Oprah’s health advice needs a shot in the arm
In Vital Signs at Salon.com, Rahul K. Parikh, M.D., writes about the lack of balance and medical evidence in the health advice offered on Oprah Winfrey’s television show.
Parikh points to recent guest Suzanne Somers, advocating bioidentical hormones. He says Winfrey failed to ask any tough questions about Somer’s history of breast cancer, her hysterectomy or the validity of her sources.
Winfrey’s health advice on other issues has also raised concern, according to Parikh. Winfrey has a development deal with actress Jenny McCarthy, who has “been leading an ideological, unscientific crusade against childhood vaccines.” Winfrey also has promoted cosmetic procedures without discussing potential problems and has done a show on which an “expert” said thyroid problems are “the result of a woman’s inability to assert herself.”
It’s certainly not news that Winfrey has strayed far from her journalistic roots but Parikh’s point that, given her influence, she should offer more solid evidence and balance, is well taken. It’s also a good reminder of the value of journalists who stick to the evidence and continue asking the tough questions.
NYC public health chief Frieden will head CDC
Thomas Frieden, M.D., M.P.H., the New York City health commissioner who has worked to reduce smoking in New York and banned trans-fats in restaurants, has been picked to lead the Centers for Disease Control and Prevention.
Thomas Frieden
Jacob Goldstein, on The Wall Street Journal’s Health Blog, discusses some of Frieden’s accomplishments. Jennifer 8. Lee of The New York Times lists some of the immediate issues Frieden will face at the CDC.
The American Public Health Association calls Frieden an “excellent choice” for the job and says he “has demonstrated an unwavering commitment to protecting the public’s health.”
Maggie Fox, health and science editor at Reuters, points out a number of possible consequences and reactions to Frieden’s appointment.
A statement from Frieden on the New York City Department of Health and Mental Hygiene lists accomplishments from the past seven years.
John Tierney, in The New York Times, takes a more skeptical view of Frieden’s work, focusing on his initiative to cut sodium intake. He says the city of New York is automatically enrolling “everyone in the experiment” and that Friedan already knows the “experiment’s outcome.” Tierney cites scientific uncertainties about the benefits of reducing sodium intake.
Paid patient spokesman blows whistle on drugmaker
An old journalism professor once told me, “If your mother says she loves you, check it out.” Same goes, unfortunately, for patients praising their treatments. Some are being paid to do so.
A front-page story in The Wall Street Journal pulls back the curtain on paid endorsers with a profile of Andy Behrman, who suffers from bipolar disorder. Bristol-Myers Squibb gave him $400,000 for testimonials about Abilify, an antipsychotic.
In a company video, Behrman says he experienced no side effects when taking Abilify, unlike other drugs he had tried. But he’d only taken Abilify for four days before shooting the video. Within a year he discontinued the medicine after side effects, including dazed spells, became too much for him. Even so, he continued talking favorably about Abilify.
The company disputes many of Behrman’s claims and tells the paper that “its experience working with patients has been uniformly good,” including an ongoing campaign featuring patients’ stories about prevailing over disease.
Philip Dawdy, a journalist who blogs about mental illness, offers an alternate explanation, based on his own experience. “The mental health system and mythologies around mental disorders are so strong that longtimers like Behrman and I often became trapped by them,” he wrote on Furious Seasons. “It’s like we were taught to forget about our bodies in deference to mood control. Perhaps with that in mind, you might understand why Behrman was slow to rage against problems caused him by Abilify.”
For more, watch this WSJ video, which includes snippets from Behrman’s work for Bristol-Myers.
Dental health care disparities overlooked
Filed under: Hot Health Headline, Pharmaceuticals
Guy Boulton of the Milwaukee Journal Sentinel investigates the “lack of access to dental care for children and adults on limited incomes,” calling it “one of the most entrenched, widespread and overlooked problems of the U.S. health care system.”
Eric Eyre, who did award-winning coverage of West Virginia’s dental health problem, shares his insights and reporting methods, as well as starting points and key sources. Eyre’s article includes a link to a questionnaire about how the story was reported, a dentist’s presentation on the “Status of Oral and Visual Health in Rural America” from AHCJ’s 2008 Rural Health Journalism Workshop and an MP3 of the discussion at that workshop.
In Wisconsin, Boulton reports, the state Medicaid program for low-income families pays less than private insurers and is thus accepted by few dentists around the state. Boulton takes an in-depth look at the deficiencies of the state program and of HMOs and finds that the state’s not yet doing enough to address the problem.
Among the things Bouton discovered: “The results can be seen in young adults: 42% of all new military recruits cannot be deployed until they receive dental care.”
Ashton: Physicians at forefront of medical media
Jennifer Ashton, M.D., the new medical correspondent for CBS News, asserts that “when you look at the people who are really at the forefront of medical media and the medical correspondents, they are physicians” in an interview for Columbia News Tonight, produced by the Columbia School of Journalism in New York.
Ashton, a practicing physician, also says that she thinks the things that make a good doctor are the same things that make a good medical correspondent. “You can do it well without the MD but I think again its like learning or knowing a foreign language and going to that country. It really puts you one step ahead of the game.”
Gary Schwitzer, of HealthNewsReview.org and the University of Minnesota, disagrees with Ashton.
Washington Post launches health reform blog
The Washington Post has announced the Daily Dose, a blog they call a “one-stop source on the biggest policy debate brewing today.”
In the inaugural post, the bloggers promise “the latest news and analysis, facts and figures, and even a bit of gossip on how the inside-the-Beltway crowd is attempting to reshape an industry that accounts for one-sixth of the U.S. economy.” The same post promises that the paper’s reporters and columnists will also use the blog’s pages to weigh in on health reform issues.
Posts so far include profiles of power players like Kathleen Sebelius and Peter Orszag as well as reports and analysis of reform-related news.
‘Virus hunter’ stays ahead of outbreaks
Writing for Men’s Journal, Tom Clynes followed Nathan Wolfe — the virological and epidemiological equivalent of a rock star — to remote regions of Cameroon (PDF), one of the raw frontiers in the transmission of disease between animals and humans and the place where some scientists believe HIV may have made its way to humans more than a century ago.
Supported by generous grant funding from heavyweights like Google.org and the United States Department of Defense, Wolfe travels the world visiting places — from East Asian poultry and wild animal markets to bush meat hunters in central African rain forests — known as hotbeds of animal-to-human disease transmission. Clynes’ sometimes-graphic account follows Wolfe, head of the Global Viral Forecasting Initiative, as he visits African subsistence hunters to take blood samples and to educate them about safe hunting practices.
Clynes writes that Wolfe has pioneered a new, immersive model of disease detection that gives him a fighting chance of detecting the next big human pandemic before it gets out of control.
GVFI’s method flies in the face of the “parachute science” approach that has long typified data collection in the Third World. Wolfe thinks he’s got the system down, and he believes that, with the right collaborators, his model can be scaled up and repeated anywhere in the world.
Working like this, one village at a time, Wolfe has quickly accumulated one of the most comprehensive blood collections on Earth, some 25,000 human and 16,000 animal samples that are available to researchers around the globe. “I can guarantee that these repositories of samples will be treasure troves of information for the future,” says Michael Worobey, of the University of Arizona.
The global health community believes the dangers Wolfe and his team and others in the field are working to detect are very real, lending an urgency to GVFI’s work.
The SARS outbreak killed more than 700, but it could have been far worse. A massive international containment effort, led by the WHO, averted a doomsday scenario and quickly controlled the outbreak. What worries people like Dr. Michael Ryan, coordinator of the WHO’s Global Outbreak Alert and Response Network, is that SARS may have been just a rehearsal for something worse. “We winged it with SARS,” says Ryan, “and we got away with it, because the core countries had the capacity to deal with it. But if SARS had happened in rural Africa we’d still be dealing with it. And I think it’s inevitable that we’ll be hit with something new that will be harder to put back in its box.”
Top N.Y. neurosurgeons suspended, sued
Heidi Evans of the New York Daily News has followed the story of a pair of embattled New York neurosurgeons, high profile doctors who earned a combined $10 million a year, since the story broke on May 6. The North Shore University Hospital surgeons, Thomas Milhorat and Paolo Bolognese, were recently suspended for what Evans described as “abandoning a patient in the operating room after she was anesthetized and prepped for brain surgery” and are the target of a lawsuit alleging they used experimental treatments that may have made some patients’ conditions worse. Milhorat, the state’s highest-paid surgeon, has since retired from dealing with patients and moved to full-time research duty.
Evans’ coverage has been persistent and thorough:
- Brain surgeons Thomas Milhorat, Paolo Bolognese suspended for abandoning anesthetized patient in OR
- Suspensions extended for brain surgeons who stranded patient in operating room, says hospital
- State’s highest-paid surgeon steps down after leaving patient on table in brain surgery no-show
- Embattled neurosurgeon Thomas Milhorat’s son comes to dad’s defense
- Family sues North Shore University Hospital, neurosurgeons for ‘experimenting’ on kid
- Woman abandoned in operating room by brain docs felt betrayed, humiliated
Some background, from Evans’ first story:
The (two-week suspension for both doctors) came a week after the disturbing April 10 incident when Bolognese was scheduled to operate on a female patient, sources told the Daily News.
Frantic staff looked for him, but he was nowhere to be found.
The patient’s head was shaved, anesthesia had been administered and she was laying out cold on the OR table near a table of sterilized instruments waiting to be used. Milhorat was then called, but he refused to do the surgery because the patient wasn’t his.
No other surgeon apparently was available, and the surgery did not take place.
The doctors founded the hospital’s Chiari Institute, dedicated to the treatment of a rare brain condition. Their suspension and Milhorat’s resignation have incited strong reactions on both sides, with Evans’ story about Milhorat’s son representing one extreme and a story about the ‘devastated’ Idaho family of a 4-year-old patient representing the other. The stories’ comment sections are all worth a read, as they help illustrate the passion of the debate. Dozens of former patients and their families express support for the surgeons and question Evans and those commenters whose support for the doctors isn’t so evident.
Urological group pushes PSA screenings
Filed under: Conflicts of interest, Hot Health Headline
The Cancer Letter’s Paul Goldberg reports that the American Urological Association released a list of best practices that included beginning prostate screening at age 40 (see page 3 of this PDF for the announcement).
It came, Goldberg reports, “Less than a month after the New England Journal of Medicine published trial results that point to overdiagnosis and low or no benefit from screening men over the age of 50.” The American Cancer Society says it “does not support routine testing for prostate cancer in men at average risk at this time.”
Meanwhile, Cancerwise’s Julie Penne looked at the American Urological Association’s partnership with the NFL and a Houston event at which partnering doctors screened 37 men between the ages of 31 and 77.”
Recently, M. D. Anderson and the American Urological Association (AUA) teamed up to screen 37 NFL retirees from the Houston area as part of a 10-city series that the NFL Player Care Foundation initiated to address the medical needs of retired players. The M. D. Anderson screening… was the seventh site in the year-long tour that has held screening events in Kansas City, Atlanta, Dallas, Tampa Bay, Washington, D.C., and Canton, Ohio, the home of the NFL Hall of Fame.
Other than a UPI story and the aforementioned blog post, the initiative doesn’t seem to have attracted much attention, though University of Minnesota professor and AHCJ member Gary Schwitzer posted his reaction. Unfortunately, overshadowed by H1N1, the AUA’s new guidelines and the controversy surrounding them have gotten little attention as well. The Los Angeles Times‘ Shari Roan offers a roundup of the issues.
FDA chides Cheerios maker for drug claims
If you’re concerned about your health, avoid foods that make health claims. That’s the tart, counterintuitive advice from the thoughtful journalist and food thinker Michael Pollan.
How come? A health claim on a product, he says,”is a good indication that it’s not really food, and food is what you want to eat.” The problem for shoppers is that makers of processed food barrage consumers with promises of health tied to eating this product or that.
Enter Cheerios, a staple of breakfasts for generations. In recent years, General Mills, the cereal’s maker, has taken to marketing the toasted oat cereal as if it were the simple solution for managing high cholesterol and heart disease. The Cheerios box chirps: “Did you know that in just 6 weeks Cheerios can reduce bad cholesterol by an average of 4 percent?”
Well, the marketing claims for the little O’s sounded so much like a direct-to-consumer drug ad that FDA just slapped the company with a warning letter that said drop the hype or prove the cereal affects disease, just the way drugmakers have to.
General Mills stands behind the Cheerios box, saying in a statement, “The science is not in question.”
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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
