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March 09, 2007
By Liz Kowalczyk, Globe Staff
Amy Lischko says she is stepping down as commissioner of the state Division of Health Care Finance and Policy, because she has been told she will be replaced by the administration of Governor Deval Patrick.
Lischko, who has worked for the state on health care issues for 16 years, oversaw former Governor Mitt Romney's initiative to make the cost and quality of health care more transparent for consumers.
Lischko tangled with doctors and hospitals over the program, under which she and her staff have posted on the state website information about the cost of various procedures at individual hospitals, and how frequently individual doctors perform certain surgeries.
Posted by Gideon Gil at 05:20 PM
March 09, 2007
By Stephen Smith, Globe Staff
The Boston Public Health Commission today reports that so far, a total of 225 patients and 119 staff members at Hebrew Rehabilitation Center in Roslindale have reported symptoms of norovirus since an outbreak at the facility began Feb. 21. Officials believe the wave of illness at the 721-bed center is now subsiding.
Posted by Karen Weintraub at 05:01 PM
March 09, 2007
By Liz Kowalczyk, Globe Staff
Bank of America will donate $5 million to mostly repay medical school loans of primary care doctors who agree to practice in the state's community health centers, which are bracing for thousands of additional patients who will get coverage under the state's new health insurance law.
The program will repay the loans of medical students, residents, and a small number of doctors already practicing in health centers, if they agree to provide primary care for at least two years in one of 23 community health centers or for Boston Health Care for the Homeless.
The fund will repay up to $25,000 of their medical debt a year for three years; the maximum repayment amount of $75,000 is about 60 percent of the average medical school debt of $130,000.
Health care and bank executives and state officials, including Governor Deval Patrick, announced the program today during a press conference at the North End Community Health Center, saying they hope it attracts as many as 50 doctors to work at health centers.
Many Massachusetts residents have trouble finding a primary care doctor who is accepting new patients, and doctors and health care executives are worried that the situation will worsen when health insurance becomes mandatory for most residents in July. These residents will have insurance coverage for primary care visits, which probably will lead many of them to seek out doctors for physical exams and other routine problems. Now, without insurance, they would have to pay for those visits entirely by themselves.
Dr. James Mongan, president of Partners HealthCare, which will oversee the program, said in a statement yesterday that the shortage of primary care doctors results from fewer medical students choosing internal medicine, pediatrics and other primary care specialties; 20 percent of US medical students went into internal medicine in 2005, compared with 55 percent in 1998.
As a result, Mongan said, the average wait for a new patient to get an appointment with a primary care doctor in Massachusetts is nearly five weeks.
The $5 million grant from the Bank of America Charitable Foundation includes $500,000 for Massachusetts General Hospital and Brigham and Women's Hospital, which are part of the Partners provider network, to study how to attract more medical students into primary care.
The remaining $4.5 million will go for loan repayment. The 23 health centers that are part of the program all are affiliated with Partners, although some are affiliated with other hospital networks as well.
The bank, Partners, and the Massachusetts League of Community Health Centers, will work out details of how doctors can qualify for the program.
James Hunt, president of the league, said about 10 percent of primary care positions are vacant at the state's health centers. On top of the shortage of primary care doctors, he said health centers face additional hurdles because they cannot afford to pay doctors what they would make in private practice or at a large teaching hospital. Community health center primary care doctors earn in the low $100,000s annually, he said.
"We have been very concerned about the growing number of vacancies and the growing amount of time it takes to fill those vacancies," Hunt said.
The $5 million grant is the largest Bank of America has made in New England since it acquired Fleet Boston Financial in 2004. Despite worries that the sale to an out-of-town company would erode charitable giving, Anne Finucane, Bank of America's chief marketing officer, said the bank has increased its charitable giving in Massachusetts every year since the merger.
Keith Reed of the Globe staff contributed to this report.
Posted by Gideon Gil at 03:08 PM
March 09, 2007
Corie Lok connects the $100 million windfall for the Broad Institute's new psychiatric research center with other grants to the Harvard-MIT venture, suggesting they account for the dominance of the Broad in papers published in Nature journals. But the effect of philanthropy doesn't stop there.
"To me, this is more evidence that Boston research is greatly benefiting from philanthropic sources of funding," she writes. "I find it interesting that people who became millionaires through businesses that have nothing to do with science are quickly becoming the benefactors of science."
Paul Levy, president and CEO of Beth Israel Deaconess Medical Center, repeats his call for hospitals to make public their rates of central line infections, which can occur after tubes are inserted into patients. An anonymous poster asked about another safety issue:
"What about the NY Times story just the other day on how rapidly the various hospitals react when someone enters the emergency room with what looks like a heart attack?" the writer says. "Boston Medical Center (is) way ahead of the BID (and all others in the Boston area). Are we working on this (and other things we are low on on the HHS measures)?"
John McDonough of Health Care For All reports on yesterday's Commonwealth Health Insurance Connector board meeting that celebrated meeting milestones, having enrolled more than 52,000 people and approving seven health plans to sell Commonwealth Choice coverage to people who don't qualify for subsidized plans.
"Working nurse" sounds a note of caution, however, saying 48,000 of those people were automatically given insurance paid for through the state budget, and the other 4,000 had state subsidies for their coverage.
"More folks having true affordable quality coverage is a very good thing," the post says. "It should be pointed out that in the big picture what’s been accomplished thus far has been the easy part."
On WBUR's CommonHealth, Jonathan Gruber, professor of economics at MIT and member of the Connector Board, asks whether health insurance can be compared with food.
"Most Americans think of health insurance as medical prepayment: you buy an up-front premium and in return all of your medical expenses are covered," he writes. "But such a system has an inherent flaw: any time something is free, it will be overused. This should not be a controversial statement to anyone who has ever gone to an all-you-can-eat buffet. Having paid at the door, you always end up eating more than if you were paying for each item your ordered."
Based on research of how insurance is used, he argues that individuals should pay for some of their health care costs, according to their income.
"Coming back to the buffet analogy, it is clearly harmful to not allow individuals to eat –- but less critical that you allow them to eat as much as they want."
Kevin, M.D. got this comment on Liz Kowalczyk's Globe story about Harvard sweetening rewards for doctors who teach:
"Great, so now my tuition goes up $10,000."
Posted by Elizabeth Cooney at 11:34 AM
March 09, 2007
Activists who believe that the results of federally funded research ought to be available free to the public won a victory this week with a deal that will ensure Web posting of studies financed by the Howard Hughes Medical Institute, the Washington Post reports today.
The Chevy Chase-based institute, which pumps $600 million a year into biomedical research, cut the deal with Elsevier, a Dutch publisher of science journals. Elsevier will post on the Web the manuscripts of all research involving Howard Hughes investigators, six months after the information appears in its journals.
Posted by Elizabeth Cooney at 07:02 AM
March 09, 2007
Hundreds of seriously mentally ill prisoners are held in cells 23 hours a day in inhumane conditions that have led to self-mutilation, the swallowing of razor blades, and at least seven suicides since November 2004, an advocacy group alleged yesterday in a federal lawsuit demanding that the inmates be housed in special treatment units.
Harvard Medical School will increase by millions of dollars a year its payments to doctors for teaching students, a recognition of how difficult it has become to persuade busy physicians to devote time to educating the next generation of care givers.
The board overseeing healthcare reform yesterday gave its approval to seven health insurance plans that will offer relatively inexpensive coverage to residents who don't have health insurance through their employers or other sources.
Boston health officials ordered the Hebrew Rehabilitation Center yesterday to improve reporting of infectious disease outbreaks, after it took the city nearly two weeks to find out about a wave of gastrointestinal illness that sickened more than 200 elderly residents and 100 staff members.
Boston's heroin epidemic appears to have plateaued after several years of increased deaths and hospitalizations as the cheap, plentiful opiate became the drug of choice on city streets, according to a study being released today by the Boston Public Health Commission.
Local biotech powerhouses were comforted by yesterday's congressional testimony that urged federal regulators to take a cautious approach to approving generic versions of biologics, including mandatory human clinical trials.
A gene known to prevent cancer also protects against sun damage by prompting the skin to tan when exposed to the sun's ultraviolet light, according to a study by researchers at Dana-Farber Cancer Institute.
Posted by Elizabeth Cooney at 06:27 AM
March 08, 2007
Beth Israel Deaconess Medical Center has named Eric Buehrens its new chief operating officer, the hospital said today.
Buehrens has been the deputy provost for administration at Harvard University. Before that he was executive dean for administration at Harvard Medical School, and associate dean for planning and facilities at HMS.
He will succeed Dr. Michael F. Epstein, who said last month he would be leaving May 1.
Posted by Elizabeth Cooney at 07:05 PM
March 08, 2007
Dr. Deeb Salem, physician-in-chief at Tufts-New England Medical Center, will receive the American Heart Association’s Paul Dudley White award at the Boston Heart Ball on May 12, the AHA said today. The event is a major fund-raiser for the organization.
Salem, who is also the chairman of the department of medicine at Tufts University School of Medicine, is being honored for his work as a cardiologist.
Posted by Elizabeth Cooney at 02:42 PM
March 08, 2007
It's state Sen. Richard T. Moore's turn at WBUR's CommonHealth. He makes the case for patient safety as another goal of the state's new health care law.
"If the quality of health care that is delivered puts patients at risk of injury or even death, we would not be doing our uninsured residents any favors by expanding access to health insurance," he wrote.
M. William Lensch, a scientist at Children's Hospital Boston who blogs on Nature Network, muses about Novartis labs now occupying space in Cambridge where the Necco candy factory used to be.
"Is it just me or is it somewhat ironic to have a drug company inside of a former candy factory?' he asks. "Maybe it’s brilliant. After all, they may share some common goals. Each wants people to eat lots of tiny, sugar-coated blobs. The chemistry of what’s inside the blobs differs (hopefully), but I feel that a certain confluence between pharmaceuticals and candy has come about in recent years, at least as far as marketing strategy goes."
Posted by Elizabeth Cooney at 11:11 AM
March 08, 2007
Cambridge Health Alliance has received a two-year, $599,999 grant from the Robert Wood Johnson Foundation to study the quality of depression treatment for ethnic and racial minorities, the hospital said today.
Margarita Alegría, director of the Center for Multicultural Mental Health Research at CHA and a professor of psychiatry at Harvard Medical School, will lead the study.
Posted by Elizabeth Cooney at 09:41 AM
March 08, 2007
About 200 elderly residents and 100 workers at the Hebrew Rehabilitation Center in Roslindale have been stricken in the past two weeks with a gastrointestinal illness that caused the sprawling facility to stop accepting new patients and summon reinforcements for its depleted staff.
Supporters and families of Fernald Development Center residents applauded when a judge walked into a federal courtroom yesterday to hear US Attorney Michael J. Sullivan present his report on a yearlong investigation that recommends that the beleaguered facility remain open.
Two investigations of Pembroke Hospital, initiated last year by the Department of Mental Health and the Occupational Safety and Health Administration, were closed in February without findings of wrongdoing by the hospital. Meanwhile, a new probe of the private psychiatric facility has been launched.
About 100 new genes have been linked with cancer in a study that increases the amount of DNA that may be probed for new therapies by almost a third. The genes can change into cancer drivers with the potential to stimulate abnormal behavior in cells, said Michael Stratton, a geneticist at the Wellcome Trust Sanger Institute in Cambridge, England, who helped lead a multinational study released yesterday by the journal Nature.
A former UCLA official and an associate were arrested yesterday on charges that they illegally sold parts of bodies donated for research in a scheme that produced more than $1 million in profits.
Posted by Elizabeth Cooney at 06:29 AM
March 07, 2007
Soliciting organ donations, whether on billboards or on the Internet, raises ethical questions and threatens the fairness of how organs are allocated, Dr. Douglas W. Hanto writes in tomorrow's New England Journal of Medicine.
Organs from deceased donors go to the people at the top of the waiting list maintained by the United Network for Organ Sharing, which is regulated by the federal government. The only exception is made for family members of deceased donors.
But when it comes to living donors who may come forward to give a kidney or part of a liver, there are no policies regulating directed donations, writes Hanto, chief of transplantation at Beth Israel Deaconess Medical Center and professor of surgery at Harvard Medical School.
"We don't have enough organs for everybody," he said in an interview. "I would like to see the system change so those donations are directed to the top of the waiting lists, after family, friends and pre-existing relationships."
Most organs from living donors go to friends or family members, according to UNOS figures, but there are increasing numbers of prospective donors with no relationship to the potential recipient. Between 1996 and 2006, the percentage of living donors without close ties rose from 6.5 percent to 23 percent.
Websites such as Canton-based matchingdonors.com were created to connect people who need transplants with live organ donors. Phone messages seeking comment today were not returned, but on its website, matchingdonors.com says "there are thousands of wonderful, altruistic and compassionate people willing to help a fellow human being. It is our belief that many of the potential donors would have never considered live organ donation if it wasn’t for the increased awareness due to our site."
Hanto urges development of rules to guard against unfair allocation of organs from living donors that will protect donors and recipients alike. He points to a study in Minnesota of altruistic donors, whose desire to donate was unaffected by knowing who would receive their gift compared with their organ going to the person at the top of a waiting list.
Hanto also cites concerns that organs will go to people with more advantages (as shown by their access to the Internet), that the potential for illegal payment is greater without previous close ties, and that recipients might be vulnerable to later demands from donors.
Dr. Francis L. Delmonico, a transplant surgeon at Massachusetts General Hospital, medical director of the New England Organ Bank and past president of UNOS, agrees that solicitation of living donors raises concerns, but he thinks that there is no legal basis to regulate how people find or identify a donor, through matchingdonors.com or other groups.
"It is not for us to tell people how they can make relationships," he said in an interview. "But it is for UNOS and for the transplant centers to exercise some caution."
Transplant centers perform a psychosocial as well as a medical evaluation of any potential donor.
"I would say this has to be done in a more heightened way," Delmonico said about screening. "The risks that are associated with donors that come along under the circumstances of solicitation are greater in having misunderstanding by the donor and misunderstanding as to what is being derived for the recipient."
Hanto does endorse the New England Kidney Exchange, an effort to pair living donations in cases where one potential donor might not be a match for the loved one they hope to help, but that organ can be exchanged for a match with another pair in the same situation who can provide a compatible organ.
"I think that's a terrific idea," he said. "It's not going to solve the whole problem, but it's a great solution."
Posted by Elizabeth Cooney at 07:29 PM
March 07, 2007
McLean Hospital in Belmont will lead the first large-scale study of a treatment for people addicted to pain medications such as Vicodin and OxyContin, the National Institute on Drug Abuse announced today.
Researchers will recruit 648 participants at 11 sites, hoping to enroll both people who have taken prescription medications for pain relief but later became addicted, as well as people who take the drugs illicitly for nonmedical reasons. People interested in participating can call (617) 855-2588.
Study subjects will receive a drug called buprenorphine naloxone, sold as Suboxone, which was approved by the U.S. Food and Drug Administration in 2002 as an alternative to methadone treatment for people addicted to opiates such as heroin.
"The major contribution of this study is that it’s focusing on this specific problem of prescription opiate dependence," Dr. Roger Weiss, clinical director of McLean Hospital’s Alcohol and Drug Abuse Treatment Center and lead investigator for the study, said in an interview. "Most studies that have looked at opiate dependence have been done on heroin addicts with a sprinkling of people with prescription opiate dependence."
Over the past five to 10 years, the number of people dependent on these prescription pain drugs has grown substantially, Weiss said.
The 2005 National Survey on Drug Use and Health found that 2.2 million Americans aged 12 or older reported being new users of pain relievers for nonmedical purposes, surpassing the 2.1 million new marijuana abusers. In 2005, more than 6 million Americans in all reported nonmedical use of prescription drugs in the past month -- more than the number abusing cocaine, heroin, hallucinogens, and inhalants, combined, according to a statement from the National Institute on Drug Abuse.
"You have adolescents and young adults who have become dependent on prescription opiates, and you also have people of middle age and older," Weiss said. "We don’t really know whether the treatment strategies that we’ve learned are successful for heroin addicts are the same for people with prescription opiate dependence."
Weiss said the researchers also wonder whether the treatment will have the same results for the 40 percent of people who have chronic pain and are dependent on the drugs as for those who take the drugs illicitly.
Most participants will take Suboxone for between three and nine months. They will also be enrolled in one of two different behavioral therapies to test how well they work with the medication. Results are due to be reported in 2009.
Posted by Elizabeth Cooney at 06:10 PM
March 07, 2007
Nurse at small writes on her blog about an elderly patient who returned to her Boston hospital last week after a stay in rehab. He has bed sores over much of his body, and he wonders what's next, for him and for his wife. He worries that his Medicare coverage will run out.
"He told me he didn't want to live like this anymore, in a bed that is basically sand with air blowing through it to prevent pressure on his cachectic body. He told me he didn't want to have these hour-long dressing changes every day," she writes. "He told me he didn't want to go on, he had nothing left to live for."
And he's afraid that when he dies, his wife will have to use their savings and sell their house to pay his medical bills, leaving her nothing. "He'd rather go now than see that happen to her," the nurse writes.
"I just wonder what it says about our system where we give so much free care, but when the elderly come to these difficult times the money runs out."
Posted by Elizabeth Cooney at 05:35 PM
March 07, 2007
By Carey Goldberg, Globe Staff
It looks to be the largest single gift ever for research into mental illness: The Broad Institute, the genomics powerhouse in Cambridge, announced this evening that it will receive $100 million to figure out the genetics of schizophrenia and bipolar disorder.
The money comes from the Stanley Medical Research Institute, a family philanthropy based in Maryland.
It will go mainly to gather and analyze thousands of DNA samples from people with schizophrenia and bipolar disorder, in hopes of finally figuring out the complex genetics behind the diseases.
That is no easy task. The diseases afflict more than 6 million Americans, and clearly run in families. But the specific genes at work have proven largely elusive. Multiple genes are believed to be involved, and they could vary from patient to patient. Environment, too, plays a role.
But in the last year or so, gene-scanning technology has reached the point that scientists believe they can run studies on a scale large enough to detect the genetic culprits, said Dr. Edward Scolnick, who oversees the Broad's psychiatric research. He wants to gather DNA samples from as many as 10,000 people with each disease, plus 10,000 without.
That DNA then needs to be scanned in its entirety for genes correlated to the disease, and that is where the Broad's expertise comes in.
Its genomic tools have been getting ever faster and cheaper, so that it can now scan a patient's sample for half a million genetic variations at once. In a couple of months, said Eric Lander, the Broad's director, that will be up to a full million.
"If you're looking for a needle in a haystack, and you can sift the whole haystack, you'll find the needle," Lander said.
The Broad is a joint institute of Harvard University and the Massachusetts Institute of Technology.
Posted by Karen Weintraub at 05:04 PM
March 07, 2007
Dr. Michael W. Groff has been named chief of the neurosurgical spine service and co-director of the Spine Center at Beth Israel Deaconess Medical Center.
He comes to BIDMC from Indiana University School of Medicine, where he was director of spinal surgery and co-director of the spinal cord injury center.
Groff received his medical degree from the University of Pittsburgh School of Medicine in Pittsburgh, and completed intern and residency training at Mount Sinai Hospital in New York, and fellowship training at the Medical College of Wisconsin in Milwaukee.
Posted by Elizabeth Cooney at 03:53 PM
March 07, 2007
When you're hot, you're hot.
Three researchers from Boston and Cambridge ranked among the world's most highly cited scientific authors in 2005 and 2006, according to the March/April issue of Thomson Scientific’s Science Watch newsletter. Its Web of Science database identifies a paper as "hot" if it is cited in scientific journals at a much higher rate than similar papers over a two-year period.
Richard D. Gelber of Dana-Farber Cancer Institute had six hot papers in biostatistics and oncology; Max Tegmark of MIT had six in space science; and Mark J. Daly of Harvard Medical School had five in genetics.
They finished behind Shizuo Akira of Osaka University, who had 7 hot papers in immunology. Akira and Tegmark are the only two researchers who stayed hot for the second list in a row.
Here is the complete list of the hottest researchers:
Shizuo Akira, Osaka University, Immunology, 7
John L. Bryant, University of Pittsburgh, Biostatistics/Oncology, 6
Norman Wolmark, Allegheny General Hospital, Oncology, 6
Richard D. Gelber, Dana-Farber Cancer Institute, Biostatistics/Oncology,6
Max Tegmark, Massachusetts Institute of Technology, Space Science, 6
Mikhail Kopytine, Kent State University, Physics, 6
Basanta K. Nandi, Indian Institute of Technology, Bombay, Physics, 6
Thomas Peitzmann, Utrecht University, Netherlands, Physics, 6
Mark J. Daly, Harvard Medical School, Genetics, 5
John F. Forbes, University of Newcastle, Australia, Oncology, 5
James N. Ingle, Mayo Clinic Cancer Center, Oncology, 5
Aman U. Buzdar, University of Texas M.D. Anderson Cancer Center, Oncology, 5
Scott M. Grundy, University of Texas Southwestern Medical Center, Nutrition/Metabolism, 5
John Cuzik, Cancer Research United Kingdom Clinical Center, Epidemiology/Oncology, 5
Aron Goldhirsch, European Institute of Oncology, Milan, Oncology, Louis Mauriac, Institut Bergonie, Bordeaux, France, Oncology, 5
Louis Fehrenbacher, Kaiser Permanente, Oncology, 5
Posted by Elizabeth Cooney at 12:22 PM
March 07, 2007
US Attorney Michael J. Sullivan yesterday urged that the Fernald Development Center in Waltham be kept open based on the findings of his yearlong investigation, which could spell the end of a state push to close the controversial center for mentally retarded people over the vehement objections of many families.
A Boston woman has filed a lawsuit alleging that a doctor at Planned Parenthood League of Massachusetts bungled her abortion in April 2004 and that she had no idea she was still pregnant until about six weeks before her daughter was born in December.
Federal regulators charged with approving generic versions of the world's most expensive drugs should follow the lead of their cautious European counterparts, according to Senator Edward M. Kennedy. In Europe, requirements for approval are tailored to the complexity of an experimental drug and can include clinical trials that cost millions for generic manufacturers to conduct.
Only five months after a major study recommended routine use of CT scans to detect lung cancer, a second study recommends the opposite, concluding that the scans do not save lives.
The low-carbohydrate, high-fat Atkins diet gets high marks in one of the biggest, longest head-to-head studies of popular weight-loss plans, beating the Zone, the Ornish diet, even US guidelines. Even so, critics say the results show how hard it is to lose weight and keep it off.
Swiss pharmaceutical maker Novartis AG said yesterday it has received US approval for the hypertension drug Tekturna -- a potential blockbuster that has shown the ability to lower blood pressure more effectively than common treatments.
Posted by Elizabeth Cooney at 06:22 AM
March 06, 2007
Children's Hospital Boston has won a grant from the Robert Wood Johnson Foundation to bring mental-health services to Somali refugee families, the hospital announced today.
The $300,000 award will fund mental health programs at the Lilla G. Frederick Pilot Middle School in Dorchester over the next three years. The project is expected to serve 700 people, including children and their families, the hospital statement said.
The Boston University Graduate School of Social Work is offering two full scholarships to their Master’s of Social Work program to Somali individuals who will provide services as part of their training during the three-year grant period.
Other organizations involved are the Boston Public Schools, Refugee and Immigrant Assistance Center, Somali Development Center, The Alliance for Inclusion and Prevention, The Boston Healing Landscape Project and the Boston Center for Refugee Health and Human Rights.
Posted by Elizabeth Cooney at 06:07 PM
March 06, 2007
Chi-Sang Poon, a research scientist at MIT who supported African-American professor James. L. Sherley's recent hunger strike to protest alleged racism in the university's decision not to tenure him and other matters, has sent an open letter to the community called "MIT's Missing Ticket to Diversity."
Poon submitted the letter to the student-run paper, The Tech, but it was rejected because it made the same points as his previous submissions, according to an e-mail from a student editor.
Poon responded to the editor: "I am putting my career at MIT on the line to speak out on these important issues challenging the administration and President Hockfield for the good of the Institute because they may significantly impact the future governance of the Institute on many levels."
In the letter he distributed by e-mail, Poon says he is disheartened by MIT's support for "an antediluvian ad hoc grievance committee system" that favors "the powerful and the old-boy networked, the well-favored and the obsequious, at the expense of the oppressed."
MIT said today that it stands by its statement of Feb. 16.
"Professor Sherley's protest has focused attention on the effects that race may play in the hiring, advancement and experience of under-represented minority faculty, and on ensuring that our grievance processes are comprehensive, fair and timely," MIT said then. "MIT is fully committed to addressing these issues and will continue to work toward resolution of our differences with Professor Sherley."
Here is Poon's letter:
MIT’s Missing Ticket to Diversity
I applaud the Institute’s unmistakable confession, in the wake of Professor Sherley’s 12-day protest about racism at MIT, of its constitutional responsibility for ensuring that "all members of its diverse community feel welcome and respected" and that "[MIT’s] grievance processes are comprehensive, fair and timely" (C.-S. Poon, The Tech, Feb 27, 2007). At the same time, I am disheartened by the Institute’s seeming about-face on this critical issue once out of the limelight, as reflected in MIT’s subsequent off-the-record contention that the grievance process has worked well in Professor Sherley’s case (M. DeGraff, The Tech, Feb 27, 2007). It is impossible to look the other way and insist that the grievance processes ain’t broke after openly vowing to fix them, without offering a true and honest response to all of Professor Sherley’s discrimination allegations as documented in the Chomsky et al. letter (The Tech, Feb 6, 2007). One simply can’t have it both ways.
In 1994, the MIT Faculty Policy Committee’s Subcommittee on Grievances asserted fatefully that "there are opportunities to improve MIT's grievance procedures, but there is no need for complete restructure or redesign as the basic mechanisms [ad hoc committee system] in place are well suited to the MIT culture and environment" (http://web.mit.edu/annualreports/pres95/15.01.html). And what about the "MIT culture and environment" back then? Not surprisingly, they were those that predated MIT’s 1999 concession of gender bias against its tenured female professors. Such an antediluvian ad hoc grievance committee system, which is completely at the disposal of the Administration, is expedient to such discriminatory culture and environment as dictated by the tyranny of the majority, the powerful and the old-boy networked, the well-favored and the obsequious, at the expense of the oppressed. It conveniently serves to sustain a sub-meritocratic system that polarizes the mainstream and the minority, the insiders and the outs, the haves and the have-nots.
Ironically, the Institute has indeed in place a highly elaborate disciplinary system to adjudicate grievances and allegations of misconduct against MIT students. The Committee on Discipline, a Standing Committee of the Faculty, is comprised of a group of elected members of the faculty, academic deans, undergraduate and graduate student representatives, and ex officio members operating under a set of detailed rules and regulations with built-in checks and balances. There is no reason why the Institute should hold its own faculty and administrative members’ accountability to a lesser standard.
The recent celebrated change at the helm of Harvard University giving them their first woman president should serve as a wake-up call to all of us that a true commitment to diversity calls for the Administration’s willingness to uphold accountability at all levels of its governance, including the highest office. For after all, the buck stops there.
Chi-Sang Poon, Ph.D.
Principal Research Scientist
Harvard-MIT Division of Health Sciences and Technology
Massachusetts Institute of Technology
Posted by Elizabeth Cooney at 04:10 PM
March 06, 2007
Corie Lok offers her take on life for postdocs in and around Boston and Cambridge, in light of a weak showing in a Scientist survey.
She talked to a number of postdocs last year about the situation, and one common complaint "was that offices, services and policies for postdocs across the Harvard campuses and affiliated hospitals were not consistent," she writes. "While the hospitals govern themselves, at least the medical school, the school of public health, and the main campus should be more coordinated in these affairs."
Paul Levy, president and CEO of Beth Israel Deaconess Medical Center, writes about saying you're sorry for medical errors and Mt. Auburn Hospital's creation of an on-call team to help doctors and nurses figure out when they need to apologize, and what to say to a patient and family members.
Posted by Elizabeth Cooney at 12:53 PM
March 06, 2007
Keeping drug safety data from clinical trials confidential to protect trade secrets can delay the discovery of dangerous side effects, two Boston researchers write in the current issue of Health Affairs.
Aaron S. Kesselheim, a clinical fellow in medicine in the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women's Hospital, and Michelle M. Mello, associate professor of health policy and law at the Harvard School of Public Health, point to Vioxx and other cases of drugs with problems that came to light after their approval by the Food and Drug Administration.
The two urge the FDA to place a greater burden of proof on drug companies to show how they would be harmed by release of their data, they recommend more comprehensive public documents from drug companies on safety, and they ask Congress to act if the FDA doesn't.
"Disclosing safety data from clinical trials would allow protection of most commercially valuable information and better balance our interests in drug innovation and patient safety," they wrote.
Posted by Elizabeth Cooney at 09:00 AM
March 06, 2007
The continued dominance of Boston's healthcare industry, the region's largest employer, could be undermined by stagnant federal funding for biomedical research, combined with the city's chronically high cost of living and competition from other cities, according to a report by the Conference of Boston Teaching Hospitals.
Dr. James Mandel, chairman of the Conference of Boston Teaching Hospitals and president and CEO of Children's Hospital Boston, comments in "Holding the edge in Healthcare."
The potential ban on unhealthy fats in Boston's restaurants got put on a back burner yesterday, when the administrator who has been directing the effort received a promotion. Led by executive director John Auerbach, who was appointed the state's public health commissioner yesterday, the Boston Public Health Commission had been investigating the feasibility of a ban on trans fats similar to the regulation adopted last year by New York.
As part of a federal inquiry into drug and medical-device marketing, Boston Scientific Corp. was asked by Congress last week to submit to investigators internal documents, marketing plans, and clinical data related to its top-selling product, the Taxus drug-coated stent.
Top Army officials faced an angry Congress yesterday during an emotional hearing about shoddy medical treatment and living conditions at Walter Reed Army Medical Center, acknowledging that they have failed in the care of wounded veterans. Calling the scandal at Walter Reed "the tip of the iceberg of what is going on all around the country," Representative Henry Waxman, Democrat of California and chairman of the Oversight and Government Reform Committee, said veterans and their families are "flooding us with complaints" about the burgeoning scandal.
Doctors discovered a blood clot in Vice President Dick Cheney's left leg yesterday, a condition that could be fatal if left untreated. Cheney, who has a history of heart problems, will be treated with blood-thinning medication for several months, said his spokeswoman, Lea Anne McBride.
People at average risk for colon cancer shouldn't take aspirin or painkillers such as ibuprofen to try to prevent the disease, a federal task force advises, because of the risk of bleeding and other potential health problems.
White teenagers who watch a lot of R-rated movies or have unsupervised access to television shows appear more likely than similar black youths to start smoking cigarettes, a study found yesterday.
Posted by Elizabeth Cooney at 06:29 AM
March 05, 2007
Blog, MD raises public awareness about a new threat to children's health in a recent post. He highlights a study in the current Archives of Disease in Childhood that reports on serious injuries to five British children wearing superhero costumes.
"The children we saw have all had to contemplate on their way to hospital that they do not in fact possess superpowers," wrote the authors. Four of the children wore Spiderman costumes, and the fifth a Superman outfit. "They were injured after initiating flight without having planned for landing strategies."
"Brilliant. Only the British can make something like this so amusing," comments Blog, MD, who under his blogger disguise is Dr. Samuel Blackman, a Boston pediatric oncologist.
"The authors indicate that while they are strong advocates of adventurous play and while they also understand that risk-taking is an integral part of childhood, they caution that parents need to be aware that children may believe that their abilities 'have been given a super-boost' with an appropriate costume," Blackman writes.
Posted by Gideon Gil at 06:33 PM
March 05, 2007
Lifetime rates of major depression are higher among whites, but depression is more likely to be severe and disabling among African-Americans and Caribbean blacks, according to a study in the March issue of the Archives of General Psychiatry. Fewer than half of African-Americans and fewer than a quarter of Caribbean blacks got any kind of therapy for their major depression.
Data on treatment was not collected for whites, the article said, but the national average for treatment of major depression among adults is 57 percent.
"These data suggest that when blacks develop major depressive disorder, it is likely debilitating in impact and persistent in its course," wrote lead author David R. Williams of the Harvard School of Public Health. "These findings underscore the pressing need to understand the factors underlying racial differences in access and quality of mental health care and the urgency of implementing interventions to eliminate these disparities."
The researchers studied major depression among 6,082 people in the National Survey of American Life, the largest study of mental health in the U.S. black population. They looked at results from face-to-face interviews followed by telephone calls with 3,570 African-Americans, 1,621 Caribbean blacks and 891 non-Hispanic whites from 2001 through 2003.
More whites (17.9 percent) than African-Americans (10.4 percent) and Caribbean blacks (12.9 percent) said they had experienced major depression over their lifetimes, but among those who had, more African-Americans (56.5 percent) and Caribbean blacks (56 percent) reported episodes in the past 12 months compared with whites (38.6 percent.)
This is the first psychiatric epidemiologic study of blacks in the United States to include a large national sample of Caribbean-origin blacks, the authors said.
Kristin N. Javaras, a biostatistician who studies mental health data at the Harvard School of Public Health and McLean Hospital, said the study's findings are valuable because they confirm in a larger population work that had been done in smaller groups. Studying African-Americans and Caribbean blacks as separate groups was also important.
"They also assessed the severity of the depression and the percentage of people getting treatment," said Javaras, who was not involved in the study. "It suggests that perhaps black Americans have less access to treatment, which could explain the increased chronicity."
Study co-author Harold W. Neighbors said in an e-mail interview, "The most important next step is to figure out ways to get more black Americans (both African-Americans and Caribbean blacks) with depression into professional care."
Responsibility rests on both the consumer and professional side for decreasing barriers to care for depression, wrote Neighbors, director and research professor in the Program for Research on Black Americans at the University of Michigan's Institute for Social Research.
"More open and honest discussion among black Americans within smaller friendship networks about their struggles with depression should lift some of the social stigma associated with depression," he said. "But we also need more effective educational programs that will help mental health clinicians establish rapport with black patients and others from cultural backgrounds that differ from the prototypical patient who too often is a white American."
The article said more research needs to be done on the social support systems, including religious activities, and individual strengths, such as self-esteem, that may account for lower levels of lifetime major depression. Further work is also needed to understand why, when severe depression occurs, it is more persistent and disruptive among both African-Americans and Caribbean blacks, the authors said.
Dr. Timothy G. Benson, a psychiatrist at McLean Hospital who lectures on African-American health disparities, said he was excited to see the report put the issue back in the forefront. He was not involved in the study.
"This gives us a gauge to see that what we are doing right now is not sufficient. There is a significant gap in access to care," he said. "What I hope to see are more papers on strategies on how to eliminate these disparities."
Posted by Elizabeth Cooney at 04:00 PM
March 05, 2007
By Stephen Smith, Globe Staff
The Patrick administration today named John Auerbach, the veteran chief of Boston's health department, as the state's new public health commissioner, placing a familiar face in a high-profile job.
For Auerbach, executive director of the Boston Public Health Commission for nine years, the appointment marks a return to state government, where he once served as director of the HIV/AIDS Bureau as well as chief of staff of the Department of Public Health.
The announcement was made by Dr. JudyAnn Bigby, health secretary under Governor Deval Patrick. Bigby and Auerbach have a long-standing working relationship: Bigby served on the volunteer board that sets health policy in Boston throughout Auerbach's tenure.
John Auerbach
Bigby announced in January that she was replacing the current public health commissioner, Paul J. Cote, who had been appointed by Mitt Romney while he was governor. As rumors about potential successors circulated at the health agency's headquarters, Auerbach's name immediately ascended to the top of the list.
He had gained national prominence in public health circles by championing sometimes-controversial causes such as banning smoking in bars and restaurants and, more recently, reviewing whether the city should ban trans-fats from restaurants and bakeries. Auerbach also directed a groundbreaking campaign to address ethnic and racial disparities in healthcare, which his boss, Mayor Thomas M. Menino, declared as the most pressing medical issue in the city.
Auerbach's appointment arrives a week after Patrick announced a $72 million increase in public health spending, with the money being used to expand childhood vaccinations and disease-prevention campaigns.
Posted by Karen Weintraub at 03:23 PM
March 05, 2007
Politicians and children's health advocates pushed for renewal of federal funding for children's health insurance in an event at Children's Hospital today, citing a poll that says 90 percent of Massachusetts voters favor providing health coverage to all uninsured children.
U.S. Sen. Edward M. Kennedy, U.S. Sen. John F. Kerry and Boston Mayor Thomas M. Menino joined Diluvina Vasquez Allard of the Massachusetts Communities Action Network and Dr. James Mandell, president and CEO of Children's, in calling for passage of the law authorizing the State Children's Health Insurance Program.
SCHIP pays for part of the state's MassHealth program.
The poll was conducted by New England Alliance for Children's Health, which found similar levels of support for SCHIP in the other five New England states, the group said in a statement.
Posted by Elizabeth Cooney at 02:30 PM
March 05, 2007
A new online research tool called The Faculty of 1000 Medicine aims to help researchers and clinicians make sense of the flood of scientific information available online. Tomorrow its 100 Boston members are invited to Dana-Farber Cancer Institute to discuss how its interpretive approach can help speed research advances along the path to patient care.
"The thing that's missing from a lot of online publications is the role of interpreter who is an expert in the field and who objectively puts things in the right perspective," Dr. Edward J. Benz, president of Dana-Farber and one of the hematology editors for the online resource, said in an interview. He and Dr. M. Rashad Massoud, senior vice president of the Institute for Healthcare Improvement, will speak at the 4 p.m. reception.
In his role as an editor, Benz gathers colleagues who are experts in particular areas of hematology such as anemia or clotting disorders, relying on them to track their specialties and compile packets of information online. Users can supply keywords that will be used to send them notices of articles they might find interesting. Other editors do the same thing in other fields of medicine, sometimes writing commentaries or pointing to key points that may be overlooked.
"This is one of the many ways people are trying to accelerate the conversion of research knowledge into clinical practice," Benz said. "A multi-disciplinary awareness is important for seeing where the clues are that might not ordinarily appear in front of you if you keep your head down in your own area."
Boston has a high concentration of medical experts, but that doesn't mean they always see one another face to face, Benz said.
"The nice thing about the Web is you can do a lot of work from your desk, but you often don't meet the people who work in other fields," he said. "They might be three hospitals away. So this can be a way to get together face to face."
Posted by Elizabeth Cooney at 11:28 AM
March 05, 2007
Drug testing of adolescents at home or in school is unreliable and lacks scientific proof of effectiveness, the American Academy of Pediatrics says in its journal Pediatrics today. Simple conversations with a school counselor are more effective and cost far less, according to the study.
In 1996 the AAP published a policy statement opposing testing adolescents for drugs without their consent. Since then two US Supreme Court decisions have upheld random testing, first for student athletes and then for any student participating in extracurricular activities. At the same time, drug-testing companies have begun marketing kits to parents for use at home. The current policy addendum was written in response to these two trends.
"Testing can be a very powerful tool when it is used properly in a clinical population," Dr. John R. Knight, associate professor of pediatrics at Harvard Medical School and director of the Center for Adolescent Substance Abuse Research at Children's Hospital Boston, said in an interview. He is the lead author of the article. "It's just a really bad screening test."
There is little proof that drug testing in schools works, he said, citing two studies whose results conflict. Testing is complicated, it produces errors, its results can be hard to interpret and the Internet is awash in ways to defeat it.
"It's almost like an arms race," Knight said. "We think up new tests and kids who are using drugs think up new ways to beat the new tests."
The tests also miss ecstasy, inhalants such as glue and paint thinners and prescription drugs such as oxycodone, as well as alcohol, he said.
Where drug tests do work is in programs where young people are committed to recovering from drug abuse and agree to monitoring, he said. For the larger population of students, talking to a doctor or school nurse works better, published data has shown, he said.
"I am in favor of screening teens for drug and alcohol abuse and I know how it can be done cheaper and more effectively," he said. "Have a health care provider ask the young person, with a confidential questionnaire or a simple oral test, and most of the time they give you an honest answer."
Schools can do the same kind of screening, instead of taking samples for lab tests, Knight said he told the president's Office of National Drug Control policy in November. Using charges for tests by Quest Laboratories, he calculated that a school with 1,000 students that tested half of them once each year, yielding 30 percent positive results, would spend $142,000 on tests and $58,000 to administer the program.
Screening all the students with confidential questionnaires and follow-up counseling would cost about $50,000 per year for one school-based counselor, he estimated. The government could better spend its money on treatment or prevention programs, he said.
"We should be taking the money they're dangling in front of the schools willing to do the testing and we should be putting it into treatment for young people," he said.
Posted by Elizabeth Cooney at 11:00 AM
March 05, 2007
In its attempt to make health insurance premiums affordable, a state board is giving the go-ahead to plans with high deductibles, but that is causing concern that many newly insured people may avoid getting treated when they're sick or may run up onerous debts to pay their medical bills.
Hospitals increasingly are expecting volunteer trustees to go beyond the role of community boosters and tackle an imposing medical issue: preventing errors that lead to patient injuries and deaths.
In today's Health/Science section, two stories of breaking barriers. Massachusetts General Hospital grants to women scientists help plug 'leaky pipeline' between grad school and tenure.
And Mildred Dresselhaus, who in 1968 became the first female tenured professor in the engineering department at MIT, was honored late last month in Paris, where she was one of five women to receive L'Oreal-UNESCO's 2007 Women in Science Award.
Also in Health/Science, even if a pregnant woman drinks heavily -- despite 25 years of warnings not to -- it may be possible to offset some of the alcohol's toxic effects on her baby's brain after she gives birth.
And in 1996, scientists solved a mystery surrounding certain gay men who were immune to AIDS. This year, Pfizer Inc. will sell the first drug based on that discovery.
On the Op-Ed page, Dr. Marcia Angell writes that over the last decade, doctors have become vendors and patients consumers operating in a medical marketplace.
In Business & Innovation, Newton start-up Emano Tec Inc. has designed a wafer-thin, wireless hand-held computer called MedTab that is designed to be washed thousands of times and give doctors full access to medical records on the go, as they move from patient to patient during rounds.
Posted by Elizabeth Cooney at 06:23 AM
March 05, 2007
Partners HealthCare is teaming up with one of the state's largest employers in an experiment to see whether they can improve employees' health and, ideally, reduce medical costs by monitoring workers' high blood pressure over the Internet. EMC Corp., an information management company based in Hopkinton, has agreed to recruit 400 employees with high blood pressure for the clinical trial.
Posted by Elizabeth Cooney at 06:06 AM
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