Archive for October, 2010

Conflicts of Interest in Health Care

This week, posted an article titled “ Docs on Pharma payroll have blemished records and limited credentials”.  According to the article, written by Charles Ornstein, Tracy Weber and Dan Nguyen, a ProPublica investigation “…uncovered hundreds of doctors on [pharmaceutical] company payrolls who had been accused of professional misconduct, were disciplined by state boards, or lacked credentials as researchers or specialists.”

Go here to read the full article:

ProPublica states that this will be the first of “several” stories to run on the site looking at the “high stakes pursuit” of our country’s doctors and physicians and their “prescription pads”.

So what, you may ask, does any of this have to do with credentialing, particularly direct care workers, nurses, aides, even dietary technicians? Just this….as a country we look to doctors, lawyers, and educators when it comes to the standards that we hold everyone to.  If your law school professor said it, nine times out of ten, you’re going to believe it. If your law school professor has a slant on a particular law, more than likely, his students are going to adopt some of that attitude also.

The same can be said about our doctors.  If pharmaceutical companies are searching out physicians to sell their products, and pay them to do so, then it is a safe bet that the patients (former or current) of those doctors are going to buy in.  That is indeed why pharmaceutical companies pay doctors to help them brand and sell certain products.

But if the doctor’s that are helping the pharmaceutical companies sell their products have been before the “review board” for misconduct, or if they don’t actually have the certifications and licensing in neurology and they are helping Eli Lilly sell one of their antidepressants, how can we, as the doctors patients’ expect the nurse’s aide – who by the way, is in and out of our hospital room more times than the doctor himself – to have the certifications necessary to do what he/she does?  How can we be sure that the other direct care workers that are busy checking serum levels and making sure IV drips are dripping correctly haven’t been before the state’s review board?

Yeah, I know, you credential them before they get hired, blah, blah.  But in a state like Georgia, where ProPublica found a Dr. Ronald Taylor, who had been kicked off of the staff at an area hospital for giving young female patients vaginal and rectal exams without documenting why, where direct-care workers are not required to have background checks done, how do you really know for sure who’s taking your temperature?

Healthcare is a system that is based on trust between the caregiver (doctor, nurse, dietician, etc.) and the patient.  No matter how much research you do on what ails you, you still  trust that your doctor (and his staff) is doing what is in the best interest of the patient. If doctors are at the head of the food chain in medicine, and they aren’t doing the right thing, how can we expect the rest of his/her staff to do the right thing? We need our doctor’s to lead by example so we as patients can be safe in knowing that the rest of the staff is being led honestly.

-Elle Terry

Felons as Caregivers in California?

On Friday, October 9, 2010 Gov. Arnold Schwarzenegger signed a budget package that included two bills, AB 1612 and SB 856 which are designed to restrict convicted felons who have been charged with certain violent crimes from working as caregivers in California’s In-Home Support Services (IHSS) program according to both the Los Angeles Times and Click here for information on the IHSS Program.

The old law kept individuals from working as an IHSS caregiver if they had received certain specific types of convictions, specifically:

• Child abuse
• Elder abuse
• Defrauding public assistance programs

Check here for information on the law.

The new law expands the number of disqualifications that block a person from working as an IHSS or direct-caregiver. The downside to this however is that with the new law an IHSS beneficiary, i.e. your loved one, can sign a waiver to continue receiving care if the caregiver had a felony conviction that is not one of the three (3) mentioned above. This is a concern to many California citizens. Taking care of a loved one puts a strain on the family and with that strain, sometimes the ability to think rationally is put at risk. So a friend of a friend refers an IHSS caregiver to you and while performing your due diligence, you discover that the caregiver committed a bank robbery ten (10) years ago. But your loved one wants to keep the caregiver because he or she is “nice” and other members of the immediate family also think that he or she is “nice”. What do you do? Will this person rob again? Will they rob your loved one?

As a country, we have a lot of laws on the books that need to be revamped (Wall Street anyone?). But we also have a quite a few laws on the books that are good and solid and do what they are supposed to do (domestic violence comes to mind). California’s original law restricted criminals from getting a position as a caregiver. Again, with a family member even mildly ill, the strain can be incredible. And until now, you had the existing law to enure that most criminals were not in the vicinity of your loved one. Now, having the option to sign a waiver, in my opinion, is not going to do anything but confuse an already tough situation. This is not to say that we aren’t intelligent enough to make good decisions about our family members. However, in emotional situations like these we need the law to guide us and give us direction, not open-ended choices with repercussions we may not fully understand.

-Elle Terry

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CredentialedCARE Corporation Launches Online Health Care Worker Credentialing Service

We are pleased to announce the launch of our new website, Our service offerings will save Care Providers time, money and resources while increasing revenue. The company mission is to enable transparency and accountability in all long-term care sectors throughout the U.S.; initial rollout will be in the home care industry. You can read the Press Release here.  Click to View

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