“Being Mortal,” flimsy conflict of interest policies, and more complications with robotic surgery: RightCare Weekly
October 9, 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 health care system toward the right care for all patients.
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Surgeon and New Yorker staff writer Atul Gawande, MD, has been among the most influential writers and thinkers in health care for the last several years, helping to popularize ideas like “hot spotting,” surgical checklists, and the problem of spending variation in medicine. In his new book, Being Mortal, he turns to the essential question of how medicine can best serve patients at the end of their lives. The book is a powerful indictment of the medical system’s failure to talk honestly with patients about dying, understand their goals and fears, and truly care for patients rather than merely treating them. You can read excerpts from the book at the New York Times, The Atlantic, and Slate, and interviews with Gawande at Mother Jones, the Diane Rehm Show, the Daily Show, and Democracy Now.
Kudos to the American Medical Student Association for releasing its scorecard of teaching hospitals with policies that disclosed potential conflicts of interest to the public. While most hospitals had conflict of interest policies in place for researchers and clinicians, only 19 of the 204 policies examined met model criteria. For example, most policies required disclosure of conflicts within the institution, but few required public disclosure. In a HealthLeaders Mediaarticle, AMSA National President Britani Kessler, DO, conveyed that “…it is so important to AMSA to advocate on behalf of students to ensure that we retain the right to unbiased training.”
There has been increasing recognition that conflicts of interest fuel biased science and corrupt the information doctors, nurses, and students get about how to treat their patients. Paid thought leaders give speeches promoting drugs, and industry-funded trials are often tainted and subject to bias. However, some still argue that the conflict of interest problem is overblown. For example, see this argument by John LaMattina in Forbes.
Robotic surgery has been touted as the next step in making surgery safer and less invasive, but a new study in Obstetrics and Gynecology finds the opposite. Daniela Hernandez writes for Kaiser Health News that robotic surgeries are thousands of dollars more expensive than laparoscopic or open surgery, and complications were more common during robotic procedures. Proponents of robotic surgery claim that the devices are useful in difficult or complex surgical cases. But even if that’s the case, it doesn’t appear that their use is being limited to complex cases, and patients are paying the price – both physically and financially.
Registration is open for our Road to RightCare conference, March 8 – 11, 2015 in San Diego! Come share your vision of what health care should be and how to get there. Save $150 if you register by October 31, 2014. There are also scholarships for the conference available for medical and nursing students, residents, patient advocates, and community leaders – apply today!