Saturday, August 16, 2014

Is Big Pharma Testing Your Meds on Homeless People? — Matter — Medium

Two years ago, on a gray January afternoon, I visited the Ridge Avenue homeless shelter in Philadelphia. I was looking for poor people who had been paid to test experimental drugs. The streets outside the shelter were lined with ruined buildings and razor wire, and a pit bull barked behind a chain-link fence. A young guy was slumped on the curb, glassy-eyed and shaky. My guide, a local mental health activist named Connie Schuster, asked the guy if he was okay, but he didn't answer. "My guess is heroin," she said.

We arrived at the shelter, where a security guard was patting down residents for weapons. It didn't take long for the shelter employees to confirm that some of the people living there were taking part in research studies. They said that the studies are advertised in local newspapers, and that recruiters visit the shelter. "They'll give you a sheet this big filled with pills," a resident in the shelter's day room told me the next day, holding up a large notebook. He had volunteered for two studies. He pointed out a stack of business cards on a desk next to us; they had been left by a local study recruiter. As we spoke, I noticed that an ad for a study of a new ADHD drug was running on a television across the room.

If you're looking for poor people who have been paid to test experimental drugs, Philadelphia is a good place to start. The city is home to five medical schools, and pharmaceutical and drug-testing companies line a corridor that stretches northeast into New Jersey. It also has one of the most visible homeless populations in the country. In Philly, homeless people seem to be everywhere: sleeping in Love Park, slumped on benches in Suburban Station, or gathered along the Benjamin Franklin Parkway, waiting for the free meals that a local church gives out on Saturdays.

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Newly Insured by Health Law, Millions Face a Learning Curve - NYT

PHILADELPHIA — Advocates of the Affordable Care Act, focused until now on persuading people to buy health insurance, have moved to a crucial new phase: making sure the eight million Americans who did so understand their often complicated policies and use them properly.

The political stakes are high, as support for the health care law will hinge at least partly on whether people have good experiences with their new coverage. Advocates of the law also say teaching the newly insured how to be smart health care consumers could advance the law's central goal of keeping costs down, such as by discouraging emergency room visits, while still improving care.

For those reasons, hospitals, clinics, insurers and health advocacy groups around the country are organizing education efforts, aimed particularly at lower-income people who might not have had insurance in years, if ever. The Centers for Medicare and Medicaid Services has jumped in, too, with a project called "From Coverage to Care," which provides educational materials to community groups and medical providers who are trying to teach health and insurance literacy.

"It's not like you enroll and, voilĂ , you immediately know how to use it," said Rebecca Cashman, a program coordinator for Resources for Human Development, a nonprofit group that is trying to help Philadelphians understand their new coverage. "There are a lot of people who really have some big questions about 'what now?' "

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Monday, August 11, 2014

Without Breaking a Sweat, a Doctor Tracks Ebola and Other Epidemics -

The call came in on a Friday morning, as Dr. Michael S. Phillips worked at his desk at NYU Langone Medical Center in Manhattan. A patient had arrived in the emergency room burning with fever after returning from a trip to Liberia.

Dr. Phillips knew instantly what this might mean: Ebola.

Within minutes, he dispatched one member of his staff to make sure that the sick man remained isolated and that doctors and nurses were taking precautions to protect themselves against contracting the virus. Then he turned to a second staff member.

"Stop what you're doing right now," Dr. Phillips told him, and sent him to the hospital's laboratory.

The lab?

Dr. Phillips, the director of the infection prevention and control unit at NYU Langone, was already envisioning what his staff had not: a tube of the patient's blood, loaded with the Ebola virus, landing in the hospital's nerve center and contaminating thousands of blood and tissue samples, endangering lab technicians and potentially bringing operations at the hospital to a halt.

"It bumps your pulse up a bit," Dr. Phillips said, with considerable understatement, as he recalled that hectic Aug. 1 morning.

The patient, it turned out, did not have the virus. But with an Ebola epidemic spreading across West Africa, Dr. Phillips and hospital epidemiologists in New York City are grappling with yet another worry as they go about their day-to-day work of preventing, tracking and controlling potentially deadly infections and diseases.

Last week found Dr. Phillips phoning into a conference call with the city's health department to get the latest guidance on Ebola and updating the hospital's protocols to include Nigeria among the West African countries affected by the epidemic.

Meanwhile, the tall, genial doctor and his staff were keeping tabs on other potential threats: Chikungunya, the mosquito-borne illness that has invaded the Caribbean; the virus known as MERS, for Middle East respiratory syndrome; and far more common maladies like tuberculosis, influenza, measles and the bacterial infections that sometimes surface and spread within hospitals.

Dr. Phillips, 50, is married and the father of three girls, and his mother still worries about his exposure to microscopic bugs.

But he has been hardened by battle after nearly 15 years of working in New York, an international crossroads that draws thousands of far-flung tourists, some of whom carry invisible illnesses along with their travel guides.

"I still get stressed, of course," Dr. Phillips said. "But worry is not a good option. We have to make sure our processes are in place and think about how we can constantly improve our game."

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