The lede:

Medical students get a failing grade on their knowledge of physicians’ ethical obligations during wartime, according to a new study authored by a team of Harvard Medical School physicians.

The authors said their study, published in October in the International Journal of Health Services, should prompt medical schools to educate future doctors more thoroughly on the ethical questions they could face in an age of terror and torture.

But experts said that although medical curricula could cover military medical ethics, such instruction should be folded into discussions about the broader problem of dual loyalty — when doctors’ advocacy for the patient conflicts with other institutional or societal objectives.

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Two teams of scientists simultaneously announced they have reprogrammed human skin cells to obtain pluripotency, the characteristic hailed in embryonic stem cells as having the potential for therapeutic breakthroughs in areas ranging from Parkinson’s disease to diabetes.

Scientists in Japan and Wisconsin created the so-called induced pluripotent cells by introducing different combinations of genes into skin cells that are normally switched off after embryonic cells differentiate into various cell types. The results were published last month in Cell and Nature, respectively.

Researchers, ethicists, religious leaders and politicians hailed the findings, saying the innovative work could allow society to reap scientific and medical benefits of stem cell research without destroying embryos.

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Large physician groups have long had a head start on solo and small practices in the medical marketplace because they can negotiate better health plan contracts. Now, a rising tide of evidence indicates that size also confers a quality advantage.

Researchers admit that the medical literature emerging on the relationship between group size and quality is far from a slam dunk. They argue, however, that bigger physician groups can pool capital to pay for electronic medical records systems and other quality initiatives that help them more reliably deliver guideline-based care.

On the opposite end of the spectrum, a small but growing movement of doctors is experimenting with a leaner model of medicine that they say improves the financial viability of solo and small-group practice and, most importantly, improves patient care.

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The lede:

Toni Cordell’s surgery would be “an easy repair,” her doctor said. Embarrassed at being a slow reader, she signed the informed-consent papers she was given without understanding them.

She said no one, including her doctor, explained the procedure in detail beforehand or uttered the word “hysterectomy.” Cordell didn’t discover the nature of her operation until months after surgery when an office nurse inquired about her recovery.

Cordell’s story of being bewildered by medical-legal jargon is not unique. According to a 2005 National Quality Forum report, between 60% and 70% of patients do not read or understand informed-consent documents and nearly half cannot recall the exact nature of the operation to be performed.

Now a growing number of hospitals and physicians are moving to redesign informed-consent protocols. They are using new computer technology and education techniques to improve safety and ensure that patients understand a surgery’s risks and benefits. Informed consent is a process, they say, not a piece of paper.

The whole shebang.

The lede:

Thirteen states this year have seen legislative proposals aimed at limiting financial relationships between physicians and drugmakers. Most bills failed to pass, due to heavy pressure from pharmaceutical lobbyists, experts said, but new efforts are afoot.

The latest proposals include a Michigan bill that would make that state the second in the nation after Minnesota to place a limit — $100 — on the total value of gifts a drugmaker can give a physician in a year. Michigan and Massachusetts are considering so-called sunshine laws requiring drug companies to publicly disclose any gifts, payments, subsidies or incentives worth more than $25.

The whole shebang.

The lede:

The Robert Wood Johnson Foundation is pouring $15.9 million into a new effort to give doctors and the public a more accurate assessment of physician performance.

The plan is to combine national Medicare and private health plan claims data and then use the data for public reporting of physician performance on quality and cost measures. Reporting in select areas is set for 2010.

The initiative comes on top of criticism that the nation’s dozens of quality measurement and reporting efforts are redundant or rely on widely varying metrics. For example, a 2005 Institute of Medicine report on performance measurement called for a new office in Health and Human Services to coordinate and fund the development of metrics for pay-for-performance and public reporting programs.

The whole shebang.

My stories for American Medical News are now freely available for about 90 days after they go live on the Web site. So, I’ve decided to start posting the first few grafs and links to the stories here in case you’re interested in reading.

The beat — medical ethics, patient safety and health care quality — is pretty interesting because quite a few of the stories are of great interest to many people who are not physicians. A great example is this story.

The lede:

The only state medical board in the country with policy declaring physician participation in executions “a departure from the ethics of the medical profession” and grounds for discipline was rebuked in state court late last month.

Wake County (N.C.) Superior Court Judge Donald W. Stephens ruled that the North Carolina Medical Board overstepped its authority in threatening to punish doctors who take an active role in the death chamber. But executions in the state will not resume due to the pending cases of five North Carolina death-row inmates on lethal injection protocols.

Read the whole shebang.

American Medical News — the weekly newspaper for which I do reporting on medical ethics, health care quality and patient safety — is still behind a password-protected firewall. However, the Web site has gone to a Salon-like model where the reader can see the first few paragraphs of a story for free, before being prompted to login or pay up.

So I’ve decided to post links to those stories over on my journalism page. If nothing else, these teasers should give you a flavor for the kind of work I’m doing. For example, my most recently published articles focus on what the November elections mean for stem-cell research funding and how hospitals are moving toward more permissive policies on cell phone use.