Trying to stem the scourge of prescription drug abuse, an advisory panel of experts to the Food and Drug Administration voted on Friday to toughen the restrictions on painkillers like Vicodin that contain hydrocodone, the most widely prescribed drugs in the country. The recommendation, which the drug agency is likely to follow, would limit access to the drugs by making them harder to prescribe, a major policy change that advocates said could help ease the growing problem of addiction to painkillers.
Robert Reed's visit to a suburban dermatologist's office last year seemed ordinary: He was led into a small exam room with a scratchy paper-covered table, where the doctor inspected his skin and squirted liquid nitrogen onto three pre-cancerous spots. The statement he received a month later appeared anything but ordinary: It included $1,525 in "operating room" and hospital "facility" charges. Surely, Reed thought, it must be a mistake. There had been no hospital, no anesthesia, no surgical nurse. And these charges were far more than what the doctor billed for her services—just $354. "I feel like I've been taken advantage of," said Reed, a 57-year-old financial analyst. "They need a reality check on what they are charging."
Wisconsin is one of the few states where a doctor can practice after completing only one year of a three-year residency program. That includes doctors who were kicked out of their residency programs after the first year. The Wisconsin Medical Examining Board has proposed tightening the rules for doctors as part of the first extensive revision of the state's regulations of doctors in decades.
Last August, Massachusetts enacted reforms that usually make doctors' apologies inadmissible in court, require claimants to file "letters of intent" before suing, and impose a six-month waiting period to allow doctors and patients to work out the matter. The law might pave the way for earlier, more amicable settlements. But the bitter fact is that there is no appetite in the medical community to come clean preemptively about every medical error. The list of them is just too long. No major reforms, including those just passed here, are truly proactive, since they all still require patients or families to call a lawyer before anything happens.
Many Bay Area hospitals are vigorously enforcing a new mandate that health care workers throughout Alameda, Contra Costa and Santa Clara counties get a flu shot or don a mask during the flu season. Comprehensive numbers are not yet available, but some institutions are reporting dramatic increases in employee vaccination rates. Many hospitals have set up flu stations with employee masks at entrances to buildings and are using stickers on employee badges to identify those who have had a shot. Stations with sanitizers and masks have also been set up for patients. The goal of the mandate is to protect patients who are most at risk, including infants, the elderly and those with weakened immune systems.
The patients come with burns from hot water, with hands and fingers crushed by steel tongs, with injuries from chains that have whipsawed them off their feet. Ambulances carry mangled, bloodied bodies from accidents on roads packed with trucks and heavy-footed drivers. The furious pace of oil exploration that has made North Dakota one of the healthiest economies in the country has had the opposite effect on the region's health care providers. Swamped by uninsured laborers flocking to dangerous jobs, medical facilities in the area are sinking under skyrocketing debt, a flood of gruesome injuries and bloated business costs from the inflated economy.