My lede:

Katie Couric’s on-air colonoscopy in 2000 was just one element of a larger awareness-raising effort that helped increase the colorectal cancer screening rate among eligible adults from about 25% a decade ago to 60%, according to 2008 data from the Centers for Disease Control and Prevention.

Yet experts have looked for ways to help primary care physicians push the rate even higher. Screening all eligible patients for colon cancer could prevent an estimated 75,000 cases annually through the timely removal of precancerous polyps, according to the American Cancer Society.

Now there is more evidence that time-squeezed doctors weighed down with recommending ever more preventive health measures need help getting patients screened.

A randomized controlled trial at Harvard Vanguard Medical Associates, a 14-site multispecialty group practice in eastern Massachusetts, found that mailing individualized screening reminders to patients worked better than using electronic medical records to alert physicians. The results from the study of 110 doctors and 21,860 patients were published in the Feb. 23 Archives of Internal Medicine.

The whole shebang.

My lede:

Teaching hospitals outperform other hospitals at saving patients who experience deadly surgical complications, but only if those patients are white.

That’s the finding of a study in the February Archives of Surgery that analyzed Medicare claims from 4.6 million patients at 3,270 acute care hospitals from 2000 to 2005. Patients at teaching and nonteaching hospitals experienced similar rates of surgical complications, but white patients at teaching hospitals were 17% less likely to die afterward.

Black patients had similar survival rates after surgical complications whether at teaching or nonteaching hospitals, even after adjusting for income.

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My lede:

The American Medical Association, the American College of Physicians and others have declared unethical the practice of paying doctors “finder’s fees” for recruiting patients as clinical research subjects. But only half of institutional review boards address in writing the conflict of interest these kinds of payment incentives pose, according to a survey of IRB policies at 117 medical schools that received National Institutes of Health research funding.

About a quarter of the IRB policies prohibit investigators from offering finder’s fees to doctors or other health professionals, said the study in the January-February IRB: Ethics & Human Research, a journal published by the Garrison, N.Y.-based Hastings Center. Payments can range from $2,000 to $10,000 per patient enrolled in a clinical trial, according to published reports.

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My lede:

For the first time, the country’s two leading professional organizations devoted to pain medicine jointly released comprehensive guidelines for physicians using opioids to treat patients with chronic non-cancer pain.

The recommendations, published in the Feb. 6 Journal of Pain, are intended to help doctors navigate the tricky terrain of caring for the estimated 9% of Americans living with severe chronic pain while averting recreational use and diversion (www.jpain.org/article/piis1526590008008316/abstract/).

Meanwhile, the Food and Drug Administration announced plans to work with manufacturers of 24 long-release opioids to develop a single plan to manage the risk of opioid misuse and overdoses. The plan could include some sort of education requirement for doctors prescribing these opioids.

The whole shebang.

My lede:

There are more than 78,000 Americans waiting for a kidney transplant, according to the United Network for Organ Sharing. Worse, the gap between the number of patients waiting and the number of kidney transplants performed has grown by 110% in the last decade.

Cutting the lengthy wait for a kidney will take more than innovative changes in medical practice, according to the National Kidney Foundation. As part of a new initiative unveiled in late January, the patient service and advocacy organization said compensation should be part of the solution.

That represents a shift from the group’s 2003 position that “offering direct or indirect economic benefits in exchange for organ donation is inconsistent with our values as a society.” Now, NKF recommends that deceased donors’ families and living donors be reimbursed for donation-related costs or medical care. For living donors, that would include lifelong coverage for any medical problems related to the donation.

The whole shebang.

My lede:

Physicians who receive $100 or more from drugmakers or device manufacturers over the course of a year would have those payments posted to the Web under bipartisan Senate legislation introduced in January.

The new bill is stricter than a version of the measure circulated last year that received support from industry and organized medicine groups, including the Pharmaceutical Research and Manufacturers of America and the American Medical Association.

The reintroduced legislation, known as the Physician Payments Sunshine Act, came amid another round of disclosure and conflict-of-interest policies announced by doctors and academic health systems.

The whole shebang.

My lede:

The rate of patients entering the hospital with methicillin-resistant Staphylococcus aureus increased eightfold between 1999 and 2006. Politicians in statehouses around the country say hospitals need to take a more active approach to stopping MRSA’s spread.

Since 2007, four states — California, Illinois, New Jersey and Pennsylvania — have enacted laws requiring hospitals to screen high-risk patients for MRSA infection or colonization and follow precautions to prevent other patients from becoming infected. Eight states considered similar legislation last year, and as of late January, new bills had been filed in Washington and Kentucky.

The whole shebang.

My lede:

What began in late January as a feel-good story of a California medical team’s Herculean efforts to deliver octuplets after a 31-week pregnancy quickly morphed into a controversy over the medical ethics of fertility practices.

The octuplets’ mother, 33-year-old Nadya Suleman, said in an interview on NBC’s “Today” that her physician transferred six embryos and two split. Suleman is single, unemployed and has six other young children. All were conceived through in vitro fertilization at the same clinic, she said. For each pregnancy, her doctor transferred six embryos, Suleman said.

If that is true, the physician’s actions went well beyond American Society for Reproductive Medicine guidelines, society president R. Dale McClure, MD, said in a statement. The Medical Board of California is investigating, and the ASRM has offered to aid the inquiry. The AMA referred requests for comment to the ASRM.

“What was done is clearly irresponsible, clearly unethical, and it placed the life and health of the mother as well as the fetuses at great risk,” said Samuel H. Wood, MD, PhD, a La Jolla, Calif., reproductive endocrinologist. “It’s simply the wrong thing to do.”

The whole shebang.

The lede:

Virtually all hospitals allow physicians and other health professionals to report adverse events, but a new study finds that most reporting systems fail to cultivate a so-called culture of safety that can help prevent future errors.

Less than a third of hospital reporting systems let doctors, nurses and others recount mistakes anonymously and promise privacy for those who identified themselves, said the survey of risk managers at 1,652 U.S. hospitals reported in the December 2008 Quality & Safety in Health Care. Only 13% of hospitals drew adverse-event reports from a wide variety of health staff. More than 80% of risk managers said they received few or no reports from physicians.

Just one in five hospitals issued adverse-event reports within two weeks of an incident. About the same number gave those reports to the key hospital departments and committees charged with protecting patients. One in three hospitals failed to disseminate analyses of the adverse events and near mistakes that were reported.

The whole shebang.

The lede:

The last few years have seen a flurry of controversies about physician involvement in capital punishment in California, Missouri and elsewhere. Organized medicine groups, including the American Medical Association, have said physicians should not participate in executions because their professional duties lie in preserving lives, not ending them.

But what constitutes participation? The latest test of this ethical standard comes from Washington state.

Just before Thanksgiving, the director of health services for the state’s prison system resigned his post prior to the scheduled Dec. 3, 2008, execution of Darold Ray Stenson, who was convicted in 1994 of killing his wife and a business partner.

As the corrections department’s top medical officer, Marc F. Stern, MD, MPH, supervised about 700 physicians, pharmacists, nurses and other health professionals. Dr. Stern said that if any of those staffers helped carry out the execution, the actions would put him “in harm’s way” ethically because he supervised them, albeit indirectly.

The whole shebang.

The lede:

Complex pharmacological regimens employed in outpatient cancer treatment and lagging use of health information technology in the specialty have created alarmingly high rates of medication errors, according to a study published in the Jan. 1 Journal of Clinical Oncology.

A review of 1,379 patients’ medical charts and nearly 12,000 medication doses at four oncology clinics around the country found a 7.1% rate of outpatient medication errors in adults — more than double the rate found in a December 2005 study. Slightly less than 1% of the adult medication errors caused injury.

The rate of medication errors among children was 18.8%, with 3.4% of the errors causing injury. More than half the errors in all patients had the potential to cause injury.

The whole shebang.

The lede:

Growing numbers of clinics abroad are marketing unproven, costly stem cell therapies to medical tourists and “exploiting patients’ hopes,” according to a report from the International Society for Stem Cell Research.

The Deerfield, Ill.-based group convened a task force of researchers, ethicists, doctors and regulatory officials from 13 countries to devise guidelines that target clinics offering experimental therapy to patients without appropriate transparency, oversight or patient protections.

“There is this tension between the slow progress of medical science and the desperation of patients and the swiftness with which disease overtakes them,” said Laurie Zoloth, PhD, on the task force that issued the report in December 2008. “Combine that with a flat world and the Internet, and it’s a recipe for stem cell fakery.”

The whole shebang.