A gap in empathy?

From the New York Times article "Taking Time for Empathy":

Listening to transcripts and recordings of 20 conversations between men with lung cancer and their doctors, Dr. Diane Morse of the University of Rochester School of Medicine and her colleagues identified 384 “empathic opportunities” in the discussions — moments when a doctor might respond with a few words to address patient concerns ranging from fear of illness and death, to mistrust about care and the health care system, to confusion about treatment.

They found that the physicians missed 90 percent of opportunities to respond empathetically to their patients.

Click here to access.

Eli Lilly and Merck to disclose payments to physicians

From the New York Times article:

Amid a national debate over the influence of industry money on medical research and practice, two pharmaceutical giants say they will begin publicly reporting payments they make to outside doctors.

Click here to access.

Joint Commission issues alert

"Preventing errors relating to commonly used anticoagulants"; click here to access.

Mobile Resource Centers on Epocrates

From Epocrates:

Recent study data from Manhattan Research, reported that nearly three-fourths of physicians say that they would like more specialty-specific drug references, clinical applications, and medical tools/alerts available to them on their PDA.

Epocrates is listening to our users and answering their call with the launch of Mobile Resource Centers! These new Epocrates Mobile Resource Centers (mRC) provide healthcare professionals with access to valuable information to stay up-to-date on diagnoses and treatments in selected clinical areas. The Centers provide practical and highly-relevant content, including breaking news, research findings, conference highlights and related continuing medical education courses.

If you'd like to learn more, email Lisa Wray at lwray@epocrates.com.

Disclosure/disclaimer: I have no financial relationship with Epocrates and am not making a recommendation, just sharing news.

Senator Grassley sends letter to NIH Director

Click here to access.

Watch out for the tie!

From the New York Times article:

In 2004, a study from the New York Hospital Medical Center of Queens compared the ties of 40 doctors and medical students with those of 10 security guards. It found that about half the ties worn by medical personnel were a reservoir for germs, compared with just 1 in 10 of the ties taken from the security guards. The doctors’ ties harbored several pathogens, including those that can lead to staph infections or pneumonia.

Another study at a Connecticut hospital sought to gauge the role that clothing plays in the spread of methicillin-resistant Staphylococcus aureus, or MRSA. The study found that if a worker entered a room where the patient had MRSA, the bacteria would end up on the worker’s clothes about 70 percent of the time, even if the person never actually touched the patient.

Click here to access the article.

"45 Ways to Use Technology to Green Meetings"

This article by Corbin Ball offers practical suggestions (and links to websites) for going green. Click here to access. Hat tip to Face2Face.

2009 State Medical Licensure Requirements and Statistics

Click here to access.

Alliance and CMSS respond to ACCME's call for comments

Click here for the Alliance's response; click here for CMSS's response.

Is Internet education effective?

Check out the JAMA article "Internet-Based Learning in the Health Professions"; click here to access (sub. req.).

P4P...unintended consequences?

From the New York Times article written by Sandeep Jauhar, M.D.:

Under P4P, there is pressure to treat even when the diagnosis isn’t firm, as was the case with my patient with heart failure. So more and more antibiotics are being used in emergency rooms today, despite all-too-evident dangers like antibiotic-resistant bacteria and antibiotic-associated infections.

I recently spoke with Dr. Charles Stimler, a senior health care quality consultant, about this problem. “We’re in a difficult situation,” he said. “We’re introducing these things without thinking, without looking at the consequences. Doctors who wrote care guidelines never expected them to become performance measures.”

Click here to read this article.

National Health Plan Collaborative Publishes Online Toolkit

The National Health Plan Collaborative has created this toolkit of resources, lessons, best practices and case studies to help other health plans join the effort to reduce disparities. The toolkit shares what the Collaborative's members have done to develop and test new methods of measuring and addressing racial and ethnic disparities so that other health care decision-makers and leaders can learn from this work, implement these best practices and make the case for addressing the unacceptable differences in health care and health outcomes for health plan members throughout the country.

Useful resources featured in this toolkit include:

• Health plan case studies;
• Sample tools, forms, policies and resources for implementation;
• Videos of experts talking about the importance of reducing disparities and about firsthand experiences in developing and implementing interventions; and
• A compilation of resources in this field.

Click here to access.

New TV talk show "The Doctors"

Apparently the brain child of Dr. Phil's child, there's a new talk show in town:

...The Doctors, four renowned physicians with different medical specialties – ER physician (and former ABC “Bachelor”) Dr. Travis Stork; OB/GYN Lisa Masterson; cosmetic surgeon Dr. Andrew Ordon and pediatrician Dr. Jim Sears.

This groundbreaking new talk show does for health care what Dr. Phil has done for psychology – provides frank discussions in a fascinating, off-the-cuff manner.

Click here to access this new show's website (above excerpt from said website).

"FDA Final Guidance

on Procedures For Determining Conflict of Interest and Eligibility for Participation in FDA Advisory Committees" is available online. Click here to access.

"Potential Signals of Serious Risks/New Safety Information Identified by the Adverse Event Reporting System"

Quarterly report issued by the FDA, click here to access. Hat tip to Pharmalot.

Senate Finance Committee to continue hearings on health care reform

From the news release:

Senate Finance Committee Chairman Max Baucus (D-Mont.) today announced the next three hearings in the panel’s year-long review of issues in heath care reform. Baucus said the September hearings will focus on health care quality, delivery system reform, and insurance market reform. Throughout 2008, Baucus has convened hearings, roundtables, and events to prepare for congressional action on health reform next year. Baucus said today that he intends for the panel’s comprehensive examination of health care reform to continue to be a top priority during the next session of Congress.

Click here to access.

The implementation buzz

There's a new journal that CME professionals might want to take a serious look at...Implementation Science. Oh, yeah, and it's open access...very cool...

Click here to check it out.

The fight against superbugs

From the Wall Street Journal article:

The efforts, known as antimicrobial stewardship programs, team top pharmacists, infectious-disease specialists and microbiologists. The groups monitor the use of a hospital's antibiotics and restrict prescriptions of specific drugs when they become less effective at fighting infections. The heightened vigilance comes as the federal Medicare program plans to begin refusing to pay hospitals to treat preventable infections that patients contract while under the facilities' care.
...
Some VHA member hospitals are working with the University of Florida in Gainesville, which offers a free program to analyze a hospital's patterns of drug resistance and compares these with regional, state or national benchmarks. The program has been used by about 400 hospitals, according to its developer, John Gums, a professor of pharmacy and medicine, who has financed the program with grants from pharmaceutical companies.

Click here to access (sub. req.)

Interesting JAMA commentaries

Check 'em out:

New Developments in Managing Physician-Industry Relationships
David J. Rothman; Susan Chimonas
JAMA. 2008;300(9):1067-1069.

Industry-Sponsored Clinical Research: A Broken System
Marcia Angell
JAMA. 2008;300(9):1069-1071.

Industry Support of Medical Education
Arnold S. Relman
JAMA. 2008;300(9):1071-1073.

Click here to access (sub. req.).

Operation Medical Libraries (OML)

OML is a grass roots efforts whose mission is providing medical texts and journals to medical schools and hospitals in Iraq and Afghanistan. Originally founded as Books Without Borders, it started in April 2007 by Valerie Walker, Director of the UCLA Medical Alumni Association (MAA).

Click here to access the OML website.

Antipsychotics and risk of stroke

From the Washington Post article:

All antipsychotic drugs can increase the risk of stroke, but the risk is greatest among older patients with dementia, British researchers report.

Concerns about the risk of stroke and antipsychotics were first raised in 2002, especially in people with dementia. In 2004, Britain's Committee on Safety of Medicines recommended that antipsychotics not be used in people with dementia. And, in 2005, the U.S. Food and Drug Administration ordered manufacturers of atypical antipsychotics to add a black box warning to their products about the increased risk for stroke.

Click here to access the WP article.

Thiazolidinediones and heart failure

From the Science Daily article:

A class of oral drugs used to treat type 2 diabetes may make heart failure worse, according to an editorial published online in Heart Wednesday by two Wake Forest University School of Medicine faculty members.

"We strongly recommend restrictions in the use of thiazolidinediones (the class of drugs) and question the rationale for leaving rosiglitazone on the market," write Sonal Singh, M.D., M.P.H., assistant professor of internal medicine, and Curt D. Furberg, M.D., Ph.D., professor of public health sciences. Rosiglitazone and pioglitazone are the two major thiazolidinediones.
...
Singh said in an interview, "Safer, cheaper and more effective treatment alternatives are available that do not carry these negative cardiovascular risks in patients with diabetes. The rationale for the use of the thiazolidinediones is unclear."

Click here to access the SD article.

Study results indicate bypass better than angioplasty

...at least at the one year mark. From the AP article:

For heart patients with clogged arteries, the choice between bypass surgery or an angioplasty may come down to one question: How many procedures would you like to have?

In research presented Monday at the European Society of Cardiology meeting in Munich, experts concluded that while bypass surgery and angioplasty offer comparable results, patients who have angioplasties are twice as likely to require another procedure within a year.

...

Doctors cautioned that more data is still needed about the pros and cons of bypass surgery versus angioplasties, and that patients needed to be tracked for at least five years.

Click here to access.

Ova not so sure?

From the New York Times article "Cancer Test for Women Raises Hope, and Concern":

“You’ve got industry trying to capitalize on fear,” said Dr. Andrew Berchuck, director of gynecologic oncology at Duke University and the immediate past president of the society. “We’d all love to see a screening test for ovarian cancer,” he added, “but OvaSure is very premature.”

OvaSure’s debut also raises questions about whether greater regulation is needed to assure the validity of a trove of sophisticated new diagnostic tests that are entering the market and are being used as the basis for important treatment decisions. OvaSure did not go through review by the Food and Drug Administration because the agency generally has not regulated tests developed and performed by a single laboratory, as opposed to test kits that are sold to laboratories, hospitals and doctors.

Think sensitivity and specificity, and positive and negative predictive values, folks!! Click here to access the NYT article. If you'd like to learn more about sensitivity and specificity, etc., check out the BMJ article "Understanding sensitivity and specificity with the right side of the brain" published in 2003 (sub. req).

ACCME releases 2007 annual report data

Click here to access.

Russia an epicenter for MDR-TB

An excerpt from the Scientific American article "A Report from the Russian Front in the Global Fight Against Drug-Resistant Tuberculosis":

The Siberian provinces of the central Russian plateau—poor, even by Russian standards, with high rates of alcoholism, drug abuse and a large prison population—are among the epicenters of a worldwide epidemic of drug-resistant tuberculosis. Whereas the 490,000 reported cases of MDR-TB account for just a small fraction of the 9.2 million new cases and 1.7 million deaths from TB reported to the World Health Organization in 2006, MDR-TB represents a significant global public health hazard. In parts of Siberia, it accounts for more than 15 percent of all cases.

Click here to access the SA article.

Another medical school moves to pooled funding for CME

From the MarketWatch online article:

The Stanford University School of Medicine will no longer accept support from pharmaceutical or device companies for specific programs in continuing medical education, as industry-directed funding may compromise the integrity of these education programs for practicing physicians, officials said.
...
Under the new guidelines, the school may accept commercial support for CME only if it is provided for broad areas, such as medical, pediatric and surgical specialties; diagnostic and imaging technologies; and health policy and disease prevention. Funding must not be linked to a specific course, topic or program. In addition, commercial exhibits will no longer be permitted at Stanford-sponsored CME activities on or off campus.

Click here to read the entire article.

New FDA labeling rule

From the CCNMoney.com article:

Government regulators have issued new rules designed to keep drug warning labels clear and concise, though some say the new guidelines would also shield drugmakers from lawsuits.

The regulations from the Food and Drug Administration, which were released Thursday and take effect next month, explain when drug and medical device companies are responsible for rushing out safety updates on their products.

Click here to access the CCNMoney.com article. Also check out Drug and Device Law's blog entry on this rule by clicking here.

Ready for some fun?

From the New York TimesN article "Best Online Psychology Tests":

1. The Stroop Test. A fun test that measures how fast and flexible a thinker you are by using color-coded words.

2. The Worst Sounds. Grab your headset and take this online sound test to find out which sounds bother you the most. You’ll hear snoring, crying babies and nails on the chalkboard.

3. Personality Test. Check out the “I Just Get Myself” personality test. It comprises just 40 easy questions but delivers a surprisingly insightful (at least I thought so) assessment of your personality traits.

Click here to access the NYT article (and more online tests).

JAMA article on the history of CME

Recommend y'all read it; click here to access (sub. req.).

FDA to mandate special training on narcotic prescription?

From the New York Times article:

Should doctors be required to undergo special education in order to prescribe powerful narcotics? The Food and Drug Administration may soon recommend that they do so, though such a move would most likely prove controversial.

“I think it is a good idea, and it is something we are considering,” said Dr. Bob Rappaport, the director of the division of Anesthesia, Analgesia and Rheumatology Products at the F.D.A. But the agency itself does not have the authority to take such a step, Dr. Rappaport said.

Typically, state medical boards, rather than the federal government, impose licensing requirements on doctors, including the type of continuing education they must receive. A few states, including California, now provide doctors with education about the treatment of pain patients. But nationally, state medical boards have shown little interest in mandating added training in the use of potent pain medications or in screening patients for those prone to drug abuse.

Click here to access.

Survey indicates disruptive behaviors impact patient care

Check out the Joint Commission Journal on Quality and Patient Safety article "A Survey of the Impact of Disruptive Behaviors and Communication Defects on Patient Safety." The authors make 12 recommendations on how organizations can address/prevent disruptive behaviors; ONE of which is education and training. A tidbit -- physicians are not alone in exhibiting disruptive behaviors.

Click here to access (sub. req.).

Coalition for Healthcare wants your input

regarding ACCME's Calls for Comments; from the Coalition's website posting:

We seek data and information that will support our comments as well as volunteers to help craft the Coalition comment. Please participate in the Coalition effort and support individual comments by your company or yourself. The Coalition comment would be strengthened by position statements supported by compelling data and examples of how commercially funded programs advance clinical knowledge in critical areas and advance patient care.

Click here to access the Coalition's commentary on this and how you can provide your input into this debate.

MA Governor signs 2863

From the Boston Globe article:

Governor Deval Patrick yesterday signed into law one of the nation's strictest limits on gifts given to medical professionals by drug salespeople, the most contentious measure contained in a broad package intended to improve healthcare safety and curb skyrocketing costs.
...
Still, the limits in the law put Massachusetts at the forefront of states in cracking down on the use of financial incentives to persuade doctors to prescribe particular drugs or medical devices. In addition to banning some gifts and requiring disclosure of others, it calls for the state to develop a code of conduct for industry representatives that includes a $5,000 fine for each violation.

Click here to access the TBG article.

6 rules for providers to keep in mind when they see patients...

From the New York Times article "Six Rules Doctors Need to Know":

Rule 1: They don’t want to be at your office.
Rule 2: They have a reason to be at your office.
Rule 3: They feel what they feel.
Rule 4: They don’t want to look stupid.
Rule 5: They pay for a plan.
Rule 6: The visit is about them.

Do you think any of these link up with the ACGME/ABMS core competencies? Click here to access the NYT article.

FDA alert issued...

"Information for Healthcare Professionals Simvastatin (marketed as Zocor and generics), Ezetimibe/Simvastatin (marketed as Vytorin), Niacin extended-release/Simvastatin (marketed as Simcor), used with Amiodarone (Cordarone, Pacerone)"

Click here to access the alert.

Important legislation introduced

From the news release on the Comparative Effectiveness Research Act of 2008:

Senate Finance Committee Chairman Max Baucus (D-Mont.) and Budget Committee Chairman Kent Conrad (D-N. D.) introduced last night legislation to improve the quality of health care that Americans receive, by creating national priorities for, and conducting and distributing research findings on the effectiveness of different health care treatments. The Comparative Effectiveness Research Act of 2008 will establish the Health Care Comparative Effectiveness Research Institute to review evidence and produce new information on how diseases, disorders, and other health conditions can be treated to achieve the best clinical outcome for patients. The Congressional Budget Office has signaled that national health care spending could be reduced if physicians and patients had more unbiased data on the effectiveness of the treatments available to them.

Click here to access the entire news release.

Med com companies take another hit

From the Business Week article "Teaching Doctors--or Selling to Them?":

Trying to steer clear of potential conflicts of interest, two medical industry giants are distancing themselves from a little-known breed of marketing specialists. The recent steps by the drugmaker Pfizer (PFE) and Zimmer Holdings (ZMH), a medical device manufacturer, illuminate subtle promotional tactics other companies continue to aim at doctors, despite mounting concern on the part of some physicians and ethicists.

Click here to access. Hat tip to Dr. Carlat.

SACME and NAAMECC release "joint" assessment tool

What's it used for?...to assess potential joint sponsors. Click here to access.

Regional differences in health care (and cost)

I've directed your attention to this resource before, but methinks it bears repeating. If, for instance, you are interested in seeing how your region stacks up against the national average (surgery rates per 1,000 Medicare enrollees) on knee replacement, heart bypass, mastectomy, then click here. Encourage y'all to click around in it...as indicated by the blog heading, there is cost information as well.

New study indicates that U.S. HIV infection rates higher than previously estimated

From the New York Times article:

The United States has significantly underreported the number of new H.I.V. infections occurring nationally each year, with a study released here on Saturday showing that the annual infection rate is 40 percent higher than previously estimated.
...
The findings confirm that H.I.V., the virus that causes AIDS, has its greatest effect among gay and bisexual men of all races (53 percent of all new infections) and among African-American men and women.
...
Dr. Gerberding said the new findings were “unacceptable,” adding that new efforts must be made to lower the infection rates. “We are not effectively reaching men who have sex with men and African-Americans to lower their risk,” she said.

The study will be published in the August 8th issue of JAMA. Click here to access the NYT article.

MA bill 2863 passes (altho altered a bit)

Click here to access.

We need a national joint registry!

From the New York Times article:

Dr. Dorr, 67, is a veteran of more than 5,000 hip replacement surgeries, a $30,000 to $40,000 procedure lasting more than an hour in which metal tools that would look at home in a garage are clanged and bashed against bone. He has been at it for three decades, long enough to say that history is repeating itself because this country does not gather evidence of how patients fare.

Eight years ago, he alerted another implant producer, Sulzer Orthopedics, that patients with one of its hip implants were having such pain they needed replacement surgery almost immediately. Sulzer withdrew the device six months later, but about 3,000 patients got replacements for the implant, which had become contaminated by oil during manufacturing. Sulzer, deluged by lawsuits, filed for bankruptcy protection.

But because of their registry, Swedish doctors were alerted after just 30 patients got the Sulzer hip that it had an alarmingly high replacement rate, Dr. Malchau said.

Click here to access.

Domestic fatal medication errors

From the New York Times article:

The authors blame soaring home use of prescription painkillers and other potent drugs, which 25 years ago were given mainly inside hospitals.

''The amount of medical supervision is going down and the amount of responsibility put on the patient's shoulders is going up,'' said lead author David P. Phillips of the University of California, San Diego.

The findings, based on nearly 50 million U.S. death certificates, are published in Monday's Archives of Internal Medicine. Of those, more than 224,000 involved fatal medication errors, including overdoses and mixing prescription drugs with alcohol or street drugs.

Deaths from medication mistakes at home increased from 1,132 deaths in 1983 to 12,426 in 2004. Adjusted for population growth, that amounts to an increase of more than 700 percent during that time.

Click here to access.

Lack of trust and patient compliance

From the New York Times article:

About one in four patients feel that their physicians sometimes expose them to unnecessary risk, according to data from a Johns Hopkins study published this year in the journal Medicine. And two recent studies show that whether patients trust a doctor strongly influences whether they take their medication.

Click here to access.

What price vanity?

From the New York Times article:

Dr. Donald Richey, a dermatologist in Chico, Calif., has two office telephone numbers: calls to the number for patients seeking an appointment for skin conditions like acne and psoriasis often go straight to voice mail, but a full-time staff member fields calls on the dedicated line for cosmetic patients seeking beauty treatments like Botox.

Click here to read the NYT article. It might not be fair and balanced, but it's interesting!

California the first state to ban trans fat in restaurants

From the New York Times article:

Under the new law, trans fats, long linked to health problems, must be excised from restaurant products beginning in 2010, and from all retail baked goods by 2011. Packaged foods will be exempt.

New York City adopted a similar ban in 2006 — it became fully effective on July 1 — and Philadelphia, Stamford, Conn., and Montgomery County, Md., have done so as well.

Click here to access the NYT article.

ICU-based pharmacists reduce medication errors

Check out this just published info in the American Journal of Health-System Pharmacy article by clicking here. (sub req.)

Study on health care value in the U.S.

From the New York Times article "While the U.S. Spends Heavily on Health Care, a Study Faults the Quality":

American medical care may be the most expensive in the world, but that does not mean it is worth every penny. A study to be released Thursday highlights the stark contrast between what the United States spends on its health system and the quality of care it delivers, especially when compared with many other industrialized nations.

The report, the second national scorecard from this influential health policy research group, shows that the United States spends more than twice as much on each person for health care as most other industrialized countries. But it has fallen to last place among those countries in preventing deaths through use of timely and effective medical care, according to the report by the Commonwealth Fund, a nonprofit research group in New York.

Click here to access.

National Pharma Audioconference: Analyzing the Newly Revised PhRMA Code

Click here to access. (Disclosure: I have no financial relationships with the sponsors of this audioconference).

ACCME Receives Clarification from CMS Regarding Stark II Regulations

Click here to access.

Massachusetts goes voluntary

From the Boston Globe article:

A hotly-debated ban on drug companies providing gifts and meals to physicians was stripped out of proposed legislation a House committee approved late yesterday.

The panel also removed requirements that drug and medical device companies report payments they make to doctors for consulting and speaking to other physicians and that the Department of Public Health post that information on its website. A proposed $5,000 fine per violation was also dropped from the bill, which is expected to be voted on by the full House today.

Instead, the measure would simply require drug companies to adopt a marketing code of conduct, such as the one the pharmaceutical industry's trade association announced last week while negotiations on the Massachusetts bill were in progress.

Click here to access the article.

ACCME Responds to Senate Special Committee on Aging

Click here to access.

Gary Gist wins American Cowboy Culture Award

From the www.myhorse.com article on my cousin:

Gary Gist, founder and president of Gist Silversmiths, named 2008 recipient of the American Cowboy Culture Award for achievement in Western Wear and Equipment. The award will be presented during the National Cowboy Symposium and Celebration in Lubbock, TX on September 4-7.

The American Cowboy Culture Awards program began in 1989 and was designed to honor individuals or institutions who have contributed significantly to Western heritage and cowboy culture. Today, it is the largest and most comprehensive awards program of its kind in the nation.

Click here to access.

Senator Grassley sends letter to medical society!

From the New York Times article:

After a series of stinging investigations of individual doctors’ arrangements with drug makers, Senator Charles E. Grassley, Republican of Iowa, is demanding that the American Psychiatric Association, the field’s premier professional organization, give an accounting of its financing.
...
“I have come to understand that money from the pharmaceutical industry can shape the practices of nonprofit organizations that purport to be independent in their viewpoints and actions,” Mr. Grassley said Thursday in a letter to the association.

Click here to access the article.

AMA to apologize for past racism

From the Washington Post article:

The country's largest medical association is set to issue a formal apology today for its historical antipathy toward African American doctors, expressing regret for a litany of transgressions, including barring black physicians from its ranks for decades and remaining silent during battles on landmark legislation to end racial discrimination.
...
Specifically, the panel noted that the AMA permitted state and local medical associations to exclude black physicians, effectively barring these doctors from the national organization. In the early 20th century, the organization listed black doctors as "colored" in its national physician directory. In addition, the AMA was silent during debates over the landmark Civil Rights Act of 1964, and, for years, declined to join efforts to force hospitals built with federal funds to not discriminate.

Click here to access.

No more pens and mugs from pharma?

From the New York Times article:

The pens, pads, mugs and other gifts that drug makers have long showered on doctors will be banned from pharmaceutical marketing campaigns under a voluntary guideline that the industry is expected to announce Thursday.

The industry’s Code on Interactions with Health Care Professionals will ask the chief executives of large drug makers to certify in writing that “they have policies and procedures in place to foster compliance with the code.” The code was written by the Pharmaceutical Research and Manufacturers of America, the industry’s trade association.

Wow, this really gets at the real issues (NOT!). Click here to read the article.

A grave problem

From the New York Times article:

“From 2000 to 2007, Medicare paid 478,500 claims containing identification numbers that were assigned to deceased physicians,” the subcommittee said in a new report. “The total amount paid for these claims is estimated to be between $60 million and $92 million. These claims contained identification numbers for an estimated 16,548 to 18,240 deceased physicians.”

Click here to access the NYT article.

Junk food at U.S. public schools

From the Robert Wood Johnson Foundation news release:

The foods and food policies in U.S. public schools become significantly less healthy as students progress from elementary to high school, according to new research published today in Pediatrics. More than 96 percent of high schools have vending machines, and 91 percent of them sell some unhealthy options, while only 17 percent of elementary schools have vending machines on campus. In addition, 93 percent of high schools and 92 percent of middle schools sell foods and beverages a la carte, and nearly 80 percent of these schools offer unhealthy options in their a la carte sales.

Click here to read the entire news release. Click here to access the journal abstract.

Pre-Publication Preview of Joint Commission 2009 Standards

Click here to access.

Wrong side surgery incident

From the Boston Globe article:

An experienced surgeon at Beth Israel Deaconess Medical Center operated on the wrong side of a patient this week, a serious medical mistake disclosed in an e-mail that hospital administrators sent to staff members yesterday.

State authorities are investigating the errant surgery, which happened Monday during an elective procedure. A hospital administrator declined to provide specifics about the operation but said it did not involve removal of organs and did not cause permanent damage to the middle-aged patient, who was expected to suffer short-term discomfort. A state health regulator described the operation as an orthopedic procedure.

Click here to access.

New York Times "The Evidence Gap: A Series"

Encourage y'all to read the first two articles in this NYT series of articles. Click here to access.

Check out this Medical Meetings article

"Pfizer Cuts Off Funding for Medical Education Companies"; click here to read it!

A new trend in pharma support of CME?

From the CNNMoney.com article:

Pfizer Inc. (PFE), hoping to temper criticism that it's improperly influencing doctors, is eliminating direct financial support for medical-education courses that are offered by third-party companies.

The New York drug giant will continue to fund so-called continuing medical education, or CME, courses at academic institutions, teaching hospitals and those supported by medical societies. But it will no longer directly support CME courses offered by for-profit medical-education and communication companies.

Pfizer may continue indirect support for commercial CME companies as well. That's because the academic centers and medical associations that it supports may contract with CME companies, Clary said. "The distinction we're making is we're not directly paying them," she said.

Good news for academia and medical societies. What about the non-academic hospital systems? Click here to read the article. Hat tip to Pharmalot.

New rapid diagnostic test for MDR-TB

From the WHO news release:

People in low-resource countries who are ill with multidrug-resistant TB (MDR-TB) will get a faster diagnosis -- in two days, not the standard two to three months -- and appropriate treatment thanks to two new initiatives unveiled today by WHO, the Stop TB Partnership, UNITAID and the Foundation for Innovative New Diagnostics (FIND).

Click here to read more.

ACCME receives letter from Senate Special Committee on Aging

Click here to access.

Big Bad Pharma?

About 74% of Americans think so, according to a recent Harris Interactive Poll. Click here to access the survey results.

Statehealthfacts.org update

Statehealthfacts.org has recently added new and updated data on Health Status, Health Costs & Budgets, Managed Care and Health Insurance, and Women’s Health. Click here to access.

WHO issues surgical safety checklist and implementation manual

Click here.

Grassley news release regarding conflicted NIH research grant recipients

From the news release:

Senator Chuck Grassley is asking members of Congress who hold leadership positions on the appropriations committee to join his effort to hold the National Institutes of Health accountable for monitoring conflicts of interest in government sponsored medical research.

“There’s mounting evidence that the NIH hasn’t done due diligence in keeping track of industry payments to medical researchers,” Grassley said. “With the objectivity and integrity of research at stake, along with public trust in the system, there are plenty of reasons for Congress to step in to establish penalties for grantees who fail to report financial conflicts and to bring transparency to taxpayer funded medical research.”

Current federal law requires the NIH to monitor financial conflicts of interest by requiring the institutions who receive grants who receive grants to collect and manage information on the money that their researchers receive from drug and device makers and others in industry. Recent reports have revealed that this tracking is not happening in individual cases. In addition, the Inspector General for the Department of Health and Human Services reported in January that the NIH does not adequately monitor its extramural grants for conflicts of interest.

Click here to access.

A bitch with a little gray hair wins!

Kelly is my cousin Lynn's dog, give it watch if you love dogs!

ACCME recent news releases hit the blogs

Check out these two recent blog entries:

"Using ACCME's New Rules for Bias and Profit" courtesy of the Carlat Psychiatry Blog
"ACCME Plans to Bulk Up While Cracking Down...I Think...Until It Will Exist No More" courtesy of the Pathophilia Blog

A girl and her dog

From Britain's Got Talent:

AAMC news release on industry support of CME!

From the news release:

The AAMC (Association of American Medical Colleges) today urged all medical schools and teaching hospitals to adopt policies that prohibit drug industry gifts and services to physicians, faculty, residents, and students, and to limit industry support of continuing medical education activities. The recommendations were part of a new AAMC report, "Industry Funding of Medical Education," unanimously approved by the association's Executive Council. In adopting the report, the AAMC's leadership urged all association members to implement policies and procedures, consistent with the report's guidelines, by July 1, 2009.

The report was the result of a 14-month effort by an AAMC task force, established in 2006, to examine the benefits and pitfalls associated with industry funding of medical education, and to develop principles, recommendations, and guidelines to help medical schools and teaching hospitals better manage their relationships with industry. The panel was chaired by retired Merck Chairman and CEO Roy Vagelos, M.D., and the vice chair was William Danforth, M.D., former chancellor of Washington University. The task force membership included institutional leaders, faculty, residents, students, CEOs from the pharmaceutical, biotechnology, and medical device industries, ethicists, and public representatives.

"Interactions between industry and academic medicine are vital to public health," said AAMC President and CEO Darrell G. Kirch, M.D. "But they must be principled partnerships effectively managed to sustain public trust in both partners' commitment to patient welfare and the improvement of health care. The recommendations outlined in this report provide essential guidance for how medical schools and teaching hospitals can achieve this important goal."

Click here to access.

Experimercial?

Giovanni A. Fava, Professor of Clinical Psychology at the University of Bologna, Itay, makes some strong statements in an opinion piece "Should the drug industry work with key opinion leaders? No" just published in the British Medical Journal.

It's definitely worth a read, as is "Should the drug industry work with key opinion leaders. Yes" written by Charlies Buckwell, CEO, Complete Medical Group.

Click here to access (sub. req.).

Doctor Radio?

Yep! Sirius Satellite Radio has launched "Doctor Radio" which features real doctors responding to callers' questions. Click here to find out more.

Epocrates and Joslin Launch Mobile Resource Center on Diabetes

From the Epocrates press release:

Clinicians across America now have access to the knowledge and opinions of a renowned diabetes expert, thanks to a collaboration between Joslin Diabetes Center, the world’s largest diabetes clinic, research center and provider of diabetes education, and Epocrates Inc., a leading developer of handheld clinical applications.

Richard Jackson, M.D., Director of Medical Affairs, Healthcare Services, Joslin Diabetes Center, is the sole contributing editor for Epocrates' new diabetes mobile resource center. This convenient handheld resource is designed to provide an intelligent, editorially independent summary of the most important clinical news and research in diabetes.

With diabetes rates on the rise among Americans and the influx of medical news and developments, clinicians need a trusted source to help them sort through the clutter and keep current. The mobile resource center’s content, including scientific articles, research findings and breaking news, is selected and commented upon by Dr. Jackson to support clinicians' care of patients with diabetes and its related conditions.

Click here to read the entire press release.

ACCME, ANCC and ACPE CEOs respond to Macy report

Click here to access.

Back to the drawing board for CEJA Report 1?

According to the Policy and Medicine blog, the AMA House of Delegates rejected CEJA Report 1 in its current form. However, don't expect this issue to just fade away. Click here to access the Policy and Medicine blog posting.

Survey results on patient use of physician rating websites

From the amednews.com article:

A Harris Interactive poll commissioned by the California HealthCare Foundation found that although more than 80% of the state's adults turn to the Internet for health-related information, less than one-quarter have looked at physician ratings sites. Only 2% of those surveyed made a change in physicians based on information posted on a rating site.

Click here to access the article.

Fasten your seatbelts!

Lay your eyes on the new ACCME policy announcements and calls for comments. Click here to access. And check out the ACCME Statement in response to IOM. Click here to access.

SACME survey results on proposed CEJA policy

SACME recently surveyed its members regarding CEJA's proposed policy which would pretty much ban industry support of "CME" although industry could still train physicians on new equipment or new devices.

Per SACME President Melinda Steele the survey results of 56 SACME members on the proposed policy "...should in no way be construed as an official position or opinion of SACME." The results of two survey questions:

The CEJA report accurately represents the current environment in academic CME:

Strongly Disagree 33.9%
Disagree 23.2%
Neutral 8.9%
Agree 23.2%
Strongly Agree 10%

The CEJA report should be referred back to CEJA for further action:

Strongly Disagree 10.7%
Disagree 7.1%
Neutral 3.6%
Agree 28.6%
Strongly Agree 50.0%

If the entire survey results get posted, I'll provide the url.

Doctor Nurse?

From the amednews.com article:

Starting this fall, doctor of nursing practice graduates will be able to take a certification test that proponents say will set a national standard for DNPs and add to the profession's credibility.

The voluntary test, being created by the National Board of Medical Examiners, is based on the medical licensing exam. It will be offered at a time of growing momentum in the DNP movement: About 200 nursing schools are expected to offer the two-year DNP degree by 2015 -- more than double the programs available today.

Click here to access the article.

Psych researchers under scrutiny

From the New York Times article:

A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators.

By failing to report income, the psychiatrist, Dr. Joseph Biederman, and a colleague in the psychiatry department at Harvard Medical School, Dr. Timothy E. Wilens, may have violated federal and university research rules designed to police potential conflicts of interest, according to Senator Charles E. Grassley, Republican of Iowa. Some of their research is financed by government grants.

Click here to access the article.

Supreme Court justices divest their pharma stock

From the AP article:

Chief Justice John Roberts and Justice Samuel Alito, whose investments forced them to sit out cases before the Supreme Court, have reduced their stock holdings, their latest financial disclosures show.

Click here to access. Hat Tip to Pharmalot.

A little dimmer or a little brighter?

You decide. From the BMJ article:

The US drug industry has persuaded key Congressional legislators to water down proposed legislation that would require detailed public disclosure of payments and gifts to doctors.

Click here to access.

More on Pri-Med survey of physicians regarding CEJA Report 1

The full results of the poll can be found on Pri-Med's website at www.pri-med.com. Click here to access.

RWJF announces $300 million commitment to improve quality of health care in U.S.

From the RWJF news release:

With increasing reports of dangerous deficiencies in the quality of health care, the nation’s largest health care foundation today announced a $300-million commitment to improve quality in regions across the United States.

Underscoring the scope of the problem, the Robert Wood Johnson Foundation (RWJF) also released new research showing that the quality of care people receive can vary dramatically depending on their race and where they live.

The $300-million commitment to improve health care in 14 communities, that together cover 11 percent of the U.S. population, is the largest effort of its kind ever undertaken by a U.S. philanthropy. Known as Aligning Forces for Quality, the community-focused program will lift the overall quality of health care, reduce racial and ethnic disparities and provide models for national reform.

“Across America, there are serious gaps between the health care that people should receive and the care they actually receive,” said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation.

Click here to access the news release.

Physicians Disagree with Proposed Ban of Commercial Support of CME

Pri-Med recently conducted a survey of 268 physicians regarding the CEJA proposed policy; some of the results:

1. The CEJA of the AMA published a report last week that stated industry-support of CME should end. Do you agree, disagree or have no opinion?

• 92% of the doctors disagree with the ban

2. If industry funding of CME ends, how would this impact the ways in which you obtain CME?

On the whole, physicians state three primary ways it will impact them:

• It will be more expensive to receive continuing medical education, which makes it more difficult for physicians to stay up-to-date
• The quality of CME will decrease
• Fewer opportunities available will hurt patient care

A hat tip to Marissa Seligman, Ph.D., of Pri-Med for these results. (To the best of my knowledge, the survey results are not yet posted online, when and if they are I will certainly repost with the link.)

AMSA PharmFree Scorecard 2008

The American Medical Student Association (AMSA) has posted their 2008 PharmFree Scorecard. Click here to check it out (encourage y'all to read the methodology information before freaking out).