[HSF] post op mediastinitis discussion

[Michael Firstenberg]

My understanding is that while Medicare will not pay for you to take care of
YOUR complications a nice little loop hole is that you can get paid for
SOMEONE ELSES complications.

I heard that an underlying agenda is to start going down the path of
rationing care and this is an "easy" way of doing it - since we all know
that avoiding little problems like UTIs, Line sepsis, post-op wound issues
really do not exists and if they do, then obviously it is the surgeon's
fault and they can all be prevented - and when encountered, we should just
ignore them since they will go away on their own.  Look at the data - how
many people had MSRA line sepsis in the 1940's?  none!  I rest my case.

-michael



On 10/3/07, hgrmd at aol.com <hgrmd at aol.com> wrote:
>
> Chuck,
> Totally agree with you.  Medicare has finally gone too far.  Who is going
> to pay the plastic surgeon for his flaps?
>
> Hal
> Sent from my Verizon Wireless BlackBerry
>
> -----Original Message-----
> From: "Douville, Chuck" <ecdouville at orclinic.com>
>
> Date: Tue, 2 Oct 2007 20:47:00
> To:"OpenHeart-L" <OpenHeart-L at hsforum.com>
> Subject: [HSF] post op mediastinitis discussion
>
>
> This discussion is relevant to our cardiac surgery colleagues around the
> world, although it is a financial issue only in the USA. CMS (center for
> medicare services), the agency responsible for medicare healthcare funding
> in the US recently announced it would no longer pay hospitals for costs due
> to postoperative mediastinitis in cardiac surgery patients effective within
> the next year. Despite perfect glucose control, antibiotic timing etc, my
> own recent morbidly obese re-do AVR pt had his chest open 7 hours due to
> difficult adhesions. S. epi wound infection on day 6 required opening his
> sternum, VAC therapy and IV antibiotics and an extra week in the hospital.
> The only way to avoid the infection in this pt that I can think of is to
> deny the operation to a 60 yr old man with critical AS after previous CABG 6
> years earlier.  I do not believe the incidence of this problem can ever be
> zero. Thoughts?
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