By the time they graduate, every doctor coming out of the University at Buffalo will have gotten a lesson from Mary Brennan-Taylor. It will come from the instructor's experience of losing her mother to medical errors. As an adjunct research instructor of family medicine, Brennan-Taylor will try to open medical students' eyes to the human cost of medical errors by telling them about the death of her 88-year-old mother, who was hospitalized for a non-life-threatening leg ailment in 2009 and died six weeks later from hospital-acquired infections and the use of numerous medications. "Every doctor that graduates from UB will hear Mary's story," said David Holmes, associate vice chair of medical student education at the university's Department of Family Medicine. "Her story adds a very human dimension to our discussion about medical errors. It helps the students realize that it's not just statistics that we are talking about. It's somebody's mom."
More heart-attack patients now than five years ago are getting a potentially life-saving procedure to open blocked arteries within the recommended time frame, a new study shows. The so-called "door-to-balloon" time refers to how long it takes for heart attack patients who need an angioplasty -- an opening of the blocked artery using a catheter -- to receive one once they've gotten to the hospital. The recommendation is to get the procedure within 90 minutes. Every minute is precious, because the longer patients go without the procedure, which restore blood flow to the heart, the lower their odds of survival. In 2005, only 44% of patients were getting treated within the recommended 90 minutes. But by 2010, that had increased to 91%, with 70% treated in less than 75 minutes, according to the study, published in Circulation. The median D2B time fell to 64 minutes from 96 minutes.
For women seeking an abortion, finding a doctor willing to offer one is easier said than done. Ninety-seven percent of OB-GYNs have encountered patients wanting an abortion, but only 14% of the doctors perform them, according to a study published in the journal Obstetrics and Gynecology. That finding suggests a smaller percentage of OB-GYNs may be offering abortion services than previous studies have estimated. Access to abortion has become more limited over the past few decades, the researchers write. Another recent study found that in 2008, 87% of U.S. counties (where 35% of reproductive-aged women live) didn't have any abortion providers. Since 1996, however, all OB-GYN residents have been required to learn how to perform the procedure. This year, states have passed at least 80 new abortion restrictions -- double the previous annual record of 34 seen in 2005, and more than triple 2010's 23 changes. Religious affiliation turns out to be a fairly significant indicator of whether a doctor will or won't provide abortions. Forty percent of Jewish doctors say yes, compared with 1% of evangelicals. Nine percent of Roman Catholics or members of Eastern Orthodox churches were likely to perform abortions. Among OB-BYNs, 10% of non-evangelical Protestants, 20% of Hindus and 27% of doctors who said they had no religious affiliation said they offer abortion services.
Rhode Island Hospital's records department rejected the court order –– and answered the subsequent subpoena by saying the law allowed 20 days to respond. A Providence detective investigating an alleged murder requested the medical records of the victim, who died at Rhode Island Hospital. In his request for the records in March 2010 -- nearly two years after the death –– the detective included a copy of the victim's death certificate, plus two signed releases from the man's father and adult son. Rhode Island Hospital refused. The federal Health Insurance Portability and Accountability Act was designed to protect the privacy of medical databases and imposes hefty fines against those who release patients' protected information. Even so, the federal law allows the release of some information to law enforcement, such as when the police need to identify a suspect, fugitive or material witness, or when the police are investigating whether a patient is a victim of a crime. States have their own versions of patient privacy laws, and Rhode Island's Health Care Confidentiality Law, written in 1978 and adapted over the years, is even more restrictive than the federal law.
When I first went into practice, I had rather firm notions of the proper boundaries between doctors and patients. I wore a long white coat, revealed little about my personal life, never called patients by their first names and felt insulted if they called me by mine. An older colleague found my rigidity amusing. Most of his patients called him Jim, and he played golf with many of them. "You'll loosen up in time," he predicted. Looking back I think I feared that as a young female physician I wouldn't be taken seriously unless I maintained an austere facade. My role models were those legendary physicians of the 19th century whose oil portraits had lined the walls of the hospital in which I did my medical training. Dr. James Jackson of Massachusetts General Hospital summed up their philosophy in his 1855 book "Letters to a Young Physician." He advised that a doctor should maintain a calm and neutral attitude with patients, "abstain from all levity,'' and, most important, "never exact attention to himself." As my colleague Jim predicted, I found this standard nearly impossible to meet over time. After all, a doctor is not simply a repository of information but a human being with a personality, a sense of humor, and a point of view.
The government plans to spend $40 million transforming 10 acres and six buildings at south Atlanta's Fort McPherson into a healthcare campus that would expand services for veterans and relieve pressure on metro area clinics that now serve them. Details of the U.S. Department of Veterans Affairs' plan come as the military continues preparations to shut down Fort McPherson in mid-September as part of the years-old "Base Realignment and Closure" program. Less than 150 workers are still on the largely vacant post now. The VA redevelopment will not affect hopes of turning other parts of the 488-acre post into mixed-use development complete with a science and technology park, houses, restaurants and shops. The VA will renovate a vacant 74,000-square-foot brick building that once was a health clinic for troops and turn it into an outpatient clinic for veterans. It is to include primary medical care, mental health, dental, lab, radiology and audiology services. An eye-care center could also be opened at some point later in the former Lawrence Joel U.S. Army Health Clinic.