A Boston Globe article noted for older patients the “cardiologist must develop a treatment plan despite little published evidence to guide his clinical decisions.”
“There are almost no data to guide cardiovascular disease management for people who are over 80 and relatively poor data for people over 70… ‘You have smart and caring doctors trying to practice evidence-based medicine, but there is little evidence.’”
“While doctors and policymakers have long recognized that translating drugs from adults to children might not be as easy as halving the dose, and that the toxicities that are common in men might be different than in women, researchers say that the same understanding lags when it comes to older adults.”
The NPR noted: “One study found that 1 in 5 prescriptions written in doctor’s offices has not been approved by the Food and Drug Administration to treat the condition it is being used for.”
“It’s actually quite common for doctors to write ‘off label’ prescriptions, including using cancer drugs to treat migraine headaches or blood pressure medication for heart failure.”
A Reuters Health article noted “Children are not simply ‘small adults,’ and a device found to be safe and effective in adults may have a very different safety and effectiveness profile when used in a pediatric population…” “Without this data, it is difficult for clinicians and parents to make informed treatment decisions that weigh the risks and benefits of a particular treatment…,” The new study examined what kind of testing has been done on medical devices meant for kids since an act of Congress incentivized their development seven years ago.
“Don’t just ask the doctor which type of treatment you should get…,” “Ask the doctor, ‘What happens if I don’t get this treatment? How does this affect the outcome?’”
A Kaiser Health News article noted ”Older breast cancer patients who received radiation treatment after surgery were more likely to undergo a more expensive and somewhat controversial type of radiation called brachytherapy if they got their care at for-profit rather than nonprofit hospitals…”
Almost a dozen not-for-profit hospitals in New Jersey have been bought by for-profit companies. The debate is on n New York and Connecticut where for-profit ownership is basically “prohibited.”
A recent article Ct Mirror article noted “State law makes it difficult, if not impossible, for for-profit hospitals to operate in Connecticut. But Tenet Healthcare, a national, for-profit hospital chain, is in the process of acquiring four Connecticut hospitals. That’s inspired two competing efforts in the legislature. One push is to change state law to make it easier for hospitals to be run by for-profits. The other is to restrict the ability of hospitals to become for-profit.”
The federal Web site has added several new resources to help the newly insured navigate the healthcare system.
The new section, “Using Your New Insurance Coverage,” guides enrollees in areas such as filling a prescription, going to the doctor’s office or accessing emergency care.
The New York Times article noted “Restricting consumers to a fixed network of doctors and hospitals, called in-network coverage, helps keep costs down, and for the first year, none of the 16 insurance companies in New York’s exchange deviated from that model.”
“Advocates for consumers had lobbied hard for out-of-network coverage, saying that some patients needed more choices, particularly since the networks are being kept small to further reduce costs. Under the current in-network system, someone who lives part of the year out of state, or a student at a college out of state, are not covered while they are away, except for emergency care.”
Some interesting advice on “visiting hours”…
The New York Times blog vignette read: “For 15 years Anna was a solitary figure sitting at the far end of our waiting room for her annual checkups, having shaved a half-hour off her workday so she could hustle over before we locked our doors.”
“The Centers for Disease Control and Prevention estimates that 3.2 million people in the U.S. have chronic hepatitis C infections. Most of them haven’t been diagnosed.”
The NPR story reported that “Sovaldi is the first hepatitis C pill that doesn’t have to be accompanied by interferon for some types of hepatitis.”
“Sovaldi has been found to be remarkably effective, essentially curing 90 percent or more patients with a common form of hepatitis C in 12 weeks.”
The Washington Post article noted: ”There’s been much written in the past year about just how hard it is to get a simple price for a basic health-care procedure.”
“About two dozen industry stakeholders, including main lobbying groups for hospitals and health insurers, this morning are issuing new recommendations for how they can provide the cost of health-care services to patients.”