Lawsuits Accuse Drug Companies of Pushing Pain Meds.

Five drug companies are under fire for allegedly participating in “aggressive marketing” of prescription opioids. The City of Chicago and two California counties have filed two separate lawsuits blaming the drug companies for aggravating the opioid addiction epidemic in the United States. Among other allegations, the lawsuits claim that patient information groups received millions of dollars from the drug companies and, in return, the information groups played down the risks of the drugs. The City of Chicago claims the drug companies gave the American Pain Foundation $10 million and then the Foundation promotes messages such as, “opioids are rarely addictive when used properly for the management of chronic pain.” Similar lawsuits were successful against the tobacco industry in the 1990’s, leading to heavier restrictions on tobacco products.

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Wal-Mart Wants to Be Your Primary Care Doctor

Recently, Wal-Mart has begun promoting itself as a “primary medical provider” in order to sway customers into becoming patients. The retail giant has opened five primary care facility clinics in South Carolina and Texas, with plans to double the number of clinics by the end of the year.   Wal-Mart is using its “vast rural footprint” to bring primary care to areas of the country where people have limited access. CVS and Walgreens already offer some medical services, but unlike Wal-Mart, they are not equipped to treat patients as a primary medical provider.

Wal-Mart relies on physicians to supervise the clinics’ operations rather than actually to treat patients. Medical assistants and nurse practitioners will administer the bulk of the patient care. Wal-Mart’s focus is becoming the first stop for patients, but some experts are concerned that stores like Wal-Mart will be unable to provide care for more complex medical issues.

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Doctors Stop Offering Costly Immunizations

The Affordable Care Act mandates that childhood immunizations be covered at no “out-of-pocket” cost. However, many people are finding it difficult to receive immunizations because doctors have stopped offering them. This is due to the high cost of vaccines and the poor reimbursement from insurers. For example, Prevnar 13, which prevents pneumococcal bacteria diseases, has increased in price at “an average of 6 percent each year” since 2010.  Currently at $136 per dose, many states require children receive up to four separate shots of Prevnar 13. Because of this, more and more doctors feel that they are left with little choice but to stop providing immunizations.

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New York’s Medical Marijuana Legislation Questioned

Recently, New York moved to legalize medical marijuana for patients suffering from various debilitating illnesses, including cancer, H.I.V./AIDS, and multiple sclerosis. Although studies have shown that marijuana use can be beneficial to patients suffering from such conditions by increasing appetite, treating nausea, and alleviating painful muscle spasms, research involving medical marijuana is limited.  As a result, many medical marijuana laws, including New York’s legislation, include conditions for which the benefits of marijuana use have not been clinically established, such as Parkinson’s disease, Lou Gehrig’s disease, and epilepsy. This has lead even proponents of the medical marijuana movement to question whether New York’s legislation was the product of well-founded clinical judgment.

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Cancer Treatment Database Gives Doctors Wider Data Set as They Prescribe Courses of Treatment

Nat Turner, along with his former University of Pennsylvania classmate Zach Weinberg (the pair previously founded the tech firm Invite Media that was eventually purchased by Google for $81 Million), created Flatiron Health. The company began collecting data on cancer treatments with the purpose of creating a database focused on providing doctors and cancer centers with helpful cancer treatment data.

Flatiron, now up and running for two years, charges cancer centers for access to its database and they contribute specifics about actual cancer cases, with patients’ personal information redacted. The information includes course of treatment prescribed, and the outcome.

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Promising Heart Valve Procedure Isn’t Without Skeptics

An alternative to open-heart surgery, transcatheter aortic valve replacement (TAVR) is a less-invasive heart-valve procedure for the treatment of severe aortic valve stenosis.   The procedure, which involves threading a catheter through patients’ arteries to implant new aortic valves, has received high praise as a “technological leap” in treatment.

TAVR has been used as an alternative for patients where open-heart surgery is too risky. Despite the early success of the procedure, TAVR has higher rates of some serious complications, including blood vessel damage and stroke than traditional treatments.

Despite its initial praise, some doctors worry that the early excitement regarding TAVR can lead physicians to rely on the procedure even when it is not the best option.  Currently the FDA requires that before patients can undergo the TAVR procedure, they must show that they “are not the right candidate” for traditional surgery. However, recent data show that more than half of Medicare patients who received catheter valves did not meet the FDA threshold for the procedure.

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Post-Hospital Syndrome: Are Hospitals to Blame?

Medical professionals are now seeing an increase in patients with post-hospital syndrome, described as a state of susceptibility that leads to a new affliction.  This is different than a relapse.  Patients are entering hospitals for particular ailments, but developing independent and unrelated illnesses after the initial reasons for hospitalization have been resolved.

Dr. Krumholz, a professor of medicine and public health at Yale School of Medicine says that in “many ways the hospital environment can be the opposite of healing.” He believes that because patients are often “deconditioned, in pain, malnourished, stressed with circadian disruptions” they become susceptible to new illnesses.

Dr. Krumholz (with the help of Dr. Desky, a professor of health policy at the University of Toronto) proposes an overhauling in hospital care as a solution to the problem. The doctors recommend more cheerful décor and preserving patients’ dignity by allowing them to remain in their own clothing.  The doctors gave harsh criticism to the “draconian unsavory diet” provided to patients and believe that eating well is critical for healing. Furthermore, the aggressive treatment provided by healthcare facilities to cure the problems that bring patients into the hospital, may be the very reason a patient will have to return.

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Government Questions Eligibility for Health Insurance Subsidies

Since June 1st, hundreds of thousands of people have been contacted by the government regarding their eligibility for subsidized health care.  Of the eight million people who signed up for healthcare through the government exchanges, two million provided information that differed from information in government records. The Obama administration has been asking those individuals for additional documentation such as birth certificates, social security cards, and driver’s licenses.  The government will use the documents to correct irregularities in areas including income, citizenship, and immigration status.  Consumer advocates worry that many people who fail to provide the information will be forced to repay the subsidies next April.

Representative Diane Black, Republican of Minnesota, attributes the problem to the government’s having enrolled people “before the systems were in place to accurately confirm eligibility.” Others such as Representative Joseph Crowley, Democrat of New York, say such criticism stems from Republicans’ “unending zeal to undermine the Affordable Care Act.”

In any event, the government has put thousands on notice that they “need to follow up as soon as possible” and if they don’t send the needed documents, they risk losing their marketplace coverage.

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Hospitals Changing Marketing Tactics to Bring in Male Patients

It is common to find medical institutions that offer medical services geared specifically for women.  However, the industry has been silent concerning the specific medical needs facing men… until recently.

 Within the last couple of years, medical institutions devoted to men have been popping up all around the country. The new clinics are aware of the lengths to which men will go in order to avoid the doctor and have tailored their marketing and treatments accordingly.  The clinics market themselves as “luxury spas” and use slogans like: “It’s the gentlemen’s club your wife would approve of.”   The treatments range from those focused on vanity, such as hair removal, to more serious matters such as prostate exams.

 Supporters of male-focused clinics think that by giving men a comfortable place to receive not-so-serious treatments, the clinics will lead to men more often receiving care for serious conditions such as prostate cancer.  Those opposed feel that clinics like these may over-treat and result in more damage than benefit to men’s health.

 

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Congress Looks to Revamp Mental Health System

Soon, Congress will hear testimony concerning the Helping Families in Mental Health Crisis Act. Republican representative, Tim Murphy, from Pennsylvania, sponsored the bill, and, though many agree that the mental health care system requires revamping, some provisions in the bill have sparked controversy. Among the more controversial provisions is one that supports the increased use of involuntary outpatient treatment—via court-ordered therapy for “certain mentally ill people with a history of legal or other problems.” Detractors of this provision claim that it will erode trust in doctor-patient relationships, and that it presents a civil rights issue. However, 45 states have compelled treatment programs already, one of which is New York.

New York’s compelled treatment program, Kendra’s Law, was passed in 1999. Since the implementation of Kendra’s Law, studies show that the percentage of patients returning to the hospital or getting arrested has greatly decreased. The statistic is significant, as “about 350,000 Americans with a diagnosis of severe mental illness…are in state jails and prisons” and the availability of psychiatric beds meets only 10 percent of that need. 

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