Primary Care

March 18, 2020

Don’t fall for malpractice malarkey: A briefing details medicine’s many harms

Cold, hard facts — not hunches, arguments, or theories — matter most when tough health care decisions must be made. Americans have been reminded of this by painful headlines on the opioid and overdose crisis, the rise of lung injuries and deaths due to vaping, and, yes, now the rapid spread of a new coronavirus. Doctors, hospitals, insurers, Big Pharma, and other major parties in the U.S. health care system aren’t always as candid as they need to be, especially in disclosing how they harm and even kill patients.

That’s a truth (with a small “t”) that readers can discover quickly in the Center for Justice and Democracy’s latest edition of its annual “Briefing Book: Medical Malpractice by the Numbers.” The center, at New York Law School, provides evidence about a field that has become the bogeyman for politicians, policy makers, and medical practitioners eager to hide egregious errors with extreme counter factual assertions.

Malpractice cases in the civil justice system provide important insights and checks on how doctors and hospitals care for the sick, injured, and vulnerable.

March 17, 2020

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

by Patrick A. Malone

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 13, 2020

Trump’s pick as top consumer product watchdog? Chemical industry insider

by Patrick A. Malone

President Trump has made it official: He intends to nominate Nancy B. Beck, a chemical industry insider and a scientist who built a record at the U.S. Environmental Protection Agency of scaling back safeguards against toxic substances, to lead one of the nation’s top and lately troubled consumer safety watchdogs.

The ascent of Beck to head the Consumer Product Safety Commission has been anticipated and is unsurprising. It still angered consumer groups and Democrats, who pointed to her record at the EPA, saying it already shows she is ill-suited to put the public’s interest above industry concerns.

As the Washington Post reported:

March 11, 2020

High court, for third time, takes up a GOP effort to kill popular Obamacare

by Patrick A. Malone

Timing may be everything in life and the law: The U.S. Supreme Court — while giving the Trump Administration a small political break for now — may give the president’s fall reelection campaign plenty of upset still. Whether the court will give the country a health care disaster is another question.

The high court, acting on a request by Democratic state attorneys general, has agreed once more to consider the fate of the Affordable Care Act, aka Obamacare, on an expedited basis, even before a federal trial court and appellate judges finish their consideration of the latest legal challenge to the ACA.

This will be the third time the justices have taken up an ACA lawsuit, with this challenge representing not only another Republican attack on government-assisted health insurance for the poor, working poor, and middle class. This also may be a legal extreme for questioning Obamacare, as the New York Times reported:

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 9, 2020

As virus spreads, concerns surge about testing, hospitals, and nursing homes

by Patrick A. Malone

The coronavirus outbreak spreading across the globe may be providing Americans with an unhappy view of the dirty downsides of the too-often dysfunctional U.S. health care system as it grapples with spiking Covid-19 infections.

Congress has appropriated more than $8 billion, so the federal government can provide the nation the support it needs in battling the respiratory illness that exploded out of central China a few weeks ago. Almost 100,000 people globally have been infected with the virus, which has killed thousands. The deaths in this country are rising into the dozens, while infections are increasing into the hundreds. In Italy, the government took a drastic step in dealing with steeply rising infections and ordered a virus-related quarantine of much of the northern part of the country — a tough lock down because the Lombardy area is the largest economic powerhouse of the nation.

In the U.S., federal efforts to stockpile needed medical supplies, notably masks, gloves, and gowns — personal protective equipment or PPEs — continue to lag. The administration is under fire for its slow and ineffectual roll-out of virus testing kits. Vice President Pence promised that big numbers of screening supplies would be available quickly — at least 1 million, asap — but he since has been forced to walk back that pledge. Even as he talked about 75,000 test kits becoming available soon, the Atlantic magazine reported that as few as 1,895 Americans have been tested so far for the virus.

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 5, 2020

At the VA, concerns increasing about top leadership and outside meddling

by Patrick A. Malone

One of the nation’s largest health systems faces yet more serious questions about its leadership and external meddling in the quality and safety of its care. So, once again taxpayers may be asking themselves, with anger, What the heck is going on now at the top of the Department of Veterans Affairs?

Internal watchdogs have formally opened an investigation of Roger Wilkie, the VA’s chief, over allegations that he used his office and authority to dig up dirt on a Democratic aide who complained that she had been propositioned and groped by a man in the main lobby of the Medical Center here in the District of Columbia.

The claims were investigated, and authorities declined to pursue it further, including with the filing of any charges.

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.”