DC Medical Malpractice & Patient Safety Blog

April 19, 2018

Retail clinics are booming, but can’t be a cheaper cure-all for patient needs

Americans are showing with their feet and their money how they feel about doctors’ offices and shiny hospitals, places they’re shunning more and more. They’re racing to neighborhood clinics and urgent care centers that seem to be popping up on every suburban street corner and shopping mall.

Before these facilities transform U.S. health care, would it be worth asking what this trend might mean, not just for profit-seeking retailers, drug store chains, and, yes, also hospitals and doctors who are shifting into new lines of business?

The New York Times found that:

April 17, 2018

Big Medicine can’t hide patient inequities by calling them ‘disparities’ in care

by Patrick A. Malone

Big Medicine can paper over its troubles with basic fairness by slapping fancy terms on them: take “health and gender disparities,” for instance. But doctors, hospitals, and the rest of us can’t make medical care more equitable, accessible, safe, and affordable without looking at inequities, square on.

That’s why the New York Times, Washington Post, and Associated Press deserve credit for recent deep digs into the struggles of women, poor women, and especially black women with modern medicine:

Why are black women and their babies confronting a “life and death crisis?” asks the New York Times.

April 15, 2018

Will opioid crisis raise red flags for long-term antidepressant use?

by Patrick A. Malone

Even as the nation enters an even scarier phase in its battle against the raging opioid abuse epidemic, new and sterner warnings are flying about antidepressants. The costs of these powerful drugs add up, as does the toll of depression and its care. Users say antidepressants are a nightmare to get off of. And medical experts cast growing doubt about whether their benefits outweigh their risks.

The New York Times deserves credit for detailing the worrisome plight of an estimated 15.5 million Americans who have been taking antidepressants — sold as brand drugs like Zoloft, Effexor, Paxil, Prozac, and Cymbalta — for at least five years. The rate of the psychiatric medications’ use “has almost doubled since 2010, and more than tripled since 2000,” the newspaper reported, adding that “nearly 25 million adults … have been on antidepressants for at least two years, a 60 percent increase since 2010.”

Users who try to wean themselves from the drugs find themselves, fast, in nasty situations with “dizziness, nausea, headache and paresthesia — electric-shock sensations in the brain that many people call brain zaps,” patients told the New York Times.

April 13, 2018

Are we back to this? Kids targeted by nicotine and sugary cereal peddlers

by Patrick A. Malone

Big Tobacco, Big Sugar, and technology may be targeting the well-being of young people faster than regulators can prevent them from heading back to the future in a bad way: Teens getting hooked on nicotine, while tots take in excess calories with super sweet breakfast cereals.

The Wall Street Journal and the New York Times each have big take-outs, reporting on the “explosive” and “epidemic” trend, mostly by more affluent teens, of vaping with so-called e-cigarettes, notably a hot new device called the Juul.

It’s about the size of a computer flash drive, and it uses fruity-flavored liquids to deliver a jolt of nicotine — more than what users might get by puffing a pack of old-fashioned cigarettes.

April 11, 2018

Lack of money can make you sick

by Patrick A. Malone

Although the United States remains the world’s most affluent nation, it also is a country where money plays a driving, negative role in its people’s well-being. Sudden financial losses may shorten some Americans’ lives, while dismal finances may keep many others from seeking medical care.

So why are politicians still pushing to slash the nation’s social safety net, even as millions of individuals and families are voting with their wallets to protect their health?

Lethal ‘wealth shocks’

April 10, 2018

Hospitals give patients and taxpayers too many causes for high anxiety

by Patrick A. Malone

Hospitals may be providing us all with too many causes for high anxiety, with reports on increasing findings of “nightmare” bacteria stalking more health care facilities than had been known, more disclosures about how taxpayers may foot an even bigger bill to deal with a beleaguered public hospital in Washington, D.C., and a respected reform advocate’s detailing of just how traumatizing many hospital stays may be.

Let’s start with the new research by the federal Centers for Disease Control and Prevention, a study that tried to determine just how many cases there might already be of patients infected in hospitals, nursing homes, and other medical care facilities with so-called Superbugs, bacteria that resist treatment not only with most standard antibiotics but also drugs that are deemed therapies of last resort. These include three types of bacterial infections deemed especially urgent but difficult to control: Clostridium difficile (C. difficile), aka C-diff; carbapenem-resistant Enterobacteriaceae (CREs, as shown above); and Neisseria gonorrhoeae.

CDC officials weren’t sure how many of the Superbug cases — which leave doctors and hospitals little option but to provide only supportive care — they might detect by scrutinizing records from pathology labs nationwide.

April 8, 2018

As opioids take a work toll, more Americans urged to carry overdose antidote

by Patrick A. Malone

Our nation’s lethal opioid epidemic is reaching its tentacles right into our paychecks, as employers face rising health insurance costs that crimp their ability to give pay raises to the rest of us. This is happening even as we are being urged to carry overdose antidotes, just in case.

The independent, nonpartisan Kaiser Family Foundation reported that its new analysis of large employer insurance claims shows that American businesses paid $2.6 billion in 2016 to treat opioid addiction and overdoses by their covered workers and dependents. That compares to $273 million in 2004, so it’s up ten-fold in a decade.

The costs of caring for opioid abuse skyrocketed, even as employer health insurance saw sharp declines in the number and expense for prescriptions and use of powerful painkillers.

April 6, 2018

Pro sports faulted for fattening fans, old and young, with blitzes of food ads

by Patrick A. Malone

If Americans want to battle obesity, including among youngsters, one place to start is avoiding unhealthy food products hawked relentlessly by major league sports advertisers.

Weight woes plague grownups and show no signs of letting up — they’re increasing, instead, with 40 percent of Americans found to be obese in 2015 and 2016, a sharp increase over a decade earlier. The picture’s no prettier for young people, with the latest federal data showing the percentage of children ages 2 to 19 who are obese increased from 14 percent in 1999 to 18.5 percent in 2015 and 2016.

With studies showing that junk food and empty calories contribute significantly to making the nation an excessive waist-land, Vox, an online information site, deserves credit for pointing out how pervasive, insidious, and even accepted it has become for sports fans — especially young enthusiasts — to be barraged by advertising for fast and unhealthful meals, sugar-laden drinks and cereals, and foods full of fats, empty calories, and excess salt.

April 5, 2018

Calif. warns hospitals to boost quality, safety of care or get booted from ACA

by Patrick A. Malone

Although Republicans have ripped at the health insurance offered under the Affordable Care Act, a less known but also important aspect of Obamacare may soon benefit Californians. This West Coast ACA-related move also may be worth watching by patients and medical safety advocates, as well as employers and insurers.

The Golden State, the San Francisco public radio station KQED reported, soon will tell hospitals that “time’s up” for them to improve their care, and, if they fail to hit new quality and safety targets that will be part of an impending three-year contract with Covered California, the ACA marketplace operator, they will get the boot from Obamacare coverage.

Because bluer-than-blue Democratic California has gone all-in in supporting and putting ACA coverages in place, the state’s Obamacare exchange is big (more than 1 million customers and 11 approved companies) and lucrative — so much so hospitals and insurers can’t ignore the quality demands. They’re neither extreme nor should they be surprising, because state officials emphasize they have consulted with key parties for several years now in the “Smart Care California” collaborative about the plans they intend to put in place.

April 3, 2018

Off-label drug tied to deaths, $1 billion in harms — and $3.6 billion in sales

by Patrick A. Malone

In a display of just how corruptive big money has gotten to be in modern medicine, Big Pharma keeps getting dubious doctors to write so-called off-label prescriptions for powerful anti-psychotic medications — no matter their proven harm to patients nor big settlements drug makers have been forced to pay.

The Washington Post deserves credit for its investigative dissection of AstraZeneca and its “blockbuster” product, Seroquel (generic name quetiapine). It’s a medication developed to treat severe cases of schizophrenia.

Instead, as has occurred with several other drugs of its kind, doctors — in response to major marketing and sales campaigns by AstraZeneca — have decided this wallop-packing drug can be given for uses for which there is less or little evidence. The Washington Post says doctors write abundant Seroquel scripts for patients with an “expansive array of ills, including insomnia, post-traumatic stress disorder and agitation in patients with dementia.”