Letters To The Editor: In Defense Of Shorter Shifts For Interns, Medicaid Managed Care Oversight, Emergency Room Frequent Flyers And Other Topics

Letters To The Editor: In Defense Of Shorter Shifts For Interns, Medicaid Managed Care Oversight, Emergency Room Frequent Flyers And Other Topics

Letters to the Editor is a periodic KHN feature. We welcome all comments and will publish a selection. We will edit for space, and we require full names.

 

Earlier this month, the Kaiser Health News’ story Some Doctors Questioning Whether Shorter Shifts For Interns Are Endangering Patients (Boodman, 7/9) drew a number of reader comments. Here’s a sampling:

Michelle Storms MD, Assistant Clinical Professor, Michigan State University; Marquette, Mich.

After surviving medical school and residency training about 30 years ago, I absolutely believe that work hours should be limited to 16 hours rather than 36 hours. Working long hours adversely affected every aspect of my life and definitely impacted the provision of quality medical care even though I tried hard not to let this happen. Unfortunately, my career since residency has continued to perpetuate the idea that physicians can and should work 36 hours straight. It is insanity and a major contributor to physician burn-out.

Julia Catherine Price, RN, MPH; Lake Wales, Fla.

To suggest that reducing the number of hours that interns can work will jeopardize patient care is ludicrous. There needs to be a reality check here. There is too much data to show that people (all people — doctors included) start to use poorer judgment when fatigued. I personally think that 16 hours in a row is still too much — 12 hours should be the maximum. Why can doctors not be regular people — working a regular job for regular pay? This goes against the corporate physician culture in the U.S. of physicians as super humans. However, we need to get back to treating people and not just making large amounts of money for the medical industrial complex. 

Steve Perry, RN; Los Angeles

This article shed some light on one of the most fundamental problems in the health care culture in the paragraph where one doctor stated that doctors are different from ordinary people and can transcend fatigue. Seriously? If they only knew they were human — that would be a good place to start. 

Another reader commented on an “Insuring Your Health” column, Finding Answers About Health Coverage (Andrews, 7/18): 

Dr. Susan Waters, CEO, National Association of Insurance and Financial Advisors; Falls Church, Va.

Michelle Andrews is correct when she says many Americans do not understand the Affordable Care Act and that assistance from government sources can be inconsistent. However, she fails to mention a group of people working diligently to get consumers up to speed on the ACA and help them face the ever-changing healthcare landscape – health insurance agents and brokers. 

These professionals do more than sell insurance. They help individuals and small businesses find plans that meet their unique needs and budgets. … Most importantly, though, agents and brokers are advisers and advocates on behalf of consumers. … While the ACA’s Consumer Assistance Programs struggle to meet consumers’ demands due to funding problems and uneven implementation of the ACA, agents and brokers continue to be a trusted source of consumer information and assistance. 

Regarding Advocates Urge More Government Oversight Of Medicaid Managed Care (Bergal, 7/5), a reader wrote:

Deborah Fickling; Santa Fe, N.M.

Why say “mentally ill and people with disabilities” instead of “people with mental illness and other disabilities?” The use of people-first language is a common and respectful way to refer to those of us who have lived with mental conditions most of our lives. While the group of people described in the article are having a more difficult time dealing with their mental illness than some of us (which is why they qualify for Medicaid), they do not deserve any less respect than recognition that they are people first, not their diagnosis. 

Another reader offered these thoughts on How Oregon Is Getting ‘Frequent Flyers’ Out Of Hospital ERs (Kristian Foden-Vencil, 7/10):

Susan Pfettscher; Bakersfield, Calif.

As a nurse, I’ve never liked the term “frequent fliers”– like many others we use in health care, it is so stigmatizing. Even more importantly, as I read this article, the other phrase that came to mind was “isn’t this common sense?” Until we meet a person’s basic needs, an emergency room becomes a safe and comfortable place — even though it is for a short time. The safety net … is full of holes at a time when more lives have been negatively impacted in our altered society. I fear it can’t be mended fast enough, but I’m so glad this program is giving it a try. They are listening to what people need — not giving them things they don’t. 

Meanwhile, here’s a reaction to the story Advocacy Group Seeks To Force Employers To Give Pregnancy Coverage To Dependents (Andrews, 7/5):

Lena Conway; Naperville, Ill.

I have been a group insurance underwriter for years. In the old days, children were covered as dependents, and our society used to think that only adult employees and their spouses had coverage for maternity claims. Of course our society changed a whole lot. With the Affordable Care Act lengthening dependent coverage up to age 26, many people are now questioning the right for female dependents to be covered for maternity claims as well. [This] changes the way insurers underwrite the premiums of health plans. Suddenly, family coverage includes older children, who demand maternity coverage. Then, when the baby is born, [will there be] grandchildren coverage as well? This has huge financial impacts, and premium rates must go up to support the people who were not traditionally covered. Employees and employers must understand there can be significant financial impact.