Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Baltimore Hospital Dumping Patients – Is it that simple?

You watch the video and wonder how could anyone be so callous and cold, to leave someone outside with only a hospital gown to wear – especially when it is so cold outside.

Is what we are seeing callous, or uncaring?

In the video farther down, there is a nice discussion of the problems, which are much more complicated than somebody being refused care for some bad reason.

I found a site that did mention her clothes being with her, but stated with her clothes and belongings scattered on the sidewalk. Here is the picture they posted. The clothes are in plastic patient belongs bags.


Psychotherapist Imamu Baraka was walking near the University of Maryland Medical Center’s midtown campus location when he saw a woman being dropped off by security at a bus stop with her clothes and belongings scattered on the sidewalk.[1]


Why didn’t she put her clothes on?

One of the first things discharged patients will do, if they can, is put their own clothes on.

There is no evidence that anyone was refused care. That would be an EMTALA (Emergency Medical Treatment and Labor Act) violation, resulting in a very big fine, which would be reported. Maybe I am wrong, but I do not expect that an investigation will end with any finding of any refusal to provide care.

But we saw it on the video!

No. I think that you saw someone being removed from private property for bad behavior in a hospital gown, and she refused to put on her own clothes on (the clothes in her bag) for reasons of her own.

Here is a video explaining this in more detail, but a couple of notes about people mentioned in the video.

Charlie Gard was an infant with irreversible MDDS (Mitochondrial DNA Depletion Syndrome). The doctors and nurses seem to have understood this, but parents, politicians, preachers, and the press thought that it would be a good idea to torture Charlie Gard with an experimental treatment with no expectation of a better outcome.

How would Solomon decide? To torture, on the ridiculously small chance of a better outcome, or to do not further harm?

Peter Gallogly is a doctor, who was selectively recorded on video to make it seem as if his unprofessional behavior was unprovoked. If you watch the video of Dr. Gallogly, realize that it is edited to distort reality. If you watch the ironically named Project Veritas videos of abortion clinics, they are similarly edited to distort reality, which is why they have been rejected as evidence in court. You might as well watch a Michael Moore film, if you want a highly edited distortion of reality.

The Delnor nurse protected staff from an escaped prisoner, when the corrections officer apparently fled. The nurse ended up being abducted for hours, grazed by a bullet, pistol whipped, and raped, but was reported as being unharmed after the inmate was killed.



We need to learn how to find out accurate information for ourselves, rather than blindly accept propaganda from far left or far right news sources. Even the mainstream news will often get information in specialized fields wrong and not realize it. When the story is from a specialized field, such as medicine, we should obtain our information from trustworthy people in that field.

More information on Charlie Gard.

More information on Peter Gallogly.

More information on the Delnor nurse.

All of the videos are from ZDoggMD.com


[1] Video shows Baltimore hospital discharging half-naked woman into cold winter night
Ana Valens
Jan 11 at 7:27AM | Last updated Jan 12 at 3:36AM
The Daily Dot


Hospital Cries ‘HIPAA’ in Investigation of Hepatitis C Outbreak

Standard of care and HIPAA (Health Insurance Portability and Accountability Act of 1996) are probably the most misunderstood misused terms in medicine.

Standard of care does not mean that all the cool kids are doing it, so if I don’t do it I will be sued, but that is essentially the way it is treated by many people. This is superstition, not medicine.

We must immobilize him because he might have been exposed to a mechanism of injury that might result in a spinal injury that might not be made much worse by immobilization and we might be sued.

HIPAA does not mean that the hospital, or EMS, cannot give out confidential information. HIPAA is about how access to that information is controlled.

The Rule strikes a balance that permits important uses of information, while protecting the privacy of people who seek care and healing. Given that the health care marketplace is diverse, the Rule is designed to be flexible and comprehensive to cover the variety of uses and disclosures that need to be addressed.[1]


Is it acceptable to release information for billing, but not to investigate, and attempt to control, an infectious disease outbreak. At least 60 people appear to be infected with hepatitis C. Since hepatitis C is often asymptomatic, less access to medical information will mean less knowledge of who is infected and who may be continuing to infect others.

Is the hospital protecting patients, protecting itself, doing something else, or just getting bad legal advice?

The hospital hired someone who apparently abused drugs and contaminated equipment that should have been sterile, which led to the infection of at least 60 patients.

Herrick argued that Exeter Hospital won’t even give the state the names and contact information for employees that investigators want to see for follow-up interviews.

“Exeter Hospital is a business and there are good business reasons for them not to want any new patients (infected) or further investigation into this matter,” she said.[2]


Should any organization be trusted to investigate itself, or to limit its investigation by others?

Should we trust any organization that claim that it is too good to be investigated by others?

Exeter Hospital told Seacoast Online that there was no information available prior to Kwiatkowski’s hiring that would have provided the hospital with a reason to not employ him. “His criminal background checks were clear, he had no restrictions placed on his professional licensure/certification, he was not included on the Health & Human Services Office of Inspector General’s list of sanctioned healthcare workers, he passed a drug test, and he had very strong references from his previous employers.”[3]


That is a different problem, but it has a similar origin – lawyers telling hospitals to hide information about problems with employees, because of a greater interest in protecting itself from liability, than in protecting patients from harm.

Why should we trust the hospital to provide all relevant information?

Why should we expect the hospital to recognize what is relevant?

We can expect the lawyers to represent their client (the hospital, not the patients), since the lawyers legal obligation is to the hospital, not to the patients.

Maybe you do not believe this. Maybe you think that the hospital’s lawyers will be objective in any malpractice cases brought against the hospital. Maybe the lawyer will help the patient to find stronger evidence against the hospital.

Do we believe the hospital’s lawyers would do that?

Then why should we believe that the hospital’s lawyers are acting in the interest of the patients, where that might be a conflict with the interests of the hospital?


[1] Summary of the HIPAA Privacy Rule
US Department of Health and Human Services
OCR Home
Health Information Privacy
Understanding HIPAA Privacy
Web page

[2] State, hospital spar over access to patient data – Judge mulls records request
By Aaron Sanborn asanborn@seacoastonline.com
October 19, 2012 2:00 AM

[3] Could a national registry save hospitals from hiring problem workers?
Fierce Healthcare
August 6, 2012
By Karen Cheung-Larivee


HIPAA vs. Advertising

The recent US Supreme Court decision in Sorrell v. IMS Health is described this way –

In the second decision, the court by a 6-3 vote struck down a Vermont law that barred pharmacies, drug makers and others from buying or selling prescription records from patients for marketing purposes. Vermont’s physicians had sought passage of the law, arguing that their prescriptions were intended for private use of patients and should not become a marketing tool.

Drug makers buy this data to gear their sales pitches to physicians. Several data-mining firms have made a billion-dollar business out of buying and selling the prescription data to drug makers and researchers.[1]

Warning – This is an oversimplification of the ruling. A detailed explanation of the ruling is available at Sorrell v. IMS Health (110-779) from SCOTUSblog.

PS – The stick figures are from xkcd, because my drawing is even worse than my writing. 😳


[1] Supreme Court sides with pharmaceutical industry in two decisions
By David G. Savage, Los Angeles Times
June 24, 2011


How to Handle EMS Week at EMS Office Hours


Jim Hoffman has an excellent discussion with Josh K. from Wantynu.com and with Army Medic SSG Broyles.

EMS Week – Take That Spoon Away, I’m Fed Up

We do focus on all of the wrong things during EMS Week.

If we are going to educate people about EMS, maybe we should spend EMS Week educating hospital personnel about what HIPAA (Health Insurance Portability and Accountability Act of 1996) really means.

HIPAA means EMS is authorized to have the same information the hospital is authorized to have.

EMS is an important part of the care of patients. EMS is not an obstacle to the care of patients.

Patient care is improved by improving communication, not by discouraging communication.

Go listen to the podcast.

Listen live to tonight’s podcast. Call in and participate.


Calling Dr. Deborah Peel – Anyone Home?


While looking at Notes from Dr. RW, a good medical site, I found a post (Psychoanalyzing medical bloggers on NPR’s Morning Edition – from March 17, I could not find a direct link, but it is in his archives). I posted the following comment on his site. Dr. Peel had commented on the same post, so I thought she might read it and respond. No luck, yet.

Being a diligent gadfly, I decided to post to Dr. Peel’s blog directly. The problem is that she has not posted anything since February. Apparently, she has more important fish to fry than medical bloggers. So, I posted the same comment after an excellent comment by erdoc85 (from M.D.O.D.) about her on air foolishness on a post from October that is more relevant than her post from February.

Her fan must go crazy waiting for his next exciting Peel Post.

If you search “Deborah Peel” blog the first two results are for White Coat Rants (read his posts) and her blog is all the way down at result number five. Sweet.

She is paving the road to hell (for patients and health care providers) with her oh-so-good intentions.

Let me know what you think of this comment, not enough oomph?

Dr. Peel jumps to the conclusion that the patients being described are individuals and not composites, that they are easy to identify and that the information about the patients has not been changed to make identification essentially impossible.

I dare Dr. Peel to identify any patient from my site. I have been using the pseudonym “Deborah Peel” for all of my patients and for some of my coworkers since her appearance on NPR.

How does a physician mass diagnose people without ever meeting them?

How does a physician prescribe treatment to people based on that fraudulent diagnosis?

Medical professionalism is completely absent from her behavior, yet she accuses others of being unprofessional and inappropriate.

Where does she find any evidence that blogs are any more of a threat to patient privacy than medical books?

House of God, MASH, Awakenings, …

There are many books that have been written on medical topics that do not always put the patient in the best light. Where is her outrage?

Where is the concern for the privacy of these patients?

Perhaps she does not read books and is unaware of the phenomenon of bound volumes of printed pages compiled for entertainment or even education.

What about television? ER has all sorts of information about patients and – horrors – you can see the patients (maybe she does not know they are only actors).

Imagine if any of those patients were to watch the TV show and recognize their own medical case being portrayed on screen.

If you want less than positive portrayals of patients and staff, what about House, MD?

She probably does not understand the sarcasm.

Dr. Deborah Peel should be reported to the state medical board for her on air medical malpractice. She should also be continuously ridiculed for her blatant hypocrisy.

Or, maybe I am wrong and she is the answer to all of the world’s problems.


Deborah Peel is the antidote to HIPAA


Well, I goofed. I originally wrote this about a non-existent Jane Peel. That will teach me to pay attention. It is Dr. Deborah Peel, who does exist and is the target of this satire. My apologies to any Jane Peel who might be offended by my mistake (for the stigma of being mistaken for Deborah Peel) and to any readers for the confusion I may have caused.

From White Coat Rants comes a pair of posts that are, well, inspiring.

I Am A Professional and the follow up Caught In The Middle point out some of the silliness that those outside of the medical establishment cause by imposing their good-intentions-paved roadway on everyone else.

The good doctor, Deborah Peel, is a psychiatrist. With her boundless experience and unquestionable ethics she has decided that anyone who writes medical blogs that describe any patient in anything less than the most glowing description possible . . . . (wait for it) . . . . needs psychoanalysis.

No conflict of interest in recommending your treatment to thousands of people you haven’t even examined.

Imagine what she thinks of you reading this.

What if you both write a blog, that does not put all patients on a pedestal, and you read other blogs?

I am truly doomed!

I need her help!

Only someone so astute that she can mass diagnose without any patient contact is good enough for me.

Or, maybe, I should treat myself.

Rogue Medic, roguishly heal thyself.

I shall use art therapy and write to heal myself.

All of my patients shall be named Rumplestiltskin.

No, even better, as White Coat Rants wonderfully demonstrated in his blog – Deborah Peel is the perfect universal patient pseudonym. I think WCR took it a little too far in performing a sex change operation on good old Deborah by making the male a John Peel. This appears to be without Deborah Peel’s consent. We must treat her with the respect she deserves – all patients are now Deborah Peel. Maniac Ted Kaczynski, you are now Deborah Peel. The adorable psycho, Chuckie Manson, you are now Deborah Peel. David Berkowitz, you are no longer Son of Sam – try out being Son of Deborah Peel. Go with it. Feel the healing power of Deborah Peel.

To further my self-directed art therapy I adapted Alice’s Restaurant to Deborah Peel and posted this in the comments.

You know, if one person, just one person does it they may think he’s really sick.

And if two people, two people do it, in harmony, they may think they’re both faggots.

And three people do it, three, can you imagine. They may think it’s an organization.

And can you, can you imagine fifty people a day, I said fifty people a day blogging, using Deborah Peel as their universal patient pseudonym.

And friends they may thinks it’s a movement.

And that’s what it is , the Deborah Peel Patient Privacy Protection Movement, and all you got to do to join is substitute Deborah Peel for your patient’s name the next time it come’s around in your blog.


My apologies to Arlo Guthrie for my lyrical butchery.

I, Deborah Peel, was inspired by Deborah Peel to heal myself.

Further information on Dr. Deborah Peel.