Tomorrow nurse Anne Mitchell, formerly compliance officer at Winkler County Memorial Hospital in West Texas, will go on trial for “misuse of official information” in reporting concerns about Dr. Rolando Arafiles to the Texas Medical Board.

The story, reported today in the New York Times, is fascinating and important on several counts. Whatever the truth of her allegations, the charge being brought against her itself appears to be tainted Read the rest of this entry »

Massachusetts Attorney General Martha Coakley, fresh from her disastrous campaign for Ted Kennedy’s senate seat, is back on the job. Last week her office released an important report – “Investigation of Health Care Cost Trends and Cost Drivers.”

Federal health reform may be in hospice care, but Massachusetts reform is alive and kicking. Here are the key findings from the report:

“Price variations are not correlated to (1) Read the rest of this entry »

While reading yesterday’s Boston Globe over coffee I encountered two stories about courtroom trials that raise central issues in psychiatric ethics along with the legal matters the trials are about. Two in one day!

The Globe reported that Dr. Kayoko Kifuji testified in trial of Carolyn Riley, who is charged with murder in the death of her four year old daughter Rebecca. The prosecution alleges that Carolyn and her husband Michael, who will Read the rest of this entry »

Melinda Lewis, who teaches Social Work at the University of Kansas, raised fascinating questions about social media and social work ethics on her excellent “Classroom to Capitol” blog yesterday. I’ve excerpted four from her post, with my responses in italics:

1. Every social media expert advises that success requires an infusion of ‘personality’ in order to connect with one’s followers. I get this–I see Read the rest of this entry »

In 1973, after Massachusetts was the only state not to vote for Richard Nixon’s reelection, bumper stickers appeared all over the state: “Don’t Blame Me – I’m From Massachusetts.”

Now our sticker should read – “Blame Me for Health Reform tanking – I’m From Massachusetts.”

I’ve been reading the pundits and mulling over where we are in the effort to get a better grip on our out-of-control health system.

The legislature Read the rest of this entry »

The January 17 Guardian shows this photo of a huge white Royal Caribbean cruise ship anchored offshore at Haiti with tourists floating in the water at the private enclave the company maintains at Labadee, sixty miles from the epicenter of the earthquake:

Royal Caribbean has been blasted for bringing tourists to bask, swim, eat and drink while people were injured and dying not far from the compound. Cavorting in the sun adjacent Read the rest of this entry »

I’ve done three recent posts on the crisis at Grady Hospital in Atlanta that has led to closure of its dialysis program. (See here, here and here.)

As I predicted, the problem is spreading. Now Jackson Health System in Miami-Dade county is closing a dialysis program that has been serving 175 South Florida patients.

Jackson is a prototypical safety net program, as evidenced by these statements from a video about the system: “we Read the rest of this entry »

At the start of my residency training in psychiatry, my bookish colleagues and I asked the training director – “what should we be reading?” He responded – “your patients will be your text book – listen to them and you will learn what you need to know.”

The training director’s advice – that our most crucial learning would come from our direct experience with patients – was totally correct. But if he’d read accounts of the experience of illness Read the rest of this entry »

Here’s what Michael Porter, the Harvard Business School strategy guru, said about employers in a New England Journal of Medicine article last summer:

We must keep employers in the insurance system. Employers have a vested interest in their employees’ health. Daily interactions with their workforce enable employers to create value by developing a culture of wellness, enabling effective prevention and screening, and directing employees Read the rest of this entry »

Rema Nagarajan, a journalist friend who writes for the Times of India, brought to my attention a recent ruling of the Medical Council of India about physician relationships with Pharma and other health sector industries. On paper at least, the ruling is very tough! The rules include:
Physicians shall not accept any gifts whatsoever
Physicians (and their families) shall not accept any paid travel, whether for CME or any other purpose
Read the rest of this entry »