical problems and may be very confused. One specialist believes that, for these reasons, the NHS is in effect using euthanasia to un-block hospital beds.

Professor Patrick Pullicino says that doctors use a controversial ‘death pathway’, the Liverpool Care Pathway, when they believe that it is impossible for a patient to recover and that death is imminent.

This process may involve withdrawing treatment, including water and nourishment by tube. Death usually follows within 33 hours. Almost a third of all deaths in the UK each year come about in this way.

Prof Pullicino says that far too often elderly patients who could live longer are placed on the LCP so that it is now an ‘assisted death pathway rather than a care pathway’ in terminal care.

It would be very wrong if patients are being killed because they are difficult to manage. But I myself would not wish to go on living unless I have reasonable control of my body and full control of my mind.

Just because something medical can be done, it does not follow that it should or must be done.

My father's mind went to heaven three years before the rest of him. From his private pension, the family paid for his care in a private nursing home. Eventually he had a stroke. Technically, it might have been possible to keep him alive even then. His heart and liver and kidneys and all other body organs were working well. Only his brain had gone.

If he had been in an NHS hospital, with a readily available 'crash team', it might have been possible to keep him alive, more as a vegetable than as a sentient human being. But what for?

In that state, I believe that it would have been better for him to be treated on the Liverpool Care Pathway. He should be allowed to die in peace, rather than officiously kept alive.

As the man he was, and as the father I loved, his life was over. Only parts of his physical body would have been ticking over.

It might have been possible to continue that pathetic existence for weeks, months or even years, until one organ after another finally gave up.

But should each of them have been treated with a transplant, simply because that might have been possible with the miracles of modern science? And should the state pay for that, while inevitably limiting the resources available to other people who might gain greater benefit?

If he had been capable of paying for his own continuing medical 'treatment', would it have been right for him to be given it?

In that circumstance, would the doctors really have been helping my father or would they simply be demonstrating their own cleverness?

And if he had been in a private hospital, would they have kept him alive in that wretched state, purely because it paid them to do so?

And if I suggested that life support should be turned off, would I have been thought to be motivated by protection of my own inheritance?

It seems to me that Professor Pullicino, may not have thought sufficiently deeply into these issues. He may see them purely from his own professional perspective. His ideas make news but would they bring happiness or, alternatively, prolonged wretchedness?

Is he truly considering the interests of patients, or of their families, or merely those of his own professorial department?

Death Panels in Obama Care...Yep, in the UK they call Death Panels "The Liverpool Care Pathway". Still does kills the old and sick!

The best way to get around the fact that Death Panels are an essential part of Nationalized Health (read Obamacare) is to simply call it (the Death Panel) something else. In the UK, the NHS call this the “The Liverpool Care Pathway”. Easy….We don’t have Death Panels….we have the more compassionate Liverpool Care Pathway! Just…Sounds as creepy to me!

 

By Steve Doughty

PUBLISHED:18:08 EST, 19 June 2012| UPDATED:11:58 EST, 31 August 2012

Top doctor's chilling claim: The NHS kills off 130,000 elderly patients every year

• Professor says doctors use 'death pathway' to euthenasia of the elderly
• Treatment on average brings a patient to death in 33 hours
• Around 29 per cent of patients that die in hospital are on controversial 'care pathway'
• Pensioner admitted to hospital given treatment by doctor on weekend shift

Worrying claim: Professor Patrick Pullicino said doctors had turned the use of a controversial 'death pathway' into the equivalent of euthanasia of the elderly. NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday.

Professor Patrick Pullicino said doctors had turned the use of a controversial ‘death pathway’ into the equivalent of euthanasia of the elderly. He claimed there was often a lack of clear evidence for initiating the Liverpool Care Pathway, a method of looking after terminally ill patients that is used in hospitals across the country. It is designed to come into force when doctors believe it is impossible for a patient to recover and death is imminent. It can include withdrawal of treatment – including the provision of water and nourishment by tube – and on average brings a patient to death in 33 hours.

There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP. Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’. He cited ‘pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients’ as factors.  Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated. He said this showed that claims they had hours or days left are ‘palpably false’.

In the example he revealed a 71-year-old who was admitted to hospital suffering from pneumonia and epilepsy was put on the LCP by a covering doctor on a weekend shift. Professor Pullicino said he had returned to work after a weekend to find the patient unresponsive and his family upset because they had not agreed to place him on the LCP. ‘I removed the patient from the LCP despite significant resistance,’ he said. ‘His seizures came under control and four weeks later he was discharged home to his family,’ he said. Professor Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, was speaking to the Royal Society of Medicine in London.

Distressing: The professor has claimed an approved technique of looking after the terminally ill is not being used in all hospitals. He said: ‘The lack of evidence for initiating the Liverpool Care Pathway makes it an assisted death pathway rather than a care pathway. ‘Very likely many elderly patients who could live substantially longer are being killed by the LCP. ‘Patients are frequently put on the pathway without a proper analysis of their condition.  Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically”.

This determination in the LCP leads to a self-fulfilling prophecy. The personal views of the physician or other medical team members of perceived quality of life or low likelihood of a good outcome are probably central in putting a patient on the LCP.’ He added: ‘If we accept the Liverpool Care Pathway we accept that euthanasia is part of the standard way of dying as it is now associated with 29 per cent of NHS deaths.’ The LCP was developed in the North West during the 1990s and recommended to hospitals by the National Institute for Health and Clinical Excellence in 2004.

Medical criticisms of the Liverpool Care Pathway were voiced nearly three years ago.

Experts including Peter Millard, emeritus professor of geriatrics at the University of London, and Dr Peter Hargreaves, palliative care consultant at St Luke’s cancer centre in Guildford, Surrey, warned of ‘backdoor euthanasia’ and the risk that economic factors were being brought into the treatment of vulnerable patients. In the example of the 71-year-old, Professor Pullicino revealed he had given the patient another 14 months of life by demanding the man be removed from the LCP.  Professor Pullicino said the patient was an Italian who spoke poor English, but was living with a ‘supportive wife and daughter’. He had a history of cerebral haemorrhage and subsequent seizures.

Professor Pullicino said: ‘I found him deeply unresponsive on a Monday morning and was told he had been put on the LCP. He was on morphine via a syringe driver.’ He added: ‘I removed the patient from the LCP despite significant resistance.’  The patient’s extra 14 months of life came at considerable cost to the NHS and the taxpayer, Professor Pullicino indicated. He said he needed extensive support with wheelchair, ramps and nursing.

After 14 months the patient was admitted to a different hospital with pneumonia and put on the LCP. The man died five hours later. A Department of Health spokesman said: ‘The Liverpool Care Pathway is not euthanasia and we do not recognize these figures. The pathway is recommended by NICE and has overwhelming support from clinicians – at home and abroad – including the Royal College of Physicians.

‘A patient’s condition is monitored at least every four hours and, if a patient improves, they are taken off the Liverpool Care Pathway and given whatever treatments best suit their new needs.’

Best States to practice medicine! Top compensation and low stress!

What are the friendliest states for physicians? Here are America's best places to practice

Publish date: Jul 22, 2009
By: Locum Life Staff

Primary care physicians in demand almost everywhere, there's not a region in the nation that wouldn't love to claim you as its own. The question is: Which state is best for your bank account, your career, and your peace of mind?

To determine the best states in which to practice, we evaluated a number of factors: overall compensation, malpractice liability insurance rates, cost of doing business, health insurance competition, and the mix of public and commercial payers. We also considered quality-of-life factors such as residential real estate prices, natural amenities, and weather.

We talked with physicians, state medical societies, and physician placement experts who recruit doctors to hospitals and group practices around the country. We tapped into survey information from the Medical Group Management Association and the Medical Liability Monitor, which publishes an annual state-by-state review of malpractice liability insurance rates. We also pored over data from the U.S. Census Bureau, the National Association of Realtors, and the Kaiser Family Foundation, among other sources.

Here's hoping the greenest pastures are just outside your window.

10 ALASKA

Why doctors love it here: If the mere thought of Alaska makes you shiver, you may be in for a surprise: Even northern climes break 70 degrees during the summer, and two of Alaska's largest cities—Anchorage and Juneau—have predictable seasonal changes. Also, hospitals and groups are offering bonuses up to $50,000 to primary care doctors who relocate.

Why you might not: Alaska's vast wilderness can be a shock to some. Statewide, food and housing costs are higher than the national average for cities its size, and if you're looking for a more relaxing schedule here, forget it: There were 267 outpatient visits to for-profit healthcare facilities per 1,000 Alaskan residents in 2007, compared to a national average of 146, according to Kaiser Family Foundation's State Health Facts Web site. Average annual primary care compensation: $310,000 (internal medicine, based on Delta Physician Placement data over several years)—plus, Medicaid fees are more than twice the national average, according to Kaiser.

Malpractice liability insurance annual rate (for internal medicine, from the Medical Liability Monitor 2008 Annual Rate Survey): $8,856 to $10,891

Major health systems: Banner Health (Fairbanks), Providence Health & Services Alaska (Anchorage)

Best town you've never heard of: Sitka (population: 8,800). The state's fourth-most-populous city boasts a rainy but mild year-round climate compared to most of the state. This gulf-coast town is a whale-watching destination with plenty of water and wildlife recreation, and numerous seafood restaurants. It's home to the Sitka Medical Center and Community Hospital.

9 WEST VIRGINIA

Why doctors love it here: West Virginia's 7.5 percent unemployment rate in April didn't reach the 10 percent mark of neighbors Ohio and Kentucky, according to the U.S. Bureau of Labor Statistics. And while the rest of the nation saw its income drop last year, the Mountaineer State's personal income and wages went up, according to West Virginia University. One recruiter has seen primary care physicians land annual compensation offers of $200,000 to $225,000.

Why you might not: Despite reforms in 2001, malpractice liability insurance rates, while on the downward trend (most dropped by 9 percent in 2008), are still some of the most expensive among the 10 Best Places to Practice. The state is also gradually enacting a number of corporate and income tax reforms, which add to an already higher than average tax burden, according to the Tax Foundation.

Median annual primary care compensation (all primary care specialties, based on MGMA 2009 survey data): $151,500

Malpractice liability insurance annual rate: $20,528 to $23,057

Major health systems: Partners in Health Network (Charleston), West Virginia University Hospitals (Morgantown)

Best town you've never heard of: Beckley (population: 16,830). A longtime coal-mining hub, Beckley, located in southwest West Virginia, about 45 minutes south of Charleston, is home to the 8,200-student Mountain State University.

8 ALABAMA

T. Michael Harrington, MD, family physician in Birmingham Harrington is the chair of the Department of Family and Community Medicine at the University of Alabama at Birmingham

Prior to moving to Alabama in 1984, the Virginia native practiced in the U.S. Navy and in a rural Florida town on the Alabama border. T. Michael Harrington, MD "It's a good medical practice environment," he says. "Our malpractice premiums are reasonable, we have good support from our medical societies, and from a primary care physician point of view, we've got great specialty support."

Why doctors love it here: Primary care physicians are landing $250,000 to $300,000 in some areas of the state. Alabama had low medical malpractice activity in 2007 in terms of both number of claims and dollars, according to the Kaiser Family Foundation. In fact, a 2008 study by a medical law journal found Alabama to be the "most difficult" environment for malpractice plaintiffs among two other neighboring southern states. The cost of living in this low-tax state is below average, with an average single-family home in the Birmingham metro area selling for $130,400 in the first quarter of 2009.

Why you might not: If it weren't for Medicare and Medicaid, Alabama might be considered a single-payer state. Blue Cross Blue Shield of Alabama controls 95-plus percent of the health insurance market in most of the major population areas, according to the American Medical Association's "Competition in Health Insurance" market study released last year.

Median annual primary care compensation: $263,687

Malpractice liability insurance rate: $7,484

Major health systems: Baptist Health (Birmingham), DCH Health System (Tuscaloosa), University of Alabama at Birmingham Health System (Birmingham)

Best town you've never heard of: Scottsboro (population: 14,863). In the northeast corner of the state, Scottsboro is nestled along the Cumberland Mountains and 70,000-acre Lake Guntersville. Aside from the outdoor activities, Scottsboro is home to the Unclaimed Baggage Center, which sells luggage and personal contents that go unclaimed by airline passengers. It's like the world's largest garage sale, every day.

7 MINNESOTA

Why doctors love it here: Minnesota offers some of the lowest malpractice rates in the country and the opportunity to consult with (or work for) one of the world's most respected health systems: Mayo Health. Though Minnesota is a high-tax state, the cost of real estate has remained stable, according to the National Association of Realtors, with an average single-family home in Minneapolis dipping from $199,000 to $174,000 last year.

Why you might not: Independents need not apply. Mayo Health, Allina Hospitals & Clinics, and MeritCare HealthSystem dominate the state, but if you're looking to switch from private practice to working within a giant, integrated—highly efficient—system, Minnesota is for you.

Median annual primary care compensation: $176,764

Malpractice liability insurance rate: $3,375 to $5,106 (Median: $4,500)

Major health systems: Allina Hospitals & Clinics (Minneapolis), Mayo Health (Rochester), MeritCare HealthSystem (statewide), Sanford Health (statewide)

Best town you've never heard of: Waconia (population: 9,151). Located on the shores of Lake Waconia, just 30 minutes west of the Twin Cities, Waconia boasts plenty of natural beauty as well as its own community indoor water park and health club.

6 OREGON

James Lace, MD, pediatrician and founder of Childhood Health Associates of Salem

Lace founded his solo practice right out of residency in 1977. Today, it includes 11 physicians, 2 physician assistants, and 2 pediatric nurse practitioners. "Liability reform is and will remain an elusive goal for the foreseeable future in Oregon," says Lace, alluding to the 1999 expiration of a limit on pain and suffering malpractice awards. "Despite the negative aspects of practice here, I have no reservations in recommending Oregon as a great place to practice pediatrics and to raise a family."

Why doctors love it here: Despite its politically liberal legislature, Oregon has consistently ranked as a business-friendly state and last year placed No. 9 in the Tax Foundation's State Business Tax Climate Index. The health insurance market is only moderately concentrated, according to the AMA's study, making it easier to negotiate better rates. Oregon did not suffer a drastic plunge in real estate values, according to the National Association of Realtors, with an average single-family home in Portland dropping from $286,000 to $264,000 last year. Oregon also has 13 national forests, more than 200 state parks, and 363 miles of public coastline.

Why you might not: Oregon has one of the largest uninsured populations in the country at 22.2 percent, according to Kaiser—a figure that will likely increase with the state's high unemployment rate (12.1 percent in April).

Median annual primary care compensation: $172,495

Malpractice liability insurance rate: $5,479 to $10,568 (Median: $8,111)

Major health systems: Legacy Health System (Portland), Oregon Health and Science University (Portland), Providence Health & Services (statewide)

Best town you've never heard of: Klamath Falls (population: 19,662). Just north of the California border, Klamath Falls has lured many former Californians with lower housing costs and an alleged 300 days of sunny weather each year, according to the city's Web site. Klamath Falls' largest employer is the Sky Lake Medical Center, a hospital and outpatient clinic.

5 NEW HAMPSHIRE

Why doctors love it here: With high taxes, high costs of managed care, and high malpractice premiums in Massachusetts, New England earns a bad rap as a challenging place to practice. New Hampshire, on the other hand, has a 1 percent state income tax, low malpractice rates, and a diverse commercial payer mix that keeps reimbursements competitive. The Granite State also boasts classic New England beauty and more affordable housing in most areas than you'd find in Connecticut or Rhode Island.

Why you might not: Compared to other states, New Hampshire dedicates fewer funds to loan repayment and forgiveness, and receives less support from private organizations for those purposes, according to a study released last year by the state's medical society, which also pointed out that New Hampshire is often not competitive with surrounding states on recruitment incentives for primary care providers.

Median annual primary care compensation: $157,015

Malpractice liability insurance rate: $9,429 to 16,810 Major health systems: Capital Region Health Care Corporation (Concord), Dartmouth-Hitchcock Health System (Lebanon)

Best town you've never heard of: Littleton (population: 4,631). "Nineteenth-century inns are flourishing on Main Street," according to New Hampshire magazine. "Upscale restaurants and galleries are sprouting in once-abandoned storefronts." Littleton is big on picturesque small-town New England qualities, but it's only a few hours by car from Boston or Montreal.

4 NORTH DAKOTA

Robert Beattie, MD, family physician, chairman of the Department of Family and Community Medicine at the University of North Dakota School of Medicine and Health Sciences

Prior to joining the university in 2005, Beattie, a North Dakota native, spent 15 years with a rural, 15-physician group practice that covered 22,000 square miles and 25,000 people. "Practicing in North Dakota is about relationships," says Beattie. "We take care of people we know, we know their families, and as a family doc, I also take care of those family members. It's a very comfortable environment in which to live and practice."

Why doctors love it here: Follow the money. North Dakota is perched atop the largest contiguous oil deposit in the lower 48 states, and new drilling techniques have created something of an oil boom here. Demand for physicians is peaking, thanks to the thousands of people relocating to operate the hundreds of new wells. Compensation is strong: One recruiter reports seeing family physicians earn $350,000 a year, including bonuses. Moreover, Medicaid reimbursement in the state is 43 percent higher than national averages and about even with Medicare reimbursement. Unlike the rest of the country, North Dakota home values actually rose through last year (an average single-family home in Bismarck sold for $134,900 in 2006 and $155,200 at the end of 2008, while Fargo showed a smaller increase, according to the National Association of Realtors). The state is paradise for fans of the outdoors, boasting 17 state parks, 1,300 designated campsites, and the 70,446-acre Theodore Roosevelt National Park.

Why you might not: While population has been on the rise in the last three years, North Dakota remains the third-least-populous state in the country, so feelings of isolation could be considerable. Plus, the northeast corner of the state has an average winter temperature of about 3 degrees.

Median annual primary care compensation: $184,418

Malpractice liability insurance rate: $6,021 to $12,770

Major health systems: MeritCare Health System (Fargo), SMP Health System (Fargo), Trinity Health (Minot)

Best town you've never heard of: Williston (population: 12,512) is one of the oil boom towns in the northwest corner of the state. As a result of the employment demand, the town is home to Mercy Medical Center, which includes a cancer center, primary care clinic, and wellness center. Williston's average high temperature of 19 degrees in January is comparable to most Upper-Midwestern states.

3 INDIANA

Why doctors love it here: The Hoosier State was the first in the nation in 1975 to enact medical malpractice reforms and has consistently performed as a low-tax, affordable, and rewarding state to practice in, with a high quality of life. There are excellent medical centers in multiple parts of the state. The most recent real estate bubble didn't have much effect here: An average single-family home in Indianapolis sold for $111,000 last year, down $8,000 from 2006, according to the National Association of Realtors.

Why you might not: Although by no means unique to Indiana, the state is dominated by two commercial health plans, so about 75 percent of your commercial revenue (if you go into private practice) could be dictated by those two plans. And if you're a downhill skier or love the mountains, Indiana may not be the place for you.

Median annual primary care compensation: $183,555

Malpractice liability insurance rate: $8,752 to $11,576

Major health systems: Clarian Health (statewide), Community Health Network (Indianapolis), Parkview Health (Fort Wayne), St. Vincent Health (Indianapolis)

Best town you've never heard of: New Castle (population: 18,347). Situated 49 miles northeast of Indianapolis, New Castle offers small-town living close to the city, but is also home to Henry County Memorial Hospital.

Notable landmark: The New Castle Fieldhouse, with a seating capacity of 9,375, is reportedly the world's largest high school gymnasium.

2 WISCONSIN

Why doctors love it here: A progressive state legislature capped non-economic damages for medical malpractice liability before it became a crisis, as it did in other Midwest states such as Illinois, Michigan, and Ohio. Wisconsin is the second-most-insured state, and more than 61 percent of its residents carry employer-sponsored coverage—more than 10 percentage points above the national average. With more than 15,000 lakes, it's a great place to live if you love watersports and the outdoors.

Why you might not: The Badger State ranks higher than average for state and local tax burden per capita, and most areas get four feet of snow each year—even more in the northernmost reaches.

Median annual primary care compensation: $190,240

Malpractice liability insurance rate: $3,946 to $8,236 (Median: $6,923)

Major health systems: Aurora Health Care (Milwaukee), Ministry Health Care (Milwaukee), University of Wisconsin Hospital and Clinics (Madison)

Best town you've never heard of: Ripon (population: 7,619) is about 90 minutes south of Green Bay and the home of Ripon College and Ripon Medical Center, which includes a heart and lung center and cancer clinic.

1 TEXAS

Robert Frischer, MD, solo gynecologist in Wichita Falls

Originally from New York, Frischer completed medical school and residency in Cincinnati, joined the Air Force, and was relocated to Texas in 1978. He opened his solo practice in 1980. "Texas is a great state, and I am originally a New York City Yankee," he says. "The liability situation is very good, with continued drops in malpractice rates. Insurance problems, at least in my area, are not as bad as what I hear from docs in other states and in larger cities."

Why doctors love it here: The Lone Star State offers the best of all worlds for physicians: a variety of cities with excellent medical centers, no state income tax, great compensation, and low real estate costs—an average single-family home in the Dallas-Fort Worth area sold for $135,700 in the first quarter of this year. Tort reform in 2003 makes Texas a leader in low-cost malpractice liability insurance despite being the second-most-populous state in the nation. Texas's median annual malpractice liability insurance rate is $16,655 (compare to $21,052 in New York and $32,328 in Florida).

Why you might not: Almost one-quarter of Texas's population was uninsured in 2007, according to the Kaiser Family Foundation, and less than half of its residents had employer-sponsored coverage. Hot, humid weather dominates the southern portion of the state.

Median annual primary care compensation: $197,042

Malpractice liability insurance rate: $8,839 to $31,668 (Median: $16,674)

Major health systems: Texas Medical Center (Houston), University of Texas Southwestern Medical Center (Dallas), Seton Healthcare Network (Austin)

Best town you've never heard of: Huntsville (population: 35,078). This bucolic town, situated between Dallas (pictured) and Houston, is surrounded by the Sam Houston National Forest and includes Huntsville Memorial Hospital and Sam Houston State University.