Thursday, September 24, 2009
America's health care system rewards poor medical treatment
By Dr. Anthony Policastro

Last week, I wrote about one of the ways that the current medical care system rewards poor medical care and non-compliant patients. I also pointed out that good medical care and compliant patients are punished for their efforts. Another example of a similar situation involves medical procedures. Most medical procedures carry a certain complication rate. Some physicians have higher complication rates than others. Under the current payment system, a physician often gets rewarded financially for having a higher complication rate. For example, let us take two surgeons. One of them does a certain surgical procedure with almost no complications. His/her patients have the procedure and do well, leaving the hospital quickly. The medical care system has to pay relatively little to the physician and the hospital for the care of his/her patients. A second physician has a high complication rate for the same procedure. The patients with complications have to spend extra days in the hospital causing the surgeon to visit the patient more often in the hospital. Each day, the surgeon's visit is paid for. Therefore, he/she gets paid more than the physician with the lower complication rate. There are extra consultations by other doctors for the patients with a complication. There is a need for more medication and additional surgical procedures to treat the complication. Extra time is spent in the hospital to treat the patient with a complication. All of these things add cost to our expensive health care system. Because of this, the system rewards the physician with the high complication rate and punishes the physician with the low complication rate. My daughter called me one night about my granddaughter who was having abdominal pain. Her other symptoms made it clear to me that she had appendicitis. I advised my daughter to have her seen. The physician who saw her diagnosed it as an intestinal virus. Four days later she was taken to surgery with a ruptured appendix. She had to stay in the hospital for a full week. She had to have drains put in the place and extra doses of antibiotics. When all was said and done, my daughter received a hospital bill for a $5,000 co-pay. That represented only a portion of the total excess medical costs. Most of that could have been avoided if the correct diagnosis had been made the first time. As a nation we need to find a way to make sure that the system rewards the kind of medical care that we want to see. The system needs to be fixed before we continue to spend money rewarding the wrong things.

Volunteers make a difference Volunteers do make a difference. Fall volunteer training classes at Delaware Hospice will be held in October. For more information, call 800-838-9800 to ask for the volunteer coordinator in your county. Volunteers are especially needed in lower Sussex County.

Dr. Klug joins NMH staff Nanticoke Memorial Hospital welcomes Pampit Klug, MD to its active medical staff. Dr. Klug joins Nanticoke Health Services as a specialist in Medical Oncology and Hematology. Dr. Klug has been providing Medical Oncology & Hematology services in the Salisbury area since 2003. She completed her medical degree at Mahidol University in Thailand and her residency and fellowship at George Washington University Hospital in Washington, D.C. She is board-certified in Hematology by the American Board of Internal Medicine. To make an appointment with Dr. Klug, call the office at 628-6289.

Higgins joins NHS staff Nanticoke Memorial Hospital welcomes Physician Assistant Leah Higgins, PA-C to Nanticoke Memorial Hospital's Occupational Health Services, at their new location on 543 N. Shipley St., Suite F in Seaford. Higgins is certified by the National Commission on Certification of Physician Assistants (NCCPA) and completed her degree at Marywood University in Scranton, Pa. Her professional memberships include the American Academy of Physician Assistants and the Pennsylvania Academy of Physician Assistants. From treatment for work-related injuries and illnesses, DOT screenings, post incident testing, pre-employment physical examinations, to drug testing, Nanticoke's Occupational Health Services has been operating for more than 20 years. The new location on Shipley Street is dedicated to only Occupational Health clients.

Outlets fights breast cancer Delaware Breast Cancer Coalition (DBCC) has partnered with Tanger Outlet Center in Rehoboth Beach to raise awareness and funds to fight breast cancer in southern Delaware from Sept. 21 through Oct. 20 with the Tanger Style of Pink promotion. During the promotion, customers may purchase a Tanger Style of Pink card for $1 that is good for 25% off any item at participating outlet stores. More than 70 stores are participating in the promotion this year. Shoppers are encouraged to buy multiple cards to receive 25% discounts at many of their favorite stores. Tanger hopes to raise $100,000. For more information about Tanger Outlets, call 866.665.8682 or visit

Family and Friends CPR course Peninsula Regional Medical Center is offering a "Family and Friends CPR" course from 6 to 9 p.m. on Wednesday, Oct. 14, in the Avery W. Hall Educational Center on the Peninsula Regional campus. The course is designed for all lay rescuers (grandparents, family members of patients at risk for heart attack, and those who want to learn rescue skills for loved ones) who want to learn CPR but do not need a course completion card. This one-time, three hour course teaches rescuers skills in CPR and relief of foreign body airway obstruction for adults, children and infants. The fee is $25. Pre-registration is required. For more information, call 410-543-7126 or visit the Classes and Events section of the Peninsula Regional Medical Center website at for online registration.

Cancer support group offered The Wellness Community-Delaware offers a free cancer support group for people affected by cancer and their loved ones. The support group meets in the second floor Conference Room of the Cancer Care Center at Nanticoke Memorial Hospital in Seaford on the third Monday of each month from 4:30 to 6 p.m. The next meeting is Sept. 21. The Wellness Community-Delaware is dedicated to helping people affected by cancer enhance their health and well-being through participation in a professional program of emotional support and hope. All group facilitators are trained mental health professionals with a master's degree or more. For more information and to register, call 645-9150.

Youth rehab lecture offered Physical therapists, physical therapist assistants, athletic trainers and gym instructors will benefit from attending the 12th annual Distinguished Lecture Series at Delaware Technical & Community College, Owens Campus on Saturday, Oct. 3 from 7:30 a.m. to 4:30 p.m. This year's topic, "Treating the Young Athlete," will provide clinicians with an evidence-based approach to the evaluation and treatment of injuries related to young athletes. More children are participating in organized youth sports. These younger participants are being exposed to new movements and musculoskeletal patterns that are leading to both acute and chronic injuries. Presenter Dr. Jeff Konin is a licensed physical therapist and a certified athletic trainer who has written several textbooks and given numerous speeches on sports medicine topics throughout the world. The seminar fee of $135 includes handouts, a continental breakfast and lunch. For more information or to register, contact Delaware Tech's Corporate and Community Programs at 302-854-6996.

Pampered Chef to benefit Hospice Delaware Hospice will benefit from a Pampered Chef Fundraiser Cooking Show, organized by Karen Rogers, Pampered Chef senior consultant, at the Delaware Hospice Center in Milford, on Monday, Oct. 19, at 5 p.m. Delaware Hospice will receive 25% of sales exceeding $600 to benefit its programs and services to the community, including additional 10% bonuses at various sales levels. Orders to benefit Delaware Hospice will be accepted through Oct. 26 at 5 p.m. Orders specifying "Delaware Hospice" may also be placed at For more information or to register for the event, call 856-7717.

Depression Support Group There will be a free bimonthly Depression Support Group meeting in Laurel on the second and fourth Wednesday evenings from 7 to 8:30 p.m. Any person who has signs and symptoms of depression and is under the care of a professional counselor/MD is welcome to attend. To register, call Life Matters Counseling and Consulting at 302-465-6612.