Patients

Six years ago, the Baltimore Washington Medical Center opened a new emergency room with the ability to treat 60,000 patients a year. But within a short time, the capacity of the new facility at the hospital - then called North Arundel - was exhausted. Last year, the ER was treating about 219 patients a day, well above its capacity of 165. As numbers grew, so did waits, which ranged from one to four hours, according to the hospital. Lately, the hospital has seen drastic improvement after implementing a new system for receiving and treating emergency patients, officials say. With help from a consulting firm, the center has an average wait of less than an hour, ambulance diversions are down to 22 hours a month and about 1 percent of patients leave without being seen.

Until recently, the sagging economy wasn't a subject Dr. Mary Newman routinely discussed during office visits. But after a steady stream of longtime patients confided that they had been laid off, were about to lose their health insurance or that their pay had been slashed, she added the recession to her standard checklist of questions. "It's hitting people I hadn't expected," said Newman, an internist who practices in Lutherville. "If a person is in financial hardship, we help them." Doctors are encountering more patients struggling to pay for care.

Four out of five patients who said they had sex with their psychotherapists after therapy ended suffered psychological harm as a result, according to a study to be published this fall in the journal Psychotherapy.The finding may bolster an emerging movement to ban sexual relationships between therapists and clients "in perpetuity." While sexual relationships are currently forbidden in all states during therapy, only Florida has an in perpetuity ban. A few states limit such relationships for varying periods after therapy.

WASHINGTON -- A federal investigation has found that three patients of a Florida dentist with AIDS were all infected with strains of the human immunodeficiency virus extremely similar to that of the dentist -- but unlike other strains found in the community -- indicating that they were infected in his office, the Los Angeles Times has learned.The case, expected to be reported next week by the federal Centers for Disease Control, is significant because it has ignited a national controversy over whether HIV-infected health care professionals should be restricted from performing surgery and other invasive procedures.

Dr. Bernetha George has gone to war with the powers that be on behalf of her patients.Dr. George's patients are poor, uneducated and unemployed. They are intravenous drug users who have been infected with HIV, the virus that causes acquired immune deficiency syndrome.It doesn't matter whether Dr. George wins or loses her battle. Her patients will still be poor. They will still be uneducated; still doomed, some day, to die of AIDS.At most, she has gone to war to buy her patients a little time, a little comfort, and possibly a little dignity.

Yearly infusions of the bone-strengthening agent zoledronic acid in elderly people who have suffered a hip fracture reduced deaths by 28 percent and new fractures by 35 percent over two years - the first time any treatment has been shown to reduce mortality in such patients. Researchers reported in May that the drug, sold under the brand name Reclast by Novartis, significantly reduced the incidence of fractures in patients with osteoporosis. But the new trial is the first to study people who have already suffered a fracture, said Dr. Dennis Black of the University of California San Francisco, who was not involved in the study.

The dreary brown and white walls, bare floors and crowded corridors are giving way at Harbor Hospital Center to an environment administrators and patients believe is more conducive to healing.The 24-bed renal-pulmonary unit is the first of six areas to be converted to this "patient-centered care" concept. On Wednesday, 13 patients moved to the north wing of the redesigned unit.Patient focus groups and hospital staff helped determine the look of the unit, picking the color scheme and making other suggestions.

Barbara Peckham remembers when she used to cook Thanksgiving dinner for 17 people. These days, she's happy to master a simple recipe for tuna noodle casserole.About eight years ago, the 48-year-old Springfield Hospital Center patient began losing her confidence in the kitchen as her manic-depressive illness became more serious.After 10 weeks in a Springfield program that reacquaints longtime patients with daily living skills recently, she began to rediscover the pleasures of cooking."It's made me realize I haven't lost the talents I thought I lost," said Ms. Peckham, who most recently entered the Sykesville hospital in October.

Is the patient-protection deal Texas struck with the managed-care behemoth, Aetna U.S. Healthcare, really good for consumers? That question matters, because the agreement is being touted as a model for Aetna and other HMOs nationally. To me, the approach looks promising. Patients should get fairer treatment and more avenues for pursuing disputes. This story began in 1998, when Texas filed suit against Aetna and three other insurers, Humana, PacifiCare and NYLCare. The state claimed that, through their financial incentives, they were effectively pushing doctors to cut back on necessary medical care.

Through a new contract with the state, the Columbia Medical Plan has become the first area health maintenance organization outside of Baltimore City to enroll Medicaid patients as full members.Seventeen Howard County Medicaid patients have become members since the contract was signed March 31. The organization also is accepting Medicaid patients in Anne Arundel, Carroll and Frederick Counties."It's another way that low-income people can get comprehensive services," said county Health Officer Dr. Joyce Boyd.