Patient Care

A Haddon Township doctor accused of submitting inflated bills to insurance companies was ordered yesterday to suspend his practice for six months and take courses in medical record-keeping and professional ethics, authorities said. Dennis M. Scardigli, whose main practice is based in Westmont, must also reimburse the state $135,000 for the cost of the investigation, according to a spokesman for the state Division of Consumer Affairs. Scardigli also had been charged with providing inadequate clinical examinations, preparing inadequate records of his motor-vehicle-accident patients, and making unnecessary referrals of his patients to other businesses that he owned: the Psychophysiological Assessment and Treatment Center, and South Jersey Diagnostics.

Patients can now create their own online medical records, receive electronic health alerts tailored to their ailments, and exchange e-mail with their doctors free of charge, under a service unveiled yesterday. The for-profit venture, called iHealthRecord, is part of an ongoing trend toward converting patient records, many of which still are maintained on paper, to the Internet. Health-care economists say conversion of patient records to databases linked to the Internet would save billions of dollars and greatly improve patient care by, among other things, helping to avoid medical errors.

It's just after 7 p.m. and Dr. Daniel Sterman is starting his rounds through the surgical intensive-care unit at the Hospital of the University of Pennsylvania. Dressed in green scrubs and holiday red socks, Sterman checks first on William Kinney, 50, who was hit by a car while riding his bike. His long list of injuries includes a perforated lung and fractured pelvic bones. Sterman takes a look at Kinney and the monitors tracking his breathing, heart rate, blood pressure, heart rhythm, and blood oxygen saturation.

The company that dominates management of mental-health care in the region has told therapists it will cut their pay in September, a move that psychologists say could reduce patient access to treatment and put some large psychological groups out of business. At meetings this month, representatives of Magellan Health Services told representatives of about 30 psychological group practices that it was restructuring the way it provided services to subscribers of Independence Blue Cross' Keystone Health Plan East, group managers said.

Joann Folz pushed through wind and rain, her clear plastic poncho fluttering as she picketed in a strike begun a week ago by nurses at Lourdes Medical Center of Burlington County. "We need to stand up for our rights," Folz said yesterday. The union has asked that the public boycott the hospital and suggested that patient care was suffering as the strike entered its second week. The hospital administration said that there had been no loss of care, and that the union was trying to "grandstand and scare off the public.

Faced with a serious shortage of nurses and increasing resistance to mandatory overtime, hospitals are struggling to balance patient care and labor costs. The month-old nurses' strike at the Medical College of Pennsylvania Hospital is the latest battle in a war being waged around the nation. The 271 nurses at MCP have twice rejected the hospital's contract proposal, saying it would permit forced overtime, would not allow them a voice in staffing, and would reduce benefits for nurses working weekend shifts.

The office is strangely quiet. It's the end of a long day of seeing patients, and I have a stack of messages from patients I need to call back. I have been open six months, and my small family practice office in East Camden already has 900 patients. I'm starting to worry about what I will do in a few months when we can't fit any more patients in the building. Sometimes the waiting room is standing-room-only. On this day, two mothers sat chatting in the waiting room while their children played together.

What really drives our health care system? Two seemingly unrelated articles in The Inquirer presented data that lead me to conclude again that the Philadelphia regional health care system is driven by competition and dollars and not by patient care. First, Josh Goldstein accurately reported that this region already has more heart transplant centers than the entire state of New Jersey ("Rivalry for heart patients growing," May 30). With Thomas Jefferson University Hospital and Lankenau Hospital planning to add new and untested programs, we will have more than the entire Los Angeles region.

Pennsylvania and New Jersey lost ground, compared with other states, in providing medical care to older residents, according to a Medicare study in today's issue of the Journal of the American Medical Association. Nationally, the percentage of Medicare patients receiving appropriate care rose in 2000-01, but New Jersey and Pennsylvania reported mixed results that diminished their rankings. Pennsylvania fell to 31st from 16th among all states, Puerto Rico, and the District of Columbia.