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The Trouble With Transvaginal Mesh - August 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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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

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