Accessibility of Healthcare

November 14, 2018

Misdiagnosis: a medical menace to quality and safety of patient care

If patients weren’t already unhappy with drive-by medicine, in which clinicians spend on average of 15 minutes with them in an office visit, safety experts warn that too many doctors’ providing of harried care can worsen a medical menace that’s already hard to ignore: misdiagnosis.

Figuring out what ails a patient and taking a correct course of action already is a “complex, collaborative activity that involves clinical reasoning and information gathering,” reports Liz Seegert, a seasoned health journalist and a senior fellow at the Center for Health Policy and Media Engagement at George Washington University.

But, in a briefing posted online for her journalistic colleagues, she goes on to amass some eyebrow-raising information on diagnostic errors, their frequency, harms to patients, and why experts in the field see corrections in this area needed, stat. Among the data points she reports:

November 13, 2018

Harms of medical bunk are real, as $105 million verdict affirms

by Patrick A. Malone

Dr. Otis Brawley, formerly of the American Cancer Society

The rising flood of health care hype, bunk, and conflicts of interst really can harm patients, as has just been emphasized by a $105-million jury verdict, the brave actions of a leading patient advocacy expert, and the commentary of an expert health researcher and New York Times columnist.

In a more perfect world, a patient like Dawn Kali, 45, and a mother of four, wouldn’t give the time of day to the wild claims of Robert Oldham Young. Both live in San Diego, and when she was diagnosed with cancer, she told a court that she found Young persuasive.

November 11, 2018

Voters nationwide sent a powerful health care message. Will partisans heed it?

by Patrick A. Malone

Last week’s election leaves two questions lingering about health care: Will politicians really hear what voters said? And, what help might beleaguered patients now expect from their elected officials?

The Affordable Care Act, the central flash point of almost a decade of bitter political battles, appears stronger and more steadfast with Republicans losing the House, despite their last-minute counter-factual claims to support pillars of Obamacare like protections on pre-existing conditions, minimum- and lifetime-benefits.

Medicaid, a program expanded under the ACA to provide more and more affordable care to the poor and struggling, got a big boost, too, in the midterms. Voters, by the ballot, voted to expand its reach in the “red-red” states of Utah, Nebraska, and Idaho. The new governor in Maine will halt her predecessor’s resistance to the Medicaid expansion, according to her campaign promises. In Wisconsin and Kansas, Democratic gubernatorial candidates who also campaigned for Medicaid expansion, defeated Republicans who had opposed it.

November 9, 2018

Big Pharma shows off its big gall with risky products and dubious practices

by Patrick A. Malone

Big Pharma is a broad commercial sector with many diverse enterprises large and small, but they keep showing they’re united in their giant gall when it comes to their unacceptable products and practices, as timely news reports demonstrate.

Just consider:

As the nation grapples with an overdose epidemic that kills tens of thousands of Americans annually, why would the firm AcelRx race to market — and why would federal regulators approve — a new opioid painkiller? Experts warn the drug is incredibly powerful and so tiny and easy to use that it fast will be much abused and lethal. The new pill, Dsuvia, is just 3 millimeters in diameter — the size of a big grain of sand. Placed under the tongue, it delivers its dose almost as soon as it dissolves. It is said to pack 10 times the potency of an already deadly synthetic painkiller: fentanyl, which is up to 100 times more potent than morphine and many times that of heroin.

November 7, 2018

There they go again: Surgeons ‘innovate,’ but women patients get put at higher risk

by Patrick A. Malone

Women may need to double-up on their consultations with their specialists about treatment for serious gynecological concerns, as new studies have raised troubling questions about a much-touted minimally invasive surgery for early-stage cervical cancer.

These concerns, in a more perfect world, also would prompt greater questioning and oversight by doctors, hospitals, regulators, and lawmakers of surgical “innovations.”

The procedure now in question removes the uterus, part of the vagina, and other surrounding tissues via small incisions and with special laparoscopic instruments, including robots. Surgeons have advocated for this surgery rather than making a large incision in an “open” procedure, arguing the less invasive approach promotes less discomfort and faster healing for patients.

November 4, 2018

Tuesday’s a crucial health care day, and health coverage deadlines loom

by Patrick A. Malone

Take some time this week to do something big for yourself, your loved ones, friends, work colleagues, and our country, for that matter:

Exercise your privilege, right, and duty as a citizen: Please vote.
You may wish to look now at your health insurance coverage, please, being mindful of onrushing deadlines especially if you may be seeking or renewing a policy through the Affordable Care Act exchanges (their 2019 enrollment period opened on Nov. 1), or Medicare.

October 31, 2018

Why are doctors and hospitals still bungling patients’ records requests?

by Patrick A. Malone

Uncle Sam more than ever wants it to happen, and patient advocates are pushing hard, too. So, why, when technology can make it easier than ever to do so, must patients struggle still to get easy, convenient, low- or no-cost access to invaluable electronic records about their own health care?

Judith Graham, a columnist focusing on aging issues for the Kaiser Health News Service, has written a timely, troubling update on perplexing challenges consumers still confront when trying to secure their electronic health records (EHRs).

She cites a study recently published by Yale researchers who gathered information from 83 leading hospitals that purport to assist their patients with EHR access. The experts swept up policies and forms the institutions said patients would need, then contacted them, telling hospital staffers not that they were academic researchers but that they were checking on behalf of an elderly relative in need of their records and how soon and how difficult and costly might it be to get them? This is an everyday dilemma for consumers, and the institutions should have dealt with these requests with ease and alacrity.

October 30, 2018

The downside of crowd-funding medical treatments for desperate patients

by Patrick A. Malone

Although the sky-high cost of providing medical care to sick or injured friends and loved ones might seem good reason to encourage community altruism to the nth degree, new technologies that have made it easy, fast, and convenient to “crowd source” online donations also may be sending well-intentioned gifts to dubious and dangerous types of treatment.

A new study by researchers in Atlanta and New York shows that campaigns on GoFundMe and other social media platforms, sought to raise tens of millions of dollars, and brought in millions for sketchy health-related applications. Experts found “1,059 campaigns that raised money for five unproven or possibly risky treatments: homeopathy or naturopathy for cancer, hyperbaric oxygen for brain injury, experimental stem cell therapy for brain or spinal cord injuries, and long-term antibiotics for chronic Lyme disease,” reported Stat, an online health and medicine news site.

CNN reported that online solicitations were targeted to allow patients to seek dubious therapies at “clinics” in Germany and Mexico (homeopathic or naturopathic cancer care), New Orleans (hyperbaric oxygen for brain injury), and Panama, Thailand, India, China, and Mexico (“stem cell” treatment).

October 28, 2018

Really? Trump embraces Europe’s price controls to fight high U.S. drug costs

by Patrick A. Malone

Days before politicians will face voters who tell pollsters they’re angry and upset about health care issues, President Trump made his first visit to the nation’s giant Health and Human Services Department to roll out a much-promoted proposal to attack soaring prescription drug prices.

The plan was plenty wonky, replete with data about how much less patients in other, similar developed nations pay for drugs than Americans do. And despite the president’s assault on “freeloading” foreigners, it was murky as to the outcomes and fate of the administration’s latest drug cost-reduction proposal.

That’s because, buried in its pages of prose, it amounted to little more than a sketch of what experts have termed a big, rigorous clinical trial of an approach that’s anathema to Trump’s own purportedly free-market-loving party: price controls.

October 24, 2018

Health care advocacy group to expand ratings to include surgery centers

by Patrick A. Malone

A familiar health care advocacy group will expand its grading of 2,000 or so hospitals across the country to also provide new safety and quality information on 5,600 stand-alone surgical centers that perform millions of procedures annually.

It may seem like a small step, and the devil will be in the details of the new data that will be voluntarily reported, analyzed, and then made public by the Leapfrog Group, a national health care nonprofit that describes itself as being “driven by employers and other purchasers of health care.”

Surgical centers have burgeoned because they can be nimbler than the hospitals and academic medical centers they now outnumber. The centers can be set up without hospitals’ high overhead costs, including for staff and equipment that may be unnecessary for a specialty practice. The facilities also can be set up closer to patients, theoretically offering them greater access and convenience, including with easy navigation and parking.