Benjamin: Leaving patients ‘bittersweet’
The U.S. Senate has confirmed Regina M. Benjamin, M.D., M.B.A., to be surgeon general, the Department of Health and Human Services announced.
Benjamin, a doctor who has been practicing in rural Alabama, made news after Hurricane Katrina by rebuilding her rural clinic - and having to rebuild it again after it burned down.
As we noted when Benjamin was nominated, the Associated Press says Benjamin “was the first black woman to head a state medical society, received the Nelson Mandela Award for Health and Human Rights and last fall received a MacArthur Foundation ‘genius grant.’” And “A decade ago, the New York Times called her ‘angel in a white coat,’ a country doctor who made house calls along the impoverished Gulf Coast, paid whatever her patients could scrounge.”
WKRG-Mobile/Pensacola has the news, comments from Sen. Jeff Sessions and reaction from Benjamin:
See President Obama’s announcement in July of Benjamin’s nomination:
Parikh: Malpractice reform’s no cost-cutter
Filed under: Health care reform, Hospitals, Hot Health Headline
Rahul Parikh, M.D., writing on Salon.com, talks about his own tendencies toward defensive medicine and debunks the idea that malpractice suits are driving up costs and pushing doctors toward defensive medicine.
In particular, Parikh targets a Wall Street Journal opinion piece penned by three past AMA presidents. The trio attacks the public option and presses instead for malpractice reform.
Parikh responds:
Their refrain is familiar to anybody following the healthcare reform debate. The only problem is that it’s not true. There’s nothing “sure or quick” about changing medical liability laws that will improve healthcare or its costs. Defensive medicine adds very little to healthcare’s price tag, and rising malpractice premiums have had very little impact on access to care.
He then tackles, point by point, the most common arguments advanced by proponents of malpractice reform.
600-plus Ill. patients drugged without consent
After a review of 40,000+ inspection reports for Illinois nursing homes, the Chicago Tribune’s Sam Roe reports that the paper found 1,200 violations (affecting 2,900 patients) involving psychotropic drugs since 2001. More than 600 patients were drugged without their consent. According to Roe, “The actual numbers are likely far higher because regulators inspect some facilities just once every 15 months, and even then they usually check only a small sample of residents for harm.”
The violations, many of which were caused by a desire to make patients easier to deal with, were “for ‘chemical restraint’ and ‘unnecessary drugs’ as well as cases involving dosages that exceeded safety standards or falls in which psychotropics possibly played a role.”
While some nursing home residents suffer from major mental illnesses, such as schizophrenia, the inspection reports show that many patients harmed by antipsychotic drugs had not been diagnosed with psychosis. They were disabled by Alzheimer’s disease, cancer or Parkinson’s disease. Some were blind or so frail that they could not breathe without the aid of an oxygen tank.
In a follow-up story, Roe reveals that doctors responsible for these dubious prescriptions are not held accountable, even when cited by government entities.
The Chicago Tribune’s full series on nursing home safety can be found here.
Recent workshop
AHCJ’s Aging in the 21st Century workshop, held Oct. 16 and 17 in Miami, addressed many topics raised by the Tribune’s reports, as well as the changing picture of aging Americans and key research and issues related to this growing population. Tip sheets and presentations from that workshop are available to AHCJ members.
Related tip sheets
Aging Nation: Troublesome Health Care Issues
Headlines an advocate for seniors would like to see
The impact of aging upon health care
Covering nursing homes and other issues of aging
How will retiring boomers affect the national health agenda?
You Can Run, but You Can’t Hide: Policy and Problems in Long-Term Care
Biology of Aging: Sources and Resources
Is community research oversight flawed?
Filed under: Government, Hospitals, Hot Health Headline
America’s 400-plus designated Community Research Sites receive much less attention than the massive academic research hospitals, but conduct the bulk of the nation’s cancer research.
The New York Times’ Duff Wilson turns the spotlight on these sites, considering problems an HHS investigation uncovered at an institution in Urbana, Ill., that may show that oversight is lacking and “the community centers may not always be adhering to the rigorous protocols of research medicine that the National Cancer Institute expects them to follow.”
If that’s true, Wilson writes, it will draw the very validity of many research conclusions into question. If you’re curious about the specific nature of the research site’s violations rather than the larger systemic implications, check out the second page of Wilson’s story.
Lopez: Gynecologist gave me permit to buy weed
Los Angeles Times columnist Steve Lopez writes about his trip to a clinic specializing in herbal medicine (known for “writing recommendations that allow folks to buy medical marijuana”).
Photo by Troy Holden via Flickr.After explaining the back pain he’s suffered through for the past few decades, Lopez was issued a form announcing that “Steve Lopez was evaluated in my office for a medical condition, which in my professional opinion, may benefit from the use of medical marijuana.”
The doctor, who described himself as a gynecologist, billed Lopez $150 for the visit.
On Sunday, Lopez will publish a follow-up (his stories are archived here) about his marijuana dispensary shopping experience.
Related
- Lopez, author of The Soloist, was the keynote speaker at AHCJ’s 2008 Urban Health Journalism Workshop.
- Covering Health: Feds issue guidance on medical marijuana
Scans at LA hospital spewed 8x normal radiation
Filed under: Government, Hospitals, Hot Health Headline
On Oct. 8, the FDA issued an alert recommending hospitals review CT scan radiation levels after dangerous doses were detected at an unnamed hospital. The Los Angeles Times‘ Alan Zarembo took over from there, finding that serious radiation overdoses at Los Angeles’ Cedars-Sinai hospital had prompted the warning.
Zarembo followed up with a series of stories on the radiation and its aftermath:
Cedars-Sinai investigated for significant radiation overdoses of 206 patients
Zarembo leads with a summary of what exactly went down at Cedars-Sinai:
More than 200 patients at Cedars-Sinai Medical Center were inappropriately exposed to high doses of radiation from CT brain scans used to diagnose strokes, hospital officials told The Times on Friday.
About 40% of the patients lost patches of hair as a result of the overdoses, a hospital spokesman said.
Even so, the overdoses went undetected for 18 months as patients received eight times the dose normally delivered in the procedure, raising questions about why it took Cedars-Sinai so long to notice that something was wrong.
Class action filed for Cedars radiation patients
Zarembo checks with experts who say the class-action suit filed on behalf of victims has little chance of success because it’s difficult to prove damages, especially since they may not develop for years.
Cedars-Sinai head expresses regret for radiation overdoses
A quick-hit story in which the hospital details exactly what they’ve done to ensure it doesn’t happen again.
4 patients say Cedars-Sinai did not tell them they had received a radiation overdose
Zarembo tracked down patients who said that, while they were contacted by the hospital concerning hair loss, they weren’t informed of radiation overdose or potential cancer risk.
Hospital error leads to radiation overdoses
Zarembo writes that the problem has been traced to a CT scanner reset in early 2008.
Cedars-Sinai radiation overdoses went unseen at several points
In one of the most remarkable moments, Zarembo writes that, before every single scan, technicians were shown a screen indicating, among many other things, the unusually high radiation level. The error was in plain sight the entire time.
Beginning in February 2008, each time a patient at Cedars-Sinai Medical Center received a CT brain perfusion scan– a state-of-the-art procedure used to diagnose strokes – the dose displayed would have been eight times higher than normal. No standard medical imaging procedure would use so much radiation, which one expert said is on par with the levels used to blast tumors.
Somebody should have noticed. But nobody did – everybody trusted the machines.
Related
The New York Times‘ Walt Bogdanich added a broader perspective on the story, adding an additional case and subtly weaving it into the debate about the dangers of medical screening.
Controversy follows medical tourism’s top couple
Reuters’ Brendan Borrell profiles Jonathan Edelheit and Renée-Marie Stephano, the 37-year-old lawyers who founded the Medical Tourism Association in 2007 and have ruled the industry ever since. A growing number of industry insiders are grumbling about the couple and their role as the faces of medical tourism.
They cite the couple’s repeated threats of lawsuits, the accusations of unauthorized and sketchy insurance sales that forced Edelheit to cease operations in the state of Washington, and their powerful annual industry conference which critics say enrich Edelheit and Stephano rather than the association or industry.
Resources
- Tip Sheet - Medical tourism: Trend or aberration
- Article - Health Journalism 2008: Medical tourism - trend or aberration?
- Role of the Internet in medical tourism
- Tip Sheet - Medical Tourism Takes Flight
House holds hearing on brain injuries in NFL
The House of Representatives is holding a hearing on “Legal Issues Relating to Football Head Injuries” that is being webcast on C-SPAN.org.
The witness list includes NFL commissioner Roger S. Goodell as well as the director of the players association, team executives, doctors, neurologists, retired players, families of former players and safety advocates.
Related
The New York Times: NFL Data Reinforces Dementia Links
Bundled payments may improve care, lower costs
Filed under: Health care reform, Health journalism, Health policy, Hospitals
Kaiser Health News’ Phil Galewitz looks at bundling hospital payments, a possible solution to the confusion and cost of separate billing. Under these programs (now in Tulsa and San Antonio, and coming soon to Denver, Albuquerque and Oklahoma City), “Medicare makes a single reimbursement for all the hospital and doctor care for heart and joint procedures, rather than making separate payments to the facility and physicians.”
In theory, the benefits are clear:
Bundling payments moves medical charges away from the traditional fee-for-service system that pays providers separately for individual services — an arrangement critics of the current system say leads to doctors and hospitals delivering more care, but not better care.
It looks like the program’s making a difference. A hospital executive admits the bundled payments make hospitals more reluctant to consult specialists (because the payment from Medicare remains the same and doesn’t rise to meet the cost of a specialist) but says the increased attention to quality brought by the bundling has improved patient care.
Similarly, Galewitz writes that a similar program in the mid 1990s “saved $42.3 million over three years, with costs decreasing from 10% to 37% at the four hospitals participating in the test.”
Deadlines for health journalism awards released
AHCJ has opened its call for entries for the Awards for Excellence in Health Care Journalism, recognizing the best health reporting in print, broadcast and online media.
Last year’s winners included a reporter’s revelation of astonishing conflicts of interest by scientists advocating for early detection of lung cancer, the exploration of a hidden world of illegal prescription drugs sold at swap meets, a narrative on a mechanic seeking to rebuild his life after an accident severed his arms, and a trip into the nightmarish world of a boy struggling with mental illness.
Entries can include a wide range of health coverage including public health, consumer health, medical research, the business of health care and health ethics.
The contest was created by journalists for journalists and is not influenced or funded by commercial or special-interest groups.
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Spend a week at the CDC studying public health, meeting sources. Apply for the AHCJ-CDC Health Journalism Fellowships today!
- Reporting on the intersection of health, environment
- Tip sheet: Covering cuts to Medicare reimbursements
- Briefing: Reporting on health reform between now and 2014
- Covering high-risk insurance pools: Tips for reporters
- Health care reform has passed: What's next?
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
