Just as patients are unwell and struggling, their well-intentioned doctors may confront them with difficult choices about their care. They often do so with daunting data, and hard to decipher numbers that don’t really answer the vital question: How well does this treatment work, especially for me?

Kudos to two Maryland experts, internist Andrew Lazris, and environmental research Erik Rifkin, for their effort to assist patients and caregivers to “reexamine the usefulness of cancer exams, cholesterol tests, osteoporosis pills, MRI scans and many other routinely prescribed procedures and medicines.” A tip of the hat, too, to the Kaiser Health News service in tapping a useful technology−online video−to illuminate exactly what the experts are up to.

adderallIf aliens beamed down from another planet, how shocked might they be by modern patients’ willingness to ingest crazy stuff in the name of their health or well-being? Is it surprising or distressing that in the 21st century so many patients swallow so much hokum and downright dangerous thinking?

Let’s start with an excellent but deeply distressing New York Times Sunday Magazine story about “Generation Adderall,” a painful dissection of how many young people have become dependent, even addicted, to drugs that their parents started them on, in the name of improving their focus and academic performance. The author reports that Attention Deficit Hyperactivity Disorder, or ADHD or even shorter ADD, has risen as a diagnosis for young people, increasing from 3 to 5 percent of American school kids in 1990 to 11 percent now. The remedy for this, of course, has been prescribing drugs:

In 1990, 600,000 children were on stimulants, usually Ritalin, an older medication that often had to be taken multiple times a day. By 2013, 3.5 million children were on stimulants, and in many cases, the Ritalin had been replaced by Adderall, officially brought to market in 1996 as the new, upgraded choice for ADHD—more effective, longer lasting.

38_Special_mushrooming_side_viewA lethal epidemic is sweeping Baltimore neighborhoods, costing taxpayers millions of dollars, as well as demoralizing caregivers who struggle with its casualties daily. Researchers, tragically, are barred from developing detailed data about this scourge to try to curb its increasingly deadly harm.

Kudos to the Baltimore Sun and reporter Justin George for investigating for a year the gun violence that torments the city, sending at least 200 patients to area hospitals already just in 2016. The Sun says hospitals in the poor city have spent in five years more than $80 million caring for patients involved in gun crimes. Hospitals have seen their gunshot caseload double, and the costs of this care increase by 30 percent. Taxpayers end up footing most of the bill under Medicaid, the federal-state insurance for the poor.

The Sun’s multi-part series looks at gun violence from many aspects but the violence’s effects on the city’s health care is tragic and distressing.

elexDutiful sons and daughters may need to see their parents, uncles and aunts, and grandparents, if nothing else to shut off their cable television news, turn off the talk radio, yank them off social media, and put down their newspapers and magazines. That’s because the American Psychological Association warns that an onslaught of media coverage, in a 2016 U.S. presidential campaign remarkable for its ugliness, is contributing to unhealthy stress for us all, especially older folks.

The association bases this claim on its annual survey, conducted by Harris Poll, of more than 3,500 adults older than 18 and living in the United States, with 52 percent of respondents saying the Hillary Clinton vs. Donald J. Trump race is a “very or somewhat significant source of stress.”

The dark campaign stresses Democrats and Republicans almost equally, and Americans’ discomfort is “exacerbated by arguments, stories, images and video on social media that can heighten concern and frustration, particularly with thousands of comments that can range from factual to hostile or even inflammatory,” the association reports.

skin“Skin to skin” therapy? That was the line item charge that appeared on the hospital bill for a young couple, and the dad decided to check it out. What he found has blown up across the Internet.

It turns out that the Utah parents were charged $ 39.35 by their hospital just so the new mom and dad, just after the C-section delivery of their son, could have their baby placed between her neck and chest. There, proud pops took the requisite newborn pictures.

Only later, as part of $13,280.49 tab for their son’s delivery, did the couple see the skin to skin charge. They posted the bill on a popular online site, where it drew more than 11,000 comments.

death-certificate-state-by-state-default-750_50California regulators have reversed themselves and decided to require hospitals to report outbreaks of “superbug” cases, rare infections that also can prove deadly. At the same time, officials in the Golden State haven’t moved to increase the information disclosed on death certificates−data that advocates suggest would give the public clearer outlines of just how severe a problem hospital-acquired infections have become.

Kudos to the Los Angeles Times, which delved in a recent front-page investigation into the dearth of information disclosed on death certificates, especially about hospital-acquired infections. The paper detailed how a Los Angeles area patient had contracted, while hospitalized, a rare carbapenem-resistant enterobacteriaceae or CRE infection. This superbug resists treatment with an array of antibiotics, eventually killing half those it afflicts. Its outbreaks are a huge concern for public health authorities.

But, The Los Angeles Times said, hospitals had cried “poor me” to the state, saying it required extensive resources to monitor and report CRE outbreaks. The death certificate for the patient with the CRE infection, the newspaper said, listed a perforated ulcer as her cause of death. Her family was outraged because they had urged Torrance Memorial Medical Center to report a CRE outbreak to the state.

SupremeCourtSealSouth Dakota’s highest court has been asked to reject hospitals’ attempts to keep secret why a doctor, who also is a convicted burglar with a checkered medical past that could have easily been uncovered, passed a peer review that permitted him to perform brutal, excruciating, and unnecessary spinal surgeries on dozens of patients.

A lower court rejected the sweeping claims by the hospitals that the reviews can never be disclosed. The judge said that indications of crimes or fraud, as raised by evidence-based malpractice lawsuits, are sufficient reason to breach confidentiality protections shielding vital insights into how hospitals judge physician performance and permit doctors to practice in their institutions.

More than 30 patients have sued surgeon Allen Sossan. He is a convicted felon, who had changed his name, and who apparently has fled to Iran. Patients assert he caused them great pain and maimed them with unnecessary, complex back procedures. Further, patients have sued more than a dozen doctors who reviewed his credentials and granted him privileges at Avera Sacred Heart and Lewis & Clark Specialty Hospital, both in Yankton, S.D.

deductiblesThe Affordable Care Act aka Obamacare has been a vital path into health insurance coverage for  millions of Americans. But the Houston Chronicle and other media deserve  credit for reminding that most people in this country still get insured by employers−and Americans are struggling with the social experiment in which ever increasing costs of care get shifted on to them.

As the Chronicle story points out, 155 million Americans are covered by employer-based health insurance, versus 11 million in Obamacare exchanges. Citing data from the Kaiser Family Foundation, the Texas news organization points out that this year, for the first time, 51 percent of those who get their health insurance now have deductibles−sums they must cover out of their own pockets first before benefits kick in−of $1,000 or more. A decade ago, that deductible, on average, was $584. Now it is $1,478.

To afford their work-based health insurance, the Chronicle says, more Americans have signed up for high-deductible options. These can lower the monthly premium for workers, and employers have pushed hard because these save companies money.

drugpriceBig Pharma’s dubious hype of its sometimes risky products marched on last week, with the industry racking up a half-billion in regulator penalties and settlements but no seeming end to its questionable strategies and tactics:

$465 million penalty, settlement for EpiPen maker

nubillAfter partnering with hospital systems, medical finance specialists, and AARP, the advocacy group for Americans 50 and older, Uncle Sam has chosen its top competitors who tried to answer the vexing question: Can anyone do anything to fix the infuriating confusion caused by the typical hospital bill?

Sure, it’s a little gimmicky. A $5,000 prize these days doesn’t seem all that grand. But a little credit is due to the intent and participants in the federal Health and Human Services design contest, “A bill you can understand.”

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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