I'm
thrilled that the transportation organization SEPTA is providing social services
to these amazing men and women who have this medical condition known as
Substance Use Disorder.
I'm
happy that police whose role is street-level law enforcement have the Police Assisted Diversion Program that assists these amazing men and women who have this medical condition known as Substance Use Disorder.
I'm
just wondering when the local medical community whose professional members have dedicated their careers to the ideals of Hippocrates for the
purpose of medical provision to medical patients will actually step forward and
start to treat their medical patients who have Substance Use Disorder with
prompt dignity and respect-filled care.
If
you're reading this blog and not familiar with Substance Use Disorder, it is recognized as a medical disease. The Philadelphia
Police Department and SEPTA should not have to be involved in a leadership role
in treating medical patients who have a medical disease.
Medical
Representatives within the Medicaid system of health care providers are not
treating their patients as they should.
Let's
personalize this personal situation:
- As I see this woman's red hair, the way she's leaning forward toward him, the way she's reaching out with her left arm, I'm wondering if this is Melanie, who I introduced to you on July 27, 2018.
- In
this picture, to the left, you see part of a doorway. That doorway leads up steps to the elevated
train line that runs above Kensington Avenue.
It
is on those steps where I administered Narcan to Allison, a Delaware County resident. She revived, was taken by ambulance to
Episcopal Hospital and was told by the Registered Nurse on duty in that emergency room which is dedicated to health care
provision to patients who are experiencing life threatening situations
and who at the beginning
of her career had dedicated that career to the ideals of Hippocrates to:
"Get out of My Emergency Room!"
It
is high time that the Medicaid-based medical community - in the spirit and name
of Hippocrates - steps forward and invites their patients into a prompt dignity
and respect filled healing experience so that these people - these inspirational human beings who are made in
the image of God and worthy of dignity, honor, respect, and love - can get
on with their lives and back to their families and realize the joy of living.
There's
a world of difference between the styles of health care provision to Substance
Use Disorder patients depending on their Private vs. Medicaid insurance
status. Here's
a blog that looks at those differences. The private insurance realm of this tragedy
can and should lead the way in finding solutions so as to save the millions of
lives that lie in wait of much wanted and needed prompt dignity and respect
filled health care services.
**********
Blog Analysis Addendum: The Abdication of the Healer
Original Blog Title: Medical Representatives within the Medicaid system of health care providers are not treating their patients as they should.
I. The Human Narrative: The "Reversed Role" of Kensington
In this account, we see a neighborhood where the traditional boundaries of profession have been flipped. SEPTA outreach workers like Kenneth Harris and the Police Assisted Diversion (PAD) program are the ones leaning in, reaching out, and offering "dignity and respect." Meanwhile, the medical community—those who have literally sworn an oath to "do no harm"—are the ones pushing patients away. You recount the chilling experience of Allison, who, after being saved by Narcan and taken to the hospital, was met not with healing, but with the command: "Get out of My Emergency Room!" This narrative exposes the "Hippocratic Gap" where the poor are treated as a nuisance rather than a priority.
"The Philadelphia Police Department and SEPTA should not have to be involved in a leadership role in treating medical patients who have a medical disease."
II. The "Lynne’s Laws" Article and Section Review
This blog identifies the need for Article 5, focusing on the professional accountability of healthcare providers.
Article 1, Section 1: The Medical Necessity and Parity Mandate. This story highlights the lack of parity. If Allison had been a cardiac patient revived by EMS, no nurse would have told her to "get out." This mandate legally forbids such a dismissal by classifying her post-Narcan state as a high-risk medical emergency requiring 24-hour observation.
Article 1, Section 3: The Hippocratic Accountability Act (New).
The Law: Mandates that any medical professional (doctor, nurse, or administrator) who explicitly refuses care or verbally dehumanizes a patient in a substance-use crisis (e.g., "Get out of my ER") is subject to an immediate ethics review and potential loss of state medical licensing.
The Application: This would hold the specific Registered Nurse in Allison’s story personally and professionally accountable for her failure to treat.
Article 5, Section 1: The Medicaid Equity and Quality Mandate (New).
The Law: Requires that Medicaid-funded facilities prove they are providing the same "Dignity and Respect" standards as private-insurance facilities. It mandates "Blind Intake" protocols where a patient's insurance status cannot be seen by the clinical staff until after the stabilization plan is enacted.
III. The Professional Tension and Consensus
The Supportive View: Ethical medical boards and human rights advocates argue that "therapeutic nihilism" (the belief that treating addicts is useless) is a violation of the Hippocratic Oath. They support Article 1, Section 3 because it restores the integrity of the medical profession by weeding out those who refuse to treat "the infirm."
The Skeptical View: Nursing unions and hospital administrators worry about "Burnout" and "ER Safety." They argue that staff who are overwhelmed by the volume of Kensington cases may snap under pressure, and that "Accountability Acts" will make it even harder to staff these critical hospitals.
The Lynne’s Law Resolution: This is an Infrastructure issue. Lynne’s Laws don't just "punish" the nurse; they mandate that the state provide the Resource Support (extra staffing and stabilization beds) so that the nurse is never in a position of "despair-driven rejection."
IV. Legislative "Teeth": The "License to Heal" Standard
The Objective Standard: A "Refusal of Care" is documented as a Sentinel Event.
Civil Liability: If a patient is told to "Get out" and subsequently suffers harm (a second overdose or injury), the facility is held Strictly Liable. Additionally, the Hippocratic Accountability Act allows for a "Private Right of Action" against the specific professional who verbalized the rejection.
V. The Prevention Savings
By forcing the medical community to take the leadership role away from SEPTA and the Police, the state saves on:
The Cost of "Non-Medical" Policing: Police officers are more expensive and less effective at "treating a disease" than doctors.
The "Revolving Door" Cost: Treating Allison with "dignity" the first time reduces the likelihood that she will be back on those SEPTA steps with a needle an hour later.
VI. The Corrected Path
Under Lynne’s Laws, when Allison arrived at Episcopal Hospital, the nurse would have seen her as an "inspirational human being made in the image of God." The Medicaid Equity Mandate would have ensured that her care was indistinguishable from that of a private-pay patient. Instead of being told to "get out," she would have been invited into a "healing experience" where her life was valued, her family was contacted, and her "joy of living" was the only goal.
#LynnesLaws
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