2010’s most popular Covering Health posts
- Tanning beds: What do the numbers really mean?
- Gays excluded from clinical trials
- Oransky: Medical study embargoes serve whom?
- Why insurers care about the medical-loss ratio
- Residents put dispute with Bronx hospital online
- PepsiCo sparks controversy on ScienceBlogs
- Doctor or journalist? Roles become blurred in Haiti
- Posting ER wait times online: Gimmick or service?
- ScienceBlogs reverses course, evicts Pepsi blog
- Report: Health care disparities aren’t getting better
UK’s Dartmouth-esque atlas yields familiar results
Filed under: Europe, Health data, Hot Health Headline, Tools
Writing for NPR’s health blog, Christopher Weaver looks at the NHS Atlas of Variation in Healthcare, which is similar to our Dartmouth Atlas. While they don’t have an interactive map up yet (they promise one will come next year), it has generous helpings of maps and graphs. The full PDF comes out to 100 pages and 19mb.
The most and least surprising thing about the NHS atlas? That, despite vastly different health care systems, it yields much the same results as the American version. I’ll let Weaver explain:
Before you blame … inconsistencies on America’s money-driven health system, take a look at Britain’s effort to anglicize the Dartmouth work: Doctors in some areas such as the college town of Oxford do one type of hip replacement at rates up to 16 times greater than in places like London, according to a November atlas by the National Health Service.
The British atlas is surprising because “doctors are not by and large paid on a fee for service basis in the NHS,” Angela Coulter, director of global initiatives for the Dartmouth Atlas-associated Foundation for Informed Medical Decision Making, said at a Salzburg Global Seminar session this week. “It illustrates the fact… that doctors tend to favor the treatments they’re trained to provide,” even when money isn’t a factor. Most British doctors get salaries rather than payments for each procedure like their American colleagues.
Related
For more European health news, see AHCJ’s Covering Europe initiative.
Lack of vaccination, awareness worsen UK flu season
Filed under: Europe, Government, Hot Health Headline, Public health
The Guardian’s Denis Campbell and Sarah Boseley report that a drop in vaccination rates and a lack of public awareness has made this flu season worse than it should have been, and that there is potential for the NHS to be “inundated” with flu cases. The story has spread quickly in the UK, and may be providing just the sort of public awareness campaign that the reporters found was previously lacking.
Professor Steve Field, who until last month was the chairman of the Royal College of General Practitioners, spoke out as the Department of Health revealed there are more than 300 people in critical care beds with flu and 17 people have died.
Field said the decision not to encourage the public to have a jab to protect themselves was “ill-advised” and needed to be urgently reversed.
The NHS should have acted more decisively to encourage people to have the jab because it was known that H1N1 swine flu was still circulating and that few NHS staff had the swine flu vaccine when it was offered to them late last year.
Related
For more European health news, see AHCJ’s Covering Europe initiative.
EU reviewing limits to physician work weeks
Filed under: Europe, Government, Hot Health Headline
The Telegraph’s Andy Bloxham writes that the European Union’s 48-hour-a-week average working time limit is under review, at least as far as doctors are concerned.
Photo by dimnikolov via FlickrThe limit has been in place since August, 2009, and doctors have a limited opt-out clause. According to Bloxham, European health providers have been hit hard by the rule, which cut back their hours “drastically.” Critics have said that “junior doctors, who used to work very long hours, were being stopped from learning or building up experience as quickly as in the past.”
The EU has committed to either reviewing or overhauling the law, and Bloxham lists a few possible modifications.
One way of altering the rules could see doctors’ hours spent on call at hospital rather than on duty counted differently to the hours spent treating patients.
It might also permit them to return from their breaks sooner than the law currently allows in cases where staff shortages are more severe.
The weekly average for American doctors is around 51, which is down from 55 in 1996.
Related
For more European health news, see AHCJ’s Covering Europe initiative.
Taking stock of big pharma in Canada
Filed under: Hot Health Headline, Pharmaceuticals
CBC and Radio-Canada have cooperated to produce a comprehensive look at the nation’s pharmaceutical industry, which centers on Montreal, Canada’s second largest city.
Pharma’s Canadian outposts have sputtered in recent months, and Quebec’s government has struggled to keep the companies in-country.
Part 1: Government incentives to pharmaceutical companies.
Part 2: Regulation of clinical trials.
Part 3: Pharma’s role in continuing medical education.
In addition to the stories, be sure to take a look at the top few comments below the story. Also, the “Quick Fact” box, which taught me that “Montreal has the largest number of clinical trial organizations of any city in North America.”
Happy holidays from AHCJ
The AHCJ offices are closed down for the holidays and will re-open on Jan. 3.
As a result, blog postings and tweets from us will be light and sporadic as we get rested up for a new year of highlighting the best work in health journalism and finding resources for our members.
Contest reminder: Get your entries for the Awards for Excellence in Health Care Journalism in no later than Friday to qualify for the discounted entry fee. After Friday, you are still welcome to submit entries until Jan. 28, but it will cost a bit more. If you have questions about the contest rules or eligibility, please send them to contest@healthjournailsm.org. If you have questions about the submission process, you can send them to info@healthjournalism.org. Someone will check those messages once a day and get back to you.
We wish all our readers a happy holiday season and look forward to a 2011 full of health news!
ProPublica finds academic physicians violating schools’ conflict rules
Filed under: Health data, Health journalism, Hospitals, Hot Health Headline, Pharmaceuticals, Public records, Tools
While journalists have been finding innovative ways to use ProPublica’s Dollars for Docs database, the database’s founders, Tracy Weber and AHCJ President Charles Ornstein remain ahead of the curve when it comes to using the freely available data for fresh stories.
This time around, the duo looked for medical schools with strict conflict-of-interest policies and ran their faculty lists through the database. They found dozens of matches, even at elite research institutions. It’s an idea so effective that it’s a wonder nobody thought of it sooner – and apparently the institutions involved feel the same way.
“For God’s sake, if the media can look at these websites, why can’t we?” said David Rothman, president of the Institute on Medicine as a Profession at Columbia University. “Why trust if you can verify?”
Stanford, the University of Pennsylvania, the University of Colorado Denver and the University of Pittsburgh drew particularly heavy attention. (On the other side of the coin, UMass Memorial Health Care was singled out as an example of a robust conflict policy.)
Pizzo, Stanford’s dean, said physicians who appear to have violated the policy will be investigated and referred for discipline if necessary. He compared some of their explanations to what a cop might hear after catching a motorist running a late-night stop sign.
“You can give 1,000 reasons: There was nobody around. It’s safe. I looked and didn’t harm anyone,” he said. “The reality is, it’s still a stop sign.”
Watch the full episode. See more Nightly Business Report.
And this isn’t just a database story. Weber and Ornstein also found time for a review of various academic conflict of interest policies and point out how policies are weakened through inaction, loopholes and a reliance on self-policing.
Report: Kosovo crime ring executed prisoners, harvested their organs
According to a draft report from the Council of Europe, a criminal network in Kosovo executed prisoners and sold their organs on the black market within the past decade. The network is linked to Kosovo’s current prime minister and victims likely included Kosovo Serb civilians. We learned about the story through Michael Montgomery and Altin Raxhimi of the Center for Investigative Reporting.
The report alleges the organ trafficking was part of a broader web of organized criminal activity including assassinations and drug dealing. The “boss” of the criminal network, according to the report, was Hashim Thaci, Kosovo’s current prime minister and the former political director of the Kosovo Liberation Army.
…
The recent case of illegal transplants conducted at the Medicus clinic in Pristina is not an isolated episode. “We believe that there are sufficiently serious and substantial indications to demonstrate that this form of trafficking long pre-dates the Medicus case, and that certain KLA leaders and affiliates have been implicated in it previously,” the report states.
According to a former U.N. war crimes prosecutor interviewed by CIR, an international investigation will be needed because of the breadth and complexity of the case.
Related
For more European health news, see AHCJ’s Covering Europe initiative.
WSJ details conflicts that drive spine fusion surgery
Filed under: Conflicts of interest, Health data, Hot Health Headline, Public records
The Wall Street Journal’s John Carreyou and Tom McGinty have taken advantage of their paper’s Medicare data stockpile to look at the conflicts of interest and piles of royalty money that drive the popularity of spine fusion treatments whose effectiveness has been disputed. Their work centers on Medtronic, which the Milwaukee Journal Sentinel’s John Fauber also has written about.
Photo by planetc1 via Flickr
For surgeons, the financial incentives to perform spine fusions can be strong. Though hospitals often lose money on the procedure when it’s performed on Medicare patients due to the high cost of the implants, the surgeons themselves can get paid as much as $12,000 per surgery.
Complex fusions … are reimbursed by Medicare at a sharply higher rate than decompressions, to account for the elaborate spinal devices used and the longer length of surgery. Complex fusions increased 15-fold among Medicare beneficiaries with spinal stenosis from 2002 to 2007, according to the JAMA study.
A big part of many surgeons’ income lies in their consulting and royalty arrangements with device makers, although disclosure of these arrangements remains piecemeal for now. Medtronic began releasing information about its payments to surgeons on its website in June, after coming under intense scrutiny from Sen. Charles Grassley (R., Iowa).
They’re required to keep some details under wraps, but the WSJ duo still manages to unleash anecdotes, including one about a surgeon who received “between $400,000 and $1.3 million in royalty, consulting and other payments from three spine-device makers.”
For reporters looking to understand the medical issues surrounding these procedures and why these conflicts can be detrimental to patients, see Janet Moore’s work in the Star Tribune.
Fla. group home’s sex policy raises questions
Filed under: Health journalism, Hot Health Headline
St. Petersburg Times reporter Justin George has painstakingly assembled the story of a group home for developmentally disabled adult men in Florida which, George writes, “enacted a bold and unorthodox policy permitting sex between residents.” Many of the men in the home were sex offenders and, according to experts, the policy created “a sexually charged atmosphere that may have encouraged sexual assaults.”
While this may sound more like a story for the crime and justice beat, keep in mind that the center “received approximately $100,000 in Medicaid funding per person annually for most residents,” despite reports that it is in an advanced state of disrepair.
George pulled hundreds of records from numerous government agencies and conducted more than 40 interviews over the course of two years. It shows in his reporting. You should read the full story to understand the breadth and complexity of the issue at hand, but I’ll summarize for the time-challenged.
Center officials regard sex as a basic human right (as the World Health Organization declared in 1975) and, in one 2005 case, “staff wrote that they could not evaluate whether Kevin was learning appropriate sexual behavior because his mother wouldn’t let him have sex with other campus men,” George found.
Compounding the problem, the state agency that oversees HDC (the group home) did not object to the policy until a whistle-blower complained to a state legislator. An investigation documented multiple instances of improper sexual activity between residents.
HDC officials say that banning sex is not the answer. It would deny basic rights and simply sweep the issue under the rug, a response they say is all too common when dealing with sex abusers.
But two years later, the state still has not written an official policy concerning sex in group homes. The whistle-blower was fired, and the mentally disabled man at the center of the controversy is stuck in a facility that he — like other men there — is desperate to leave.
After it learned of George’s investigation, the state finally set out to draft a policy for sex in state-run group homes, and perhaps for private homes as well.
A draft of one policy would ensure that sexually aggressive residents don’t room with anyone else, but it doesn’t prohibit sexual activity in group homes unless the disabled are children. Prohibiting adult sex might violate civil rights, Palecki said.
The Human Development Center’s revised policy on sexual behavior states it will not promote sexual activity among residents. Condoms will still be available, but only if competent adults ask for them.
George also tells the stories of two women who lost their jobs after speaking out about the situation and suspicions that a resident has been unable to move to a different home because his mother has cooperated with an investigation.
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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
