U.S. News & World Report ranks best hospitals

From the most recent issue:

In July, America's Best Hospitals turned 18. From the very first, U.S. News has ranked hospitals in pediatrics, identifying medical centers that excel at helping the sickest young patients. We've heard reassuringly few complaints through the years that one or another of the ranked hospitals might not merit such distinction.

Still, improving the usefulness and relevance of the rankings in this important specialty has been a long-standing goal. Mortality data and other information factored into various adult specialty rankings cannot be obtained for children's hospitals. In pediatrics, therefore, the rankings have always relied solely on a facility's reputation among an annual sampling of board-certified physicians in various pediatric specialties. We've long wanted to move beyond reputation.

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ACCME issues policy updates

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Washington state's "decade of pain"

From the Healthdecisions.org article:

Ten years ago, the state of Washington began a major push to make sure doctors weren't undertreating pain. The change was revolutionary for people dealing with chronic pain, but it was also a boon for drug dealers and those with addiction problems.

Between 1997 and 2005, the percentage of people using five major painkillers rose 96 percent in Washington state, according to an Associated Press analysis of statistics from the Drug Enforcement Administration.

Oxycodone, commonly known as Oxy Contin, is responsible for most of the increase in this state. Use of oxycodone increased by 500 percent between 1997 and 2005. Use of morphine and hydrocodon, commonly known as Vicodin, also have increased dramatically: morphine by 223 percent and hydrocodon by 166 percent.

I can personally understand the good intentions of this major effort in the state of Washington for adequate treatment of pain. A few years back I was suspected of seeking pain medication (that was before the x-rays came back). Click here to access the article.

Real Age

According to the Real Age test, I'm 13 years younger than my "calendar" age and I'll live to be 90. I know nothing about the scientific accuracy of this test, so you should probably think of it as entertainment. That said, it might get you thinking about your lifestyle choices. Click here to access.

Gist artistry in silver and gold

Okay, this is the last Friday for a while on Gist artists (don't worry, we're growing up some more of them). This week I'm highlighting the artistry of my cousin, Gary, and his sons over at Gist Silversmiths:

Click here to access their website.

On-site ACCME monitors?

Well, it hit the WSJ's Health Blog:

In a recent conversation with the Health Blog, Kopelow said ACCME will likely start sending auditors to CME lectures. “We could have trained monitors observing CME presentations and reporting their findings to us,” to see whether the presentations are straying from the rules, he said. The group hasn’t yet decided whether the monitors would work undercover.

CME providers that step out of line might find themselves facing sanction more quickly and more often. Providers now have several years to clean up their act, and only one provider or so a year loses its accreditation. “The Senate and others have said we don’t … have as heavy a hand as we could. The ACCME is going to talk about that,” Kopelow said.

The way money passes from drug and device companies to CME providers could also change, Kopelow said. Now, a provider applies to a company for funding, and the company decides whether to grant the request.

Click here to access.

New study from the Center for Studying Health System Change

From the news release:

The proportion of physicians in solo and two-physician practices decreased significantly from 40.7 percent in 1996-97 to 32.5 percent in 2004-05, according to a new national study released today by the Center for Studying Health System Change (HSC).

Changes in physician practice setting and organization have important implications for the practice of medicine and the care patients receive. Some experts believe that large, multispecialty practices, which combine primary care physicians and a range of specialists in the same practice, are the organizational structure with the greatest potential to provide consistently high-quality care.

Despite the shift away from the smallest practices, physicians are not moving to multispecialty practices, the study found. The proportion of physicians in multispecialty practices decreased from 30.9 percent to 27.5 percent between 1998-99 and 2004-05.

While growth of multispecialty practices stalled, other significant changes in physician practice settings and organization took place over the last decade—more physicians moved to larger practices and more physicians gave up an ownership stake in their practices. Physicians increasingly are practicing in mid-sized, single-specialty groups of six to 50 physicians (17.6 % of physicians in 2004-05 vs. 13.1 % in 1996-97). At the same time, the proportion of physicians with an ownership stake in their practice declined from 61.6 percent in 1996-97 to 54.4 percent in 2004-05.

Perspective?

It's Friday and you should be looking forward to the weekend! The artist?...my nephew, Erik Gist. You can access Erik's website by clicking here. Be forewarned, it's not for the faint of heart!

Breast implants and higher suicide rate

From the Los Angeles Times article:

The report in the August issue of the Annals of Plastic Surgery was the most recent to detect a higher suicide rate among women who had their breasts enlarged, providing a gloomy counterpoint to other studies that showed women felt better about themselves after getting implants.

While the study did not look at the reasons behind the suicides, senior author Joseph McLaughlin, a professor of medicine at the Vanderbilt University School of Medicine, said he believed that many of the women had psychological problems before getting breast implants and that their condition did not improve afterward.

Duh. Click here to access the article.

ACCME Responds to Senate Committee on Finance Report

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"New Prescriptions for Neglected Diseases"

That's the title of a new article just published in Open Medicine. From the article:

Consider that, between 1975 and 1999, only nine medicines of the 1393 that were developed targeted the most neglected diseases. (This figure rises to 16 if one considers tuberculosis and malaria.3) Of the remaining 1377 medicines developed, only two made the World Health Organization’s Model List of Essential Medicines. All 16 new medicines for neglected diseases did. In the ensuing five years, an additional 163 drugs were brought to market, of which four were for the treatment of malaria and one targeted a neglected disease—the drug miltefosine for treatment of leishmaniasis.

Click here to read the entire article.

Bibliotherapy

From the Wall Street Journal article:

A growing number of therapists are recommending something surprising for depressed and anxious patients: Read a book.

The treatment is called bibliotherapy, and it is gaining force from a spate of research showing that some self-help books can measurably improve mental health. In May alone, the journal Behaviour Research and Therapy published two studies demonstrating the effectiveness of bibliotherapy in patients with depression or other mood disorders. The national health system in Britain this year is prescribing self-help books for tens of thousands of people seeking medical attention for mood disorders.

Decades after the emergence of the self-help book, it remains one of publishing's hottest categories. This year, U.S. revenue for the category will exceed $600 million, a single-digit jump from 2006, says Simba Information, a market research firm in Stamford, Conn.

Click here to access the article (sub. req.).