Industry invades the cath lab, the value of informal caregiving, and more

April 6, 2017

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It seems like drug and device companies have infiltrated every possible corner of medicine – the doctor’s office, the operating room, and now, hospital management. UH Cleveland and medical device manufacturer Medtronic have struck a deal for Medtronic to operate one of the hospital’s cardiac catheterization labs, Medpage Today reports. As hospitals are increasingly pressured to cut costs and increase efficiency, industry “insourcing” has become a tempting option. Although Medtronic claims that UH Cleveland will control procurement decisions, others are concerned that having Medtronic employees in the lab will compel physicians to use more Medtronic devices.

In a new report from Mind Australia, researchers estimated the economic value of informal mental health caregiving in Australia. They found that if the government paid for the 200 million hours of care currently provided by informal caregivers, it would cost $13.2 billion AUD, almost double what the Australian government currently spends on mental health care. “The role of informal carers needs to be better recognised, and the mental health system can learn from the wealth of experience of these individuals,” The Lancet Editorial Board writes.

This week in STAT, the Lown Institute’s Judith Garber, MPP and Shannon Brownlee, MSc give their take on Scott Gottlieb, Trump’s pick for commissioner of the Food and Drug Administration. Although Gottlieb is more experienced in health care and drug policy and less politically extreme compared to other candidates the administration had floated, his nomination raises concerns. He supports deregulatory efforts such as fast-tracking and approving drugs based on small clinical trials and surrogate markers. Such practices may lower the cost of testing new drugs and devices, but they also reduce the FDA’s ability to judge whether a product is truly safe or effective. Garber and Brownlee predict that “his nomination will likely lead to the demise of some FDA rules that are barely keeping a lid on useless or dangerous medical products.”

The American College of Physicians believes that physicians are overburdened with administrative tasks, according to a position paper published last week. In a review of the literature, they find that clinicians and staff spend between 3-5 hours a week on billing and insurance administration and up to 15 hours a week on quality measures. The ACP recommends evaluating administrative tasks based on their financial, time, and quality-of-care impact, and removing those with negative effects. Tasks that cannot be removed “must be regularly reviewed, revised, and streamlined” by the payers, oversight entities, vendors, and others who require them, the authors write.

What does it mean to be a clinician in the 21st century, and how can medical education equip students to reach this evolving ideal of a modern health professional? In the Beyond Illness Roundtable series, a collaboration between In-Training and the Right Care Alliance, medical students across the U.S. led discussions on these questions. Common themes among students at the roundtables included frustration at the stifling bureaucracy in medical schools, feeling as though social justice is merely given lip service in the curriculum, and feeling pressure to compete against fellow students. “Without concern for grades or professors’ perceptions, students’ authenticity broke through as they laid out their version of an ideal physician and improved healthcare culture,” write Jack Penner and Michael Pappas, students at the Georgetown School of Medicine, in their reflective essay. Read a summary of all the essays here.



The Lown Institute Conference, Beyond the Bottom Line: Defending the Human Connection in Health Care will take place on May 5-7, 2017 in Boston, MA. The full conference agenda is available for viewing here. Don’t miss your chance to experience three exciting days of learning and right care advocacy – Register and reserve your hotel room by this Friday, April 7. Hotel rooms are going fast, so book your spot now!

The Right Care Alliance is marching for science on Earth Day, April 22, in 10 cities across the country! See the Facebook page for the full list. If you want help organizing a group of Right Care Alliance members to march in your city, email

Congratulations to Vinay Prasad, MD, MPH, member of the RCA Science and Evidence Council, who recently received a grant from the Laura and John Arnold Foundation to study the evidence base for tests and treatments, and evaluate ones that contribute to low-value care.

Are you ready to take back health? Local single-payer advocacy groups in Massachusetts have organized a Rally to Take Back Health at Boston Medical Center on April 8, as part of a National Day of Action for Improved Medicare for All. If you want to join them check out the Facebook page here.





Conflicts of interest

Cost of care

Doctor-patient communication

End of life

Health equity

Mental health


Public health

Quality and safety



Women’s health


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