medicine

Cleveland Clinic announces top ten innovations for 2008

Anne Zieger — Thu, 13 Nov 2008 11:50:24 -0500

For the third year in a row, Cleveland Clinic has picked what they think are the top ten innovations in medicine. The picks, which are ones that they think will have the most impact on medicine in the next year, include circulating tumor cell technology, the warm organ perfusion device, and the diaphragm pacing system. Article

SPOTLIGHT: One doctor reflects on important moments in medicine

Anne Zieger — Tue, 22 Jul 2008 12:55:14 -0400

In this piece, a geriatric physician shares how she feels about the times when patients die--and other moments when it's important for caregivers to stop and appreciate the importance of the moment. Far too often, providers miss the opportunity to stop and take in the significance of what they're doing, writes Jessica Israel, M.D., chief of geriatrics and palliative medicine and Monmouth Medical Center in Long Branch, NJ. In her view, physicians should take the time to stop and "feel the 'wow'" that comes from doing such important work. Article

AMA debates ethics of hospital 'mystery shoppers'

Anne Zieger — Mon, 16 Jun 2008 11:20:00 -0400

These days, it's far from unusual for hospitals and clinics to send undercover patients in to check out how the staff treats them. Administrators say such phantom patients--better known as "mystery shoppers" in the retail world--can help them get a realistic picture of the experience real patients have when they visit their facility. However, to date such practices haven't had the official approval of organized medicine--and some doctors actually have suggested that such patients can crowd out 'real' patients from getting the timely care they may need.

At this year's American Medical Association, the ethics council is going to take an official vote as to whether the trade group should endorse the use of mystery shoppers. The AMA's proposal doesn't offer blanket approval for the practice. Still, the ethics group will include recommendations that mystery shoppers don't interfere with the treatment of real ones, that doctors are warned that undercover patients may be coming through, and that doctors aren't punished if they get bad reviews.

To learn more about the discussion:
- read this Associated Press article

Related Article:
Improving service with mystery shoppers

Did Glaxo conceal Paxil users' risk of suicide?

Fri, 13 Jun 2008 06:59:55 -0400

Did drugmaker GlaxoSmithKline conceal suicide risks for users of its antidepressant Paxil within the mountains of data it submitted to the FDA? That's a question Sen. Chuck Grassley (R-Iowa) would like to see answered, and in some detail. Grassley would like to find out who within Glaxo knew what, and when, about the medicine's possible link to increased suicidal behavior. In his correspondence with the FDA and HHS Secretary Michael Leavitt, Grassley notes that the U.K. recently concluded that the firm withheld safety information when submitting data for approval in Europe. Now, he wants to know whether Glaxo did the same in the U.S. In testimony on the Senate floor, Grassley noted that a report by one Harvard researcher contends that Glaxo probably knew about Paxil safety concerns all the way back in 1989, when it first asked the FDA for approval--and that it probably manipulated studies to diminish the perceived risk.

To learn more about Grassley's concerns:
- read this Wall Street Journal blog entry

Related Articles:
Study highlights link between Paxil and suicide
Glaxo wins Paxil suicide case
FDA says Glaxo didn't report Avandia data

SPOTLIGHT: Settlements between PBMs, states not tough enough

Wed, 04 Jun 2008 06:59:52 -0400

Recently, the industry has seen a string of cases in which pharmacy benefit managers have agreed to fork over settlements over allegations of bad behavior. Most recently, this includes the instance in which Express Scripts struck a $9.5 million agreement with 28 states over its attempts to steer patients into brand name drugs. However, these settlements are nowhere near tough-enough to deter erring PBMs from continuing with crooked practices, argues Los Angeles Times columnist David Lazarus. He argues that it will take "stronger medicine" to turn the industry around. Article

ALSO NOTED: IL critics say there's been too many hospital mergers; TN Medicaid patient wins right to experimental treatment cos

Tue, 27 May 2008 06:59:50 -0400

> Illinois critics are challenging the volume of hospital mergers taking place there, arguing that there's been just too much consolidation. Article

> A patient covered by Tennessee's Medicaid program has finally won the legal battle to get the plan to pay for an experimental treatment. Article

> Thousands of University of California hospital and campus workers may go on strike in June unless the university pays them as much as others doing the same work at its other locations. Article

> New research suggests that a common chemical--sodium nitrite--might be able to restore blood flow to tissues damaged by vascular disease. Article

And Finally... Without bodies, sadly, there's no medicine... and lately, that's been a problem. Article

Study: Med schools could dramatically boost rural MD supply

Tue, 20 May 2008 06:59:54 -0400

Right now, only 9 percent of doctors live in rural areas, while 20 percent of the U.S. population is based there, according to current research. But medical schools could help close this gap. In fact, if each medical school added a rural training program, they would more than double the number of new graduates going into rural practice, according to a study in the journal Academic Medicine. The study estimated that if each of the 125 allopathic medical schools committed 10 seats per class to a rural training program--producing 1,139 new rural doctors a year--that would far exceed the current flow of graduating students to rural areas. This would help ease the burden of care in rural areas, which are not only underserved by volume, but also include many older, sicker residents, researchers said.

To learn more about the study:
- read this AMNews piece

Related Article:
Trend: Rural doctor shortage could get worse

Hospital night shifts severely lacking

Mon, 19 May 2008 06:59:58 -0400

The differences between being treated at a hospital at night and during the day often can be daunting, the Wall Street Journal's health blog points out. Not only is the quality care not as high during the night, but there usually are fewer professionals at a patient's discretion. The blog references an article in the New England Journal of Medicine by David Shulkin, president and CEO of Beth Israel Medical Center in New York, who recently took his senior management team on a tour of the midnight shift at his facility. Shulkin believes that "We should be establishing equal standards for staffing and service and striving for acceptable outcomes for every hour of the week," and said that his midnight stroll wasn't meant to catch people doing anything wrong, but more to bring attention to an area of concern.

To learn more:
- read the blog
- here's the New England Journal of Medicine article

Cleveland Clinic will pay tuition for med school students

Thu, 15 May 2008 06:59:56 -0400

Following a practice that is growing increasingly common, the Cleveland Clinic says that it plans to pay the entire tuition bill for the 32 students entering its medical education program later this year. The program, the Lerner College of Medicine, is offered at Case Western Reserve University. The new policy has boosted applications to what already was a competitive program; more than 1,400 students applied for the 32 slots. Leaders with Cleveland Clinic said that they're establishing the scholarships to make sure students feel free to go into academic and research-oriented medicine rather than opting for the highest-paying specialties possible.

In taking this step, the Clinic is following in the footsteps of other institutions, including Mayo Clinic, which lets about 60 percent of students attend tuition-free, and the University of Central Florida, whose new med school will start out in 2009 with students getting not only free tuition, but also their living expenses paid. Also, Harvard University recently announced that it would eliminate the $12,500 per year family contribution expected for med students in families with incomes of $120,000 a year or less.

To learn more about this trend:
- read this Cleveland Plain Dealer article

Related Articles:
Repaying student loans helps MA health centers get staff
New Orleans fights doctor flight with loan paybacks
Harvard Med offers tuition discount
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Study: Acute shortage of adult primary care MDs coming

Thu, 01 May 2008 06:59:54 -0400

A new study appearing in the journal Health Affairs attaches some numbers to a problem we all see coming--the growing U.S. shortage of primary care physicians. According to the study, by 2025 the U.S. will see a shortage of 35,000 to 44,000 family or general internal medicine physicians who care for adults. Worse, with population growth and an aging population figured in, existing family physicians and general internists will see their workloads grow by a substantial 29 percent by 2025 (versus 2005 levels) if nothing is done.

To learn more about the study:
- read this Kaiser Daily Health Policy Report item
- check out the study abstract

Related Articles:
'Dr. Nurse' might help with primary care shortage
Primary care shortage blocks healthcare reform
Shortage of primary care docs in MA