Disclosure

March 17, 2020

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

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 10, 2020

All U.S. adults are urged to get hepatitis C test, as opioid crisis-infections spike

by Patrick A. Malone

The opioid-overdose crisis has not disappeared, not by a long shot, and there’s a new warning about its toll: A blue-ribbon expert panel has urged doctors to expand testing for hepatitis C to all adults, ages 18 to 79, and no longer limiting the screening to those born between 1945 and 1965. That’s because the risky conduct that goes with abusing opioids also bumps up the risk of this potentially deadly but treatable liver infection.

Hepatitis C is growing as a significant health concern, the New York Times reported:

“Despite substantial advances in treatment over the past five years, infections are on the rise. Roughly 44,700 new hepatitis C infections were reported in the United States in 2017, according to federal data. A major challenge for health officials is that a significant number of people have the virus but do not know they are infected … Hepatitis C leads to chronic liver disease in most people who contract it, and some eventually develop cirrhosis and liver cancer. It is spread primarily through the sharing of needles among people who use illicit drugs.”

March 6, 2020

Routine cognitive tests for seniors? Not for now, blue-ribbon panel advises

by Patrick A. Malone

It sounds like a good idea. Have primary care doctors learn about older patients’ cognitive health by putting all of them, during routine office check-ups, through a few minutes of tests in which they are asked to recall lists of words, draw a clock face, describe the day and date of their appointment, talk about current events, and take on other simple tasks.

Such screenings, some advocates for the aged say, can be an important way to diagnose early and try to provide for help for patients with dementia and its most common affliction, Alzheimer’s disease. But a blue-ribbon panel of experts that advises the nation on medical testing and procedures isn’t buying the argument: The U.S. Preventive Services Task Force (USPSTF) has given such screenings the group’s letter-grade rating of I, meaning the evidence is incomplete that a test or procedure is harmful or beneficial.

The panel, updating its 2014 findings, reported on the JAMA Network (the online medical journal collection) that:

March 3, 2020

Drug maker to pay $1.6 billion to settle claims over its big role in opioids crisis

by Patrick A. Malone

The civil justice system has scored a win in curtailing what once was a major maker of much abused and lethal prescription painkillers: Mallinckrodt, a global drug making giant, has agreed to send its opioids-making generics division into bankruptcy as part of a $1.6 billion settlement to settle thousands of opioid damage claims by state and local governments.

As the New York Times reported of the hefty deal:

“The agreement was endorsed by 47 states and U.S. territories along with a committee of lawyers representing thousands of cities and counties … The money, to be paid into a cash trust over eight years, will be used to underwrite the costs of opioid addiction treatments and related efforts across the country … Under the terms of the agreement, the United States division of Mallinckrodt that produces generic opioids would file for Chapter 11 bankruptcy. After a bankruptcy judge approves the restructuring plan, an initial payment of $300 million would be disbursed to plaintiffs to alleviate the opioid crisis, with the remaining $1.3 billion to be paid out over eight years. Other divisions of the company, which has its headquarters abroad and also produces branded drugs, are not filing for bankruptcy. Mallinckrodt is the first opioid company to reach even a tentative national settlement agreement with municipal governments and most of the states.”

February 27, 2020

That $ —.99 sale isn’t a deal. ‘Left-digit bias’ isn’t great for health care, either.

by Patrick A. Malone

Highly educated and rigorously trained doctors may be just as susceptible to a built-in bias that bargain-seeking consumers yield to when they hit stores seeking 99 cent goods, buy into TV hype for $19.99 wares, or fall for a salesman’s pitch for a used car priced at $17,999.

Ivy League researchers call the cognitive flaw “left digit bias.” They warn that this common irrationality can have consequences with doctors and patient care.

As Anupam B. Jena of Harvard and Andrew R. Olenski of Columbia reported in the New York Times’ evidence-based column “The Upshot:”

February 23, 2020

University of Michigan doctor accused of decades of sexual misconduct

by Patrick A. Malone

The University of Michigan is investigating allegations that Robert E. Anderson, former head of the university health service and physician to UM football teams coached by Bo Schembechler and Lloyd Carr, sexually assaulted youthful patients across decades.

Anderson worked for the university for more than 30 years and died in 2008. As the New York Times reported:

“Michigan said its campus police department had opened an inquiry last summer, after Warde Manuel, the athletic director, received a message from a former student who said that Anderson had engaged in abuse during medical exams in the ’70s. During the investigation, Michigan said, other people described ‘sexual misconduct and unnecessary medical exams,’ including at least one allegation that wrongdoing had occurred in the ’90s.”

February 21, 2020

Safety roundup: New cautions on headlights, off-road vehicles, and groceries and food recalls

by Patrick A. Malone

Consumers need to stay informed and to protect their own interests, especially because big businesses — whether they’re car makers, grocers, or manufacturers of off-road vehicles — may put their own interests ahead of public safety.

With car makers, a leading highway safety group has spotlighted how only a select few of these global enterprises have reckoned with an unexpected consequence of high-tech, energy saving advances: Just six of the 2020 passenger vehicles deemed by the Insurance Institute for Highway Safety (IIHS) offer top-rated headlights as standard equipment. This is not just an issue for gear heads but is an important safety consideration affecting not only motorists’ capacity to navigate roads well but also to protect vulnerable pedestrians who are becoming traffic victims in rising numbers.

Grocers, meantime, have gotten called out by a notably public interest group for their lax approach in informing their customers about tainted food and recalls of risky products.

February 21, 2020

Will voters buy $1 trillion in U.S. health care cuts, as ’21 budget proposes?

by Patrick A. Malone

President Trump’s 2021 budget proposal is thicker than an old-fashioned phone book. Lots of the document became little more than chaff the instant it was printed, due to the likelihood of big changes in the spending plan by congressional Democrats and lawmakers of the president’s own party.

The fiscal wish list, unsurprising at its contents were, may raise a big political question: How, with evidence like this, does the leader of the free world campaign on a counter-factual argument that his policies and practices protect and advance the health of the American people — a prime concern, pollsters say, of the voting public?

The $4.8 trillion Trump budget, for example, proposes to slash the Medicaid and food stamp programs by $1 trillion over a decade, with presidential critics noting the various, sometimes bureaucratic means to do so, ultimately, will reduce desperately needed social supports and throw millions of vulnerable Americans off aids for their health care. (Federal courts, including the appellate panel overseeing Arkansas, have rejected the latest way the administration and GOP states have sought to reduce Medicaid costs by imposing draconian work, reporting, and qualifying rules.)

February 19, 2020

When organs get shipped as cargo, delays and losses become disastrous

by Patrick A. Malone

For tens of thousands of patients anxiously awaiting lifesaving transplants, a new media investigation has provided what must be heart-breaking news on the laxity with which dozens of donated organs get transported, causing them to be lost or delayed “cargo” and rendered unusable.

The nonprofit, independent Kaiser Health News Service and the Center for Investigative Reporting deserve kudos for following up on the jaw-dropping story of how a human heart got left behind in 2018 on a Southwest Airlines flight. Medical specialists involved at the time downplayed the incident, noting that surgeons had not planned a direct transplantation of that heart in a patient in dire shape, taking various of its valves and tissues, instead.

Still, when reporter JoNel Allecia dug into the ghastly gaffe, she found an organ transplant nightmare. As Allecia described it: