My lede:

Some hospitals have virtually eliminated deadly catheter-related bloodstream infections by implementing a checklist of simple preventive measures, yet an initiative to spread the success nationwide has run into some resistance.

A project funded by the Agency for Healthcare Research and Quality, On the CUSP: Stop BSI, has attracted the participation of at least 400 hospitals in 27 states. The project seeks to build on the success in Michigan, where intensive care units at more than 100 hospitals cut their median central-line infection rate to zero per 1,000 catheter days, compared with a national average of 5.2.

The whole shebang.

My lede:

It was bad enough that Seattle Grace Hospital intern Isobel “Izzie” Stevens, MD, fell in love with a patient in need of a heart transplant. But she really crossed the ethical line when she cut the wires to his left ventricular assist device so his health would deteriorate and he’d move higher on the United Network for Organ Sharing waiting list.

That behavior — portrayed by actress Katherine Heigl on the hit ABC TV medical drama “Grey’s Anatomy” — is probably the most outrageous example of scores of unethical medical actions shown on “Grey’s” and Fox TV’s “House,” according to a study in the April Journal of Medical Ethics.

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My lede:

Medical journal editors should require independent analysis of industry-sponsored trial data by an academic statistician before publishing results, according to an editorial published in the March 24/31 Journal of the American Medical Association.

The call comes in response to internal GlaxoSmithKline documents revealed as part of a February Senate Finance Committee report investigating the company’s handling of data related to its diabetes drug Avandia (rosiglitazone).

The whole shebang.

My lede:

Robert O. Bonow, MD, graduated from medical school in 1973. Caitlin Schaninger will graduate in June. Despite training in different generations, they see similar gaps in quality and safety education.

Much has changed in medical education in the nearly four decades that separate their medical school experiences.

What has remained largely unchanged is the lack of education most medical school graduates receive in the science and skills of quality improvement and patient safety — how to deliver the right care to the right patient at the right time, and how to prevent a patient from being harmed.

The whole shebang.

My lede:

Most of the attention given to the health reform law has focused on its sweeping changes to the insurance system. But the law also could dramatically change the way that care is delivered, according to experts on patient safety and quality.

For example, the overhaul uses pay bonuses and penalties to physicians and hospitals to incentivize the care coordination and safety interventions that can help prevent nosocomial infections and unnecessary hospital readmissions. It also requires an unprecedented level of public reporting on hospital and physician quality performance, and could hasten implementation of care improvement practices, experts said.

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My lede:

The health system reforms signed into law in March will cover an estimated 32 million uninsured patients by 2019. But there may not be enough physicians to care for them.

The nation likely will see a shortage of about 160,000 physicians by 2025 — leaving too few to keep up with the flood of newly insured patients seeking care for long-neglected health problems.

“It’s sort of a race against time,” said Edward Salsberg, director of the Assn. of American Medical Colleges’ Center for Workforce Studies, whose 2025 physician supply estimate includes a shortage of 46,000 primary care physicians and 41,000 general surgeons, even after accounting for the supply of international medical graduates.

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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.

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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.”

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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.