Communication

March 27, 2020

With youngsters ages 10 to 14, a tragic and scary spike in suicides

While alarms have been raised about the nation’s ever-increasing numbers of suicides, mental health experts, educators, and medical researchers also are making urgent pleas for grownups to pay heightened attention to the spike in cases in which youngsters are taking their own lives.

As the independent, nonprofit Kaiser Health News Service reported:

“[S]uicide by children ages 10 to 14 has gone up and up. The suicide rate for that age group almost tripled from 2007 to 2017. Newly released 2018 data from the Centers for Disease Control and Prevention show a 16% increase over the previous year. While experts point to a host of explanations for the alarming rise, scientific proof about cause isn’t conclusive. Some research shows correlations with social media use, cyberbullying and the internet, but studies citing them as a suicide cause are less decisive.”

March 25, 2020

For 70+ women and their MDs, more reasons to rethink routine mammograms

by Patrick A. Malone

As Americans live longer, clinicians may need to reconsider whether they need to subject older patients to routine screenings that may trigger even more costly, invasive, painful, and unnecessary medical testing and procedures. For women 70 and older, for example, yet more new evidence raises doubts about mammograms designed to detect breast cancers.

As the New York Times reported, researchers in Boston examined 2000-2008 Medicare claims “to follow more than one million women, ages 70 to 84, who had undergone a mammogram.” Quoting Dr. Xabier Garcia-Albéniz, an oncologist and epidemiologist at RTI Health Solutions and lead author of a new observational study of their women subjects:

“They had never had breast cancer and had a ‘high probability,’ based on their medical histories, of living at least 10 more years. ‘That’s the population who will reap the benefit of screening,’ Dr. Garcia-Albéniz said, because it takes 10 years for mammography to show reduced mortality. The researchers divided the subjects into two groups: one that stopped screening, and another that continued having mammograms at least every 15 months. They found that mammograms provided a survival benefit, if a modest one, for women ages 70 to 74. In line with previous research, the study found that annually screening 1,000 women in that age group would result, after 10 years, in one less death from breast cancer. But among the women who were 75 to 84, annual mammograms did not reduce deaths, although they did, predictably, detect more cancer than in the group that discontinued screening. ‘You’re diagnosing more cancer, but that’s not translating to a mortality benefit,’ Dr. Garcia-Albéniz said.”

March 23, 2020

Trump storms into medical-ethics minefield by flogging drugs’ untested use

by Patrick A. Malone

President Trump has stormed past accepted professional practices and triggered alarms about ethical decision making by caregivers, as he persists in his noisy advocacy for treating seriously ill patients with Covid-19 infections with an unproven pair of prescription drugs.

Promoting this drug regimen — on social media and in White House news conferences — has pitted the onetime real estate developer and reality show host with an undergraduate economics degree squarely against Dr. Anthony Fauci, one of the nation’s foremost infectious disease experts at the National Institutes of Health.

They have squared off publicly, with the leader of the free world talking about how he “feels good” about giving patients two, long-used antimalarial drugs — chloroquine and hydroxychloroquine (aka plaquenil) — while Fauci has insisted such prescribing has no basis now, and, at best, should be subjected to rigorous clinical trial to determine their effectiveness.

March 22, 2020

As pandemic grips the globe, outbreaks, too, of ‘What were they thinking?’

by Patrick A. Malone

Even as Covid-19 wreaked unprecedented harms, there also have been actions that might lead even the most jaded observer to cry out: What were these people thinking?

The pandemic’s global toll has risen to hundreds of thousands of infections and thousands of deaths. The U.S. toll at the end of the third week in March, the New York Times reported, exceeded 21,000 infections and nearly 300 deaths, with 1 in 5 Americans also now living under tough restrictions that have shut non-essential businesses, schools, colleges and universities, restaurants, gyms and health clubs, and sports and cultural events.

In the throes of such calamitous circumstances, consider:

March 20, 2020

Alcoholics Anonymous can benefit many with drinking problems, research finds

by Patrick A. Malone

Although federal experts estimate that alcohol abuse leads to 88,000 Americans’ deaths annually and economic costs of almost $250 billion, one of the nation’s oldest and best-known programs to deal with this problematic behavior has long been surrounded by doubts.

Critics have questioned its effectiveness, criticized its “irrationality,” and focused on its stepped regimen, desperate and self-enrolling participants, and core tenets, including its spiritual appeals to higher and external powers.

But after a deep dig into the building and rigorous evidence about it — including scrutiny of 27 studies, (some of them randomized clinical trials) with more than 10,000 participants — researchers from Harvard, Stanford, and Europe have concluded in a published, research review for the respected Cochrane Collaboration that Alcoholics Anonymous, indeed, can be beneficial for many but not all excessive alcohol users.

March 18, 2020

Don’t fall for malpractice malarkey: A briefing details medicine’s many harms

by Patrick A. Malone

Cold, hard facts — not hunches, arguments, or theories — matter most when tough health care decisions must be made. Americans have been reminded of this by painful headlines on the opioid and overdose crisis, the rise of lung injuries and deaths due to vaping, and, yes, now the rapid spread of a new coronavirus. Doctors, hospitals, insurers, Big Pharma, and other major parties in the U.S. health care system aren’t always as candid as they need to be, especially in disclosing how they harm and even kill patients.

That’s a truth (with a small “t”) that readers can discover quickly in the Center for Justice and Democracy’s latest edition of its annual “Briefing Book: Medical Malpractice by the Numbers.” The center, at New York Law School, provides evidence about a field that has become the bogeyman for politicians, policy makers, and medical practitioners eager to hide egregious errors with extreme counter factual assertions.

Malpractice cases in the civil justice system provide important insights and checks on how doctors and hospitals care for the sick, injured, and vulnerable.

March 17, 2020

Patients get rule-making boost to access and use important medical records

by Patrick A. Malone

The Trump Administration, to its credit, has put out finalized new rules that aim to give patients greater access to and use of their all-important medical records, now mostly captured and contained in electronic form.

Federal officials had to battle a handful of wealthy, powerful corporations that own and install proprietary software and computing systems to try to help patients.

They also instantly created major new concerns with their “interoperability” regulations for doctors and hospitals:

March 15, 2020

Life grinds to a halt as Americans start to deal with gravity of Covid-19 spread

by Patrick A. Malone

Across the nation, and throughout the DC region, Americans — finally — have started to come to grips with the gravity of a fast-spreading, new respiratory virus’ infections. The novel coronavirus has infected almost 150,000 internationally, killing thousands as part of what now is officially a global pandemic and a national emergency.

Cases of Covid-19 have been detected in Washington, D.C., Virginia, and Maryland, as public health officials have urged the public to increase safeguards against contracting the disease, notably by staying home and practicing not only hygienic measures (washing their hands, covering their coughs and sneezes, and foregoing handshakes and hugs) but also keeping their distance from others.

Businesses have urged their people to work from home. Schools have shut their doors. Concerts, plays, museums, and cultural events and institutions have closed and canceled. Professional and amateur sports have suspended play. Travel, domestic and international, has screeched to a halt. Panic buying has broken out at groceries and big box warehouse stores.

March 13, 2020

Trump’s pick as top consumer product watchdog? Chemical industry insider

by Patrick A. Malone

President Trump has made it official: He intends to nominate Nancy B. Beck, a chemical industry insider and a scientist who built a record at the U.S. Environmental Protection Agency of scaling back safeguards against toxic substances, to lead one of the nation’s top and lately troubled consumer safety watchdogs.

The ascent of Beck to head the Consumer Product Safety Commission has been anticipated and is unsurprising. It still angered consumer groups and Democrats, who pointed to her record at the EPA, saying it already shows she is ill-suited to put the public’s interest above industry concerns.

As the Washington Post reported:

March 11, 2020

High court, for third time, takes up a GOP effort to kill popular Obamacare

by Patrick A. Malone

Timing may be everything in life and the law: The U.S. Supreme Court — while giving the Trump Administration a small political break for now — may give the president’s fall reelection campaign plenty of upset still. Whether the court will give the country a health care disaster is another question.

The high court, acting on a request by Democratic state attorneys general, has agreed once more to consider the fate of the Affordable Care Act, aka Obamacare, on an expedited basis, even before a federal trial court and appellate judges finish their consideration of the latest legal challenge to the ACA.

This will be the third time the justices have taken up an ACA lawsuit, with this challenge representing not only another Republican attack on government-assisted health insurance for the poor, working poor, and middle class. This also may be a legal extreme for questioning Obamacare, as the New York Times reported: