The lede:

A new study of medical weblogs says anonymity, negative comments about patients and product promotions often prevail.

The July 23 Journal of General Internal Medicine study of 271 blogs authored by physicians and nurses found that more than 40% of such blogs are published anonymously and describe individual patients. About one-third contain negative comments about the medical profession, and 18% comment negatively about patients.

The study also found that 17% of the blogs include enough information for patients to identify themselves or their physicians. While violations of patient privacy were rare, three blogs showed recognizable photos of patients, and eight displayed patient radiographs.

The study’s lead author, Tara Lagu, MD, MPH, said blogs are a welcome development because they allow doctors to communicate freely, but they present a challenge to medical professionalism.

The whole shebang.

The lede:

Forty-four states now merit a grade of “C” or higher for policies that support appropriate medical use of opioid analgesics while controlling diversion and abuse, according to a report card published in July by the University of Wisconsin Pain & Policy Studies Group.

The report is the fifth by the group since 2000, when 24 state policies earned a “C” or better. Seven states saw their grades improve from 2007 to 2008, and no state’s grade has worsened since 2000. Five states — Kansas, Michigan, Oregon, Virginia and Wisconsin — have “A” grades.

The whole shebang.

The lede:

The American Psychiatric Assn. has appointed a work group to identify the industry money it receives, what the funds pay for and whether to go without them. The Ad Hoc Workgroup on Adapting to Changes in Pharmaceutical Revenue was appointed last spring and is set to report to the APA’s board of trustees in October.

The move comes on the heels of intense news media and congressional scrutiny of potential conflicts of interest posed by drug- and device-makers’ support of clinical researchers, medical education programs and practicing physicians.

The whole shebang.

The lede:

One physician had the social skills of a 2-year-old, said a nurse in an anonymous survey on disruptive behavior published last year. A cardiologist was upset by phone calls and told a nurse it was not her job to think, just follow orders — a squabble that delayed treatment for a patient with a heart attack. On the other hand, a doctor complained about an increasing lack of respect from nurses who frequently challenged or flatly disobeyed clinician orders.

The Joint Commission is calling on hospitals to crack down on “disruptive” health care professionals, over concerns that such behavior impacts patient care. A new commission standard taking effect in January 2009 will require hospital administrators to adopt codes defining disruptive behavior and develop procedures to discipline medical staff and other health professionals who behave badly.

The whole shebang.

The lede:

In March, a patient at Park Nicollet Methodist Hospital in the Minneapolis suburb of St. Louis Park underwent surgery to remove a cancerous kidney. But the next day, a hospital pathologist reported no evidence of cancer in the kidney that was removed.

The surgical site had been marked, and the surgeon and operating room team did the
recommended “time out” briefing to confirm the plan before surgery. The problem: Weeks before the surgery, the side of the patient’s body with the diseased kidney was wrongly identified in the patient’s medical chart.

Officials at Park Nicollet told the patient and family about the error and apologized for it. Days later, the Minneapolis Star Tribune ran a story headlined, “Wrong kidney removed from Methodist Hospital cancer patient.” But the scoop was not planted by an aggressive trial lawyer or dug up by a resourceful investigative reporter. Rather, officials at Park Nicollet decided to go public with the mistake.

The whole shebang.

The lede:

Chicago — It’s a relatively simple case, Dr. Murphy told the ethics consultants he met with in June. A Spanish-speaking, 65-year-old woman of Mexican descent presented with a large growth in the soft tissue of her lower torso. He suspected it might be cancer and wanted to order a biopsy, but was worried the woman’s daughter — who handled interpreting duties — would try to shelter her mother from the bad news.

“It’s crazy,” Dr. Murphy said. The patient “needs to be involved in her own health care decisions at some level.”

When the daughter, Ines, stepped in to meet with the same ethics consultants, Michael Bliss and Jeffrey Loebl, tension filled the room.

“I know how she is,” Ines said of her mother. “When my dad was really ill — he had cancer — she used to say to me all the time, ‘You shouldn’t tell someone they have cancer.’ She’s right. Knowing that information doesn’t help you get better.”

The case represented a clash of cultures. On one side was Dr. Murphy’s medical culture of patient autonomy; on the other was the patient’s cultural preference to be left in the dark. Slapped on top was a healthy dose of strained relations that left the ethics consultants flummoxed on how to satisfy everyone.

Perhaps it’s a good thing the scenario was just pretend.

The whole shebang.