A 36-year-old woman recently presented with flu-like symptoms at Shonan Kamakura General Hospital in Kamakura, Japan. Just a week earlier, her son had been diagnosed with influenza, leading her doctors to think that might be the cause of her fever, fatigue, sore throat and dry cough.

But she tested negative for flu, so she was diagnosed with an upper respiratory infection, prescribed 1,200 mg of acetaminophen daily and sent home. The woman returned the next day, reporting symptoms of vertigo. Testing showed she had suddenly become anemic. Within days she was dead, felled by acute promyelocytic leukemia, which has a 5-year survival rate surpassing 70% when correctly diagnosed and treated.

The tragic case of delayed diagnosis, presented at the Diagnostic Error in Medicine 6th International Conference in Chicago in September, was one of those extremely rare “white zebras” that every physician dreads, expert diagnosticians said.

“These are tough cases at every level,” said David E. Newman-Toker, MD, PhD, associate professor of neurology and otolaryngology at Johns Hopkins University School of Medicine in Baltimore.

But new research shows that it’s not just the one-in-a-million diagnoses that get missed, Dr. Newman-Toker noted. Diagnostic errors are responsible for more patient deaths, disabilities and medical liability costs than any other kind of medical mishap.

My latest is in the December issue of ACP Hospitalist, a holdover from when I was still freelancing. Read the whole shebang.

Valentin Torres is the kind of resident Illinois officials know they need to reach if their effort to vastly expand health insurance coverage under the Affordable Care Act is going to succeed.

Torres, a truck driver and the sole provider for his wife and three children under 18, said his family has gone uninsured since 2005 when he lost the coverage he had through an employer.

At a state-organized outreach event he heard about on Spanish-language radio, Torres learned the family would be eligible for Medicaid under the health law’s expanded income rules. He planned to complete his application from home through abe.illinois.gov, a site for Medicaid applicants separate from the troubled federal website where private insurance plans are sold.

“I came here to get health coverage for me and my family,” said Torres, 44, who is bilingual but spoke to a counselor in Spanish. “Without insurance, you can’t afford to get sick.”

Federal health officials estimate that Latinos make up nearly a quarter of Illinois’ uninsured population, inspiring a special effort by state officials to spread the word about options available under the health law. To help raise awareness, Illinois is partnering with nearly 50 community-based organizations with close ties to immigrant populations.

My latest is in the Chicago Tribune. Read the whole shebang.

After more than a year of research, public hearings, and consideration of nearly 3,000 comments filed by physician organizations, patients, and others, the U.S. Food and Drug Administration in September altered the labeling of extended-release and long-acting opioid analgesics to place a greater emphasis on the medications’ safety risks. The action falls far short of the strict limits on the dosage and duration of opioid therapy for patients’ noncancer pain that were proposed by advocacy groups last year.

My latest, published in the American Academy of Pain Medicine’s Pain Medicine Network newsletter. Read the whole shebang.

As schools around the country wrap up their first month back in session, parents soon may start receiving the first reports on how their children are shaping up — literally.

Public schools in 19 states now track students’ body mass index numbers and report the fat metrics back to parents. There may, indeed, be more schools tracking students’ BMI than there are schools teaching kids the arithmetic needed to do such calculations on their own. To some, this would seem like the prudent step to take given that childhood obesity has nearly tripled since 1990. The Centers for Disease Control and Prevention says about one in five American children is obese, and one in three is overweight or obese.

There are only a couple of problems with this increasingly popular nanny-state tactic: There’s not much evidence that BMI-tracking reduces obesity, and it may harm the very children it’s meant to help.

My latest, for the R Street Institute. Read the whole shebang.