FRONTLINE: Can Camden, New Jersey save health care?

During a recent interview with BHN, organizers with Health Care for All mentioned a project in Camden, New Jersey that identified and targeted high cost patients. The Massachusetts group is considering doing the same here to show that it is possible to lower costs and improve care.

This week, Boston doc and New Yorker writer Atul Gawande took to the air with a report on the Camden project for the locally produced PBS program FRONTLINE. Check out the story online, as well as web extras, including a link to a live chat with Gawande, as well as another to his New Yorker story.

From the site:

Using medical billing data in Camden, N.J., Dr. Jeffrey Brenner mapped out “hot spots” of the impoverished city’s most costly patients. By targeting unique care — including home visits and social workers — at high-cost patients, he developed a program that he argues has both lowered health care costs and provided better care in Camden. But can his model work for the rest of the nation?

Harvard Med appoints LGBT advisors

Harvard Medical School has appointed two professors — Drs. Harvey J. Makadon and Graham T. McMahon– to act as LGBT advisors to lesbians, gay, bisexual and transgender medical students.

Harvey J. Makadon, MD, is  director of education and training at The Fenway Institute, the research arm of  gay-friendly Fenway Community Health in Boston. Graham T. McMahon, MD, is an endocrinologist at the Brigham and Women’s Hospital and the editor for medical education at the New England Journal of Medicine. Both are also on
the med school faculty.

This from a letter dated August 2011 from the  Office of Recruitment and Multicultural website. (The direct link is acting  finicky, so  click here and find the letter under “Links.”)

In this role, Drs. Makadon and McMahon will be advising students, participating in ongoing work to develop an inclusive curriculum that will lead to better care for LGBT patients, and helping to nurture a learning and working environment that is supportive to LGBT students, trainees, staff and faculty….

 Recommendations from the American Association of Medical Colleges among others call for physicians to treat each patient with dignity and respect, regardless of the patient’s sexual orientation or gender identity. Medical
schools must ensure a safe learning environment for all our students, regardless of their sexual orientation or gender identity. We look forward to working with our students, faculty and staff as we embrace our diversity, and
foster an inclusive and respectful environment for all.

Click here for The Kinsey 2-6ers – ” so-named for  the Kinsey scale of sexual orientation.” – the Harvard Med LGBT student group.

Tufts research: Does Sleepytime tea really make you sleepy?

From Nature Network Boston.

Works for me, but if you need more than anecdotal evidence,
researchers Diane McKay and Jeffrey Blumberg at the US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University have gathered some for you. From the USDA’s Agricultural
One popular herbal, chamomile tea, has long been considered a
soothing brew. In the early 20th century, it was mentioned in a classic
children’s book about a little rabbit named Peter. At the end of a rough day,
Peter’s mom served him some chamomile tea. Interestingly, when Blumberg and
McKay reviewed scientific literature on the bioactivity of chamomile, they found
no human clinical trials that examined this calming effect.They did, however, publish a review article on findings far beyond
sedation–describing test-tube evidence that chamomile tea has moderate
antioxidant and antimicrobial activities and significant antiplatelet-clumping
activity. Also, animal feeding studies have shown potent anti-inflammatory
action and some cholesterol-lowering activity.
The center gets an impressive amount of press. Check out their site for stories on the food pyramid, picky eaters and the benefits of berries.

#WBUR: When young people get #cancer

WBUR’s On Point is about to begin a segment on young people and cancer. Guest include two women who made a film based on their late friend’s life and Dr. Stuart Goldman, psychiatrist at Children’s Hospital Boston. If you miss this morning’s show, it repeats tonight or you can listen onlin.


Harvard prof targets sperm tails in search for male contraceptive

From the NY Times:

Male contraceptives are attracting growing interest from scientists, who believe they hold promise for being safe, effective and, also important, reversible…While male contraception has been studied before, no method met the stringent safety and effectiveness criteria that female methods do. It was also unclear whether men would use them.  Now, scientific advances are producing approaches that could pass muster…

At Harvard, Dr. David Clapham, a neurobiologist, discovered that sperm tails contain calcium ion channels, with electrically charged atoms “turbo-charging the sperm” to reach eggs, he said. He is developing a drug to disable the channel.       

“You just turn off the motor, rather than alter the people in a car,” he explained.       

Is MIT’s Gruber an objective source on Massachusetts health reform?

In this week’s heat wave edition of Health Wonk Review, John C. Goodman —  the self-described “Father of Health Savings Accounts”  – gets  steamed over the what he sees as the limits of Mass health reform. He says it amounts to little more than “moving money from one bucket to another.”

Goodman is is president and founder of the National Center for Policy Analysis, a Dallas “free-market think tank.”

In his post, he takes on MIT Professor Jon Gruber  who “calls Massachusetts an unqualified success, citing some of the very same studies I am citing. But since Gruber was one of the architects of the Massachusetts health reform, this is like a student grading his own exam. NCPA senior fellow Devon Herrick has shown that Gruber sorted through the evidence, cherry-picked what he liked, and ignored everything else.”

Comments welcome.

NatNetBoston: Why no comment on Kolata’s New York Times cancer stories?

Nature Network Boston ponders why we’re hearing little comment on the NYTimes story on the failure of personalized medicine.  Here’s some from GoozNews:

I’ve been covering this subject for the Journal of the National Cancer Institute (subscription required). As I noted in a recent article:

Though hundreds of studies have appeared in the medical literature making claims for the predictive power of multi-gene signatures of different cancers, few have been deemed ready for prime time. A review last year of 16 studies of multiple gene-signatures in non-small cell lung cancer found “little evidence that any of the reported gene expression signatures are ready for clinical application.”

Reduced to its essence, here’s the problem. These tests are based on the measurement of the under- or over-expression of dozens of genes. Those results are then subjected to a complex algorithm that is based on a series of “weights” given the  expression levels of each of the genes in the targeted panel. Those weights are added up for a composite score that determines whether you have of a particular form of a disease, and whether it is more or less likely to be affected by a particular drug. In other words, this extraordinarily complex test based on dozens of unvalidated, epidemiological observations leads to a clinical decision that is binary. Either you have or don’t have that kind of cancer; either you will or will not benefit from that drug.

While you’re at NNB, check out posts on the resignation of a Harvard researcher with ethical issues and a post on the Broad Institute’s Midsummer Nights’ Science talks, which continue tonight.

VT investigators help find drop in surgical errors at VA hospitals.

VT investigators led this study that found a drop in surgical errors at Veteran’s hospitals. From Medpage:

Reported event rates fell from 3.21 per month in 2006 to 2.4 per month in 2009 (P=0.02), according to Julia Neily, RN, of the Veterans Health Administration in White River Junction, Vt., and colleagues.

And analysis of events most likely to cause the greatest harm found that these events decreased by an annual rate of 14% (rate ratio 0.86, 95% CI 0.75 to 0.97, P=0.02), the research team reported online in the Archives of Surgery.


Does “health care” equal “health” in Massachusetts? Not yet

Healthy People Healthy Economy First Annual Report Card

In 2007, and again in 2009, the Boston Foundation and NEHI published major reports that alerted our community to the growing crisis of preventable chronic disease among our state’s residents—which is driving up health care costs to the point where they are crowding out investments in virtually all other areas of community life. In 2010, the two organizations came together again to launch a powerful coalition, called Healthy People/Healthy Economy, with the goal of shifting our state’s focus from “health care” to “health,” and making Massachusetts the national leader in health and wellness.  This annual Report Card will track the policies, programs and practices designed to improve the health of our state’s residents.

Here’s the report’s conclusion:

Massachusetts leads the nation in access to health care, medical innovation and educational attainment—milestones that are at the core of our state’s economic competitiveness. However, as we have seen, the recent doubling of adult obesity and the increasing percentage of children who are overweight or obese in the Commonwealth are resulting in a rising tide of preventable chronic disease. That, in turn, is increasing the likelihood of unsustainable cost burdens on families, businesses and the Commonwealth. The Healthy People/Healthy Economy Coalition seeks to reverse these trends and the threat they pose to residents’ health and the Commonwealth’s fiscal health andcompetitiveness. Its ultimate goal is to address the crisis in preventable chronic disease among Massachusetts residents while improving lives and curtailing health care costs.

The Healthy People/Healthy Economy Coalition’s policy agenda is designed to focus attention on transformative best practices and policies, to inspire action at every level, and to foster collaboration across sectors, institutions, cities and towns.

Success will benefit all residents of the Commonwealth, and particularly those now lacking access to physical activities and fresh nutritious foods. Reducing preventable chronic disease rates in all of our communities will reduce future spending on medical services and free up public and private resources to invest in the social determinants of health such as education, recreation and community safety. That, in turn, will help to increase health equity, boosteconomic dynamism and make Massachusetts the national leader in health and wellness.

This annual Report Card tracks the progress of the Commonwealth’s adoption and implementation of proven policies and best practices. In the future, the Report Card will connect our progress on policies with health outcomes and costs.

The Healthy People/Healthy Economy Coalition addresses one of the Commonwealth’s greatest challenges—the rebalancing of our investment in health care services with our investment in the basic determinants of health—in order to create the kind of future we all need if we are to achieve the goal of “healthy people in a healthy economy.”

Please join us.

Harvard nurtures the physician scholar

Harvard nurtures the physician scholar

Next fall, Harvard Medical School will launch a major new component of medical education reform: the Scholars in Medicine Program. Starting with the entering class of 2011, every medical student will be required to undertake a scholarly project. According to Gordon Strewler, the program’s director, projects will run the gamut of inquiry, from molecular biology to health care policy and the history of medicine.

The goal is to hone critical thinking and foster curiosity among students while equipping them with the tools for discovery. “Students will not only master knowledge, but also help create it—in the form of a written work, perhaps even a publication,” said Strewler, professor of medicine at Beth Israel Deaconess Medical Center and master of the Cannon Society, one of five medical student societies at HMS.


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