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The Medical Arms Race Heats Up

I have written many times on this blog about one shining example of the medical arms race – the slow (some would say not so slow), steady, proliferation of huge and hugely expensive proton beam radiation facilities in medical centers in the US. I have written about how the proliferation never seems to occur in single units – rarely just one per town – but almost always two simultaneously – the medical arms race among health care institutions and providers at play.

The latest chapter is playing out in San Diego, as captured by HealthLeaders Media Online senior editor Cheryl Clark.


“As members of the debt reduction “super committee” wrestle to slice $400 billion from Medicare over 10 years, I wonder what they might say about the $430 million proton beam center war now being waged a few miles from my home in San Diego.

This nearly half a billion dollar investment in proton therapy is a big part of Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Doctors Fail To Disclose Evidence About Spine Product’s Cancer Risk

Reporter John Fauber has published the latest in his “Side Effects” watchdog series, headlined “Doctors didn’t disclose spine product cancer risk in journal: Spine-product paper omitted key data.” Excerpts:

“Doctors paid millions of dollars by Medtronic failed to identify a significant cancer risk with the company’s spine surgery product in a 2009 paper about results of a large clinical trial.

The surgeons left out important data and claimed there was no significant link between the product and cancer.

The company and doctors had become aware of information on Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Is The FDA Too Lenient When Reviewing Medical Devices?

I speak to people in the pharmaceutical industry much more than folks who develop medical devices. I know how pharma researchers spend years and hundreds of millions of dollars trying to develop a useful, safe new drug that the FDA will approve for marketing. Certainly there are big payoffs, but the road is filled with potholes and trapdoors and the analysis by the FDA is rigorous.

But for years we’ve been hearing that it is much less rigorous when it comes to medical devices. Artificial hip joints and stents to open blocked arteries fall into this category. And recently, the less stringent review process has been highlighted in the news. Metal-on-metal hip joints are being removed from patients who had them implanted. They thought Read more »

*This blog post was originally published at Andrew's Blog*

Medical Device Used To Treat A Leaky Mitral Valve Has Been Recalled

As of May 2011, performance of MitraClip, a minimally invasive procedure to correct mitral regurgitation, has been voluntarily suspended due to a problem with its catheter delivery system.

Since 2008, about 3000 patients with severe mitral valve regurgitation (leaky mitral valve) have been treated with MitraClip rather than open surgery. In this minimally invasive procedure a small clip is delivered via catheter to the heart, where it is carefully placed over the center of the mitral valve. This non-surgical option has been an important alternative for patients who may be unable to withstand open surgery. MitraClip has been advanced and investigated at NewYork-Presbyterian/Columbia since the first EVEREST trial in 2004, and is currently available throughout the U.S. as part of the EVEREST II trial. Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

The Difficulties Of Managing Implanted Medical Devices

With the explosion of medical devices to treat various medical ailments in medicine, we have seen significant improvements in quality and quantity of life. An underappreciated consequence of all of these electronic device therapies, however, has been the manpower and expertise required to manage these implanted electronic medical devices long-term.

Problems with electromagnetic interference (EMI) with medical devices are real. Innovations in medicine have come from various portions of the electromagnetic spectrum including analog and digital wireless technology, diagnostic and therapeutic radiation therapy and magnetic resonance imaging. The effects of these technologies on implanted electronic medical devices can vary and specialty physicians, ancillary health care providers, and medical device manufacturers expend significant man-hours managing these potential interference sources and their affects on devices without a single prospective randomized trial to guide us. The sheer number of devices and the many ways that EMI can interfere with these complex devices makes constructing an all-inclusive trial with sufficient number of “events” to compare difficult or nearly impossible. As a result, most of our management recommendations and hospital policies in this regard have been based from literature case reports or personal experience and expertise.

To date, recommendations for minimizing EMI with cardiac implantable electronic devices has Read more »

*This blog post was originally published at Dr. Wes*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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