Nobel Prize reflects IVF’s acceptance as medical procedure

My lede:

Four decades ago, a majority of Americans told pollsters that the idea of creating a baby in a test tube went “against God’s will.” In early October, the Nobel Prize in Physiology or Medicine was awarded to one of the men who helped make in vitro fertilization a reality.

Physicians specializing in fertility medicine said the prize — awarded to 85-year-old British biologist Robert G. Edwards — was long overdue and reflects how far the field has come. IVF initially sparked suspicion and condemnation from religious authorities, scientists, medical ethicists and the public.

In the 32 years since, more than 4 million children worldwide have been born with the help of IVF. Doctors have seen the attitudes shift in their patients, who in decades past felt stigmatized when seeking out IVF but today often regard the technique as a first option when natural methods fail.

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Posting emergency wait times: Good marketing or good medicine?

My lede:

Every three minutes, Scottsdale Healthcare in Arizona tells patients how long they can expect to wait to see a doctor or other health professional at one of its four emergency departments. The times are automatically posted on electronic billboard ads and the hospital system’s website.

Posting ED wait times on billboards, websites, Twitter accounts and mobile apps may seem like a way to better serve patients. Yet it could backfire, some physicians say.

Hospital systems from Oregon to Arizona to Virginia see it as an opportunity to boost revenue and smooth patient demand over the course of the day and week, as well as among different EDs they operate. The argument is also made that greater transparency about wait times could encourage hospital administrators to devote more resources to reducing patient boarding and diversion.

But the growing trend could lead to misuse. Patients could self-triage in a dangerous way. There could be inappropriate use of the emergency department. There also might be a misplaced emphasis on door-to-doctor times versus more meaningful measures, such as how long it takes for an ED patient to be admitted or discharged once their care is completed.

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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 –