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Physicians participating in torture, pervasive conflicts of interest, and hospitals keeping patients healthy at home?

December 11, 2014

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.

Join the conversation: Post your comments in our new section at the bottom of this page.

 

Features:

  • In this week’s U.S. Senate report on torture carried out by the CIA after 9/11, it’s clear that medical professionals played an important role in enabling the abuse of detainees at Guantanamo Bay and elsewhere. Read perspectives on the report from Atul GawandeRanit Mishori, and Physicians for Human Rights.

 

  • Articles in the New York Times and Wall Street Journal this week cover the pervasive conflicts of interest within medicine. The Times focuses on payments to physicians who prescribe Lucentis for macular degeneration over the much cheaper Avastin. (Other recent stories have covered how it’s far more lucrative for ophthalmologists to prescribe Lucentis than Avastin, even though several trials say the drugs are basically equivalent.) In addition to the larger commissions that physicians can make by using the more expensive drug, many of the top prescribers of Lucentis are paid thousands of dollars by Genentech, the maker of Lucentis, which is engaged in a vast promotional campaign for the drug. The payments are for speaking fees,The Journal story covers the extremely common practice of physicians with conflicts of interest serving on FDA advisory panels for medical devices. The agency uses an exceedingly narrow definition of what kinds of payments from device makers can create conflicts of interest. So most of the time, panel members’ financial interests in device companies aren’t even disclosed.

 

  • In an op-ed on Monday in USA TodayRobert Umbdenstock, president and CEO of the American Hospital Association, credits our nation’s hospitals with implementing innovative ways to keep patients healthy, rather than treating them when they’re sick. Hospitals are concentrating on more care coordination, boosting wellness and preventive services, at the same time that they are utilizing best practices, data and evidence-based medicine, he said. The result of these efforts: Readmissions for Medicare patients are down and hospital spending growth has slowed. “To restore the nation’s fiscal health—without sacrificing its personal health—hospitals are working collaboratively with their communities to ensure that fewer patients walk through their doors,” he concluded.

 

QUESTION: What do you think? Are hospitals playing a significant role in advancing good health in our communities? Let us know what you think in our comments section below.

 

Announcement:

  • It’s not too late register for our annual conference, Road to RightCare: Engage, Organize, Transform, March 8-11 in San Diego. We can’t wait to hear our keynotes: Diane Meier, MD, Steven Nissen, MD, America Bracho, MD, MPH, Mitchell Katz, MD and Harlan Krumholz, MD. The conference scholarship application period has now closed, but you can still register. Register now.

 

Headlines:

 

Global health

  1. A Depression-Fighting Strategy That Could Go Viral – Tina Rosenberg, NY Times Opinionator
  2. The pathology of a public health tragedy – Yogesh Jain and Raman Kataria, The BMJ blogs

 

Healthcare spending growth

  1. The Health-Cost Slowdown Isn’t Just About the Economy – David Leonhardt, The Upshot
  2. Good News Inside the Health Spending Numbers – Margot Sanger-Katz, The Upshot
  3. Health Spending Rises Only Modestly – Robert Pear, New York Times
  4. Our Fragmented Approach to Health-Care Costs – Drew Altman, Wall Street Journal

 

Elder care

  1. Nursing Homes Rarely Penalized For Oversedating Patients – Ina Jaffe and Robert Benincasa, NPR
  2. Old And Overmedicated: The Real Drug Problem In Nursing Homes – Ina Jaffe and Robert Benincasa, NPR

 

Patient safety

  1. Nearly 9 Percent Of Medicaid Births Delivered Early For No Medical Reason – Phil Galewitz, Kaiser Health News
  2. V.I.P. Syndrome Can Lead to Bad Care – Alison Brecher, ABIM Foundation blog

 

Regional variation

  1. Geographic Variation in Cancer-Related Imaging: Veterans Affairs Health Care System Versus Medicare – J Michael McWilliams, MD, PhD, et al., Annals of Internal Medicine
  2. Exploring Variation in Care: Alternative Conceptual Models – Michaela A. Dinan, PhD; and Kevin A. Schulman, MD, Annals of Internal Medicine
  3. Geographic variation tells us less than we think – Austin Frakt, The Incidental Economist
  4. Regional Variation in Cancer Imaging Not Related to Overuse – Roxanne Nelson, Medscape
  5. Geographic variations don’t necessarily signify imaging overuse – Kate Madden Yee, AuntMinnie.com

 

Research data

  1. Disclosing drug and alcohol related data – Austin Frakt, The Incidental Economist
  2. Why is CMS withholding substance use data? – Nicholas Bagley, The Incidental Economist
  3. An update on CMS’s data withholding – Austin Frakt, The Incidental Economist
  4. Which claims is CMS deleting from Medicare and Medicaid data? See this spreadsheet. – Austin Frakt, The Incidental Economist

 

Population health

  1. Prescribing Vegetables, Not Pills – Jane E. Brody, New York Times Well blog
  2. States Focus on ‘Super-Utilizers’ to Reduce Medicaid Costs – Michael Ollove, Pew Charitable Trusts Stateline
  3. Delivering Health Care To The Uninsured For $15 A Pop – Alison Bruzek, NPR
  4. Less mental illness among southerners, less access to treatment, too – Lenny Bernstein, Washington Post
  5. Big Data Offer New Strategy For Public Health Campaigns – Shefali Luthra, Kaiser Health News
  6. Diabetes training programs are underused – Shereen Lehman, Reuters
  7. New city health commissioner to lead campaign against substance abuse – Yvonne Wenger, Baltimore Sun (about Dr. Leana Wen)

 

Patient communication

  1. Why I’m Opting out of Mammography – Christie Aschwanden, JAMA Internal Medicine
  2. Unintended Influence: When Our Words Mean More Than We Think – Tom Bartol, MN, JAMA Internal Medicine
  3. A Doctor Unlocks Mysteries Of The Brain By Talking And Watching – Jon Hamilton, NPR

 

Tech

  1. Kaiser virtual-visits growth shows the technology’s potential – Darius Tahir, Modern Healthcare
  2. Walgreen Joins MDLive To Access Doctors Via Telemedicine – Bruce Jepsen, Forbes

 

Costs of care

  1. Bangor startup aims to help doctors avoid costly confusion in writing prescriptions – Jackie Farwell, Bangor Daily News
  2. More Cost of Health Care Shifts to Consumers – Stephanie Armour, Wall Street Journal
  3. Demands for Price Transparency Pressure Providers – Christopher Cheney, HealthLeaders Media

 

Medical culture

  1. If Slow Is Good For Food, Why Not Medicine? – John Henning Schumann, WBUR
  2. The Unintended Consequences Of Cultural Blindspots In Health Care – Jennifer Potter, WBUR