Doctors use Formula One pit crews as safety model

My lede:

First it was aviation, then the Toyota assembly line. Now physicians are looking to auto-racing pit crews for ways to improve health care quality and patient safety.

Hospitals in at least a dozen countries, including the U.S., are learning how to translate the split-second timing and near-perfect synchronization of Formula One pit crews to the high-risk handoffs of patients from surgery to recovery and intensive care. The racing crews can refuel a car and change all four tires in seven seconds, and no F1 driver has died at the wheel in a Grand Prix race since 1994.

The key lessons physicians, nurses and other health professionals can get from these well-honed teams is how to use briefings and checklists to prevent errors, apply technology to transfer key information and learn afterward by mining data, according to a recent study published in the British medical journal Quality and Safety in Health Care. The findings were based on structured interviews with the technical managers of nine F1 racing teams.

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Million-dollar payouts to researchers often go undisclosed

My lede:

Highly paid consultants for orthopedic device makers disclose their company ties about half the time and rarely share details with readers about their financial relationships, according to a new study calling for more transparency.

Researchers examined payments from five orthopedic device makers to consultants in 2007 and then zeroed in on the 32 researchers, nearly all physicians, who received more than $1 million each to see whether those relationships were disclosed when they published articles the following year.

When writing directly about the firm’s products, authors paid $1 million or more disclosed their company tie half the time, said the Archives of Internal Medicine study, published online Sept. 13. Only one of the 26 orthopedics-related journals studied, The Journal of Bone and Joint Surgery, required authors to acknowledge they were paid more than $10,000.

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Physician background doesn’t tell whole quality story

My lede:

The information patients typically use when looking for a new doctor is not very helpful in determining physician quality, according to a new study of more than 10,000 Massachusetts physicians caring for 1.1 million patients.

Researchers found little correlation between physician performance on 124 process-based quality measures in 30 clinical areas and characteristics such as medical education, board certification, malpractice claim payments and disciplinary actions commonly listed by health plans and consumer websites.

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Heart bypass quality ratings go public on Consumer Reports

My lede:

In a first-of-its kind bid to make clinical quality performance data available to the public, the Society of Thoracic Surgeons partnered with Consumer Reports in September to rate 221 cardiac surgical groups in 42 states.

The groups are graded on a one- to three-star scale on their performance in providing coronary-artery bypass grafting procedures. The ratings are included in the October issue of the magazine and are available to subscribers at the Consumer Reports website.

The risk-adjusted metrics, developed by the society, gauge patients’ 30-day mortality, complication rates, whether patients receive recommended medications and whether they get at least one optimal surgical graft. The ratings are based on group performance, because grading individual surgeons would be statistically invalid, society leaders said.

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Patients worry about pharma’s sway over doctors

My lede:

How relationships with industry may influence physician decisions is not just a concern limited to Capitol Hill or medical ethics committees. A new poll found that 69% of patients say they believe drugmakers hold too much sway over doctors’ prescribing.

Nearly half of the 1,154 adults surveyed nationwide said physicians’ prescribing decisions are influenced by gifts from drugmakers, according to poll results released in August. A third of patients were so worried about pharmaceutical marketing that they felt they could not rely on their doctors’ medication advice.

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My TV caught fire

Here’s something I wrote about a month after the 9/11 attacks.


The Page

A month ago, my TV caught fire
With the explosion of a new age
The smoke and ash of dying dreams
Buried the remains of a scattered page

On that page was written the record
Of a trial, a trade, a law, a life
A deal gone sour over mislaid details
A string of betrayals by a faithless wife

On that page was written a telephone bill
For the last desperate call that was made
To her husband’s answering machine
Before she fell victim to a box-cutter blade

That page laid out the measurements
For an insured engagement ring
Thousands died for a political world
But they never did a goddamn thing

On that page was printed a forgotten e-mail
“I’m sorry, honey, for the things that I said
In the heat of the moment, I let my tongue slip
I’ll do better, I promise,” was the way that it read

That page was trimmed with the threadbare
Lives of men and women I never knew
It was soaked in the searching tears
That I spat out so hard for you

A month ago, and that page has been printed
A trillion times over with words bitter and rank
To describe the evil that brought down the ash
A month has gone by — and the page is still blank

– 30 –

City of Chicago, Richard M. Daley, Mayor

Here is a little something I wrote a few years back, but given the news it seems appropriate to publish it now.


Come from the East
Come from the West
Back to the town
We love the best
By boat, by plane
By land, by air
We find this tidbit
Everywhere
To remind us of our master
As if we hadn’t been aware
It says, “City of Chicago
Richard M. Daley, Mayor”

It seems no inch of property
Escapes Hizzoner’s glare
Without his leaden stamp
Is it really even there?
Why, even babies’ heads
Are marked before they grow their hair
Welcome to the world, my boy
But you had better beware
You’re in the City of Chicago
Richard M. Daley, Mayor

Bundled up in business cazh
Or attached to fanny packs
On a muggy Mag Mile morning
The throng is making tracks
Past dem purty flower boxes
Past a prophet’s jumbled prayer
Much to do, much to see
Can’t stop, can’t spare
In the City of Chicago
Richard M. Daley, Mayor

He arrived as “Rich”
But today he’s Da Mare
In daddy’s footsteps
City Hall’s rightful heir
Cronies and crooks
Creep up on the screen
We’re so damn amazed
By a magical Bean
Behind every denial
Just a hint of despair
In the City of Chicago
Richard M. Daley, Mayor

– 30 –

Early palliative care lengthens survival for lung cancer patients

My lede:

Palliative care not only helps patients with terminal illnesses have less painful deaths but also can increase survival times when it is integrated soon after diagnosis.

That is the finding of a study of 151 Boston-area patients with lung cancer in the Aug. 19 New England Journal of Medicine. The 74 patients who received standard oncologic care at Massachusetts General Hospital for metastatic non-small-cell lung cancer had a median survival time of nine months, compared with nearly a year for the 77 patients who received standard care and visited the hospital’s outpatient palliative care service within three months of diagnosis. The patients getting palliative care lived longer despite spending more time in hospice care and receiving less chemotherapy.

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