boston.com Your Life your connection to The Boston Globe
White Coat Notes: News from the Boston-area medical community
Comments
Send your comments and tips to whitecoat@globe.com
Categories


Blogger
Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
Contributors
Boston Globe Health and Science staff:
Scott Allen
Alice Dembner
Carey Goldberg
Liz Kowalczyk
Stephen Smith
Colin Nickerson
Beth Daley
Karen Weintraub, Deputy Health and Science Editor, and Gideon Gil, Health and Science Editor.
 Short White Coat blogger Ishani Ganguli
 Short White Coat blogger Jennifer Srygley
Week of: July 1
Week of: June 24
Week of: June 17
Week of: June 10
Week of: June 3
Week of: May 27

« June 03, 2007 - June 09, 2007 | Main | June 17, 2007 - June 23, 2007 »

June 15, 2007

Program aims to cultivate universal insurance in other states

By Alice Dembner, Globe Staff

In many states, Massachusetts is serving as a model for efforts to expand health insurance.

Now, with the help of a Massachusetts organization, the grass-roots work that helped propel reform here will be cultivated in other states.

Today, the Robert Wood Johnson Foundation is announcing a $12 million program, called Consumer Voices for Coverage, that will be based in Boston at the offices of Community Catalyst, a 10-year-old non-profit group that works to expand consumer action to improve the healthcare system.

The program will provide $750,000 grants to community groups in each of 10 states -- yet to be selected -- to help foster universal health insurance. The goal is to create a broad healthcare advocacy network in each state pressing for change.

"At the end of three years, hopefully we'll have 10 states with significant reform," said Robert Restuccia, executive director of Community Catalyst.

The initiative grows, in part, from a report released last fall by Community Catalyst called "Consumer Health Advocacy: A View from 16 States."

June 15, 2007

MGH Institute picks president

bellack100.bmpJanis P. Bellack (left) has been named president of the MGH Institute of Health Professions, an independent graduate school and academic affiliate of the Massachusetts General Hospital.

Bellack had been vice president for academic affairs/provost and professor of nursing and health sciences at the Massachusetts College of Pharmacy and Health Sciences. She will succeed Ann W. Caldwell, who announced in September that she would step down after 10 years as president.

Bellack earned a bachelor's degree in nursing from the University of Virginia, a masterís degree in pediatric nursing from the University of Florida, and a Ph.D. in educational policy studies and evaluation from the University of Kentucky.

Posted by Elizabeth Cooney at 11:15 AM
June 15, 2007

Today's Globe: birds, Lyme cases, diet pill, teen obesity surgery, stem cell bill

grackle150.bmpThe loss of millions of acres of grasslands and shrubs nationwide to suburban sprawl and agriculture -- along with a warming planet -- has dramatically reduced the numbers of common birds (including the grackle, left) seen across the United States over the past 40 years, according to a National Audubon Society study released yesterday.

The number of Lyme disease cases reported in Massachusetts jumped by about 50 percent from 2004 to 2005, a single-year increase that prompted concerned state health officials to say they were stepping up efforts to educate the public about prevention of the disease.

Eager dieters snapped up all the packages of alli at dozens of Walgreen Co. stores yesterday, providing a sneak peek at how the nation's only federally approved over-the-counter diet pill would be greeted today, the first day of nationwide sales.

Adolescents are less likely to suffer complications from obesity surgery than adults, a reassuring finding because little had been known about the risk facing the small but growing number of teens who opt for it, researchers said yesterday.

As the bill to allow federally funded stem cell research heads to the White House, the question is not whether research on embryonic stem cells will go forward, Ellen Goodman writes on the op-ed page. It is going forward in foreign countries and private companies and states that support it from Massachusetts to California. It's whether it will go forward with federal funding and oversight and accountability.

Posted by Elizabeth Cooney at 06:24 AM
June 14, 2007

Short White Coat: Take a number

Short White Coat, our blog about medical school, has a new blogger: Jennifer Srygley, a third-year student at Harvard Medical School. Jennifer grew up in Tallahassee, FL, and attended the University of Georgia, where she majored in genetics and creative writing. As a medical student, she tries to remain aware of the strangeness and beauty of her surroundings on the hospital wards, all while taking good care of patients. Her posts will appear here as part of White Coat Notes. E-mail Jennifer at jen.shortwhitecoat@gmail.com.

srygley- -short white coat106.bmp

My day starts and ends with numbers. As a medical student on the surgical service, my first task every morning is to go to every patientís room and record temperature, heart rate, blood pressure, fluid intake, and urine output.

With time, the numbers themselves have come to take on meaning. The number 102, for example, is alternately alarming or reassuring, depending on whether it is a temperature or a systolic blood pressure measurement. There are some patients that I have come to know not only by chief complaint or social history, but by their numbers: Mr. Lís heart usually beats between 70 and 80 times per minute. Knowing this detail is enough to recognize the earliest signs of dehydration when his heart rate climbs to the 90s.

And there is something else. I find it comforting to know exactly how fast the hearts of all my patients are beating. While my task of writing down the vital signs every morning and afternoon does not require any particular skill or training, I enjoy the sense of vigilance and duty that it provides.

The next step in medical training is to know what to do about each number, when to become concerned about the deviation of a particular number from normal, and when to act. The clinical skill of number interpretation will come with time, I hope. For now I am content to carry my patientís pulses on an index card in my pocket.

June 14, 2007

Hospital Association chairman takes gavel

Robert G. Norton, president and CEO of North Shore Medical Center in Salem, became chairman of the Massachusetts Hospital Association's board of trustees today, the group said.

Norton came to the Partners HealthCare hospital from Shands Jacksonville Medical Center in Florida after being executive vice president at Beth Israel Deaconess Medical Center.

Other MHA officers are Winchester Hospital president and CEO Dale M. Lodge, chairman elect; Tufts-New England Medical Center president and CEO Ellen M. Zane, treasurer; and Cambridge Health Alliance president and CEO Dennis Keefe, secretary.

Posted by Elizabeth Cooney at 04:07 PM
June 14, 2007

Provider groups object to MinuteClinics in CVS stores

By Liz Kowalczyk, Globe Staff

Wait a minute!

Five medical-provider groups say they have major objections to CVS Caremark's plan to open 20 to 30 MinuteClinics in Boston-area stores by the fall.

In a letter this week to state public health Commissioner John Auerbach, the groups called for a public hearing on the proposal; they said his department should not waive certain clinic requirements for CVS without a hearing and vote by the Public Health Council. CVS wants a waiver of many normal clinic licensing requirements, such as having blood collection equipment because the clinics won't do blood tests.

The groups objected to granting waivers of "basic public health protections and standards of care to a for-profit company in order to reduce the economic burden to that company in competing with other health care providers. ..." They said a waiver would be unfair to medical providers struggling to meet regulations.

Groups that signed the letter are the Massachusetts Medical Society, Massachusetts Academy of Family Physicians, Massachusetts Chapter of American Academy of Pediatrics, Massachusetts Hospital Association, and Massachusetts League of Community Health Centers.

The Department of Public Health did not make any promises about whether it would hold a public hearing before deciding on CVS's application. "The Commissioner will certainly consider the request from these organizations," the department said in a written statement. "We recently organized a meeting to hear from both proponents and opponents of the proposal and we value the input that we received."

June 14, 2007

Houston $3b, Boston $1b

texas gov150.bmpLast week Houston won Harvard's Stephen Wong and his bioinformatics team of 20 when they said they were wooed to Methodist Hospital. Yesterday Texas Gov. Rick Perry (at left with cancer survivor and lobbyist Andrea McWilliams) signed a bill that will put on the November ballot a $3 billion bond issue to fund research in the fight against cancer, today's Houston Chronicle reports.

The initiative, modeled after a 2004 California measure in which voters approved $3 billion for stem-cell research, seeks to compensate for the federal government's declining funding for scientific research in recent years, the story says.

"There is no piece of legislation that could mean more to the future of this state than this cancer-research bill," Perry said at the University of Texas M.D. Anderson Cancer Center in Houston, where he was joined by Lance Armstrong, a cancer survivor and seven-time Tour de France winner.

Officials at the ceremony, the story said, expect no area to receive a bigger share than Houston's Texas Medical Center, which is home to M.D. Anderson Cancer Center and Baylor College of Medicine, two of the state's three federally designated cancer centers. The third is at the University of Texas Health Science Center at San Antonio.

Last month Massachusetts Governor Deval Patrick announced a plan to invest $1 billion in life sciences, including a new stem-cell bank, job training, biomedical research, and tax breaks for companies hiring new workers.

Posted by Elizabeth Cooney at 11:11 AM
June 14, 2007

Today's Globe: DNA challenge, aging workers, diet pill

A massive international study of the human genome has caused scientists to rethink some of the most basic concepts of cellular function. Genes, it turns out, may be relatively minor players in genetic processes that are far more subtle and complicated than previously imagined.

An aging workforce, combined with the growing obesity epidemic and the high cost of medical care, could result in an epidemic of preventable illness that might cripple the region's economy, according to a study being released this morning by the New England Health Care Institute and the Boston Foundation.

Sanofi-Aventis SA's weight loss pill Acomplia shouldn't be approved in the United States because the company hasn't showed that the benefits outweigh the risk of suicidal thoughts among those taking the drug, an advisory panel said.

Posted by Elizabeth Cooney at 06:34 AM
June 13, 2007

The revolution will be e-mailed

A quiet revolution in health care has begun with the growth of secure e-mail communication, Dr. John H. Stone writes in tomorrowís New England Journal of Medicine.

"The 'laying on of hands' will increasingly include the pressing of keys," he says in an opinion piece.

Web visits in which doctors answer patientsí non-urgent questions arenít the only services e-medicine can enable, he said. He describes a transition that came about at his clinic in part as self-preservation in the face of round-the-clock contacts flooding office, clinic and home phones and fax machines.

Stone directed the vasculitis center at Johns Hopkins until recently becoming deputy editor for rheumatology at UpToDate, a subscription-based provider of clinical information in Waltham. He will soon resume clinical work part-time at Massachusetts General Hospital.

Appointment scheduling, prescription refills, and messages about routine issues (such as whether an X-ray is needed before a visit) were moved to e-mail.

"In time, secure e-mail communication among patients, physicians, and medical centers (hospitals, emergency rooms) will become the norm, because it is efficient and makes sense," Jones said in an interview (by e-mail).

His clinic had to overcome concerns about privacy and security and get around compatibility issues for e-mails to become part of the patientís record. And even if patients were frustrated by the trouble they had reaching their doctors by telephone, they werenít necessarily ready to pay for Web consultations, which Stone says cost from $10 to $25. Physicians need to be compensated in order for this kind of communication to be a success, he said.

"The extra effort cannot simply be added on to the rest of their work day (and evening)," he said.

The payoff comes not only in convenience, but also in safety, he argues. E-mail between doctors, hospitals, pharmacies and other parts of the healthcare system have the potential to improve medical care by bridging gaps between them.

In a health policy report also appearing in this issue, Dr. David Blumenthal and John P. Glaser of Massachusetts General Hospital discuss the implications of health information technology for doctors, patients and the healthcare system.

"Implementing HIT (health information technology) nationwide will require changing, quite dramatically, the work of millions of health professionals and tens of thousands of institutions throughout our $2 trillion health care system," they write. "In the face of this challenge, the will to improve will be primary, the technology itself secondary, and patience critical."

Posted by Elizabeth Cooney at 05:31 PM
June 13, 2007

Yale buys Bayer complex to expand research

Yale University is buying the Bayer HealthCare complex to house an expansion of its medical and scientific research programs, the university announced today.

The purchase, whose price was not disclosed, includes 550,000 square feet of lab space as well as offices and warehouses on a 136-acre campus that straddles the West Haven and Orange, Conn., border. The property off Interstate 95 has 17 buildings, including one for the former Bayer division Miles Laboratories and a chemical research facility used to develop drugs to treat cancer, diabetes and obesity.

"Yale is already in the midst of a boom in the expansion of its science and medical facilities," Yale President Richard C. Levin said in a statement. "The availability of Bayerís science laboratories will enable us to undertake research programs that we would not have had space to develop for a decade or more."

Closer to home, Harvard University is making its own major expansion in the sciences, including a new science-focused campus that will be built on land it owns in Allston.

Posted by Elizabeth Cooney at 05:28 PM
June 13, 2007

Family members rate Mass. nursing homes highly

By Stephen Smith, Globe Staff

Nine out of 10 families that have a relative living in a Massachusetts nursing home would recommend the facility to other relatives and friends, according to a state survey released today.

The survey, which was conducted from February through April and drew nearly 21,000 responses, gave nursing homes good grades in categories ranging from the quality of staff to the quality of food. When asked to rate their overall satisfaction with their relatives' nursing home, family members on average gave scores above 4 (satisfied) on a scale of 1 (very dissatisfied) to 5 (very satisfied).

The Massachusetts Legislature ordered that the Department of Public Health conduct the survey as a way of measuring quality in the state's roughly 450 nursing homes, which have about 42,000 residents. The survey was first conducted on a more limited basis in 2005, and this year for the first time, it applied to all nursing homes.

About 60 percent of families who were sent surveys completed them. Among six specific categories evaluated, staff fared best, winning high marks for delivering medication on time and respecting cultural and ethnic differences.

Scores were reported separately for facilities that participated in the earlier survey and those that were evaluated for the first time this year. Among facilities being graded for the second time, staff in 2007 received a satisfaction score of 4.19, essentially identical to the earlier mark. Staff at facilities participating for the first time in the survey received a score of 4.11.

The lowest marks were in the activities category, which includes recreation and religious services, ranging between 3.75 and 3.86.

June 13, 2007

Beth Israel Deaconess posts performance data online

By Liz Kowalczyk, Globe Staff

On a portion of its website labeled, "We're putting ourselves under a microscope," Beth Israel Deaconess Medical Center today began publicly comparing its performance -- both good and bad -- in key areas of quality and safety with that of hospitals nationally and to internal goals.

The Harvard teaching hospital reports that it's not meeting its own goals for preventing patients from falling and that it scores below top hospitals nationally in giving pneumonia patients in the emergency room antibiotics within four hours. But on many measures, Beth Israel Deaconess reports it is meeting or exceeding its own goals and the performance of its peers, including in many aspects of cardiac care and orthopedics.

A growing number of hospitals are posting performance data on their websites, part of a new "transparency" movement pushed by employers, insurers and government agencies, which believe more openness will lead to better care and lower costs.

But few hospitals -- Dartmouth-Hitchcock Medical Center in New Hampshire and now Beth Israel Deaconess among them -- include areas where they need improvement as well as those where they shine.

New England Baptist Hospital posts some limited quality indicators on its website, though they're hard to find and the hospital has selected ones only where it does well. Mount Auburn Hospital also shares a limited amount of information comparing how it does preventing four types of infections, but again, in all cases the hospital compares positively to national standards.

June 13, 2007

On the blogs: wait 'til next year

On A Healthy Blog, John McDonough of Health Care For All comments on the Commonwealth Fund report that ranks Massachusetts eighth in the nation on measures of health care access, quality and cost.

As noted by Alice Dembner here this morning, the state's performance was uneven.

McDonough thinks the picture is brighter today.

"Room for satisfaction and pride. Room for improvement. Worth remembering ó data is from 2003-2005. If it were data from today, we would 100% surely be #1 on access, and probably better on quality," he writes. "Got to focus on costs, got to focus on healthy lives and public health."

Posted by Elizabeth Cooney at 01:33 PM
June 13, 2007

Tufts doctor diagnoses conflict of interest

carlat150.bmpAvandia is the latest example of a drug whose dangerous side effects are rarely on the curriculum when drug companies underwrite education that doubles as advertising, Daniel Carlat (left) writes in an opinion piece in today's New York Times.

A professor at Tufts University School of Medicine and editor in chief of The Carlat Psychiatry Report, Carlat was the subject of a profile by Globe reporter Carey Goldberg last month in Health/Science.

"Because pharmaceutical companies now set much of the agenda for what doctors learn about drugs, crucial information about potential drug dangers is played down, to the detriment of patient care," he writes.

Posted by Elizabeth Cooney at 01:30 PM
June 13, 2007

Short White Coat: Signing out for the summer

Short White Coat is a blog written by first-year Harvard medical student Ishani Ganguli. During Ishani's absence this summer, third-year Harvard med student Jennifer Srygley will take on the blogging duties. Her posts will appear here, as part of White Coat Notes.

ishani 2.JPG

First year ended on Friday with a final exam and a frenzy of packing and goodbyes. Though Iím still feeling my way through the medical system, this year has provided me a unique perspective on health and healthcare issues that affect us all and has led me to think deeply about disparities in the system, the patient-doctor relationship, and the science underlying both. Not to mention that I finally buckled down and figured out my own health insurance plan.

As my classmates dispersed to Boston labs to pipette their way to biomedical miracles, and to other continents to save the world one health survey at a time, I flew into Washington, DC, later that Friday with a slightly different plan: to write about such activities, making both medical research and global health news accessible to the public.

Iíll be spending my one summer break at Reuters, through the Kaiser Family Foundationís Media Internship in Health Reporting. Though Memorial Day has passed, my white coat may get some strange looks at the DC Bureauís health desk, so Iíll have to stash it for the summer. But I look forward to returning to Short White Coat in late August when I start my second year.

Posted by Ishani Ganguli at 11:35 AM
June 13, 2007

Mass. healthcare system ranked eighth by foundation

By Alice Dembner, Globe Staff

Massachusetts ranks eighth among the states in the overall performance of its healthcare system, according to a report out today from the Commonwealth Fund, a private foundation that promotes improvements in healthcare.

The scorecard rated each state on measures that included quality of care, access to care, avoidable hospitalizations, costs, and avoidable deaths.

Massachusetts scored particularly well on access, quality and equity of care, based on statistics that are several years old. The ongoing state health insurance initiative is likely to improve those scores if they are measured in the future.

The state ranked much worse Ė- 35th -Ė in avoidable hospital use and costs, which reflected higher hospitalizations of Medicare patients and higher insurance premiums among other things.

If Massachusettsí performance improved to match that of the best states, nearly $240 million would be saved, the report found.

Nationally, the savings could reach $22 billion a year, the study found. In addition, 90,000 lives could be saved annually and millions would receive better care.

June 13, 2007

Today's Globe: mystery shoppers, Stephen Wong, ovarian cancer, tainted water, human tissue industry, TB case, childhood obesity

Mystery shoppers, a new breed of hospital employees in Boston and nationwide, secretly watch fellow workers to see whether patients are treated courteously and helpfully.

wong100.bmpGlobe columnist Steve Bailey worries about the Yankees, but he worries even more about Stephen Wong (left), the scientist who left Harvard for Houston with 20 members of his lab, as reported here last week.

Cancer specialists have identified a set of health problems that may be symptoms of ovarian cancer, and they are urging women who have the symptoms for more than a few weeks to see their doctors.

marine family150.bmpMarine families (such as former Navy Dr. Michael Gros and his wife, Janie, left) who lived at Camp Lejeune in North Carolina over three decades drank water contaminated with toxins as much as 40 times over today's safety standard, federal health investigators said yesterday.

Federal regulators say they have dramatically boosted inspections of companies that harvest cadaver body parts for transplant, acknowledging weaknesses in government oversight of the multibillion-dollar human tissue industry that last year was rocked by scandal.

Health officials trying to stop a globetrotting honeymooner with a dangerous form of tuberculosis got little assistance from his lawyer father and his future father-in-law, a TB specialist who not only balked at stopping the Greek wedding, but went to the ceremony himself, according to e-mails.

Doctors ought to quit using fuzzy terms to define children's weight problems and instead refer to truly fat children as overweight or obese, a committee of medical specialists recommended.

Posted by Elizabeth Cooney at 06:26 AM
June 12, 2007

She calls it 'phenomena,' not art

frankel150.bmpFirst an artist in residence and now a research scientist at MIT and also a senior research fellow at the Institute for Innovative Computing at Harvard, Felice Frankel (left) helps researchers use cameras, microscopes and other tools to display the beauty of science, a story in today's New York Times says.

But she doesn't call it art.

frankelslide100.bmp"My stuff is about phenomena," she says in the story, referring to magnetism or the behavior of water molecules or how colonies of bacteria grow ó phenomena of nature. "When itís art, itís more about the creator, not necessarily the concept in the image."

Frankel and George M. Whitesides, a Harvard chemist and her longtime collaborator, are finishing a book about "small things," Whitesides told the Times, things at the limit of what can be seen with light, even through the microscope.

"She has transformed the visual face of science," he said.

Posted by Elizabeth Cooney at 10:54 AM
June 12, 2007

Brigham and Women's wins $2m equipment grant

Brigham and Women's Hospital is one of 14 research centers to receive a total of $20.65 million in High-End Instrumentation grants to buy advanced biomedical equipment.

The National Institutes of Health made the one-time awards through its National Center for Research Resources, which announced the round of funding today.

Brigham and Women's, the only research institution in Massachusetts to be named, received the maximum award of $2 million. It will purchase a 3 Tesla magnetic resonance imaging scanner to be used for navigation during open surgeries, minimally invasive treatments, vascular procedures and thermal ablation of tumors, the NIH statement said.

Previous winners since the program's inception in 2002 have included Beth Israel Deaconess Medical Center, Brandeis University, Harvard Medical School and Massachusetts General Hospital.

Posted by Elizabeth Cooney at 09:48 AM
June 12, 2007

New Florida school's dean remembers Harvard scholarship

deborah german150.bmpDr. Deborah German (left) won a full scholarship to Harvard Medical School. Now the 1976 graduate wants to offer the same free ride to students at the new medical school where she is dean, according to a story in today's St. Petersburg Times.

The University of Central Florida's medical school isn't even built yet, but it plans to pay the full ride for its entire inaugural class of 40 medical students admitted in 2009, the story says. The four-year scholarship of more than $160,000 would cover tuition and living expenses, under a money-raising campaign to be announced at UCF's main campus in Orlando today.

German's full scholarship to Harvard "made all the difference," she told the Times. Before becoming dean, she held positions at Vanderbilt and Duke.

"I want to offer the same gift that others offered to me."

Posted by Elizabeth Cooney at 09:01 AM
June 12, 2007

Today's Globe: Tufts-NEMC cuts, FBI warnings, autism test cases, China probe, young men's health

At a time when most Boston teaching hospitals are thriving, Tufts-New England Medical Center is
laying off about 35 employees,
less than 1 percent of its staff, because it hasn't met targets for increasing the number of inpatients.

bamford100.bmpFederal agents are warning leaders at some of the region's top universities -- including MIT, Boston College and the University of Massachusetts -- to be on the lookout for foreign spies or potential terrorists trying to steal their research, Warren T. Bamford (left) special agent in charge of the FBI's Boston office, said yesterday.

Lawyers began arguments yesterday in the first of several test cases that may help decide whether the government should pay millions of dollars to parents of children with autism. Nearly 5,000 parents say that vaccinations caused their children to develop autism and many of their claims have been pending for five years. The hearing was held at the "federal vaccine court" set up by Congress 20 years ago when a series of vaccine scares nearly crippled the industry.

china pharma150.bmpChina said yesterday that it was investigating the sale of fake blood protein, a potentially dangerous and widespread practice that underscores the country's problems with product safety. The report centered on an inquiry in the northeastern province of Jilin (above), where 59 hospitals and pharmacies were sold more than 2,000 bottles of counterfeit blood protein.

Young men are making real strides toward greater sexual responsibility, Laura Lindberg, a senior research associate at the Guttmacher Institute, writes in an opinion piece. But they're getting almost no credit for it, and, worse, a snapshot of current policies shows that we're actually making it more difficult for them to continue their progress as they make the transition toward adulthood and eventual fatherhood.

Posted by Elizabeth Cooney at 06:29 AM
June 11, 2007

On the blogs: lab waste, hospital competition

lab bucket100.bmpOn Nature Network Boston, Anna Kushnir lets us in on a dirty little secret: Labs are an environmentalist's nightmare.

"The amount of waste that my lab generates every day makes paper mills look Earth-friendly," she writes reluctantly (while noting it's not her waste bucket at left). "There is nothing I can do about it. I am not willing to risk my samples being contaminated and my experiments failing to save a pair of gloves or spare a pipette."

A Healthy Blog's John McDonough of Health Care For All and Running a Hospital's Paul Levy of Beth Israel Deaconess Medical Center are engaged in a back-and-forth on hospital competition, cost and quality. This follows previous discussions about the power of Partners HealthCare to influence payment rates.

Levy asks. "Since BIDMC has and will continue to have an excellent clinical reputation and very good relationships with community hospitals, multi-specialty groups, and other referring physicians, should we abandon our call for structural changes in the payment system? Would we be better off just living with the current arrangement, i.e., receiving rates that are just below those provided to the dominant provider network?"

McDonough lists financial data for Beth Israel Deaconess and two Partners hospitals, Massachusetts General and Brigham and Women's.

"Yes, BIDMCís major competitors are bigger and badder," he writes. "Doesnít seem, though, that BIDMC is doing too shabbily itself. Doesnít seem like itís time to take the hankies out."

That said, McDonough asks how to measure quality in hopes of moving the converstation forward.

"There are literally hundreds and hundreds of quality indicators, and each provider would like to get paid for those things it does well, and not get penalized for the things it does poorly," he says. "Who should decide which indicators matter, and which do not?"

Posted by Elizabeth Cooney at 03:52 PM
June 11, 2007

Journal Watch makes financial ties more visible

By Carey Goldberg, Globe Staff

Late last month, Dr. Adam Urato filed a complaint with the editors of Journal Watch, which summarizes research highlights for doctors, about an article on antidepressant use during pregnancy.

Urato, an assistant professor and obstetrician at Tufts-New England Medical Center, complained that the piece failed to disclose prominently enough that its author had received payments from several antidepressant makers, and that it painted antidepressant use in a more positive light than warranted by current data.

Now, Urato pointed out to the Globe today, the online journal has changed the piece to display the authorís financial ties right at the bottom of the main body of the article, instead of a few clicks away.

"It's a step in the right direction," he said in an e-mail.

Journal Watch is published by the Massachusetts Medical Society, which also publishes the New England Journal of Medicine.

June 11, 2007

Harvard names acting medical school dean

mcneil100.bmpHarvard has named an acting dean for the medical school in a move that means a permanent appointment will not be made before the current dean leaves.

Dr. Barbara J. McNeil (left), chair of health care policy and professor of radiology, will assume the interim position after retiring dean Dr. Joseph B. Martin steps down June 30. A 1966 graduate of Harvard Medical School, McNeil has been a member of the faculty since 1983.

In a statement from Harvard last week, incoming President Drew Gilpin Faust said it did not seem feasible for a permanent dean to be appointed or to start as dean by July 1.

"We have made good progress in the search for a new dean and identified some very promising candidates," Faust said in the statement.

The Globe reported on May 24 that nationally known cardiologist Dr. Elizabeth Nabel, director of the National Heart, Lung, and Blood Institute, and leading Harvard diabetes researcher Dr. Jeffrey Flier were among the finalists, according to several Harvard doctors and officials with knowledge of the search.

Posted by Elizabeth Cooney at 11:11 AM
June 11, 2007

The cost of health

People do put a price tag on their existence, a story in a special section on the business of health says in today's New York Times.

Studies of real-world situations produce relatively consistent results, suggesting that average Americans value a year of life at $100,000 to $300,000, Peter J. Neumann, director of a program at Tufts-New England Medical Center that measures the cost-effectiveness of new treatments, told the Times.

The story also quotes David Cutler, a professor of economics at Harvard and author of "Your Money or Your Life: Strong Medicine for Americaís Health-Care System." He says such estimates have value, at least as guides to the diseases and conditions that people will spend the most to avoid.

kingsdale150.bmpAlso in the Times section, Jon Kingsdale (left) of the Commonwealth Health Care Connector and John McDonough of Health Care For All describe the challenges of implementing Massachusetts' new healthcare law.

"Weíll try to be the test laboratory for the rest of the country," Kingsdale said.

Posted by Elizabeth Cooney at 08:25 AM
June 11, 2007

Today's Globe: alternative therapies, spiritual needs, culture change, Alzheimer's test, biologics standards

Most cancer patients try herbs, vitamins, or other untested treatments in search of relief, or even a cure. Now, scientists are figuring out which ones might really work.

alyssarosen150.bmpAt Massachusetts General Hospital, the Clinical Pastoral Education program trains people who are already healthcare providers to attend better to their patients' spiritual needs, including Alyssa Rosen (left), a fourth year Harvard Medical School student who just graduated from the program.

brockreeve150.bmpBrock Reeve (left) was hired last year as the Harvard Stem Cell Institute's executive director to broker agreements and transform the way researchers at Harvard and affiliate institutions pursue stem cell science to treat and cure disease. So far, scientists and others give Reeve glowing reviews.

Also in Health/Science, answers about fingernails, paper cuts and Central American frog cousins.

New tests involving blood and brain scans can detect symptoms of Alzheimer's disease, and brief appraisals of real-life functioning can predict who is likely to develop it, researchers said yesterday.

The rush by some in Congress to create a new market for generic drug makers in the field of biologics, (biotech drugs produced from living cell cultures rather than synthesized chemically) would actually sacrifice patient safety over the long term, Una S. Ryan, president and chief executive officer of AVANT Immunotherapeutics Inc., writes on the op-ed page.

Posted by Elizabeth Cooney at 06:02 AM
June 11, 2007

In case you missed it: warming and pests, veterans' misdiagnoses

hemlock300.bmp
Entomologist Brenton Teillon studied a branch
infected with the woolly adelgid at Purgatory
Chasm in Sutton. (Dina Rudick/Globe Staff)

The woolly adelgid is turning Hemlock Hill in Boston's Arnold Arboretum into a hemlock graveyard. It does not get as cold as it used to in New England and the rest of the world. And as temperatures continue to rise, researchers believe the tiny adelgid and dozens of other pests could dramatically expand their range and abundance, Beth Daley writes in the fifth in a series of occasional articles examining climate change, its effects, and possible solutions.

wounded soldier150.bmpAs the medical community learns more about the brain impairments afflicting troops fighting in Iraq and Afghanistan, concern is growing back home that these battle-weary soldiers may be facing yet another obstacle: misdiagnosis. Traumatic brain injury shares many of the same symptoms with a common battlefield psychological condition known as post-traumatic stress disorder.

Posted by Elizabeth Cooney at 06:00 AM
Sponsored Links