Articles Posted in Patient Privacy

kprobes-300x167An 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.

krumholzIn 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.

debtyoungmed-300x177Big 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.

buckeyes-300x295Soon, many young people  will be back to school and signing up for  sports teams. Many will have to undergo physical exams before they can play.  And it’s a tragic reality that grown-ups may need to think a lot how to protect young people from sexual predators who also are doctors.

That’s because Ohio State University, sadly, has joined the University of Southern California, Michigan State-USA Gymnastics, and Penn State University in the notoriety of dealing with a sexual abuse scandal involving adults and students. In the case of the Buckeyes, it’s Big Ten male wrestlers.

OSU said it had hired an outside law firm to investigate the allegations against Richard Strauss, who had blue-chip credentials and served as the team doctor to university wrestlers roughly from 1979 to 1997. The doctor killed himself in 2005. Lawyers interviewed more than 200 one-time OSU students, with 100 of them accusing Strauss of sexual misconduct, “including former athletes from 14 different sports teams.”

Kevin_Love-215x300DeMar_DeRozan_Nov_2016_cropped-163x300With all the excesses, abuses, and nonsense that pro athletes and pop stars can get into these days, it’s gotten rarer that commentators can point to positive actions these influential personalities can take. But a growing number of them deserve credit for publicly discussing their struggles with mental health issues, helping to reduce widespread stigma about them and to better the lives of their young fans.

The list of outspoken and helpful athletes and performers includes:  Olympic legend Michael Phelps, National Basketball Association All-Star DeMar DeRozan of the Toronto Raptors, and NBA Cleveland Cavaliers superstar Kevin Love, as well as five-time Grammy winner Mariah Carey and actresses Catherine Zeta-Jones and Demi Lovato, and the late Hollywood icon Carrie Fisher.

Phelps and DeRozan bravely have discussed their problems with depression, which affects an estimated 16 million Americans annually and may be one of the most common mental health disorders negatively affecting the nation.

medicare-300x109Callous institutional inertia can allow dangerous doctors to keep harming patients. But media digging deserves credit for raising needed alarms when professional caregivers and others fail to step up to protect individuals as disparate as taxpayers, seniors, coeds, and heart transplant recipients.

The Milwaukee Journal-Sentinel and MedPage Today performed a public service, reporting that they found more than 200 doctors nationwide who surrendered a license, had one revoked, or were excluded from state-paid health care rolls in the previous five years  but somehow remained on the federal Medicare rolls in 2015.

This meant the problem doctors could keep bad practices afloat, in part because Uncle Sam ─ that’s taxpayers like you and me ─ paid these hundreds of MDs $25.8 million to care for seniors, among the nation’s most vulnerable patients.

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:

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.

probe-300x195With more than 10,000 boomers retiring each day and more seniors ending up at some point in their lives in nursing homes, regulators need to step up their oversight of elder care facilities. But there’s disturbing information they’re failing at this crucial task, allowing terrible abuses of older Americans who also may be evicted unfairly from facilities and who may be insufficiently protected when natural calamities occur.

The Minneapolis Star-Tribune deserves credit for its multipart investigation of abuses in nursing homes. As the news organization has reported of its findings:

Every year, hundreds of residents at senior care centers around the state are assaulted, raped or robbed in crimes that leave lasting trauma and pain for the victims and their families. Yet the vast majority of these crimes are never resolved, and the perpetrators never punished, because state regulators lack the staff and expertise to investigate them. And thousands of complaints are simply ignored. … Last year alone, the Minnesota Department of Health received 25,226 allegations of neglect, physical abuse, unexplained serious injuries, and thefts in state-licensed homes for the elderly. Ninety-seven percent were never investigated. That includes 2,025 allegations of physical or emotional abuse by staff, 4,100 reports of altercations between residents and 300 reported drug thefts. When the Health Department did investigate, records show that it often neglected key steps in a criminal probe. In dozens of those cases, for instance, no one interviewed the victims, and no one called the police. Health Department documents contain dire tales of residents being choked, punched, smothered with pillows, fondled and forcibly restrained.

clown-246x300Social media have become a “circus” for some plastic and cosmetic surgeons to clown around in unprofessional ways, including: videos in which one doctor has cradled fat removed from a tummy-tuck like an infant and put a baby face on it using a Snapchat filter. Other costumed surgeons have posted visual displays of themselves dancing before surgery and showing off on camera procedures or with tissues they have removed.

The abuses have become so bad that faculty and students from Northwestern University’s medical school, after researching incidents online, have published a prospective social media code of ethics for plastic surgeons, calling for its adoption by specialists at their next major meeting.

Robert Dorfman, one of the Northwestern students and an author of the draft ethics proposal,  has described plastic surgery’s social media landscape “like the Wild West out there, with no guidelines or rules.” Clark Schierle, senior author of the guidelines, a plastic surgeon, and a medical school faculty member, has observed that practitioners in the field are “uniquely drawn to social media because we tend to do more marketing and we are a visual specialty.”

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