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Antibiotic overuse is rampant and has major consequences, reimbursements for lack of compassion, and rising death rate among middle-aged white Americans

RightCare Weekly
November 19, 2015

In order to bring you more of the news you want to read, RightCare Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, RightCare Weekly presents articles related to moving our healthcare system toward the right care for all patients.

 

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We have written about this often, but how many people know about the harms of antibiotic overuse, including antibiotic resistance? Vox this week tells us about a WHO study, involving a multi-country survey of 10,000 people and their views on antibiotics: 64 percent of respondents mistakenly believe flus and colds can be treated with antibiotics. The more antibiotics are taken or misused, the greater the chance of developing antibiotic-resistant bacteria, now more concerning because of recent news involving animal agriculture. In Pediatrics, a report from the American Academy of Pediatrics finds that antibiotic overuse in livestock feed, commonly used to promote growth in healthy animals, makes it difficult for treating life-threatening infections in children. Co-author of the study, Theoklis Zaoutis, MD, in Scientific American, cautions that the feed can lead to the development of antibiotic resistant bacteria in the animal “and these bacteria can then be spread to other animals, the environment and to humans.” In STAT, Keiji Fukuda, MD, from WHO, warns about infection treatment challenges in those with chronic diseases. “Patients who have these kinds of diseases are susceptible to infections…people are going to have infections for longer. More people are going to die. It’s going to cost more.” Recently, sandwich chain Subway announced that its restaurants will serve only animal proteins never treated with antibiotics, as The Washington Post reports. That may be a step in the right direction, one that more restaurants and home cooks should follow.

 

Geisinger Health System in Pennsylvania announced this month that it will be launching a program that offers refunds to surgery patients who were not treated with “kindness and compassion.” This innovative program allows patients to utilize an app, developed by Geisinger, to rate their experience on a sliding scale. If they felt mistreated, they are able to then use the app to assess the amount of their refund, from $1 to $2000. Geisinger Health System CEO David T. Feinberg, MD, has decided to move forward with the idea in spite of initial skepticism and resistance. Healthcare IT News reports that Feinberg recalled, “In the beginning, I talked to other health system CEOs and industry leaders about ProvenExperience and they all said, ‘Don’t do it.’” This innovation comes at a time when clinicians and patients alike are expressing deep concern about the limited amount of time patients get to spend with their doctors, and a growing body of evidence demonstrating the importance of empathy to patient outcomes. Probably more important to better outcomes: Michael Stein, MD, writes in The Washington Post that the short amount of time his employer and other medical groups allot for a medical visit impedes getting a good history, making and good diagnosis, and being able to care about the patient. “The average number of empathic utterances per visit is one.”

 

The death rate among some middle-aged white Americans is rising at an alarming rate; for whites between the ages of 45 and 54 with a high school education or less, the mortality rate has increased by 134 deaths per 100,000 between 1999 and 2014. This trend is not seen among any other age, racial, or ethnic group. Angus Deaton, PhD, coauthor of the study reporting these findings and 2015 Nobel Memorial Prize recipient, in the New York Times observes “Only HIV/AIDS in contemporary times has done anything like this.” Deaton and first author Anne Case, PhD, report that the major causes of the excess deaths are alcoholism, drug abuse, and suicide. These researchers and others postulate that this trend may be at least partly attributable to the considerable increase in prescription narcotics. Bill Gardner, PhD, of The Incidental Economist asks what are we doing about substance abuse, mental health, and pain management. Not enough, it seems; since 2004 NIH funding for research on alcoholism, drug abuse, mental health, and arthritis and musculoskeletal diseases has declined. Gardner adds, “We need a better understanding of the social determinants of these problems and we need much better treatments.” RightCare Alliance Cardiology Council member John Mandrola, MD, thinks we need to go even further and pursue “policies that decrease despair, improve opportunity and foster families. If our focus remains only on pain pills, heroin and other drugs, the disease will continue to run amok.”

 

Announcement:

  • Reminder: A limited number of travel scholarships are available for medical and nursing students, residents, patient advocates, community leaders and others for the 4th Annual Lown Institute Conference, to be held April 15-17, 2016 in Chicago.  Read more about the scholarships here and apply. And don’t forget, we are still accepting abstracts for Research Day to kick off the conference on April 15. Deadline for abstract submissions is December 15, 2015. For submission information, click here. Register for the conference here.

 

Headlines:

 

Overuse

 

More on Case & Deaton paper

 

FDA

 

Safety

 

Pharma

 

Cost of drugs

 

Public health

 

Presidential race & healthcare

 

Veteran health

 

Practice models

 

Med ed

 

Private insurance

 

Doctor-patient relationship

 

RightCare Action Week

 

Tech & innovation

 

Cost of care

 

Evidence-based medicine

 

Transparency

 

RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation.