Massachusetts has long held a special status in the debate about President Obama's health care law. It was a 2006 Massachusetts law that provided the inspiration for the 2010 national law, and Massachusetts already had near-universal coverage before the federal law took effect. Now the state that gave birth to a sweeping expansion of health coverage nationally is trying to knit the two laws together and struggling to make sure no resident falls through the insurance net. At the center of their frustration is a glitchy website that has forced the state to rely on workarounds to ensure access to coverage.
The hospital that shined so brightly during the darkness of the 2011 Tucson shootings is in a bitter professional dispute that has impaired its transplant services. The University of Arizona Medical Center's world-famous heart transplant program is on hiatus, as is its lung transplant program. Two other programs recently closed after the doctor who created them — department of surgery head Dr. Rainer Gruessner — was forbidden from setting foot in the hospital where he'd worked for the past six years. Before his suspension, Gruessner had brought stability to a historically troubled department that's vital to Tucson. He more than doubled the number of surgeons, added new transplant services and rebuilt Southern Arizona's lone top-level trauma center for people with life-threatening injuries.
Puentes de Salud, which in English means "bridges of health," was founded to provide low-cost but quality health care and social services to the growing Latino population in South Philadelphia and began treating patients in 2006. A co-founder, Dr. Steve Larson, said the organization distinguished itself from other community-health groups by addressing the underlying causes of illness, like poor nutrition, illiteracy or urban violence. "It's not about me writing prescriptions," said Dr. Larson, 53, a professor of emergency medicine at the University of Pennsylvania who said he began to develop his approach to community medicine while working in rural Nicaragua in the early 1990s. "This is an underground health system."
A new dress code for doctors, nurses and other health care workers calls for outfits that may be short on style, but long on what it takes to keep dangerous germs from spreading among patients. Short sleeves, bare hands and forearms and white coats that are laundered at least once a week — if not more often — are the keys to keeping nasty bugs such as Staphylococcus aureus from hitching a ride on a doctor's wrist. Neckties are questionable. Watches and rings have to go. It's not clear what to do about name tags, lanyards, necklaces and cell phones, but when in doubt, it's best to clean the offending items — or get rid of them.
Kim Little had not thought much about the tiny white spot on the side of her cheek until a physician's assistant at her dermatologist's office warned that it might be cancerous. He took a biopsy, returning 15 minutes later to confirm the diagnosis and schedule her for an outpatient procedure at the Arkansas Skin Cancer Center in Little Rock, 30 miles away. That was the prelude to a daylong medical odyssey several weeks later, through different private offices on the manicured campus at the Baptist Health Medical Center that involved a dermatologist, an anesthesiologist and an ophthalmologist who practices plastic surgery.
The American College of Emergency Physicians has released its 2014, state-by-state report card on America's emergency care environment. Georgia got a D+, ranking 29th in the country overall. ACEP's report card "evaluates conditions under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers," the organization said in a release. It includes 136 measures in five categories. Georgia got failing or near-failing grades in three of the five: access to emergency care (F), public health and injury prevention (D+) and disaster preparedness (D+); its passing grades came in quality and patient safety environment (C) and medical liability (B-).