A little-known provision of the Homeland Security Act has accomplished what healthcare association officials have feared for years: Investigators for HHS' inspector general's office are now fully authorized to pack heat.
Although it's true the inspector general's office has always had criminal investigators, the agency is best known for its crack auditors, accountants and attorneys. Its agents typically arrive with nothing more than a search warrant. In the cases where they have thought they needed to, agents have been deputized by U.S. marshal's offices to carry weapons and get battering rams to bring to hospital offices and clinics, though Outliers has never heard of an office door being smashed in.
Now Congress, which passed the law last year, has conferred full law enforcement authority on the inspector general's more than 400 criminal investigation agents. That inspector general staffer with the pocket protector may also have something with more firepower, even if the best-armed occupants of hospital offices might have only hypodermic needles as a defense.
To date, the inspector general's office has not reported any armed resistance while retrieving medical records. "We have confiscated weapons," HHS' inspector general's spokeswoman Judy Holtz said. "And (agents) have gotten into touchy situations."
A spokeswoman for HHS Inspector General Janet Rehnquist, who allegedly carried a firearm into her office last year, said the law enforcement authority does not extend to her boss. "I think the badges are just for the agents," she said.
"Sooner or later one sees everything if one waits long enough," was all that AHA spokesman Richard Wade was willing to say about the pistol-packin' inspectors.
Hot lines, hot business
Speaking of fraud, one company has really found a comfy niche saving healthcare providers money on their compliance programs.
National Hotline Services staffs 24-7 hot lines for employees at hundreds of facilities to anonymously report tips of wrongdoing and other problems.
With antifraud efforts ramping up in recent years, compliance is good business. Fredericksburg, Va.-based NHS, in business since 1992, now runs 500 hot lines for 360 clients, 75% of which are in healthcare. It reports $2 million in annual revenue.
The company notifies providers immediately when there is an urgent matter, but all tips are fed back within a business day. In addition to reports of alleged fraud, NHS operators routinely field calls about sexual harassment, patient-safety problems and more routine concerns.
The company's executives have solid compliance backgrounds. Its president is Richard Kusserow, who was HHS inspector general from 1981 to 1992. The vice president and COO is Larry Tomayko, a former executive assistant to HHS Secretary Richard Schweiker in the 1980s.
Says Tomayko: "The need for more integrity is growing."
About 10,000 hospital and nursing-home workers, members of New York's largest healthcare union, 217,000-member Local 1199 of the Service Employees International Union, marched through Manhattan's streets on a bitterly cold Saturday earlier this month to protest the Bush administration's military buildup and possible invasion of Iraq.
City officials said the Feb. 15 rally drew about 100,000 people. But officials from United for Peace and Justice, a coalition of more than 200 local and national organizations working against the "reckless drive toward war" that organized the antiwar event, put the number at 400,000 to 500,000.
The local's parent, the Washington-based SEIU, is one of roughly half a dozen major unions opposing the war.
"If they can march in Rome and Barcelona and London, we can march in New York, too," Dennis Rivera, president of the New York local, told the assembled throng. "We are going to stop this war."
The laugh treatment
Humor and serious illness rarely go together, but believe it or not, there's an association devoted to it. And it is holding its 14th annual conference next month in Chicago.
Humor and laughter, playfulness and silliness are important in treating any disease, says Ed Dunkelblau, conference co-chairman and former president of the 16-year-old Association for Applied and Therapeutic Humor in Phoenix. Keeping a sense of humor can reduce anxiety, possibly boost the immune system and open up communications between the patient and doctor.
"It helps all involved feel better and less frightened," says Dunkelblau, also director for the Institute for Emotionally Intelligent Learning in Hoffman Estates, Ill., and a clinical psychologist in private practice.
Two hundred people are expected to go to this year's AATH conference in Chicago, co-sponsored by Gilda's Club Chicago, founded in memory of Gilda Radner, a comedian who died of ovarian cancer in 1989. At one meeting, a healthcare worker said after she underwent a mastectomy, she stopped being herself. She stopped laughing. Then one day, she woke up and realized her sense of humor and her identity weren't in her left breast.
Other stories, in books such as Not Now ... I'm Having a No-hair Day, by Christine Clifford, and information about the group's annual conference, can be found at aath.org.
"These are people passionate about their work," Dunkelblau says of the group's 600 members including nurses, doctors, psychiatrists and others who use humor in working with patients. "They recognize the importance of being effective clinicians, but they also recognize the lightness of being."