November 16th, 2010 by DavedeBronkart in Better Health Network, Health Policy, News, Opinion
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Last Friday the board of the American Medical Informatics Association (AMIA) published a position paper in its journal saying that the “hold harmless” clause is unethical. One of the paper’s authors is Dr. Danny Sands, currently President of the Society for Participatory Medicine. I hope to write more about it this week, after attending the AMIA conference in DC, but here’s the basic issue:
— For ages, makers of electronic medical record systems (EMR) have insisted on a “hold harmless” clause in the contracts a system buyer must sign. It says, in essence, that if any harm comes to anyone because of a system problem, the buyer (the hospital) will hold the manufacturer harmless.
— In other words, if anything goes wrong with the system and someone gets hurt, it’s not the manufacturer’s fault. The reasoning has been: “Hey, you doctors are smart. If our system displays a wrong value, you’re supposed to notice it.”
I’m told this policy has been one big impediment to adoption of EMR systems, because it removes all motivation for vendors to fix things that make their product hard to use: If there’s a bug or the system slows someone down, and a patient gets hurt, the hospital gets sued, not the vendor.
If you were a hospital, wouldn’t that make you eager to buy? What would that do to your trust of the vendor? Patients, how do you feel about that? Providers? Read more »
*This blog post was originally published at e-Patients.net*
November 16th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Health Tips, News, Opinion, Research
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A new analysis of long-term data from the Women’s Health Initiative confirms what we already knew the first time around: Use of combination hormone replacement (HRT*) is associated with a small, but real, risk of breast cancer. This new 11-year followup data carries that knowledge out to its not unexpected conclusion — namely, that some (although not most) breast cancers can be fatal, and therefore the the use of HRT can increase breast cancer mortality.
While it may seem a bit of a “duh,” this study was, in fact, necessary to quell the WHI critics who continued to argue that the breast cancers caused by HRT were somehow less aggressive than those occurring off HRT (which they are not.) It was also a wake-up call for many women who were continuing to use HRT and thinking that somehow its risks did not apply to them. A fair number of these women appear to be coming off of HRT, at least in my practice. Others are staying the course and accepting the risks as they have been defined. Either of which is fine with me.
The spin going on around this study — both for and against HRT use — is tremendous and ultimately confusing to women. The pro-HRT crowd (some of whom have relationships to Pharma) is using language like: “The increased risk from using HRT for five years is the same as if your menopause occurred five years later,” which is technically true, but so what? The bioidentical hormone crowd (usually also selling the same) are using the study to further hype how their regimens are safer than the evil Big Pharma products — based on no data. Which leaves the rest of us to try to find ways to help our patients understand the risks, place them into perspective for themselves, and make a decision about how and if to treat their menopausal symptoms. Read more »
*This blog post was originally published at tbtam*
November 15th, 2010 by GruntDoc in Better Health Network, Health Policy, Opinion
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From a recent post of the Retired Doc’s Thoughts blog entitled “What Are the Plans Of Don Berwick’s ‘Leaders With Plans?’“:
“I wonder which is worse: A medical leader recommending price controls out of ignorance of basic economics or being aware of the likely outcomes and mak[ing] that recommendation anyway?”
Wow. I’m speechless. Thanks to Retired Doc for getting this out in a cogent summary.
*This blog post was originally published at GruntDoc*
November 15th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion
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Last week, after the National Lung Screening Trial results were released, David Sampson, American Cancer Society director of medical and scientific communications, wrote that “our greatest fear was that forces with an economic interest in the test would sidestep the scientific process and use the release of the data to start promoting CT scans. Frankly, even we are surprised how quickly that has happened.”
And, yes, the marketing has even hit fly-over country in the Twin Cities, with this ad appearing in the Sunday Minneapolis Star Tribune in the “A” section:
Of course, no where in the ad will you read about the potential harms of such scans, the false positive rate, what happens when you get a false positive (unnecessary followup testing and perhaps unnecessary treatment), and more costs. And nowhere in the ad will you read that 300 heavy smokers had to be scanned in order for just one to get a benefit of extending his life. But six clinics in this chain are standing by to take your money and do your scan.
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
November 15th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News
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Today begins a lame duck session of Congress before it breaks for Thanksgiving. It’s the final chance to work out a temporary patch to Medicare reimbursement before a 23 percent cut takes effect Dec. 1. Doctors are going to stop taking new Medicare patients if the cuts happen. And, as one breast cancer surgeon explains, if Medicare stops paying, so to private insurers and even military health programs. Congress will meet in December, but the damage will be done.
This all is happening two weeks before the baby boomers become eligible for Medicare. That populous generation starts to turn 65 beginning on Jan. 1, which means they become eligible for Medicare on Dec. 1, which, as we mentioned, is the day the 23 percent Medicare pay cut kicks in. Boomers will continue to become eligible for Medicare, one person every eight seconds, until December 2029. (CNN, The Washington Post, USA Today)
*This blog post was originally published at ACP Internist*
Last Friday the board of the American Medical Informatics Association (AMIA) published a position paper in its journal saying that the “hold harmless” clause is unethical. One of the paper’s authors is Dr. Danny Sands, currently President of the Society for Participatory Medicine. I hope to write more about it this week, after attending the AMIA conference in DC, but here’s the basic issue:
