Boston surgeons can help patients get a new penis, or lose the old one

CaptureNot at the same place. Both the Globe and WBUR report today on Boston Medical Center’s new male-to-female gender reassignment surgery program. News comes just after MGH’s announcement of the first penis transplant.

From the Globe

Boston Medical Center plans to become the first hospital in Massachusetts — and one of a few in the country —to offer gender reassignment surgery, responding to a growing and unmet demand for treatment in the transgender community.

The hospital said more than 100 patients have already signed on to a waiting list to be evaluated for surgery — even before it has widely publicized the program. Boston Medical Center has long provided primary care, mental health services, and hormone therapy for transgender men and women, and most of the patients considering surgery are from the Boston area. Capture2Across the country, many hospitals have been reluctant to offer male-to-female and female-to-male genital surgeries, but health care providers said that is slowly changing as insurance coverage expands and public acceptance of transgender people grows.

 

Do we need to learn to live with sponsored health care content?

I was going to scan in the front page of today’s Globe, which features a story on Partners staff complaining about how hard it is to learn the new $1.3 billion HIT system. There was a teaser nestled up to it for a story on the first penis transplant. That juxtaposition made me wonder how a slip of the finger on keyboard might impact the noted surgery. But, I decided to be a grown up.

Instead, I’ll let someone else rag on the Globe, or in this case the sort of Globe. That would be the part of the Globe Media Co. that is hiring new staff, not the newspaper itself, which is offering staff buy-outs.

Over at Health News Review, Trudy Lieberman complains about a “serious and rapidly emerging dilemma for consumers of health news. What’s real journalism and what’s “content” masquerading as journalism as we know it?  Examining stories on The Guardian’s Healthcare Network site and on STAT, the fledgling digital news service that’s making a name for itself with loads of daily content, I discovered a blending of traditional stories with advertising and promotion that simply fools the reader.

She goes on: When I first caught on to what STAT was doing, I felt deceived like I was when I read The Guardian’s breakthrough piece. The pooh-bahs at STAT are making it easy for me to read something I don’t want to read and confusing me with look-alike content prepared by some of the biggest names in the healthcare business— Cigna, CVS Health, Johnson & Johnson, Baxalta, a new biopharmaceutical company, and PhRMA whose contributions to Morning Rounds have included “America’s biopharmaceutical researchers and scientists are tireless in the fight against disease” and “Imagine “smart bombs” that fight cancer and reduce side effects.”

First, my conflicts. I was involved in a major sponsored content project once. And I have a family member who works at the Globe.  And while I’m not a big fan of native advertising, I am a big fan of good journalism and we need to pay for it somehow. Or, the folks at STAT will be getting those buy-out offers.

Plus, it looks pretty well-Capturemarked to me with all that orange.  Also, I’m not sure the idea is so much to hide PR in news-sheep’s clothing. My understanding it that the idea is to get this stuff out on social media where the orange banners and disclosures don’t show up — social marketing. That concerns me, along with all these university and hospital publication that look and sound like news but are PR and marketing. Many will argue — we report these stories just like journalist. The difference is — who do they answer to? Who is the customer? That would be the marketing staff at institution or the hospitals, not the reader. But, that stuff gets tweeted out and no one knows the difference. My journalism students don’t know the difference.

Honestly, I hate this stuff as much as Lieberman does. I want to keep that wall between advertising and editorial up. Are native advertising and social marketing, by nature, deceiving the reader?  You could make that argument.  But, I see the dilemma. Here’s hoping we find a better way to support good journalism.

 

 

Docs reject Harvard jobs because of conflict of interest policy?

Well, that’harvard meds  what Dr. Peter Slavin, president of Massachusetts General Hospital, told STAT news in a story about Harvard’s revised conflict of interest policy:

Slavin said the change may help with a recruitment problem: “Some faculty don’t come because they perceive that Harvard Medical School has rules that are much too restrictive.”

Or they leave, according to Gretchen Brodnicki, dean for faculty and research integrity.

 Brodnicki said she has heard anecdotes of faculty leaving, or being unable to conduct specific studies, because of the rule, though she said the impact is hard to measure.

Here’s the new rule:

First, the school is raising the thresholds: Faculty will have to receive at least $25,000 in income (up from $10,000), or hold $50,000 in equity of a publicly traded company (up from $30,000) to trigger the prohibition on clinical research. Faculty still cannot hold any equity in a privately held company if they want to do clinical trials on that company’s product.

Second, the school will now allow faculty to petition for an exemption if they’re over those thresholds and still want to do the research.

 

Boston health interviews: Spotlight on surgery, Lown and Berwick

You correspondent has been tooling around the city lately asking a lot of questions. Three recent Q&A column in Health Leaders with Boston, Brookline and Cambridge, Mass. links.

Also, the staff at the Brigham had a few questions when a VIP guest make some special requests. Check out the story from the Sunday Globe

When state investigators interviewed an employee identified as “nurse director #1’’ in the report, she said the patient interpreted the use of protective gowns as an indication they thought he was “dirty’’ and asked that staff not wear them. A physician told inspectors that he visited the patient five to seven times a week and did not wear protective gear because the patient “found it offensive.’’ And the hospital had no infection control policies in place for the patient’s personal staff, it told the state. 

sox win 07

Go Sox!

Concurrent Surgery Gets the Spotlight treatment: The editor of The Boston Globe’s investigative reporting unit discusses his team’s series raising questions about the practice of concurrent surgeries and patient safety.

 

Vikas Saini, MD, president of the Lown Institute:”There really needs to be an alliance among patients, families, and communities. At the end of the day, they get to decide what is the right care,”

 

Donald Berwick: The former head of CMS says “we will never solve the problem of cost and finance by focusing on cost and finance.” Instead, it will be resolved “by focusing on the design and redesign of healthcare and the improvement of its quality.”  Part 2

 

 

Guns in hospitals? MGH guards go with pepper spray

579 mill tower MGH

MGH 2010

Deep into a disturbing  New York Times story on hospital guards who shoot patients, find a passing reference to Massachusetts General Hospital’s security program.

(More on guns in hospitals here.  It has been about a year since the son of a patient walked into the Brigham and fatally shot a doctor. 

From the Times:

To protect their corridors, 52 percent of medical centers reported that their security personnel carried handguns and 47 percent said they used Tasers, according to a 2014 national survey, more than double estimates from studies just three years before. Institutions that prohibit them argue that such weapons — and security guards not adequately trained to work in medical settings — add a dangerous element in an already tense environment. They say many other steps can be taken to address problems, particularly with the mentally ill.

Massachusetts General Hospital in Boston, for example, sends some of its security officers through the state police academy, but the strongest weapon they carry is pepper spray, which has been used only 11 times in 10 years. In New York City’s public hospital system, which runs several of the 20 busiest emergency rooms in the country, security personnel carry nothing more than plastic wrist restraints. (Like many other hospitals, the system coordinates with the local police for crises its staff cannot handle.)

“Tasers and guns send a bad message in a health care facility,” said Antonio D. Martin, the system’s executive vice president for security. “I have some concerns about even having uniforms because I think that could agitate some patients.”

Surgeons, MGH react to to Globe story on surgery scheduling

ss2 (2)Reaction to the Globe’s Spotlight series on simultaneous surgeries — where a surgeon has two operations going at the same time — continues in the paper and beyond

In late December, the paper reported:

 

The American College of Surgeons plans for a roughly 10-member committee — which includes both critics and supporters of concurrent surgeries — to craft a consistent approach to keeping patients safe and informed when doctors run two operating rooms, according to Dr. David Hoyt, executive director of the organization.

“We are going to move as quickly as we can on this,” Hoyt said. “This is a priority.”
A Globe survey of 47 hospitals nationwide found that it is common for surgeons to start a second operation before the first is complete, often after the surgeries were deliberately scheduled to overlap briefly. However, some surgeons have operations that run simultaneously for longer periods. And few hospitals call on doctors to explicitly tell patients when their operations are double-booked.

The paper also ran an editorial cartoon — a surgeon on RollerBlades –with a super long disclosure statement.

MGH got a lot of space in the Sunday “Ideas” section to offer their unfiltered take on the matter, as did this doctor:

When I handle concurrent procedures, I have to carefully design the schedule around when I can and cannot be absent from an operating room. Surgical procedures have “critical” and “noncritical” portions, and this changes on a case-by-case basis depending on the patient and his or her unique problem as well as the team I’m working with. For instance, if I’m working with a brand-new intern, then every moment, from preparation to wake-up, is critical. If I’m working with a seasoned fellow with five years of operating experience, then the critical portions are much more focused.

From the Jan. 10 piece  by Dr. Peter L. Slavin –president of Massachusetts General Hospital  and Dr. Thomas J. Lynch chairman of the Massachusetts General Physicians Organization ran in the Sunday “Ideas” section of the paper

Overlapping surgery occurs at MGH and hospitals throughout the country for a variety of reasons. Overlapping surgery saves lives in certain clinical situations, such as after the Boston Marathon bombings and the Rhode Island Station nightclub fire, when multiple critically ill patients need rapid access to surgical care. Overlapping surgery enhances access to care, helping meet the high demand for certain specialties and specialists.

Partners has also posted detailed comments on its own web site.

 

Partners’ Kvedar’s new book on “The Internet of Health Things”

Joseph  Kvedar, the VP of Partners’ Connected Health Program was on to  “The Internet of Healthy Things” way before any of the rest of us.  Now he’s collected his thoughts — aimed a “business executives” — in a new book.

More video from this year’s connected health conference here.

 

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