AP story focuses on overuse of medical treatments
Lindsey Tanner of The Associated Press addresses the overtesting and overtreatment that have become the focus of several studies and journal articles.
Tanner points to President Obama’s recent medical checkup, during which he had a prostate cancer screening and a virtual colonoscopy - neither of which is normally recommended for patients his age.
Increasingly, experts are questioning whether doctors are practicing “defensive medicine” - ordering tests and treatments to be sure they have covered all the bases even if they are not indicated. Other factors, such as a fee-for-service system and patients who insist on testing and treatments, also come into play.
This week alone, a New England Journal of Medicine study suggested that too many patients are getting angiograms — invasive imaging tests for heart disease — who don’t really need them; and specialists convened by the National Institutes of Health said doctors are too often demanding repeat cesarean deliveries for pregnant women after a first C-section.
Last week, the American Cancer Society cast more doubt on routine PSA tests for prostate cancer. And a few months ago, other groups recommended against routine mammograms for women in their 40s, and for fewer Pap tests looking for cervical cancer.
The focus on overtesting and overtreatment comes the same week CBS News sent out a press release announcing that Early Show anchor Harry Smith underwent a colonoscopy on live television, reported on by Katie Couric. The press release proclaims:
Following Couric’s on-air colonoscopy in 2000, University of Michigan researchers documented a 20% increase in the number of colonoscopies performed across the country, dubbing it “The Couric Effect.”
Tribune investigates nursing home psychiatrist
In the latest installment of the Chicago Tribune’s investigation into Illinois nursing homes, Sam Roe and ProPublica’s Christina Jewett investigate Dr. Michael Reinstein, an impressively prolific prescriber who, in 2007, wrote more prescriptions for clozapine (”a potent psychotropic medication that carries five ‘black box’ warnings”) than all physicians in Texas put together.
In that same year, he prescribed medications to 4,141 Medicaid patients. Furthermore, while the average American doctor sees about 35 patients each with, Reinstein sees an incredible 60 patients each day. Reinstein’s workload may have something to do with the fact that he’s the psychiatric director at 13 different nursing homes, but Roe and Jewett write that the ultimate blame lies on systemic problems in Illinois.
Earlier
New slim guide:
Covering the Health of Local Nursing Homes
Check out AHCJ’s latest volume in its ongoing Slim Guide series. This reporting guide gives a head start to journalists who want to pursue stories about one of the most vulnerable populations – nursing home residents. It offers advice about Web sites, datasets, research and other resources. After reading this book, journalists can have more confidence in deciphering nursing home inspection reports, interviewing advocacy groups on all sides of an issue, locating key data, and more. The book includes story examples and ideas.
AHCJ publishes these reporting guides, with the support of the Robert Wood Johnson Foundation, to help journalists understand and accurately report on specific subjects.
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, as are these 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
‘Too old for surgery’ a more complicated decision
Marie McCullough of The Philadelphia Inquirer takes a look at lifesaving surgeries performed on older patients, finding that “Age is no longer the deciding factor, even for invasive treatment such as open-heart surgery.”
McCullough reports that the growing population of elderly Americans and advances in surgical procedures are changes the way doctors approach some older patients. With elderly patients better able to survive major surgery, the question moves from the realm of health to that of economics and morality. McCullough explores both.
Blogger, author and doctor Lucy E. Hornstein extends McCullough’s conclusions, writing that “A cost-effective, medically appropriate way to address this issue is to curb overtreatment in those patients with advanced dementia and multiple co-morbidites, whatever their age.”
Upcoming workshop
AHCJ’s Aging in the 21st Century workshop, to be held Oct. 16 and 17 in Miami, will address some of the topics raised above, as well as the changing picture of aging Americans and key research and issues related to this growing population.
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
In speech, Gawande asks new MDs to cut costs
Filed under: Health care reform, Hot Health Headline
In the wake of his much-discussed New Yorker piece about health care costs, Dr. Atul Gawande spoke to graduates of the University of Chicago Pritzker School of Medicine about their role in lowering the national cost of health care.
After Gawande explained the situation through analogy and observation, he called for further research into the “positive deviants,” the cities and institutions offering the best care for the lowest cost. He gave examples of methods to avoid the unnecessary treatment he blames for high health care costs and finished by urging graduates to enter the workforce and fight for the soul of American medicine.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- 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
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
