Articles Posted in Ethics

kidshot-300x292As outbreaks of preventable infectious diseases rise to concerning levels, doctors, regulators, and lawmakers may need to toughen important laws requiring youngsters to be inoculated, protecting better our collective health and closing off legal loopholes for sketchy vaccination exemptions.

It would be ideal if more than a century of lifesaving experience and decades of rigorous scientific research were sufficient to persuade parents to get their children vaccinated against an array of harmful and dangerous infections. But grownups’ hesitancy or rejection of shots, out of unfounded personal belief or due to medical disinformation, has set in and spread. This has undercut local, national, and global campaigns to rid humanity of contagions like measles. Public information campaigns and evidence-based persuasion hasn’t worked as well as experts might hope, leading officials to pass vaccination laws.

But those protective measures have been eroded by the exploitation by a few, so far, of well-intentioned exemptions, reporters for the independent, nonpartisan Kaiser Health News reported.

casho-300x168Although lawsuits can result in needed financial support and welcome recognition of harms suffered by patients seeking medical services, the civil justice system has its limits. They showed in cases in the news in which disputing parties agreed to more than $1 billion in resolutions that left issues unanswered.

What to make of the:

cardinalexperts-300x195Doctors, hospitals, and their malpractice insurers like to demonize lawsuits brought by injured patients,  but these  legal actions provide a powerful way to identify problem practitioners, and the medical profession should see this truth and use it to better police its own ranks.

That’s one of the recommendations from medical-legal researchers at Stanford University, who examined more than a decade of 60,000 payments for malpractice claims against more than 50,000 doctors. They found a tiny slice of doctors rack up a disproportionate share of repeated malpractice claims. They describe these MDs as “frequent flyers,” a term familiar to the medical community because it often is applied to indigent and homeless patients who rack up big bills for repeated emergency room visits.

Profs. David Studdert and Michelle Melloound found that 2% of physicians accounted for 40% of the paid malpractice claims over a 13-year period. Further, in the report of their study in the New England Journal of Medicine, they offered details on doctors who lose, and keep losing, malpractice cases due to problem care:

carter-300x300The rich and powerful may seem to run amok as the nation lurches through its latest gilded age. But sometimes:

punchy-300x262Those who are senior enough to remember the allures of sweet drinks like Tang, Hawaiian Punch, and Kool-Aid also may need to be sage enough to share a deep, evidence-based distrust and disapproval for the nefarious actions of Big Sugar and Big Tobacco. Those suspicions may need to be renewed in regulators’ crackdowns on vaping, its flavorings, and flavored tobacco cigarettes.

Yes, the federal Food and Drug Administration now has formally detailed its plan to curb the soaring youthful purchases and uses of e-cigarettes for vaping, telling merchants that they soon will be required to keep these goods, including flavored liquids that the devices catalyze, in separate walled off areas of stores and away from those age 18 and younger. This will affect not only big retailers like Walgreens and Wal-Marts but also gas stations and convenience stores.

Online vendors soon will be required to have mechanisms, so proof of age becomes part of cyber buys of e-cigarettes and their associated products.

Kaiserexempt-300x205If a surgical staple gun malfunctioned so seriously that it generated not a few dozen formal complaints but more than 10,000 reported incidents, shouldn’t patients, doctors, and hospitals have the right to know that information from the federal agency overseeing the safety of medical devices?

Apparently not. Or maybe not without a big kick in the pants from journalists.

Instead, the staff at the federal Food and Drug Administration turned a move to ease paperwork and bureaucracy into a giant and little-known system that lets medical device makers hide serious and significant numbers of reports about failures and flaws with at least 100 products, a Kaiser Health News Service investigation found.

fdachiefgottlieb-150x150The Trump Administration has lost yet another top health official: So, what happens now with key policies pushed by Scott Gottlieb, the departing federal Food and Drug Administration commissioner, to battle teen nicotine abuse, cut skyrocketing drug costs, and attack the opioid crisis?

Administration officials insist Gottlieb wasn’t ousted, and the physician and onetime Big Pharma insider said he resigned from his post after a year on the job because he wanted to spend more time with his family (they hadn’t moved from Connecticut to join him in the nation’s capital).

Though Gottlieb received mixed or favorable media coverage as he leaves, his effect on the nation’s health is as cloudy as many high school vaping spots.

allenplaque-240x300Truth can be stranger than fiction, and for an investigative journalist covering the outrages of health care costs, ProPublica reporter Marshall Allen had a dream medical story call him on his phone: A well-known New York company reached out and told him he had been “honored” as one of the nation’s Top Doctors.

Not bad for a guy with an English degree from the University of Colorado and zero medical credentials, he reported in a recent, wry article.

He tried to explain to a saleswoman for the company how unqualified he was. But after a chat and after negotiating a “nominal fee” for his accolade — down to $99 from $289 — he bought a plaque and the right to promote himself as a specialist in “investigations” and a Top Doctor.

drughearing-300x172As tens of thousands of Americans die from overdoses and many millions struggle with skyrocketing prescription medication costs, lawmakers and regulators in the nation’s capital plodded along with procedural steps they claimed would help attack what voters insist are some of their top public policy priorities.

On Capitol Hill, seven of Big Pharma’s top executives danced and dodged with members of a U.S. Senate Committee about who is to blame for the relentless rise and unaffordable cost of American drugs. Media reports of the Senate Finance hearing called it “political theater,” and it offered lawmakers a chance to vent at execs from AbbVie, AstraZeneca, Bristol-Myers Squibb, Johnson & Johnson, Merck, Pfizer, and Sanofi.

Sen. Ron Wyden, the senior Democrat on the committee from Oregon (shown above), blasted Big Pharma, telling the stone-faced corporate suits arrayed before him, “You’re willing to sit by and hose the American consumer while giving price breaks to consumers overseas,” the New York Times reported. He added that Big Pharma attempts to justify its prices, when so many patients cannot afford them, are “morally repugnant.” Sen. Bill Cassidy (R-La.) decried sky-high U.S. drug prices, especially compared with lower rates for patients elsewhere, saying, “It is almost as if the taxpayer has ‘stupid’ written on their face.”

devito-300x169As tens of millions of Americans struggle with workplace medical insurance that provides them with little benefit when they most need it, consumers may wonder just how naïve their employers may be in overlooking industry SPIFFs, SPIVs, and other little-discussed payments that jack up costs and may reduce benefits.

Before any confusion arises, don’t think about health insurance in high-minded terms, and, instead, as just another business transaction — maybe what occurs at the cheesy used car dealership in the neighborhood (ala actor Danny DeVito in “Matilda,” as shown above). There, customers have gotten savvy about bonuses (Sales Promotion Incentive Funds or Sales Promotion Incentives) ladled on salesmen to get them to move vehicles out of showrooms, asap.

Pro Publica, a Pulitzer Prize-winning investigative site, deserves credit for digging in to the medical insurance business to show how similar incentive programs proliferate in brokerages that purportedly help companies of all sizes figure how to cover their employees’ health needs.

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