Sadly - and smartly - someone has removed the YouTube video of the unknown anesthesia provider who let his patient inject his own induction dose of propofol. That doesn't mean we can't talk about it, though.

Several thoughts:

A Texas court's rejection of an appeal that challenged restrictions on physician-owned specialty hospitals has cast doubt on the future viability of such facilities.

The Physician Hospitals of America (PHA) and Texas Spine and Joint Hospital (TSJH) of Tyler had filed suit against U.S. Health and Human Services Secretary Kathleen Sebelius in June 2010 after healthcare reform legislation restricted construction and expansion of physician-owned facilities. Under the reform law, any physician-owned hospital licensed as of Dec. 31, 2010, was allowed to operate, but such grandfathered facilities could not expand unless first obtaining an exception from HHS.

At the time, TSJH was in the midst of a $27 million expansion to add 3 ORs and 20 beds and unable to complete the project by the government-mandated deadline, so it stopped construction. The hospital alleged in the lawsuit that moving forward with the project would have risked millions of investment dollars, possibly incurred regulatory fines and potentially resulted in a large, empty building.

Last December, a proposed Congressional bill would have loosened restrictions placed on physician-owned hospitals. However, the final version of the bill that was signed into law had omitted such relief.

Scott Oostdyk, a partner at the Richmond, Va.-based law firm McGuireWoods and lead counsel for PHA and TSJH, says his clients are disappointed in the ruling and considering their options, including appealing to the U.S. Supreme Court.

There are currently 275 physician-owned hospitals serving patients in 33 states, according to the PHA.

Daniel Cook

When it comes to draping your patients and gowning your OR staff for surgery, is there really a bottom-line difference between disposable products and laundered textiles? In a comparison of the 2 options, an infection control researcher and an industrial textile expert consider each in terms of their clinical effectiveness, economy and sustainability.

David Bernard

Many anesthesia providers predict that video laryngoscopy will soon replace conventional laryngoscopy as the intubation method of choice. Tell us what you think in this week's InstaPoll.

Who double-gloves at your facility? Nearly three-fourths (73%) of the 230 respondents to last week's poll practice double-gloving some of the time. One-third (33%) of surgeons and techs represented in our poll double-glove for every case.