Joan Rivers Emergency Underlines Importance of Hospital Admitting Privileges

NewsBusters ^ | 09/01/2014 | Jill Stanek

[celmak]

What connects this to the abortion issue is what NBC News’ chief medical editor, Dr. Nancy Snyderman (pictured below right), said we could learn from this tragedy on the August 29 Today show:

SNYDERMAN: The really important thing here is that every time you think you’re going to have a procedure, no matter how minor, you have to constantly remind yourself that although these things are rare, they can happen. And one more thing I should say, make sure your doctor has admitting privileges to the local hospital, because in this case it may well have saved Joan Rivers’ life.”

This is logical and sound medical advice, right? Noncontroversial… except when it comes to abortion, when common sense is thrown out the window.

[celmak]

Full title: NBC's Dr. Nancy Snyderman: Joan Rivers Emergency Underlines Importance of Hospital Admitting Privileges

This is a good point to bring up when talking about Joan River's condition around the water cooler at work.

[kaila]

What does hospital admitting privileges have anything to do with what happened to Joan Rivers?

[Morgana]

prolife ping

[Kozak]

What nonsense. As if the ENT doctor who did the procedure was going to admit Rivers to the ICU intubated on a vent and in a coma. That’s not how it works..

[exDemMom]

She was having a minor procedure at a clinic when the problem occurred and had to be rushed to the hospital. She received continuity of care since her physician had admitting privileges and could consult with the hospital staff. That’s the connection.

My understanding is that since abortionists typically do not have admitting privileges, when their clients have a medical emergency, they call 911 (sometimes), whereupon the client is taken to any hospital and there is no continuity of care.

[morphing libertarian]

Unless Joan went to an abortion clinic and then needed to be admitted to a hospital, I don’t see the connection.

Willing to learn.

[kaila]

Your connection is very tenuous. If someone arrested at an outpatient surgery center, the MD would most likely escort her to the hospital in the ambulance, and communicate with the ER staff ( in which he most likely called prior to arrival). Then the ICU intensivist would help take over.
I am sure the doctor had hospital admitting privileges, as I do not know of any GI or ENT doctor without privileges.
So, what was the point of this article?
Not getting this at all.
Even though I disagree with abortion, there is no continuity of care with a patient who falls ill in the doctors office, gets taken via ambulance to the hospital, and the hospital intensivist take over. It is getting very rare to have community physicians take care of their own patients in the hospital.

[Hulka]

Post 5

[celmak]

As if the ENT doctor who did the procedure was going to admit Rivers to the ICU intubated on a vent and in a coma. That’s not how it works..

Please explain.

[Kozak]

See post 7.
Although I have never seen a doc escort the patient to the ER. At best they call and discuss the patient with the ER staff.

[exDemMom]

Abortionists, as a rule, do not have admitting privileges. At least, that is the rationale behind the state laws being enacted that require them to secure such privileges, and the rationale behind clinic closures when the abortionists cannot (or refuse to) secure such privileges.

Abortion mills are allowed to operate under loosely enforced, lax standards that no real medical clinic would be able to get away with.

[kaila]

Even if you have admitting privileges, the hospital does not inspect your clinic facilities to see if it is up to par. They check your licensure, any malpractice actions or complaints, but they do not check the clinic.
And, I have seen physicians escort their patients if they are critically ill to the hospital. Not when they are moderately ill. Joan Rivers was critically ill. Most likely laryngospasm.

[ClearCase_guy]

If an outpatient facility — the one Joan Rivers went to, or, let’s say, an abortion clinic — if that facility does not have admitting privileges, is there any downside? I don’t know enough about admitting privileges, so I guess I don’t know what they are good for. It seems like some facility have them, so I guess there’s some benefit, I just don’t see it. Can you enlighten me?

[SamAdams76]

People die getting their tonsils taken out. Sometimes surgery is inevitable but for those with "elective" surgery, in most cases, they should elect not to have it and attempt to resolve the issue through natural means.

Case in point is an obese relative of mine who decided to have surgery to staple her stomach. Almost died from it and put the weight right back on within two years, after dealing with all sorts of complications from the surgery. Now she'll never be right again.

Exercise and diet would have been a much better option but she never even considered it. I don't think she walked a mile in her entire life.

[celmak]

What does hospital admitting privileges have anything to do with what happened to Joan Rivers?

If you do not see the connection the story is making...

[celmak]

See post 5.

[kaila]

Most physicians have admitting privileges. I guess abortion physicians do not, per the comments here.
Hospital admitting privileges really don't do much. There is oversight if you do procedures in the hospital, due to peer review of complications.
if you are doing procedures in an outpatient setting, not a part of the hospital, then the hospital has no control over that.
There are licensing bodies that require physicians to have hospital admitting privileges in ambulatory/outpatient surgery centers. Due to the size of the Yorkville Endoscopy Clinic I suspect that they have the proper certifications and the docs have admitting privileges.
If you are a private family practice physician, and the nearby hospital has intensivists, there is really no need to have privileges. Your patient goes to the ER, and the hospital takes over until discharge.
If you do not have privileges, and do a procedure in the office and your patient has complications, there really is no science or mystery to it. A simple 5 minute phone report to the ER will get your patient treated.

[ClearCase_guy]

Thanks for the response.

Most physicians have admitting privileges.

I don't see why they bother. It seems quite pointless.

[kaila]

If you are a surgeon, a lot of your cases require inpatient stays, therefore you need the privileges. Same with GI, ENT, Plastic, General Surgery, ObGyn, Oncology.
The advent of intensivists ( at least in my community) for family practice and internal medicine has made obtaining privileges more of a hassle than it is worth, since the intensivist does the care on your patient anyway.

[GeronL]

Judges have decided that even abortion clinics shouldn’t be forced to have them. Crazy