The BMJ reviews our conference, an antipsychotic drug reaction, and social services and health

May 5, 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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One of the best summaries of last month’s 4th Annual Lown Institute Conference came from journalist Jeanne Lenzer, associate editor at The BMJ, who recapped how the conference tackled “the problems of bad science, under-treatment, and overtreatment—and how to build a movement for change, which several speakers likened to civil rights movement.” (The link to the full article in The BMJ is free.) Lenzer included highlights from many of the compelling speakers: Drs. Rita Redberg, John Ioannidis, Joanne Lynn, Roy Poses, Adriane Fugh-Berman, and Jeff Brenner, as well as Kim Witczak, Casey Quinlan, Phil Thompson and Lauren Taylor. Central to conference speeches and sessions was the continuing call for action, the need to grow the Right Care Alliance, the grassroots movement advocating for a better system. Quinlan, a vocal activist who has written a book about managing medical care following the substandard care both she and her family members had received, told The BMJ, that such a movement is vital to catalyzing real transformation in the system. She said [Healthcare] “is a $3 trillion industry. Who wants to give up any of that? All of us, whether it’s clinicians or patients or administrators, have either acquiesced or actively worked to build this system and now we all have to work together to change it.”

Risperdal, one of several antipsychotic drugs, was the focus on Sunday’s Full Measure, which reported that Janssen, its manufacturer, had failed to disclose a significant adverse reaction to it—a spike in prolactin levels. Seventh-grader Josh Scholl, who took the drug to alleviate Tourette’s syndrome tics, had developed breasts, known as gynecomastia. Josh’s mother began researching the drug and learned that Janssen had left out the prolactin adverse effect information from its internal study, which would have alerted patients to a possible link to gynecomastia. Thousands of boys taking the drug have been affected, and some of them were producing milk. For Josh, that omission was more than merely embarrassing; it led to a double mastectomy—at age 12. Stephen Scheller, an attorney representing one of the 10,000+ patients affected, blames the study lead. “He specifically made the decision not to tell the public, not to tell the doctors, not to tell even the FDA or anybody about this study…”  Another news story this week involving a lack of transparency was reported on 60 Minutes, this one involving medical gown manufacturer Halyard Health. HH’s Level 4 gowns are supposed to be impermeable, preventing such blood-borne viruses as hepatitis, Ebola and HIV from coming into contact with clinicians’ skins. But the gowns had one problem—they leaked. Michael Avenatti, an attorney representing hospitals suing Halyard, cites test results showing the defect and known by the company. “They [Halyard] didn’t tell the public. They didn’t tell the FDA. They didn’t tell physicians. They told no one. They kept selling the gown to the tune of millions of dollars every month.”

Which states have the healthiest residents? According to a study released on Tuesday and reported in USAToday, the states that spend more on social services and public health programs relative to medical care. Seven measures were tracked: adult obesity, asthma, mentally unhealthy days, days with activity limitations, and mortality rates for lung cancer, acute myocardial infarction and type 2 diabetes. The study’s investigators include Elizabeth Bradley and Lauren Taylor, authors of The Great American Health Care Paradox: How Spending More is Getting Us Less. (Taylor was a speaker at last month’s 4th Annual Lown Institute Conference.) The study is the first to compare state spending on social services to spending on Medicare and Medicaid and to residents’ health. Colorado, Nevada and Washington, DC had the highest ratios of social service and public health spending relative to medical costs—around $5 for every $1 of medical treatment, and residents there were much healthier. Businesses, churches and community groups should join with state and local government to provide residents with services that include nutrition support, job training and transportation, the study authors conclude. “It’s not just that it’s moral or immoral, it’s just smart,” said Bradley.


  • The 12th Annual International Conference on Clinical Ethics Consultation, Caring for the Ethically Complicated Patient, will take place May 19-22 at the Omni Shoreham Hotel, Washington, DC. The conference, targeted to ethicists, physicians and other clinicians, is hosted by The Center for Ethics at MedStar Washington Hospital Center. For information and registration information, please visit the website.
  • Reminder: You can now see slides from our presenters at our 4th Annual Lown Institute Conference here.






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