Web News Raises New Questions

The Schwitzer health news blog has an interesting post today regarding the value of on-line discussions as they related to responses to news articles. A couple weeks back, the New York Times published a somewhat controversial column about lack of answers in the treatment of prostate cancer. In 10 days there were over 100 responses to the column, but neither the author nor any representative of the NY Times responded to answer any questions or respond to any concerns. Gary Schwitzer questions the journalistic integrity of such a situation. If a news source throws something out there that elicits response, what responsibility does the news source have to respond?

Being a publisher myself, I have had many conversations with my staff about how and when to respond to “Letters to the Editor”. We do not receive an overwhelming volume of them, as we publish smaller circulation specialty publications, but our policy has always been that if we receive reader feedback that makes a reasonably valid point, we run it.

That said, on-line media in many, many ways is a different animal than print media. Volume, access and speed have changed the game. The rules are a bit different and remain still largely undefined. I’d like to think certain journalistic obligations are unchanged, but I’m not sure they are. I have no answer to this, but I thank Gary Schwitzer for raising the issue.

Payola For Docs

The Wall Street Journal has an article today about insurance companies paying doctors to prescribe generic drugs. So, once again, our healthcare and our doctors are caught in the crossfire between 2 of the most powerful lobbies out there -- pharmaceuticals v. insurance. With both lobbies trying to "influence" physicians to benefit their bottom lines, we need our medical professionals to make the decisions that are best for their patients. Period.

http://online.wsj.com/article/SB120114138064112219.html.html?mod=home_health_right

ER waits are up.

On Tuesday The Washington Post published an article about the growing wait time in our ERs. This one hit home for me as I waited in the ER with a family member for two and a half hours last week with what were seemingly serious symptoms. We went through triage and were asked to take a seat, so we did and we waited and waited and waited. Within 2 minutes of actually seeing a physician, we were informed that the situation was potentially extremely dangerous and my family member was whisked away for a battery of tests. Ultimately, the physician ruled out anything serious, but the tests were required to make that assessment.

My observation in our case was that the ER at this hospital just does not have enough beds to accommodate the local population, which has rapidly increased over the last 20 years. Once we got in there were plenty of physician, nurses and other staff to give each patient plenty of face time, in fact, I observed a fair amount of idle time for most of the staff during the hours we waited for tests and test results.

As our population grows, it seems evident that facilities need to be updated and expanded to keep up with demand along with the need for more healthcare professionals.\

A link to the full WP story is below:

-WJ

Emergency room waits are longer, study finds

Patient vs Physician: An internet story

I admit it. I've got a little bit of hypochondriac in me. Growing up we always had a few of those self diagnostic manuals on the bookshelf. From the time I was old enough to read them and follow a flow chart, I began killing myself off with rare and mysterious diseases. The more I read, the more symptoms I felt. When companies like WebMD hit the web, my paranoia became exponentially worse.

During one visit to see my PC doc, I told him about this and asked if he believed such sites as being healthy. He chuckled and responded that it was the same sort of feelings in him that had driven him down the path to becoming a physician and the same feelings that almost pushed him out of med school. He told me how common it is for med students to imagine they have the symptoms of whatever debilitating disease they are learning about at any given time. His advice to me was to stay away from the self diagnosis sites as much as I could, but if I did venture on, treat them like you should treat a trip to Las Vegas - for entertainment purposes only.

Since then it hasn't been an issue for me, but my little experience has made me think about the affects of such sites on the way people visit and interact with their physicians and on the doctor/patient relationship. There is an article on the NY Times site this week on just this subject. Enjoy!

A Doctor’s Disdain for Medical ‘Googlers’

-WJ

Healthcare Careers: To Go Private or Public?

One of the most important decisions an individual has to make when searching for jobs in the healthcare industry is where and who to work for. For many the question of “where” is answered by simply deciding to stay in whatever area they consider home.

Nevertheless, considering relocation can often help those who are searching for jobs in healthcare make more of the career. The cost of living and salaries offered in different areas throughout the country can show significant differences. For example, if it costs one around $10,000 extra to afford to live in a city where a job is offering $7,000 more a year then the position offered might not be the best to be had.

As with any career path, those in the healthcare industry who are willing to relocate stand the greatest chance of making more a year. With many cities throughout the country experiencing shortages in workers to fill available jobs in healthcare, competition for qualified employees is on the rise. In most cases, if an area desperately needs healthcare workers then these positions will pay much more.

After narrowing one's search for a job in the healthcare industry to a specific area, one has to decide if they prefer to work in the private or public sector. For most individuals this decision is made based on what jobs are available and what pay is offered. Many individuals neglect a third option when searching for jobs in healthcare; working for one of the many government organizations that hires such professionals.

Government jobs in healthcare often have salaries that have been adjusted more accurately for the area's cost of living. These positions often offer more overall insurance coverage for an individual's entire family. Most government jobs see to it that all family members receive medical, dental, eye, and even life insurance. For those who find healthcare employment on a neighboring military base also have the added incentive of being able to purchase much needed necessities, such as groceries and gas, tax free. Over the course of a year, these bonuses can really make a difference.

One of the largest provides of government healthcare jobs is the Department of Veterans Affairs, which employes over 225,000 individuals. The VA currently runs 163 hospitals, 850 outpatient clinics, 137 nursing homes, 43 domiciliary facilities and 73 home-care programs nationwide.

Breaking down nursing careers in healthcare

Between job security, an increasing need for properly trained workers, and a raise in expected salaries, healthcare careers are becoming a more popular and profitable choice that many are showing interest in. With a national nursing shortage, those who do chose this path will rarely struggle to find employment.

Healthcare careers in nursing break down into more than one type of position, each requiring different training and provide differing responsibilities and salaries. Although all fall, to the general public, under the category of nursing, CNAs, LPNs, and RNs are not the same.

A healthcare career as a certified nursing assistant requires more face to face time with patients that other options may provide. Because of this, CNAs need to have fairly good people skills. These individuals are responsible for everything monitoring patients' blood pressure to bathing those who cannot do so for themselves.

Although this healthcare career requires one to handle some of the less pleasant aspects of nursing, CNAs often find their interactions patients very fulfilling. Those who chose this option have to obtain a diploma through an accredited course that takes six months to a year. The average salary for a nursing assistant is $22,000 a year. According to a simplyhired.com survey, there has been a 79 percent increase in the hiring of CNAs since 2006

Licensed practical nurses maybe responsible for some of the same things that CNAs are, but they may also collect patient samples, perform routine lab tests, set up exam or treatment rooms, and in, some states, prescribe certain medications. LPNs may also supervise the work of CNAs.

To become an LPN, one usually has to get an associates in nursing which can take anywhere from one to two years. Although the education may take longer, LPNs are rewarded with larger salaries. The average licensed practical nurse makes approximately $36,550 a year. Simply Hired's survey showed that 18 percent more LPNs have been hired this year than previously.

Requiring more education than either of the other two healthcare career's mentioned, registered nurses almost always have to have a bachelors degree in nursing. RNs also work more closely with doctors to ensure that patients continue their recovery. These individuals often perform more complicated tests and can be responsible for writing health care plans, which they supervise CNAs and LPNs to carry out.

Many RNs assist in surgery, handling sterilization of instruments and a variety of other things that the doctor in charge may require. These individuals make, on average, $57,280 a year, but many enjoy much larger salaries. In the last year, simplyhired.com says there has been a 52 percent increase in the hiring of RNs

Salaries in thse careers are usually effected by the degree of education and experience that one has. As in most cases, extra training and certifications can increase the size of one's paycheck.

A tool for consumers and physicians alike.

I came across a website that I saw a while back, but forgot about. Check out HealthNewsReview.org. It’s a well done watch-dog website for medical news, which is an incredibly valuable tool, considering the the “In-bed” status of so much of the mass media and the “big business” of health care. Here’s a little about the site in their own words:

What is Health News Review?

HealthNewsReview.org is a website dedicated to:

improving the accuracy of news stories about medical treatments, tests and procedures
helping consumers evaluate the evidence for and against new ideas in health care

We support and encourage the ABCs of health journalism:

Accuracy Balance Completeness

What news stories are reviewed?

HealthNewsReview.org reviews news stories that make a therapeutic claim about:

specific treatments
procedures
investigational drugs or devices
vitamins or nutritional supplements
diagnostic and screening tests

Who conducts the reviews?

A multi-disciplinary team of reviewers from journalism, medicine, health services research and public health assesses the quality of the stories using a standardized rating system. Stories are graded and critiques are published on this website.

HealthNewsRevier.org also has a fine blog, written by Gary Schwitzer of University of Minnesota School of Journalism & Mass Communication. It’s a great read. Here is sample of a recent entry:


Influence of industry on academic medicine

A new study published in the Journal of the American Medical Association gives perhaps the best picture yet of how extensive are industry-academic relationships are in medicine. The authors surveyed department chairs in the 125 accredited allopathic medical schools and the 15 largest independent teaching hospitals in the United States. 67 percent of the 688 eligible department chairs completed the survey.

It showed that "almost two-thirds (60%) of department chairs had some form of personal relationship with industry, including serving as a consultant (27%), a member of a scientific advisory board (27%), a paid speaker (14%), an officer (7%), a founder (9%), or a member of the board of directors (11%). ... More than two-thirds of chairs perceived that having a relationship with industry had no effect on their professional activities, 72% viewed a chair's engaging in more than 1 industry-related activity (substantial role in a start-up company, consulting, or serving on a company's board) as having a negative impact on a department's ability to conduct independent unbiased research."

The authors concluded:

"Failure to address the existence and influence of industry relationships with academic institutions could endanger the trust of the public in US medical schools and teaching hospitals."

The Associated Press reports:

Dr. Jerome Kassirer, a former New England Journal of Medicine editor and frequent critic of industry influence over doctors, called the study eye-opening.

"I was appalled by the results," Kassirer said. "No one knew that so many chairs of medicine and psychiatry were paid speakers. We've never had that data before."

-WJ