A successful leadership training, discussing overtreatment in Maine, and combining palliative and curative treatment

November 20, 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.


  • Last weekend, we gathered ​the recipients of our Young Innovator Grants – ​students, residents, and faculty members working on 11 innovative projects across the country –​ to discuss the culture of overuse, the changes coming to the medical system, and how their projects will move us toward a better medical culture.​ The day was full of powerful stories and shared experiences, and we’re looking forward to working with all of the Young Innovators throughout the next year. You can read about their projects here, and here’s what they had to say at the training:



  • Senior Vice President Shannon Brownlee was the keynote speaker at the Maine Quality Counts Healthcare Town Hall Meeting on November 6 in Brunswick. Her talk, When Less is More: Curing the Epidemic of Medical Overtreatment, was well received by the packed house, which included an overflow room and web-streaming. In her speech, she described the many harms associated with overtreatment. “Healthcare is having less and less effect on our nation’s health even as we are spending more and more on it,” she said. “Healthcare can’t keep pace with the rate of disease, and mostly it’s chronic disease, which results from socioeconomic determinants of health.” Her talk was followed by a panel discussion and an audience Q&A.


  • As the debate around legalized assisted suicide for the terminally ill continues, authors Arthur Caplan, PhD and Wesley Smith, in an opinion piece last week in USA Today, suggest a compromise for caring for patients at the end of life. Give patients hospice care AND provide curative treatments at the same time.  That way, patients are not forced to choose one over the other because insurance historically pays only for one. One third of all U.S. hospice patients die within a week after being admitted, they believe, most likely due to the Medicare rules. “Hospice is not doing end-of-life care as much as brink-of-death care,” they conclude.


QUESTION: Palliative care is deeply rooted in the idea that patients need to be able to have open and clear conversations with their caregivers about their goals from treatment. The care that patients get after those conversations can be much more humane, and sometimes can even allow patients to live longer than they would with “usual care.” But while palliative care need not require “giving up,” combining palliative care and curative care often seems contradictory to people. How do you talk to your patients about balancing curative and palliative treatment? If you’re a patient, how would you want your doctor to approach that question? Tell us in the comments!




  • On behalf of RightCare Weekly and the Lown Institute, we wish you a happy and healthy Thanksgiving. We’ll be taking a break next week but we’ll resume distributing RCW on December 4.


  • Next week is your last chance to get the early bird registration price for the Road to RightCare Conference! Prices go up after December 1. There’s still time to apply for a scholarship to the conference, as well. Scholarships are for students, clinical trainees, nurses, patients, patient advocates and community leaders. You could receive up to $1200 to defray travel costs to conference in San Diego, and registration fees will be waived – make sure you get your application in by December 7!


  • The Lown Institute, in collaboration with the Do No Harm Project, is calling for applications to the first Do No Harm Project Vignette Competition. The top two vignettes will be eligible for up to two conference scholarships. Applications are due by January 7, 2015. To learn more, read here or apply now.




Patient communication

  1. What your doctor won’t disclose – Leana Wen, TEDMED
  2. Elderly kidney patients may not understand treatment choices – Shereen Lehman, Reuters
  3. Redesigning Surgical Decision Making for High-Risk Patients – Laurent G. Glance, MD,  Turner M. Osler, MD, and Mark D. Neuman, MD, New England Journal of Medicine



  1. The sham drug idea of the year: ‘pink Viagra’ – Ellen Laan and Leonore Tiefer, LA Times op-ed
  2. The insidious new ways Big Pharma is manipulating your doctors’ drug choices – Julia Belluz, Vox



  1. Seeing the ‘Invisible Patient’ – Jane Gross, New York Times New Old Age blog
  2. I Loved My Wife, But I Wished She Would Die – John LaGrange, Zocalo Public Square


Patient safety

  1. One Drug or 2? Parents See Risk but Also Hope – Alan Schwarz, New York Times
  2. Multiple Interacting Factors Influence Adherence, and Outcomes Associated with Surgical Safety Checklists: A Qualitative Study – Anna R. Gagliardi, Sharon E. Straus,  Kaveh G. Shojania, David R. Urbach, PLOS One
  3. Risk of hospital infections increases at end of work shifts, study finds – Susan Perry, MinnPost
  4. Analysis shows widespread discrepancies in staffing levels reported by nursing homes – Jeff Kelly Lowenstein, Center for Public Integrity
  5. Minorities With Cancer Not Using High-Volume Hospitals – Laird Harrison, Medscape


Primary care

  1. Why Family Physicians Are Different From Other Doctors – Shelly Reese, Medscape
  2. Millions Of Medicaid Kids Missing Regular Checkups – Phil Galewitz, Kaiser Health News
  3. When Patients Don’t Follow Up – Barron H. Lerner, MD, New York Times Well blog
  4. Kaiser Permanente joins forces with Target Corp. on in-store clinics – Chad Terhune, LA Times


Medical education

  1. Do NNTs work? – Austin Frakt, AcademyHealth blog
  2. What a student learned: Medicine’s hidden curriculum – Bruce Campbell, MD, KevinMD
  3. Doctor Shortage Looming? Maybe Not – Julie Rovner, NPR
  4. What Doctors Don’t Know About LGBT Health – Julie Beck, The Atlantic


End-of-life care

  1. Humane Endeavor – Grace Bello, Guernica
  2. Laws Spreading That Allow Terminal Patients Access To Experimental Drugs – Michelle Andrews, Kaiser Health News
  3. Death with Dignity legislation sparks support, opposition in Pennsylvania – Lexi Belculfine, Pittsburgh Post-Gazette


Palliative care

  1. Hospice Care Lowers Cost and ICU Use in Cancer Patients – Roxanne Nelson, Medscape
  2. ONA Interview: Breaking the barriers to effective palliative careOncology Nurse Advisor


Opioid abuse

  1. Memo To Gov.-Elect: Include Pain Sufferers As You Seek Opiate Solution – Cindy Steinberg, WBUR CommonHealth blog
  2. Addiction problem puts spotlight on doctors – Christian Schiavone, The Patriot Ledger


Rural health

  1. Rural hospitals in critical condition – Jayne O’Donnell and Laura Ungar, USA TODAY



  1. High blood pressure? There’s an app for that – Nidhi Subbaraman, BetaBoston
  2. Brigham and Women’s opening access to the medical record – Jessica Bartlett, Boston Business Journal


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