No More Feeling Around for Pedals
Tech's Invention a Time-saver for Cataract Surgeons
A surgical tech has invented and patented a Plexiglas platform with Velcro straps that holds phaco machine and wireless microscope pedals in the surgeon's preferred position during surgery. Travis Kirgan says he was inspired to create the Pedal Glide when one of his surgeons at the Physicians' Eye Surgery Center in Charleston, S.C., remarked how tiresome it was to have to feel under the stretcher with his feet for the pedals. Wouldn't it be nice, he said, if you could mount the pedals to something so they'd always be there under the table together?

"By eliminating the time wasted on positioning the pedals, the nursing staff can devote more time and energy on the patient," says Mr. Kirgan, who adds that the Pedal Glide cuts down on room turnover time by letting staff change from right eye to left eye in one easy motion.

JoAnne Collins, RN, says the Pedal Glide also helps her back. She doesn't have to bend down to readjust the pedals with each patient.

Mr. Kirgan (writeMail("[email protected]")) has made only two 29-inch by 17-inch Pedal Glides so far, but he plans to make more in his garage and sell them for $200. He'd like to offer an adjustable model that lets surgeons keep one foot angled and one straight. "It's so simple, yet it makes so much sense," he says. "This may be one of those things that takes off."

- Dan O'Connor

Surgeons v. Health System Antitrust Suit
Was Doc-owned Hospital Locked Out of Insurance Networks?
The physicians who founded a small hospital in Houston are biting back at the Texas health system that they say put them out of business.

In a pair of lawsuits filed in Texas state court in June, the doctors who founded Houston Town & Country Hospital say that Memorial Hermann Healthcare System used anticompetitive tactics to pressure major health insurance companies into shying away from dealing with the 99-bed facility, which opened in November 2005 and closed 14 months later.

The more than 100 physicians at Town & Country say that because of Memorial Hermann's interference, the hospital was able to contract with only one major insurance company, Cigna. "The hospital was out-of-network for most patients," says one of the investors, Richard Pohill, MD, ACCP. Additionally, physicians with privileges at Memorial Hermann hospitals who had invested in Town & Country were ostracized by Memorial Hermann, says Dr. Pohill, who notes that he was removed from the board of directors after investing (see "When Hospitals Play Hardball" on page 88).

After the hospital closed, Memorial Hermann paid $80 million for the facility and the land. This price is above market value for the hospital, which cost $60 million to build and start up, says Richard Zook, an attorney for seven of the physicians. "It was more valuable to shut it down." Triumph HealthCare currently leases the facility.

In a statement, a spokeswoman for the health system says "the claims brought against Memorial Hermann have no merit." In return, Memorial Hermann has filed suit in federal court requesting a ruling it acted lawfully. This is one of a handful of lawsuits where physician-owned hospitals are suing larger hospitals.

- Kent Steinriede

Medical Theft
Former Olympus Rep Charged in Colonoscope Stealing Spree
A former Olympus Medical sales representative was sentenced to 37 months in federal prison for stealing 66 colonoscopes valued at $1.6 million from 22 hospitals in Pennsylvania, Ohio, Indiana, Virginia, West Virginia and New York between March 2004 and August 2006. Michael D. Marburger, 37, of Pittsburgh, resold the stolen scopes for a $440,000 profit by selling them for a fraction of what they were worth - authorities say he typically collected $5,000 for devices worth $25,000 - to companies that bought and sold used medical equipment.

The case's lead federal investigator recounts Mr. Marburger's actions. He began the stealing spree shortly after being fired by Olympus for alleged poor performance. After his termination, Mr. Marburger still played the part of sales rep, using his professional experience to hoodwink unsuspecting hospital staff and security.

He initially targeted facilities he had visited previously, first casing the hallways to note the locations of security guards and surveillance cameras. Later the same day he would return, timing his visit to coincide with staff shift changes. Mr. Marburger often wore an Olympus shirt and boldly introduced himself as a company sales rep. He could speak the sales rep language, carried his former business cards, knew his way around the clinical areas and could easily locate the scopes' storage areas. On a few occasions he wore scrubs, posing as a physician. Once he used the name of a current Olympus sales rep to gain the staff's trust.

Mr. Marburger would locate the scopes himself or tell the staff that he was visiting to inspect the scopes' serial numbers to ensure they weren't outdated or part of a device recall. Federal investigators discovered that many hospitals employed magnetic security swipe cards, but Mr. Marburger gained access to these supposedly secured areas when locked doors were propped open by staff for convenience's sake. One victimized hospital's magnetic swipe registered just two staff entries during an entire day.

After taking a scope from storage, Mr. Marburger hid the device under his shirt or coat and simply walked out of the facility. Once outside, he would contact one of three companies in Chicago, New Hampshire and Florida that bought and sold used medical equipment. Mr. Marburger would strike a deal, request half the money wired before he sent the scope and would collect the remainder when the scope arrived at the company via FedEx. All but one of the 66 stolen scopes were Olympus devices. Pentax manufactured the other.

The scheme unraveled when a police detective investigated a missing scope at Mount Nittany Medical Center in State College, Pa., and was notified of a similar theft at a hospital in Altoona, Pa. He traced the stolen scopes' serial numbers, discovered they had passed through Mr. Marburger's hands and turned the investigation over to federal authorities.

The case's federal investigator suggests that facilities document the serial numbers of all medical equipment, keep scopes locked in storage when not in use, and require sales reps to schedule appointments and present valid company identification when they visit.

Mr. Marburger's attorney, Michael O'Day, was unable to be reached for comment. In court papers, Mr. O'Day says that his client used the money from his two-year criminal enterprise to feed a horse-racing and casino gambling addiction.

- Daniel Cook

Make This Frog a Favorite
Looking for credible medical information on the Web? You might want to bookmark a new medical search engine for clinicians called PogoFrog.com, described as a custom search engine that jumps over layman-focused sites and returns only credible medical site links on its results pages. This focused search is done by specifically excluding consumer sites and specifically including only such healthcare sites as FDA.gov, peer-review journal sites, association sites and others.

In the Know
Maryland No. 1 in Outpatient Centers. Maryland has the highest concentration of outpatient surgery centers in the nation with 352. Following Maryland in most facilities per capita are Idaho, Washington and Wyoming, according to the Foundation for Ambulatory Surgery in America. Maryland doctors must apply for a certificate of need when opening a freestanding outpatient facility with two or more sterile ORs. But since 1995, the state has let doctors open office-based centers with only one OR to perform outpatient surgery without a CON.

Consumer Group Wins Lawsuit Freeing Vast Government Data on Physicians. Consumers' Checkbook, a non-profit consumer research and information organization, has won a Freedom of Information Act lawsuit that will require the U.S. Department of Health and Human Services to release data on every physician claim paid by Medicare. With information on more than 40 million patients and 700,000 doctors, the Medicare database is far richer than any private insurer's. The data to be released will identify physicians but won't make identification of patients possible. As a first use of the data, the consumer organization will create a resource, free to the public, on its Web site, writeOutLink("www.checkbook.org",1), that will report the number of various types of major procedures performed by each physician and reimbursed by Medicare, "so a consumer selecting a physician for a knee replacement or prostate surgery or other major procedure will be able to easily check that a physician has an appropriate level of experience," says the group. For many types of procedures, there is strong research evidence that doctors with a lot of experience performing a given operation tend to have better results.

Study: ASCs Present Competition to HOPDs. There's been a lot of arguing about how significant of a competitor freestanding ASCs are to hospitals, but a study published in the summer 2007 edition of Inquiry, a quarterly journal published by Rochester, N.Y.-based Excellus Blue Cross Blue Shield, suggests that the big buildings may have valid cause to fear that the smaller facilities are stealing their outpatient business. Researchers found that markets with more ASCs per unit population had fewer hospital outpatient surgeries. Each ASC per 100,000 people seemed to lead to a 4.3 percent reduction in hospital outpatient surgical volume. Researchers also found that the ASCs' presence had essentially no impact on the hospital's inpatient case volume.

Certified Coders Make More. Certified coders earn an average of 17 percent more than their non-certified counterparts, according to a survey of more than 5,100 coding professionals conducted by the American Academy of Professional Coders. On average, the survey found that non-certified coders earn $25,000 to $30,000 annually, certified coders earn $30,000 to $35,000 and specialty-certified coders earn $35,000 to $40,000.

Olympus Introduces Camera in a Pill. Olympus's EndoCapsule, a camera in a pill designed for the visualization of the small bowel mucosa, has received FDA approval for U.S. marketing. Olympus says the device features high resolution, a wide field of view, enhanced depth of field, automatic brightness control and structure enhancement. It also has a portable, lightweight, real-time viewer so the physician can be sure the capsule works well before administering it to the patient.

Two Sterile Processing Industry Groups Merge. The American Society for Healthcare Central Service Professionals and the International Association of Healthcare Central Service and Materiel Management have merged to form a single organization. The Certification Board for Sterile Processing & Distribution says this merger in no way affects the CBSPD or personnel certified through the CBSPD.

Most Popular Forms of Plastic Surgery? According to the American Society of Plastic Surgeons, the top five cosmetic surgery procedures performed in 2006 were breast augmentation (329,000 breast augmentations were done last year), rhinoplasty, liposuction, blepharoplasty and tummy tuck.