Saturday, February 15, 2014

Patient Safety in the News January 2014

A stunning expose by Julie Creswell Reed Abelson in the New York Times detailed how a multi-state hospital chain is alleged to have put profits before patients in an increasing trend that is moving medicine away from individual decision making by doctors toward corporate control focused on profits.

Journalist Ryan White wrote about the implications of a report issued by the Dartmouth Atlas Project which found significant variations in care provided to children in different geographic regions in New England, raising questions about overuse of medical services and whether financial gain is impacting the medical decision making of pediatricians.

In this book review, Marcia Angell highlighted the disturbing conflicts of interest that permeate the pharmaceutical industry and medical academia and result in the over-prescription of drugs in a way that is against the interests of patients. Ms. Angell discusses three books: (a) Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial; (b) Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs and (c) Shyness: How Normal Behavior Became a Sickness. 
Jenny Gold, writing for NPR, discusses the complete absence of price transparency in the field of medicine. Most surgeons do not know the cost of the medical devices they implant into patients, and make decisions based on the fact that they are aligned with a particular manufacturer because they receive some sort of royalty or consulting fee. Meanwhile, hospital systems and purchasing groups sign agreements keeping the actual price of these devices confidential so medical device manufacturers can sell the same product at vastly different prices.

Robert Langreth, writing for Bloomberg, points out how underreporting of adverse events is creating a false sense of security in patients who undergo robotic surgical procedures and otherwise impacting the FDA’s oversight of medical devices.

This article in Elsevier points out how the gap between hospital policy and clinician compliance leads to inadequate infection control practices in hospital intensive care units.

This article by Melisa Healy in the Los Angeles Times points out that in response to a campaign to encourage children to eat better and exercise, childhood obesity rates have stabilized and appear to be poised for a reversal. Unfortunately, this trend appears to be dependent on a family’s education and affluence levels.

Marcia Allen wrote an article discussing why medical malpractice cases that clearly have merit are rejected by attorneys because they are not often not financially viable. Ms. Allen points out how this problem is exacerbated in states that have capped damages in these kinds of lawsuits and how it disparately impacts young children, the poor and the elderly.

Chuck Douglas, writing for the Concord Monitor wrote a short article discussing how statistics undercut the argument that lawyers are driving up the cost of healthcare with medical malpractice cases, pointing out that (a) the number of malpractice payouts on behalf of physicians fell for the eight consecutive year in 2011, and (b) the actual cost of medical malpractice payments amounted to one-eighth of one percent of healthcare expenditures.

Anahad  O’Connor, writing for the New York Times published an article highlighting the dangers over-the-counter dietary aids, which account for 20% of hospital visits for injuries to the liver.

Nancy Shute, writing for NPR, discusses the fact that a study performed in Finland and reported in the New England Journal of Medicine demonstrated that surgery for meniscus tears yields no better result than people who underwent fake surgery for the same medical problem.

This article by Denise Grady for the New York Times discusses two recent articles in JAMA that raise concerns about morcellation surgery to remove fibroid tumors from the uterus. The authors question whether this surgery may be linked to abnormal growths and cancer spread when it is performed with the use of an electric device that contains a rapidly spinning blade because it can spray bits of uterine tissue or fibroids around the abdomen like seeds.

This blog post, by Brian Hatten, MD, questions whether joint replacement manufacturers should provide warranties for their products. Currently, only one company, Biomet, provides this kind of consumer assurance.

The World Health Organization reported that four more people have died of Middle East Respiratory Syndrome, a SARS-like disease that is suspected to be associated with contact with camels. 

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