Al Franken's New Bid to Strengthen FDCPA, Protect Patient Rights

The bill, titled the End Debt Collector Abuse Act of 2012 (S 3350), is an update and expansion of earlier legislation Senator Franken proposed along with Senator George LeMieux of Florida in 2010. Like its predecessor, Franken's current bill would amend the Fair Debt Collection Practices Act to provide further protections for consumers against abusive or deceptive collection tactics sometimes employed by creditors and their agents.

But with this bill, Franken also hopes to establish special protections for medical patients who are suffering collection abuses when seeking care at hospitals and emergency rooms. Franken announced his new bill at the conclusion of Senate hearings which explored debt collection and health privacy practices of Chicago-based Accretive Health Inc. and Fairview Health Services in Minnesota.

Standing Up For Patients

According to Franken, a member of the Senate Health committee, too many patients are being harassed for payment of medical bills when they are in a weakened, vulnerable state seeking urgent medical services. Franken's updated End Debt Collector Abuse Act calls for recognizing the "special nature" of medical debt and clarifying its status under the FDCPA. As outlined in a bill summary available on Franken's website, the bill would establish that:

1. Hospitals and their collection agents are subject to FDCPA restrictions against abusive or deceptive practices, regardless of whether the debt in question is in default

2. Collectors are prohibited from approaching patients in hospital emergency rooms, labor and delivery departments, and intensive care units

3. Hospitals are prohibited from withholding, delaying or threatening to withhold emergency medical services until a debt is paid

4. Collectors are required to inform patients about any financial assistance programs such as hospital charity care initiatives or Medicaid which might help pay their medical bills

Reinforcing the Federal Debt Collection Practices Act

The bill goes on to restate the central provisions of Franken and LeMieux's 2010 End Debt Collector Abuse Act. Chief among these is an outright prohibition against creditors seeking arrest warrants in order to compel consumers to pay off debts. While this practice is not widely known or discussed outside of legal circles, debtors can be arrested and jailed in some states for refusing to comply with court orders to repay debt or for failing to attend certain debt-related court proceedings. Franken points out that this practice flouts our nation's abolishment of debtors' prisons, and furthermore exploits public law enforcement and court resources for the benefit of private creditors.

Notably, Franken does not propose to restrict courts from issuing arrest warrants in cases where a judge decides on this course of action. Rather, Franken wants to ensure that courts - and not creditors or their collection agents - will make such decisions.

Besides prohibiting debt collectors from issuing arrest warrants, Franken's End Debt Collector Abuse Act proposes amendments to the Federal Debt Collection Practices Act which would require collectors to provide additional information to consumers regarding their debt and their rights under the law. Specifically, the new bill would require that collectors provide:

1. The original creditor's name and address - which can be unclear in situations where debts are bought and sold several times by collection agencies before any collections are made

2. A full itemization of the principal, interest and fees which comprise the total debt so that consumers can understand what a collector is alleging, and dispute it point by point if necessary

3. Instructions and contact information for filing a complaint or dispute with the collector's organization

4. Thorough investigations in cases where consumers dispute a debt, as well as verification specific to the disputed issue

Finally, Franken's bill calls for raising statutory damage limits set forth in the FDCPA and tying them to the Consumer Price Index to adjust for inflation, noting that these limits have not changed since the law's enactment almost 35 years ago in 1977. Franken feels that raising these damage limits will more effectively punish bad actors in the debt collection business and encourage all debt collectors to reexamine their practices to help promote compliance.

Shifting Hospital Buying Criteria Is Transforming Medical Device Sales Strategies

Worked as an executive coach and strategy consultant in the healthcare market provide a unique perspective. Over the past few years I have found myself involved in a project with a global, multi-billion dollar medical device, a leading teaching hospital, a leader in information technology, investor-based start-up, and the regional hospital system. It has delivered an interesting perspective to see the shadow health reform has been put on the whole landscape. While many of these changes is yet to come, driving this change is rippling through the sector.

Have the opportunity to see things unfold from both sides of the medical device / hospital, producer / consumer relationship does not go unappreciated. It is a privilege to ignore that reveals not only the drivers behind the rapidly changing market, but the initiative of both sides of symbiotic relationships are scrambling to implement.

Two major changes that occurred, one that would lead to another. First, hospitals are moving towards evidence-based care. I know this may sound a bit odd and confusing to the layman (ie patients) who looked at as a practice of medicine and science. Does not always evidence-based science? Well yes, of course, in a laboratory or clinical trials. But delivered through the practice of clinical medicine. While we all believe that the surgeon and physician guided and immersed in medical science, we must also appreciate that once they are in the practice of medicine continues to evolve scientifically and technologically.

Medical science does not stop. Nearly $ 30 billion in annual tax research dollars invested by the National Institutes of Health to push the envelope forward at an ever accelerating. And this figure does not include private research and development dollars biopharmaceutical and medical device companies. In fact, recently projected that the scientific knowledge of mankind is doubling every five years. How many peer-reviewed, clinical studies that we can expect even the best surgeons and medical practitioners to read every year?

Surgeons and physicians do the best they can to keep pace with the state of the science, but traditionally, they practice medicine within a relatively small community of peers, institutions, and colleagues. The practice of clinical medicine, unlike many other technologically-driven industries, has been fragmented. All of the critical-to-quality variables that have been captured, analyzed, and applied in aeronautics, electronics, software, automotive engineering, pharmaceutical manufacturing, even the frying of the perfect fast-food french fry have been unattainable in clinical medicine. Until now.

The federal requirements for automating patient records is unleashing a new age in medicine. And patient records are just the beginning. The application of informatics, the ability to capture large, statistically significant pools of clinical data regarding demographics, genetics, presenting conditions, treatments, surgical procedures, peri-operative care, and patient outcomes is driving a seismic shift in how medicine will be practiced in the future. It is probably the last frontier, the last industry to benefit from transposing raw data into cogent information that will dramatically effect quality, costs, and the standardization of processes to optimize both of these factors simultaneously.

The net effect of this is a fundamental shift in the buying influences and decision makers for purchasing medical devices within the hospital. Once the sole domain of surgeon preference, these decisions are now migrating to value-add committees; teams of clinical and administrative professionals that are looking to optimize the coming wave of efficiencies and positive patient outcomes that are the promise of evidence-based care. Which brings us to the inevitable and immediate challenge of medical device manufacturers. The entire criteria for who, where, and what will be purchased is spiraling away from their traditional sales and marketing model.

The sales engines of multi-billion dollar medical device companies are not haphazard organizations that organically sprouted up in the marketplace. These are organizations that have been meticulously optimized by a continuous succession of exceptionally bright professionals over a hundred years of market presence, and, in many cases, decades of distinguished market leadership. These are organizations of pride and pedigree. Organizations that fine-tuned the wining and dining of key decision makers, of hiring and the training just the right type of sales professionals capable of persuading key surgeons, clinical opinion leaders, and early adopters of sway within the clinical community. Vastly expensive enterprises of dozens, if not hundreds, of highly paid sales mercenaries that invested years, if not decades, in cultivating key relationships and a professional presence within their territories.

The tidal shift that is occurring in the marketplace is rapidly displacing the traditional value proposition and delivery vehicles of these finely tuned machines. These are not frigates that can turn on a dime. They are the equivalent of aircraft carriers being tasked to come about in the middle of the Suez Canal without losing steam or momentum. Many medical device companies recognize they need to adapt to dramatically different circumstances of which they collectively have no historical experience in navigating. Keep in mind, cataclysmic change rarely serves the incumbent. Well established and longstanding careers emerged and evolved under very different drivers, influences, and environments, solidly anchored to the past. Transformational change does not come easily.

All of this culminates in the need for medical device companies to find new, unprecedented approaches for developing, marketing, and selling their technology. Their is no turnkey, off-the-shelf solution for adaptive change. Adaptive change requires a shift in perspective to occur, for fresh thinking to emerge, and for new, efficacious processes to coalesce. The imperative that will enable adaptive success requires organizations to align and leverage their leadership, strategy, and culture; fully engaging the human talent and intellectual property they enjoy. Adapting to the transformational and rapidly shifting healthcare environment will require the courage to step away from timeworn sales and development models and discover entirely new paths to market.

With what we are witnessing, I cannot help but think of Darwin and his theory of evolution. Many people misunderstand his theory of survival of the fittest. It isn't the strongest, the largest, or the most intelligent that survive. It is those that are the most adaptable to change. And as it is with species, it will be with today's medical device companies...those that are most adaptable to change will be those that thrive in the future.

Terry Murray is a professional coach and business executive with twenty-five years of progressive experience in strategic development, executive leadership, and the deployment of highly profitable business teams. His executive leadership with Fortune 1000 and start-up companies has directly contributed more than $1 billion in market capitalization growth throughout his career.

Terry is the founder and managing partner of Performance Transformation, LLC a Professional Coaching and Strategic Development firm focused on igniting breakthrough performance through the authentic engagement and development of human talent. The company's evidence-based programs and philosophical approach employs their proprietary Accretive Coaching Process™. The organization's engagements align the clients' human capital with their strategic imperatives driving tangible results, delivering a sustainable competitive advantage and an exceptional Return on Investment.

Terry is a graduate of The Whittemore School of Business, University of New Hampshire and a veteran of U.S. Naval Intelligence. He has just completed his first book, "The Law of Traction ~ Engaging the Mind, Heart, & Spirit for Transformational Performance".

Learn The Art Of Making Pack For Your Surgical Instruments

Surgical packs are very popular amongst surgeons as it includes the necessary items like gauze sponges, sterile drapes that are properly wrapped, the basic instruments, and other similar materials that are usually laid out during surgical procedures on proper fenestrated pans. It is the duty of technicians in hospitals to sterilize and prepare these surgical packs for the E.R and then stock them for future need. The process of sterilization for instruments is very important and has to be done adequately through the use of pressurized steam created in an autoclave, especially if the surgical instruments require sterilization on a low pressure, using plasma or gas sterilization.

Learning how to properly sterilize and pack surgical instruments is really important for the safety of the patient. This is why learning the basic principles that apply in the art of packing instruments should be learned by all doctors and technicians working in hospitals. To start the process you have to first painstakingly clean and then fully dry all the instruments. Then collect all the other materials that you need to add in to your pack. The use of an ultrasonic instrument for cleaning the instruments once you are done washing is preferable. Otherwise you can simply hand wash the instruments using enzymatic solution which is specially designed for cleaning surgical instruments. You should make sure that you properly clean off all rust and debris from the instruments. You have to make sure that the solution you are using for cleaning your instruments is neutral pH otherwise you can end up with stains on your instruments.

Now proceed to lubricating the surgical instruments that need to be lubricated. Again always purchase a lubricant that is specifically designed for this purpose. Give proper time for the instruments to fully dry once you are done lubricating them. You have to make sure that you properly count all the materials and instruments like suture needles, gauze sponges, etc to ensure that you have the count absolutely necessary. This is a very crucial stage because when the pack of instruments is opened, the surgeons count every item before stitching up the patient to make sure that they have not accidentally left any item from the pack inside the surgeon.