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February 23, 2007
By Liz Kowalczyk, Globe Staff
Dr. Peter Slavin, president of Massachusetts General Hospital, jumped into the fray yesterday over the blog started by his competitor, Paul Levy, chief executive of Beth Israel Deaconess Medical Center.
Levy has posted on his website month-by-month hospital-acquired infection rates for patients at his hospital, and challenged other hospitals to publicize their rates as well, according to a story in today's Globe.
Slavin confirmed that Mass. General will not publicize its infection rates, at least not until the state develops a standardized approach to measurement that has been embraced by the medical community. But he made it clear his hospital has nothing to hide: "Our internal data shows our numbers are lower than Beth Israel's," he said.
"There are at least two ways to compete in health care, provide great care, do great research and excel at teaching -- that's the way we choose to do it," Slavin said. "The other way is to criticize one's competitors. That's not the method we choose to employ."
Posted by Karen Weintraub at 04:51 PM
February 23, 2007
Two workers at Tufts-New England Medical Center allegedly planted a fake pipe bomb in an office the same day that Boston was panicked by a Cartoon Network marketing ploy.
The stunt sparked a 45-minute evacuation of the first floor of one building and other offices nearby, including an on-site day-care center but no patient-care areas, Brooke Tyson Hynes, vice president of public affairs and communications at Tufts-NEMC, said today.
The Boston Police Department bomb squad, called by Tufts-NEMC security, determined the device was not active. No charges against the two employees have been filed. The prank was first reported in this morning's Boston Herald.
The employees have been suspended without pay for two weeks, Hynes said.
"The fake device found here was part of an inappropriate, but not malicious, prank between friendly coworkers," Hynes said. "This type of behavior is not acceptable here."
Posted by Elizabeth Cooney at 12:01 PM
February 23, 2007
Jessica Wang, a second-year student at the University of Massachusetts Medical School, has won the 9th Annual Lesbian, Gay, Bisexual and Transgender Health Achievement Award.
The American Medical Student Association and the Gay and Lesbian Medical Association honored Wang for introducing issues that affect LGBT patients into the medical school curriculum and for leading QMass, a UMMS student organization dedicated to supporting and promoting LGBT issues.
Jessica Wang
Posted by Elizabeth Cooney at 09:47 AM
February 23, 2007
Three Cambridge Health Alliance physicians have earned academic promotions from Harvard Medical School.
Dr. Jean A. Frazier, director of the Child and Adolescent Neuropsychiatric Research Program at CHA and co-director of CHA’s Center for Child and Adolescent Development, has been named associate professor of psychiatry at the medical school.
Dr. Elizabeth H. Gaufberg, an internist and a psychiatrist at CHA, has been named assistant professor of medicine and assistant professor of psychiatry.
Dr. Cynthia J. Telingator, training director of CHA’s Division of Child and Adolescent Psychiatry, has been named assistant professor of psychiatry.
Posted by Elizabeth Cooney at 09:13 AM
February 23, 2007
On his blog Running a Hospital, Beth Israel Deaconess CEO Paul Levy challenged other hospitals to publicize teir monthly central line infection rates, a step that is also being pushed nationally by patient advocates. The infections, which come from intravenous tubing inserted by staff, can cause serious harm and even death. The Globe asked several other Boston teaching hospitals if they would release their infection rates, which they have collected internally for years. They all said no, at least for now, but added they expect to in the near future.
Testing of peanut butter jars obtained from people sickened by salmonella has confirmed the presence of the dangerous germ, the Centers for Disease Control said yesterday.
Texas Governor Rick Perry yesterday angrily defended his relationship with Merck & Co. and his executive order requiring that 11- and 12-year-old girls receive the drugmaker's vaccine against the sexually transmitted virus linked to cervical cancer. The Associated Press reported on Wednesday that Perry's chief of staff had met with key aides about the vaccine on Oct. 16, the same day Merck's political action committee donated $5,000 to the governor's campaign.
The British government has approved a plan to allow women to donate eggs for stem cell and cloning research and to be compensated for it -- an action that scientists hope will improve the supply of eggs.
Posted by Elizabeth Cooney at 06:31 AM
February 22, 2007
Boston figures in a new HBO documentary series, "Addiction," that will begin airing in March. City and state health leaders will discuss the problems of addiction after a screening of the first episode at 6 p.m. Monday at the State House.
The cable television series is part of a campaign by the Robert Wood Johnson Foundation, the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism to improve understanding of addiction as a treatable brain disease.
The South Boston Drug Court is featured in one episode about long-term treatment for people involved in court cases.
But the local connections don't end there, said John Auerbach, executive director of the Boston Public Health Commission, pointing to neighborhood coalitions focused on fighting substance abuse. He is a panelist at the event.
"Behavioral change doesn't happen easily," he said. "You have to have the message reinforced on TV, in your neighborhood, by your coach, wherever you are, and with a linkage to support."
Maryanne Frangules, executive director of the Massachusetts Organization for Addiction Recovery, wants people to know that addiction is a disease and that more people than they might expect are recovering from it. MOAR is hosting the screening.
"There's help out there, but not enough," she said.
Posted by Elizabeth Cooney at 02:29 PM
February 22, 2007
Retiring Harvard Medical School Dean Joseph B. Martin will get an early musical send-off tonight when second-year students present "Joseph Martin and the Amazing Technicolor White Coat."
The centennial show runs through Saturday at the Media/Arts Center at Roxbury Community College. (Tickets are available at the door.)
"It's our gift to the first-year students," said Heather Gunn, director of the show, a tradition since 1907. "We make fun of all the professors we had last year and they have now."
Gunn said the time devoted to the show has meant a lot of nights when the 190 full-time medical and dental students involved get only about two hours of sleep a night. That makes it good training for their third year, when they will be working on hospital wards, she said.
Her training to direct the HMS Follies comes from 13 years as an actor in Los Angeles.
"I got into Harvard Medical School because they needed me to direct the second-year show," she joked.
Posted by Elizabeth Cooney at 11:56 AM
February 22, 2007
"Flea," a Boston-area pediatrician who writes drfleablog, suggests that pediatricians might running out of things to do -- given a report based on U.S. vital statistics in Pediatrics that says fewer children are dying from disease, while deaths from unintentional injuries, homicide and suicide are rising.
"Flea," by the way, is what surgeons called pediatricians when he was training.
"Fleas are no longer needed to prevent deaths in children," he writes. "That is, unless you believe that pediatricians are uniquely positioned in society to prevent accidents, murders, and suicides. Even if we were to stipulate that this proposition is true, you would have to agree that Pediatrics is a completely different specialty from the one originally conceived in the 1920's."
Posted by Elizabeth Cooney at 10:50 AM
February 22, 2007
More than 500 cases of mostly minor side effects have been reported in girls and women who got the new cervical cancer vaccine Gardasil, but government health officials say no additional warning labels are needed.
Treating genital herpes can also help keep the AIDS virus under control in women with both infections, and might reduce the spread of HIV, too, the first major study to test this strategy suggests.
The Federation for American Hospitals, whose members include Universal Health Services Inc., Tenet Healthcare Corp., and Health South Corp. say providing health insurance for all Americans can be achieved by expanding government coverage, and by giving lower-income Americans vouchers to pay for the private plan of their choice.
Posted by Elizabeth Cooney at 06:25 AM
February 21, 2007
By Liz Kowalczyk, Globe staff
The state Board of Registration in Medicine, which licenses Massachusetts doctors, disciplined a surgeon, an internist, and a cardiologist today.
Dr. Putnam P. Breed, a surgeon who once practiced at Anna Jacques Hospital in Newburyport, resigned from the practice of medicine in Massachusetts. Breed, a former Massachusetts medical examiner, was convicted last month of nine felonies for signing cremation certificates without viewing the bodies in the Bayview Crematory scandal in New Hampshire.
The board also accepted the resignation of Dr. James R. Tierney, an internist and pulmonologist who practiced in Gardner.
The board reprimanded Dr. Carl R. Feind, a cardiologist who was affiliated with Cape Cod Hospital until last year, for negligence and failure to maintain proper documentation. The board said that Feind failed to see a lesion in a patient's artery, and, in another case, did not inform a patient having a heart attack of all of the treatment options.
Posted by Gideon Gil at 05:27 PM
February 21, 2007
By Liz Kowalczyk, Globe staff
Doctors from Cambridge Health Alliance, which includes Cambridge Hospital, and Harvard Medical School tout a new way of training medical students in tomorrow's New England Journal of Medicine.
Third-year medical students who spend the entire year following the same patients as they are treated by various doctors throughout the health care system see patients more frequently and are supervised more often by experienced faculty, than students trained the traditional way, write Dr. David Hirsh and Dr. Barbara Ogur, both physicians at the hospital; and HMS professors Dr. George Thibault, an executive with Partners HealthCare, and Dr. Malcolm Cox of the federal Veteran's Health Administration. Students normally go from hospital to hospital for one- to three-month stints in specific specialties.
Students in the Cambridge pilot program, which began in July 2004, also score as well or better on tests of clinical skill and knowledge than their peers, the authors report, although results are preliminary.
Cox, who helped Hirsh and Ogur develop the program, gets revenge of sorts in the article. Many doctors at Harvard's other teaching hospitals considered the Cambridge approach too radical, and felt Cox was not building a consensus as leader of a curriculum reform initiative at Harvard Medical School. He resigned after 18 months, saying in an interview with the Globe last year that he had "deep philosophical differences" with many Harvard faculty who believed that students learn better the traditional way.
Posted by Gideon Gil at 05:02 PM
February 21, 2007
The pay gap between primary care physicians and specialists is widening because fees for office visits not only aren't keeping pace with fees for procedures, but the volume of visits is also lagging behind the number of procedures, according to an article in this week's Annals of Internal Medicine.
Every five years a committee from the American Medical Association updates the Resource-Based Relative Value Scale, which is designed to reduce physician pay imbalances. The Annals authors says the committee is made up mostly of specialists.
The study has provoked a contentious exchange about the worth of specialists vs. primary care physicians on Kevin, M.D., the blog of Dr. Kevin Pho, a Nashua, NH, primary care physician.
"Instead of trying to lower the income gap by decreasing specialty salaries, why not try to lower the income gap by raising primary care salaries?" one anonymous poster asked. "In many cases being a specialist requires double the amount of residency that being a primary care doc requires. Why shouldn't they be paid better!"
Another anonymous entry suggested how to pay for this:
"Make docs employees of the federal govt. with a flat salary pay grade just like other federal employees. Have malpractice coverage thru the fed. Give them a G15 pay grade for primary care (about 120k per year) and a G20 pay grade for specialists (about 170k per year). That's still a 50k per year difference, which is quite substantial."
That drew the following reply: "Dream on. I would be willing to work about 10 hours a week for this salary."
Posted by Elizabeth Cooney at 04:23 PM
February 21, 2007
Dr. George L. King, director of research at Joslin Diabetes Center and co-director of Joslin's Asian American Diabetes Initiative, was sworn in today as a member of the state's new Asian American Commission in a State House ceremony.
King also heads vascular cell biology at Joslin and is a professor of medicine at Harvard Medical School.
Posted by Elizabeth Cooney at 02:45 PM
February 21, 2007
A new campaign called The Prescription Project seeks to end conflicts of interest that may arise from pharmaceutical company marketing aimed at physicians. It calls for academic medical centers to tighten their policies governing ties with industry.
"We are looking to see that payers, consumers and physicians work together to promote evidence-based medicine and to counter the bias of drug marketing," said Robert Restuccia, the project's Boston-based executive director.
The Prescription Project points to Stanford University Medical School, University of Pennsylvania Health System and Yale University School of Medicine as leaders. While their models vary, the institutions restrict gifts to doctors, drug samples and visits by industry sales representatives.
Boston hospitals surveyed by the Globe during the past week say they require drug company employees and other vendors to register with them before visiting, but other policies vary.
Tufts-New England Medical Center does not allow pharmaceutical sales representatives in clinical areas. Caritas St. Elizabeth's Medical Center says its doctors cannot give patients free samples of medications, but Partners' hospitals, Brigham and Women's and Massachusetts General, do let doctors give free samples to patients at certain approved sites, such as a practice serving a significant number of uninsured patients unable to pay on their own.
Beth Israel Deaconess Medical Center and St. Elizabeth's prohibit on-site meals paid for by drug companies and restrict gifts to under $100. Partners' hospitals have a similar cap on what doctors can accept. Gifts may include nominal-value items related to education or patient care, the Partners' rules say.
A speaker or panelist at a professional meeting may accept payment for expenses if the meeting's purpose is "promoting objective scientific and educational activities," the Beth Israel Deaconess policy states.
"We take this issue very seriously and continue to update our policies," said St. Elizabeth's spokeswomen Melanie Franco. "We will look at what the Prescription Project is saying."
The Prescription Project, funded by $6 million from the Pew Charitable Trusts, is a joint effort of Community Catalyst in Boston and the Institute on Medicine as a Profession at Columbia University. Its impetus was a January 2006 article in the Journal of the American Medical Association that said the $12 billion spent annually on drug marketing influences how doctors prescribe medications, whether they receive free lunches, free samples or free trips from companies.
Posted by Elizabeth Cooney at 01:28 PM
February 21, 2007
Violence gets our attention, in movies, video games, television, music, print, or on the Internet, especially if our children are watching.
The Center on Media and Child Health at Children's Hospital Boston has created a database of research findings and chose violence as the first topic they would make available free to parents, clinicians and researchers who want to know what peer-reviewed studies can tell them.
They can ask a question, read a summary in lay language or search 700 research articles to find answers.
"Our goal was to gather all of the studies in a single location and present them in a standardized form to create the first interdisciplinary library of research on media effects," Brandy King, librarian for CMCH, said in a statement from Children's. "We chose violence as our first research topic because it is the most thoroughly investigated area of media effects."
Posted by Elizabeth Cooney at 11:38 AM
February 21, 2007
The Charlie Weis medical malpractice trial came to an abrupt end in Suffolk Superior Court yesterday when the doctors accused of mishandling Weis's gastric bypass surgery rushed to the aid of a juror who collapsed in the jury box and the judge declared a mistrial.
Hospital ERs have been seeing twice the usual number of winter patients after last week's ice storm. Boston Medical Center has treated about 40 people who broke bones and bruised bodies on the ice in the last week. Massachusetts General Hospital and Beth Israel Deaconess Medical Center have treated about 30 people each day who have fallen on the ice, and Newton-Wellesley Hospital has treated another 20 to 30 people a day since last Wednesday's storm.
Contrary to traditional notions of grief after the death of a loved one, a new study from Harvard and Yale finds that yearning is felt more powerfully than depression.
Bowing to pressure from parents and medical groups, Merck & Co. is suspending its lobbying campaign to persuade legislatures to mandate that adolescent girls get the company's vaccine against cervical cancer as a requirement to attend school.
The Canadian government and Bill Gates yesterday announced an initiative to establish a research institute to develop an AIDS vaccine, committing up to $119 million to the project.
Posted by Elizabeth Cooney at 06:21 AM
February 20, 2007
Interesting suggestion from Blog, MD, the blog of Dr. Samuel C. Blackman, a Boston pediatric oncologist. He discusses a recent study in the British Medical Journal, which looked at whether mothers of infants in the ICU were able to recall information better when given audiotapes of their conversations with doctors.
"A couple of years ago, when I was a relatively new 1st year fellow, a family brought a tape recorder into the room and set it down right in front of me," he writes. "I can’t remember whether or not they asked me if I would mind being taped (I think they did), but I remember being weirded out by it and telling them that I’d prefer not to have my every word recorded."
But he's had a change of heart. "One would think that a tool as simple as a tape recorder would be more widely used for complex discussions such as informed consent for chemotherapy," he writes. "I believe that offering parents the opportunity to tape one’s important discussions with them telegraphs a message of confidence and trust, and would go a long way to establish rapport at a very important moment in a family’s life."
He's eager for comments from parents of children with cancer and from cancer patients themselves.
Posted by Gideon Gil at 08:19 PM
February 20, 2007
"Flea," a Boston-area pediatrician who is the author of drfleablog, comments today on Liz Kowalczyk's story in Sunday's Boston Globe about state efforts to reduce the use of emergency rooms by patients with non-urgent illnesses:
"Here's the problem: Overuse of emergency services for non-emergent complaints educates parents and their children that non-emergent conditions require emergency level of care. Thus when a toddler in my practice goes to the E.D. with cold symptoms and gets an I.V. (true story from last night), the parents learn that colds deserve I.V.'s
"Once the lesson is taught, it's friggin' hard to unlearn. Flea knows that E.D. docs have a lot on their plates. If they can find the strength to do so, could they please help us educate patients not to go to the E.D. for minor complaints?"
Posted by Gideon Gil at 07:37 PM
February 20, 2007
Dr. Joseph V. Bonventre and Dr. Frederick J. Schoen have been named directors of the new Technology in Medicine Initiative at Brigham and Women's Hospital's Biomedical Research Institute, the hospital has announced.
They also will serve as liaisons between the hospital and the Center for Integration of Medicine and Innovative Technology, a consortium of area teaching hospitals, universities and research laboratories that develops medical devices.
Bonventre is a professor of medicine and health sciences and technology at Harvard Medical School, director of the renal division at Brigham and Women's and co-director of the BRI Stem Cell, Regenerative Medicine and Tissue Engineering Center.
Schoen is professor of pathology and health sciences and technology at Harvard Medical School, director of cardiac pathology and executive vice-chairman of the Brigham and Women's department of pathology.
Posted by Elizabeth Cooney at 05:48 PM
February 20, 2007
Contrary to traditional notions of grief after the death of a loved one, a new study finds that yearning is felt more powerfully than depression.
Researchers from Harvard Medical School and Yale University School of Medicine found that yearning was the strongest negative emotion after loss, they report in tomorrow's Journal of the American Medical Association.
Negative emotions associated with grief peaked within six months, meaning people with more prolonged symptoms might need more help after that point. And the researchers recommend that the standard psychiatric reference, the Diagnostic and Statistical Manual of Mental Disorders, be revised to focus less on depression after the death of a loved one.
"Yearning is reacting to the loss of someone or something, and once that is gone, you miss it, you pine for it, you hunger for it, you crave it. That was the primary emotional experience after bereavement, rather than depression," Holly G. Prigerson, one of the authors, said in an interview. "This suggests that the DSM reconsider what the natural response to loss is, especially with respect to depression and yearning."
Prigerson is an associate professor of psychiatry at Harvard and director of the Center for Psycho-Oncology and Palliative Care Research at the Dana-Farber Cancer Institute.
Prigerson and her colleagues were testing the theory that people respond to loss by moving through disbelief, yearning, anger, depression and acceptance, with depression being the dominant negative emotion. To do that they interviewed 233 people in the Yale Bereavement Study for up to two years following the death of a loved one from natural causes.
The participants in the study, mostly widows, did experience the five stages of grief in the sequence popularized by Elisabeth Kubler-Ross's description of terminally ill patients, but yearning was the most powerful negative emotion and, on average, participants' worst feelings peaked within six months. The level of acceptance -- the strongest emotion of all -- rose steadily over six months.
In contrast, the DSM focuses exclusively on depressive symptoms, saying they should be expected two months after a loss, Prigerson said.
Prigerson emphasized that the people in the study had lost loved ones to natural causes, reflecting 94 percent of deaths in the United States. People who had lost a child or a loved one after a traumatic death, such as a car crash or suicide, were excluded from the study.
The ones who knew for six months or more that their loved ones had a terminal illness reached acceptance sooner than those who had less time to prepare for the death, the study found.
"People never get over a loss, they just get used to it," Prigerson said. "Even years after someone dies, they get pangs of grief, they need to think about the person, and they miss them with heartache," she said. "That's normal. But intense levels beyond that become problematic."
Posted by Elizabeth Cooney at 04:14 PM
February 20, 2007
By Stephen Smith, Globe Staff
At the health department founded by Paul Revere, they're going totally 21st century: Starting today, the Boston Public Health Commission will begin regularly airing podcasts on everything from fears about a global flu epidemic to substance abuse to healthcare reform.
The feature, called Health Click, is an outgrowth of podcasts used to provide information during a measles outbreak last summer and, more recently, during the wave of gastrointestinal illness that swept Boston. The podcast will be updated regularly and is available in Spanish and English. The first installment introduces the feature and talks about the basics of public health.
"We want these podcasts to be helpful and informative for people," John Auerbach, executive director of the health commission, said in a statement. "We also want to use it as a way to educate people about the many health resources that are available here at the commission."
Posted by Karen Weintraub at 04:03 PM
February 20, 2007
The Tufts University Family Medicine Residency Program at Cambridge Health Alliance is one of 14 programs in the country to be chosen for an initiative to improve how doctors are trained to practice family medicine.
The Preparing the Personal Physician for Practice program is a $1.75 million, five-year project funded by the Association of Family Medicine Residency Directors and the American Board of Family Physicians.
"The goal here is to create graduates of family medicine residency programs who are expert clinical decision makers, who use the best technology available and who are able to apply this in a very individualized process to provide personalized care," said Dr. Randy Wertheimer, chief of family medicine at CHA.
The 24 residents in the Tufts-CHA program will be based in a new CHA-Malden Family Medicine Center, reflecting the emphasis on outpatient care, said Dr. Lyle Bohlmann, associate director of the Family Medicine Residency Program.
Posted by Elizabeth Cooney at 10:12 AM
February 20, 2007
Dr. Dennis Choi, a professor of pharmacology and experimental therapeutics at Boston University, is one of four finalists to become the new dean of the University of Florida College of Medicine, according to a report in the Gainesville Sun.
Before coming to BU last year, Choi had been head of the neurology department at Washington University Medical School and then vice president for neuroscience at Merck Research Labs, the newspaper said.
Posted by Elizabeth Cooney at 07:20 AM
February 20, 2007
David Shribman remembers Deena Newberg, the girl across the street in Swampscott who had open-heart surgery 42 years ago when it was terrifying and new. Recovering from his own heart operation, he finds her and shares her lesson in today's New York Times.
Posted by Elizabeth Cooney at 07:08 AM
February 20, 2007
Healthcare, a major theme in the 1992 presidential campaign, has returned as a critical issue in the 2008 contest. But this time, contenders in both parties are placing new focus on preventive care as a way of improving public health and ultimately reducing the skyrocketing cost of medical care.
Nearly all American women are in danger of heart disease or stroke and should be more aggressive about lowering their risk -- including asking their doctors about daily aspirin use, the American Heart Association said yesterday in new guidelines.
The federal response to hurricanes Katrina and Rita showed that medical personnel deployed to emergencies need more hands-on training rather than relying on computers to prepare, federal investigators say.
Posted by Elizabeth Cooney at 06:18 AM
February 19, 2007
The death of a 4-year-old Hull girl has put Dr. Kayoko Kifuji, a Tufts-New England Medical Center psychiatrist who treated the girl, at the center of controversy.
The repeat concussions suffered by former New England Patriots linebacker Ted Johnson have brought new attention to concussions in sports. Writer Joseph Williams, himself a former football player, writes that the culture of athletics and human nature are the largest hurdles to preventing head injuries.
Also in today's Health/Science section: Columnist Judy Foreman recommends her favorite books about alternative medicine; MIT neuroscientist Pawan Sinha says his research on congenital cataracts in India suggests that sight can be restored in older children thought permanently blind; and a profile of Dr. Paul K. Kleinman, a Children's Hospital Boston pediatric radiologist who had done pioneering work on identifying victims of child abuse.
In Business & Innovation: two treatments for Crohn's disease are expected to get FDA approval this year.
Posted by Gideon Gil at 08:28 AM
February 19, 2007
We know what it feels like to sense a connection with another person. It's called empathy.
But researchers from Massachusetts General Hospital wanted to measure biologically the experience we have when we feel understood and connected with somebody. They studied interactions between patients and their psychotherapists, whose job is to be empathetic.
Using skin sensors that measure arousal and observers' reactions to videotaped therapy sessions, they found that the more therapists and patients felt the same, the more connected they seemed to be and positive about the relationship. The study appears in the February Journal of Nervous and Mental Diseases.
"When we feel like we are really connected, we literally are in tune with others," said Dr. Carl D. Marci, director of social neuroscience at Mass. General. "This supports brain imaging data that shows humans are literally 'wired to connect' emotionally."
The 20 patient-therapist sessions suggested that shared positive emotions and shared physiological responses create an empathetic connection.
How therapists engage with their patients can play a huge role in the outcome of therapy, Marci said, so these findings can help therapists do a better job.
One other factor was important: Patients and therapists seemed more in tune when the therapist was listening.
"It's very hard to be empathetic when you are talking," he said. "Talking is engaging an altogether different part of the brain to think about what you are saying. You sort of shut down or dampen this emotional response we have."
Posted by Elizabeth Cooney at 08:11 AM
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