Why young docs shun practicing in rural America
Filed under: Health journalism, Hot Health Headline
For a look at the quotidian struggles facing young doctors who accepted federal loan aid in exchange for a three-to-five-year commitment to practicing in underserved rural areas, The Washington Post’s Darryl Fears profiles a 33-year-old, Northwestern-trained doctor working as the only full-time physician at a practice in rural Virginia.
Having learned her trade in a world of electronic medical records and iPhone diagnostic apps, the physician is at sea in a world of paper records, dial-up Internet and 40-mile drives to the full-size grocery store. There are few dating prospects, and even less culture. She’s not convinced that she’ll stay in town beyond her initial commitment.
Retaining these young, eager physicians is the next big challenge facing the stimulus-boosted National Health Service Corps, which placed thousands of doctors in rural areas last year, and is gearing up to do the same this year.
Related
Rural Health Journalism Workshop: Speaker presentations
CDC releases 2007 foodborne illness numbers
In the latest Morbidity and Mortality Weekly Report, the CDC has released the 2007 numbers on foodborne illness in the United States. Norovirus (39 percent) was the most common culprit, followed by Salmonella (27 percent). In terms of illnesses caused, poultry led the way, followed by beef and leafy greens. In the majority of the 1,097 reported outbreaks of foodborne illness, no agent was identified – a fact the CDC attributes to the small scale of many of those outbreaks. Here’s a breakdown of what investigators managed to find:
Those looking to dig a little bit deeper into the numbers should consult this four-page PDF, which breaks it all down by contaminant, food, number of outbreaks and number of illnesses caused.
Resources for covering food safety
Tip Sheets
- Lifting the shroud: Using multiple-cause-of-death data
- FDA Reform: The Time Has Come (Nancy Donley presentation)
- Why Is It So Difficult to Prevent Foodborne Illnesses? (Michael Doyle presentation)
- Reporting on the intersection of health and the environment
- Fatal Food: A study of illness outbreaks
Websites
- Center for Infectious Disease Research & Policy
- Outbreak Alert! Database
- Center for Food Safety and Security Systems
- FoodRisk.org
Related
- Recent stories and studies on foodborne illnesses
- Video study finds risky food-safety behavior more common than thought
- Airlines delay testing of onboard water
- A selection of stories about a 2008 salmonella outbreak
- Private companies, not the FDA, increasingly perform food safety inspections
Member’s book for nurses is published
“Anatomy of Writing for Publication for Nurses,” written by AHCJ member Cynthia Saver, R.N., M.S., has been published by Sigma Theta Tau International. Saver is the president of CLS Development Inc., an editorial consulting firm.
Send us your latest news
Got a new job? Earned a promotion? Won an award or fellowship? Just published a book? AHCJ members are encouraged to share your news by sending it to info@healthjournalism.org. Member news items are published on Covering Health and in HealthBeat, AHCJ’s newsletter.
Tougher concussion rules from high school assn.
The National Federation of State High School Associations has released tougher rules about removing players with potential concussions from the field. The initial release outlines the changes:
Photo by Les_Stockton via Flickr
The previous rule directed officials to remove an athlete from play if “unconscious or apparently unconscious.” The previous rule also allowed for return to play based on written authorization by a medical doctor. Now, officials are charged with removing any player who shows signs, symptoms or behaviors consistent with a concussion, such as loss of consciousness, headache, dizziness, confusion or balance problems, and shall not return to play until cleared by an appropriate health-care professional.
The Tampa Tribune’s Mary Shedden and Katherine Smith reported on how the change would affect Florida high school football and on how implementations of the new rule vary from district to district.
Language in the new rule is vague, stating a player can’t return until cleared by a “health-care representative.” In Hillsborough and Pinellas counties, players will need a doctor’s clearance, but Pasco officials may interpret the rule to include medical officials who were at the game, said Phil Bell, Pasco’s supervisor of athletic programs and facilities.
The best-known guidelines for returning to the game come from a sports medicine expert consortium in Zurich. It recommends athletes gradually return to activities, from light aerobic activity to noncontact drills to game day. Each step takes a minimum of 24 hours, and if symptoms return, an athlete must revert to the previous step.
Texas, Oregon and Washington have state laws mandating when players should be taken off the field; many other states rely on their athletic associations to format such rules. With the school year and football season getting under way, this would be a good time for reporters to check on the policies at local schools. Read more about concussions, including some recent reports and Congressional testimony.
Forum offers stats on well-being of elderly
Filed under: Government, Health data, Health journalism, Studies, Tools
AgingStats.gov is an often-overlooked federal clearinghouse of aging-related data from the Federal Interagency Forum on Age-Related Statistics. It focuses on summary reports.
Its latest effort, Older Americans 2010: Key Indicators of Well-Being (174-page PDF), summarizes 37 key indicators it believes are broadly relevant and easy to understand. By my count, 24 of those are explicitly health-related.
Everything is illustrated with an abundance of charts and maps, and an emphasis on bulleted summary and analysis helps keep things accessible. Those looking for a deeper dive into the summary numbers will want to head to the appendix.
As part of its health sections, the report contains seven “Health Status” indicators, including chronic health conditions, depressive symptoms, sensory impairments and oral health, and functional limitations.
One example:
It also includes eight “Health Risks and Behaviors” – things like diet, air quality, mammography and vaccinations – and nine “Health Care” indicators, including expenditures, prescription drugs and residential services.
The forum, which nobody seems to refer to by the acronym FIFARS, has been around since 1986. Participants include the Census Bureau, a number of Health and Human Services departments (AHRQ, CMS, NCHS and others), HUD, the Bureau of Labor Statistics, the Department of Veterans Affairs, the EPA, the Office of Management and Budget, and the Social Security Administration.
Thanks to AHCJ member Eileen Beal for suggesting this as a tool other members might find helpful.
Fraud-busting contractors slow to refer cases
Despite recent high-profile busts, the private contractors hired by Medicare to sniff out fraud cases and refer them to law enforcement seem to be lagging, according to recent government reports. The Associated Press’ Ricardo Alonso-Zaldivar reported on investigations that found that contractors took an average of 178 to refer fraud cases, and that the government was only able to recover a small fraction of the money identified as lost to fraudsters (OIG report | Testimony).
As this letter summarizing the congressional investigation shows, Iowa Sen. Chuck Grassley is on the case. He’s looking to figure out how much the fraud hunters are paid ($102 million in 2005) and how that balances with their benefit to taxpayers ($55 million recovered by the feds in 2007). The numbers are tricky, Alonso-Zaldivar writes, because fraudulent claimants have a habit of closing up shop and disappearing as soon as they’re notified of the pending investigation. Thus, the fraudbusters can’t be blamed entirely for the collection failures, though their tardy referrals are at least partially responsible.
The contractors have widely different track records. One identified $266 million in overpayments in 2007, while another found just $2.5 million, the Health and Human Services inspector general said in May.
Earlier, the inspector general found gaping differences in the number of new cases the contractors generate for law enforcement. Some had hundreds of cases, while others were in the single digits. Most were doing a poor job at spotting new fraud trends, with “minimal results from proactive data analysis,” the inspector general concluded.
The Obama administration says it’s aware of the problem and is close to completing a reorganization of the contractors, to consolidate their work, define their jurisdictions more clearly, and help them coordinate better with claims processors and law enforcement.
The new “Zone Program Integrity Contractors” will cast a somewhat wider net, and be more closely monitored by federal health officials.
Related
- Investigating health care: Essential public records
- Duff Wilson: Investigating health care fraud
- Reporting on the business of health care
- Center for Public Integrity writer says listserv led to Medicare-fraud story
(Hat tip to Ricardo-Alonzo Zaldivar for providing a copy of the Grassley letter)
Report looks at oil-spill fallout for children, families
Filed under: Children, Hot Health Headline, Studies
As the gulf oil spill dragged on, coverage of its psychological and economic aftermath gained momentum. Now, Poynter’s Al Tompkins has spotlighted coverage of what is sure to be a flood of follow-up reports and post-mortems. Based on research conducted from July 19 through 25 (the well has been effectively capped since July 15), the National Center for Disaster Preparedness at Columbia University has released its “Impact on Children and Families of the Deepwater Horizon Oil Spill,” subtitled “Preliminary Findings of the Coastal Population Impact Study.”
Photo by kk+ via Flickr
As Tompkins points out, the study has already pulled in significant media coverage. Shaila Dewan’s story in The New York Times, for example, covered both specifics and context:
“There’s been a very overt effort by BP and the Coast Guard to project a sense that the crisis is over, but this is far from the case,” said Dr. Irwin Redlener, the director of the center and president of the Children’s Health Fund, a sponsor of the survey. “Our survey shows a persistent and overwhelming level of anxiety among families living near the coast, driven by both medical symptoms in their children as well as a substantial level of psychological stress.”
The survey included 1,200 coastal residents in Louisiana and Mississippi, most of whom live within 10 miles of the ocean.
One in five reported that their household income had dropped since the spill. Forty-three percent said they had been directly exposed to oil, either at beaches, on their property or in helping with the cleanup. Those who had been exposed were more than twice as likely to report that their children had developed physical or mental health problems since the spill. Also, families that had more concerns about their children’s mental health were more likely to report that they are considering moving.
Related
- For psyches, Gulf is Valdez on ‘fast forward’
- CDC says monitoring system finds no ill from spill
- Mental health impact of the BP spill multiplies
- Resources for reporting on health and the oil spill
- Assessing the Effects of the Gulf of Mexico Oil Spill on Human Health: A Summary of the June 2010 Workshop
- Tip sheet: reporting on the intersection of health, environment
- CDC Emergency Response and Preparedness
- A recent Dart Centre Europe panel looked at covering the human consequences of environmental disaster.
- Grief in the Gulf: Tanya Paperny writes about the challenge of reporting a slow-motion disaster.
- Dart Center resources for covering the Deepwater Horizon Spill
Sapien wins award for natural gas impact coverage
An investigation into the environmental impact of natural gas drilling, conducted by AHCJ member Joaquin Sapien and his ProPublica colleagues Abrahm Lustgarten and Sabrina Shankman, earned a second place, print, Kevin Carmody Award for Outstanding Investigative Reporting in the Society of Environmental Journalists’ Awards for Reporting on the Environment.
Photo by arimoore via Flickr
In its announcement of the award, SEJ cited four particular entries in the extensive series (64 parts!), including Sapien’s “With Natural Gas Drilling Boom, Pennsylvania Faces an Onslaught of Wastewater.”
This exhaustive ProPublica series into the environmental impact of natural gas drilling on water resources raised public awareness of an important, but largely overlooked, environmental issue and helped to spur politicians to action. The methodical and well-written stories were easily understandable, neatly melding the human experience with the investigative paper chase. Importantly, the series exposed not just problems, but also pointed to solutions.
Hospital infections on rise in Nev., reporters find
Filed under: Health journalism, Hospitals, Hot Health Headline
Part two of Marshall Allen and Alex Richards’ Las Vegas Sun hospital investigation series “Do No Harm” takes on hospital-acquired infections. Even though no agency in the state tracks such things, the duo managed to find 2,010 instances of drug-resistant bugs in local hospitals between 2008 and 2009. That number included 647 instances of hospital-acquired MRSA.
In the story, the explain how they overcame industry resistance to dig up the data themselves:
No health agency tracks these cases. In fact, hospitals derailed proposed legislation in 2009 that would have required them to publicly report cases of MRSA in their facilities.
However, hospitals are required by law to submit to the state billing records based on each patient visit. The Sun obtained that information from 1999 to 2009 and analyzed the 2.9 million hospital billing records as part of its two-year investigation, “Do No Harm: Hospital Care in Las Vegas.”
Because of how the records are coded, the Sun was able to identify the number of infections by the two bacteria, and for the years 2008-09 further identify the cases in which the records say the patients acquired the bacteria while hospitalized.
While it’s hard to put their numbers in a national context because of widely varying methods of measurement and reporting, the duo can say that such infections jumped 34 percent from 2008 to 2009. Allen and Richards then establish two facts:
- Some institutions have developed ways to keep MRSA and friends under control.
- None of those institutions are in Las Vegas, where inspections show that hospitals could be doing a lot more.
Efforts to force Nevada hospitals to disclose MRSA cases withered under heavy industry opposition, though the legislature is now considering a watered-down version that would not public the MRSA rates of specific facilities.
It’s worth noting that the paper has published responses from readers who have plenty of their own hospital horror stories. The website includes their input both in text and through excerpts of some of the voicemails Allen has received since the first part of the series was published. They are heart wrenching but serve as an excellent example of how reporters can involve readers in a project.
Conference walks back description of partnership with heart news website
A medical conference has retreated from a claim suggesting a trade website was being used to promote it and that supporters would be able to “reach new audiences” through a partnership between the conference and the website.
The 2010 Dallas-Leipzig International Valve conference has issued a correction after it came to light that it was promoting its partnership with theheart.org as a “highly influential source of publicity” and said theheart.org will “cover the benefits of attending DLIV 2010; it will forecast key aspects the meeting will offer; it will report on the highlights of the two-and-half day event - and more.”
Conference organizers have since posted the following note on its website (emphasis added):
Given the success of DLIV 2009 and its potential to grow in years to come, the meeting organizers have partnered with theheart.org to promote DLIV through their banner advertisements and e-blasts. [Correction: the previous material erroneously stated that industry would have the opportunity to gain exposure through theheart.org's news and editorial programs: this is incorrect, and the meeting organizers apologize for the error. theheart.org had no other involvement with DLIV's offers to industry.]
Shelley Wood, managing editor for Heartwire news and theheart.org, said, “There is a firm firewall between news activities and any advertising or sponsored content on theheart.org and at no point would outside parties be able to dictate the news or editorial content of theheart.org.” She pointed out theheart.org includes a staff of seven journalists.
Larry Husten, on his CardioBrief blog, pointed out details about sponsorships at the conference, including the opportunity for supporters to pay large amounts of money to meet with faculty members. He noted that its website linked to an Industry Prospectus, a document listing opportunities for exhibitors and sponsors. Sometime after he published the post with a link to the Industry Prospectus (now archived on Husten’s site), conference organizers removed it from the website.
In the prospectus the conference announced its partnership with theheart.org:
Given the success of DLIV 2009 and its potential to grow in years to come, theheart.org recognizes the impact the meeting has in the field of cardiac care. Through its website, online blog and print publications, theheart.org will cover the benefits of attending DLIV 2010; it will forecast key aspects the meeting will offer; it will report on the highlights of the two-and-half day event - and more.
With this highly influential source of publicity, DLIV 2010 offers to its supporters new benefits. By participating in DLIV 2010, you will not only reach the physician leaders who attend the meeting; you will also have the opportunity to make contact and establish relationships with a worldwide audience. Don’t miss out on the chance to reach new audiences, gain additional media benefits and connect your company with the specialty source for news and information.
Theheart.org’s editorial policy says it is committed to providing “balanced, accurate health information” and it “employs editorial professionals who are responsible for content selection, development and maintenance process.” It says it discloses “sources of funding and site contributors’ possible conflicts of interest.” It also says it complies with the HONcode standard for health information (more here).
It should be noted that Husten (aka @cardiobrief on Twitter) is the former editor of theheart.org, something he is quite open about.
Related
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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
