Nysha Recent News

Hospital News

February 27, 2017        

By Mendy Hecht, Hamaspik Gazette

U.S. Agents complicate status of Canadian nurses in Detroit hospitals

In mid-March, some 30 advanced practice nurses and nurse anesthetists from Canada employed by the Henry Ford Health System in Detroit were told by U.S. border agents that their visa status—and hence, the legality of their presence—was uncertain under the North American Free Trade Agreement (NAFTA).

Under the much-debated NAFTA pact, highly trained foreign professionals from outside the U.S. have qualified for so-called TN visas, or documentation allowing them long-term U.S. jobs as non-immigrants.

But Henry Ford reported that at least one of their Canadian nurses was recently denied entry to the U.S., with others being told by U.S. Customs and Border Protection (CBP) agents that their status is in question.

In a statement, the CBP said there have not been “any policy changes that would affect TN status” and blaming any issues on “improper paperwork presented by the traveler.”

Under NAFTA, 63 occupations, including registered nurse, qualify for TN visas allowing citizens of Canada, Mexico, or the U.S. to cross borders for a job.   According to Henry Ford immigration attorney Marc Topolesky, nurses to fill the advanced positions are hard to find—with foreign professionals helping fill that shortage.

Memorial Sloan Kettering outpatient visits, income grows

Memorial Sloan Kettering Cancer Center (MSK), one of New York City’s several national medical-care leaders, saw its income grow in 2016, according to its newly-released financial disclosure.

That growth in operating income was driven primarily by growth of MSK’s regional outpatient centers.  Its newest outpatient center, in Monmouth, New Jersey, opened in December and its Commack, New York center was nearly doubled in size this past October.

The growth stands in stark contrast to another noted cancer center, MD Anderson Cancer Center in Houston, whose president Dr. Ronald DePinho announced recently that he was stepping down in the wake of a $266 million loss in fiscal 2016.

Big-hospital doctors paid more than independents

The recently-released 2016 Fee Schedule Survey by Physicians Practice, an industry group, confirms that the classic neighborhood doctor’s office of old continues its fade-away.

Based on Physicians Practice’s newest data, the reason is fairly obvious: Doctors working for hospitals or health systems get paid more.

The Survey found that affiliated doctors got paid an average of $74 for new-patient office visits, while independent doctors reported an average of $58.40.

For office visits by existing patients, Physicians Practice found that hospital- or health-system- based doctors got a per-visit average of $58.70, compared to about $43.10 for independent doctors.

At the same time, the 2016 Fee Schedule Survey finds that about 38 percent of all currently practicing U.S. doctors are employed by hospitals or health systems—and that 25 percent of physicians’ practices are owned by hospitals or health systems.

However, for independent doctors, all hope is not lost—industry experts note that in many regions, independent doctors can join an independent physician association (IPA) to increase bargaining power without sacrificing independence.

Too many stroke patients not getting TPA “clot-buster”

Because artery blockages caused by internal blood clots are the cause of most strokes, the “clot-buster” drug TPA is the first ER treatment for most strokes—or at least should be.

A recent study found that patients treated for strokes at large urban hospitals, teaching hospitals or designated stroke-center hospitals were likelier to get TPA.  However, the study found that minorities, women, Medicare members, rural residents and southeastern U.S. “Stroke Belt” residents were less likely to get TPA upon suffering strokes.

But the good news is that study also found that across-the-board rates of stroke patients getting TPA rose each year by 11 percent.

A second related study further found that stroke patients who get TPA even before they get to hospital ERs—in mobile stroke units, or ambulances carrying special equipment to diagnose and treat strokes on the road, including TPA—had an even lower risk of stroke-related long-disability (like partial loss of speech or movement) than those only first treated in ERs.

That study concluded that for every 1,000 stroke patients given TPA on their way to the hospital, 182 will be less disabled by their stroke and 58 will have no disability at all.

To be effective, TPA must be administered within 4.5 hours of the start of a stroke—and the closer to the start, the better.  (Theoretically, a person having a stroke in a hospital ER and getting on TPA within five minute could emerge with no long-term damage whatsoever.)

Rude parents, doctors, hurt medical team care

A new study in Pediatrics suggests that if a parent of a baby says something rude to medical staff at a hospital’s neonatal intensive care unit (NICU), the quality of care might suffer.

“All the collaborative mechanisms and things that make a team a team, rather than four individuals working separately, were damaged by the exposure to rudeness,” said researcher Dr. Arieh Riskin.

Rudeness has long been part of medical culture, whether between senior doctors and trainees, or between surgeons and nurses in the operating room, according to Dr. Riskin.  And an earlier related study by Dr. Riskin found that rude comments made among hospital professionals also hurt medical-team performance.

In both of the NICU studies, the effects on performance were significant; rudeness explained more error than the levels of error that have been shown to result from sleep deprivation.

“We are human beings,” Dr. Riskin told The New York Times.  “We are affected by rudeness.”