When Cost-Cutting Jeopardizes Patient Safety
Physician claims he was told to skimp on anesthesia to hasten discharge.
T
his might sound a bit off the wall, but here's a great way to speed
patient emergence and discharge that you might have overlooked:
Skimp on the anesthesia.
What better way to avoid bottlenecks and quickly move patients out of
the recovery room than to withhold the Versed in pre-op, give no more
than the minimum amount of fentanyl in surgery and not order Dilaudid for
patients in PACU? This way, patients arrive in PACU awake or easily awak-
ened so you can pull their IVs out and, wham bam, show them the door.
Your patients might wail and writhe in pain, so you'll need to warn
them beforehand to expect pain and nausea from the surgery and anes-
thesia. The good news is they'll be home by lunchtime.
We wish we were making this stuff up, but an anesthesiologist's $9 million
whistleblower retaliation and wrongful termination lawsuit claims that those
are the strict marching orders upper management at Northwest Permanente
(Kaiser) in Portland, Ore., handed down to the anesthesia department.
In his suit, Erik Franck, MD, claims he was particularly disturbed when
Kaiser's higher-ups told hospital and surgery center anesthetists to spare
no mercy for pediatric patients either.
"Dr. Franck became increasingly concerned that his pediatric patients
were having their IVs pulled too soon after arrival in the recovery room
while they were still crying with pain," the suit states.
When Dr. Franck recommended that the anesthesia staff use a small
amount of fentanyl to control patients' pain, the anesthesia department
director said yes — but told Dr. Franck that he could only administer half
of the amount he'd suggested.
Dr. Franck worked for Kaiser for 2 years, until August 2015, when, he
claims in his suit, Kaiser didn't renew his expiring contract in retaliation for
voicing his concerns that cost-cutting measures were jeopardizing patient
1 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 6
Editor's Page
Dan O'Connor