Disclosure

December 12, 2019

Top experts, by failing to disclose conflicts of interest, shortchange taxpayers

Elite researchers — professors and staff with ties to 20 of the nation’s top universities and the respected National Institutes of Health — may be failing to be as candid as institutions and laws require about their potential professional conflicts of interest, notably the significant sums they get from Big Pharma and medical device makers.

ProPublica, the Pulitzer Prize-winning investigative organization, and the Los Angeles Times jointly scrutinized the experts’ required disclosures, finding they not only fall short. They may fail to give the public a fair view of the credibility of their findings. And, in California, they may be a unique rip-off of the state’s top university system. The “UCs” provide research faculty with costly facilities and other support, as well as sharing its global renown — in exchange for revenue the experts may earn outside the system.

In total, after examining records on tens of thousands of university scholars and NIH experts, ProPublica not only has made public its “Dollars for Profs” database, it also quotes federal watchdogs as estimating that with the NIH alone, conflicts of interest with agency grants amounts to $1 billion.

December 10, 2019

Hospitals’ preventable patient deaths add to big concerns in mental health care

by Patrick A. Malone

With mental health services stretched thin and failing to fill significant need, it may be more distressing still for the public to confront growing evidence of big problems in existing facilities that try to treat those with serious psychiatric ills.

The Los Angeles Times, based on its investigation, has found “nearly 100 preventable deaths over the last decade at California psychiatric facilities, including at La Casa Mental Health Rehabilition Center (shown here). It marks the first public count of deaths at California’s mental health facilities and highlights breakdowns in care at these hospitals as well as the struggles of regulators to reduce the number of deaths.”

The newspaper said it “submitted more than 100 public record requests to nearly 50 county and state agencies to obtain death certificates, coroner’s reports and hospital inspection records with information about these deaths.” Reporter Soumya Karlamangla said she had to look far and wide for data on problems in psychiatric facilities because, “No single agency keeps tabs on the number of deaths at psychiatric facilities in California, or elsewhere in the nation.”

December 8, 2019

Investigations rip FDA for laxity on asbestos-tainted talc and medical devices

by Patrick A. Malone

When it comes to medical products — devices put in or substances put on our bodies — consumers may be ill-served by the federal regulators who are supposed to protect them from injury.

The federal Food and Drug Administration has taken a double hit in recent news reports, with an investigation by Reuters news service raising big doubts about the agency’s oversight of products with supposedly safe talc — but that long may have been tainted with disease-causing asbestos. The Kaiser Health News service, meantime, has followed up on the wave of lawsuits and research that has resulted from its discovery that the FDA for years allowed device makers to hide from public view a million complaints about medical devices.

The scathing findings in these two reports, combined with other deep digs into agency work, might well prompt members of Congress to conduct hearings into whether the FDA is acting as the watchdog that the public deserves or as a lap kitten beholden to the rich, powerful, and booming medical device industry.

December 2, 2019

Grim way to increase nursing home profit: Toss out frail seniors and disabled

by Patrick A. Malone

Profit-hungry nursing home operators persist in throwing out vulnerable seniors and disabled patients from needed care, too often because the facilities find they can get higher-paying patients to fill their already costly beds.

Thousands of complaints about potentially improper discharges or transfers from nursing homes and assisted living facilities dominate the work of ombudsmen, whose work is federally required, and state supported, an NBC News investigation found.

The broadcast journalists reported:

November 26, 2019

Ignore doctors’ malpractice claims history? The U.S. did. 66 patients died. It cost $55 million.

by Patrick A. Malone

Although doctors, hospitals, and insurers may howl about the professional harms they claim to suffer due to medical malpractice lawsuits, research studies show that it’s just a tiny slice of MDs who lose in court and must pay up for injuring patients. Further, the data show that the problem few doctors don’t rack up one, but two or three malpractice losses before they even start to see their work curtailed.

Common sense would suggest that if judges and juries find doctors’ conduct egregious enough to slap “frequent flyers” with multiple losing malpractice verdicts, these MDs might best be parted of the privilege of treating patients. Not only doesn’t that occur often enough, a Wall Street Journal investigation has shown the terrible consequences that can result for patients and taxpayers alike when it doesn’t.

The federal government, the newspaper reported, long has struggled to provide promised care through the Indian Health Service (IHS) to those who live on rugged, spare, and sprawling reservation lands. This obligation to provide such medical services is embedded in the Constitution and old treaties. But if it’s tough to get doctors to practice in rural America — where the hours may be extra long and the pay decidedly lower than cities — it had become a nightmare for the IHS to fill its many vacancies.

November 24, 2019

On vaping, gun violence, and health insurance, the big talk flows, but action, not so much

by Patrick A. Malone

When it comes to key health concerns of the American public, President Trump and his administration have offered evidence anew that whatever they say may not last to the next political moment, that inaction is its own powerful kind of action, and that what officials say they’re doing may be exactly the opposite.

This is not intended as partisan commentary. It reflects the turn of a few news cycles and how Trump and his officials have dealt with:

The outbreak of serious lung illnesses and deaths tied to vaping

November 20, 2019

U.S. orders price postings in hopes of curbing hospitals’ trillion-dollar costs

by Patrick A. Malone

Tthe Trump Administration deserves credit for doing something right on hospital prices — but with what likely will be ineffective results.

The president and Alex Azar, the head of the sprawling Health and Human Services agency, have rolled out delayed new federal rules that will order hospitals, starting in 2021, to make public the discounted prices they negotiate with insurance companies and require insurers to allow patients to get advance estimates of their out-of-pocket costs before they see a doctor or go to the hospital.

Trump explained why, as reported by the New York Times, saying: “For decades, hospitals, insurance companies, lobbyists and special interests have hidden prices from consumers, so they could drive up costs for you, and you had no idea what was happening. You’d get bills that were unbelievable, and you’d have no idea why.”

November 19, 2019

Superbugs’ deadly rise has plunged planet into risky ‘post-antibiotic’ era

by Patrick A. Malone

Federal officials have put out some scary new findings about the state of patients’ health in the 21st century: Superbugs may be more common and potent than previously believed. And we may now have plummeted into what experts are calling the perilous “post-antibiotic age.”

This all amounts to far more than a hypothetical menace. It could affect you if you get, for instance, a urinary tract infection. Or if you undergo a surgery, say, for a joint replacement or a C-section. Depending where and how you live, you may see the significance of this health problem if you contract tuberculosis or some sexually transmitted diseases.

As the news website Vox reported of the startling new information from the federal Centers for Disease Control and Prevention: “Every 15 minutes, one person in the U.S. dies because of an infection that antibiotics can no longer treat effectively.”

November 17, 2019

Drugs are better for heart patients than surgery (except in mid-heart attack), study finds

by Patrick A. Malone

Tens of thousands of patients with serious but stable heart disease soon may see themselves treated more with prescription drugs and less with rushed surgeries, especially bypass procedures or operations that seek to open clogged blood vessels with wire cages called stents.

A possible shift away from stents — which have come under question for some time now — may be accelerated by the just-announced findings of a $100 million, multi-year study of more than 5,000 heart patients at 320 sites and in 37 countries. The research, the New York Times reported, sought to provide rigorous and more incontrovertible evidence on procedures that now are a bulwark of heart care:

“[The study dubbed] Ischemia is the largest trial to address the effect of opening blocked arteries in non-emergency situations and the first to include today’s powerful drug regimens, which doctors refer to as medical therapy. All the patients had moderate to severe blockages in coronary arteries. Most had some history of chest pain, although one in three had no chest pain in the month before enrollment in the study. One in five experienced chest pain at least once a week. All participants were regularly counseled to adhere to medical therapy. Depending on the patient’s condition, the therapy variously included high doses of statins and other cholesterol-lowering drugs, blood pressure medications, aspirin and, for those with heart damage, a drug to slow the heart rate. Those who got stents also took powerful anti-clotting drugs for six months to a year. Patients were randomly assigned to have medical therapy alone or an intervention and medical therapy. Of those in the intervention group, three-quarters received stents; the others received bypass surgery. The number of deaths among those who had stents or bypass was 145, compared to 144 among the patients who received medication alone. The number of patients who had heart attacks was 276 in the stent and bypass group, compared with 314 in the medication group, an insignificant difference.”

November 15, 2019

13 million and one reasons why simultaneous operations should be barred

by Patrick A. Malone

A big Boston hospital has offered 13 million and one ways to try to make good with a former orthopedic surgeon who assailed the respected institution and colleagues for performing simultaneous operations in which doctors went from suite to suite, working for hours on multiple patients at once.

Massachusetts General Hospital insisted this practice was safe. Dr. Dennis Burke, a hip and knee specialist whose patients have included former Secretary of State John Kerry, disagreed. He told his bosses at the Harvard-affiliated hospital that simultaneous procedures put patients at risk, and, at minimum, they should be told that the surgeons they flocked to for surgery on them might pop in and out of their procedures.

Burke infuriated his bosses by taking his criticisms outside the hospital, including to investigative reporters for the Boston Globe. The newspaper dug into hospital surgeries, particularly in orthopedic cases where operations lasted for hours.