Federal action sought to curtail drug noncompliance

A new coalition of patient groups, physician organizations, drugmakers, pharmacists and pharmacies is aiming to make headway in battling the persistent problem of medication noncompliance. The coalition, dubbed Prescriptions for a Healthy America and led by the employer- and insurer-backed Council for Affordable Health Coverage, said it hopes to educate lawmakers about the importance of the issue and pursue public-policy solutions to improve drug adherence.

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Pediatricians offer newborn care standards for home births

Babies born through planned home deliveries should receive the same level of newborn care as those born in hospitals or freestanding birthing centers, according to American Academy of Pediatrics policy published in May.

The academy’s statement, formulated by its Committee on Fetus and Newborn, is meant to supplement the American College of Obstetricians and Gynecologists’ policy adopted in February 2011 and reaffirmed in 2013. The ob-gyns and pediatricians agree that hospitals and birthing centers are the safest settings for birth. Although the ACOG statement acknowledges that women have the right to make a medically informed choice about delivery, the AAP strikes a somewhat softer tone, saying its policy is “intended to help pediatricians provide supportive, informed counsel to women considering home birth.”

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Diagnostic errors are lead cause of medical liability payouts

Errors in diagnosis are responsible for more deaths, disabilities and medical liability payments than any other kind of medical error, according to a review of more than 350,000 paid claims from 1986 to 2010 included in the National Practitioner Data Bank.

The findings echo earlier research and draw on the largest set of cases yet to be analyzed. More than 100,000 medical liability cases involved errors in diagnosis, nearly 30% of the total. That compares with 27% for treatment mistakes and 24% for surgical errors, said the study, published online April 22 in BMJ Quality & Safety.

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Med schools improve grades on cutting links to pharma

Most U.S. medical schools are earning high marks on an influential scorecard that grades their conflict-of-interest policies. In the latest edition of its PharmFree Scorecard, released April 9, the American Medical Student Assn. handed out A’s and B’s to 114, or 72%, of the nation’s 158 allopathic and osteopathic medical schools.

That represents a rise from last year’s results, which saw 102 schools, or 65%, get an A or a B. The scorecard grades schools’ policies on how tightly they restrict interactions with pharmaceutical companies, device makers and other medical industry firms in 11 areas such as gifts, meals, drug samples and faculty participation in speakers’ bureaus.

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Cancer center goes public with assisted-suicide protocol

The physicians who run the Seattle Cancer Care Alliance do their best to treat patients who have cancer. For patients whose disease progression cannot be controlled, the University of Washington-affiliated comprehensive care center offers palliative care and transition to hospice.

And for those who seek physician-assisted suicide under state law, the center is prepared to help them with that, too.

Providing access to doctor-hastened death is an element of top-notch care for terminally ill patients, SCCA’s clinical leaders argue in a first-of-its-kind published report to outline an organization’s physician-assisted suicide protocols and the results for its patients. The authors wrote in the April 11 issue of The New England Journal of Medicine that their program should be “particularly instructive” to other comprehensive cancer centers in states where doctor-assisted suicide is legal or may be legal one day.

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The fire across the street

On Saturday afternoon, I was absorbed in a big reorganization project on my computer so I didn’t pay much mind when sirens started to sound. Epworth United Methodist Church across the street runs a shelter and there have been a handful of times when ambulances have been called out to cart folks away for treatment.

But the sirens got louder and I heard yells through my closed windows. I looked up from my desk and saw this:

The roof was on fire

You can see that the fire truck has recently arrived and a firefighter is lugging the fire hose up the steps of the parsonage. It was fascinating to watch from my window as the men  fearlessly fought the fire, extending the ladder across the street to hack their way through the roof to go at it from above. A crowd of dozens gathered to watch. Within minutes, the fire was safely under control and it was out completely within the hour. No one was hurt, I learned later.

Later that evening, the board-up company was there doing its job, hammering away through the night. I awoke to this sight:

I'm so board with the U.S.A.

It felt scary enough to me — I could feel the heat and smell the smoke from across the street — but the firefighters apparently did their job well. It didn’t even make the news, so far as I can tell.

Update: While no one was hurt, the pastor and his family are living in a Super 8 for the time being. All of their clothes and most of their belongings were destroyed by smoke and fire-hose water.

Quality effort yields big drop in death rate at hospitals

Working together to share best practices, analyze data and implement care improvements, 333 hospitals participating in a quality collaborative have cut their risk-adjusted mortality rate by 36% since 2007, said a report issued in March by the project’s organizers.

The Quality, Efficiency, Safety, Transparency initiative — dubbed QUEST for short — was launched in 2007 with 157 hospitals by Premier Inc., a Charlotte, N.C.-based purchasing and quality improvement alliance of more than 2,800 U.S. hospitals.

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Primary care rebounds on Match Day

After a slight dip in the 2012 Match, the share of fourth-year U.S. medical students opting for residencies in primary care specialties rose again in 2013. But physician organizations and medical schools warned that rising student interest in primary care is not enough to avert projected physician shortages and does not make up for the lack of graduate medical education slots available due to a cap on federal funding of such residency positions.

The number of U.S. seniors entering primary care residencies fell by less than 1% in 2012 but saw an increase of 5.5% in 2013. A total of 6,327 seniors opted for GME positions in family medicine, internal medicine and pediatrics. Nearly 700 more residency positions of all kinds were offered this year, yet the share of U.S. students choosing primary care still rose by 1.3% to 38.6% in 2013.

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