A small but growing number of parents think vaccines against childhood diseases are unsafe and are refusing or delaying shots for their children, despite the discrediting of a medical study linking vaccines and autism that stirred alarm. Ground zero in the debate is the pediatrician's office. Some frustrated pediatricians are drawing a line in the sand by requiring parents in their medical practices to vaccinate their children or seek healthcare elsewhere, a position that rubs some medical professionals the wrong way. Among those taking a stand are the eight pediatricians of Northwestern Children's Practice in Chicago. They no longer see children whose parents refuse to follow the childhood immunization schedule developed by the Centers for Disease Control and Prevention and the American Academy of Pediatrics. A letter and email sent to parents this year announced the policy, which went into effect in June.
Even as skin cancer rates in the Sunshine State are on the rise, scheduling an appointment to diagnose and treat the disease may be difficult. An aging population, lots of sun exposure and the rise of cosmetic procedures are cited as reasons for the growing patient volume. That's compounded by a stagnant number of dermatologists graduating from medical school. The result is a backlog of patients who can wait from weeks to months for appointments and have to drive as long as 90 minutes to the doctor's office. Longer wait times can delay identifying pre-cancerous lesions and skin cancer, the most frequently diagnosed cancer in the United States. Florida is second only to California for incidences of melanoma, the deadliest type of skin cancer, according to the most recent data from the Centers for Disease Control and Prevention. "I think there is a shortage," said Douglas Robins, MD, of the Florida Society of Dermatology and Dermatologic Surgery. "I know some places have monthlong backlogs."
University Hospitals in Cleveland, like health systems nationwide, is searching for ways to prevent patients -- especially those who have been hospitalized because of heart failure, pneumonia or a heart attack -- from being readmitted into their full-time care. University Hospitals and other area health systems are providing follow-up visits, as well as phone calls and other services to patients just released from their care, in an effort to keep former patients healthy and prevent them from returning to hospital's bricks and mortar facilities. If hospitals don't stop patients from being readmitted, they will pay: Starting in October 2012, Medicare will begin withholding payments to those that have higher-than-expected 30-day readmission rates for patients suffering from pneumonia, heart attack or heart failure.
A new policy at the Michigan Secretary of State's office could shorten the wait for nearly 3,000 other Michigan residents for organ and tissue donations. About 2.2 million of the state's 10 million residents have indicated they would donate organs upon their death. The changes already spurred a 20% growth in donors in one month since being implemented in May. The policy change comes after years of lobbying by activists and follows the lead of other states. It directs staff at the Secretary of State to ask customers if they want to join the Michigan Organ Donor Registry. Other changes also are under way to bolster the rolls. Currently, Michigan's participation rate is among the nation's lowest. Compared with last year, 5,300 people added their names to the donor registry in May.
Outside of heart attacks, doctors are often too quick to use a common $20,000 procedure to treat patients suffering from coronary artery disease, a new study suggests. About 600,000 angioplasty procedures, which almost always involve placement of a stent, are done in the U.S. each year. Roughly 70% of these procedures are performed on patients suffering symptoms of a heart attack and aren't medically controversial. But the remainder are done on stable patients who are suffering mild symptoms or no symptoms at all. Of those, 50% are deemed appropriate, 38% uncertain and 12% inappropriate, the report says. The results, published in the Journal of the American Medical Association Tuesday, come amid rising concern about the overuse of big ticket medical technology. Such concerns are rising not only in cardiology, but in other major specialties as state and federal governments and health insurers seek to contain healthcare costs.
Home births increased 20% from 2004 to 2008, accounting for 28,357 of 4.2 million U.S. births, according to a study from the Centers for Disease Control and Prevention released in May. White women led the drive, with 1 in 98 having babies at home in 2008, compared to 1 in 357 black women and 1 in 500 Hispanic women. Sherry Hopkins, a Las Vegas midwife, said the women whose home births she's attended include a pediatrician, an emergency room doctor and nurses. "We're definitely seeing well-educated and well-informed people who want to give birth at home," she said. Robbie Davis-Floyd, a medical anthropologist at the University of Texas at Austin and researcher on global trends in childbirth, obstetrics and midwifery, said "at first, in the 1970s, it was largely a hippie, countercultural thing to give birth outside of the hospital. Over the years, as the formerly 'lay' midwives have become far more sophisticated, so has their clientele."