tag:blogger.com,1999:blog-82419677545153639312012-01-19T21:29:33.442-08:00A fly on the wall of medicine, exploring public health and family healthLaurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.comBlogger116125tag:blogger.com,1999:blog-8241967754515363931.post-84600458242569586102011-11-30T14:09:00.000-08:002011-11-30T14:09:55.650-08:002011-11-30T14:09:55.650-08:00

Whether you love or loathe pharmaceutical companies, it's clear that we have a problem with pharmaceutical delivery in the U.S. First of all, some drugs are inexplicably expensive. There's the $93,000 prostrate cancer drug Provenge, for example,  which I've blogged about in the past ("The Skewed Values of Drug Prices"). A more recent example is Anascorp, an orphan drug (used to treat rare

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-71877736810707235722011-10-31T23:10:00.000-07:002011-10-31T23:10:05.713-07:002011-10-31T23:10:05.713-07:00

Two vaccines targeted to children have been in the news this month: a vaccine in clinical trials in parts of Africa that offers some protection from malaria (which is a leading cause of death in African children, according to the World Health Organization), and the human papillomavirus (HPV) vaccine, which prevents infection with certain cancer-causing strains of the HPV virus. Although the HPV

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-67432023439361082242011-10-17T15:09:00.000-07:002011-10-17T15:09:06.114-07:002011-10-17T15:09:06.114-07:00

In print and screen advertisements, retirement is often portrayed as a time to start a second career, spend more time with the grandchildren, volunteer for a worthy cause, or travel around the world. Any health problems can be managed with prescription medications and moderate exercise. Realistically, however, many Americans will ultimately need long-term care in a nursing home or in their own

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com1tag:blogger.com,1999:blog-8241967754515363931.post-1411616729384798492011-09-30T11:21:00.000-07:002011-09-30T11:26:49.507-07:002011-09-30T11:26:49.507-07:00

I thought it was a truck going by, but that's what I always think when the little earthquakes strike. It took me a moment to realize what it might be. It was near the end of the work day for me, but my laptop was still on, so I logged on to the U.S. Geological Survey site to find out that it was a magnitude 3.3 earthquake near Oakland, CA yesterday. I was far enough away that I barely felt it. I

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-31269998386931357102011-09-26T17:00:00.000-07:002011-09-26T17:03:10.256-07:002011-09-26T17:03:10.256-07:00

Texas' Baylor Health Care joined the Cleveland Clinic and other hospitals in banning smokers from hospital jobs, Fierce Healthcare reported today. As Alice Wolke of My FOX Houston explained in an article about Baylor Health Care's decision, "on the company's Careers page, the rules are laid out: Applicants who admit to nicotine use will not have their applications processed Anyone who is hired

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-30274692804569775332011-09-09T16:43:00.000-07:002011-09-09T16:43:51.469-07:002011-09-09T16:43:51.469-07:00

A study published recently in Pediatrics cited the "statistical uncertainty" of using mortality rates in children's hospitals to rank their quality. The study of approximately 473,000 U.S. patients discharged from children's hospitals in 2008 found that adjusted mortality rates at the 42 hospitals studied did not vary much by the hospital's ranking ("Statistical Uncertainty of Mortality Rates and

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-32936379872290859742011-08-29T12:50:00.000-07:002011-08-29T12:50:43.007-07:002011-08-29T12:50:43.007-07:00

With cancer rates soaring - an estimated 1.5 million Americans were diagnosed with cancer in 2010, according to the National Cancer Institute - there's an increasing need for better cancer treatments. But fewer than 1% of cancer patients join clinical trials. In an article just published in the Annals of Surgery, Waddah B. Al-Refaie, MD and colleagues found that just 0.64% of patients with solid

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-83138976368498067682011-08-19T17:18:00.000-07:002011-08-19T17:19:10.932-07:002011-08-19T17:19:10.932-07:00

Recently, several doctors that my family uses told me that they are leaving the hospital where they practice to become independent. I was surprised to hear this, because I had read that the the opposite is true: doctors are leaving private practice for the safety of a steady hospital salary. Our doctors' frustrations, however, were legion. They disagreed with the hospital's billing practices,

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-601480829660337252011-08-14T21:37:00.000-07:002011-08-14T21:37:44.138-07:002011-08-14T21:37:44.138-07:00

Florida recently passed a law making it illegal for doctors to ask patients whether there is a gun in their house during a routine health care visit. The law, CS/CS/ HB155, which became effective in early June, makes some exceptions for EMTs and paramedics, who frequently treat people injured by gun violence. But the law's wording makes it clear that Florida firearm owners are primarily

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com1tag:blogger.com,1999:blog-8241967754515363931.post-76440591040963967222011-08-07T22:21:00.000-07:002011-08-07T22:22:08.516-07:002011-08-07T22:22:08.516-07:00

With a shortage of health care providers looming, the U.S. is trying to tap foreign-trained professionals to fill the gap. There are two tactics to achieve this, as several recent articles in Fierce Healthcare point out: giving temporary visas to nurses currently living and working abroad, and creating on-ramps for foreign-trained health care professionals living in the U.S. to practice medicine

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-14928180921005209012011-07-30T22:35:00.000-07:002011-07-30T22:35:58.094-07:002011-07-30T22:35:58.094-07:00

Later this year, a small clinical trial will begin in Europe to test the use of stem cells to manage or possibly reverse the progress of multiple sclerosis, a disease in which a patient's immune system attacks the myelin sheath that protects nerve cells from damage. The disease tends to first strike when a patient is in their 20s and 30s, and it causes a range of symptoms (which vary widely by

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-77961267348350382722011-07-24T20:46:00.000-07:002011-07-24T20:46:50.606-07:002011-07-24T20:46:50.606-07:00

The business of health care is not always good for your health, at least if you look at the ongoing problems at Johnson & Johnson (J&J). I've written before about problems with the company's McNeil division, which manufactures many household medicines such as children's Tylenol. Over the past two years, some products manufactured at McNeil have been recalled due to musty odors, inadequate active

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-39687981730500733992011-07-13T15:40:00.000-07:002011-07-13T15:40:59.809-07:002011-07-13T15:40:59.809-07:00

A recent study found that about half of U.S. health care expenses are incurred by just five percent of U.S. patients. These 2009 figures were just released in a data brief by the nonprofit National Institute for Health Care Management Research Foundation. The data brief found that the U.S. spent an average of $8,086 per person on health care in 2009, almost twice the $4,166 per-capita cost in

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-40544431596281956302011-06-28T15:57:00.000-07:002011-06-28T15:57:03.906-07:002011-06-28T15:57:03.906-07:00

I'm a bit of a food safety zealot, poking cooked meats with thermometers and whisking leftovers into the refrigerator. But it's hard to keep food fresh and safe when you eat outdoors. On the second day of a camping trip last summer, for example, my daughter held up a bun and said "Mommy, why is my hot dog bun blue?" Horrified, I tossed the bun right away, along with a bag of its azure-tinged

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com1tag:blogger.com,1999:blog-8241967754515363931.post-48088389220071048672011-06-14T09:27:00.000-07:002011-06-14T09:27:00.309-07:002011-06-14T09:27:00.309-07:00

Many years ago, I developed a sore throat and a cough at the tail end of recovering from a cold. The sore throat became worse and worse each day, so I called my primary care doctor. But her office refused to see me. They were swamped with patients, it was flu season, and "you just have the flu," the receptionist told me. Ultimately, sick and fed up, I dragged myself to my local emergency room.

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-4558260538012783022011-06-06T13:14:00.000-07:002011-06-06T13:15:40.574-07:002011-06-06T13:15:40.574-07:00

A paper presented today at the 93rd annual Endocrine Society meeting in Boston describes a possible link between bone density and facial wrinkles in women. The study's principal investigator, Lubna Pal, MD, looked at the number and depth of face and neck wrinkles and facial skin firmness in 114 post-menopausal women in their 40s and 50s. Pal and her colleagues found that the women with fewer

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-65856885974288630852011-05-30T21:29:00.000-07:002011-05-30T21:29:50.664-07:002011-05-30T21:29:50.664-07:00

The New York Times ran an interesting article today about the political consequences of the job choices that doctors are making. Historically, many doctors have owned their practices, explained journalist Gardiner Harris ("As Physicians' Jobs Change, So Do Their Politics"). As business owners, they fought for fewer restrictions on practices that they felt were hampered by business expenses such

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com1tag:blogger.com,1999:blog-8241967754515363931.post-66614934006563201722011-05-20T17:13:00.000-07:002011-05-20T17:13:02.336-07:002011-05-20T17:13:02.336-07:00

I've spent many, many hours on the CDC website researching different health topics over the years. But this week they provided advice on a health hazard that I'd never considered before: a zombie invasion. "The rise of zombies in pop culture has given credence to the idea that  a zombie apocalypse could happen," wrote Assistant Surgeon General Ali S. Khan in a May 16th Public Health Matters

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-46877769367110317432011-05-15T22:37:00.000-07:002011-05-15T22:38:04.532-07:002011-05-15T22:38:04.532-07:00

Many years ago, a neighborhood firehouse in San Francisco was quietly converted to a battered women's shelter. If you have to take a firehouse out of commission, at least turning it into a shelter keeps the building's function in the realm of public service. But that type of firehouse conversion is not the norm here. I was dismayed to read a profile in the San Francisco Chronicle today of a

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-28840350607193886202011-05-06T17:18:00.000-07:002011-05-06T17:18:55.834-07:002011-05-06T17:18:55.834-07:00

A recent article in the Washington Post by Rob Stein pointed out shortages of 211 medications in 2010, including lifesaving drugs used in emergency rooms and oncology wards ("Shortages of key drugs endanger patients"). What is causing this shortage? "Experts cite a confluence of factors," writes Stein: Consolidation in the pharmaceutical industry has left only a few manufacturers for many older,

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-55941176035119537452011-04-26T20:50:00.000-07:002011-04-26T20:50:32.083-07:002011-04-26T20:50:32.083-07:00

I'm off to the ASJA Conference this week to moderate a panel on using widgets to maximize your blog (ahem, see the widget on the right for a link to the conference info). But this week's food for thought is the menigococcal disease vaccine Menactra, generally given to tweens and teens (and sometimes to at-risk children as young as 2), which the FDA just approved for children as young as 9 months

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-37696043589061112992011-04-22T14:32:00.000-07:002011-04-22T14:34:39.403-07:002011-04-22T14:34:39.403-07:00

In the biotechnology sector, when non-profit and government organizations can't or don't provide funding, venture capital firms (VCs) often do. The for-profit VCs, of course, want a good return on their investment -- first through promising clinical trials that lead to FDA approval for a product, then through wide and profitable adoption of the product by patients and their health care providers.

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-71233458159465016882011-04-13T15:33:00.000-07:002011-04-13T15:34:31.776-07:002011-04-13T15:34:31.776-07:00

Radio frequency identification (RFID) tags can track people, equipment, and paperwork in a variety of settings. They are currently used to track objects ranging from military equipment and nuclear materials to more mundane retail merchandise. These chips are either passive, transmitting a signal only when an electronic device requests information, or active, constantly transmitting a readable

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-3651342544952054702011-04-05T13:05:00.000-07:002011-04-05T13:07:24.413-07:002011-04-05T13:07:24.413-07:00

The eye-popping pricing strategies for two pharmaceuticals have been big news lately. First, the cost of a weekly progesterone injection, designed to prevent premature births in at-risk pregnant women, jumped from about $20 per shot to $1,500 per shot. What happened? The active ingredient of the shot had been compounded by pharmacies as needed by physician request to prevent premature births in

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0tag:blogger.com,1999:blog-8241967754515363931.post-58115578225990683012011-03-29T14:49:00.000-07:002011-03-29T14:49:29.817-07:002011-03-29T14:49:29.817-07:00

Much has been written about the shortage of primary-care doctors needed to treat the influx of patients anticipated when the Affordable Care Act is fully implemented in 2014. To help solve this problem, Kaiser Health News reported today that some states are expanding the role of nurse practitioners to serve as a patient's primary care provider. The KHN Daily Report also cited a Chicago

Laurie Bouckhttp://www.blogger.com/profile/10423495739817698993noreply@blogger.com0