Here’s what happens when a for-profit company takes over your local ER | Clayton Dalton

Earlier this year, I stood outside the hospital in New Mexico where I worked as an emergency physician. I was, for the first time, picketing. The next day I would be fired, another first. At least I wasn’t the only one – all of my colleagues would also be terminated.

Why would a hospital fire an entire department of doctors?

The hospital, it turns out, had decided to outsource us.

The emergency room at the hospital, Presbyterian Santa Fe medical center, would be taken over by a company called Sound Physicians. Sound is a contract management group, or CMG. It’s a for-profit corporation, owned in part by a private equity firm.

Private equity-backed CMGs now operate a quarter of all ERs in the US. The rise of the CMG reflects growing private equity investment in healthcare generally, up more than 20-fold since 2000.

The pitch is that CMGs can bring business savvy and financial resources to a struggling clinic or department. They argue that this is exactly what American healthcare needs: seasoned investors bringing an infusion of capital and business acumen.

Last fall, a local newspaper published a story about Presbyterian’s plan. An administrator stated that Sound was brought in to “consistently provide physician coverage” so that the “community has access to care when they need it most”.

“I literally laughed when I read that,” John Wagner told me. Wagner has worked in private equity and investment banking for over 20 years. I reached out to him after he published a letter in the Santa Fe New Mexican criticizing the privatization.

Private equity investors often expect a several hundred per cent return on their investment, Wagner explained in his letter. “Where do you think those earnings come from, tip jars?” he wrote. “Nope. They’re extracted from overextended doctors,

Communicable Disease Prevention in K-12 Schools

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Communicable disease activity at school

Communicable diseases circulate in our communities. As long as cases occur within our communities, K to12 students and staff members may be affected. Schools have communicable disease prevention measures in place and will contact public health if they have concerns about communicable disease transmission within schools and require additional support.


Prevention measures

Prevention measures are in place to reduce the spread of communicable diseases. These include effective personal practices like health awareness, staying home when sick and regular hand cleaning. All students and staff should:

Online and homeschooling programs are available to students if alternative learning options are needed.

Health awareness

Health awareness reduces the likelihood of a person coming to school when they are sick. This includes checking regularly for symptoms of illness to make sure you or your child don’t come to school while sick.

Students, staff and other adults should follow public health guidance and the recommendations of their health care provider when they are sick. Health information is also available from Healthlink BC or by calling 8-1-1.

Masks

The decision to wear a mask or face covering is a personal choice for everyone. People can choose to continue to wear a mask throughout the day or during specific activities. This choice will be supported and treated with respect. 

Communicable disease guidelines

The Provincial Communicable Disease Guidelines for K-12 School Settings are developed by the Ministry of Education and Child Care, in collaboration with the B.C. Centre for Disease Control (BCCDC), Indigenous rightsholders and education partners, including teachers, parents and school leaders.

These guidelines build on public health guidance, and are used by boards of education, independent school authorities and schools to support communicable disease prevention planning.

Ventilation

School districts will ensure heating, ventilation and air conditioning (HVAC) systems

Don’t Call These Clothes Minimalist. Or Quiet Luxury for That Matter.

“Quiet luxury, oh God,” Isabel Wilkinson Schor, the designer of Attersee, said with a small sigh. “I don’t consider us a part of that trend at all. It’s been around for a very long time, and it’s equated with minimalism. I don’t see what we are doing as minimalism.”

Attersee, which Ms. Wilkinson Schor founded in 2021, is known for the kinds of high quality, strokeable fabrics associated with the trend. The clothes are classic in that they are not meant to easily go out of style, but do have quirks: a knit tube wrap as an alternative to a cardigan, a print of figure drawings, a plissé silk cape dress and caftans for summer and winter.

The impetus for the line was simply to find everyday clothes that were comfortable and beautiful, not the kind of thing that would be worn only to a big event once a year. There are oversize collarless shirts in a silk-cashmere blend for $525, sculpted duchesse satin vests for $725 and linen-cotton Mary Janes made in collaboration with the Italian shoemaker Drogheria Crivellini for $175.

This week Attersee, which is named after an Austrian lake where the artist Gustav Klimt spent summers, is opening its first public showroom, in a former fitness studio on the Upper East Side. It is a working space for Ms. Wilkinson Schor and her employees as well as an appointment-only place for customers to see and try on the clothes in person.

Ms. Wilkinson Schor, the former digital director of T magazine, grew up on East 19th Street in Manhattan, eating at Veselka and shopping at Love Saves the Day. Until she moved to the Upper East Side in 2020, she had lived downtown for her entire life.

Moving didn’t change how she dressed, she said: “I don’t

Audit of Maryland Health Department finds $1.4 billion accounting lapse

The Maryland Department of Health failed to adequately track federal reimbursements it received during the height of the pandemic, leading to more than $1 billion in unaccounted-for funds, according to an audit made public Tuesday.

At the end of fiscal 2022, the department could not account for $3.5 billion in reimbursed funds the agency should have received from the federal government, according to the report published by the state Office of Legislative Audits. By April, the agency had recovered $2.1 billion of those federal funds, leaving $1.4 billion of those funds that should have been reimbursed undocumented.

Gov. Wes Moore (D) said Wednesday during an unrelated public meeting that the audit “raises significant concerns about how finances were documented and handled at the Department of Health during the previous administration.”

The governor, who took office in January, said he is committed to ensuring “that we improve fiscal discipline and that we use best practices to ensure that Maryland’s government does better going forward and it’s not just within the Department of Health. … We have to make sure fiscal responsibility is something we hold ourselves to.”

A representative of former governor Larry Hogan’s administration did not immediately respond to a request for comment.

Maryland Secretary of Health Laura Herrera Scott said the agency is deeply concerned about the “severe findings” in the audit, which covered a period before her appointment to lead the agency. Most of the agency’s top leadership had already changed before the audit was completed, during the transition between Hogan (R) and Moore.

“In short, the report raises grave concerns about the stewardship of taxpayer dollars during a critical period for public health,” Herrera Scott said in a statement. “The Department is moving swiftly to

Opinion | Open Enrollment Reminds Us How Easy It Is to Lose Health Insurance in America

A few days before New Year’s Eve, an unfamiliar health insurance card for me arrived in the mail. I assumed there must have been an error and called the human resources department of the medical center where I’m employed as a doctor.

“No,” the representative replied, “it’s not a mistake. You didn’t enroll this year, so you automatically got put on the basic plan.”

“That’s … that’s impossible,” I stammered. “I’ve always signed up my family for the same health plan.”

“I’m sorry, Dr. Ofri,” the representative said, rechecking her records, “but you didn’t enroll this year.”

Could that be? Could I have somehow forgotten? Or missed the notification? “But don’t worry,” she said. “We’ve put you on the basic plan.”

“OK,” I said, starting to relax and thinking out loud. “I guess my kids will get to meet some new doctors.”

But the representative did not match my tone. “I’m sorry, but the basic plan is just for the employee,” she said, “not your family.”

That’s when a coil of disbelief clamped my heart to a standstill. My spouse and children would be left without health insurance? The panicked questions quickly percolated: What about their ongoing medical treatments? What about their medications? What if someone got hit by a car, or got cancer? There’s hardly a more devastating feeling for a parent than to realize that you haven’t adequately provided for your family.

Swirling in panic, I hardly heard anything else the representative said. There was something about referring my case to a supervisor, but it was a holiday week, so many employees were on vacation. All I could think about was that in a few days it would be the new year, and my family would be uncovered. I felt tears creep into the corners of my eyes

Should Patients Get Immediate Access to Cancer Test Results?

Event Transcript

Click here to access the full transcript (pdf)

Summary and Key Highlights

By Kara Grant

In the second installation of the Medscape Masters series, Aaron Goodman, MD, a hematologist at UC San Diego, and Mark Lewis, MD, director of gastrointestinal oncology at Intermountain Healthcare in Utah, came together to debate the topic of patients’ immediate access to cancer test results. Moderated by WebMD’s chief medical officer John Whyte, MD, who practices as an internist himself, Goodman argued in favor of patients getting access to their electronic health records (EHRs) without delay, a key feature of the 21st Century Cures Act that went into full effect in October 2022. Lewis took the opposing position, arguing that even though there’s no changing the Cures Act, patients’ unprecedented access to their results has been burdensome for both patients and the healthcare system alike.

The argument in favor of immediate patient access to test results:

According to Goodman, his position is obvious: Patients deserve to see their EHRs without delay. It’s their health information, and they should be able to control when and where they see it. Patients also don’t have to look at it, Goodman emphasizes.

The argument against:

Lewis knows that his stance against Open Notes and immediate EHR access isn’t a popular one, especially among patients. He also knows that despite his opposition to it, the 21st Century Cures Act isn’t going away anytime soon. But Lewis holds that giving all of this information to patients — or what he calls “à la carte oncology” — puts the onus of understanding their labs and test results unfairly on patients before they have the chance to see a doctor.

Should AI play a role?

Both Goodman and Lewis agree that the movement to write plain-language summaries of medical reports and

Health advice all women in their 30s should know

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Maria Shriver talks with her two daughters, Katherine and Christina, about health issues they face in their 30s. Then, Dr. Lisa Larkin joins the discussion to share advice on everything from fertility and egg freezing to experiencing mood disturbances and more.

Inside MoMu fashion exhibition ‘Echo. Wrapped in Memory’

‘I’m always quite sensitive to the past while feeling more detached in the present,’ says Irish fashion designer Simone Rocha, one of three protagonists of a new fashion exhibition at MoMu Antwerp which explores the emotional link between fashion and memory – what meaning do we attach to the clothes we wear, and why? And how does clothing shape the way that we remember the past? Of her own works – several of which have recently been acquired by the institution, having reopened after a major renovation in 2021 – Rocha says the idea of memory is woven into every garment. ’History, nostalgia, remorse, emotion… I pull those ideas into the reality of today and see how they reveal themselves.’

Titled ‘Echo. Wrapped in Memory’, the recently opened exhibition places Rocha in conversation with two other women artists, Belgian choreographer Anne Teresa De Keersmaeker and prolific French sculptor and painter Louise Bourgeois. MoMu calls it a ‘conversation’ between the three women, who despite working across mediums and time periods, nonetheless share a fascination with clothing, fabric and the body, and the way that interplay shapes the way we understand our personal histories. Alongside, MoMu has selected a number of historical pieces from its vast archive – now numbering over 38,000 pieces – which bear marks of their wearer’s lives, whether stains, smells, or tears (one extraordinary weighted satin silk bodice from the late 18th century is eerily shredded across its surface).

‘Echo. Wrapped in Memory’ fashion exhibition at MoMu Antwerp

MoMu fashion exhibition Echo Wrapped in Memory

A view of the exhibition, featuring Louise Bourgeois’ 2007 work ’The Feeding’

(Image credit: Photography by Stany Dederen, courtesy of MoMu Antwerp)

Bourgeois – who described art as ‘the re-experience of a trauma’ – clothing became a particularly important part of her practice in the final two decades of her

Gaza’s health care system in ‘state of complete collapse,’ Gaza Health Ministry says

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Reopening ERs won’t fix Manitoba’s struggling health-care system: doctor

As wait times increase and more patients are walking out of emergency departments without receiving care, some Manitoba doctors say reopening previously closed emergency rooms isn’t necessarily the solution.

The recently elected NDP government ran on a pledge to reopen three emergency rooms that were closed and converted to urgent care centres under the previous Progressive Conservative government.

But some front-line workers say addressing patient flow and the systemwide “access block” needs to be the top priority. 

“It’s important to look at the system — not to impose expensive solutions [of reopening ERs] and oversimplify complex problems,” said emergency department physician Dr. Alecs Chochinov.

According to Shared Health data, more than one in three patients who recently sought medical care at Health Sciences Centre’s emergency department in Winnipeg left without seeing a doctor.

That number is an important benchmark that doctors and health officials say shows the state of the health-care system.

“The ‘left without being seen’ rate is a symptom of system dysfunction,” Chochinov said. 

A man in a black sweater standing outside on the sidewalk.
Dr. Alecs Chochinov warns that moving too quickly to reopen ERs will not fix the current patient flow and ‘access block’ problems in Manitoba’s health-care system. (Jeff Stapleton/CBC)

While hospitals are dealing with critical staffing shortages, Chochinov said one of the single biggest problems throughout the system remains “access block” — when the right care is potentially available, but people cannot access it.

The ER is the canary in the coal mine, said Chochinov.

“Whenever there is a block anywhere, it manifests in the emergency department.”

In emergency departments, that’s most often due to admitted patients taking up stretchers, blocking people in the waiting room from being able to access care. 

But it also comes up with hospital patients “waiting for long-term care options who are stuck,” or for those waiting to see a 

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