Stories focus on suicides of doctors, soldiers
New York Times columnist Pauline Chen, M.D., serves up a reminder that suicide prevention isn’t just a matter of access to counseling and resources, in the form of a story about high physician suicide rates. If there’s any sector of the population that should be able to recognize that they are suffering from mental illness, and that the condition is treatable, it should be doctors, Chen writes. Yet still they kill themselves at a rate above the American average.
For several decades now, studies have consistently shown that physicians have higher rates of suicide than the general population — 40 percent higher for male doctors and a staggering 130 percent higher for female doctors. While research has traced the beginning of this tragic difference to the years spent in medical school, the contributing factors remain murky. Students enter medical school with mental health profiles similar to those of their peers but end up experiencing depression, burnout and other mental illnesses at higher rates. Despite better access to health care, they are more likely to cope by resorting to dysfunctional behaviors like excessive drinking and are less likely to receive the right care or even recognize that they need some kind of intervention.
Chen mentions two recent studies published in the Journal of the American Medical Association that shed more light on the issue, one showing that in medical school depression and burnout are separate entities, and the other showing that depressed students believe others view them as incompetent. In the end, she calls for further long-term research, but does not take the next logical step and investigate comparative research and statistics. Is it just American medical students who are depressed? Do countries with low-cost, low-pressure med schools produce doctors with better mental health? There’s a lot of room for investigation.
Suicides in another high-access group
Chen’s New York Times colleague, James McKinley, writes that as many as 20 soldiers connected with the Army base at Ft. Hood have killed themselves this year, despite the Army’s suicide prevention efforts.
The spate of suicides in Texas reflects a chilling reality: nearly 20 months after the Army began strengthening its suicide prevention program and working to remove the stigma attached to seeking psychological counseling, the suicide rate among active service members remains high and shows little sign of improvement. Through August, at least 125 active members of the Army had ended their own lives, exceeding the morbid pace of last year, when there were a record 162 suicides.
As of July, the Army requires all returning soldiers to be evaluated by a mental health specialist, though veteran advocates still point to a shortage of psychiatrists and an emphasis on treatment through medication rather than through therapy. The system is taxed by record numbers of soldiers seeking help for psychological problems, and mental health was the leading reason for hospitalization in the Army last year, McKinley writes.
Each suicide is unique, McKinley writes, and it’s hard to find patterns.
Medicare competitive bidding ramps up
Filed under: Health care reform, Health journalism, Hot Health Headline
The California HealthCare Foundation Center for Health Reporting and the San Bernardino County (Calif.) Sun teamed up for a package of stories explaining the local roll-out of a Medicare program that’s testing a competitive bid process for medical devices and equipment.
On Jan. 1, 2011, Medicare will implement the program in nine metropolitan areas nationwide. Bids are already underway. In the series’ flagship story, Deborah Schoch, of the Center for Health Reporting, and the Sun’s Monica Rodriguez looked into the program’s potential for controlling costs and cutting down on fraud. For an illustration of potential savings and payment amounts, see the graphic that ran alongside their work.
The potential savings of going from a set fee schedule to a competitive one should be fairly evident. The anti-fraud measures, on the other hand, require a bit of explaining. According to Schoch and Rodriguez, the system promises to prevent fraud by requiring vendors to be bonded and insured, and to have legitimate storefronts for their durable goods. It will be harder for vendors to upsell seniors into buying needlessly elaborate equipment, and the smaller community of suppliers will be easier to police overall.
Local reporters can refer to the CMS site for precise zip code maps of the round one bidding areas.
Competitive bidding is nothing new to government agencies, and the duo’s sources believe that they’re ready to make it work in Medicare as well.
After working for Medicare for 32 years, (regional Medicare administrator David Sayen) believes the new plan contains the elements to make it work, Sayen, 57, said in a recent telephone interview. “It’s got the three legs - a mechanism to set pricing, a mechanism to provide quality assurance, and one to prevent waste and fraud.”
The ambitious program has, of course not gone unchallenged, though officials seem confident they will be able to resist the last-minute push from vested interests this time. Some, they write, were inefficient enterprises that were sustained only by Medicare’s generous fee schedule. They will probably not survive in a competitive environment.
Industry groups are pointing to a Sept. 26 letter signed by 166 economists, including two Nobel Prize winners, addressed to California Rep. Pete Stark, Democratic chairman of the powerful health subcommittee of the House Ways and Means Committee.
The signers lambaste what they call four key problems with the program: a lack of binding commitments, the use of composite bids, and what they call flawed pricing and a lack of transparency.
The program could degenerate if vendors become unreliable, product and service quality lags and supplies dwindle, they wrote.
Medicare recipients will be advised of the changes by mail, and through a series of educational sessions.
And, for the record, here’s a list of items up for bids in this first round:
- Oxygen supplies and equipment
- Standard power wheelchairs, scooters, and related accessories
- Complex rehabilitative power wheelchairs and related accessories
- Mail-order diabetic supplies
- Enteral nutrients, equipment and supplies
- Continuous positive airway pressure (CPAP), respiratory assist devices (RADS) and related supplies and accessories
- Hospital beds and related accessories
- Walkers and related accessories
- Support surfaces (Miami only)
If you work in one of the nine bidding areas and have written something about the process, let us know in the comments! We’re hoping to feature more local stories on the program as the new year draws nearer.
Catch up with the latest AHCJ member news
KMSP-Minneapolis investigative reporter Jeff Baillon earned two Upper Midwest Regional Emmy awards. “Where’s the Money,” a series looking at the financial collapse of a company owned by a former U.S. senator, won for investigative reporting. “Car Trouble,” a piece about a man imprisoned for killing three people in a car crash involving a Toyota Camry, also won. The story uncovered evidence which supported the driver’s claim that the accident was the result of “unintended acceleration.” The man has since been freed from prison.
Theresa Brown’s new book, Critical Care: A New Nurse Faces Death, Life, and Everything in Between, was published by Harper Collins in June.
Heather Chambers left the San Diego Business Journal for the California Healthcare Institute in June. She is serving as their writer – technically “communications specialist.”
Columbus Business First reporter Carrie Ghose’s health care beat coverage in 2009 won second place for business reporting among papers with less than 100,000 circulation in the 2010 Ohio Society of Professional Journalists Awards.
Carol Goldsmith, an anchor at WYFF-Greenvile, S.C., won a Peabody award for “Chronicle: Paul’s Gift,” an hour-long documentary on organ donation that goes from the hospital bed, to surgery for organ recovery, to the transplant recipients, and the meeting months later between the donor’s widow and the recipients. She was the co-anchor and co-producer for the project.
On Aug. 30th, Christine Gorman started work as the health/med/bio features editor at Scientific American, with a mandate to beef up its health and medicine reporting. She works in the print, online and mobile spaces. You can find her first health column in the October 2010 issue.
Terri Hansen won first place in the 2010 Native American Journalists Association’s Media Awards for “Best Environmental News Story.”
Andrew Holtz’s third book, House M.D. vs. Reality, will be published in early 2011 by Berkley/Penguin in the United States. He also has deals for Brazilian and Czech editions with other proposed editions pending. The bad news is that www.MDiTV.com, where Holtz was anchor & senior news editor, has suspended production of video news reports. Holtz continues to do reviews for www.HealthNewsReview.org and, along with Bill Heisel, occasionally fills in for Gary Schwitzer to coordinate the reviews.
Lisa Jaffe Hubbell has become a regular blogger at GE’s healthymagination.com health blog and is contributing to Today’s Hospitalist.
Chicago Tribune health care reporter Bruce Japsen has a new column answering readers questions specifically about the implementation of health reform.
Sandra Jordan is a winner of the American Cancer Society High Plains Division 2010 Media Awards competition in the Newspaper - Weekly Feature category for her story, “The New Age of Prostate Cancer.” Jordan is also a 2010 National Press Foundation fellow for the “Cancer Issues” seminar in Washington, D.C. in October. Chris King (managing editor) and Jordan (health reporter) shared honors with the rest of St. Louis American staff when it was recognized as best non-daily paper in North America (circ. greater than 37,500) of 2010 by Suburban Newspapers of America.
P. Mona Khanna, M.D., M.P.H., F.A.C.P., is the recipient of the American Medical Writers Association’s Walter C. Alvarez Award. The award honors excellence in communicating health care developments and concepts to the public.
Euna Lhee is now a multimedia health reporter for Florida Public Radio, as a part of the Healthy State Collaborative project. Based at WMFE in Orlando, Lhee reports on health care issues, biotechnology and medical research.
The Salt Lake Tribune’s Heather May was awarded a fellowship this summer through the USC Annenberg/The California Endowment Health Journalism Fellowship program. She will be writing about minority health disparities in Utah.
Maryn McKenna became one of the seven launch bloggers on Wired.com’s new invitation-only science-blog network.
Marilyn Nelson took part in the International Center for Journalists’ personal finance class, for which she completed a story project about American Indians and personal finance.
Tom Paulson curates a niche news site for KPLU as part of NPR’s new Argo project. His focus, based in Seattle, is on global health and development.
Peggy Pico has returned to her hometown of San Diego as the science and technology reporter at KPBS, where she does daily radio and weekly TV reports on the biotech industry.
Lisa A. Price, chief editorial adviser at Sound Integrated Health News, was featured in the Journal for Minority Medical Students (Vol. 22 No. 2), NCCAM Researcher Profile, Special Report for research on medicinal mushrooms and cancer.
Lee-Lee Prina, senior editor of GrantWatch at Health Affairs, is now managing the journal’s new GrantWatch Blog, which launched in March 2010.
Marilyn Werber Serafini has been selected as the inaugural Robin Toner Distinguished Fellow of the Kaiser Family Foundation. Serafini, who spent 19 years at National Journal, covered the U.S. Congress since 1985, writing about health care, tax, trade, welfare, pension and banking legislation. She covered the health reform debate during the Clinton Administration and the recent debate that led to the Patient Protection and Affordable Care Act. Serafini began her fellowship in August and is working closely with the editors of Kaiser Health News and KHN its partners on a series of articles on health policy and politics, as well as stories that explore the intricacies of health reform implementation.
Tampa Tribune consumer health reporter Mary Shedden won a SPJ Green Eyeshade Award, which recognizes excellence in 11 Southern states. She took first place in the category of “Public Affairs – Print – Daily.” Her entry, “Stuffy Nose? Tired? You may already have had swine flu,” included her body of work that aimed to help readers understand how to identify the flu’s symptoms and to protect themselves. Shedden also was a 2009 AHCJ-CDC Health Journalism Fellow.
Lorena Tonarelli’s new book, Caring - The Essential Guide, has been published by Need2KNow books.
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.
Lawsuit reveals failures in hospital hiring practices
St. Petersburg Times reporter Curtis Krueger’s story about a successful whistleblower suit against a Florida hospital provides a powerful storyline about how disciplined health care workers continue to get hired. Here, he skips the government agencies and state databases and looks at communication between the hospitals themselves.
After all, don’t hospitals consult references and do background checks when hiring new doctors and nurses? In the corporate world of major hospitals, the answer is apparently “yes, but it doesn’t seem to do any good.”
… in general, (Beth Hardy, a spokeswoman for Morton Plant Mease Hospitals) said, if a hospital calls seeking information about a former employee, the company will simply confirm the worker’s dates of employment and last position held. She said that is “a standard and accepted policy across a lot of large organizations.”
The whistleblower suit itself, which resulted in a $450,000 award, involved a nursing supervisor who was fired soon after she criticized nurse Bernard M. Moran for falsifying records, a practice which got him fired at a previous job. Moran now works at another area hospital, one which says it checks the disciplinary records of all new hires.
The story only came to light because of the lawsuit. To understand just how many blind eyes were turned toward Moran’s behavior during this series of events, just take a look at Krueger’s story.
(Hat tip to Health News Florida)
Rise, fall of two St. Louis pharma companies
Filed under: Health journalism, Hot Health Headline
Midwest Health Journalism Program fellow Jim Doyle, a reporter at the St. Louis Post-Dispatch, tells the story of Forest Pharmaceuticals (a subsidiary of Forest Laboratories), which has been accused by federal regulators of sketchy marketing practices, primarily involving its antidepressants Celexa and Lexapro and unapproved pediatric use. The company has pleaded guilty to federal criminal charges and agreed to pay $300 million in criminal and civil penalties, Doyle reports.
Armed with the breaking news, Dolye then goes deeper, finds the company’s local roots, charts its rise and tries to pinpoint where it went wrong. It’s the same formula he used for his story on another imploding local drug-maker, KV Pharmaceuticals, earlier this year.
Welcome to AHCJ’s newest members
These journalists have joined AHCJ recently:
- Roger Bird, website news director, World Federation of Science Journalists; Ottawa, Ontario
- Emily David, student, Missouri School of Journalism; Columbia, Mo.
- Lynne DeLucia, editor, Connecticut Health Investigative Team; New Haven, Conn. (@lynnedelucia)
- Lon Osmond, executive editor, Audio-Digest; Glendale, Calif.
- Barbara Peters Smith, health & aging writer, Sarasota Herald-Tribune; Sarasota, Fla.
- Kenneth Rubenstein, biotech writer/analyst, independent journalis; Haleiwa, Hawaii
- Laura Smith, student, University of Georgia; Athens, Ga.
- Stephanie Souchery Grell, student, UNC-Chapel Hill; Durham, N.C.
- Janice Valverde, reporter, BNA Daily Environmental Report; Washington, D.C.
- Vicki Zwart, content producer, ThinkGlink.com; Woodridge, Ill. (@VicksterZ)
If you haven’t joined yet, see what member benefits you’re missing out on: Access to more than 50 journals and databases, special data sets, tip sheets and articles from your colleagues on how they’ve reported stories, conferences, workshops, online training, reporting guides and more. Join AHCJ today to get a wealth of support and tools to help you.
Is America’s high health spending linked to short lifespans?
Filed under: Europe, Government, Health care reform, Health policy, Member news, Public health, Public records, Studies
The United States lags behind other developed nations in life expectancy, yet spends far more on health care than any other nation. This is not news. Now if someone could definitively tell us why, that would be news. Life expectancy’s a dangerously blunt measure of the efficacy of a nation’s health care system, as there more confounding factors than anyone can possibly account for.
Neverthless, Columbia-affiliated public health researchers publishing in the latest edition of Health Affairs (free to AHCJ members!) have taken a stab at it, doing their best to tease out the biggest confounds and determine why Americans don’t live as long as their counterparts in the other 12 large, historically developed nations, all of which happen to provide universal health care of one variety or another. The paper looked at 15-year survival rates for 45- and 65-year-olds, in order to avoid the confusion introduced into life-span statistics by each country’s different reproductive (and end-of-life) policies. It’s a little complicated, so I’ll let the authors explain:
In this paper we explore changes in fifteen-year survival at middle and older ages, alongside per capita health care spending, in the United States and twelve other wealthy nations. We then examine the extent to which the survival and cost variations over time among these nations can be explained by demographics, obesity, smoking, or mortality events that are not closely related to health care, such as traffic accidents and homicide. By comparing health system costs and mortality rates over time, it is possible to assess whether trends in risk factors for health or causes of death can explain the observed relative decline in broad health outcomes among American men and women over the past thirty years.
As it turns out, those risk factors don’t appear to explain anything. In the 30 years between 1975 and 2005, the American system has weakened relative to equivalent countries despite the fact that smoking rates declined, obesity rates grew more slowly than they did overall in the other 12 nations and accident and homicide rates remained the same. So, while risk factors stayed steady (or improved), America continued spending more and getting less in return.
The researchers didn’t come up with a perfect explanation, of course, but they have their suspicions. On the Health Affairs blog, Chris Fleming summarizes their conclusion:
Rising health spending itself, the authors conclude, might be responsible for the relative decline in survival. They cite three consequences of rising health spending: an increase in the number of people with inadequate health insurance; the inability to allocate financial resources to life-saving programs; and unregulated fee-for-service reimbursement and an emphasis on specialty care that leads to unneeded procedures and fragmented care. As a result, they conclude, “meaningful reform may not only save money over the long term: it may also save lives.”
Online health info matters because people act on it
Filed under: Health journalism, Hot Health Headline, Studies
Google health industry director Mary Ann Belliveau guest-posted on CNN’s health blog this week. Her main point? That after 15 years in health care (nine with Google), she’s learned that “‘health’ isn’t just another category of information,” a fact she attributes to privacy issues and the life-or-death stakes that don’t generally accompany videos of Justin Bieber or Mentos and Coke.
She also said that health videos are exceedingly popular on Youtube — they beat out celebrities, sports and food — and that patients’ (and caregivers’) No. 1 desire is to “hear from people in situations similar to their own.”
More interestingly, she shared the results of what appeared to be recent, Google-conducted user surveys. The big lesson? People really do take real-world action based on health information they find online. It’s yet another reminder of the importance — and stakes — of accurate online health reporting. Here are the numbers:
Report cards and rankings for 227 HMOs
Filed under: Health care reform, Health data, Tools
The National Committee for Quality Assurance, a nonprofit health plan accreditation organization, has unleashed its annual ranking of private health insurance plans, which have also been published in Consumer Reports. As present, the list only contains health management organizations.
Only the top four providers received the full five points in consumer satisfaction, treatment and prevention. New England providers took top honors this year, with Harvard Pilgrim taking first (Massachusetts and Maine) and third (New Hampshire), and Tufts Associated coming in second. Florida’s Capital Health plan came in fourth.
In addition to the list, NCQA released a detailed report card for each HMO (241-page PDF). There, plans are rated for specific satisfaction measures, diseases and patient groups.
Look for similar rankings of Medicare and Medicaid plans to come out in the next month or so.
A new wave of hospital consolidation looms
Nationally, the hospital consolidation craze has leveled off since its 2006 peak, but Kaiser Health News senior correspondent Julie Appleby, an AHCJ board member, reports that acquisitions are on the march again, especially in the mid-Atlantic region. Appleby found that this rising wave is due, in part at least, to health care reform and its emphasis on integrated care and Accountable Care Organizations.
Hospital leaders from Baltimore to Seattle say the health law approved by Congress in March gives them even more reason to merge with or buy rivals because of its emphasis on integrated systems where hospitals and doctors better coordinate care.
Also fueling the trend: More doctors want to be employed directly by hospitals, allowing them more job security without the hassles of running a business. But hiring groups of doctors can be an “expensive and daunting proposition” for a stand-alone facility, says Steven Thompson, senior vice president for Johns Hopkins Medicine.
Nationally and locally, he says, “it’s fair to say that (independent) hospitals are talking with everyone, feeling that they don’t want to be the last one standing.”
Other causes include increasingly contentious negotiations with insurers, more direct employment of doctors and access to the capital needed to adopt things like electronic medical records.
We were pointed to the KHN story by AHCJ Immediate Past President Trudy Lieberman’s cjr.org column, in which she compares hospital consolidation to HMOs and insurance consolidation.
It was good to see Appleby’s story, because the media pretty much gave hospitals a bye during the reform debate, instead making insurance companies the saga’s primary villains. Quietly, though, it seems the hospitals were up to the same thing as the insurers—organizing themselves into larger and larger groups with tons of market power to keep insurance premiums in the stratosphere.
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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
