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Yelp compiled customer reviews and ratings in 2018 to determine its Top 100, with company officials saying, “We considered both the rating and the volume of the reviews, while accounting for the overall volume of reviews in each business’s area so as not to disadvantage businesses in areas with relatively low review volume.” 326

While the details of Alyssa's case are extraordinary -- the Grandma Betty trick, the escape from the hospital with police on their heels -- the core of her story is not uncommon in many ways, according to patient advocates.Dr. Julia Hallisy, founder of the Empowered Patient Coalition, says families often tell her that a hospital won't allow their loved one to transfer to another facility. Often, they're afraid to say anything publicly or on social media."You sound like a crazy person -- that your family member was held hostage in an American hospital," she said. "People can't believe that would happen. It's like the stuff of a science fiction story."Kristen Spyker said it happened to her family.When Spyker's son was born with a rare heart defect, she says she told doctors at the Ohio hospital where he was born that she wanted him to have a surgical repair at a hospital with a larger pediatric heart program.She said the heart surgeon at the first hospital refused to send her son's medical records to other hospitals. She also says a surgeon resisted her efforts to transfer her newborn son to another hospital to get a second opinion on what surgery he should have for a rare heart defect."The surgeon said, 'This is my patient. This is my show. I'm the boss, and I say what happens,' " she said.She said a social worker, accompanied by hospital security guards, then came into her son's hospital room and said she was worried that Spyker had postpartum depression that was affecting her ability to make decisions for her son's care.Spyker said the hospital discharged her son only after she threatened legal action.Her son then had a successful procedure at another hospital -- a different procedure than the one recommended by the first doctor.When she told her story on Facebook, Spyker said, other parents shared similar stories."It was parent after parent after parent saying 'this happened to us,'" she said. "They had been so embarrassed to talk about it, but they felt freer when I said it happened to us."Spyker was one of several people who spoke with Alyssa's parents last year while their daughter was at Mayo.In a statement to CNN, the American Hospital Association addressed conflicts between families and hospitals."Communication between physicians and patients is extremely important in working to identify the best treatment," said Dr. Jay Bhatt, senior vice president and chief medical officer of the organization. "Each patient is unique. It is for this reason that the majority of hospitals have patient advocates on staff to help patients and families navigate the care process. Hospitals recognize that patients are critical members of any care team and many are employing new strategies to ensure their voice and perspective is heard and accounted for."When hospitals and families get into intense conflict, Hallisy, a dentist who practices in San Francisco, says human emotions can run amok. She says she saw it happen when her daughter, Katherine, was being treated for cancer."People think that doctors are immune to petty disagreements, but they're human beings, and sometimes ego and primitive emotions take over," she said.She said that in Alyssa's case, she wonders whether a sensitive hospital staffer, perhaps a social worker, could have prevented the situation from becoming as contentious as it did.She thinks back to her daughter, who died at age 10. She remembers the sadness and fear of having a very sick child, as well as the stress of taking care of her two other children and keeping her dental practice afloat while her daughter was in and out of the hospital.She thinks about how Alyssa was near death and how her parents had five younger children 130 miles away, as well as farms and a family business to run."They were under incredible stress," Hallisy said. "They'd almost lost a child, and they had other responsibilities, too. You would think that someone at Mayo would be trained to see that." 3956

While we cannot comment on the specifics of this case because it is pending litigation, we can say that Beaumont’s highest priority is providing a safe environment that is free from discrimination for both our patients and staff, and delivering care with compassion, dignity and respect. 287

with the SEC about his tweeting habits.Regulators on Monday had asked a federal judge to hold Musk in contempt for violating a settlement deal reached last year that involved criticism of Musk's Twitter use. Musk and Tesla settled their dispute with the SEC in October. They agreed to pay million in fines and to start policing Musk's social media posts after he caused a stock surge with a tweet that regulators said over-hyped Tesla's value.But Musk drew regulators' ire again with a February 19 tweet that overstated how many cars Tesla plans to deliver in 2019. The SEC claims Musk did not receive pre-approval for that tweet.If the judge sides with the SEC, it could expose Musk to serious new consequences.Musk has lashed out at the SEC, which he called "embarrassing" in a tweet earlier this week. He has also previously referred to the agency as the " 863

With those dynamics at play, GOP leaders are dismissing the possibility of a shutdown while predicting a funding fight.Sen. John Cornyn, the No. 2 Senate Republican, acknowledged that a fight over border funding might lead to a "lack of funding for certain limited functions," but argued that would not amount to a shutdown even if it did happen."We've avoided the shutdown by getting the vast majority of the federal government funded through the next fiscal year," he said."We knew that that fight was important and it was coming," the Texas Republican added, "but we didn't want to go through another shutdown narrative."Congress averted a halt in government funding ahead of the midterms by passing legislation at the end of last month to pay for a large portion of the federal government and a shorter-term spending bill to fund the rest until December 7. The package did not, however, include money for the President's long-promised border wall, effectively putting the issue on hold for lawmakers to figure out how to deal with before the December deadline.House Majority Leader Kevin McCarthy, a California Republican, helped reignite the border debate this week by announcing plans for a bill that would set aside an eye-popping .4 billion to fund a wall.That is far greater than the .6 billion for border security that Congress allocated in a spending bill enacted in March. In August, Trump said he is looking for roughly billion in wall funding "for this next coming year," adding that "we're building the wall, step by step." 1546