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Media Malpractice: H1N1 Fear Mongering In NYC

July 27th, 2009 by Nicholas Genes, M.D., Ph.D. in Better Health Network, News, Opinion

Tags: CDC, Emergency Medicine, Flu, H1N1, Infectious Disease, media, New York City, Pulmonology, Social Media, Twitter

Friends visiting New York City this summer keep asking if it’s safe. As in, will they be catching and suffering from novel H1N1 (swine) flu.

I like to think my friends are pretty sharp, discerning folks (after all, they’re choosing my company) so I have to attribute these inappropriate questions to a wider problem.

For reference, here’s the latest and thought probably not last NYC DOH guideline on H1N1, which notes about 900 hospitalization and 45 deaths in H1N1+ patients over three months. About three quarters of these patients had at least one risk factor such as existing lung disease.

This deaths and hospitalizations are concerning, naturally, but some perspective is in order: as many as half a million New Yorkers have been infected with H1N1, and this spring in US cities, we actually saw a smaller fraction of deaths due to infectious respiratory illness, compared with 2008. Also, for reference, based on data from a few years ago, I’m guessing that any given three month period, there are between 10,000 to 15,000 deaths in New York City.

So why were ED’s swamped in May? Why are my friends still afraid to come to NYC? Dr. David Newman has some thoughts in EPMonthly:

…with constant messages of swine flu lethality on the nightly news, it is little surprise that ED’s in New York City, departments in a chronic state of over-crowding and crisis, were soon bursting at the seams with record volumes. In some institutions daily ED volumes doubled, as EP’s worked through third-world conditions of extreme crowding, questionable hygiene, extended wait times, and swarms of infectious, coughing congregates all within arm’s reach of each other.

The impact is clear: lives were lost. High quality studies have shown repeatedly that when ED’s experience crowding patients in need of rapid, high intensity care are identified later, treated more slowly, and devoted fewer resources. Mortality goes up during crowding in virtually every condition that has been studied, including MI, sepsis, and others. The irony is stark: Once a critical mass is reached, the more that come to be saved, the fewer we can save.

…The overall management of information during the swine flu of 2009, despite some progress in our access to information, was misguided and dangerous. Frantic media outlets drove a nation to fabricated fears, while state-level institutions not only failed to contain or counteract these messages, but also used expensive, fruitless, prescription-only pills, available to most only in their local ED’s, as a means of false comfort. Instead of using honest information to provide safety, comfort and education, the approach created panic, cost money and resources, and took lives.

All of this was preventable and is reversible for the future. There is no reason why the media cannot be recruited into the information dissemination process…

Unfortunately, there is a good reason why: Responsibly framing public health risks is no longer a role that suits traditional media. They’ve decided it’s just not in their interest.

I remarked on this years ago with West Nile virus, which never will never kill as many as, say, food poisoning or swimming pool accidents.

There are many factors driving the public appetite for health risk information — and that’s understandable. I think it’s even ok for news organizations to shuffle around reporting to some extent, to satiate those desires.

But what happened in NYC this spring was media malpractice — night after night, opportunities to put the risks of swine flu in perspective were passed up for breathless reporting. I recall one occasion in which a phalanx of reporters were camped outside a hospital I worked at, providing next to no detail about an infant who died it respiratory distress. It turns out this child did not have H1N1, but communicating that was not a priority — by the next day the lead story was ED’s are overcrowded and schools are closing.

EPMonthly ran a nice sidebar from Dr. Jim Augustine, enumerating the ways in which ED docs can engage the media to get the right message out.

But I’m more encouraged by approaches to bypass traditional media and reach patients directly. Yesterday I heard some encouraging news from the CDC: their emergency twitter feed has over 500,000 followers. Millions saw their videos. This is amazing reach, for public health communication.

It wasn’t enough to help ED’s this spring. But individual hospitals and the CDC is ramping up their use of social media, even as traditional news sources decline in influence. It’s really the first good viral news I’ve heard in a while.

*This blog post was originally published at Blogborygmi*

Emergiblog In DC: The Panel, the Politics and the Ce-Ment Pond

July 25th, 2009 by Emergiblog in Announcements, Better Health Network, Health Policy, Opinion

Tags: Better Health, Bloggers, Congressman Paul Ryan, Healthcare reform, Medbloggers, National Press Club, Paul Ryan, Putting Patients First

This is Congressman Paul Ryan of Wisconsin, speaking at the Better Health “Putting Patients First” event  in D.C.

I should talk about how passionately he spoke about health care reform (he did), about why he does not believe government should be running health care (he doesn’t) or that he took the time to come and speak at 8 am even though he had been up until 2 am working on the health care bill (he did) or that he spoke right up until he – literally- had to run back to the House to vote (he did).

And I will talk about these things.

But first, let me state the obvious and get it out of the way so that I can go on to discuss the serious nature of the health care reform debate before us.

Whoa.

Seriously, is it just me or are politicians getting better looking?

There. Now I can move on to the meat of the matter.

(I had to say it because you all know I was thinking it!)

*****

This event marked my first time in Washington, and just being there is awe-inspiring. Seeing the White House from the car window took my breath away, literally. I felt like Ellie May Clampett marveling at the ce-ment pond.  The National Press Club is a museum in and of itself.  Mother Jones and I were hoping we’d catch a glimpse of Sanjay Gupta, but he must have been off doing neurosurgery or something.

*****

By now, you’ve probably read who was on the panel (Dr. Wes, DrRich, Dr.Rob, Dr.Kevin, me, and Better Health contributors Dr. Alan Dappen, Valerie Tinley, NP and “token” – his words, LOL – surgeon Dr. James Herndon).

I will tell you straight up that I learned much more than I contributed.

The panel shot from the hip and spoke from the heart. Some of us had notes, some of us illustrated our comments with anecdotes and one of us (*cough*) had no clue what was going to come out of her mouth until that moment.

I’ll give you a hint….it wasn’t Valerie…..

*****

For the record, those of us on the panel were not told what to say, how to say it or what to believe, nor were we chosen based on what we do believe.  Some discussed concepts that should be taken into account no matter what plan we end up with, others were definitely against a single payer plan run by the government (*raising hand*).

The inefficiencies of national health plans of other countries were illustrated/discussed.  This hit me later: we should look at what works in those plans, not just what is wrong with them.  We don’t have to emulate them, just learn from them, and that includes the good and the bad.  It also applies to any universal form of coverage, not just a government-run plan.

Wish I had said that at the time.

So much for thinking on my feet (or on my butt, as the case may be).

*****

There was some controversy about not having any patient bloggers on the panel.  There should have been. I hope that, as a nurse, I spoke for patients, but it was not the same as having someone there who navigates the system as a patient every single day.

The patient bloggers were in the audience, though, and if you go to Twitter you can find the live tweeting at “#patientsfirst”. There was a pretty healthy debate going on in the Twitterverse while the panel was up on the dais.

Here I am with Lisa Emrich (Brass and Ivory) and Kerri Morrone Sparling (Six Until Me). Duncan Cross was also there, but my pic was blurry!

*****

While health care reform has been a hot topic for awhile, it was especially acute this week as the President was actively promoting a government run health care system and there seemed to be a huge sense of urgency to get what is called “America’s Affordable Health Choices Act of 2009″ passed ASAP.

The bill is over 1000 pages long.

I just downloaded it.

And Congress has not read it.

Folks, our representatives are being asked to pass legislation they have not had a chance to read.

While I will admit to being a bit unsure of exactly what happens in the Beltway (Civics classes and Schoolhouse Rock’s “I’m Just a Bill” notwithstanding), that can’t possibly be business as usual.

Can it?

*****

I’ll say one thing: no matter what we believe, why we believe it or what our role is in the health care system, it is a conversation rife with strong opinions and passionate debate.

And, in the end, because we are all patients in one form or another at some point in our lives, the conversation is about us.

So, when you hear the phrase “putting patients first”, think of it as “putting me first”.

That may help you get a foothold in the morass of information that is the health care debate.

It worked for me.

*This blog post was originally published at Emergiblog*

Thoughts From The Official Twitter Reporter Of The Medblogger National Press Club Event

July 25th, 2009 by MotherJonesRN in Better Health Network, Health Policy, Opinion

Tags: Better Health, Healthcare reform, National Press Club, Paul Ryan, Politics, Putting Patients First, Twitter

“The doctor will see you now.” I’m hoping to hear those golden words soon because I’m sitting in my primary care physician’s office on my day off from work. I’m lucky that I have a primary care physician who is still taking new patients. Did you know that a lot of primary care doctors are struggling to keep their doors open? That was just one of the issues that healthcare bloggers were talking about last week in Washington, D.C.

I was honored to receive an invitation to serve as the official Twitter Reporter for Better Health’s Putting Patients First event. The summit on healthcare reform took place last week at the National Press Club in Washington, D.C. I sat under the Twitter Gallery sign (pictured above) during the conference. The experience was amazing, but I’d like to make two suggestions to the management of the National Press Club. First, please install more electric wall sockets in your building. There were no wall sockets to plug my computer into during the conference, so my battery almost went dead while I was tweeting. Next, please have Anderson Cooper onsite when I’m in the building. He’s hot.

I was happy to finally get to meet the people behind the blogs that I read everyday. I met Kim from Emergiblog, Dr. Wes, DrRich, Dr.Rob, Dr.Kevin, and Better Health contributors Dr. Alan Dappen, Valerie Tinley, NP and Dr. James Herndon. I sat in the Twitter Gallery with Kerri Morrone Sparling from Six Until Me , Dr. Edwin Leap, and Evan Falchuk from See First Blog. I also got to meet Lisa Emrich from Brass and Ivory, and Duncan Cross. I think Kim was a knockout in her new Calvin Klein suit. Note to Fox News: You need to hire Kim as one of your Sunday morning talking heads. She has a lot of good ideas about healthcare reform and she looked right at home at the National Press Club. She also comes complete with her own professional wardrobe.

Every blogger expressed their personal viewpoint about healthcare reform at the conference. The bloggers were not told what to say, and I was not told what to tweet, or what comments to make before, during, or after the conference. We came to D.C. to add our voices to the healthcare debate. No, I didn’t agree with everything that I heard during the conference. I thought a lot of the information presented by the keynote speakers was bunk. I’m in favor of a public option healthcare reform bill, and I don’t like the disinformation being spread via partisan politics about this important issue. I get infuriated when members of Congress from both sides of the aisle play partisan politics while my patients languish in a healthcare system that’s literally killing them. I’m really very frustrated, and I’m just like everyone else in this country that wants to give our politicians a good swift kick in the butt. What gives me hope is seeing good people from both sides of this debate coming together at a healthcare blogger conference in Washington, D.C. Healthcare providers truly want to put patients first.

*This blog post was originally published at Nurse Ratched's Place*

Valerie Jarrett, White House Senior Advisor At BlogHer09

July 25th, 2009 by Emergiblog in News, Opinion

Tags: Bloggers, BlogHer, BlogHer09, Government-run Healthcare, Healthcare reform, Obama, Obamacare, Single Payer, Valerie Jarrett

I was honored to receive an unprecedented opportunity to hear a Senior Advisor to President Obama speak about his health care reform efforts at BlogHer 09.

Valerie Jarrett, Senior Advisor and Assistant to the President for Public Engagement and Intergovernmental Affairs, spoke to an intimate group of bloggers at a luncheon today.

And I was 15 minutes late.

How humiliating! This was definitely not the event where one should be “fashionably late”.

Ms. Jarrett was totally cool though, and said “Come on in and tell us who you are!” Apparently I had just missed intros; the discussion was just starting.

(Photo credit: Wikipedia)

********************

Now I’ve been pretty clear about not wanting a government run health care system, and I attended the luncheon knowing I did not have a clear grasp on the President’s proposal. (I have downloaded the Bill, have not had a chance to finish it.) I wanted to keep an open mind; I wanted to learn as opposed to opine.

The best way to learn is to keep your mouth shut and listen. That is exactly what I did.

It was not easy.

*****

Ms. Jarrett is warm, sincere and truly passionate about the President’s efforts at health care reform;  Ms. Jarrett has full faith in the ability of the President to positively reform our health care system.

Now, if I heard and understood correctly, what the President wants is a public plan as an option; a choice to obtain health care coverage through the government should you find yourself unemployed/without any health care coverage.  Ms. Jarrett was adamant that the goal is not a single-payer government run plan, but there was some group questioning of (1) why the idea of a government plan is perceived as scary and (2) whether or not it would be tantamount to socialism and indeed, what would be wrong with that anyway. One blogger noted that she knew many Canadians who were happy with their health care.

These questions were more rhetorical in nature. Honestly, I don’t think time would have permitted in-depth discussion.

*****

There was discussion on how bloggers can get out the message of health care reform and ideas on how the President can best communicate his ideas to the public.  It was noted that the President is holding press conferences for which he is asking full coverage because he wants the entire story told, not just sound bytes.  (Side note: I found this interesting because just recently ABC News encamped in the White House for an entire day – and the topic was health care reform.)

I actually did have a question enter my mind, as I was intrigued by the idea that the public plan was an option: I wanted to know if one could move in and out of the public plan as desired, or were you stuck in the public plan once it was chosen.

I didn’t get a chance to ask, as the discussion moved forward with two bloggers sharing stories of their personal experiences with the health care system.  Very personal, heart wrenching stories. Their frustration and anguish was palpable. Ms. Jarrett listened with empathy; she truly cared about what my fellow bloggers had/were enduring.

I found out later that both bloggers left with her personal business card with her office number for them to call her directly after the conference.  That was impressive.

*****

So, some final thoughts.

I like Valerie Jarrett.  It was amazing that she took time to come and speak to us, and it was informative. She speaks straight, she is sincere and she seems very passionate and compassionate regarding health care reform.  I’m a bit more informed about what the President is looking for.  This was the advantage shutting up and listening. I don’t necessarily agree but I’m starting to at least get a hold of the concept.

Gratuitous political commentary: I think a little too much time was spent decrying the last administration. It’s over; time to move on.

Now for my totally off-the-cuff observation. I could not help but notice this was the exact opposite of my experience in DC last week. This was a full-on Obamafest, last week seemed like an “anything BUT Obamafest”. This week the “opposition” was putting out misinformation, last week the “opposition” was trying to cram a bill through before Congress could read it.

Is there no middle ground? Does it have to be this contentious? Maybe it’s the way of politics and I’m just now realizing it.

Between the two events, I guess I have now been exposed to a “fair and balanced” view of health care reform by Washington insiders.

So….why does it still feel like I have vertigo?

*****

This post was written from my own notes and memory. It was actually live-blogged in real time and if you would like to read the entire transcript, it is written here: Valerie Jarrett/Health Care Reform Live Blog BlogHer 09.

Valerie Jarrett, White House Senior Advisor Talks to Bloggers at BlogHer09

*This blog post was originally published at Emergiblog*

Would You Like A Bigger Butt With Those Fries?

July 22nd, 2009 by Nancy Brown, Ph.D. in Better Health Network, Opinion

Tags: Calorie Counts, Calories, Fast Food, Food and Nutrition, Menu, Obesity, Restaurant, Weight Gain, Weight Loss

Do you know that most adults should eat less than 2,000 calories a day? Sounds like a lot, until you consider that if you eat out, you can get your entire days worth in one meal. Here are some amazing facts (chosen at random):

• At Burger King – a triple whopper with cheese has 1,230 calories – add medium fries (360) and medium chocolate shake (690) and you are up to 2,280 calories!
• The Cheesecake Factory brings you beer battered fish & chips at 2,160 calories, add a piece of Adam’s Peanut Butter Fudge Ripple Cheesecake (1,326) for a total of 3,486 calories!
• How about Chicken & Biscuits instead, with 68 grams of saturated fat? Yes, that is more than four days worth of saturated fat (for a 2,000 a day diet, <16 grams a day is suggested).

Right now you can usually request the nutritional information at chain restaurants and someone will point you to or produce a pamphlet, but the information is not apparent. The idea of having those nutritional facts printed clearly on menus is meeting some serious resistance from the restaurant industry. I wonder why?

Public health advocates however are pushing hard to get this information in front of consumers hoping that people will make healthier choices when faced with the facts! The Senate supported a federal labeling law last month as part of comprehensive health-care reform, but we shall see what happens when it all comes to a vote.

Until then, it would be good to know when ordering – and passing on these facts to our teens who are likely to be eating out.

This post, Would You Like A Bigger Butt With Those Fries?, was originally published on Healthine.com by Nancy Brown, Ph.D..