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Prostate cancer screening guidelines updated
The American Cancer Society has updated its screening guidelines for prostate cancer, emphasizing that doctors educate patients about the potential risks and benefits of screening. The updated guidelines, published online March 3 in CA: A Cancer Journal for Clinicians, keep the society's core recommendations on what age to begin discussions. The main difference from the last ACS guidelines issued in 2001 is the emphasis on informing patients about screening uncertainties and involving patients more in the decision-making process (caonline.amcancersoc.org/cgi/content/full/caac.20066v1/). "With all the evidence we've got, it's increasingly clear that the benefits are uncertain for prostate cancer screening," said Andrew Wolf, MD, lead author of the ACS guidelines and associate professor of medicine at the University of Virginia School of Medicine. "We felt it was time to really emphasize the informed and shared-decision making [approach]." The cancer society continues to recomme [Read more]
Medical errors: Doctors, risk managers take different approach to disclosure
When things go wrong and patients are harmed, doctors and risk managers have reasons to fear telling patients what happened and offering an apology. For a physician, the result could be the turmoil of a years-long medical liability lawsuit. For a risk manager, the hospital's bottom line could be hurt. So how do these two groups compare when it comes to disclosure? A new study, apparently the first to pose that question, found that physicians are more hesitant than risk managers to tell patients when an error occurs. But doctors are likelier than risk managers to use the word "error" in describing the mistakes and are quicker to say, "I'm sorry." The study was published in the March Joint Commission Journal on Quality and Patient Safety (www.ingentaconnect.com/content/jcaho/jcjqs/2010/00000036/00000003/art00002). Nearly 3,000 risk managers at health care facilities nationwide were surveyed in 2004 and 2005 for the study. More than 1,300 doctors in Washington state and Mis [Read more]
Obama opts for virtual colonoscopy; CMS covers traditional only
If a virtual colonoscopy is an appropriate screening tool for arguably the most important patient U.S. Navy physicians will see all year, then shouldn't it be good enough for Grandma and Grandpa? That's what radiologists have been saying since President Obama on Feb. 28 received his first routine physical exam as commander-in-chief at the National Naval Medical Center in Bethesda, Md. During the exam, Obama received a virtual colonoscopy, also known as a CT colonography. But administration officials at the Centers for Medicare & Medicaid Services last year denied coverage of the same exam for Medicare beneficiaries, limiting access to a screening that advocates say is as accurate as a standard colonoscopy and much less invasive for the patient. "We are pleased that the president is in good health and that he and his doctors have embraced CT colonography's ability to accurately detect colorectal cancer," said Judy Yee, MD, chair of the American College of Radiology's Colon Cancer [Read more]
Kidney paired donations may expand under pilot program
The Organ Procurement and Transplantation Network in February selected five organizations that work with more than 80 transplant centers to help test a nationwide kidney paired donation system. The pilot project could result in an additional 1,000 live-donor kidney transplants a year. The United Network for Organ Sharing operates OPTN, which sets the country's organ transplant policy. "We think [the pilot] is going to be part of the solution to the organ shortage in this country," said John Friedewald, MD, chair of the OPTN/UNOS Kidney Paired Donation Workgroup. "We won't address the entire gap, but it's a good start." An added 1,000 live-donor kidney transplants a year would represent a 17% increase over the 5,749 such transplants performed in 2009. Another 9,653 transplants were performed last year using kidneys from deceased donors. At this article's deadline, 83,715 U.S. patients were awaiting a kidney transplant. Often, patients in need of kidneys are able to find will [Read more]
Anti-smoking groups want crackdown on fraudulent tobacco marketing
Several public health organizations in February asked the U.S. Supreme Court to impose new requirements for anti-smoking efforts on tobacco companies that were found misrepresenting the health risks of cigarettes. A federal trial court in 2006 ruled that the nation's largest tobacco manufacturers violated federal racketeering laws when they conspired in various marketing tactics that misled the public, particularly youth, about the addictiveness of nicotine. The Tobacco-Free Kids Action Fund, the American Cancer Society and the American Heart Assn. were among six public health advocacy groups that joined the federal government in bringing the suit against Philip Morris USA Inc. and several other cigarette makers and retailers. The tobacco companies admitted no wrongdoing. In May 2009, an appeals court upheld the decision, which prohibited the tobacco companies from engaging in fraudulent advertising and ordered them to make certain health information regarding their products publ [Read more]
Public health departments to test accreditation program
A voluntary accreditation program for public health departments across the country is being tested by 30 departments before its national launch in 2011. The goal of the new program is to improve the quality of care delivered by public health agencies that are responsible for such services as immunizations, hearing tests for children and restaurant inspections. The initiative, believed to be the first of its kind, is being funded by the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention. "With accreditation status, public health departments will be able to demonstrate increased accountability and credibility to the public, funders, elected officials and other stakeholders," said Kaye Bender, RN, PhD, president and CEO of the nonprofit Public Health Accreditation Board, which was established in 2007 to oversee the effort. At least two states accredit their local health departments, public health officials said. Those programs, in North Carolina and [Read more]
Doctor who linked vaccines, autism acted unethically, British medical council rules
Dr. Andrew Wakefield, the investigator whose research sparked fears of a link between autism and the measles, mumps and rubella vaccine, was rebuked on ethical grounds in a British medical regulator's report released in late January. The General Medical Council said Dr. Wakefield acted "with callous disregard for the distress and pain" that children would experience after being subjected to blood draws, lumbar punctures and other tests that were clinically unnecessary and not approved by his hospital's ethics committee. The council, which registers and regulates physicians in the United Kingdom, said Dr. Wakefield misled an ethics committee at London's Royal Free Hospital about his work. The council released its findings Jan. 28 (www.gmc-uk.org/concerns/hearings_and_decisions/data/5614.asp). The council found that two of Dr. Wakefield's research colleagues also broke ethics rules. The council will next move to consider disciplinary action, which could include barring the docto [Read more]
National health spending may nearly double by 2019
A shrinking economy combined with greater public health spending in 2009 produced a 1.1 percentage point increase in national health spending as a share of gross domestic product -- the largest single-year jump since records began in 1960. National health spending as a share of gross domestic product reached 17.3% in 2009. This was largely because of a spike in Medicaid spending and relatively low growth in private spending, according to "Health Spending Projections Through 2019: The Recession's Impact Continues," published in Health Affairs on Feb. 4. National health spending increased by 5.7% in 2009 to reach $2.5 trillion, up from a 4.4% increase in 2008, according to the report's preliminary estimates, produced by the Centers for Medicare & Medicaid Services Office of the Actuary. Spending on physicians and clinical services increased by 6.3% in 2009 to $527.6 billion, 1.3 percentage points faster than in 2008. This increase also was driven largely by higher Medicaid spend [Read more]
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