Heroin epidemic:”She wants us to tell her story…”

This Boston Globe obit caught my eye. I cried anyway.

ENDICOTT, Kelsey Grace Age 23, passed away on April 2, 2016, from an accidental overdose. For many years, she fought a heroic battle with addiction. She had been sober for almost ten months, but her disease still had a powerful hold on her. We wish she had recognized the beauty and strength everyone else saw in her. Kelsey did not want to leave this world. She yearned for a life without fear and pain; a life that would permit her to realize that the world was open for her to explore and that change was possible. During her adolescence, Kelsey hid her vulnerability with meticulously-crafted sarcasm, but in recent years, she had allowed her kindness and compassion to shine – she had found the courage to be herself. It is not true that everything happens for a reason. The reality of Kelsey’s death is devastating, and no possible reason can justify the loss of this beautiful young woman, who had so much to give to the world. Wherever she went, people loved her. The disease of addiction is merciless. It is up to us to open our minds and hearts to those who are still sick and suffering. Kelsey does not want us to cry for her. She wants us to fight for her. She wants us to fight for her memory and all she believed. She wants us to use our voices to speak up about what is happening to her generation. She wants us to tell her story and never forget she was an amazing young woman with a bright future…not a statistic. Kelsey is survived by her son Camden Endicott, her parents Kathleen (Meehan) Errico and Paul Errico of Haverhill and her father Stephen Endicott of Malden. She is also survived by her sisters, Kaitlyn Meehan of Haverhill and Melissa Fucci of Holden and her nephew, Colin Thomas Meehan-Daniels. Also among her survivors are her grandparents, maternal grandfather, John Terrance Meehan of Hampstead and her paternal grandmother Grace Endicott of Bridgewater as well as Paul and Carole Errico of Littleton. She is also survived by many cousins, aunts and uncles. A Funeral Mass will be offered on Friday at 10 AM at St. Michael’s Church in North Andover. Burial will follow in Ridgewood Cemetery also in North Andover. Family and friends may call on Thursday from 4-8 PM at the Conte Funeral Home, 17 Third Street, NORTH ANDOVER. In lieu of flowers memorial contributions may be made to North Shore Recovery High School located at 112 Sohier Road, Beverly, MA 01915 or to the H.A.R.T House located at 365 East St., P.O. Box 477, Tewksbury, MA 01876 in Kelsey’s name. For directions or to offer online condolences please visit http://www.contefuneralhomes.com

Cambridge Adopts Overdoes Prevention Program
http://www.prx.org/p/54390/embed.js?size=full

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

 

 

New psych hospitals tap new market — insured heroin addicts

WBUR’s piece on private treatment centers for insured heroin addicts harkens back to  the ‘80s, when  private psychiatric hospitals popped up to treat troubled adolescents. Teenage angst was medicalized for the insured and  when 30 days were up, the kids were out the door. Often, not a lot of healing happened. From a 1990 LA Times story:

Mental health professionals have welcomed expanded psychiatric care for a segment of the population long overlooked: seriously disturbed or drug-dependent children under 18. But many worry that the pendulum has now swung too far.

“It’s the proliferation and commercialization of psychiatry,” said Dr. W. Robert Beavers, director of the Southwest Family Institute in Dallas. “We now have something nobody ever heard of 20 years ago–marketing people.”

Beavers, a family psychiatrist for more than three decades, said he has watched with some alarm as the number of children under 18 admitted for inpatient psychiatric treatment increased from about 77,000 in 1970 to about 112,000 in 1986, the last year for which complete statistics were available.

WBUR’s piece on addiction  programs for the insured raises some of the same troubling issues. Start with this quote from Brad Greenstein, CEO of Recovery Centers of America:

Capture1The facility will provide both inpatient and outpatient care, and Greenstein says it will feel almost like a boutique hotel — with well-appointed bedrooms, private therapy rooms, coffee shops and cyber cafes. Although he says eventually RCA plans to build other facilities that will accept those with public insurance, this center in Danvers will only accept commercially insured patients or those who pay out of pocket. These are people, Greenstein says, who are now underserved.

“For people who lack resources, there are a lot of programs that are funded to work with that population, and on the opposite extreme are people who have tremendous resources [who] can go really anywhere they want,” Greenstein said. “What we found, not just in Massachusetts but nationwide, is this lack of availability for your average everyday individual who has been dutifully paying insurance premiums — those are the ones having a hard time accessing care.”

Which takes us to today’s story in the Globe

The Department of Justice is investigating five hospitals run by the largest private provider of mental health services in Massachusetts for possible billing fraud, according to a report filed recently with the Securities and Exchange Commission

In Massachusetts, Arbour has been cited repeatedly by state regulators over poor care and inadequate staffing at its hospitals and outpatient clinics. At Arbour-HRI two years ago, public health officials found the hospital failed to provide active treatment to some patients, whose diagnoses included bipolar disorder and paranoid schizophrenia. Instead of attending group Capture3therapy, inspectors said, patients spent many hours sleeping or wandering the hallways — an allegation the company disputed.

This spring, the US Supreme Court plans to review a case brought by the parents of a deceased Massachusetts teenager against Universal Health Services. Yarushka Rivera died soon after receiving care at an Arbour clinic in Lawrence. Her parents contend that the company defrauded government insurance programs by charging for services provided by therapists unqualified to care for their daughter, who was covered by Medicaid.

DIY #abortions:Using #Google search as #datareporting

Boston #Sanders marchers on #healthcare

Photos from 2/27 Sanders March in Boston.

 

Sanders meyers

Alan Meyers, a Boston Medical Center pediatrician, said Sanders has brought discussion of single-payer into the mainstream. “We’ve been waiting for this for years.”

Sanders mna

Donna Kelly-Williams, RN, President of the Massachusetts Nurses Association and a maternity nurse at Cambridge Health Alliance.

 

Sanders nurse

File Feb 27, 3 46 42 PM

 

#STATnews asks: Are #Alzheimer’s numbers inflated?

CaptureIn her “Gut Check” column, STAT’s Sharon Begley notes that a NEJM report  from Boston University’s Framingham Heart Study claims that “The percent of people developing dementia each year is falling significantly… raising hope that some cases can be prevented and, possibly, that the worst forecasts of a “looming dementia crisis in the United States are overblown

The study notes that other evidence has the Alzheimer’s Association “sticking with its projection that, by 2050, the prevalence of Alzheimer’s will nearly triple, to 13.8 million Americans.

… The reluctance to dial down those forecasts might reflect “public health catastrophism,” added Dr. Jeremy Greene of Johns Hopkins, who, together with Jones, coauthored an accompanying perspective article on the Framingham study.

“It’s risky for advocates [to temper the most dire forecasts] for fear that it might bring a loss of funding,” Greene said.”

For more on this, see this list of stories on the topic of pharmaceutical support for non-profit patient groups. A bit dated, but USA Today offered an update in January.

Health charities say they work with drug companies in the search for cures. Corporate support is a standard form of fundraising for non-profits. The stories linked above question whether those relationships — and the dollars that come with them — bias these health groups. Will they challenge the efficacy of a new drug if they get tens of thousands from the drug’s  maker?

So, how much does the Alzheimer’s Association get from drug makers?  No one knows –non-profits are not required to report donations. Deep into its annual report, you’ll find a list of donors, but not exact amounts of donations.

$100,000-$249,000

Include:

Actavis

Amgen Foundation

AstraZeneca

Axovant

Biogen Idec

Eli Lilly

Forum Pharmaceuticals

Genentech/Roche

Janssen Pharmaceutical

Merck

Some of the same companies sponsored the group’s annual conference.

 

 

 

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.”

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