Articles Posted in Primary Care

devicemakerpaymentsHA-300x257Although Big Pharma has taken deserved heat for selling its drugs by slathering doctors with cheesy tchotchkes, lavish or even cheap meals, and pricey trips, as well as lucrative consulting and speaking opportunities, medical device-makers’ physician-payment programs also should get a tougher, deeper look.

That’s because device manufacturers paid doctors $3.62 billion in the years 2014–17 — 1.7% of the revenue in their business sector and more than seven times the percentage of drug industry revenue spent on payments to MDs, according to a new study published in the respected medical journal Health Affairs.

The payments have come under increasing fire, as even the smallest sums — yes, even for a slice of pizza and a beer or a few sodas — may sway doctors in prescribing drugs or favoring treatments, notably with certain medical devices. The sketchy product-promotion spending may not benefit patients and may boost health care costs, a growing body of evidence from studies is showing.

bauchner-150x150dredlivingston-150x150While the federal Centers for Disease Control and Prevention has declared racism a serious threat to the nation’s health, establishment medicine finds itself mired in an angry scandal over doctors’ inability to recognize the term, much less its existence, or its considerable harms.

An uproar at a leading medical journal might seem a tempest in an ivy-covered tower. But patients will want to track even a little the professional furor falling on the leaders of the respected Journal of the American Medical Association.

Its website recently featured a podcast, for which doctors could get continuing professional education credit, in which host Ed Livingston (photo above left), JAMA’s deputy editor for clinical content and “a white editor and physician, questioned whether racism even exists in medicine,” Usha McFarling, a Pulitzer Prize-winning journalist reported for Stat, the medical-science news site.

covidmichmayo-300x203The campaign to conquer the coronavirus pandemic is having its cautious optimism tested by a stubborn and concerning surge of cases in the Midwest and Northeast, as well as frustrating vaccine supply problems — worsened by manufacturing bungles in a Baltimore plant.

Expert forecasters now see options for how the crucial next several months could go in the battle against the disease. These include an effective vaccination program outpacing the rise of variants (including the B117 strain that has become the most common in this country) and quashing the pandemic, to the viral mutations getting out of control and the nation limping into persistent and unchecked infections for a long time.

In Michigan, where one of the worst outbreak rages (see Mayo Clinic hot spot map, above), the governor and state officials have found themselves in a public policy quandary, uncertain whether stern health restrictions may have lost their public support to be effective now after showing results before. But in California, officials are waiting and watching to see if plunging infections, hospitalizations, and deaths will reverse as they have elsewhere.

stop-150x150Although state licensing boards have taken more than their fair share of criticism for failing to discipline bad doctors as quickly and severely as circumstances merit, regulators appear to be trying to get ahead of a problem that especially plagues women patients and women health staff: doctors’ sexual misbehavior.

This inappropriate conduct can encompass a range of bad acts — all of which are unacceptable and should result in serious consequences for offenders, a viewpoint in the Journal of the American Medical Association argues. The article describes a review and consensus reached by the Federation of State Medical Boards, representing the 71 state medical and osteopathic regulatory boards — commonly referred to as state medical boards — in the United States, its territories, and the District of Columbia.

The authors wrote this:

agedwalk-179x300As the coronavirus pandemic’s most catastrophic effects recede in nursing homes and other long-term care facilities, notably due to vaccinations and other public health measures, residents and their loved ones still face costly, confounding issues in safeguarding the aged, sick, and injured. The Biden Administration wants to spend hundreds of billions of dollars to help.

But will the plans founder due to Republican resistance? And will even a huge jolt of funding be enough to deal with a graying nation’s growing problems with long-term care?

Our own homes provide a cornerstone of Democratic proposals to deal better with nightmares with the cost, safety, and availability of long-term care. Instead of sinking yet more public money — via Medicare and Medicaid — into institutions, can the federal government, instead, improve funding so seniors, the ill, and injured can stay home and get treatment there? As the Washington Post reported:

waitingroom-2-300x202Patients packed in their doctors’ waiting rooms in pre-pandemic times may have looked around and wondered: Why are there so many seniors here receiving medical care?

It isn’t just age that gets older Americans in numbers to treatment for illness or injury or preventive care — it’s also, of course, their qualification at 65 for government-supported medical insurance, aka Medicare. That, perhaps, unsurprising conclusion has been affirmed by Stanford doctors and researchers in newly published research. The study also offers important insights on delayed treatment and the crucial role played by health insurance.

The work involved running down a hunch of Dr. Joseph Shrager, a cardiothoracic surgeon who wondered why so many older patients he saw were diagnosed with lung cancer at age 65 — and not, say, at 61, or 64? He discussed the observation with colleagues who concurred in their curiosity about Medicare eligibility and its role in disease diagnosis. As the university news service reported of the insurance hypothesis:

carpeddeathssoar-300x166Although Americans drove far fewer miles in 2020 due to the coronavirus pandemic, the pedestrian death rate skyrocketed nationally, with blacks, Latinos, and Native Americans dying in disproportionate numbers when struck by motorists.

Preliminary data from the first half of last year shows that roughly the same number of pedestrian deaths occurred — 3,000 or so. But those fatalities happened when the nation recorded a more than 16% decline in vehicle miles traveled.

And the deaths in 2020 continued an ugly, decade-long trend in which pedestrian killings increased 46%, compared with a 5% increase in the same period for other vehicular fatalities. The Governors Highway Safety Association reported the sobering data and observed this:

arpacaextension-300x191The Biden Administration has further expanded a special sign-up season for health insurance plans offered on Obamacare exchanges, giving consumers until Aug. 15 to enroll in coverage that also may be much cheaper.

The newly confirmed Health and Human Secretary Xavier Becerra said in a statement:

“Every American deserves access to quality, affordable health care — especially as we fight back against the Covid-19 pandemic. Through this special enrollment period, the Biden Administration is giving the American people the chance they need to find an affordable health care plan that works for them.”

usccampus-300x165The University of Southern California apparently has set a record — one which parents should pray no college has reason to challenge and for which the educators and leaders at the Los Angeles campus should be sorry and ashamed.

The Trojans have announced they will pay $1.1 billion to settle lawsuits over the tawdry actions of Dr. George Tyndall, who was the lone gynecologist for young women treated in the student health service.

The school has admitted that he saw 17,000 patients in his three decades at the school and sexually abused many of them. As the Los Angeles Times reported:

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