Dr. Niran Al-Agba

MedStar Franklin Square Hospital: The Case Against Global Capitation

The unforeseen casualty in this story is the pediatric department at MedStar Franklin Square Hospital. On April 3rd, 2018, MedStar abruptly announced all pediatric inpatient care and emergency services were closing, effective April 6th, and all pediatric staff, including eight physicians, were terminated. Sadly, Baltimore County is home to some of the nations’ most vulnerable families, struggling with high rates of drug addiction, domestic violence, and poverty.

Niran Al-Agba2020-05-30T23:34:12+00:00May 9, 2018|Categories: Policy, Practice|Tags: Consolidation, Corporatization, Health Policy, Hospitals, Nonphysicians, Physician Autonomy, Underserved|

Mayo Clinic Health System: Truth, Falsehood, and Ice Cream

Mayo has fractured trust by misrepresenting operating losses in Albert Lea to justify hospital closure, Dr. Noseworthy condoned prioritizing patients based on their pocketbooks while third quarter earnings went through the roof, and hospital leadership condescendingly compared driving 23 miles in labor as being equivalent to buying ice cream.

Niran Al-Agba2020-05-26T02:11:40+00:00January 23, 2018|Categories: Patient, Policy|Tags: ACA, Affordable Care, Consolidation, Corporatization, Hospitals, Mayo, Rural Care, Transparency|

Does the CVS-Aetna Merger Condone Segregation in Healthcare?

CVS considers having a medical degree to be an “obstacle” to affordable medical care, which they plan to eliminate with “one-stop shopping,” having pharmacists and nurses practicing medicine by protocol. A segregated, two-tiered healthcare system will ultimately emerge as Aetna members are directed to “Minute Clinics” without access to physicians while those on other commercial insurance plans will see the physician, nurse practitioner, or physician assistant of their choice.

Niran Al-Agba2020-05-26T02:04:44+00:00December 12, 2017|Categories: Equality, Policy|Tags: Affordable Care, Consolidation, Corporatization, CVS, Health Policy, Hospitals, Minute Clinic, Physician-led Care, Rural Care|

Honesty, Trust, and Transparency: PA-C and MD

When asked about this, the Public Affairs Manager, Cassandra Hockenson, at the Medical Board of California responded“there is not a huge difference between plastic surgery and dermatology.” She suggested contacting the Physicians’ Assistant Board for the State of California instead. She kept repeating that the supervising plastic surgeon had no complaints against him. I learned two important lessons from contacting the Medical Board of California: 1) Without complaints, a physician can supervise midlevel providers in any specialty they choose, and 2) while required by law to supervise mid-level providers, the safety of patients is not a high priority for the Medical Board of California.

Niran Al-Agba2020-05-26T02:20:36+00:00December 5, 2017|Categories: Patient, Policy|Tags: Hospitals, Medical Board of California, Midlevel, Nonphysicians, Providers, Transparency|

CHI Franciscan Harrison to Close, So Where Do We Go From Here?

Confucius said, “the man who moves a mountain begins by carrying away small stones.” It is time to lay the groundwork for Kitsap residents to formally engage in meaningful dialogue with leaders of our local hospital corporation, whether operated by CHI Franciscan, Dignity Health, or a still-to-be-named corporate entity.

Niran Al-Agba2020-05-26T02:21:56+00:00November 28, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, CHI, Consolidation, Corporatization, Franciscan Health, Health Policy, Hospitals, Rural Care|

As Ohio Goes, So May the Nation: The Patient Access Expansion Act

The American Board of Medical Specialties (ABMS) eliminated “lifetime” certification to shore up their financial outlook; a modification having little to do with quality and much to do with rate of return. Between 2003 and 2013, the ABMS member boards’ assets ballooned from $237 million to a staggering $635 million, an annual growth rate of 10.4%. MOC is outrageously lucrative. Almost 88% of their revenue came from certification fees.

Niran Al-Agba2020-05-14T04:05:26+00:00September 26, 2017|Categories: Patient, Policy|Tags: Affordable Care, Anti-MOC, Hospitals, MOC, Patient Physician Relationship, Rural Care, Underserved|

Musings on a Micro-Hospital for the City of Bremerton

The idea of micro-hospitals is gaining traction because costs of construction are far lower than that of more traditional hospital facilities –costing anywhere between $7-$30 million, depending on the range of services available, according to Advisory Board statistics. Micro-hospitals can meet 90% of the community healthcare needs. They seem to flourish best in markets with critical service gaps. Ideally, micro-hospitals are located within 20 miles of a full-service hospital, facilitating the transfer of patients to larger facilities if higher-acuity needs arise. Hospital stays anticipated to be longer than 48 hours are sent to higher-acuity facilities.

Niran Al-Agba2020-05-14T04:04:04+00:00September 22, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, CHI, Consolidation, Corporatization, Dignity, Franciscan, Hospitals, Microhospital, Surprise Billing|

Hold the Mayo and Save Our Hospital

There is a grassroots movement, 4500 strong, known as “Save Our Hospital” gaining notoriety in Albert Lea, Minnesota. This story is symptomatic of the fact that hospital consolidation has slowly become a national pastime. With declining revenue under the Affordable Care Act, mergers increased by 70%, leaving small communities scrambling for healthcare access. The latest casualty in the ‘hospital-consolidation-for-sport’ trend is Albert Lea, a small city located in Freeborn County, Minnesota.

Niran Al-Agba2020-05-14T04:00:56+00:00September 12, 2017|Categories: Patient, Policy|Tags: Albert Lea, Consolidation, Corporatization, Health Policy, Hospitals, Mayo Clinic, Rural Hospital|

A Two-Hospital Solution in the Event of a Mass Casualty Incident (MCI)

In June 2016, Kitsap County emergency personnel participated in Cascadia Rising, a large-scale earthquake drill. At the time, three local hospitals planned to coordinate management of injured casualties: Navy Hospital, which would treat the “walking wounded” (least injured), or Harrison Silverdale and Harrison Bremerton, which would clear their emergency departments to receive the flood of injured patients. While those plans have changed, the grave risk to our community in the event of an earthquake should not be ignored.

Niran Al-Agba2020-05-14T03:58:17+00:00September 5, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, Cascade Rising, CHI, Consolidation, Dignity, Franciscan, Hospitals, Mass Casualty Incident, Patient Physician Relationship|

Washington State Regulators Gave CHI a Monopoly. It is Time to Take it Back.

How did we get here? America has struggled to balance access to hospital services with utilization, quality and price for the past 50 years. In the mid-1960’s, certificate of need laws were established to limit the supply of hospital beds and equipment, prevent overutilization of services, control costs and improve quality.

Niran Al-Agba2020-05-14T03:57:15+00:00August 22, 2017|Categories: Patient, Policy|Tags: Certificate of Need, CHI, CON laws, Consolidation, Corporatization, Franciscan, Hospitals, Rural Care, Washington State|