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March 16, 2007
Ever wondered why a medical center becomes the official hospital of a sports team?
Today on his blog, Beth Israel Deaconess Medical Center chief Paul Levy explains why his hospital pays the Boston Red Sox an annual fee for the right to join their names together, inside and outside Fenway Park.
"In our case, finding ourselves engaged in a successful turnaround after almost going out of business because of a botched merger between 1996 and 2001, we were looking to remind people in Boston that we were alive and well," Levy wrote. "We wanted to portray a sense of permanence for our hospital, which had been badly beaten up in news reports and in community perception for several years."
BIDMC offers first aid in the park, sponsors 25 students as Red Sox Scholars and works with the American Red Cross to encourage blood donations.
Levy didn't say in his blog how much the naming rights cost each year and he declined to give up the stat when the Globe asked for it in an e-mail.
"Sorry, that is not public -- unlike our infection rates!"
Posted by Elizabeth Cooney at 04:38 PM
March 16, 2007
By Alice Dembner, Globe Staff
Advocacy groups are stepping up lobbying efforts on the next big issue that will be addressed by the state board overseeing implementation of the universal health insurance law -- who will be exempted from the requirements.
The Affordable Care Today Coalition today recommended that low-income state residents be exempted from having to buy insurance if the premiums and deductibles would cost them more than 5 percent of their income.
The law requires the Commonwealth Health Insurance Connector to define what level of spending on health insurance is affordable and to allow waivers for people for whom even the least-expensive basic insurance would be too costly. The connector is expected to take up the issue next month.
ACT, a coalition of health and advocacy groups that helped push for passage of the law, said the state should define “affordable insurance” on a sliding scale, starting with zero cost for those below the poverty line and rising to 5 percent of income for those earning $39,200 a year and 8 percent for those earning $58,800 or more.
“We want a commonsense proposal that’s true to the spirit of health reform, but that gives assurance to people that they won’t be forced to buy unaffordable coverage,” said Brian Rosman, research director at Health Care for All, a member of the coalition.
He said the coalition arrived at the recommendation after studying what people now spend for insurance, the cost of living, and affordability standards used nationwide for federal health insurance programs.
Posted by Karen Weintraub at 04:19 PM
March 16, 2007
Massachusetts Secretary of Health and Human Services JudyAnn Bigby has appointed Melissa Shannon director of policy for the Executive Office of Health and Human Services, the agency announced today.
Shannon comes from the advocacy group Health Care for All, where she was director of government affairs. She
was responsible for the organization’s legislative and regulatory agenda and worked on implementation of the new healthcare law with the Commonwealth Health Insurance Connector Authority.
Before joining Health Care For All in 2005, Shannon was associate counsel to the Senate Ways and Means Committee under Chairman Mark Montigny and later his general counsel and legislative director, working on issues realted to healthcare access.
Posted by Elizabeth Cooney at 03:50 PM
March 16, 2007
Thomas L. Magnanti, dean of engineering at MIT, recently sent his colleagues a message defending the unversity's tenure and grievance review processes, saying he was surprised at some of the assumptions made regarding the case of James L. Sherley.
Sherley, an African-American stem cell scientist in the division of biological engineering, fasted for 12 days last month to protest what he called racist policies in denying him tenure.
Magnanti's March 8 e-mail followed a message from research scientist Chi-Sang Poon supporting Sherley and criticizing the grievance committee that reviewed his case.
"MIT's grievance review policy is an integral part of the Institute's system of overall faculty governance. I am puzzled that some members of our community have come so quickly to the conclusion that the grievance review process was flawed," Magnanti wrote. "About half of the junior faculty members in the School of Engineering do not receive tenure. Such decisions are difficult, often painful, and are not taken lightly by any of the individuals involved."
The dean also said MIT was not backtracking on its commitment to diversity.
"Even though I firmly believe that the Institute handled Professor Sherley's tenure case fairly, I also believe that we all can and must do more to create a more welcoming and diverse community," he wrote. "The future of the Institute, like the future of American society, depends on it."
Read Magnanti's e-mail below.
Statement to the School of Engineering Faculty Concerning Professor Sherley's Tenure Case
Thomas L. Magnanti
Dean of Engineering
March 8, 2007
Dear Colleagues,
In many conversations recently and in various other forums, I have been surprised by the assumptions some people have made and conclusions some have reached about the School of Engineering's policies as they relate to the issues Professor James Sherley has raised in connection with his tenure decision. Therefore, I feel it appropriate for me, as Dean, to comment on the tenure and grievance review processes.
In the School of Engineering, the senior faculty serve in an advisory capacity to the department or division head in the promotion and tenure process. Some departments authorize a standing committee to represent the faculty. Other units, such as the Biological Engineering Division (BE), as well as Civil and Environmental Engineering, Chemical Engineering, and the Engineering Systems Division, directly involve all of their senior faculty. Often, there is a clear consensus or even near unanimity among the faculty. In such cases, it would be extremely unusual for the department or division head not to accept the faculty's collective judgment.
After the BE faculty had completed its review of Professor Sherley's tenure case in December 2004, at the request of the Division Head, I reviewed the case myself. From my perspective, the decision was clearly correct on the merits, and the case had been handled fairly and in accordance with the Division's standard process. I did not see any evidence to suggest that racial discrimination or conflict of
interest had played a role in the tenure decision.I told Professor Sherley this in a meeting on January 24, 2005. I also informed him of the availability of MIT's grievance process should he wish to pursue his claims that racial discrimination and/or conflict of interest were factors in the decision not to grant him tenure. Subsequently, Professor Sherley did avail himself of this process.
When a faculty member files a grievance, the senior administration, usually the Provost, in consultation with the chair of the faculty and the aggrieved faculty member, appoints a committee of faculty specifically chosen to review that particular grievance. In his January 29, 2007 letter to the MIT community (see http://www-tech.mit.edu/V127/N1/1sherley/reif.html), the Provost summarized this process, as used in Professor Sherley's case. MIT's grievance review policy is an integral part of the Institute's system of overall faculty governance. I am puzzled that some members of our community have come so quickly to the conclusion that the grievance review process was flawed.I have not seen the reports that the Committee that investigated Professor Sherley's grievances issued, but I did meet with the Committee on two occasions and was impressed by its thoroughness.The Committee consisted of diverse and distinguished senior faculty members (none from the Biological Engineering Division) who took their responsibilities very seriously.
I could comment on several other issues raised in various communications concerning Professor Sherley's tenure case, but I understand that Professor Peter Dedon, in his role as Associate Head of the Biological Engineering Division, will be addressing these issues in a communication that he is preparing.
About half of the junior faculty members in the School of Engineering do not receive tenure. Such decisions are difficult, often painful, and are not taken lightly by any of the individuals involved. Having worked closely with Professor Lauffenburger for the last eight years during my tenure as Dean, I am confident that the process in BE was fair and just and that Professor Lauffenburger has fulfilled his responsibilities as Division Head in a manner that is entirely consistent with our very high standards of quality and integrity. As expressed in a recent open letter to the MIT community (see http://web.mit.edu/fnl/volume/sherley/be_sherley.pdf), a vast majority of the Division's senior faculty have publicly stated that they share this view. The 20 faculty who signed the letter included 16 of the 18 BE faculty members who were present and voted at the December 2004 meeting in which Professor Sherley's tenure case was considered.
I believe that as Provost, Professor Reif has similarly fulfilled his very difficult responsibilities in a manner that is entirely consistent with our very high standards. Having also worked closely with the Provost for the past eight years (previously in his role as Associate Head and then Department Head in EECS), I am confident that he too has been fair and just. I hope that the MIT community will emerge from this painful situation with an even greater commitment to our principles of excellence, integrity, and mutual respect.
I write to you with some trepidation since it seems that some of those involved in Professor Sherley's case have been unfairly characterized in ways that are less than flattering. Also, by my speaking out as Dean, the School of Engineering might be misunderstood in some eyes to be backtracking on its commitment to diversity. This is not the case. As I have stated in a recent School of Engineering newsletter, (see http://web.mit.edu/engineering/enews/vol1no5-feature.html), diversity is critical to MIT's and the School's educational mission: "Simply put, our diversity efforts are important to us because we believe they make MIT a better institution. Diversity is a matter of self interest." Diversity is also the right thing to do. I am proud of what the School has been doing to create a more diverse and welcoming community and I am proud of the programs we have put in place to enhance our diversity (see the newsletter article for examples). I also applaud the initiative that the MIT President and Provost have put in place to undertake a comprehensive, rigorous, and systematic study of the impact of race on the hiring, advancement, and experience of under-represented minority faculty at the Institute. Even though I firmly believe that the Institute handled Professor Sherley's tenure case fairly, I also believe that we all can and must do more to create a more welcoming and diverse community. The future of the Institute, like the future of American society, depends on it.
Posted by Elizabeth Cooney at 01:20 PM
March 16, 2007
The ambitious goals of the state's universal health insurance law collided with reality again this week, as officials struggled to balance broad coverage for the uninsured with concerns about forcing those who already have coverage to buy more. In the end, state officials yesterday recommended dropping one of their key requirements for comprehensive basic insurance and allowing residents extra time -- perhaps more than a year -- to obtain higher-quality insurance.
Reports of bodies piled upon one another in the overcrowded state medical examiner's office prompted an extraordinary public clash yesterday in the Patrick administration over who is to blame for the conditions and how they can be solved.
Humana Inc. will today send letters to more than 600 Massachusetts senior citizens telling them they will not have to repay money to the health insurance giant because of a billing error in a popular Medicare drug plan.
Senate President Robert E. Travaglini did little to dampen speculation about his future yesterday as the board of the Massachusetts Council of Community Hospitals prepared to formally vote today to offer him its top leadership position.
Fewer than a third of American adults eat the amount of fruits and vegetables the government recommends, a trend that's remained steady for more than a decade, health officials said yesterday.
Scientists found a range of genetic damage in patients with autism, evidence the brain disorder has many causes, a report from Cold Spring Harbor Laboratory said yesterday.
If Massachusetts is serious about leading the nation on health care reform, we must expend as much effort on decreasing cost as increasing access, Thomas Wroe Jr., chairman of Associated Industries of Massachusetts, writes in an Op-Ed piece.
Posted by Elizabeth Cooney at 06:24 AM
March 15, 2007
(David L. Ryan Globe staff photo)
Boston University medical students Miriam Shiferaw (left) and Nawal Momani check letters together to find out where they have been accepted for their residency, during the Match Day at BU Medical School in Boston.
By Elizabeth Cooney, Globe Correspondent
Now they know.
Graduating medical students ripped open envelopes at noon today that contained their futures. Known as "Match Day," today was the day 15,206 medical school seniors across the country learned where they will be going and what specialty they'll embark on once they get there.
Nationally, 94 percent of students trained in the United States got their first choices, according to the National Resident Matching Program, which has coordinated the preferences of medical students with residency programs since 1952.
Massachusetts' four medical schools -- Boston University School of Medicine, Harvard Medical School, Tufts University School of Medicine and University of Massachusetts Medical School -- took part in the ritual. They did not all have data today on who's going where.
At Harvard, 44 percent of its 180 graduates will be going into primary care, which includes family practice, internal medicine, pediatrics, and obstetrics and gynecology. A third of all students will be training in internal medicine. The next closest specialty was emergency medicine, where 8 percent of students are headed. These percentages are in line with what they've been over the last several years, according to Harvard data.
At Tufts, primary care was the choice of 49 percent of graduating students, while 18 percent are going into surgical specialties. Five percent of the students will go into military residencies.
At UMass, there was no crush at the mailboxes. Students were randomly called by name in a conference room to get their envelopes. They were reminded to bring $1 to put in a pot. Daniel Egan, the last one called, picked up $79 for his patience.
Posted by Elizabeth Cooney at 05:41 PM
March 15, 2007
In tomorrow's issue of the journal Science, four researchers from Massachusetts General Hospital -- Nicole Frahm, Toshiyuki Miura, Christian Braner and Bruce Walker -- are among the authors of a paper that says HIV evolution appears to be less predictable than previously thought. They discuss specific ways the rapidly evolving virus changes that may have implications for vaccine design.
Posted by Elizabeth Cooney at 03:59 PM
March 15, 2007
Dr. Steve Colchamiro, dental director at Brookside Community Health Center, which is part of Brigham and Women's Hospital, has won this year's Founder's Award from the Massachusetts League of Community Health Centers.
The award honors a leader who protects and promotes healthcare access as a right for all, the community health center said in a statement. In 1971, Colchamiro established the School Dental Transportation Program, which has bused thousands of students from Boston public schools to Brookside for oral health services, often for their first visit to the dentist.
Posted by Elizabeth Cooney at 03:32 PM
March 15, 2007
Dr. Luis F. Lobón has been named chief of emergency medicine at The Cambridge Hospital campus of Cambridge Health Alliance. Lobón comes to CHA from Caritas Carney Hospital in Dorchester, where he was chief of emergency medicine.
Lobón received his MD from the University of Cantabria Faculty of Medicine in Spain and performed his internship and residencies in emergency medicine in New York City at Albert Einstein College of Medicine, Mount Sinai Medical Center, Beth Israel Medical Center and Elmhurst Hospital Center. He received a master’s degree in health management and finance from New York University’s Robert F. Wagner Graduate School of Public Service.
Posted by Elizabeth Cooney at 03:24 PM
March 15, 2007
Dr. Aaron Lazare stepped down as chancellor and dean of University of Massachusetts Medical School today because he has developed a cardiac arrhythmia, the medical school announced.
Dr. Aaron Lazare
Lazare, 71, has headed the state's medical school since 1991, presiding over a complicated merger between its hospital and the private Memorial Health Care that was completed in 1998, as well as an expansion of research reflected in a $100 million laboratory building that bears his name.
"This is a bittersweet moment for me," Lazare said in a memo sent to faculty, staff and students this morning. "I have had an extraordinary vantage point as this institution has grown into a role as a health sciences campus of international distinction. To say that my work over the years has been professionally and personally rewarding is an utter understatement: It has been a privilege."
Feeling fatigue and an abnormal heart rhythm a few weeks ago, Lazare went to Newton-Wellesley Hospital and was diagnosed with atrial flutter, he said in an interview today. He's taking medication to regulate his heart beat and trying to cut back on the demands on his time.
"I began to think with this carrying two jobs for all this time, it might be time to step down from these very heavy responsibilities," he said. "I expect to return to health, but diminishing stress is part of the treatment."
Lazare will remain on the faculty as a professor of medical education and psychiatry, continuing his research and writing. His latest book, "On Apology," was published in 2004. His next topic is humiliation.
"I love writing and I believe I have some ideas that are worth passing on," he said.
He also hopes to spend more time with his seven children and 11 grandchildren, most of whom live near his Newton home.
Lazare joined UMass as a professor of psychiatry and chair of the department in 1982 after 14 years at Massachusetts General Hospital, where he led its outpatient psychiatry department, among other services.
A search for a successor to one of his UMass roles is already underway. In June the jobs of chancellor and dean were separated and recruitment for a dean and executive deputy chancellor was begun, leaving Lazare to focus on relationships with UMass trustees, donors and the community.
The heart condition is not the first health problem for Lazare. He had a kidney removed after he was diagnosed with renal cancer.
UMass president Jack M. Wilson accepted his resignation with sadness, he said in a statement.
"As a colleague and friend, Aaron’s well-being is of greatest importance to me, and I know that the entire University of Massachusetts community joins me in wishing him a very speedy recovery," he said. "Because the circumstances that have caused Aaron to step aside arose without warning, I will work with the campus leadership in the coming days to make arrangements for interim appointments, and will in due course define a search process for a Chancellor."
Posted by Elizabeth Cooney at 10:53 AM
March 15, 2007
The Massachusetts Council of Community Hospitals plans to offer Massachusetts Senate President Robert E. Travaglini its top job tomorrow, with an annual salary of more than $300,000, according to someone briefed on the council's discussions.
State public safety officials said yesterday they are looking into problems at the medical examiner's office, which acknowledged that an increase in autopsies has recently led to a shortage of body bags, more autopsy-related injuries to staff, and on one occasion an overwhelmed plumbing system that resulted in blood and water pooling on the floor.
All prescription sleeping pills may sometimes cause sleep-driving, federal health officials warned yesterday, almost a year after the bizarre side effect made headlines when US Representive Patrick J. Kennedy crashed his car after taking Ambien.
MacArthur Williams and other paralysis patients and advocates yesterday urged state legislators to impose a $25 surcharge on all handgun purchases in Massachusetts to fund spinal cord injury research. Dr. Eric Ruby, a Taunton pediatrician who is leading the effort, said that despite world-class medical talent, Massachusetts lags far behind some other states in funding for such research.
Governor Deval Patrick and legislative leaders proposed yesterday an emergency $1.47 billion borrowing package they said is needed to repair crumbling roads, bridges, and state buildings; to build a new psychiatric hospital for Central Massachusetts; and to begin work on promised transit projects meant to offset air pollution from the Big Dig.
Substance abuse on college campuses is nothing new, but it is taking a more extreme and dangerous form, with higher rates of frequent binge drinking and prescription drug abuse, and more negative consequences for students such as arrests and risky sexual behavior.
Heart attack patients have a slightly higher risk of death if they go to the hospital on the weekend, when they are more likely to miss or wait longer for crucial treatments, one of the largest studies of the issue finds.
The Texas House of Representatives voted yesterday to overturn Governor Rick Perry's executive order that sixth-grade girls be vaccinated against the virus that causes cervical cancer.
When it comes to healthcare, Governor Deval Patrick said he is speaking up for the little guy. He needs to do it more loudly, more often, and more effectively, Joan Vennochi writes on the Op-Ed page.
Posted by Elizabeth Cooney at 06:26 AM
March 14, 2007
By John Donnelly, Globe Staff
Investor and philanthropist George Soros today announced a $3 million grant to Boston-based Partners in Health and Brigham and Women's Hospital in hopes of curbing the spread of extremely drug-resistant strains of tuberculosis in the small African nation of Lesotho.
Partners in Health, which has a decade of experience in treating drug-resistant TB in Haiti, Peru, and Russia, hopes that it can develop regimens to effectively battle these emerging strains of the disease. About five Brigham and Women's doctors will be involved in the project.
These new strains -- labelled XDR-TB -- have been found in 28 countries after an outbreak was reported last year in the Kwa-Zulu Natal province of South Africa. In that first documented outbreak, 52 of 53 patients identified with XDR-TB died. Since that outbreak, South Africa's death rate for those co-infected with HIV and the drug-resistant TB has been 85 percent.
"We were always afraid that multiple drug-resistant TB could meet HIV/AIDS and this is now happening," Soros said in a conference call with reporters. "It is not getting the attention it deserves."
The resistant TB has been found mainly in patients who have HIV, a virus that weakens a person's immune system and allows other diseases to flourish.
"It's a huge problem," said Dr. Paul Farmer, co-founder of Partners in Health and one of the world's leading experts on HIV and TB treatment in poor settings. "I do think there is some paralysis" in addressing the issue, he added.
But Farmer and Dr. Jim Yong Kim, another co-founder of Partners in Health and the former HIV/AIDS director at the World Health Organization, said they believed that the Soros gift would help spark both other funding and lead to a way of treating XDR-TB.
Kim said he hopes that the research in Lesotho -- a mountainous country surrounded completely by South Africa -- will lead to treatment guidelines in a year's time for people who have both HIV and XDR-TB. He said the process of developing treatment guidelines normally takes between three and five years.
Tuberculosis can be passed by coughing or sneezing to those in close proximity. Roughly 8 million people contract the disease every year, and an estimated 2 million die annually, including many who have AIDS. Kim said that an estimated 500,000 people worldwide have multiple drug-resistant TB, and that number could jump to 1.5 million by 2015, including many cases of XDR-TB.
"We need to get ahead of this problem," Kim said, adding that if the world didn't, it could return to "the pre-antibiotic era of TB control," with no effective medication for many patients.
Partners in Health will bring experts from Haiti and Peru to Lesotho to fight the disease. Doctors in Lesotho also will be trained. The Boston groups, which have set up quarters outside a hospital in the capital of Maseru, had been sending sputum samples to the Massachusetts state laboratory for testing, but a South African lab will now take the samples.
Posted by Gideon Gil at 02:48 PM
March 14, 2007
Eric Lander, founding director of the Broad Institute of MIT and Harvard, will receive the 2007 Society for Biomolecular Achievement Award for Innovation, the organization said.
Also a member of the Whitehead Institute for Biomedical Research and a leader of the Human Genome Project, Lander will receive the award and make a presentation called "Beyond the Human Genome Project" at the group's conference in Montreal next month.
Posted by Elizabeth Cooney at 10:45 AM
March 14, 2007
Home visits by healthcare providers to Medicare patients who are homebound have increased sharply since 1998, but this Washington Post story points to an entirely different kind of house call.
What could be called the convenience call has growing appeal for young, relatively healthy professionals in New York and other high-income locales, the story says. They summon a doctor or physician's assistant with a cellphone call who comes after a wait ranging from minutes to hours. Their demand fuels several Manhattan-based practices.
Posted by Elizabeth Cooney at 09:06 AM
March 14, 2007
A growing network of National Football League players' wives are seeking guidance and support as their husbands deteriorate mentally, the New York Times reports today.
Both the league and the players union are quick to deny any connection between someone’s having played football and later cognitive failure, the story says, but they have approved a plan that will allow families of former players who have various forms of dementia to receive money for their care and treatment — up to $88,000 a year if the player must live in an outside facility, and up to $50,000 a year if the player is cared for at home.
The first applications were mailed in late February to families of 22 former players who are already known to have dementia.
The 88 Plan, named after Hall of Famer John Mackey’s jersey number, comes at a time of heightened scrutiny of the effects of brain injuries among football players, including former New England Patriots linebacker Ted Johnson, who is 34. His doctors told the Globe and the Times last month that he was exhibiting the depression and memory lapses associated with oncoming Alzheimer’s.
Posted by Elizabeth Cooney at 08:28 AM
March 14, 2007
A renowned Harvard economist unveiled a plan yesterday to revamp the US healthcare system by focusing on the value of care to patients, arguing that improving the quality of medical services can by itself save money and provide a road map to a national health plan. Michael E. Porter, a specialist in competition and strategy at Harvard Business School, said that doctors should work together in teams and measure their performance afterward to help fix the national health system. Porter outlined his ideas at a briefing in Washington and in an article published today in the Journal of the American Medical Association. His coauthor was Elizabeth Olmsted Teisberg of the University of Virginia.
Americans don't always get the follow-up medical care they need even if they have health insurance, say two studies, also in JAMA, that underscore the complexity of ensuring everyone has access to good care.
The Veterans Affairs' system for handling disability claims is strained to its limit, and the Bush administration's current efforts to relieve backlogs won't be enough to serve veterans returning from Iraq and Afghanistan, investigators said yesterday.
A yacht voyage that genome pioneer Craig Venter took around the world has turned up a startling array of new genes and new gene families, his team reported yesterday.
Revenue growth at Massachusetts hospitals did not keep pace with the increase in expenses during the 2006 fiscal year, which ended Sept. 30, according to an analysis by the Massachusetts Hospital Association.
Posted by Elizabeth Cooney at 06:24 AM
March 13, 2007
By Scott Allen, Globe Staff
The United States faces a looming shortage of cancer specialists by the year 2020 as aging Baby Boomers become increasingly cancer-prone and medical schools can't train enough new oncologists to keep up with them, according to a national survey released this afternoon.
The report from the American Society of Clinical Oncology forecasts a 48 percent increase in need for cancer treatment by 2020, while the number of oncologists will rise by only 14 percent, leaving a need for 2,550 to 4,080 more cancer specialists nationwide.
"This is a problem for the whole cancer care delivery system and everyone who is involved with it," said Dr. Michael Goldstein of Beth Israel Deaconess Medical Center, who chaired the society's Workforce in Oncology Task Force. "The whole work force is going to be challenged 10 to 15 years from now."
In a way, oncologists are victims of their own success. As cancer treatment has become more successful, deaths from cancer have begun to decline, leaving more people living with cancer -- and still needing care. In addition, more than half of oncologists are already at least 50 years old, raising the prospect of mass retirements in the decades ahead.
So far, the shortage of oncologists is little more than an inconvenience for the doctors who are seeing an increased workload, but Goldstein and other cancer specialists say action needs to be taken now because it takes so many years to train new physicians. The Society of Clinical Oncology is already developing recommendations to ease the coming shortage, such as delegating more care to nurses and other medical staff, persuading older oncologists to delay retirement, and reducing the paperwork that keeps doctors away from patients.
Posted by Karen Weintraub at 06:07 PM
March 13, 2007
By Stephen Smith, Globe Staff
Boston health officials reported today that their review of an ongoing outbreak of gastrointestinal illness at Hebrew Rehabilitation Center shows that 241 patients and 151 staff members have fallen ill since Feb. 21.
Those figures are substantially higher than Friday, when the Boston Public Health Commission last released figures on the outbreak at the Roslindale facility. Then, 225 patients and 119 staff were listed as having experienced nausea, vomiting, and diarrhea -- classic symptoms of norovirus, the infection that has sickened tens of thousands in New England and across the country this winter.
But Tom Lyons, spokesman for the Boston health agency, cautioned that the latest numbers, which indicate a total of 392 people have become ill, do not necessarily reflect a burst of new infections. Instead, the city's investigation is identifying people who became sick earlier in the outbreak but who weren't included in the count.
In the past day, only three new cases have been recorded, Lyons said. Still, he said, city disease trackers are reluctant to declare that the outbreak is trailing off until there have been several additional days when few if any additional infections are reported.
Posted by Karen Weintraub at 05:26 PM
March 13, 2007
By Scott Allen, Globe Staff
Federal regulators today approved a new treatment for breast cancer that oncologists believe could be the second coming of Herceptin, one of the most successful anti-cancer drugs of the last decade.
The Food and Drug Administratrion is expected to approve Tykerb, also called lapatinib, for women with advanced cancer that can no longer be controlled by Herceptin, but major studies are already underway to find out if Tykerb should also be given to millions of women who are in the early stages of cancer.
Dr. Paul Goss, director of breast cancer research at Massachusetts General Hospital, is leading a trial of Tykerb in 3,000 breast cancer patients who have recently undergone chemotherapy. Goss's TEACH trial (Tykerb Evaluation After Chemotherapy) will help the FDA -- and drugmaker GlaxoSmith Kline Plc -- determine just how effective the drug is in women whose cancer has not spread to other parts of their bodies.
Goss said Tykerb might be even more effective than Herceptin, which is credited with extending the life expectancy by more than 1.5 years for women who suffer HER-2 positive breast cancer. Tykerb, he said, appears to shut down more molecular pathways that lead to cancer than Herceptin partly because Tykerb molecules are small enough to get inside cancer cells. As a result, he said Tykerb could be stronger than Herceptin and work in some women other than the 20 to 30 percent who have the HER2-positive form of the disease.
"If I can equate it to lighting a building and your task is to turn all the lights off, you can go room by room and turn them off, or if you're lucky, you discover a circuit breaker that can shut down whole floors," said Goss. Tykerb "might be that circuit breaker."
Goss said it's premature for doctors to prescribe Tykerb for early stage breast cancer unless women can't take Herceptin for some reason, such as side effects. In the long run, he said doctors will likely need both, though women may like Tykerb better because, unlike Herceptin, it's a pill rather than an injection.
Posted by Karen Weintraub at 04:08 PM
March 13, 2007
By Scott Allen, Globe Staff
In a region where most of the medical firsts happen in Boston, here's one for Brockton: sometime this month, a cancer patient at Brockton Hospital will become the first in New England to undergo a new kind of radiation therapy that allows doctors to boost the amount of radiation aimed at the tumor while doing less harm to the surrounding tissue.
The TomoTherapy machine, part of a $3.8 million upgrade to Brockton Hospital's cancer center, is expected to more effectively kill the cancer with fewer side effects for the patient.
"We'll be able to increase our dosage by about 10 to 15 percent while minimizing the dose to other tissues," said Dr. Mark Vasa, the hospital's acting chief of radiation oncology. "We're all very excited."
TomoTherapy combines a CT scan that allows radiologists to see any changes in the tumor's size and shape with a rotating radiation beam that can be aimed in any direction. As a result, radiologists can focus the beam more precisely on the tumor. The technology, developed at the University of Wisconsin-Madison and commercially available since 2002, is available at more than 25 cancer treatment centers nationwide, but none north of New York City. (The University of Connect Health System plans to offer TomoTherapy soon, too.)
TomoTherapy machine
Vasa doesn't know whether New England medicine's conservative streak explains why TomoTherapy hasn't caught on yet here -- Boston doctors, in particular, have a reputation for being skeptical of breakthroughs that happen somewhere else. Whatever the reason, Vasa said the arrival of TomoTherapy is a boon for Brockton patients who will undergo an estimated 15,000 radiation treatments this year.
Posted by Karen Weintraub at 01:07 PM
March 13, 2007
People who changed their health insurance to a high-deductible plan went to emergency rooms 10 percent less often in the first year than people covered by traditional insurance, cutting down on their visits for such illnesses as colds, headaches and nausea, a study by Harvard Medical School and Harvard Pilgrim Health Care researchers shows.
High-deductible health plans are an important part of discussions in Massachusetts about how to make health insurance affordable as the state implements its new law mandating coverage for all citizens.
Previous studies, including the landmark RAND Health Insurance Experiment conducted almost 30 years ago, showed that making health care more expensive drives down the use of hospitals, medications and prevention services, whether needed or not.
The new study, which appears in tomorrow's Journal of the American Medical Association, came to a different conclusion: "Most HDHP (high-deductible health plan) members did not forgo high-severity emergency department visits and seemed able to distinguish low-severity conditions not requiring emergency department care." Dr. J. Frank. Wharam of Harvard and Harvard Pilgrim is the lead author.
The researchers also wanted to see if the drop in emergency department visits was followed by any change in hospitalizations that might suggest harm from a delay in seeking care. They didn't find such a link, but warn that their study was not designed to pick up this kind of association.
In an editorial commenting on the study, Dr. Corita R. Grudzen of the University of California at Los Angeles and RAND, and Dr. Robert H. Brook of UCLA make the point that a patient can't tell if a headache is serious or not.
"It is inconceivable that high-deductible health plans will not affect the health of some patients," they wrote. "If costs are to be constrained by less generous health insurance, some patients will be harmed."
The study analyzed emergency department visits and hospitalizations afterward among 8,724 people for one year before and after their employers switched from a traditional health-maintenance organization insurance plan to one that had a high deductible. They were compared to 59,557 people who stayed in the traditional HMO plan.
In high-deductible plans, monthly premiums are lower but patients must pay for most medical services, including emergency department visits and hospitalizations, up to a set level. The deductibles for people in the study ranged from $2,985 to $4,008 per year for family plans.
The rate of first visits that patients with high deductibles made to emergency departments wasn't different from those with traditional HMO coverage, but the number of second visits in that year fell 25 percent compared to the control group. That implies that once people get billed for an emergency visit, they are less likely to return, the authors said.
Patients still sought help in the emergency department for severe illness, the study found. But the authors warn that longer follow-up is needed to see if patients who defer care have worse health, particularly if they have low income.
"Our findings imply that, at least in the short term, HDHPs may be associated with reduced overall emergency department utilization without significantly affecting the highest-severity visits," they concluded. "Although we did not detect adverse outcomes, broad decreases in emergency department and hospital utilization raise concerns about long-term effects on health."
Responding to concerns raised in the editorial about harm to patients, Wharam said in an interview that high-deductible insurance plans might be offered by employers who would otherwise offer no coverage at all.
"It's possible that if the employer didn't purchase health insurance, the outcomes could be even worse," he said.
Massachusetts' new healthcare law presents a different case because it targets the uninsured population, he said, making it difficult to extend the study's results to it.
"The attempt to cover all Massachusetts residents is a noble one," he said. "I think the bottom line is that we need more research about how the high-deductible plans affect the behavior and outcomes of patients before making conclusive statements."
The study was funded by the Harvard Pilgrim Health Care Foundation and researchers were supported by federal and medical school grants and fellowships.
Posted by Elizabeth Cooney at 01:06 PM
March 13, 2007
Boston popped into third place in a "most energetic city" survey, behind San Francisco and San Diego but ahead of the next East Coast competitor, 21st-place New York, a survey said today.
Sponsored by Tahitian Noni International to promote its new beverage Hiro, the survey was conducted by Sperling's BestPlaces, a company that produces flocks of best-city surveys that rank anything from dating to migraines.
The rankings were based on how people commute to work, how much time they spend exercising, what their body mass index is and how they rate their emotional well-being.
San Francicso had the highest proportion of people who walk or bike to work and get exercise every day, the survey said. The Bay Area also had the most opportunity to surf, rock climb, bike, run, ski and enter marathons or triathlons.
Washington, D.C., came in first on overall quality of health, measured by BMI and emotional well-being.
The 50 largest metropolitan areas were also rated on the number of farmer's markets, food co-ops and organic product manufacturers they had.
The other top 10 finishers were Sacramento, Denver, Honolulu, Seattle, Portland, Ore., and Los Angeles.
Memphis sits in last place.
Posted by Elizabeth Cooney at 10:56 AM
March 13, 2007
Nancy R. Kruger has been appointed senior vice president and chief nursing officer at UMass Memorial Medical Center in Worcester, the hospital said.
Kruger had been chief nursing officer and vice president of patient care services at Brigham and Women’s Hospital for five years. Before that she was chief nursing officer at Hershey Medical Center, the Pennsylvania State University College of Medicine’s academic medical center.
She received her bachelor’s degree in nursing from Skidmore College, completed a graduate degree in nursing from New York University and earned a doctorate in nursing science from the University of Pennsylvania.
Posted by Elizabeth Cooney at 10:37 AM
March 13, 2007
Many men would rather diagnose the roar of their muffler than the rasp in their throat; they'd sooner talk about what's going on with their engine's fuel injection system than about their own cardiovascular health.
Dr. Harvey B. Simon, founding editor of the Harvard Men's Health Watch newsletter, came to that conclusion after 33 years working as a primary-care internist at Massachusetts General Hospital, he writes in today's Washington Post.
Posted by Elizabeth Cooney at 07:32 AM
March 13, 2007
The fast-growing world of voluntary carbon offsets — an unregulated, largely online marketplace — has skyrocketed worldwide. Although specialists say some of the money is well spent, it can be difficult for consumers to figure out if they are buying any new environmental benefit.
The name of the state Department of Mental Retardation is an offensive relic that should be abandoned, some lawmakers say. Senators Karen E. Spilka and Stephen Brewer are sponsoring a bill that calls for the department to find a politically correct name.
Lieutenant General Kevin C. Kiley, the Army's surgeon general, agreed to step down from his position after weeks of intense public criticism stemming from revelations about poor conditions at Walter Reed Army Medical Center, defense officials said yesterday.
Carrots, rich in beta carotene, have long been thought to sharpen eyesight, but beta carotene pills are powerless against a common type of vision loss among older people, according to a new study by Dr. William G. Christen of Brigham and Women's Hospital and others.
Some obese people who have weight-loss surgery, particularly younger women, develop a neurologic condition most often seen in severe alcoholics and linked to a vitamin deficiency, researchers from Wake Forest University School of Medicine said yesterday.
Plagued by chronic bad news about its marquee cardiovascular products, stent maker Boston Scientific Corp. yesterday moved to shift Wall Street's focus to a strong, solidly growing part of its business: endoscopy products used in treating everything from kidney stones to throat and digestive-tract cancers.
Schering-Plough Corp. agreed to buy Akzo Nobel NV's drug-making division Organon for $14.4 billion to gain the world's third-largest maker of birth-control pills and a stable of experimental medicines.
Posted by Elizabeth Cooney at 06:26 AM
March 12, 2007
If you could pick your parents, you'd be wise to choose ones who live long and have few risk factors for heart disease. But don't lose hope if your parents died young -- you still can lower those risks yourself, researchers from the Framingham Heart Study say.
Results published in tomorrow's Archives of Internal Medicine show that middle-aged children who had at least one parent who lived to age 85 were less likely to develop high blood pressure, high cholesterol and other risk factors for cardiovascular disease than people whose parents died younger.
Other research has connected longevity to heredity, but this multigenerational study showed that having fewer risk factors for cardiovascular disease, the leading cause of death in Americans, was an advantage that lasted. The Framingham Heart Study has followed generations of residents since 1948 to study cardiovascular and other chronic diseases. This latest analysis included 5,124 people who were examined every 4 to 8 years from 1971 to the present.
"If you weren't lucky enough to choose your parents, this study shows how some of destiny is determined by risk factors we already know about and know to be modifiable," study co-author Dr. Daniel Levy, director of the Framingham Heart Study and a member of the National Heart, Lung and Blood Institute, said in an interview. "We know that if we eliminate high blood pressure, eliminate high cholesterol and then cigarette smoking, we would eradicate the overwhelming majority of cardiovascular disease in the United States."
People in mid-life shouldn't wait for signs of trouble to take steps to lower their blood pressure and cholesterol, said study co-author Dr. Emelia J. Benjamin, a professor of medicine at Boston University School of Medicine and a cardiologist at Boston Medical Center.
"Clearly there is a genetic basis to longevity but what this says is, some of the basis has to do with risk factors," she said in an interview. "You don't have to say, 'My parents died young so I can't do anything about it.' What this suggests to me is, 'Why don't you change the risk factors?' "
In an editorial about the article, Dr. Clyde B. Schecter of Albert Einstein College of Medicine asks whether cardiovascular disease is just postponed in long-lived people or if longevity might be a factor in whether people survive cardiovascular disease.
"Heart disease accounts for a large enough proportion of all deaths that any factor that promotes exceptional longevity almost inevitably must lead to decreased risk of cardiac death," he wrote.
The Framingham researchers, funded by NHLBI and NIH, are pursuing answers in the genes. A genome-wide scan of participants across the generations in the study began last fall with genotyping that Levy expects to be completed by the end of the summer.
"Longevity may be related to risk factors we don't yet know," he said. "We intend to look at the genetic variations that may differentiate children whose parents live to an old age from children whose parents died at a young age."
Posted by Elizabeth Cooney at 04:01 PM
March 12, 2007
Do you know a doctor, nurse or other caregiver who displays extraordinary compassion? The Kenneth B. Schwartz Center is looking for nominations for its 9th annual Compassionate Caregiver of the Year Award. The winner will receive $5,000 and four finalists will receive $1,000 each.
The award honors Kenneth B. Schwartz, the Center’s founder and a health care attorney who died in 1995 after battling lung cancer. Nominations are due April 16.
The Schwartz Center is a non-profit organization housed at Massachusetts General Hospital promoting ways to improve relationships between caregivers and patients.
Posted by Karen Weintraub at 02:21 PM
March 12, 2007
By Stephen Smith, Globe Staff
More than 1,000 patients in Boston who previously did not have consistent medical care received services during the first year of the city's campaign to address racial and ethnic health disparities, according to a report released today.
The patients, half of whom live in Dorchester and Roxbury, were screened for HIV and diabetes, as well as for breast, cervical, and prostate cancer -- in some cases, the first time patients had undergone screening exams. The patients were then linked with health workers who helped manage their care and directed them to clinics and other providers of medical services.
In 2005, Boston Mayor Thomas M. Menino declared healthcare disparities the city's most pressing medical issue, and the Boston Public Health Commission issued a blueprint to address the problem. Grants were given to a range of healthcare and community organizations and plans drafted to educate hospitals, doctors and nurses, and patients.
During the first year of the initiative, more than 450 health professionals received training in how to provide care that was more culturally appropriate -- lessons designed to make an increasingly diverse patient population feel more comfortable seeking medical treatment.
The report reviewing the first year's work, presented today at a conference, was prepared by Northeastern University. (See, also the 2-page executive summary)
“We know that we have a long way to go," Menino said in a statement, "but this is a start and we will learn from the experience of the first year projects as we move forward with our efforts in Boston."
Posted by Karen Weintraub at 11:15 AM
March 12, 2007
A Canadian province is putting out the welcome mat to Ontario-trained doctors living in the United States to encourage them to return home to practice there. Ontario Health Minister George Smitherman plans to launch a recruitment drive this spring by traveling to Boston and New York, where there are clusters of Canadian doctors.
Ontario is struggling with a chronic shortage of doctors, made worse because the province loses about 30 percent of its new medical graduates to other jurisdictions within two years of completing their training, according to the Ontario Medical Association in a Globe and Mail story today.
This will be the first time the government has ever attempted to lure doctors back to Ontario, said Dr. Joshua Tepper, assistant deputy minister and an obstetrician.
"Nobody has ever reached out and said, 'Why did you leave? Would you like to come back?' "
Posted by Elizabeth Cooney at 08:03 AM
March 12, 2007
An ongoing Harvard project funded by the National Cancer Institute that will involve about 800 terminally ill cancer patients in Massachusetts, Texas, Connecticut, New Hampshire and New York -- is finding that African Americans are two to three times as likely as whites to want everything possible done to keep them alive, to get life-prolonging care and to die in intensive care. A Washington Post story reports on the debate about what is a "good death."
Posted by Elizabeth Cooney at 07:06 AM
March 12, 2007
The much-anticipated "smart," or targeted, cancer treatments are joining the war on cancer -- four were approved last year alone -- but scientists are discovering that cancer is a tougher foe than they realized even a few years ago when stunning results in mice raised expectations sky high.
An experimental cancer drug gave one patient three years of life and a new mission.
This weekend the clock sprang forward an hour, three weeks earlier than the usual spring wake-up call. While it was a simple thing to move the clock hands or change the digital clock (don't ask us about the DVD player), bodies don't reset so quickly.
Half of the human brain is devoted to the matter of vision. But "what do we know about what we see?" asks Ennio Mingolla, professor of cognitive and neural systems and psychology at Boston University. "What makes black look black?"
Is sedation safe for children undergoing dental procedures or medical tests like MRIs?
Patients at the veterans' medical center in West Roxbury are largely satisfied with the care they receive, but an infusion of funds would make it better, Senator John F. Kerry said yesterday after he made a surprise visit to the facility, prompted by recent reports of poor medical treatment and conditions at a veterans' medical center in Washington, D.C.
We are too quick to slap a diagnosis on someone before we have any real personal in-depth understanding, Lexington clinical psychologist and psychoanalyst Stephen Schlein writes in an Op-ed piece.
Posted by Elizabeth Cooney at 06:23 AM
March 12, 2007
Federal scientists have discovered that a new strain of norovirus is responsible for the wave of intense gastrointestinal infections that have overwhelmed hospitals, nursing homes, and college dormitories across New England and the nation this winter, Stephen Smith reported in Saturday's Globe.
Posted by Elizabeth Cooney at 06:20 AM
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