Articles Posted in Communication

HouseGregoryHouse-276x300Doctors, nurses, and hospitals should stop ignoring colleagues who act like jerks because obnoxious physicians—think of  Dr. Gregory House, the TV internist—may hurt patients, especially in surgery.

Researchers, who published a study in the JAMA Surgery, looked at two years of quality care data from seven medical centers, involving 800 surgeons and 32,000 adult patients. They also had information on physicians with “unsolicited patient observations,” meaning complaints from those undergoing care and their friends and families.

Stat, the online health information site, summarizes what the researchers found:

ryanMembers of Congress are home in their districts for a week-long break, and many lawmakers are expected to get an earful from voters upset over many issues at the start of the Trump Administration, especially this: What the heck’s going on with health care?

Republicans have insisted for years now—counter-factually, as the evidence has amply demonstrated—that they had a cheaper, better, more inclusive alternative to the Affordable Care Act, aka Obamacare. The promised to repeal the ACA on the day they gained control of Congress and the White House. That hasn’t happened. Nor has the GOP proffered its vaunted replacement. Instead, the party had talked in recent days about an ACA repair.

But under fire from their most conservative party members, Republican leaders have thrown up what they call an outline of Trumpcare. The GOP has moved from lots of R’s—repeal, replace, and repair—to some C’s and D’s: Costly, callous, divisive, and cruel. Those are some ways their retread plan elements (dubbed “déjà vu all over again” in one report) could be described. The outline still faces major challenges, not the least of which is whether a chaotic White House and a lumpen Congress can conduct the nation’s business and enact public policy.

ear-187x300Traffic, rock concerts, leaf blowers, and blaring head phones — these are among the many noise sources that have played a part in 40 million American adults suffering from hearing losses not caused by their work conditions, Uncle Sam says.

The federal Centers for Disease Control and Prevention, based on a study of more than 3,500 people who underwent tests and questioning, estimates that a quarter of Americans ages 20 to 69 suffer hearing impairment that constitutes “a significant, often unrecognized health problem.”

This diminished capacity, especially if untreated, can lead to “decreased social, psychological, and cognitive functioning,” the CDC says. Its study also reported that:

http://www.protectpatientsblog.com/wp-content/uploads/sites/69/2016/09/Food_and_Drug_Administration_logo.svg_-300x129.pngTo hear some powerful proponents tell it, Uncle Sam needs to really hurry up the government’s approval of drugs and medical devices. He’s got to make oversight over them easier, lighter, and less complex.

But consider just some of the health news in recent days:

nhlDo the leaders of professional hockey need to spend some time in the penalty box? It might seem so based on a report in the New York Times that the National Hockey League, as it battles its own players in court over the harms caused by repetitive head injuries, is adopting the dubious legal playbook used by pro football, Big Tobacco and Big Sugar.

The $4-billion-a-year NHL, it seems, has taken off its mitts, thrown them on the ice, and is throwing blows to challenge the ever-mounting, evidence-based research that finds that concussions are detrimental to brain health and can lead to the disease known as chronic traumatic encephalopathy or CTE.

The National Football League, after years of CTE denial, including efforts to undercut its medical science and to attack its researchers, conceded that repeated head trauma harmed its players, and pro football settled with them for more than $1 billion.

harlanYes, there can be progressive steps in health care—and with all the controversy and change going on in the sector it’s worth spotlighting some of these:

Patients should get access to own health records, researchers say

  • Three researchers—Dr. Harlan Krumholz of Yale Medical School (photo right), Connecticut lawyer Jennifer L. Cox, and Yale student Austin W. Jaspers—deserve credit for publishing a pointed opinion piece in the JAMA Internal Medicine detailing the costs and needless obstacles patients confront when they want copies of their own health records. As Krumholz told Reuters of the study’s message about excessive records fees charged by doctors and hospitals:  “Higher costs are a higher barrier for people to get their own information. Without that information it is not possible to correct errors in the record, get informed second opinions, donate your data to research – or share with others what is happening with your care.”  That’s spot on, doctor, as I have written recently and in my book,  The Life You Save: Nine Steps to Getting the Best Medical Care, and Avoiding the Worst. Uncle Sam has stepped in and tried to make it easier and more affordable for patients to get their own records, which Krumholz and company point out should be even more available now that they are digitized (he’s working on software to help, too). But states aren’t doing enough to help, except for Kentucky, which requires a free first copy on request, he and his colleagues say. My firm’s site contains information that may be helpful to those struggling to get their records. Here’s hoping that doctors, hospitals, and other caregiving facilities read the Jaspers, Cox, and Krumholz viewpoint, and, because it appears in one of their publications and Krumholz is a physician-researcher of growing influence, they heed it more.

sen-collins-288x300Bill_Cassidy_headshot-237x300Will the partisans who promised and now can’t deliver on a blitzkrieg to repeal and replace the Affordable Care Act, aka Obamacare, end up deeply dividing the country in even more disturbing ways?

GOP leaders, after conceding that they cannot legislate their hoped-for Obamacare replacement until much later this year (reversing their pledge to do so on Day One of the new Administration), huddled in Philadelphia, nervously, to develop strategies and tactics. As they develop “Trumpcare,” they’re confronting growing and significant restiveness about the potential destructiveness of their current course, including the possibility their repeal may cost 43,000 American lives annually.

Meantime, the health care policy proposals that have floated up, including the Patient Freedom Act of 2017 from Republican senators Susan Collins of Maine and Bill Cassidy of Louisiana, raise as many questions as they offer, including:

skepticism-image-197x300At one point, medical experts recommended that physicians aggressively treat patients 60 and older so the top number of their blood pressure readings ran as close as possible to 140. Maybe not so, anymore. For a while, physicians were told to treat patients so their “good cholesterol” increased significantly. But maybe this approach doesn’t protect against heart disease after all. Pediatricians once warned parents to protect newborns by not exposing them to certain allergens, especially peanuts. If you haven’t had your head buried in the sand, that counsel, of course, has just changed 180 degrees.

Thanks are due to Aaron E. Carroll, a pediatrician, health research and policy expert, and columnist with the New York Times “Upshot” feature, for reminding — yet again, as repetition is the Mother of Learning — that medical news must be taken in by patient-consumers with a “dose of healthy skepticism.” This he says is especially true about reports on nutrition.

I’ve written about the harms that result from hype and the many, sometimes dramatic reverses in health and medical news. I’ve pointed out that there are accessible resources, such as the excellent healthnewsreview.org, to watchdog coverage of medical science and so-called advances. I’ve suggested that patient-consumers look closely at key elements in research stories, including how the work was done, how long the study ran, whether its data is visible and if it was published in a reputable medical journal. This will help savvy readers look askance, even at pieces in quality news sites — such as recent articles touting turmeric or eating lots of hot peppers.

pthiel-200x300Although attention has focused on the GOP-promised repeal and replacement of the Affordable Care Act, other big changes also are afoot in the federal government that will have significant effects on health care in this country.

There are appointments pending from President Trump at the federal Food and Drug Administration and the Centers for Disease Control and Prevention. Sonny Perdue, the administration’s pick for Agriculture secretary, also will play a big public health role, as will the personnel decisions that may be made at the troubled National Institutes of Health, where, for now, Francis Collins will continue to lead.

Will the FDA be run by a venture capitalist?

PE-Color-240x300As partisans race to fulfill their seven-year political pledge to “repeal and replace” the Affordable Care Act, aka  Obamacare, their rhetoric has collided with reality, posing huge questions as to how responsibly they will act in the days ahead in regard to Americans’ health.

Curiously, the new president made no mention of health care in his inaugural address, and the White House web site, when it changed over, did not list this among top issues for the new administration.

But late Friday, President Trump signed an executive order, just several paragraphs long, that directed federal agencies to “waive, defer, grant exemptions from or delay” ACA rules — a move, symbolically if nothing else, to gut Obamacare, by undercutting, for example,  enforcement of its key requirement for Americans to carry health insurance or face penalties.

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