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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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« May 20, 2007 - May 26, 2007 | Main | June 03, 2007 - June 09, 2007 »

June 01, 2007

Patients steered to female Ob/gyns, Harvard Vanguard doctor alleges

By Elizabeth Cooney, Globe Correspondent

A Harvard Vanguard obstetrician/gynecologist is suing his employer for allegedly steering new patients away from older, male doctors and attempting to move him out of the practice through unfavorable financial and night-call arrangements.

baer100.bmpDr. Stephen D. Baer (left), 63, filed a lawsuit in Middlesex County Superior Court last week against Harvard Vanguard Medical Associates and ob/gyn director Dr. Robin S. Richman, alleging discrimination based on disability as well as age and gender.

The suit claims that discrimination in how new patients were assigned to doctors coincided with the group's running a deficit of about $3.5 million in 2005.

"On several occasions the employer's ob/gyn management stated that male doctors do not attract patients and that HVMA needed to hire young female doctors to attract new patients and increase patient volume and revenue," the suit says. "To this day, HVMA's policy is to get rid of older, male ob/gyn doctors, when possible, and replace them with younger, female ob/gyn doctors in order to stimulate growth in the practice."

Harvard Vanguard issued a response today.

"It is our policy not to discuss specifics of employment matters and pending litigation. However, we believe this claim is without merit," the statement said. "Harvard Vanguard Medical Associates is committed to delivering the highest quality patient care, which depends on our physicians and other healthcare professionals. We are an equal opportunity workplace."

According to the suit, new patients calling for an appointment who did not request a specific doctor were assigned to younger female doctors or told "you don't want to see a male doctor, do you?"

Baer began working for Harvard Vanguard's predecessor, Harvard Community Health Plan, in 1977. He stopped doing night call in 1993 after suffering a heart attack in 1989 and having heart surgery in 1993, the suit says. In 2005 he was told he could no longer practice obstetrics without doing night call, the suit says. Since November 2006, he has been working as a gynecologist only, with a significant cut in pay, the suit says. He is based in the Copley office on Dartmouth Street in Boston.

In 2005, Harvard Vanguard changed how it credits doctors with revenue in a way that hurt Baer and other older, male doctors, the complaint alleges. Under the new system, the "doctor of record" for an obstetrics patient was credited with revenues from the patient, regardless of which doctor saw the patient or delivered her baby, according to the suit. This favored younger, female doctors to whom new patients were assigned, it said.

Baer alleges that he has lost wages and suffered severe emotional distress because of gender and age discrimination and lack of accommodation for his disability.

Baer's lawyer, Judith A. Miller of Wellesley, declined to comment on the suit.

Posted by Elizabeth Cooney at 04:12 PM
June 01, 2007

Harvard's Herzlinger a 'healthcare heretic'

herzlinger150.bmpHarvard Business School professor Regina Herzlinger (left) is trying to transform America's health-care system through her advocacy of consumer choice, an article in The Economist headlined 'health-care heretic' says.

Calling her America's leading advocate of market-driven, consumer-orientated health reform, the article quotes Ray Gilmartin, a former chairman of drug giant Merck, on her efforts in the 1980s: "She argued for a greater role for competition and choice when market forces and productivity were foreign concepts in this sector."

In the 1990s, when managed care was all the rage, the story says, she predicted correctly that such a cost-obsessed approach would alienate consumers while it failed to rein in cost inflation ("I said, ‘this fish stinks’," she recalls in the article).

Today, "the US health-care system is in the midst of a ferocious war. Four armies are battling to gain control: the health insurers, hospitals, government and doctors," the article quotes from her new book, "Who Killed Health Care?"

Then she moves in for the kill, the story continues: "Yet you and I, the people who use the health system and who pay for all of it, are not even combatants."

Posted by Elizabeth Cooney at 07:48 AM
June 01, 2007

Today's Globe: TB warning ignored, Fernald future, Shirley Maciver

A widely traveled Atlanta lawyer with a dangerous strain of tuberculosis was allowed back into the United States by a border inspector who disregarded a computer warning to stop him and don protective gear, officials said yesterday.


Governor Deval Patrick's
administration argued yesterday that a federal judge, whose prior oversight forced dramatic improvements at state institutions for the profoundly mentally retarded, has no authority to order the state to keep the Fernald Development Center open.

maciver100.bmpA sense of where she fit in the history of medicine informed Dr. Shirley R. MacIver's approach to being a physician, from the days she tagged along as a girl for her mother's nursing duties to her service on a state board in retirement. Dr. MacIver, who spent the last decade of her medical practice at Cape Cod Hospital and designed the medical herb garden at the Massachusetts Medical Society headquarters in Waltham, died at her house in North Chatham May 3 of complications from Alzheimer's disease. She was 85.


Posted by Elizabeth Cooney at 06:31 AM
May 31, 2007

Flea's fall sobering for other bloggers

By Elizabeth Cooney, Globe Correspondent

If there was any remaining doubt, the settlement of Natick pediatrician and medical blogger Dr. Robert Lindeman's malpractice trial removed any illusion that blogging could be done anonymously.

Under the name Flea -- a derogatory term surgeons used for pediatricians when he was in training -- Lindeman posted opinions on his case and the plaintiff's lawyer, described his preparations for it and the defense strategy, and commented on the jurors. Today's Globe story details how the plaintiff's lawyer asked him on the stand if he was Flea. The case, which was settled the next day, involved the 2002 death of a 12-year-old patient from complications of diabetes.

Dr. Kevin Pho, a Nashua, NH, internal medicine physician who blogs under his own name on Kevin, M.D., called the situation sobering. He said he doesn't know Lindeman or anything about the malpractice case.

"I blog under my own name so I have to be more tempered in my posts," he said in an interview today. "But I think it's a mistake to assume that people won't find out who you are. You can assume there's no anonymity on the Web. People can find out who you are."

Pho has been blogging for close to four years, but after the Flea blog came down, as Pho reported on his blog May 16, he removed some of his own items.

"I don't blog about patients. I stay away from all of that," he said. "Reading what happened to Flea, I've taken out 20 to 30 posts that would have been a little more controversial just because I wanted to play it safe. I don't want any posts to come back and bite me."

Eric Turkewitz, a lawyer who writes the New York Personal Injury Law Blog, posts today that he'd been fascinated by Flea's blog, although he does not know him or the specifics of the malpractice case. And he says he was not alone, listing 30 blogs, including this one, that took note of Flea's trial.

"The subject was, simply put, irresistible," Turkewitz writes. "I know that I found his activity fascinating, not only for its raw content, but also for the walking-a-high-wire-without-a-net danger of what he was doing."

Turkewitz doesn't forget the plaintiffs.

"This case was a tragedy for two parents, and a nightmare for a doctor," he writes.

As for the medical bloggers, they're feeling gun-shy, Pho said.

"It's a little bit sad in a way. The whole purpose of blogging is to be open and pull back the curtain to talk about how it really is," he said. "So the question is, how realistic is that? I think that's what physicians and other health professionals are wrestling with right now. It's part of the growing pains of the medical blogosphere."

David E. Williams, co-founder of MedPharma Partners LLC in Boston, says on his Health Business Blog that he won't debate Lindeman's case but gives this endorsement:

"Let me just say that Rob is a fantastic pediatrician and a wonderful human being. If you have kids and live anywhere near Natick, MA you should consider choosing him as their physician," he says. "I just wish he had blogged under his real name rather than anonymously. The world is a poorer place now that his blog is gone."

Dr. Tim Sturgill, an emergency physician in Sacramento, Calif., who finished law school in December, makes this point on his blog, symtym.

"Arrogance, ignorance, or both? Dr. Lindeman’s most potent defense was his character -— a character the Flea so thoroughly impeached —- case over and settled," he writes, then quotes from Hosea 8:7: " 'For they sow the wind and they reap the whirlwind.' "

Posted by Elizabeth Cooney at 11:00 AM
May 31, 2007

Today's Globe: Flea unmasked, TB scare, NJ fitness agency, AIDS funding, Fernald, Patrick's Life Sciences plan

lindeman100.bmpIvy League-educated pediatrician Robert P. Lindeman (left) was unmasked as the blogger Flea this month as he defended himself in Suffolk Superior Court in a malpractice suit involving the death of a 12-year-old patient. In his blog, Flea had ridiculed the plaintiff's case and the plaintiff's lawyer. On May 15, the morning after Lindeman admitted that he was, in fact, Flea, he agreed to pay what members of Boston's tight-knit legal community describe as a substantial settlement -- case closed.

The Atlanta man with extensively drug-resistant tuberculosis who sparked an international health alarm by flying to Europe and back for his wedding twice ignored requests to stay put and not travel, officials said yesterday.

New Jersey's health department is escalating the battle against the bulge by starting a new Office of Nutrition and Fitness to better coordinate programs to prevent obesity.

Hoping to cement a positive part of his legacy, President Bush yesterday asked Congress to double the funding of the US global AIDS program to $30 billion over five years, which sets goals of helping support AIDS treatment of 2.5 million people.

At stake in the battle to keep open the Fernald Developmental Center in Waltham are the services for future generations of individuals with intellectual and developmental disabilities, say the parents of teenagers with disabilities. Mary Ellen Mayo, president of The Arc of Massachusetts, an advocacy organization, and John Nadworny, coauthor of "The Special Needs Planning Guide" and member of the Governor's Commission on Mental Retardation, write on the op-ed page why they think Fernald should be closed.

Governor Deval Patrick's proposal to inject $1 billion into medical research and biotechnology is a complex plan whose details have yet to be worked out, and it depends on the Legislature's willingness to fund it over a decade. But his strategy could also be more flexible and cost effective than competing plans in California and other states, according to policy specialists and a Globe analysis.

Posted by Elizabeth Cooney at 06:01 AM
May 30, 2007

Elder Affairs secretary taking UMass Medical School post

carey100.jpgJennifer Davis Carey (left), who served in four governors' adminstrations, will be leaving Beacon Hill to become director of training and education at University of Massachusetts Medical School's Commonwealth Medicine, the school announced today.

She had been secretary for the Executive Office of Elder Affairs since 2003. Governor Deval Patrick has asked cabinet secretaries to send him letters for reappointment, but she said she did not submit one.

"This is a wonderful administration with wonderful people and Governor Patrick is extraordinary, but this is a tremendous opportunity," she said in an interview. "UMass is an extraordinary institution and Commonwealth Medicine is on the cutting edge, so taking their academic assets and putting them together with my educational background and what I learned in public policy really allows me to put these passions together."

Commonwealth Medicine is best known for overseeing the health system for 10,000 inmates in the custody of the Department of Correction, but it also carries out research and public health initiatives.

"Commonwealth Medicine is like an action tank as opposed to just a think tank," she said. "They do more than just think."

Carey’s experience in state government began when Paul Cellucci was governor; she stayed when Jane M. Swift succeeded him and was promoted during the Mitt Romney administration. From 1999 through 2003 she was director of the Office of Consumer Affairs and Business Regulation.


Posted by Elizabeth Cooney at 07:12 PM
May 30, 2007

Promoting insurance through My Space

By Alice Dembner, Globe Staff

Reaching out to the young crowd, an health insurance advocacy group in North Adams has set up a MySpace page to encourage enrollment in the state’s new health plans.

In the first 12 days, Ecu-Health Care’s page received 642 views and has signed up 140 "friends," who are contacting others about the requirement that every adult in the state have insurance by July 1.

"It's a great way to network," Charles Joffe-Halpern, executive director of Edu-Health Care said in an e-mail. "One ‘new friend’, a local pizza restaurant, agreed to send notices about health care opportunities to their 1,000 friends. Health care outreach in the 21st century."

How well this translates into insurance sign-ups is yet to be seen, he said.

"It’s just one part of the strategy," said Joffe-Halpern, who also sits on the board of the Commonwealth Health Insurance Connector, which is overseeing implementation of the health insurance law. "We have to go where kids live."

Check it out at myspace.com/ecuhealthcare.

Posted by Karen Weintraub at 03:41 PM
May 30, 2007

Weinberg honored for developing breast cancer treatment

weinberg.jpgRobert Weinberg (left) of the Whitehead Institute for Biomedical Research is one of four scientists being honored today for their collaboration in developing the breast cancer therapy Herceptin.

Weinberg will share the $200,000 Warren Alpert Foundation Scientific Prize with H. Michael Shepard of Receptor BioLogix Inc. of South San Francisco, Dr. Dennis Slamon of UCLA's Jonsson Comprehensive Cancer Center, and Axel Ullrich of the Max Planck Institute for Biochemistry in Germany. They will be honored at a ceremony at the Four Seasons Hotel in Boston following a symposium at Harvard Medical School.

Herceptin is a specially engineered antibody that blocks a protein whose levels are high in about 25 percent of all breast cancers. This form of breast cancer is also the most rapidly fatal.

Posted by Elizabeth Cooney at 11:53 AM
May 30, 2007

Website maps the sniffles

whoissick-1.JPG

Now here's a sick map.

The Los Angeles Times has a story about a website called Who Is Sick? that allows you to post your sniffles, aches and pains by ZIP code or just click to see who else has let the world know how they really feel.

Today it would appear Boston has a lot of runny noses, with coughs coming in second. Beats the higher level of bloody stools and urine of five and seven weeks ago, according to spikes on the bar chart that filters certain symptoms.

The site was founded in March to help people figure out if they were suffering from just a bug that was going around or something more uncommon, according to the site. If misery does love company, there's also that urge to take the temperature of other cities.

Headaches in New York and Washington? About the same, at 14 and 15 percent. How about Miami? The map is empty, with no posts in the last 60 days. Or maybe it's just a slice of heaven.

Posted by Elizabeth Cooney at 11:51 AM
May 30, 2007

Today's Globe: phys. ed, lethal TB, health insurance costs, mosquito tests, Marge Dunton-Reida, Medicare 'Part D,' Genzyme cancer partner

volleyball300.bmp
First graders at the JFK Elementary School in
Jamaica Plain played balloon volleyball during
gym class yesterday. (Barry Chin/ Globe Staff)

State lawmakers are considering bills that would establish a minimum time commitment to physical education, ranging from 150 minutes to about 200 minutes a week. The bills, however, do not address how much it would cost cities and towns to meet the time requirements, how schools would pay for the increase, and what other part of the curriculum would have to give to make way for more exercise.

The US Centers for Disease Control and Prevention, underscoring the threat of an emerging, lethal form of tuberculosis, issued a rare federal public health order on Monday that placed an infected Georgia man into quarantine and announced yesterday that it is searching for airline passengers he may have exposed to the disease on two trans-Atlantic flights earlier this month.

The state agency overseeing the new mandatory health insurance law was urged to tighten limits on out-of-pocket expenses, one of several suggestions offered at a four-hour State House hearing on ways to improve proposed rules for basic insurance coverage and to determine if that insurance is affordable.

State officials will begin testing trapped mosquitoes this week for Eastern equine encephalitis and West Nile Virus, mosquito-transmitted viruses that have severely disabled or killed several Massachusetts residents in the past three years.

dunton-reida100.bmpMarge Dunton-Reida (left) helped hundreds of visitors reclaim sobriety at her old country inn, which became Naukeag Hospital, and many returned again and again as they continued their struggles with alcohol. The hospital is now McLean Center at Naukeag. She died in her son's house May 2 after a period of declining health. She was 83.

The much-criticized Medicare drug benefit program that began last year has enrolled the vast majority of eligible people in Massachusetts, and saved the state more money -- about $76 million -- than planners predicted, according to a study being released today.

As part of its push to become a bigger player in cancer drugs, Genzyme Corp. of Cambridge said yesterday it will buy out business partner Bioenvision Inc. of New York for $345 million, consolidating its ownership of a cancer treatment to which the two companies had been sharing rights.

Posted by Elizabeth Cooney at 06:08 AM
May 29, 2007

On the blogs: surgeons and sleep, cholesterol testing for kids, shortage of primary care doctors

On Nurse at small, Betsy Baumgartner, who works at a Boston teaching hospital, wonders about the safety of surgeons operating without enough sleep.

"We've all had a rough night where we weren't able to sleep, or where our kid was sick and kept us up the whole night," she writes. "Surgeons go through these same things, and they show up to work the next morning running on empty with only their Starbucks as fuel. Just like you and me. The one difference is that they are about to cut someone open."

On Healthy Children, pediatrician Dr. Steven Parker of Boston Medical Center and Boston University School of Medicine votes no on testing kids' cholesterol levels.

"I'm concerned that the testing will imply to some parents that their obese child with a normal cholesterol level should not be a concern and, alternatively, others will become unduly overwrought about their perfectly healthy child with a high number," he writes. "Seems to me a set-up for both unwarranted reassurance and needless anxiety."

On WBUR's CommonHealth, Michael V. Sack, president and CEO of Hallmark Health, asks if there will be enough primary care physicians to take care of people gaining health insurance under the new healthcare law.

"Across the state, too few primary care physicians are signing up for participation in the MassHealth and Commonwealth Care plans because of low reimbursement," he writes.

Posted by Elizabeth Cooney at 08:34 AM
May 29, 2007

Today's Globe: young adult coverage, bird flu antibodies, Thai AIDS activist, heart choices, Fosamax suit, MGH expansion cost

friedmans300.bmp
Ekaterina and Mark Friedman of Lowell once
faced massive hospital bills related to their
daughter's early birth. They were enrolled in a
student insurance plan that had coverage limits.

The state's new low-cost health insurance coverage for young adults may have the same drawback as a long standing program for college students: It doesn't work for the seriously ill.

Blood donated by four survivors of bird flu seems to harbor a potent protection against the deadly virus.

viravaidya150.bmpIn Thailand, he persuaded Santas and toll booth operators to hand out condoms. Traffic police gave them away, too, which he called "Cops and Rubbers." And Buddhist monks blessed packets of the latex sheaths in ceremonies. Such creative HIV prevention tactics helped Mechai Viravaidya (above) -- known as "Mr. Condom" -- and his Population and Community Development Association win the Gates Award for Global Health, a $1 million prize to be announced today by the Bill & Melinda Gates Foundation.

Physicians at a growing number of hospitals nationwide are signing cooperative agreements designed to cool turf battles that can leave patients confused by differing treatment recommendations and unsure about which specialist to see. Competition for patients has become especially intense in recent years among doctors who treat diseases of the circulatory system -- including cardiologists, vascular surgeons, cardiac surgeons, neurosurgeons, interventional radiologists, and neurologists -- as treatment options have increased and the lines between specialties have blurred.

Merck & Co., the drug maker defending about 27,000 lawsuits filed by users of the painkiller Vioxx, was accused in a Canadian lawsuit of failing to warn consumers its bone drug Fosamax may damage jaw bones, a law firm said.

There wasn't a whisper of opposition last week at the state Public Health Council as Massachusetts General Hospital presented its plan to replace some old buildings with a $498 million complex. The council approved the plan unanimously, but the expansion raises the question of whether the state can afford to rely so heavily on healthcare providers who combine quality with high costs, a Globe editorial says.

Posted by Elizabeth Cooney at 06:22 AM
May 28, 2007

Today's Globe: avian flu, trauma trials, breast cancer genes, business of survival, Children's seizure drug trial

Even as avian flu has faded from the headlines, the lethal viral illness continues to strike in certain corners of the world and, in an especially ominous development, health authorities said they believe it has reemerged in Vietnam, where control measures had stopped its spread for more than a year.

The federal government is undertaking studies that allow researchers to conduct some kinds of medical experiments without first getting the patient's permission. The $50 million, five-year project will involve more than 20,000 patients in 11 sites in the United States and Canada and is designed to improve treatment after accidents, shootings, cardiac arrest, and other emergencies.

A genetic mutation that raises the risk of breast cancer is found in up to 60 percent of US women, making it the first truly common breast cancer susceptibility gene, researchers including David Hunter of Harvard reported yesterday.

Avi Kremer, diagnosed with ALS just months after enrolling in Harvard Business School, decided to take what he had learned at Harvard and apply it to a condition that is invariably lethal. His disease became his business plan.

Children's Hospital Boston wants to participate in a clinical trial comparing two drugs commonly given to children suffering life-threatening seizures, but because treatment must start within five minutes of the child's arrival in the emergency room, parental consent will not be obtained until after one of the medications is given.

Also in Health/Science, meet MIT physicist Jocelyn Monroe, who studies neutrinos and tests the basic theory of matter, and read Judy Foreman's answer to whether it's OK to suppress menstruation for a year.

Posted by Elizabeth Cooney at 07:35 AM
May 28, 2007

In case you missed it: Fernald future, TV under 2

hanlons300.bmp
Twins Jean (left) and Joan Hanlon, 49, in an
activity room at the Fernald Development Center
in Waltham. (Globe Staff Photo/Suzanne Kreiter)

Joan and Jean Hanlon are part of the dwindling community of disabled people who, admitted to Fernald Development Center as toddlers decades ago, now cling to their tiny piece of the vast rolling property, Sally Jacobs writes in Sunday's Globe. With the long-running debate over the possible closure of the facility nearing its climax, the Waltham facility's remaining 186 residents are virtually all silent spectators, bystanders in the fight that will shape the rest of their lives.

About 40 percent of 3-month-olds watch television or videos for an average of 45 minutes a day, or more than five hours a week, according to the first-ever study of the viewing habits of children under the age of 2, Barbara F. Meltz reports in Sunday's Globe.

Posted by Elizabeth Cooney at 06:59 AM
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