Can hospitals be leaner?@STATnews take you insides the Brigham’s “struggle to cut costs.”

More here.

Over the past three months, the Brigham provided STAT unbrigham

usual access to meetings of its top management and internal deliberations and documents. 

This inside look shows how one of the nation’s leading hospitals is confronting the daunting financial and marketplace forces buffeting academic medical centers across the U.S.

“This wasn’t about ordinary cost-cutting,” Walls said. “It was very clear we had to become a much leaner, more efficient organization.”

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Globe: BWH surgeon sues BWH over wife’s post-#hysterectomy #cancer diagnosis

The Globe’s play on this story should say something — Metro front rather than 1A.  Malpractice stories are tricky– serious charges and a response penned by a lawyer, not a doctor.  (At 8 a.m., a complete version of the story was lingering on White Coat Notes, outside the paywall.)

Note the Brigham’s carefully worded statement on the link between cancer and  morcellation, the procedure used during a minimally invasive hysterectomy.

The Brigham said in a statement that “while it’s not possible to know what impact the procedure will ultimately have on Dr. Reed’s health, we do know that literature suggests morcellation of malignant tumors increases the chances of mortality. 

Here’s the lead

A Boston surgeon and his wife, an anesthesiologist, are pushing to stop a widespread surgical technique used on thousands of women during hysterectomies, which they say caused her undetected cancer to dangerously spread.

The she said/she said suggest that

Dr. Barbara Goff  president of the Society of Gynecologic Oncology and director of the Division of Gynecologic Oncology at the University of Washington in Seattle says “Morcellation allows many women to have safer hysterectomies with better outcomes than full abdominal surgery, including less blood loss, smaller wounds, and a quicker overall recovery.”

“You try to balance cost and outcomes and doing the best you can for an entire population of women,” Goff said.

But Dr. Bobbie Gostout, chairwoman of obstetrics and gynecology at the Mayo Clinic, said more women should be given the option of a vaginal hysterectomy, where the uterus can often be taken out intact through the vagina, especially because morcellation “is a questionable practice.”

She said morcellating devices are not yet good at capturing tissue or protecting other sensitive organs from rotating blades.

“I don’t want to see [morcellation] go away, but I would like to see it kept in perspective and occupy its necessary place,” she said. “Morcellation is still so far off what it ought to be.”

Globe: Justice to investigate Partners Healthcare

The Boston Globe reports this morning that the Justice Department is investigating Partners Healthcare  for “anticompetitive behavior.”

In a letter sent to Partners and the state’s three largest health insurers on April 19, investigators from the Justice Department’s antitrust division demanded documents relating to Partners’ “contracting and other practices in health care markets in Eastern Massachusetts.’’

The letter, obtained by the Globe, said the probe sought to determine whether the practices violated the Sherman Antitrust Act, which bars companies from using their market power to limit trade or artificially raise prices. The parties were told to respond by May 19.

Partners responded  by saying the company was cooperating in the investigation, which a spokesman described as “an ongoing analysis of health care in Massachusetts.’’

The group, which owns MGH, the Brigham and a more, is the biggest health care player in the state. Investigations by both the Globe and the state’s attorney general suggest that Partners’ market power and high prices are fueling high health costs in the state and limiting competition. Partners responded to the Globe series on its own website.

All that’s changing now. Stay tuned.

If all that is too depressing, John Stewart has collected all his Daily Show reports on health care on one page with titles like “Men who Stare at Votes.”

For the humorous take on health reform from the other side, see comments by former Saturday Night Live cast members Victoria Jackson, who performed with the Tea Party Express,  and Fox regular Dennis Miller.

Face transplants for soldiers

The Globe reports this morning that the U.S. military is sending them a group of injured soldiers to  Brigham and Women’s for face transplants.

Many of the veterans with damage to their faces were injured by improvised explosive devices and are recuperating at Walter Reed. Although some have other injuries such as brain damage and missing limbs that limit their ability to work, others return to military jobs, living on or near bases. As is the case with civilians who have lost portions of their faces to burns, disease, or traumatic injury, some of these veterans struggle with going out in public, relationships, and work.