Disclosure

August 16, 2018

Lax oversight and safety nightmares burgeon with boom in surgical centers

An innovation in medical treatment — which was supposed to offer more affordable, accessible, and even convenient care — instead may be getting swamped with safety problems that long have plagued hospitals and academic medical centers.

USA Today and Kaiser Health News Service deserve credit for digging into patients’ nightmares with specialized surgical centers, not only those performing “routine” procedures but also those handling increasingly longer, more complex, and difficult operations. The many surgeries, once the province only of big and well-staffed hospitals, put patients at risk, the newspaper reported, saying:

[Our] investigation found that surgery centers operate under such an uneven mix of rules across U.S. states that fatalities or serious injuries can result in no warning to government officials, much less to potential patients. The gaps in oversight enable centers hit with federal regulators’ toughest sanctions to keep operating, according to interviews, a review of hundreds of pages of court filings and government records obtained under open records laws. No rule stops a doctor exiled by a hospital for misconduct from opening a surgery center down the street.

August 15, 2018

NFL settlements raise new questions on head trauma and Parkinson’s and ALS

by Patrick A. Malone

The National Football League, which long has resisted the growing reality that game-related head blows can cause major harms to its players, may be providing yet new and unintended warnings about the sustained damages of concussions.

The Los Angeles Times reported that pro football’s pay-outs, as part of its billion-dollar head-injuries settlement with NFL players and their union, have been surprisingly high in cases where retirees have claimed damages due to Parkinson’s and ALS.

Parkinson’s, the newspaper noted, is a “progressive movement disorder that produces tremors, impaired movement, and slurred speech.” It is “marked by the buildup of proteins called Lewy bodies in brain cells.” ALS, also known as amyotrophic lateral sclerosis or Lou Gehrig’s disease, is a condition affecting “nerve cells in the brain and spinal cord and ultimately results in a fatal inability to initiate and control muscle movement.”

August 12, 2018

Say what? Mar-a-Lago trio acting as ‘shadow rulers’ of Trump’s VA

by Patrick A. Malone

So, see, Ike, Marc, and Bruce may be pretty swell guys. They’ve done well in business: Ike in comic books and entertainment, Marc in the law and consulting on white collar crime, and Bruce as a medical concierge who gets affluent patients in to see big name doctors.

But this odd trio —Ike Perlmutter, Bruce Moskowitz and Marc Sherman — never served in the U.S. military. They’re certainly not veterans. Perlmutter and Sherman have zero experience in health care. And Moskowitz, while a doctor, is a respected primary care practitioner — not someone known for his direct experience in running big, complex operations.

They also, however, happen to be FOT — Friends of (President) Trump. They pay him to belong to his Mar-a-Lago country club. And, apparently at his request and with the assistance of powerful partisans and the acquiescence of sheepish bureaucrats, Perlmutter, Moskowitz, and Sherman have become “shadow rulers” of the U.S. Department of Veterans Affairs.

August 9, 2018

For sick seniors, hospitals and nursing homes can be nothing but bad news

by Patrick A. Malone

In many parts of the developing world, families play a big part in patients’ hospital care. They not only sit for long hours with loved ones, supporting and encouraging their recovery. They also may help with direct services, bathing and cleaning patients, tending to their beds and quarters, and even assisting with their medications and treatments.

Such attentiveness from loved ones— once common in this country, too — may be deemed by many now as quaint and unnecessary, what with the rise of big, shiny, expensive American hospitals.

But think again: As Paula Span reported in her New York Times column on “The New Old Age,” care-giving institutions across the country have become such stressful, disruptive places that seniors, especially, not only heal poorly in them but also may be launched into a downward cycle of repeat admissions.

August 8, 2018

Shift-and-shaft: Why is it always patients’ burden to hunt for affordable care?

by Patrick A. Malone

The health policy wonks and those who purport to “reform” the U.S. health care system may be long on academic and other fancy credentials. But they also persist in demonstrating they can be short on old-fashioned common sense, especially about the way most of us lead our lives.

That’s a point emphasized in a recent column in the evidence-based “Upshot” feature of the New York Times, written by Austin Frakt. He directs the Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System and is an associate professor with Boston University’s School of Public Health and an adjunct associate professor with the Harvard T.H. Chan School of Public Health.

Frakt looked at some recent research to dissect a question that occupies many experts: Could Americans cut their health care costs by shopping around more for medical services? This is a fond notion held by a slice of health care “reformers,” whom Frankt proceeds to disabuse.

August 6, 2018

As Big Pharma rivals battled to hype opioids, watchdogs dozed. They slumber still.

by Patrick A. Malone

When Big Pharma pursues rapacious profits and regulators snooze, patients suffer terrible consequences, as new revelations about the opioid crisis show.

Kaiser Health News Service , via the Washington Post, and The New York Times both have done excellent investigative digging into drug makers’ role in fueling the prescription painkiller mess that authorities estimate claims 116 lives a day due to overdoses.

Fred Schulte, writing for the independent, nonpartisan Kaiser service, reported that rival makers — seeing how much money Purdue Pharma was making with its powerful and addictive OxyContin drug and that it was encountering law enforcement and regulatory challenges — stepped in with “similarly dangerous painkillers, such as fentanyl, morphine and methadone.”

August 3, 2018

Pediatricians, with blast at FDA, warn of food additive and packaging risks to kids

by Patrick A. Malone

Moms and dads who have tried to safeguard their kids’ health by emphasizing fresh fruits and vegetables in their diet may need to take yet more steps to protect youngsters from harms associated with chemicals found in common foods and their packaging.

The American Academy of Pediatrics has issued a formal, research-based caution to consumers about “colorings, flavorings, and chemicals deliberately added to food during processing (direct food additives) as well as substances in food contact materials, including adhesives, dyes, coatings, paper, paperboard, plastic, and other polymers, which may contaminate food as part of packaging or manufacturing equipment (indirect food additives).”

As the New York Times reported of the advisory from the group representing 67,000 doctors who care for kids:

August 1, 2018

Colonoscopies carry higher infection risks than previously believed

by Patrick A. Malone

More than 15 million Americans each year undergo an invasive medical test, roughly once a decade and starting at age 50. If some medical experts had their way, more patients would get this cancer checkup, beginning at an even younger age. But as Emily Bazar, a senior editor and consumer columnist (Ask Emily) for the independent, nonprofit Kaiser Health News service, points out, physicians may want to heal themselves and their hygiene practices before pushing even more patients to get colonoscopies and endoscopies (procedures to examine the upper gastrointestinal tract).

That’s because a growing body of research shows that the switch by doctors, hospitals, and specialty centers to reusable scopes to peer into various parts of the body have resulted in rising infection rates among colonoscopy and endoscopy patients, among others.

Inspections show that the reused scopes don’t get cleaned properly and all the time. The more complex the medical device, the greater the risk, as clinicians and patients learned when complex and dirty duodenoscopes were tied to the deaths of 35 patients since 2013 and the sickening of dozens of others, leading to congressional investigations, lawsuits, and product recalls.

July 31, 2018

Patients? We’re just profitable bit$ and byte$ to Big Pharma and insurers

by Patrick A. Malone

Big Data may be a business buzzword that puts most consumers into a big sleep, but big alarms are sounding for Americans about Big Brother intrusions into their lives via the collection and analysis of vast amounts of highly personal information. Of course, Big Pharma and medical insurers are at the fore of invasive practices — some of which patient-consumers themselves are helping, likely without knowing they’re doing so.

Millions of Americans may be little aware, for example, that they’re now working for GlaxoSmithKline, a global pharmaceutical conglomerate with $9 billion in revenues in just the most recent quarter. GSK just struck a $300-million deal with 23andMe, the company that has persuaded roughly 5 million consumers to spit in a test tube to get a glimpse of their genetic information, notably information about their ancestry and purportedly some of their genomic health risks.

Firms like 23andMe, with promotions at events like Baltimore Ravens pro football games, also have amassed highly personal genetic and medical data on millions of patient-consumers, promising to protect the information but also offering, casually and by the way, that this vital information could be shared — ostensibly for the betterment of public health.

July 29, 2018

With 100 deaths a day, when will the U.S. renew campaign for safer motoring?

by Patrick A. Malone

How outraged and motivated to political action might you be if an avoidable disaster in a week claimed the lives of all the youngsters in your kids’ school? How upset might Americans be if a calamity wiped out in 24 hours seven NBA professional basketball teams, or two pro NFL squads?

David Leonhardt, associate editor of the New York Times Editorial Page, threw a powerful jab in his Op-Ed at lawmakers and regulators who, as always, seem to be shrugging off not only the summer deadliest season but also the rising annual toll of road deaths. The carnage has made America’s streets and highways the most dangerous in the industrialized world.

As Leonhardt points out, federal data show that 100 people die daily in US vehicle wrecks. Many are young. They’re killed by drunken, distracted, and drugged drivers, or they die due to their own bad decisions, including poor maintenance of their vehicles, or because of bad luck.