Monday, January 16, 2017

The Heroism of Incremental Care - The New Yorker

We devote vast resources to intensive, one-off procedures, while starving the kind of steady, intimate care that often helps people more.

http://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care

Physician Aid in Dying Gains Acceptance in the U.S. - The New York Times

Judith Katherine Dunning had been waiting anxiously for California to adopt legislation that would make it legal for her to end her life.

The cancer in her brain was progressing despite several rounds of treatment. At 68, she spent most of her day asleep and needed an aide to help with basic tasks.

More centrally, Ms. Dunning — who, poignantly, had worked as an oral historian in Berkeley, Calif. — was losing her ability to speak. Even before the End of Life Option Actbecame law, in October 2015, she had recorded a video expressing her desire to hasten her death.

The video, she hoped, would make her wishes clear, in case there were any doubts later on.

More ...

https://www.nytimes.com/2017/01/16/health/physician-aid-in-dying.html?

Wednesday, January 11, 2017

A Fix for Gender Bias in Health Care? Check. - The New York Times

When Dr. Elliott Haut and his team at Johns Hopkins Hospital in Baltimore designed their blood clot prevention protocol back in 2006, they didn't expect to discover systemic gender bias. But the data were clear and the implications were alarming: Women who were trauma patients at Johns Hopkins Hospital were in considerably greater danger of dying of preventable blood clots than men.

Why? Because doctors were less likely to provide them with the appropriate blood clot prevention treatment. At Hopkins, as at many hospitals, both men and women were receiving treatment at less than perfect rates, but while 31 percent of male trauma patients were failing to get proper clot prevention, for women, the rate was 45 percent. That means women were nearly 50 percent more likely to miss out on blood clot prevention.

Blood clots, gelatinous tangles that can travel through the body and block blood flow, kill more people every year than breast cancerAIDS and car crashes combined. But many of these clots can be avoided — if doctors prescribe the right preventive measures.

Haut is a trauma surgeon, not a bias expert, so gender disparities were the last thing on his mind when he and his team put together a computerized checklist that requires doctors to review blood clot prevention for every patient. "Our goal was not to improve care for men or women or whoever, it was to improve the care of everybody," he said. But what they found was that after the introduction of the checklist, appropriate treatment for everyone spiked. And the gender disparity disappeared.

More ...

https://www.nytimes.com/2017/01/11/opinion/a-fix-for-gender-bias-in-health-care-check.html?

Friday, January 6, 2017

Snapshots of an Epidemic: A Look at the Opioid Crisis Across the Country - The New York Times

Opioid addiction is America's 50-state epidemic. It courses along Interstate highways in the form of cheap smuggled heroin, and flows out of "pill mill" clinics where pain medicine is handed out like candy. It has ripped through New England towns, where people overdose in the aisles of dollar stores, and it has ravaged coal country, where addicts speed-dial the sole doctor in town licensed to prescribe a medication.

Public health officials have called the current opioid epidemic the worst drug crisis in American history, killing more than 33,000 people in 2015. Overdose deaths were nearly equal to the number of deaths from car crashes. In 2015, for the first time, deaths from heroin alone surpassed gun homicides.

More ...

http://www.nytimes.com/2017/01/06/us/opioid-crisis-epidemic.html?

NHS trials artificial intelligence app as alternative to 111 helpline

NHS patients will be assessed by robots under a controversial 111 scheme to use "artificial intelligence" to ease pressures on Accident & Emergency units.

More than one million people will be given access to a free app which means they can consult with a "chatbot" instead of a human being.

Hospitals across the country are struggling to cope with unprecedented demand, which has left thousands of casualty patients waiting on trolleys.

In the last week, growing numbers of hospitals and ambulance services have declared critical incidents - even though most operations have been stopped for the last month.

The new measure is part of a national drive by health officials to "digitise" the health service, while speeding up help for minor complaints to reduce strain on services.

The company behind the scheme said it would save the health service "substantial" money and time.

But leading doctors and patients' groups last night expressed fear that the experiment, due to start later this month, is too risky. They raised fears that serious conditions could be missed - or casualty units end up swamped - by too great a reliance on automated systems.

More ...

http://www.telegraph.co.uk/technology/2017/01/05/nhs-trials-artificial-intelligence-app-place-111-helpline/

Tuesday, December 20, 2016

Female Doctors May Be Better Than Male Doctors - The Atlantic


Salaries for female physicians average some $19,879—eight percent—lower than male physicians. At academic hospitals, male physicians receive more research funding and are more than twice as likely as female physicians to rise to the rank of full professor.

These disparities have historically been attributed to the effects of disproportionate domestic responsibilities—including maternity leave and subsequent part-time schedules. As physicians Rita Redberg and Anna Parks note, this can be perceived to "undermine the quality of female physicians' work and explain male physicians' higher salaries."

But no. Female physicians actually tend to provide higher-quality medical care than males, according to research released today. If male physicians were as adept as females, some 32,000 fewer Americans would die every year—among Medicare patients alone.

More...

Friday, December 16, 2016

Go to the Wrong Hospital and You’re 3 Times More Likely to Die - NYTimes.com

Not all hospitals are created equal, and the differences in quality can be a matter of life or death.

In the first comprehensive study comparing how well individual hospitals treated a variety of medical conditions, researchers found that patients at the worst American hospitals were three times more likely to die and 13 times more likely to have medical complications than if they visited one of the best hospitals.

More ...

http://mobile.nytimes.com/2016/12/14/business/hospitals-death-rates-quality-vary-widely.html?

Tuesday, December 13, 2016

The Power of Simple Life Changes to Prevent Heart Disease - The New York Times

Billions of dollars are spent every year on medications that reduce the risk of heart disease — the No. 1 killer in the United States.

But some people feel powerless to prevent it: Many of the risk factors seem baked into the cake at birth. Genetic factors can have a huge impact on people's chances of dying of heart disease, and it has long been thought that those factors are almost always outside of one's control.

Recent research contradicts this, though, and that should give us all renewed hope.

More ...

Sunday, November 27, 2016

Center for Innovative Collaboration in Medicine and Law - FSU College of Medicine

The Center for Innovative Collaboration in Medicine and Law is a joint effort of the FSU College of Medicine and FSU College of Law. The mission is to identify and facilitate (through education, the conduct and dissemination of scholarship, and performance of service activities) opportunities for members of the medical and legal professions, working together and with others, to foster improvements in the quality of life enjoyed by individuals and to promote public health in Florida, the United States, and globally.

http://med.fsu.edu/index.cfm?page=innovativeCollaboration.home#

Saturday, November 19, 2016

Hepatitis And Multiple Sclerosis Specialists Among Biggest-Dollar Prescribers In Medicare : Shots - Health News : NPR

The number of doctors who each prescribe millions of dollars of medications annually in Medicare's drug program has soared, driven by expensive hepatitis C treatments and rising drug prices overall, federal data obtained by ProPublica show.

The number of providers who topped the $5 million mark for prescriptions increased more than tenfold, from 41 in 2011 to 514 in 2015. The number of prescribers — mostly physicians but also nurse practitioners — exceeding $10 million in drug costs jumped from two to 70 over the same time period, according to the data.

Most of the doctors atop the spending list prescribed Harvoni or Sovaldi, relatively new drugs that cure hepatitis C. Other providers on the list prescribed pricey drugs to treat cancer, multiple sclerosis and rheumatoid arthritis.

More ...

http://www.npr.org/sections/health-shots/2016/11/17/502341021/a-growing-group-of-doctors-are-big-money-prescribers-in-medicare