The lede:

Despite intense focus on improving care and keeping patients safe from harm, American health care quality is only about 2% better this decade than last, according to the U.S. Agency for Healthcare Research and Quality. That is just not good enough, say leaders of a major new initiative aimed at coordinating quality improvement and patient safety efforts among physicians, hospitals, accreditation and certification bodies, health plans, payers and patients.

The initiative is known as the National Priorities Partnership (www.nationalprioritiespartnership.org). It was launched in November by the National Quality Forum, a voluntary standards-setting body that convened 28 national organizations to work together to cut unnecessary care and improve quality and patient safety.

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The lede:

For 10 years, Oregon stood alone as the state with a legal physician-assisted suicide process. But two other states now allow the practice.

Washington voters in November 2008 passed a ballot initiative legalizing aid in dying. Then in December 2008, Montana Judge Dorothy McCarter ruled that state homicide laws unconstitutionally restrict terminally ill patients’ right to dignified deaths.

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The lede:

A federal appeals court ruling that upheld New Hampshire’s ban on commercial use of prescribing data could clear the way for other states to pursue legislation restricting drugmakers’ access to information they use to tailor marketing pitches to doctors.

The 1st U.S. Circuit Court of Appeals in November found that the 2006 New Hampshire law did not violate the First Amendment, overturning a lower court ruling. The court’s three-judge panel rejected the plaintiffs’ argument that the law prohibited free flow of information.

The judges said the law regulates conduct, not speech, and the state had presented evidence to show that prescribing data was used to fine-tune drug reps’ marketing pitches for higher-cost, brand-name drugs that were not always more efficacious.

“While the plaintiffs lip-synch the mantra of promoting the free flow of information, the lyrics do not fit the tune,” wrote U.S. Court of Appeals Judge Bruce M. Selya in his opinion.

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The lede:

Doctors know there’s little clinical value in prescribing medications that won’t work. But that doesn’t keep patients from asking for them.

Mitchell Kahn, MD, knows this struggle. The Bellingham, Wash., internist prefers to talk patients through their problems and offer therapeutic reassurance. But the reality is that days are long, time is short and sometimes, he said, patient demands just wear you down.

Dr. Kahn is not alone. Patients who demand antibiotics for the common cold or ask their doctors to recommend vitamins are found frequently in physician exam rooms. They present doctors with an ethical dilemma: When all else fails, is it OK to harness the power of the placebo effect, and what should patients be told?

According to a British Medical Journal study, more than half of American physicians regularly recommend treatments aimed primarily at achieving a placebo effect.

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The lede:

The lack of access to primary care doctors leads to worse health outcomes and higher costs, according to an American College of Physicians report released in November and aimed at influencing the shape of impending health system reform. As the population ages and demands on health services increase, Americans will find it more difficult to locate primary care physicians to help coordinate care in a fragmented system.

The 63-page ACP white paper reviews more than 100 studies from the last 20 years and concludes that the proportion of primary care doctors in a community is related to population health outcomes and system costs. The number of U.S. medical graduates entering residences in family medicine and internal medicine has dropped by half in the last decade as physicians pursue less time-squeezed and higher-paying specialties, the ACP report said.

The report comes amid signs from Capitol Hill that politicians are taking the work force shortage seriously.

The whole shebang.