Doctors say pressure on ERs may rise, give US failing grade
STORY HIGHLIGHTS A state judge makes the ruling Monday The ruling could make NM the fifth state to allow doctors to prescribe fatal doses to terminal patients New Mexico’s attorney general is contemplating whether to appeal (CNN) — In a decision sure to cause debate, a New Mexico judge has ruled that terminally ill, mentally competent patients have the right to get a doctor to end their lives. The landmark decision Monday by New Mexico Second Judicial District Judge Nan Nash came after a two-day trial and could make New Mexico the fifth state to allow doctors to prescribe fatal prescriptions to terminal patients. The ACLU and Compassion & Choices, an end-of-life choice advocacy group, filed the lawsuit on behalf of two New Mexico doctors and cancer patient Aja Riggs. The judge was asked to consider whether the doctors should be allowed to write prescriptions for a terminally ill cancer patient who wanted to use drugs to end her life. ‘Heartbroken’ right-to-die advocate dies UK man fighting for the right to die Is assisted suicide ever OK? “This Court cannot envision a right more fundamental, more private or more integral to the liberty, safety and happiness of a New Mexican than the right of a competent, terminally ill patient to choose aid in dying,” the judge wrote. “If decisions made in the shadow of one’s imminent death regarding how they and their loved ones will face that death are not fundamental and at the core of these constitutional guarantees, than what decisions are?” New Mexico’s Attorney General’s office said it was analyzing the decision to see if it would file an appeal. Paralyzed after falling from tree, hunter and dad-to-be opts to end life Years of debate Most states ban assisted suicide, but aid-in-dying is permitted in Oregon, Washington, Montana and Vermont. The practice has been hotly debated since it was first adopted in Oregon in 1997. But Riggs, the 50-year-old terminally ill cancer patient named in the New Mexico lawsuit, says she’s glad she now has a choice. “I am really pleased that the court has recognized that terminally ill patients should have more choice in the manner of their death,” said Riggs. The cancer is currently is in remission, but Riggs says statistically her cancer is likely to return. “Most Americans want to die peacefully at home, surrounded by loved ones, not die in agony in a hospital,” she said.
Marys and Charles counties. This year, the CAO is focusing on promoting awareness about the group. The most important thing is how we care for our patients, said Dr. Daniel Bauk, an orthopedic surgeon and partner at Southern Maryland Orthopaedics and Sports Medicine, which has seven doctors and offices in Leonardtown and Waldorf. The Center for Advanced Orthopedics, a separate practice, also has offices in Hollywood and Waldorf, with two doctors and is a member of the CAO. Private practice, Bauk said, gives the most quality, the most compassionate care and is most flexible to patients needs. But the controversy is complex. Newer physicians coming out of medical school may be seeking steady income and more regular hours. Doctors who have been in the game much longer often grapple with the increasing cost of doing business and recruiting new doctors. Some are opting to work in hospital or university systems where paychecks are steady, executives run the business side of things and resources are under one roof. American Medical Association researchers surveyed physicians in 2012 and found that 60 percent worked in practices fully owned by doctors. But there was a shift toward hospital employment, the AMA said. The problem is, Bauk said, intimate doctor-patient relationships seem to be becoming a thing of the past as patients in those larger systems are shuffled from one physician to the next. Doctors in the CAO have maintained their private practices and business models, but say their employees now fall under the CAO, their teams share resources, and theyve reduced overhead, which will allow them to study best practices, for patients and their businesses, over the long term. Joining forces, Bauk said, offers those physicians better bargaining power than they would have alone with insurance companies.
Doctors face decision: work for hospital or private practice
Some health experts have predicted that increasing the number of insured patients should reduce pressure on hospital emergency rooms because access to regular doctor care will improve, something that is hoped would prevent chronic conditions from spiraling out of control or help catch other problems before they worsen. But insurance coverage could also lead those who might have held off going to the emergency room to seek care, said Jon Mark Hirshon, an emergency medicine doctor and researcher at the University of Maryland who oversaw the group’s report card. Newly insured people also may have a hard time finding a regular doctor who accepts their plan, he said. “On top of that, emergency departments are open 24 hours a day, seven days a week. If I have a primary care provider but it’s 9 o’clock at night on a Friday and they’re closed, then people come to the emergency department,” Hirshon told Reuters. The group is asking for congressional hearings to probe whether the law puts “additional strains” on emergency rooms. Already, beds for patients have fallen from a rate of 358 per 100,000 people four years ago to about 330 beds per 100,000 people now, the report said. Wait times have increased to a median of 4.5 hours compared to four hours in 2009. Despite the dismal U.S. grade given by the group, it noted that policies and infrastructure varied widely by state. States with the best emergency care include Massachusetts, Maine, Nebraska and Colorado, while Kentucky, Montana, New Mexico and Arizona rounded out the bottom, just above Wyoming. States are also still grappling with the uninsured. By law, hospitals must provide emergency care regardless of patients’ ability to pay.