WBEZ | Doctors http://www.wbez.org/tags/doctors Latest from WBEZ Chicago Public Radio en Working Shift: Ask An ER Doctor http://www.wbez.org/programs/morning-shift/2016-02-02/working-shift-ask-er-doctor-114674 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/Ask an ER Doc-torange.us_.jpg" alt="" /><p><div><p>Monday we start a series when we talk to someone with an interesting job to learn more about their day to day life, and give listeners the chance to ask what they&#39;ve always wanted to know about that line of work. We&#39;re calling it &ldquo;Working Shift.&rdquo; First up-an ER doctor.</p><p>You&rsquo;ve seen it on TV and movies, but is it always that action packed and stressful? What&rsquo;s a bad day look like? Mary Ella Kenefake is a doctor at Northwestern Medicine Central DuPage Hospital in suburban Winfield and Methodist Hospital in Gary, Indiana, and she&rsquo;s ready to see you now.</p></div><div><div>&nbsp;</div></div><div><div><div>&nbsp;</div></div></div><div>&nbsp;</div></p> Mon, 01 Feb 2016 10:56:00 -0600 http://www.wbez.org/programs/morning-shift/2016-02-02/working-shift-ask-er-doctor-114674 A Doctor Wrestles With Whether To Keep Wearing His White Coat http://www.wbez.org/news/doctor-wrestles-whether-keep-wearing-his-white-coat-113904 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/doctor-coat_wide-1060c55f0842fabb7a04c0391fc61d0d95c3980f-s800-c85.jpg" alt="" /><p><div id="res456823405" previewtitle="Lorenzo Gritti for NPR"><div data-crop-type=""><img alt="Lorenzo Gritti for NPR" src="http://media.npr.org/assets/img/2015/11/20/doctor-coat_wide-1060c55f0842fabb7a04c0391fc61d0d95c3980f-s800-c85.jpg" style="height: 349px; width: 620px;" title="(Lorenzo Gritti/NPR)" /></div><div><div>&nbsp;</div></div></div><p>I remember being handed a white coat during my first year of medical school. It came crisply folded in a cellophane bag. I was told to wear it anytime we were in the hospital or with patients as a sign of respect.</p><p>There was no pomp about it. I took it home and tried it on. It was like putting on a costume and pretending to play doctor. The white coat continued to feel that way to me for a long time.</p><p>Over the years, the costume has become second nature and part of my clinical identity. I slip it on when I&#39;m seeing patients, because when I&#39;ve asked, most of them tell me they prefer it. The coat provides a mutual comfort to us both.</p><p>My, how times have changed. Now the vast majority of the nation&#39;s medical schools (along with more than 700 nursing schools and physician assistant programs) host special&nbsp;<a href="http://humanism-in-medicine.org/programs/rituals/white-coat-ceremony/" target="_blank">white coat ceremonies</a>, in which new students are welcomed into their profession with a solemn ceremony invoking commitment to the healing arts. White coats are formally offered to students, and put on them by their school&#39;s leadership.</p><p>These ceremonies present an opportunity for the students and their families to mark the beginning of health careers in an educational and professional crucible that will challenge their ideals, empathy and compassion. &quot;The iconography, the ritual of holding up members of the profession in this time of change must be maintained,&quot; says Dr. Richard Levin, president and CEO of the&nbsp;<a href="http://humanism-in-medicine.org/about-us/" target="_blank">Arnold P. Gold Foundation</a>, whose mission is to promote and maintain humanism in health care.</p><p>Now in the role of medical educator myself, I find anything that helps students stay connected with their highest ideals valuable in imparting a sense of professionalism. That&#39;s why it&#39;s disconcerting to think that our white coats are being challenged as possible vectors of infection.</p><p>A group of doctors in the field of infectious diseases has begun to rally around a<a href="https://www.bostonglobe.com/metro/2015/11/18/doctors-debate-hanging-white-coat/wRJxWpiRFtm4ehy8Q9pIEJ/story.html" target="_blank">mantra</a>&nbsp;of &quot;bare below the elbows,&quot; suggesting that health professionals avoid wearing white coats altogether, as is the custom in the U.K.</p><p>It turns out we don&#39;t wash the things nearly enough.</p><p>In a&nbsp;<a href="https://theconversation.com/its-time-for-doctors-to-hang-up-the-white-coats-for-good-47536" target="_blank">piece</a>&nbsp;titled &quot;It&#39;s Time for Doctors to Hang up their White Coats for Good,&quot; Boston-based infectious diseases specialist&nbsp;<a href="https://twitter.com/philiplederer" target="_blank">Philip Lederer</a>&nbsp;argues that white coats have outlived their usefulness, both as guardians of cleanliness and as symbols of the profession.</p><p>Studies demonstrate the presence of harmful&nbsp;<a href="http://www.ncbi.nlm.nih.gov/pubmed/18834751?dopt=Abstract" target="_blank">bacteria</a>&nbsp;on our white coats, though evidence of direct harm to patients is lacking.</p><p>&quot;We don&#39;t need a randomized trial to prove that parachutes save lives,&quot; Lederer told me. He prefers wearing khakis and dress shirts with the sleeves rolled up; no tie. He mentioned other docs who favor vests for their pockets and warmth, a trend some hope will catch on. And while Lederer supports the idea of a humanism-themed ceremony to welcome students into the profession, he and others suggest that even as a symbol white coats are more of a barrier than a conduit to strong doctor-patient relationships.</p><p>Levin counters that with all of the changes in health care, people in the field feel a tremendous sense of dislocation. &quot;The idea of taking away [professional status] rather than elevating it is a problem for health care,&quot; he said. But taking away the coats wouldn&#39;t necessarily be a blow, he said, pointing to a&nbsp;<a href="http://www.ncbi.nlm.nih.gov/pubmed/23278829" target="_blank">study</a>&nbsp;that challenges the notion that white coats are fundamentally elitist.</p><p>The debate over white coats has forced me to consider my own practice. In the end, I think the issue is as much about generational change as it is about infection control. I&#39;d give up my white coat instantly if I knew it was spreading harmful bacteria. But colonization with bacteria is different from transmitting them to another person.</p><p>Bacteria live on all of us, so are white coats necessarily worse than our other garments or even our own skin?</p><p>It&#39;s likely that this debate will continue, unless patients were to somehow come to consensus on what they want doctors to wear. And that&#39;s not likely to happen anytime soon.</p><p>Until then, I vow to wash my white coat more frequently.</p><p><em>John Henning Schumann is a writer and doctor in Tulsa, Okla. He serves as president of the University of Oklahoma, Tulsa. He also hosts Public Radio Tulsa&#39;s&nbsp;<a href="http://kwgs.org/term/medical-matters">Medical Matters</a>.&nbsp;He&#39;s on Twitter:&nbsp;<a href="https://twitter.com/GlassHospital">@GlassHospital</a></em></p><p>&mdash;<a href="http://www.npr.org/sections/health-shots/2015/11/21/456811455/a-doctor-wrestles-with-whether-to-keep-wearing-his-white-coat?ft=nprml&amp;f=456811455" target="_blank"><em> via NPR</em></a></p></p> Mon, 23 Nov 2015 15:55:00 -0600 http://www.wbez.org/news/doctor-wrestles-whether-keep-wearing-his-white-coat-113904 Chicago Matters (1999): Doing the Right Thing in Health Care's Brave New World http://www.wbez.org/news/chicago-matters-1999-doing-right-thing-health-cares-brave-new-world-113885 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/3093950d-c565-40f2-9821-67b56e27ae98.jpg" alt="" /><p><blockquote><div><em>&ldquo;What is a life worth living? When is it time to die?</em></div><div>&nbsp;</div><div><em>As modern medicine&#39;s tools grow more powerful, these questions are asked each day, in every hospital in the country. This program will profile the people who answer them: clinical medical ethicists.&rdquo;</em></div></blockquote><div>&nbsp;</div><div>In 1999, Alex Blumberg was a fledgling radio producer who was hired by WBEZ to produce his first half-hour audio documentary.&nbsp;</div><div>&nbsp;</div><div>Blumberg later became a producer at <em>This American Life</em> and co-founder of NPR&rsquo;s <em>Planet Money</em> podcast. In recent years he co-founded<a href="https://gimletmedia.com/" target="_blank"> Gimlet Media</a>, a for-profit podcast company that&rsquo;s innovating around the creation of narrative storytelling podcasts.</div><div>&nbsp;</div><div>But back in 1999 when he was hired to produce the half-hour documentary, &ldquo;Doing the Right Thing in Health Care&#39;s Brave New World,&rdquo; he had very little experience.&nbsp;</div><div>&nbsp;</div><div>&ldquo;This was my third career,&rdquo; Blumberg says. &ldquo;I was 31 or 32-years-old but I was just a beginner. I worked at <em>This American Life </em>as the intern/administrative assistant for six months, and then I quit to freelance.&rdquo;</div><div>&nbsp;</div><div>He was hired for the project by Johanna Zorn, then-Executive Producer of <em>Chicago Matters</em>, a WBEZ collaboration with WTTW Channel 11, the Chicago Public Library and <em>The Chicago Reporter</em>, funded by the Chicago Community Trust. Zorn went on to co-found the <a href="http://thirdcoastfestival.org/" target="_blank">Third Coast Audio Festival</a>.</div><div>&nbsp;</div><div>She says digital editing was just coming into vogue and Blumberg had cut down some interviews for the Poetry Foundation that she liked. &ldquo;He seemed like such a natural,&rdquo; she says.</div><div>&nbsp;</div><div>Each year the <em>Chicago Matters</em> series focused on a different topic. In 1999, the series was called Examining Health.</div><div>&nbsp;</div><div>Blumberg had heard from some medical residents that end-of-life decisions were becoming so common that hospitals were having to employ medical ethicists.&nbsp;</div><div>&nbsp;</div><div>Blumberg says, &ldquo;I had this vision of families and doctors being like: &lsquo;We don&rsquo;t know what to do. Call the ethicists!&rsquo; But it wasn&rsquo;t like that. There wasn&rsquo;t the ethicists lounge with a big red light going, &lsquo;Somebody needs an ethical decision made!&rsquo;&rdquo;</div><div>&nbsp;</div><div>&ldquo;What intrigued me about it was that here was this modern field of medicine calling on this ancient field of philosophy to solve this problem that modern medicine had created. And then it&rsquo;s happening at one of the most intense moments you can imagine.&rdquo;</div><div>&nbsp;</div><div>Blumberg says he got good tape but his original draft was a mess. His editor - Julia McEvoy - made him go back in the writing and identify key turning points in the story. &ldquo;&lsquo;Help us pay attention to this point.&rsquo; I remember her suggesting that. It was a narrative you could follow then.&rdquo;</div><div>&nbsp;</div><div>Zorn, the editor who hired Blumberg, says she&rsquo;s in awe of everything he has gone on to do. &ldquo;He&rsquo;s been such an innovator. It&rsquo;s more than enough to be a fabulous storyteller, but to reinvent radio with a for-profit model is just incredible.&rdquo;</div><div>&nbsp;</div><div>Blumberg says the documentary was an important learning experience for him. &ldquo;I haven&rsquo;t heard it in forever. I would be curious to hear what it sounds like. I was very proud of it at the time.&rdquo;</div><div>&nbsp;</div><div>Tell us what you think in the comments.</div></p> Mon, 23 Nov 2015 09:23:00 -0600 http://www.wbez.org/news/chicago-matters-1999-doing-right-thing-health-cares-brave-new-world-113885 House calls for the homebound make a comeback http://www.wbez.org/news/house-calls-homebound-make-comeback-113747 <p><p>&nbsp;</p><p style="text-align: center;"><iframe frameborder="0" height="338" scrolling="no" src="http://www.npr.org/templates/event/embeddedVideo.php?storyId=455470438&amp;mediaId=455481394" width="600"></iframe></p><p>Dr. Roberta Miller hits the road at 8 a.m. to see her patients.</p><p>Many are too old or sick to go to the doctor. So the doctor comes to them.</p><p>She&#39;s put 250,000 miles on her Honda minivan going to their homes in upstate New York. Home visits make a different kind of care possible.</p><p>&quot;You can evaluate the person as a whole,&quot; says Miller, who has been a home care physician in Schenectady, N.Y., for more than 20 years. &quot;You see everything that influences their health and well-being: the environment, the surrounding people, the support system, whether they had or didn&#39;t have food.&quot;</p><p>Miller spends about an hour at each house call. Conversation with patients and their family members flows so naturally that it&#39;s easy to miss that she&#39;s also checking vital signs, gently stretching a hand, noting which pill bottles are empty.</p><p>Although Miller&#39;s practice may harken back to the country doctor of decades past, it could be the future of medicine. In 2013, about 2.6 million Medicare claims were filed for patient home visits and house calls. That&#39;s up from 2.3 million visits in 2009 and 1.4 million visits in 1999, according to Medicare statistics.</p><p>The trend is&nbsp;<a href="http://www.aafp.org/afp/2011/0415/p925.html">expected to accelerate</a>&nbsp;as baby boomers grow older. One in 20 people over the age of 65 is homebound in the U.S., according to a&nbsp;<a href="http://archinte.jamanetwork.com/article.aspx?articleid=2296016">study</a>&nbsp;published in July inJAMA Internal Medicine.</p><p>&quot;That&#39;s just the nature of the population we treat,&quot; Miller says. &quot;They&#39;re extremely ill. Homebound patients often have up to 12 or 13 problems, not just one.&quot;</p><p>And they&#39;re often invisible. These people could be living just down the block, and you&#39;d never know it. Many of them never leave their homes.</p><p>Miller&#39;s patients include a 55-year-old woman with ALS who can communicate only with her eyes, a 27-year-old former quarterback left quadriplegic and in a coma after surgery on an Achilles tendon, a 92-year-old woman cared for by her daughter, and a severely depressed man who lives alone.</p><p>After the Affordable Care Act took effect in 2014, Miller saw a spike in new patient requests after Medicare reimbursements increased for people who are disabled or 65 and older.</p><p>&quot;Now we can afford to see them and take care of them. Because they haven&#39;t had medical care, they have multiple medical needs and psychosocial needs,&quot; she says. &quot;It has given us access to a group of people, but more importantly, they have access to us.&quot;</p><p>But reimbursements declined in 2015 because of sequestration. And now Medicaid reimbursements rates are starting to fall as well.</p><p><em>Editor&#39;s note: This is an abbreviated version of a&nbsp;<a href="http://www.npr.org/2015/11/08/448406540/doctor-treats-homebound-patients-often-unseen-even-by-neighbors">story</a>&nbsp;that ran on Sunday, Nov. 8.</em></p><div class="image-insert-image "><a href="http://www.npr.org/2015/11/08/448406540/doctor-treats-homebound-patients-often-unseen-even-by-neighbors" target="_blank"><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/see-more-here_custom-d0f9b8fb9bd953bf8cf1f5b9bcb0a041dc792d31-s800-c85.jpg" style="height: 414px; width: 620px;" title="(Misha Friedman for NPR)" /></a></div></p> Wed, 11 Nov 2015 16:51:00 -0600 http://www.wbez.org/news/house-calls-homebound-make-comeback-113747 Morning Shift: Health care, CPS and music http://www.wbez.org/programs/morning-shift-tony-sarabia/2013-07-22/morning-shift-health-care-cps-and-music-108131 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/Doctor-Flickr- caroline_1.jpg" alt="" /><p><p>Host Tony Sarabia is back, and we talk about the recent CPS layoffs and how they may effect the education system? And with National Health Care on the horizon, we are taking a look at preventive care and its effect on our overwhelmed emergency care services.</p><script src="//storify.com/WBEZ/morning-shift-28.js?header=false"></script><noscript>[<a href="//storify.com/WBEZ/morning-shift-28" target="_blank">View the story "Morning Shift: Health care, CPS and music" on Storify</a>]</noscript></p> Mon, 22 Jul 2013 08:19:00 -0500 http://www.wbez.org/programs/morning-shift-tony-sarabia/2013-07-22/morning-shift-health-care-cps-and-music-108131 Surgeons in short supply in Uganda http://www.wbez.org/episode-segments/2012-01-20/surgeons-short-supply-uganda-95696 <img typeof="foaf:Image" src="http://llnw.wbez.org//segment/photo/2012-January/2012-01-20/uganda1.jpg" alt="" /><p><p><span class="piece-description-lead">Uganda desperately needs surgeons. In a country of 32 million people, there are only about a hundred specialist surgeons. As a result, accident victims with critical injuries must sometimes wait weeks or months for operations. </span></p><p><span class="piece-description-lead">One reason for the shortage: Ugandan medical students increasingly choose to work in the better paying field of HIV and AIDS care. Bonnie Allen reports.</span></p><p>&nbsp;</p><p><em>The piece originally aired on the <a href="http://www.prx.org/group_accounts/5538-worldvision" target="_blank">World Vision Report</a>. We got it from the <a href="http://www.prx.org" target="_blank">Public Radio Exchange</a>.</em></p><p style="margin-left: 1in;">&nbsp;</p></p> Fri, 20 Jan 2012 18:59:00 -0600 http://www.wbez.org/episode-segments/2012-01-20/surgeons-short-supply-uganda-95696 Weight-loss program beats doctor's advice to shed pounds http://www.wbez.org/story/2011-09-08/weight-loss-program-beats-doctors-advice-shed-pounds-91676 <img typeof="foaf:Image" src="http://llnw.wbez.org//npr_story/photo/2011-September/2011-09-08/docweighspt.jpg" alt="" /><p><p>Doctors are supposed to help overweight patients lose weight, since those extra pounds boost the risk of diabetes, heart disease and many other illnesses. But those patients might be better off going to Weight Watchers, according to new research. And, a second study finds, paying for weight-loss programs now may reduce health care costs over the long haul.</p><p>People who participated in the commercial weight-loss program <a href="http://www.npr.org/blogs/health/2010/11/30/131695177/fruit-ride-free-in-new-weightwatchers-point-system">Weight Watchers</a> lost twice as much weight as people who were advised by their doctors on weight loss. The Weight Watcher group lost an average of 11 pounds over a year, compared to five pounds in the doctor's advice group. The <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961344-5/abstract">study</a> was just published in the <em>Lancet.</em></p><p>These results need to be taken with a few chunky grains of salt, though. Almost half of the study's 772 participants dropped out before the year was out, and the reported results don't reflect the dropouts, who probably had less success.</p><p>Also, the study was funded by Weight Watchers, which provided a year of free membership for each participant. (All the major diet plans <a href="http://www.npr.org/blogs/health/2011/05/10/136143997/jenny-craig-winner-winner-diet-dinner">typically fund</a> their own research.) Fees for the program in the United States run about $40 per month.</p><p>Still, a commentary accompanying the article notes that in some parts of England, where the study took place, national health insurance already pays for Weight Watchers and other commercial weight-loss programs. That's not true in the U.S., where people usually have to pay their own way.</p><p>But a second study suggests that paying for weight-loss programs for pre-diabetic baby boomers could shave billions of dollars off of future Medicaid costs.</p><p>Those researchers looked at the YMCA's <a href="http://healthylivinginnovation.challenge.gov/submissions/2422-taking-the-ymca-s-diabetes-prevention-program-to-scale">Diabetes Prevention Program</a>, which uses group classes on nutrition and exercise to encourage people to lose 7 percent of their body weight, and exercise 150 minutes a week. It costs about $240 a person for a 16- to 20-week program, and is currently available through 50 YMCAs in 26 states.</p><p>People lost about 6 percent of their weight over six months in one study of the program, and sustained that weight loss for more than a year. Studies of the program have found that it reduces participants' risk of developing diabetes by up to 71 percent.</p><p>If the federal government paid for overweight people in their early 60s to participate in the YMCA program, it would save the Medicare program $1.8 to $2.3 billion dollars in the following 10 years. "Those people would be healthier when they entered the Medicare program," Kenneth Thorpe, an economist and professor of health policy at Emory University, told Shots. The <a href="https://mail.npr.org/owa/redir.aspx?C=d9a4904183f9472ebbc9dc43a0ea3e46&amp;URL=http%3a%2f%2fcontent.healthaffairs.org%2fcontent%2f30%2f9%2f1673.abstract">study</a> was published in the September <em>Health Affairs</em>.</p><p>The high and low numbers are based on the 70 percent participation rate in the YMCA clinical trial, and the 55 percent rate typical of good workplace wellness programs. Medicare spending is 15 to 35 percent higher in people who are obese at age 65, compared to people of normal weight.</p><p>Thorpe and his colleagues liked the concept so much they applied it to aging baby boomers with high cholesterol and high blood pressure. If the government paid for those folks to take the YMCA program, it could increase the Medicare cost savings to $3.7 billion over 10 years.</p><p>The federal Centers for Disease Control and Prevention is funding some of the YMCA diabetes prevention programs, and insurer UnitedHealth Group <a href="http://healthylivinginnovation.challenge.gov/submissions/2422-taking-the-ymca-s-diabetes-prevention-program-to-scale">said</a> last year that it will pay for the program for people in selected markets in Ohio, Indiana, Arizona, and Minnesota.</p><p>There are 2,686 YMCAs nationwide, Thorpe notes, and 60 million Americans live within 3 miles of a branch. But other community organizations, including local health departments or nonprofit organizations, could sponsor similar prevention programs.</p><div class="fullattribution">Copyright 2011 National Public Radio.</div></p> Thu, 08 Sep 2011 07:39:00 -0500 http://www.wbez.org/story/2011-09-08/weight-loss-program-beats-doctors-advice-shed-pounds-91676 Prominent Surgeon Resigns Post After Backlash Over Editorial http://www.wbez.org/story/doctors/2011-04-18/prominent-surgeon-resigns-post-after-backlash-over-editorial-85346 <img typeof="foaf:Image" src="http://llnw.wbez.org//npr_story/photo/2011-April/2011-04-18/greenfield_lazar_vert.jpg" alt="" /><p><p>The American College of Surgeons, the leading group for the profession, will have a new president come this fall.</p><p>But it won't be <a href="http://surgery.med.umich.edu/portal/about/emeritus/faculty/greenfield_bio.shtml">Dr. Lazar Greenfield</a>, a distinguished vascular surgeon who last year was honored by the group with an <a href="http://www.facs.org/news/jacobson10.html">award for innovation</a> and who was until this weekend the college's president-elect.</p><p>Though he may be an ace in the operating room, Greenfield, a professor emeritus at the University of Michigan, proved tone deaf — or worse — as a writer and editor. In a Valentine's Day editorial for <em>Surgery News</em>, a <a href="http://www.nxtbook.com/nxtbooks/elsevier/sn0411/#/0">publication affiliated</a> with the ACS, Greenfield extolled the virtues of semen as a mood-enhancer for women. That editorial proved his undoing.</p><p></p><p>The piece recounted a bunch of different studies and concluded:</p><p><blockquote></p><p>So there's a deeper bond between men and women than St. Valentine would have suspected, and now we know there's a better gift for that day than chocolates.</p><p></blockquote></p><p>Well, that didn't sit well with quite a few people. The entire February issue of <em>Surgery News</em> was pulled from the Web. And complaints poured into the American College of Surgeons.</p><p>"I was aghast," <a href="http://www.mc.vanderbilt.edu/root/vumc.php?site=vascularsurgery&doc=28065">Dr. Colleen Brophy</a>, a professor of surgery at Vanderbilt University and an ACS member for more than two decades, told Dr. Pauline Chen, who <a href="http://well.blogs.nytimes.com/2011/04/15/sexism-charges-divide-surgeons-group/">wrote about the controversy</a> on the <em>New York Times</em>'s Well blog last week. Brophy resigned from the group to protest how it mishandled things.</p><p>The blog Retraction Watch has been all over the case, and you can read the full text of the editorial <a href="http://retractionwatch.wordpress.com/2011/04/06/forget-chocolate-on-valentines-day-try-semen-says-surgery-news-editor-retraction-resignation-follow/#comments">there</a>. Pretty quickly, Lazar lost his job as editor of <em>Surgery News</em> because of the editorial.</p><p>And, as Retraction Watch <a href="http://retractionwatch.wordpress.com/2011/04/17/semen-editorial-costs-greenfield-presidency-of-american-college-of-surgeons/#more-2332">reported</a>, Lazar has now been replaced as president-elect of ACS by <a href="http://www.upstate.edu/surgery/healthcare/breastcare/">Dr. Patricia J. Numann</a> of Syracuse, N.Y.</p><p>Lazar <a href="http://www.nytimes.com/2011/04/18/health/18surgeon.html?_r=1">told</a> the <em>New York Times</em> in a statement that he had apologized many times but ultimately resigned to put an end to the "disruptive issue." Copyright 2011 National Public Radio. To see more, visit <a href="http://www.npr.org/">http://www.npr.org/</a>.<img src="http://metrics.npr.org/b/ss/nprapidev/5/1303150070?&gn=Prominent+Surgeon+Resigns+Post+After+Backlash+Over+Editorial&ev=event2&ch=103537970&h1=Treatments,Doctors,Health+Headlines+Newsletter,Shots+-+Health+Blog,Health,Health+Care,Home+Page+Top+Stories,News&c3=D%3Dgn&v3=D%3Dgn&c4=135507352&c7=1128&v7=D%3Dc7&c18=1128&v18=D%3Dc18&c19=20110418&v19=D%3Dc19&c20=1&v20=D%3Dc20&c31=133188451,126948545,121027244,103537970&v31=D%3Dc31&c45=MDA0OTc2MjAwMDEyNjk0NDE4OTI2NmUwNQ001"/></p></p> Mon, 18 Apr 2011 08:57:00 -0500 http://www.wbez.org/story/doctors/2011-04-18/prominent-surgeon-resigns-post-after-backlash-over-editorial-85346 Doctors Were Big Spenders On Health Lobbying in 2010 http://www.wbez.org/story/doctors/doctors-were-big-spenders-health-lobbying-2010 <p><p>The health care battles didn't end for doctors with the passage of the federal health law last year, and their lobbying shows it.</p><p>The American Medical Association was the biggest spender for lobbying operations among health care groups last year. The AMA, which <a href="http://www.npr.org/blogs/health/2010/06/25/128114477/did-health-overhaul-train-leave-doctors-on-the-platform">supported</a> the Democratic health law, faced a serious backlash from members angry that planned cuts in Medicare reimbursements weren't <a href="http://www.npr.org/blogs/health/2010/02/another_shortterm_solution_to.html">reversed</a> by the law. To overturn the cuts, the AMA mounted a <a href="http://www.rollcall.com/issues/56_47/-200583-1.html">strong campaign</a> on Capitol Hill.</p><p>The AMA spent nearly $22 million for the year, an increase of nearly 9 percent. That effort helped the organization <a href="http://www.ama-assn.org/amednews/2010/12/13/gvl11213.htm">secure</a> in December "a one year reprieve from the scheduled cuts resulting from the broken Medicare physician payment system," said AMA President Cecil Wilson in a statement to KHN.</p><p></p><p>Overall, however, the health law's enactment brought a decrease from the <a href="http://www.usatoday.com/news/washington/2009-11-22-health-lobby_N.htm">massive effort</a> stakeholders staged during the heated congressional debate in 2009. Ten key health care players spent about $127 million on lobbying, down nearly 9 percent from 2009, according to <a href="http://www.publicintegrity.org/articles/entry/1953/">lobbying documents</a> filed with the Senate Office of Public Records on Jan. 20 for the fourth quarter of 2010 and <a href="http://www.opensecrets.org/lobby/index.php">records</a> from the Center for Responsive Politics as of Jan. 26. The drop was led by pharmaceutical companies and that industry's lobbying group, the Pharmaceutical Research and Manufacturers of America, which cut its lobbying expenditures by 17 percent for the year. PhRMA aggressively lobbied to get the health law passed in 2009, and then announced in early 2010 that its CEO, Billy Tauzin, was leaving.</p><p>"When legislation is moving, that is when we are engaged," said Wes Metheny, PhRMA senior vice president, when asked why there had been a decline in spending. The health law passed last March.</p><p>However, at least one major drugmaker, Merck & Co., and the CVS/Caremark increased their spending.</p><p>In addition to the AMA, the American Hospital Association, America's Health Insurance Plans and the Biotechnology Industry Organization all spent more in 2010 on lobbying than in 2009, driven by lingering issues related to the health overhaul and the Medicare reimbursements.</p><p>"The doctors and hospitals still had to get a fix on" Medicare reimbursement rates, said Randy Fenninger, a senior policy adviser at Holland & Knight, whose firm represents hospitals, doctors and insurers. "And for the insurance and biotech industry, there was a lot of (federal) rulemaking which kept them very, very active."</p><p>In addition to the 10 health care players, the seniors group AARP, which lobbies on health care as well as a number of other issues, boosted its expenditures by 5 percent to $22.05 million. AARP supported the health law and among its top issues in 2010 was getting a $250 rebate check out to Medicare beneficiaries caught in the "doughnut hole" for prescription drug reimbursements. Copyright 2011 Kaiser Health News. To see more, visit <a href="http://www.kaiserhealthnews.org/">http://www.kaiserhealthnews.org/</a>.<img src="http://metrics.npr.org/b/ss/nprapidev/5/1296168127?&gn=Doctors+Were+Big+Spenders+On+Health+Lobbying+in+2010&ev=event2&ch=103537970&h1=Health+Inc.,Medicare+%26+Medicaid,Doctors,Health+Headlines+Newsletter,Shots+-+Health+News+Blog,Health,Health+Care,Politics,Science,U.S.,Home+Page+Top+Stories,News&c3=D%3Dgn&v3=D%3Dgn&c4=133278997&c7=1001&v7=D%3Dc7&c18=1001&v18=D%3Dc18&c19=20110127&v19=D%3Dc19&c20=105043435&v20=D%3Dc20&c45=MDA0OTc2MjAwMDEyNjk0NDE4OTI2NmUwNQ001"/></p></p> Thu, 27 Jan 2011 15:45:00 -0600 http://www.wbez.org/story/doctors/doctors-were-big-spenders-health-lobbying-2010 How neurosurgeons size up brain injuries like Giffords' http://www.wbez.org/story/arizona-rampage-congresswoman-others-shot/how-neurosurgeons-size-brain-injuries-giffords <p><p>With Rep. Gabrielle Giffords <a href="http://www.npr.org/blogs/health/2011/01/10/132805493/hopeful-signs-but-many-questions-for-giffords-medical-outlook">hospitalized in Tucson, Ariz.,</a> after Saturday's shooting, we checked in with some leading neurosurgeons for insights into her condition and what the future might hold.</p><p>You'll be able to listen to Jon Hamilton's report on Monday's <em>All Things Considered </em>and Tuesday's <em>Morning Edition</em>. Here are excerpts, edited for length and clarity, from interviews done for the pieces.</p><p><strong><a href="http://www.cedars-sinai.edu/Bios---Physician/A-G/Keith-L-Black-MD.aspx">Dr. Keith Black</a>, chairman of neurosurgery at Cedars Sinai Medical Center, Los Angeles.</strong></p><p><em>Q: The trajectory of the bullet through Giffords' brain appears to have been higher than initially thought. Why would that be a good sign?</em></p><p>A: The language areas are lower down. There's one in the left temporal lobe, which is responsible for comprehension of language, and there's another area in the lower frontal lobe, off to the side, that's critical for expression of language. If the bullet is high, then it can avoid those two areas. The one caveat with the bullet being higher is that the motor areas can be high, particularly the motor areas that control the legs.</p><p></p><p><em>Q: What should we watch for in the next few days?</em></p><p>A: The maximum amount of swelling typically occurs three days after injury. Tomorrow (Tuesday) is going to be an important day to make sure she doesn't get into any increased swelling issues or any pressure issues. After that things should start to stabilize and improve. If she hasn't had any new bleeding by this time that's also a very positive sign. The next big step for her is going to be getting off the respirator. When they wake her up and see if she can support her respirations.</p><p><em>Q: Have you treated patients who have an injury like this and seen them walk out eventually in pretty good shape?</em></p><p>A: Absolutely. The fact she got immediate care, got to the CT scanner, and got neurosurgical attention right away is very positive.</p><p><strong><a href="http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/pituitary_center/profiles/team_member_profile/EF48C2ECB225F29CCA8C801AAEB2BE26/Henry_Brem">Dr. Henry Brem</a>, chief of neurosurgery at Johns Hopkins Hospital, Baltimore.</strong></p><p><em>Q: What can you say about the course of care for patients with injuries like Giffords'?</em></p><p>A: When someone comes in and they're alert and following commands, there's the hope they survive the injury and get through successfully. The fact that the person is awake and alert coming into the emergency room is a very good prognostic sign.</p><p><em>Q: What's the most important factor?</em></p><p>A: It's all about what damage was done. Clearly what you hope for is that the bullet is as superficial as possible. The bottom line is the functions. If someone is able to talk or follow verbal commands then that means you have  understood spoken language, processed it and turned it into a function -- into doing something to follow that command. That, in and of itself, tests a great deal of the brain.</p><p><em>Q: What lies ahead for Giffords?</em></p><p>It's a terrible injury to have. But, given that, the longer that she's alive and the longer she has encouraging signs, the more encouraging it is for the future. The best predictor for how she's going to do is how these next few days unfold.</p><p><strong><a href="http://neurosurgery.med.miami.edu/find-a-doctor/profile?id=1393">Dr. Jonathan Jagid</a>, assistant professor of neurological surgery, Miller School of Medicine, University of Miami.</strong></p><p><em>Q: What sorts of things are doctors treating Giffords looking for? </em><strong> </strong></p><p>A:  Whenever you've got an injury to the brain or any part of the body it swells. The difference between your arm swelling and the brain is that the brain is in a closed compartment. Once the damage has been done from the bullet, the only thing you're trying to prevent from there on out is what's called secondary injury from swelling of the brain. Copyright 2011 National Public Radio. To see more, visit <a href="http://www.npr.org/">http://www.npr.org/</a>.<img src="http://metrics.npr.org/b/ss/nprapidev/5/1294768345?&gn=How+Neurosurgeons+Size+Up+Brain+Injuries+Like+Giffords%27&ev=event2&ch=103537970&h1=Rep.+Gabrielle+Giffords,Arizona+Rampage%3A+Congresswoman%2C+Others+Shot,Doctors,Shots+-+Health+News+Blog,Health,Science,Home+Page+Top+Stories,News&c3=D%3Dgn&v3=D%3Dgn&c4=132810638&c7=1007&v7=D%3Dc7&c18=1007&v18=D%3Dc18&c19=20110110&v19=D%3Dc19&c20=1&v20=D%3Dc20&c21=2&v21=D%3Dc2&c31=132800636,132783213,126567578,103537970&v31=D%3Dc31&c45=MDA0OTc2MjAwMDEyNjk0NDE4OTI2NmUwNQ001"/></p></p> Mon, 10 Jan 2011 14:08:00 -0600 http://www.wbez.org/story/arizona-rampage-congresswoman-others-shot/how-neurosurgeons-size-brain-injuries-giffords