My lede:

Wide regional variations in physician supply have little effect on patient perceptions of access to care and the quality of medical care patients receive, according to a new study.

An article in the February Health Affairs reported the results of a nationwide survey of more than 2,500 Medicare beneficiaries. Although the number of physicians per capita varies by 200% to 300% across the country, the surveyed patients responded similarly to questions such as whether they have a personal physician, have seen a doctor in the last year and are satisfied with their care.

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My lede:

Oncologists caring for patients with incurable cancer should have realistic conversations about treatment options and refer patients for palliative care services earlier, according to a new policy statement by the American Society of Clinical Oncology.

The recommendations come on the heels of research showing that fewer than 40% of oncologists have such candid talks with their patients and that patients who receive palliative care live longer than those who receive only oncologic care.

Honest conversation with patients whose cancer cannot be cured is “happening far less often than it should,” said Allen S. Lichter, MD, CEO of ASCO, which has more than 30,000 oncology professionals as members. “It should happen 100% of the time.”

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My lede:

Higher spending on hospital care is linked to lower death rates, according to new research analyzing a decade of cost and quality outcomes for more than 2.5 million patients at 208 California hospitals.

The study, published Feb. 1 in Annals of Internal Medicine, is the largest yet to apparently contradict well-known research published as part of the Dartmouth Atlas of Health Care. The atlas researchers have found wide regional variations in care costs without corresponding increases in quality outcomes, including mortality rates. Sixty percent more care in the highest-spending regions due to hospitalizations, physician visits, diagnostic imaging and other interventions had little apparent effect on mortality outcomes or other quality metrics for Medicare patients, Dartmouth researchers have concluded.

But in the new study, California hospitals that spent more had lower in-hospital mortality rates for Medicare patients with six common deadly conditions such as congestive heart failure and pneumonia. For example, heart attack patients at the lowest-spending quintile of hospitals from 2004 to 2008 were 19% less likely to survive their stay than counterparts at the highest-spending hospitals. The average cost of hospital care for such patients was $21,072, four times greater than at the lowest-spending hospitals.

“We’re sort of taking on the view that more [health care spending] is actually worse — that more is less,” said John A. Romley, PhD, the study’s lead author. “We’re just saying, in this context, more is more.”

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The state Supreme Court ruled that no law prohibits doctor-aided death. Now legislators will debate whether to regulate the practice or ban it.

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My lede:

Many U.S. hospitals frequently deliver babies before 39 weeks’ gestation without a medical indication, according to data released in January by The Leapfrog Group, an employer-funded organization that seeks to improve health care quality and safety.

Half of 773 hospitals voluntarily reporting to Leapfrog last year said they exceeded an expert-set 12% target rate for the proportion of babies delivered early by elective induction. American College of Obstetricians and Gynecologists guidelines say elective deliveries should not be done before 39 weeks’ gestation.

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Better discharge planning and quicker follow-up care are keeping patients at home — and helping to avert Medicare pay cuts.

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My lede:

Single-bed patient rooms, wider bathroom doors, ubiquitous hand-hygiene facilities and other hospital design elements add to the costs of construction but can pay for themselves within a few years, according to a series of journal articles published in January.

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A leading medical journal says MMR vaccine-autism study was fraudulent. Doctors still face a barrage of safety questions from worried parents.

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My lede:

Nearly half of patients misunderstand dosage instructions on prescription container labels, and more than half do not comprehend the warnings on those labels, according to different studies. For years, medical experts have advocated for simpler labels to help patients take their medications as intended.

Labeling standards proposed in January by the influential U.S. Pharmacopeial Convention could make those recommendations a reality.

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My lede:

Kathy Niedzwiecki of Pelham, N.H., and Ken Crowder of St. Louis needed new kidneys and had loved ones willing to donate them — but those donors were medically incompatible.

Thanks to a United Network for Organ Sharing pilot program launched in 2010 that matches incompatible donor-recipient pairs through a nationwide pool, Niedzwiecki and Crowder got the kidney transplants they needed.

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My lede:

As the misuse of opioids has grown, more physicians have urged patients to sign so-called pain contracts in an effort to prevent medication diversion.

But these contracts, also called opioid treatment agreements, can be used indiscriminately and harm rather than enhance the physician-patient relationship, according to an article by a panel of physicians and pain-policy experts in the November issue of The American Journal of Bioethics.

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My lede:

Skokie, Ill. — In the 1930s and 1940s, hundreds of German medical professionals took part in a euthanasia program that targeted children younger than 3 years old with severe birth defects. Doctors and midwives were required to report such cases, and parents were told that advanced care could be given to children at 30 special pediatric wards around Germany.

Instead, the children were murdered, usually with sedatives. Physicians drew up falsified death certificates, and parents were told their children died of natural causes such as pneumonia. An estimated 5,000 children fell victim to physicians and other medical professionals who went from healers to killers.

These actions were far from the exception in Nazi Germany, said experts at a recent lecture on this ghastly chapter in medical history.

The misguided scientific ideas of physicians and scientists were integral to Nazis’ crimes against humanity and should serve as a reminder to doctors to put patients before political ideology, they said.

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