DC Medical Malpractice & Patient Safety Blog

January 23, 2020

Yes, you may suffer heart disease, even in the most fitness-fanatical state of the union

Sure, it can be fun to watch two East Coasters take a long, sharp pin and pop the fantasy bubble that Westerners, especially Coloradans, like to float around in. Mountain state residents may like to tell themselves how the people on the Front Range skew young, educated, and active. How blue skies and open spaces keep folks busy and outdoors. And did they mention super healthy?

Or maybe not.

There’s a bigger takeaway in the recent focus on the Rockies by reporters Betsy McKay and Paul Overberg. As the Wall Street Journal duo found:

January 21, 2020

FDA reviews go faster — but with less proof drugs are safer or more effective

by Patrick A. Malone

For anyone concerned with the quality and safety of prescription medications, this may be an especially displeasing commentary from a pharmaceutical expert about drugs raced to approval now: “Some of them are really great,” the professor observed. “And some of them [are] not so great. And a lot of them are very expensive.”

That quote, by the way, comes from a news report by NPR on so-called reforms of the federal Food Drug and Administration prescription drug oversight process. Big Pharma has howled for some time now at politicians, regulators, and the public for fixes to the system — and the industry has gotten its way.

Now, as NPR reported, based on a new study posted online on the JAMA Network:

January 20, 2020

On MLK Day, never forget his view: ‘Injustice in health is the most shocking …’

by Patrick A. Malone

With the nation taking a holiday to celebrate the remarkable life of the Rev. Dr. Martin Luther King and his pioneering push for Americans’ civil rights, it may be worth remembering that his far-reaching visions of equality and social justice were deeply unpopular in their time, as was he.

King infuriated many, including in medicine and health care, observing, for example, that:

“Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.”

January 17, 2020

Critics may howl. But with stubborn wrongs, big settlements may be necessary

by Patrick A. Malone

Doctors, hospitals, insurers, politicians, and businesses may assail the civil justice system over sums it awards to people who have proven they have been harmed. But as significant as some judgments may be, they may be exactly what judges and juries decide may be required to get institutions and enterprises to stop stubborn wrongs.

Is $215 million enough in a federal case, for example, to get the University of Southern California to learn the hard lesson that it needs to listen and to act swiftly if coeds and nurses complain about inappropriate sexual behavior of its student health service staff?

Is $46 million sufficient to get Ikea to fix, recall, and inform the public yet more about the dangers to children of pieces of its furniture that can tip over and kill kids — the latest victim being Jozef Dudek, 2?

January 16, 2020

Spiking death rate a harsh reminder of alcohol’s risks, especially for women

by Patrick A. Malone

Tipple much, much less in 2020. That might be a life-saving bit of advice for too many Americans to follow, especially because of new data on a worrisome spike in alcohol-related deaths.

As NBC News reported, based on published research by federal researchers:

“The yearly total of alcohol-related deaths for people ages 16 and over more than doubled, from 35,914 in 1999 to 72,558 in 2017. There were almost 1 million such deaths overall in that time. While middle-age men accounted for the majority of those deaths, women — especially white women — are catching up, the study found. That’s concerning in part because women’s bodies tend to be more susceptible to the effects of alcohol.”

January 15, 2020

Good news on cancer shows why the battle against smoking matters. A lot.

by Patrick A. Malone

There’s good news out on declining deaths caused by one of the nation’s leading killers. But experts warn that the country will need to work hard to sustain a sharp drop in cancer mortality rates — mostly due to smokers quitting their nasty habit. That’s because other factors like rising obesity may undo the recent favorable results.

The findings reported by the American Cancer Society were heartening, as the New York Times reported:

“The cancer death rate in the United States fell 2.2% from 2016 to 2017 — the largest single-year decline in cancer mortality ever reported … Since 1991, the rate has dropped 29%, which translates to approximately 2.9 million fewer cancer deaths than would have occurred if the mortality rate had remained constant.”

January 14, 2020

Here’s a cause for anger and despair: We’re all forced to pay $8,000 ‘health tax’

by Patrick A. Malone

Even as economic inequity and inequality fuel a nationwide plague of “deaths of despair,” a runaway and inefficient health system hits Americans hard in their pocketbooks, in effect imposing an $8,000 annual tax on every household, a pair of leading economists say.

The crushing cost of the U.S. health system, exceeding $1 trillion a year, forces all Americans to pay this “tribute,” as if it were going to a foreign power, except this is a toll on themselves that we tolerate and allow, say Anne Case and Angus Deaton. The Princeton economists have reached this conclusion, as part of their research for their upcoming book, “Deaths of Despair and the Future of Capitalism.”

Case told economists at a San Diego conference: “A few people are getting very rich at the expense of the rest of us.”

January 10, 2020

Need simple, clear, and direct ideas to be healthier? Heed these 48 words

by Patrick A. Malone

Bravo, brevity. Four dozen words is all it takes for a doctor and noted writer on diet and obesity to offer plenty of sound advice on how to get and stay healthy.

Here are the suggestions from Yoni Freedhoff, associate professor of family medicine at the University of Ottawa, founder and medical director of Ottawa’s Bariatric Medical Institute, blogger at Weighty Matters, and author of “The Diet Fix: Why Diets Fail and How to Make Yours Work:”

“Don’t smoke. Get vaccinated. Avoid trans fats. Replace saturated fats with unsaturated if you can. Cook from whole ingredients — and minimize restaurant meals. Minimize ultra-processed foods. Cultivate relationships. Nurture sleep. Drink alcohol at most moderately. Exercise as often as you can enjoy. Drink only the calories you love.”

January 8, 2020

Hospital mergers and acquisitions aren’t great for patients’ care, study finds

by Patrick A. Malone

Big hospitals keep getting bigger. But, contrary to what the suit-wearing MBAs may claim, the rising number of institutional mergers and acquisitions isn’t necessarily better for patients and their care.

At hospitals subjected to corporate wheeling and dealing, the quality of care got worse, or, at best, it stayed the same and didn’t improve, a new study in the New England Journal of Medicine reported.

Researchers scrutinized federal data “from 2007 through 2016 on performance on four measures of quality of care … and data on hospital mergers and acquisitions occurring from 2009 through 2013,” they said. These measures, the Wall Street Journal reported, included: patient satisfaction; deaths within a month of entering the hospital; return trips to the hospital within a month of leaving; and how often some heart, pneumonia, and surgery patients got recommended care. They looked at 246 hospitals involved in M&A activity, controlling their findings with data from 1,986 institutions not similarly affected.

January 7, 2020

A caution about rising hype for artificial intelligence in medicine

by Patrick A. Malone

In recent years, doctors, hospitals, and popular media have promoted emerging treatments to the public with enthusiasm that in each case would turn out to be overblown. Just consider the red-hot chatter that once surrounded regenerative medicine, precision medicine, gene therapy, or immunotherapy. And now, it may be the turn of artificial intelligence to be hyped hard in health care.

Caveat emptor, as Liz Szabo reported for the Kaiser Health News Service. She sets the stage, thusly, about developments in a field that might worry some who remember Hal 9000 from “2001: a Space Odyssey”:

“Health products powered by artificial intelligence, or AI, are streaming into our lives, from virtual doctor apps to wearable sensors and drugstore chatbots. IBM boasted that its AI could ‘outthink cancer.’ Others say computer systems that read X-rays will make radiologists obsolete. ‘There’s nothing that I’ve seen in my 30-plus years studying medicine that could be as impactful and transformative’ as AI, said Dr. Eric Topol, a cardiologist and executive vice president of Scripps Research in La Jolla, Calif. AI can help doctors interpret MRIs of the heart, CT scans of the head and photographs of the back of the eye, and could potentially take over many mundane medical chores, freeing doctors to spend more time talking to patients, Topol said. Even the Food and Drug Administration ― which has approved more than 40 AI products in the past five years ― says ‘the potential of digital health is nothing short of revolutionary.’”