Sen. Charles E. Grassley (R-IA) has asked Mary K. Wakefield, PhD, RN, administrator of the Health Research and Services Administration to schedule an in-depth briefing on the issues surrounding the decision to shut down public access to the National Practitioner Data Bank's Public Use File. In a letter dated Oct. 7, Grassley sent a letter about the matter stating that the NPDB PUF serves as the backbone for providing transparency for "bad acting healthcare practitioners." However, in light of one Kansas City Star reporter shining on their abilities to identify a physician's databank record by comparing de-identified information with state court records, HRSA wrote the reporter Aug. 26, "threatening monetary penalities for 'republication of information obtained from the NPDB.'" Wrote Grassley: "It seems disturbing and bizarre that HRSA would attempt to chill a reporter's First Amendment activity with threats of fines for merely 'republishing' public information from one source and connecting it with public information from another..."
The outcry among many physicians and patients over a government panel's recent announcement that healthy men should no longer receive P.S.A. blood testing to detect prostate cancer is rooted in a long and impassioned history among cancer screening advocates that early detection must always save lives. But as science has taught us, that?s not always the case. As early as 1913, physicians and laypeople formed the American Society for the Control of Cancer, which later became the American Cancer Society, bearing this hopeful message: ?With early recognition and prompt treatment, the patient?s life may often be saved.? The idea had some scientific basis. ?Delay kills!? posters bluntly warned. But research also emerged that questioned the cancer society?s original assumption that cancer was a local disease that spread in a gradual and orderly fashion. Scientists had found cancer cells in the blood of patients with seemingly tiny, localized cancers, suggesting that cancer cells could spread silently early in the course of disease. In that case, so-called early detection might not really be early, or of much value.
A day after a government panel said that healthy men should no longer get screened for prostate cancer, some doctors' groups and cancer patients' advocates began a campaign to convince the nation that the advice was misguided. Their hope is to copy the success of women's groups that successfully persuaded much of the country two years ago that it was a mistake for the same panel, the United States Preventive Services Task Force, to recommend against routine mammograms for women in their 40s. This time, the task force found that a P.S.A. blood test to screen for prostate cancer does not save lives, but results in needless medical procedures that have left tens of thousands of men impotent, incontinent or both. Both sides in the battle have marshaled distinct arguments, and both said their only goal was to protect patients. Caught in the middle are 44 million men in the United States over the age of 50 who must now decide whom to believe.
Federal inspectors will soon pay an unannounced visit to Grady Memorial Hospital. The federal survey was triggered by the death of 60-year-old Gloria Shavers who fell to her death from an open 11th floor window of the hospital last month. Centers for Medicare and Medicaid Services spokesperson Lee Millman says investigators plan to conduct a full survey of the hospital. "The facility agrees to provide quality care in a safe environment and we agree to pay for that care. If there's a deficiency than the survey If it was not corrected and it was severe enough then we could terminate the funding." If violations are found and the hospital does not adequately address them, Millman says that could put Grady's Medicare funding in jeopardy. But Millman says those cases are rare. "Hospitals do want to come into compliance. We have found that."
Michelle Malizzo Ballog was nervous as hospital staff wheeled her into surgery to replace a temporary stent in her liver. In a procedure two weeks earlier, also at University of Illinois Medical Center at Chicago, she had awakened too early from the anesthesia, an unsettling experience. But this time she didn't wake up. Monitoring errors were made while she was under anesthesia, and Ballog, whose youngest daughter had turned 1 the day before, stopped breathing and suffered cardiac arrest on the operating room table. She lapsed into a coma and died nine days later at 39. Her parents and sister had no idea at first that Ballog's death was caused by preventable medical errors, of which the monitoring problem was only the first. When they found out, they were livid. Bob Malizzo, Ballog's father, remembers angrily asking doctors: "How could this happen?" To the family's astonishment, hospital officials did not duck their questions, cover up their mistakes or hide behind lawyers. Instead, they shared the tragic details. As a result, the family made a surprising decision of their own: They chose not to sue and joined the hospital's safety review committee to help the medical center avoid making such errors in the future.
Surgery is surprisingly common in older people during the last year, month and even week of life, researchers reported Wednesday, a finding that is likely to stoke, but not resolve, the debate over whether medical care is overused and needlessly driving up medical costs. The most comprehensive examination of operations performed on Medicare recipients in the final year of life found that nationally in 2008, nearly one recipient in three had surgery in the last year of life. Nearly one in five had surgery in the last month of life. Nearly one in 10 had surgery in the last week of life.