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State-authored medical misinformation, defining right care, and overuse of physical restraints

March 10, 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.

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Features:

“A new study by researchers at Rutgers University suggests that women considering abortions are getting medically inaccurate information a third of the time,” reports Emily Mullin of Forbes. The data come from 23 states with informed consent laws—laws that require a woman seeking an abortion to read a “state-authored informational packet” before she can access the services she seeks. The study analyzed these informational packets and found that 31% of the information was medically inaccurate. Some of the examples of medical inaccuracies include “from week 2, ‘the head has formed’; from week 4, ‘brain activity can be recorded’; and from week 9, ‘hiccups begin.’” Particularly concerning is that most of the inaccuracies were about the first trimester of pregnancy, the time during which most abortions are performed. Authors of the study write, “Misinformation is a threat to the integrity of the doctor-patient relationship and to the medical system as a whole, especially in decisions about pregnancy.”

 

“There needs to be an alliance among patients, families and communities,” says Vikas Saini, MD, Lown Institute president, in an interview with HealthLeaders Media on topics ranging from the complexities of the health care delivery system to Institute’s Right Care Alliance and a vision for a better system. “Our conception of right care is that there will be a day when patients, families, and communities have a much stronger voice not only in their own care, but the organizational structure of health care,” says Saini, because the question of how we get to the right care can’t be answered by technocrats. If you haven’t signed up officially as a member of the Right Care Alliance, you can do so here. Learn more about the Alliance at the 4th Annual Meeting of the Institute, April 15-17 in Chicago. Register here.

Medpage Today this week uncovers the overuse of physical restraint of patients at Park Ridge Health in North Carolina, which had a restraint rate of more than 800 times the national average. About 800 out of every 1,000 hours that psych patients were hospitalized there, they were in physical restraints. While Park Ridge is an outlier, the use of restraints continues to be problematic in the U.S., more common than it should be, and often signals that staff is overworked or a facility is understaffed. CMS rules indicate restraints should be used only when medically necessary and should be of the least restrictive form. George Annas, JD, MPH, of Boston University is quoted: “I think it’s just become recognized as just abusive, used for convenience of staff, not for welfare of the patient. There are hardly any medical indications for restraining someone. What could there be? It’s much more an act of a jailer than it is of a physician or a nurse or a nursing assistant.” In 2014, internal medicine resident, Ravi Parikh, MD, in The Atlantic, wrote about his disturbing experience witnessing the use of restraints in the ICU. He advocated for other means of restraining patients who might be a threat to themselves or others. While measures, like calming patients, are more time consuming for staff, he asserts that restraints don’t reduce falls as was once thought, and they are, in fact, very harmful. In addition to the brutality of them, restraints are also associated with increased rates of pressure ulcers, respiratory problems and even strangulation.

 

Announcement:

  • Come hear Lauren Taylor, MPH, who will be part of a panel discussion titled What Are the Real Harms of a Culture of Over-testing and Overtreatment? Perspectives from Patients, Clinicians and Communities on Saturday morning, April 16 at the 4th Annual Lown Institute Conference. The panel discussion and Q&A will explore the ways in which overuse results in harm to patients, clinicians, and our communities—a must-attend event! Taylor is co-author of the The American Health Care Paradox: Why Spending More is Getting Us Less. Read our blog about Taylor here. If you haven’t registered for the conference, do so here. Hurry, space is limited.

 

Headlines:

Overuse

 

Pharma

 

Social determinants

 

Public health

 

Elder care

 

Patient experience

 

Transparency

 

Primary care

 

Access

 

Med ed

 

Evidence

 

Conflict of interest

 

Women’s health

 

Dr. Lown

 

Safety

 

Hospitals

 

Screening

 

Prevention

 

Mental health

 

Medical tourism

 

Cost of care

 

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

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