My lede:

Physicians who receive nearly any kind of payment of $10 or more from a drugmaker, device maker or other medical industry firm will see the information listed on a publicly searchable Web site starting Sept. 30, 2013.

The “sunshine” provisions of the health system overhaul President Obama signed into law in March also apply to teaching hospitals and are aimed at curbing industry’s influence on medical decision-making.

The whole shebang.

My lede:

When students from the University of Chicago Pritzker School of Medicine opened their resident Match envelopes in March 2009, only one was bound for a family medicine residency. On Match Day 2010, 12 future family doctors were among the 114 students who unsealed their fates in an auditorium that exploded with shrieks of joy when the big moment arrived.

The family medicine shift among the University of Chicago seniors is indicative of a greater nationwide interest in primary care. There was a 9% rise in the number of U.S. allopathic medical school seniors choosing family medicine — compared with a 7% drop in 2009.

The whole shebang.

My lede:

Not a single allopathic medical school opened its doors during the 1980s and 1990s.

But since 2007, more than a dozen allopathic schools have started the Liaison Committee on Medical Education accreditation process. Another 10 are under discussion, and five osteopathic medical colleges have opened.

The surge in new medical schools is taking place as the Assn. of American Medical Colleges predicts a shortage of at least 125,000 physicians by 2025. Hopes among educators and physician leaders are high that the new schools can help underserved areas and spur local economic growth.

But some experts on work-force issues say new schools are not enough. They say that without more federal funding for residency slots or changes in the doctor payment system, the schools are unlikely to avert an overall work-force shortage or address the undersupply of primary care physicians and general surgeons.

The whole shebang.

My lede:

Ninety-five terminally ill patients died in 2009 after taking lethal doses of medications prescribed by their physicians under death-with-dignity laws in Washington and Oregon, according to health department reports released in March.

Thirty-six of those deaths occurred in Washington in the 10 months after the state’s physician-assisted suicide law took effect March 5, 2009, said a report from the state health department. Nearly 60% of Washington voters approved a 2008 ballot measure that made physician-assisted suicide legal.

The whole shebang.

My lede:

What would happen if it were legal in the United States to pay living kidney donors?

Would fewer donors give altruistically, ultimately driving down overall donation rates? Would the poor, motivated by a quick payday, face exploitation and grave health consequences?

Short of a real-world pilot test, physicians and medical ethicists have been left to speculate about the consequences of using financial incentives to secure kidneys for the 83,868 patients on the United Network for Organ Sharing waiting list as of mid-March.

But a study in the March 16 Annals of Internal Medicine used a sophisticated survey of 409 Philadelphia-area commuters to see how willing people would be to donate under 12 different scenarios and found that many concerns about paying kidney donors may be overblown. Among other things, participants were asked how willing they would be to donate a kidney to family members or strangers for no pay, for $10,000, or $100,000.

The whole shebang.

My lede:

When the time came that his child no longer could enjoy life, the father of a terminal cancer patient asked Joanne Wolfe, MD, if she could help facilitate the child’s death.

She declined, explaining that she and her team would do everything possible to manage the patient’s pain. After the child died, the father told Dr. Wolfe that his request came from his own suffering and the anticipation of losing his child.

“That is one person’s reflection, but it is so meaningful because of the recognition that it is an extraordinarily painful experience to lose a child in this way,” said Dr. Wolfe, director of pediatric palliative care at Children’s Hospital Boston. “It’s heart wrenching.”

The whole shebang.

My lede:

The Organ Procurement and Transplantation Network in February selected five organizations that work with more than 80 transplant centers to help test a nationwide kidney paired donation system. The pilot project could result in an additional 1,000 live-donor kidney transplants a year.

The United Network for Organ Sharing operates OPTN, which sets the country’s organ transplant policy.

“We think [the pilot] is going to be part of the solution to the organ shortage in this country,” said John Friedewald, MD, chair of the OPTN/UNOS Kidney Paired Donation Workgroup. “We won’t address the entire gap, but it’s a good start.”

The whole shebang.

My lede:

When things go wrong and patients are harmed, doctors and risk managers have reasons to fear telling patients what happened and offering an apology.

For a physician, the result could be the turmoil of a years-long medical liability lawsuit. For a risk manager, the hospital’s bottom line could be hurt.

So how do these two groups compare when it comes to disclosure?

A new study, apparently the first to pose that question, found that physicians are more hesitant than risk managers to tell patients when an error occurs. But doctors are likelier than risk managers to use the word “error” in describing the mistakes and are quicker to say, “I’m sorry.”

The whole shebang.

My lede:

A new study is the latest to document the high costs and deadly consequences of preventable nosocomial infections.

Researchers examined 69 million hospital discharges in 40 states from 1998 to 2006, looking at two conditions, sepsis and pneumonia, often caused by drug-resistant infections. Nosocomial sepsis and pneumonia kill 48,000 patients annually and cost $8.1 billion to treat, said the study, published in the Feb. 22 Archives of Internal Medicine.

The whole shebang.

My lede:

About half the time, the doctors and nurses on popular fictional TV medical shows give improper seizure first aid that, in reality, could lead to broken teeth, bruises or dislocations, according to a study to be presented in April at the American Academy of Neurology’s annual meeting.

Epileptologists noticed a trend of “people doing very inappropriate things on television and seeing some of the same sorts of things happening to our patients in real life,” said Dr. Jeremy Moeller, who co-authored the study. “It’s impossible to definitively prove the connection, but one of the potential sources of misinformation is TV.”

The whole shebang.

My lede:

For years, catheter-related bloodstream infections seemed to be a sometimes unavoidable complication of caring for the sickest patients in intensive care units. The infections kill 17,000 patients annually, and the average cost of caring for an infected patient is $45,000, studies show.

But then a stunning thing happened: A group of Michigan hospitals implemented a relatively simple set of interventions, including a checklist of infection-control practices, and their average infection rate dropped 66% after one year. The median central-line infection rate fell to zero per 1,000 catheter days, compared with a national average of 5.2. The achievement was due to hand washing, using full-barrier precautions when inserting central venous catheters, cleaning the skin with chlorhexidine, avoiding the femoral site for insertion and removing unnecessary catheters.

Three years after the project began, 85 Michigan ICUs have improved their success. The average infection rate has dropped 86%, while the median rate remains at zero, according to a Feb. 4 study published in the British medical journal BMJ.

“Most of the time these things go a different way,” said Peter J. Pronovost, MD, PhD, lead author of the study and a consultant on the Michigan project. “The history is that quality improvement is like an accordion. You push on it, it goes in, and then you stop pushing on it and it comes back out.”

The whole shebang.

My lede:

No U.S. medical board has disciplined a doctor for taking part in an execution, and that is unlikely to change, according to a new legal study.

The study, published in January in the Federation of State Medical Boards’ Journal of Medical Licensure and Discipline, is believed to be the first to comprehensively review all state laws and regulations on doctors, medical boards and executions. The study found that only seven death-penalty states incorporate the American Medical Association’s ethics code, which, among other things, bars physician participation in executions.

Nearly all capital punishment states specifically call for doctors to be involved in some way, the study said.

The whole shebang.