Archive: February, 2010
After a huge earthquake hit Chile on Saturday it was difficult to avoid a feeling of déjà vu.
Just seven weeks ago similar scenes of destruction streamed out of Haiti. Following the Haitian quake Americans responded generously. In similar fashion medical aid and emergency response teams are now rushing to Chile.
Doctors, nurses and other medical personnel from the Philadelphia region were early responders in Haiti. Teams from Cooper University Hospital and the University of Pennsylvania quickly arrived to care for survivors. Individuals and ad hoc medical teams from South Jersey and southeastern Pennsylvania dropped everything to help.
And hospitals here stood ready for the most grievously injured Haitians. Five days after the earthquake hit, the first three Haitians evacuated to the U.S. for care arrived at the Hospital of the University of Pennsylvania. On February 3, a pregnant Haitian woman delivered a healthy baby girl at Penn-affiliated Pennsylvania Hospital. Nine Haitian children have received care at Philadelphia hospitals – four at Shriners Hospital for Children-Philadelphia, three at Children’s Hospital of Philadelphia, and two at St. Christopher’s Hospital for Children.
Sunday's Philadelphia Inquirer contains the first in an occasional series of stories by my colleague Michael Vitez from inside Abington Memorial Hospital in Montgomery County. The stories will examine the issues confronting health care in America from the front lines, a large community hospital.
As health-care spending continues to spiral up past the $2 trillion a year mark, Democrats and Republicans in Washington have not found much common ground to address many of these significant problems. So the people who lead and work in hospitals like Abington are left to adapt to the ever changing realities of health care in America.
Here's what Michael said about his series:
My goal is to spend a year at Abington, writing stories that show how one hospital deals with the biggest issues in health care today and also the changes that are coming fast and furious - regardless of what Congress and the President do - to hospitals and health care.
Does smoking pot over long periods of time increase the risk of hallucinations, delusions or psychosis? Or are people prone to such problems more likely to use marijuana? An Australian study looking into the complex relationship between psychosis and marijuana use was scheduled to appear in the Archives of General Psychiatry in May, but made public early yesterday by the medical journal.
Researchers from the University of Queensland and other Australian schools studied 3,801 young adults born between 1981 and 1984. The study was funded by the National Health and Medical Research Council of Australia. At follow up interviews 21 years into the study, the participants were asked about their use of marijuana and assessed using several methods to measure psychosis including diagnostic interviews.
Overall, 65 of the participants had been diagnosed with schizophrenia or another form of “non-affective psychosis.” Among all the study participants longer term use of marijuana was associated with hallucinations, delusions or psychosis.
“Compared with those who had never used cannabis, young adults who had six or more years since first use of cannabis (i.e., who commenced use when around 15 years or younger) were twice as likely to develop a non-affective psychosis and were four times as likely to have high scores” on measures for delusion,” the study’s authors wrote.
Pennsylvania is getting a $17.1 million federal grant to help it develop the infrastructure to enable a statewide sharing of computerized health records. The grant comes on the heels of nearly $100 million in federal funding to a consortium of education and health groups to build a fiber optic network through much of the state for health systems to communicate quickly over the Internet.
The Pennsylvania Health Information Exchange, or PHIX, will use the $17 million federal stimulus grant to further develop a statewide network that will allow patients, doctors, hospitals, pharmacies and a host of other health providers share a medical records quickly and securely.
The PHIX “will support patient-centered health care and improve access, quality and efficiency of care,” said Ann Torregrossa, director of the Governor’s office of Health Care Reform.
Torregrossa’s office is in the process of finishing the strategic plan for PHIX. Over the next four years the grant money will be used to “implement” the exchange statewide.
After the day-long Obama health summit you’ve heard all the talking points and more from Democrats and Republicans. If you still really want to dig into all the different health proposals floating in Washington, the Kaiser Family Foundation provide you with a handy side-by-side comparison chart.
If you want to compare the proposals of House Minority Leader John Boehner (R., Ohio) to that of Rep. Pete Stark (D., Calif.), the foundation site lets you dig in. In fact it allows you to check as many as 17 aspects of each of 15 proposals from benefit design and individual mandates to the role of the states and financing.
And if that’s not enough the foundation provides links to detailed materials for each of the plans examined. Yes, it’s a little on the wonkish side, but if you spent even a couple hours tuned into the health summit, it could be right up your alley. After all why rely on the TV pundits when you can read it all for yourself.
Oh, and if you get tired of checking off all the buttons by clicking, you can just download the 49-page PDF with the full comparison all 15 proposals.
As the snow falls in what could be the fourth major storm of the winter, hospitals across the region geared up their now-well practiced contingency plans.
The key element of preparation was making sure staff can get to work. While some hospitals cancel nonessential appointments and procedures when a big storm looms, urgent cases such as heart attacks, major accidents and births can’t be put off.
To ensure they have key personnel on hand, the hospitals take a variety of approaches. Thomas Jefferson University Hospital in Philadelphia asked employees with four-wheel-drive vehicles to volunteer to transport key staff in to work and back home. Lourdes Medical Center in South Jersey has a cadre of community volunteers to help doctors, nurses and others get there.
For the last storm, Doylestown Hospital made rooms available for staff to stay overnight, and Bucks County hospital rescheduled may non-urgent surgeries. Cooper University Hospital in Camden also rescheduled nonessential appointments and procedures last time around.
So I’m squarely in the vaccinate camp. On Saturday my youngest daughter turned 6 months old. On Monday at her 6-month doctor’s appointment she got five different vaccinations, four shots and one oral. That included shots for both seasonal flu and for the swine flu strain.
In fact, last year our household worked hard to get everyone their flu shots. My wife, our older daughter, who is three-and-a-half, and I went to the nearest city health center and got our swine flu shots. We wanted to protect our infant and ourselves from the second wave of the 2009 H1N1 flu that was sweeping across the country and the globe.
Honestly, I was mystified by friends and family in high-risk groups who refused to get vaccinated. They often cited concerns about the vaccine’s safety that had been dismissed by scientific, public health and medical experts.
While the new strain of the virus generally resulted in mild cases, it impacted the young, pregnant women, and adults with underlying medical conditions particularly hard. Still, many people refuse to vaccinate their children or themselves.
The anti-vaccinate crowd is likely to dismiss the recommendation yesterday by a key panel of experts that everyone – the entire population - above six months of age get flu shots next year. The federal Advisory Committee on Immunization Practices ruled unanimously that everyone should be vaccinated for the 2010-2011 flu season. The committee’s recommendations typically are endorsed by the Centers for Disease Control and Prevention and by insurance companies.
On Sunday the obstetrics unit at Mercy Suburban Hospital in East Norriton, Pa. in Montgomery County will be shut down. The closure announced last year will take place four months earlier than originally planned due to dwindling resources and patients the hospital said.
As the sixteenth hospital to stop delivering babies in the Philadelphia region since 1999, Mercy Suburban could be exhibit A – really exhibit P – for advocates seeking to add limits on medical malpractice suits to the health legislation at the so-called bipartisan summit in Washington today.
The high cost of medical malpractice insurance for doctors and hospitals, particularly for obstetricians combined with low payments from insurers for delivering babies, is a prime cause of the closures of units such as the one at Mercy Suburban, Ken Braithwaite, regional executive of the Delaware Valley Healthcare Council of the Hospital and Healthsystem Association of Pennsylvania, which represents area hospitals said in a recent article.
“The failure to address these issues will likely lead to more OB closures.” Braithwaite said.
Opponents of restrictions on such suits, argue that the medical community needs to do a better job of reducing errors and policing itself. They could point to the case of Philadelphia doctor, Kermit B. Gosnell. The 69-year-old doctor had his license suspended after federal and state drug agents investigating on suspicion of illegal distribution of prescription painkillers raided his West Philadelphia clinic.
The state order suspending Gosnell's license said conditions at the clinic were "deplorable and unsanitary" with "blood on the floor and parts of aborted fetuses in jars."
It also said that an employee with no medical license routinely dispensed prescription drugs and performed medical exams while Gosnell was not at the clinic.
Gosnell's license had been temporarily suspended by the state board of medicine in 1996 for allowing a physician's assistant to treat patients. He got it back after paying a $1,000 penalty. And he was involved in a medical controversy 38 years ago, The Inquirer reported today.
The Philadelphia region has been at the epi-center of the clash over so-called tort reform. Since 2000 escalating malpractice costs led some in the medical industry to claim the health care system here would collapse without fundamental changes to the legal system.
A dramatic rise in the number of cases of infectious syphilis among women of childbearing age led the Philadelphia Health Department of alert health-care providers and issue new screening guidelines Wednesday, my colleague Don Sapatkin reported.
The numbers were relatively small: 218 cases in 2009, including 23 among women ages 15 to 29. But that represented 360 percent increase from 2008 among young women, who can transmit the disease to their babies who are at risk of being born with mental retardation and physical deformities such as cleft palate.
Four cases of congenital syphilis were reported in the city last year. Cases of primary and secondary syphilis - the infectious stages - have been increasing around the country in recent years, particularly in big cities and the South.
The American College of Physicians, a Philadelphia-based organization representing 129,000 doctors and medical students across the nation, said President Obama’s proposed health care bill “has many of the key policies needed to make health insurance coverage available to all Americans, to ensure that patients have access to a primary care physician of their choice, and to reform payment and delivery systems to achieve better value.”
Specifically, the group said it supports the elements of the proposal that seek to make affordable health coverage available to most people and to boost payments for primary care doctors.
But the group wanted more changes to limit and change the way medical malpractice suits are handled. The college said the legislation should provide states with incentives to try alternatives to the current civil lawsuit system, including health courts and safe harbors for the practice of based on best methods – so-called evidence-based medicine.
The group also said the legislation should “include proven liability reforms like those enacted in California and Texas.” In other words, the legislation should put caps on malpractice awards for pain and suffering and other “non-economic” damages. That is an approach that is sure to draw strong opposition from trail lawyers, traditionally strong supporters of Democrats.