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The epidemic of overuse, academics for hire, and more

March 2, 2017

In order to bring you more of the news you want to read, Right Care Weekly presents articles related to moving our healthcare system toward the right care for all patients.

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Bravo to David Brown, MD, a cardiologist from Washington University School of Medicine and Right Care Alliance member, who is quoted in an extensive article on unnecessary care, appearing in The Atlantic. The piece labels unnecessary care and unhelpful treatments “an epidemic,” citing examples like stents, beta blockers, and meniscectomy. Brown stood up for right care when he refused to perform an unnecessary angiogram on a patient whose physician had recommended it. “Right Care is bringing medicine back into balance, where everybody gets the treatment they need, and nobody gets the treatment they don’t need,” he said.

As pharmaceutical companies have come under attack for high drug prices, the industry is hiring academics to lend credibility to their pricing models. According to ProPublica, more than 25 pharmaceutical and biotech companies have enlisted Precision Health Economics, a consulting firm of distinguished academics, to conduct research and testify at congressional hearings. About 75% of published studies from PHE’s academics were funded by or collaborated with industry; however, these conflicts of interest are not always disclosed.

Hospitals are among the costliest facilities to build because of regulations and safety codes, but more consideration should go into improving their design. In The New York Times, Dhruv Khullar, MD, calls attention to design deficiencies such as shared rooms, which exacerbate hospital-acquired infections, toilets installed too high off the floor, leading to patient falls and noisy alarms, causing sleep deprivation. Khullar calls for improvements to enhance patient safety and promote healing. “It’s clear that evidence-based medical care will require evidence-based hospital design,” he writes.

Writer Bruce Lee underscores in Forbes that physicians make better hospital leaders, citing studies showing higher quality scores in hospitals run by physicians. And no wonder. Working in medicine teaches one leadership skills such as remaining calm under duress, communicating with diverse populations, making decisions quickly with limited information, and exhibiting empathy. Lee doesn’t believe every physician is up for the challenge but asserts that “maybe it’s time to uncover the leadership talent that remains under covers.”

In 2016, more than 60,000 teens had electrocardiograms (ECGs) subsidized by non-profits to help prevent sudden cardiac arrest, according to Kaiser Health News. Here’s the problem: There’s no evidence that providing these heart screenings to adolescents actually saves lives. Additionally, false positive ECGs can cause families unneeded stress and expenses. Some cardiologists recommend collecting more data on ECG effectiveness and making defibrillators more available, rather than promoting screenings.

Announcements

If you missed last week’s UC Berkeley School of Public Health Dean’s Speaker Series, where Lown Institute Senior Vice President Shannon Brownlee, MSc  spoke about our nation’s fragmented, market-based health care system, check it out here.

Consider attending “Community Agency & Health,” the inaugural symposium of Bridging Health & Community, an organization committed to overcoming the disconnect between the health sector and communities.  The meeting will take place May 15-16, in Oakland, CA. More information here.

There’s still time to register. Join us for the Lown Institute Conference, Beyond the Bottom Line: Defending the Human Connection in Health Care. The conference will take place May 5-7 in Boston. See the full agenda and register now.

Do you have a colleague or teammate who is passionate about right care and getting others involved in the movement? What about someone who organized exceptional Right Care Action Week events last year? They deserve to be recognized for their passion and dedication to right care, so nominate them for a Right Care Alliance Award! Award winners will be honored at the Lown Institute Conference. The deadline for nominations is March 6, 2017.

The Right Care Alliance is growing in leaps and bounds. Over the past week alone, 126 individuals joined our organization. Welcome to all.

Headlines

Overuse

21st Century Cures Act

Access

Clinician health

Conflicts of interest

Cost of care

Cost of drugs

Disparities

Empathy

End of life

Evidence

Lancet Right Care Series

Mental health

Model of care

Nursing

Pharma

Public health

Quality and safety

Shared decision-making

Social determinants

Transparency

 

RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.