Speculation begins on new FDA, CDC leaders
Can an acting FDA commissioner make a difference? There is no clear answer, of course. Generally, such a role is seen as caretaker until, or if, a permanent choice is confirmed. But for now, Frank Torti, the agency’s chief scientist and principal deputy commissioner, will run the FDA. And, although Health and Human Services Secretary-designee Tom Daschle has said he wants to move quickly to insert agency heads, a new FDA commish is unlikely to be appointed for a few months, given the confirmation process.
Moreover, Torti is intriguing to many because of his background - he’s an academic cancer researcher - who gave a speech last May at the FDA Science Board in which he outlined his plan for his first 100 days as FDA’s chief scientist and “sounded like someone who was ready and willing to settle into the job for the long haul … Even the title of his speech had a political ring to it: ‘Science at the FDA: Vision, Plans and Timetable.’” (Partial transcript available through the RPM Report .) Maybe Torti will turn out to be more than a place holder.
Julie Gerberding
Separately, Julie Gerberding is about to step down as head of the Centers for Disease Control and Prevention and will be replaced by William Gimson III, the agency’s chief operating officer, until a permanent replacement is named. The Wall Street Journal speculates that a permanent head may be James Marks, a former senior CDC official who is now at the Robert Wood Johnson Foundation; Helene Gayle, former CDC director for HIV/AIDS and president and chief executive officer of CARE; or Thomas Frieden, commissioner of the New York City Department of Health and Mental Hygiene. Meanwhile, see the discussion at CDC Chatter.
Fellows to spend a week studying at CDC
The first class of AHCJ-CDC Health Journalism Fellows will learn about public health issues at two Atlanta campuses of the Centers for Disease Control and Prevention. The fellowship program, supported by the CDC Foundation, will include presentations, roundtable discussions and lab tours on epidemiology, global disease prevention efforts, obesity, vaccine safety, pandemic flu preparedness, autism and many other topics. Fellows will tour the CDC director’s National Emergency Operations Center, meet sources on policy and research and learn how to tap the agency’s abundant resources to produce better stories.
Find out who the fellows are and learn more about the program.
Academic docs collect money from manufacturers
Filed under: Hot Health Headline, Pharmaceuticals
In a two-day series, “Side Effects: Are doctor’s loyalties divided?,” John Fauber of the Milwaukee Journal Sentinel reports on university doctors who are paid by drug companies and device manufacturers.
“More than 40 University of Wisconsin-Madison physicians were paid in 2007 to work as speakers or authors by drug or medical device companies, records show. In most cases, they worked for at least two companies, and sometimes three or four. Several doctors described their work as promotional.”
Fauber looks at concerns that it can be hard to distinguish between education and marketing and that such practices “can influence patient care and raise the cost of treatment, in addition to blurring the line between research and marketing.”
He also points out that it may be difficult to figure out just how much drug company money is going to doctors because some of it goes through medical education and communication companies that are funded by drug companies and used to pay doctors to give speeches.
- Doctors face pressure to disclose all side pay
- UW psychiatrist paid to speak about disputed anti-smoking pill
- UW researcher in clinical trial consults for medical firm
- Drug firms wine, dine and pay up for doctors’ speeches
- UW doctors speak for drug companies
- FDA could miss money conflicts
Topics in the news: food safety, coal ash
Some resources that could be helpful in reporting on a couple of hot topics today:
Peanut butter is suspected in an outbreak of salmonella that appears to have affected about 200 people in 42 states, prompting a recall of two kinds of peanut butter. Thomas Hargrove of Scripps Howard News Service wrote about foodborne illness outbreaks in a 2007 article for AHCJ. He found that some states did a good job of diagnosing and tracking down the causes of outbreaks, while other states “are virtually blind in detecting outbreaks of food illness.” Read more about the findings and get links to some related resources.
Following the failure of a retention pond for the TVA Kingston Fossil plant, dumping fly ash over 400 acres in Tennessee, Sen. Barbara Boxer has said she plans to file legislation calling on the federal Environmental Protection Agency to regulate coal fly ash ponds across the country. The National Library of Medicine has information about potential effects of fly ash exposure on human health following the TVA Kingston Fossil Plant Coal Ash Spill in December 2008.
Study: Hospital quality rankings inconsistent
A study published in the November/December 2008 issue of Health Affairs finds that five consumer-oriented Web sites that rank hospital quality are inconsistent and likely to confuse consumers.
The study involved rankings provided by Hospital Compare, HealthGrades, Leapfrog Group, U.S News and World Report, and Massachusetts Healthcare Quality and Cost (a state-run service). Researchers compared community-acquired pneumonia, total hip replacement, percutaneous coronary intervention, and coronary artery bypass grafting at nine Boston-area hospitals.
In American Medical News, lead author Michael B. Rothberg, M.D., M.P.H., said, “I don’t think these ratings are at the point where doctors or patients can really use them.”
Rothberg, an assistant professor of medicine at Tufts University School of Medicine in Boston, also said that “Public reporting was created to be a tool for consumer choice and to improve quality, but the inconsistency in these systems does a disservice to patients rather than achieve its true potential.”
The American Medical News article also includes reactions from representatives of the rankings.
Note: Remember, AHCJ members can sign up for free access to Health Affairs.
Three health-care issues Obama, Congress will face
The NewsHour with Jim Lehrer recently ran three stories about some of the health care challenges that President-elect Obama and Congress are facing.
In part one, correspondent Betty Ann Bowser looks at people who are underinsured in Nashville, Tenn. She found a 40 percent increase in patients who have canceled appointments with a cardiology practice, many of whom are insured. She reports that people who are underinsured are delaying care, putting off tests and treatments, skipping doses of prescription medications or just not filling the prescriptions.
In part two, Bowser reports from Massachusetts on the shortage of primary care doctors. Among the reasons medical student cite for looking at other specialties: lower pay for primary care doctors makes it hard to pay off large student loans, primary care doctors are overworked and having to spend time dealing with insurance issues.
In the last part of the series, Bowser goes to Kansas to report on small businesses and the difficulties they face in providing health insurance to workers. Climbing costs have led many workers to look elsewhere for insurance, leaving the pool of workers in plans with very few young, healthy people. Businesses are finding they have to offer less coverage at a higher cost.
NEJM article critical of health reporting
In commentary in the New England Journal of Medicine, Susan Dentzer, the editor-in-chief of Health Affairs and an on-air analyst on health policy for the NewsHour with Jim Lehrer on PBS, takes journalists to task for not properly or fully reporting important health issues.
She starts out by praising some “seasoned reporters who perform thoughtfully even in the face of breaking news and tight deadlines.” But then admonishes the rest: “But all too frequently, what is conveyed about health by many other journalists is wrong or misleading.”
The problem, as she sees it, is that “some distortion is attributable to ignorance or an inability to interpret and convey the nuanced results of clinical studies. And some is due to uncertainty about journalists’ proper role: Is our job to describe the bigger picture, or simply to report what is new?”
She cites a few examples, such as the flap over the risks and benefits of the Vytorin cholesterol pill after clinical trial results were belatedly released by Schering-Plough, which sells the drug. “Some journalists asserted that (the trial) showed the drug had no benefits in preventing heart attacks and strokes - something it certainly did not show, since heart attacks and strokes were not end points in the trial. We will never know the cost of this misinformation in terms of panicked patients or physicians who, perhaps unnecessarily, discontinued use of the drug.”
In response, Trudy Lieberman, president of AHCJ’s board of directors, points out that journalists, particularly those on extremely tight deadlines, are often facing an uphill battle in understanding conveying complicated health issues. ”Reporters often told me that they would like to write about gray areas and nuances, but their editors won’t let them because the editors are looking for something jazzy,” she tells Scientific American. “If the nuances are there, they’re jumped to the second page if they’re there at all.”
Dentzer makes some valid points, which are likely to come into greater relief as newspapers cut back on staffing and space for stories.
Some have doubts about Gupta as surgeon general
To say that choosing CNN’s Sanjay Gupta for U.S. surgeon general caught most people by surprise is an understatement. Sure, he has credentials – Gupta is a neurosurgeon and is on the faculty at Emory University School of Medicine in Atlanta. During the Clinton administration, he was a White House fellow and special adviser to former first lady Hillary Clinton. And as the CNN go-to guy for health stories, Gupta is seen as a trusted voice. (Not to mention that People magazine named him one of the sexiest men back in 2003).
But not everyone is convinced. The issue, to some, appears to be style over substance. “He’s a fine communicator and does a good job covering subjects for a consumer audience,” writes Val Jones on Getting Better with Dr. Val. “But I don’t think he has the gravitas or appropriate experience for the role of Surgeon General of the United States.”
Conversely, Robert Schlesinger on the Thomas Jefferson Blog writes that this may not be such a bad thing. “The job description for surgeon general is ‘America’s chief health educator.’ Say what you want about cable news and the irritating trend toward highlighting personalities over substance; and say what you want about Gupta specifically; but public education involves some of the same skills one develops working on television news.” And the WSJ Health Blog reader poll finds that two-thirds believe tapping Gupta is a good call.
Trudy Lieberman, on CJR’s Campaign Desk blog, concludes that Gupta has proven himself to be an adept communicator/health educator, as well as a pitchman. She also notes that last fall, she wrote that Gupta botched a description of John McCain’s health plan, giving CNN viewers a confusing and ultimately misleading explanation of both McCain’s proposal and the individual insurance market, where many uninsured people must turn for coverage.
Meanwhile, Merrill Goozner of GoozNews points out that Gupta has been one of the hosts of Accent Health, a TV network beamed into medical waiting rooms and sponsored, in part, by drug makers. As Gooz points out, if Gupta has ties to industry, he ought to disclose them right away so his qualifications can be fully vetted. Of course, if he doesn’t, his media colleagues may have more stories to pursue.
But what do you think? What exactly should the Obama camp consider when selecting a surgeon general?
Update: Politifact.com’s Truth-O-Meter is back and has an interesting explanation of what the surgeon general’s job is.
Foundations’ role in health reform is changing
Some philanthropic foundations and think tanks in California are frustrated that efforts to finance studies and projects have done little to improve medicine. So some are taking on a crusading role for health care reform in Sacramento, which is the state capitol, and Congress, according to the Los Angeles Times.
Breaking from more traditional practice, several have staffed offices in Sacramento and hired experienced former advisers to lawmakers in hopes of educating legislators. However, as the paper points out, this may be risky, since nonprofits are barred under Internal Revenue Service rules from lobbying or engaging in partisan politics.
Here’s one example: the California Endowment, a foundation based in Los Angeles with more than $3 billion in assets, has hired Daniel Zingale, a senior adviser to Gov. Arnold Schwarzenegger, to encourage policies the endowment favors. Such as? Ensuring that all children have health coverage and making doctors and hospitals focus more on disease prevention and the management of chronic ailments, the Times tells us.
“We really consider ourselves to be supporting positive change and not just making grants,” Dr. Robert Ross, the endowment’s president, tells the paper. As for the California HealthCare Foundation, its Sacramento office employs a former legislative health expert to ensure the foundation’s research topics are relevant to legislative agendas.
“Our view is the legislature is not facing a shortage of recommendations but a shortage of reliable information,” Dr. Mark Smith, president of the foundation, tells the Times.
Sally Pipes, president of the Pacific Research Institute, a conservative think tank based in San Francisco, says foundations risk undermining the credibility of their research by wading into policy deliberations. “I think that’s a bad move for them, because I think they will be really tarred as lobbyists,” Pipes tells the paper. “I don’t think lobbyists have the respect of economists or researchers.”
What do you think? How far should foundations go in pushing for legislative change?
Businesses, lobbyists profit from Texas system
The Dallas Morning News is running a four-part series about Texas’ poor treatment of the vulnerable:
“Texas has long been hard on the weak and vulnerable. It fares badly in national surveys of child poverty, food assistance and care for the mentally ill and disabled.
“But it isn’t only the poor and afflicted who need help; everyone relies on state government for some protection.
“Not everyone receives it.”
The first part looks at the privatization of programs for the poor, disabled and elderly, finding that private companies, lobbyists and former state officials are profiting even as complaints about the programs grow.
Reporter Gregg Jones write about Evercare, a program that is “supposed to coordinate medical and long-term care for more than 80,000 elderly, blind or disabled North Texans.”
Part two of the series, about health care corporations trying to limit public access to information, is scheduled to run Jan. 11 & 12. Part three, focusing on environmental concerns, will run Jan. 18 & 19. Part four, about the high insurance premiums Texans pay for reduced coverage, will be Jan. 25.
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
- Focus on freelancing: Tips for buying liability insurance
- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
