My lede:

As many as a third of doctors are dissatisfied with their work, stressed and burned out by increasing workloads and declining pay. But physicians’ well-being also is affected by the quality of care their practices deliver, according to a new study.

The results of a statewide survey of nearly 1,900 Massachusetts doctors published in the August Medical Care showed that 31% felt stressed, 27% were dissatisfied with their work and 17% felt isolated from colleagues. Doctors who said their practices had quality problems were more likely to feel stressed.

The whole shebang.

My lede:

Patients are especially vulnerable to harmful medical mix-ups when they leave the hospital. Doctors and hospitals have devoted much attention in recent years to improving the process of reconciling the medications patients were taking before they arrived with what they should take after discharge.

New research highlights another continuity-of-care challenge: following up on tests ordered in the hospital. Four in 10 patients are discharged with test results pending, and about 9% of those tests should lead to a change in the patient’s care.

But how can primary care doctors check up on these tests if they do not know about them?

The whole shebang.

My lede:

A relatively obscure provision in the House’s massive health system reform legislation that would reimburse physicians for counseling Medicare patients about end-of-life care options came under intense fire from conservative opponents in August.

The political fallout prompted a group of six senators working on health system reform to drop the idea from ongoing negotiations. The House may follow suit when Congress reconvenes in early September, sources said.

But physicians said the controversy shows that despite decades of focus on helping patients choose what — if any — interventions they want as they die, end-of-life care remains a political and ethical tripwire.

The whole shebang.

My lede:

For nearly two decades, the medical and legal consensus has been that it is permissable to withdraw life-sustaining artificial hydration and nutrition from adult patients in a persistent vegetative state. But should that standard apply to children, too?

Yes, it should, but only if their parents agree, according to a new position statement issued by the American Academy of Pediatrics’ Committee on Bioethics and published in the August Pediatrics.

The whole shebang.

My lede:

Federal authorities in July charged a Brooklyn, N.Y., man with conspiracy to violate the federal law banning buying or selling of human organs. If the allegations are true, it would be the first documented case of a black market for organs for transplant operating in the U.S., and experts said it could undermine public confidence in the country’s organ system.

A criminal complaint filed in the U.S. District Court of New Jersey alleges that Levy Izhak Rosenbaum asked an undercover FBI agent for $160,000 to line up an unrelated living kidney donor from Israel. The agent pretended to be a longtime secretary of a cooperating witness and in need of a kidney for an uncle waiting on a transplant list in the Philadelphia area.

“This kind of thing happens in Third World countries. There have been suggestions of it happening here, but I just never believed them,” said Joren C. Madsen, MD, DPhil, president of the American Society of Transplantation and director of the Massachusetts General Hospital Transplant Center.

The whole shebang.

My lede:

Pressure is mounting on Capitol Hill to reveal the financial relationships among doctors, drug companies and devicemakers through the Physician Payments Sunshine Act.

Six states already have enacted payment-disclosure laws or bans on gifts to doctors. Meanwhile, more medical centers are restricting doctors’ and students’ interactions with industry, as calls grow for medical societies and educators to turn down drugmakers’ dollars.

But now some doctors and physician organizations say the push to police financial relationships with industry has gone too far.

The whole shebang.

My lede:

Alzheimer’s disease is unpreventable and largely untreatable. Though genetic testing can tell patients if they have an elevated risk of developing the condition, the expert consensus has been that disclosing such information would distress patients while giving them no medical benefit.

That consensus may be wrong, according to a study in the July 16 New England Journal of Medicine.

The whole shebang.