Articles Posted in Conflicts of Interest

mom-300x171Big 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:

kidtv-300x225If 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.

coveredcalif-300x169Although 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.

Seroquel-25mg-300x195In 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.”

FAST-infographic-2016-300x169It’s no April Fool joke: Emergency doctors across the country, according to the New York Times, have been defying widely accepted standards of care and withholding a drug that rigorous clinical trials and medical specialists long have recommended for stroke victims.

Administration of the drug, tPA or tissue plasminogen activator, helps to prevent brain injury after a stroke by dissolving the blood clot and opening up the blocked vessel. Neurologists and neurosurgeons as well as cardiologists, have campaigned for its aggressive use within hours after the onset of symptoms.  Indeed, hospitals nationwide have adopted speedy stroke care, including with tPA, under slogans like “Time is Brain.”

The drug’s fast use has become so accepted, the capacity to administer it is a keystone for hospitals to receive a much-sought designation as specialized stroke treatment centers. And though it has long been thought that tPA needed to be given within three or four hours from the start of stroke symptoms, new research funded by the National Institute of Neurological Disorders and Stroke has opened the strong possibility that many more patients could benefit from tPA and neurosurgery within 16 or even 24 hours after suffering a stroke.

Dumpster-300x251Although enthusiasts still wax on about  how technology will improve lives, patients may want to be wary about purported advances that may end up complicating and even compromising crucial parts of their medical care — including how their medical records are kept and how payers decide if they’re covered.

Let’s start with some kudos for dumpster-diving doctors in Canada who discovered flaws in hospitals’ disposal of supposedly confidential and legally protected patient health records. They went around unidentified facilities collecting from various bins a half ton of paper that doctors, nurses, and hospitals were ready to toss.

After examining the piles of paper, they found most private records had been properly handled. But thousands of documents also were not: They were improperly disposed of, and contained identifying or confidential patient treatment information, the researchers found. Though Canada’s patient privacy laws differ from those in the United States, they agree that patient health records must be guarded, and the researchers found violations of practice, policy, and potentially privacy laws.

redfieldPresident Trump’s latest rant  that drug dealers should face capital punishment fell flat in the face of new revelations on what’s going on with the fight against opioid drug overdoses and abuse that have become the leading killer of Americans younger than 50.

It turns out that states have failed to spend hundreds of millions of dollars in funding appropriated by Congress to battle the abuse of prescription painkillers, potent synthetic versions like fentanyl, and illicit drugs like heroin.

Politico reported that the Obama Administration, in the 21st Century Cures Act, passed by the Congress and signed into law by the president as 2016 ended, provided more than $1 billion over two years in grants to help states attack the opioid crisis.

cnnopioids-300x130Doctors already taking heat for selling out  their prescription pads for financial gain may want to brace themselves for new anger from patients, regulators, and lawmakers over two sets of data detailing unsavory links between MDs’ payments from Big Pharma and their opioid drug prescribing.

CNN, Harvard University, and CareDash.com — a site that says it seeks to serve low- to middle-income patients with reliable health care information — have examined national prescribing data, finding links between Big Pharma pay and doctors’ ordering of prescription painkillers central to a nationwide epidemic of abuse.

CNN, with Harvard, reported its findings:

shulkin-240x300More than 100,000 patients in the area surrounding the nation’s capital rely on a flagship hospital for what should be blue-chip care. They deserve better than the continuing scandal that envelops not only the VA Medical Center in Washington, D.C., but also its parent Department of Veterans Affairs.

Investigators have excoriated the VA and its leader for failing to address problems in the agency’s medical facilities nationwide but especially in Washington, because officials, as USA Today reported,  “had been informed of the issues repeatedly since 2013.”

The news organization added that investigators concluded “a culture of complacency and a sense of futility pervaded [VA] offices at multiple levels,” such that, “In interviews, leaders frequently abrogated individual responsibility and deflected blame to others. Despite the many warnings and ongoing indicators of serious problems, leaders failed to engage in meaningful interventions of effective remediation.”

frail-300x150Although patient advocates long have pressed Big Medicine to eliminate unnecessary care — waste in the health care system that some experts estimate adds as much as $765 billion annually in needless costs — it may be past due for a public condemnation of a notably extreme example of this practice: The all too frequent, unhelpful surgeries for the old, many of whom are at the end of life.

Liz Szabo of the independent, nonprofit Kaiser Health News Service, and National Public Radio deserve credit for their report, detailing how 1 in 3 Medicare patients undergoes a serious procedure, “even though the evidence shows that many are more likely to be harmed than to benefit from it.”

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