As an intern admitting emergency-room patients to a Cincinnati hospital, I saw it happen again and again: Late-stage cancer patients in the midst of medical crises would roll into our ER in need of a ventilator as expected complications mounted. We would ask for their advance directives, who had their power of attorney, and whether they had considered "do not resuscitate" orders or hospice. Too often, these concepts were unfamiliar, even for patients who had been undergoing cancer treatments for months or years. If it ever makes its way out of Congress, a bipartisan bill introduced this month in the Senate Finance Committee would correct some of the structural problems that lead to this sad and costly phenomenon.
A newly released Government Accountability Office study says that the Department of Veterans Affairs awarded bonuses to most of the doctors and dentists serving at its medical centers, despite lacking reasonable assurances that the added pay was linked to performance. In 2011, about 80 percent of the Veterans Health Administration's nearly 22,500 providers received about $150 million in performance pay. Every medical provider who was eligible for performance pay at four medical centers the GAO visited received bonuses, including five who had actions taken against them related to their clinical performance, the GAO said.
Medicare continues to exhibit remarkably slow growth: a modest 3 percent over the past year. That's great news, but a debate is raging about whether this is caused by a weak economy (and therefore will reverse as the economy recovers) or other factors (and therefore may persist, drastically improving the budget outlook). Two new studies tilt toward the optimistic possibility. The first, a technical paper from the Congressional Budget Office, parsed the decline in cost growth per beneficiary from 7.1 percent a year from 2000 to 2005 to 3.8 percent from 2007 to 2010.
SACRAMENTO (AP) – Two California neurosurgeons who infected brain-cancer patients with bowel bacteria in an effort to save their lives have resigned their positions at the University of California, Davis, after officials concluded their actions violated the school's code of conduct. Dr. J. Paul Muizelaar and Dr. Rudolph J. Schrot told had the permission of the three patients to try the injections, but university officials concluded they failed to get the required prior approval from either the school or the federal Food and Drug Administration for such an experimental treatment that had not been tested on animals. The three patients, two middle-aged women and a man, each had been diagnosed with glioblastoma, a highly malignant brain tumor.
When Ira Horner, 62, found out how much his knee surgery for a torn meniscus was expected to cost, he worried that he would spend the rest of his life in debt. A floor associate at Hutchinson Oil, in Woodward, Okla., Horner had health insurance through his employer, but it was unclear as to what he would ultimately be expected to pay. After talking to friends and nurses at the medical center where he was being treated, Horner estimated the surgery would cost at least $16,000, and he'd end up paying about 20 percent of that plus his $1,000 deductible.
In health care, not all patients are equal. Some need costly treatment while others are relatively healthy, so providers must often decide who requires more attention and resources. Reston-based information technology firm Altruista Health is attempting to automate that decision process, using its own predictive algorithm to identify a hospital's sickest patients. Mining millions of health records, the 75-person company's software performs a sort of triage, alerting physicians to patients statistically at risk of worsening and then providing treatment suggestions.