Gorman takes job with Scientific American
AHCJ member Christine Gorman (@cgorman) has been announced as a new editor at Scientific American, where she’ll work primarily on health and medical features.
From the release:
Christine Gorman began her publishing career at Time magazine, where she worked for more than 20 years in the business, nation, science and health sections. She inaugurated the magazine’s personal health section, which won awards from the National Press Club and the Deadline Club. Her cover stories, which addressed such topics as AIDS, anxiety, cancer, diabetes and sleep disorders, consistently ranked among the magazine’s top sellers each year. Gorman received a 2008 Nieman Fellowship to study global health at Harvard University, followed by a three-month reporting trip to investigate the nursing crisis in Malawi.
At the same time, the magazine announced the appointments of book section editor Anna Kuchment and blog and community editor Bora Zivkovic. You can find Gorman’s personal site here.
Reporters urged to insist on response from federal agencies
Filed under: Government, Health journalism, Public records
When the FDA would offer only “no comment” on a notorious incident last summer, Felice J. Freyer, a medical writer at The Providence (R.I.) Journal, was disappointed but not surprised. She published her story about an FDA matter (the use of unapproved IUDs) without the FDA’s input.
But Freyer became concerned when, four days after her story came out, the FDA posted on its website a “consumer update” that answered some, but not all, of the questions she had posed to the agency.
“Turns out the FDA’s position was not the ‘no comment’ I received,” Freyer wrote in an account of the incident posted on the AHCJ website.
FDA headquarters in White Oak, Md.
(Photo by thisisbossi via Flickr)
“I don’t think the FDA had anything major to hide,” Freyer added. “It seemed like the agency just couldn’t be bothered with my questions, preferring to focus on a statement for release on its own time.”
But the web-only consumer advisory left questions unanswered and probably reached few consumers.
Freyer, who is an AHCJ board member and chair of AHCJ’s Right to Know Committee, complained about the incident, pursuing the matter up the chain of command. She eventually received an apology, but little by way of explanation. She is sharing her experience in the hope of encouraging other reporters - especially the beleaguered folks who work for the regional media - to persist in seeking information from the federal government.
“The Obama Administration has done some admirable work posting user-friendly information on the Internet,” Freyer said. “But as long as the administration’s press officers ignore and deflect reporters’ questions, the government’s websites begin to function like a state-sponsored press, containing only the information the government wants to share, forever impervious to questioning.
“I urge my fellow journalists to push back against this trend.”
Hirsh files from ‘health journalist heaven’
Filed under: Health journalism, Member news, Public records, Tools
For the past few days, Consumer Reports‘ Jamie Hirsh has been filing dispatches from what she calls “health journalist heaven,” otherwise known as the National Library of Medicine in Bethesda, Md. She and five other health reporters were there on an AHCJ-NLM Health Journalism Fellowship.
The National Library of Medicine in Bethesda, Md. Photo by rex libris via FlickrNot only is it the largest medical library in the world, Hirsh writes, it’s also relatively immune to nuclear attack, courtesy of an underground vault. Also, thanks to exhaustive databases of both research and clinical trials, it’s also a spectacular resource for health journalists.
Pharmaceutical spending varies geographically
Filed under: Hot Health Headline, Pharmaceuticals, Studies
The New England Journal of Medicine has examined geographical variation in Medicare drug spending, an area the authors said previous analyses hadn’t addressed. They used data from Medicare Part D and adjusted for local cost variations and other factors. You can find their nifty maps here and here.
Eileen Beal, the AHCJ member who suggested this report, reminds us that “While the report is specifically focused on Medicare spending, since that’s a major indicator of/for drug spending in general the report is probably going to be good background and resource material for AHCJ members covering healthcare cost/delivery.”
Their main findings, as summarized from the report:
- Pharmaceuticals account for more than 20 percent of total Medicare spending, and drug spending “varies substantially among hospital-referral regions, with the highest-spending region spending 60 percent more per beneficiary on pharmaceuticals than the lowest. This variation is driven by variation in both the drugs prescribed and the number of prescriptions filled each month, with physicians in higher-spending areas prescribing both more drugs and more expensive drugs.”
- It does not, however, vary as much as other medical spending. This difference, though, isn’t enough to really lower the total spending variation, even when drugs are taken into account.
- “Pharmaceutical spending and medical (nondrug) spending are only weakly correlated across hospital-referral regions.”
And, the conclusion:
Thus, areas with high medical spending do not have offsetting lower pharmaceutical spending; in fact, if the coding practices in different regions are not too dissimilar, the substantial variation in pharmaceutical spending does not seem to be strongly associated with variations in medical spending at all.
Beal says she learned about the report from the Public Policy & Aging e-newsletter.
In addition to lives, checklists save money
Filed under: Health data, Health policy, Hot Health Headline, Studies
Last year, Atul Gawande and company made a splash by showing what a profound clinical impact checklists made on patient outcomes. Now they’re back, but this time the checklist evangelists are aiming for the pocket book. In the latest Health Affairs, Gawande and seven others contributed a paper with the descriptive title “Adopting A Surgical Safety Checklist Could Save Money And Improve The Quality Of Care In U.S. Hospitals.”
Photo by cybrjoe via FlickrHere’s their arithmetic, courtesy of The Boston Globe’s Elizabeth Cooney
Time was the biggest cost in setting up the checklist, Gawande and his co-authors write in the journal Health Affairs. They estimated that a hospital with at least a 3 percent rate of complications per year would begin to see savings after five major complications were prevented. That means a hospital where 4,000 noncardiac operations were done each year could save about $25 on each procedure, or about $100,000 annually, they concluded.
As always, free access to Health Affairs studies is one of many perks enjoyed by AHCJ members.
Aussie researchers find value in health reporters
In Croakey, Melissa Sweet explains a new study about coverage of avian flu by Australian media and how it demonstrates the benefits of using specialized beat reporters to cover health stories. The study approaches the coverage from a public health communication angle, and addresses head-on concerns that the media has been a menace to public health with its reckless disregard for actual evidence.
Among other things, it notes that reporters seem to be genuinely dedicated to honest and effective reporting, which often puts them at loggerheads with editors and producers, groups which must be cognizant of what the report euphemistically calls “economic and structural imperatives.”
See Sweet’s post for more details but here are some of the highlights:
- reporters shared the same concerns as health professionals about the depth, accuracy and social impact of their reporting.
- specialist health and medical reporters had much greater capacity to produce better quality health stories.
- specialist reporters had a significant gatekeeper role for letting stories in, and keeping them out, of the paper. As one newspaper medical reporter said:If all I’ve done all day long is keep three really crap stories out of the paper then I consider I’ve done a good day’s work. And sometimes that can be quite a lot of work if somebody higher up than me has got “themselves all ignited about something. Then there’s a lot of work to do to hose people down and to bring these things round.”
Croakey is, of course, the health blog of Crikey, an Australian online magazine based in Melbourne.
In another study of health journalism, just published in PLoS Medicine, researchers found that stories written by health journalists were “superior to those written by other groups.” This study also looked at stories from news organizations in Australia.
The researches point out that, given economic considerations, editors might be tempted to use stories from wire services, foreign media outlets or other news organizations for their health coverage, however, they caution that editors should choose carefully because AP achieved fairly high and consistent ratings, whereas AFP had significantly lower average scores.
Ethics professor takes on clinical trials, marketing
Filed under: Hot Health Headline, Pharmaceuticals
Writing for Mother Jones, University of Minnesota medical ethics professor Carl Elliott digs into the Dan Markingson story first covered by St. Paul Pioneer Press reporters Jeremy Olson and Paul Tosto. Elliott works at the same institution as the physicians who who administered a Seroquel trial that the 26-year-old was enrolled in when he committed suicide.
Given his teaching field and institution, it’s not surprising that Elliot couldn’t stay away from the Markingson story.
…the more I examined the medical and court records, the more I became convinced that the problem was worse than the Pioneer Press had reported. The danger lies not just in the particular circumstances that led to Dan’s death, but in a system of clinical research that has been thoroughly co-opted by market forces, so that many studies have become little more than covert instruments for promoting drugs. The study in which Dan died starkly illustrates the hazards of market-driven research and the inadequacy of our current oversight system to detect them.
Elliot goes after the idea that the new wave of anti-psychotics was any safer than its predecessors, then explains the clinical trial manipulations he says were used to claim they were.
From there, Elliot takes on the use of clinical trials for marketing purposes. Clinical trials can be dangerous, which is theoretically acceptable if they have the potential to advance medical care. But what if patients are just being exposed to those dangers in an effort to sell more drugs?
Yale doc knows the right data is out there
Writing for Forbes Magazine, Matthew Herper profiles Harlan Krumholz, the pioneering quality of care researcher and Yale cardiologist. During his career, Krumholz, 52, has been at the leading edge of everything from Hospital Compare and angioplasty delivery times to recent headline grabbers like the Vioxx suit and the 2009 study on radiation exposure during routine scans. The highlight of the profile comes when Herper highlights Krumholz’ knack for picking out just the right metrics with which to hold feet to the fire.
Harlan M. Krumholz, M.D.
By figuring out what to measure and how, he showed that even top hospitals were systematically underperforming, largely because no one was tracking the results.
…
Krumholz’s basic idea is that if you ask the right question and pick the right measurement, you can figure out a way to get the answer, often using billing records or existing databases. This frequently involves partnering with insurers or Medicare. He has a knack for focusing on performance metrics that hold hospitals accountable.
The real challenge for Italian health care
Changes are on tap for the Italian health care system. Standard health care costs will be defined, which means determining the amount necessary to keep Italians healthy, starting with what “virtuous regions” spend, (meaning those regions with their balance sheets in order: Emilia-Romagna, Lombardy, Tuscany and Veneto). A saving on standard costs of at least 4 billion euro is expected.
Gianluca Bruttomesso
Right now, Italy spends less on health care than 15 other European nations, which allocate 9.2 percent of their GDP compared with Italy’s 8.7 percent. This figure is even less than the Organization for Economic Cooperation and Development average (8.9 percent). The Italian public health care system is ranked second worldwide, according to the WHO.
However, AHCJ member Gianluca Bruttomesso raises some questions about why the system should be subjected to limits and deceleration in development. Read more …
Data: Calif. for-profits order more C-sections
Filed under: Health data, Health journalism, Hospitals, Hot Health Headline
Writing for California Watch, Nathanael Johnson leads with the numbers on his story about for-profit hospitals and C-sections. Appropriately for a story based on a hand-built database, classic health anecdotes don’t even surface until after the 20th paragraph. Instead, readers are immediately hit with this:
A database compiled from state birthing records revealed that, all factors considered, women are at least 17 percent more likely to have a cesarean section at a for-profit hospital than at one that operates as a non-profit. A surgical birth can bring in twice the revenue of a vaginal delivery.
It’s a powerful and nuanced – if not unexpected – finding. Johnson digs deep in the numbers, and hits on a litany of confounding factors and caveats. In the end, some of his most surprising findings were that patients at for-profit hospitals in poorer areas of Los Angeles were the most likely to receive C-sections, and that variation in these surgeries can be attributed to everything from cultural differences, patient preferences and even a desire to avoid malpractice suits.
How Johnson put it all together
For health journalists, the most exciting part of the entire package is likely Johnson’s detailed “how I did it” sidebar. He talks about how he chose which data to pursue, how he created the database behind the story, and even which specific Excel functions he used to find meaning within the numbers. Of particular interest are the sections in which he lists the sources he used to help him understand what he was seeing within the numbers, and to guide him toward his subsequent conclusions.
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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
