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Physician whistleblower in Flint, MI, journal editors call for public study data, and ‘listening booths’ are spreading

January 28, 2016

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 section at the bottom of this page.

 

Features:

 

We first wrote about the Flint water crisis last month and revisit it now to shine a light on the pediatrician-whistleblower who challenged authorities after they insisted the water in their city was fit for drinking. When children began presenting in clinics with extremely high levels of lead in their blood, Mona Hanna-Attisha, MD needed to get to the bottom of it. She started her own analysis from hospital records, according to the HuffPost. High lead levels can lead to lower IQs and behavioral problems, among other conditions, and there is no treatment that can reverse the effects. Her findings were so shocking that Hanna-Attisha held an immediate press conference to alert the Flint community. In USATodayeditors blasted officials for failing Flint, writing “when Mona Hanna-Attisha…publicly sounded the alarm… her work was publicly derided by the governor’s then-press secretary.” For now, bottled water is available to residents showing IDs at distribution sites in the area. But Vox points out that the estimated 1,000 unauthorized immigrants in Flint don’t have IDs, and fear deportation if they ask for water at the sites. Yesterday, a coalition of activists, comprised of the Concerned Pastors for Social Action, the Michigan ACLU and others, filed suit in federal court, alleging the state had violated the Safe Drinking Water Act and ordered the state to replace all lead service lines in the city. There had been no plans to do so previously. Kudos to Hanna-Attisha, who demonstrates that health care professionals have a moral imperative to stand up for patients. Her voice, combined with community activists, has the power to advocate for solutions.

 

“Last Wednesday, the editors of the leading medical journals around the world made a proposal that could change medical science forever,” writes Harlan Krumholz, MD, for NPR this week. The editors’ stance, published in the Annals of Internal Medicine, is that researchers must make public all study data in order to publish results in their journals. The authors argued that widespread data sharing will increase trust in study results and conclusions, enable the independent verification of findings, lead to the development and testing of new hypotheses, eliminate unnecessarily duplicative work, and fulfill the moral obligation to study participants and patients. Authors of the editorial belong to the International Committee of Medical Journal Editors (ICMJE), members of which include New England Journal of Medicine (NEJM), The Lancet, Journal of the American Medical Association, and 12 other highly regarded medical journals in the U.S. and abroad. What was not evident for readers and listeners of mainstream media was the social media storm that met this editorial, also published in NEJM, expressing concern that making data public would open the flood gates to “research parasites,” — “people who had nothing to do with the design and execution of the study but use another group’s data for their own ends.” As Larry Husten, author of the blog Cardiobrief, put it, “the response was brutal,” and the NEJM’s reaction swift: Within days, Jeffrey Drazen, MD, co-author of the editorial and editor-in-chief of NEJM, backed down, writing that the journal “is committed to data sharing in the setting of clinical trials” and that “we believe there is a moral obligation to the people who volunteer to participate in these trials to ensure that their data are widely and responsibly used.”

 

In October of last year, Aaron Stupple, MD, and Vikas Saini, MD, took to the streets of Boston to learn what patients and the public want from their health care. This “listening booth” project took place during Right Care Action Week. Stupple said, “The trouble with health care is an absence of listening. If we don’t have time to listen, everything that comes after that is likely to be wrong.” Annie Brewster, MD, who is both an internist and a patient, shares this sentiment. Driven by her yearning for “a therapeutic arena in which patients could tell their full health stories and feel they were actually heard, not rushed out the door and where doctors, as well, could share a little more with patients,” Brewster has led the charge for the newly established SharingClinic at Massachusetts General Hospital. The hospital’s “listening booth,” as Brewster dubbed it, holds more than 100 clips from patients, families and friends, doctors, nurses, and others. Though in its current form as an interactive screen, it does not yet have the capability to collect patient stories, Brewster hopes that eventually the “SharingClinic will fundamentally transform the culture of the hospital by encouraging and facilitating storytelling.” The question we have is whether the listening will translate to action; will the stories in the SharingClinic highlight the need for transforming health care—even the care delivered by the Mass General?

 

Announcements:

 

  • Mark your calendars! Right Care Action Week is October 16-22. Last year’s event was a huge success. Read our final report here. And watch for details coming soon about this year’s special week to demonstrate how much better health care can be.

 

  • We’ve extended early bird registration until Sunday, January 31 for the 4th Annual Lown Institute Conference at the JW Marriott Chicago, April 15-17. Join us for what promises again to be a great conference. Don’t miss hearing from our renowned speakers: Jeffrey Brenner, MD; Gordon Guyatt, MD; John Ioannidis, MD; Joanne Lynn, MD; and Rita Redberg, MD.  Register now. Space is limited.

 

  • Be part of our second annual Right Care Vignette Competition. We are seeking clinical vignettes written by trainees that describe harm or near harm caused by medical overuse. The deadline to apply iss 11:59pm EST Monday, February 8. The top two vignettes will be eligible for up to two scholarships to participate in the fourth annual Lown Institute Conference. To learn more or to submit a vignette, visit our RightCare Vignette Competition page.

 

Headlines:

 

Overuse

 

End of life

 

Practice

 

Screening

 

Social determinants

 

Patient engagement/empowerment

 

Safety

 

Conflict of interest

 

Drugs

 

Telemedicine

 

Access

 

Women’s health

 

Doctor-patient relationship

 

Cost of care

 

Population health

 

Primary care

 

Employee wellness

 

Elder care

 

 

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

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