Breast cancer, tick bites, gluten, G.M.O.s, artificial sweeteners, shark attacks — and now Ebola. The news is replete with seemingly endless tales of health threats. Who could blame you for deciding to remain indoors, alone in bed, indefinitely? That would hardly be a life worth living. But many people do respond to health risks, however small, in ways that take joy out of their lives, all the while falsely believing that they are protecting themselves. I once wrote that there are as many cancer-causing mutagens in two raw mushrooms as in a serving of peanut butter. It was supposed to be reassuring, but a reader lamented, "Now I can't eat mushrooms!"
Two years ago, Inova Health System recruited a top executive who was not a physician, had never worked in hospital administration and barely knew the difference between Medicare and Medicaid. What Paul Westbrook specialized in was customer service. His background is in the hotel business — Marriott and the Ritz-Carlton, to be precise. He is one of dozens of hospital executives around the country with a new charge. Called chief patient experience officers, their focus is on the service side of hospital care: improving communication with patients and making sure staff are attentive to their needs, whether that's more face time with nurses or quieter hallways so they can sleep.
When a team of health-care and social service workers in Allentown went looking for frequent visitors to emergency departments and hospitals, they quickly learned that many were dialysis patients. Ask those patients what's most important for maintaining their lives, and they'll, of course, say the dialysis treatment, when a machine cleans the bloodstream the way healthy kidneys would. Next on the list? For many, it's transportation. For a significant number of the patients served in the Allentown Super-Utilizer Partnership, the issue of simply getting to treatment is critical and sometimes more problematic than getting the treatment itself.
U.S. hospitals are grappling with whether to withhold aggressive treatments from Ebola patients to avoid further exposing doctors and nurses to the virus. Some facilities have decided they will forgo cardiopulmonary resuscitation or may opt not to pursue invasive surgical procedures on deteriorating Ebola patients. Such procedures can expose health workers to bodily fluids that transmit the disease, and hospitals say in many cases have little chance of saving a patient. The decisions are sparking a thorny debate at hospitals across the country and calls for national guidelines. Facilities are turning to medical ethicists to decide if and when it is appropriate to withhold treatments, a practice that runs counter to many physicians' instincts. [Subscription Required]
A U.S. nurse who challenged quarantines of health care workers returning from treating West African Ebola patients said on Sunday she thought "an abundance of politics" lurked behind them. Kaci Hickox has fought a heated public battle over what she considers draconian measures to isolate her for 21 days after her return from Sierra Leone, in a case that highlights the dilemma over how to balance public health needs and personal liberty. In some U.S. states officials such as New Jersey Governor Chris Christie have imposed strict quarantines on health workers returning from three Ebola-ravaged West African countries, but the U.S. federal government opposes such measures.
More than seven in 10 Americans support mandatory quarantines for health professionals who have treated Ebola patients in West Africa, even if they have no symptoms, according to a new NBC News/Wall Street Journal poll. The survey shows that 71 percent of those surveyed say the health workers should be subject to a 21-day quarantine, while 24 percent disagree. The question of mandatory quarantines exploded into the public debate after nurse Kaci Hickox battled with the governors of New Jersey and Maine over the mandated isolation, arguing that she has exhibited no symptoms and tested negative for the virus.