The high-producing neurosurgeon who has led a dramatic shift in the business at Swedish Health has resigned, officials said Wednesday, less than three weeks after a Seattle Times investigation exposed widespread concerns about his practices.
By Marshall Allen
If the last few years are any guide, one group that may find itself in the crosshairs of Rep. Tom Price, President Trump’s pick to lead the Department of Health and Human Services, is an influential panel of medical experts.
The U.S. Preventative Services Task Force, a group of mostly physician and academics from top universities, reviews medical practices to see whether they are supported by research and evidence.
Under the Affordable Care Act, the group’s recommendations have been used to guide private insurers. If the group gives a test high marks, insurers are required to cover it. If it doesn’t, they are free not to.
But letters reviewed by ProPublica show that Price twice pushed HHS to quash the task force’s recommendations to limit widely used cancer screenings. The panel said that the screenings too often led to unnecessary biopsies and other harmful treatment. [Read more…] about HHS nominee Tom Price targeted panel that urged fewer cancer screenings
By Richard Harris, NPR News
Kaiser Health News
The federal government will pay more than $100,000 to give someone a kidney transplant, but after three years, the government will often stop paying for the drugs needed to keep that transplanted kidney alive.
Constance Creasey is one of the thousands of people who find themselves caught up by this peculiar feature of the federal kidney program.
Creasey started kidney dialysis about 12 years ago after her kidneys failed. That meant going to a dialysis center three times a week, for three hours per session. (A typical patient undergoes three to five hours of dialysis per session).
“The first three years of dialysis was hard. I walked around with this dark cloud. I didn’t want to live, I really didn’t,” she says. [Read more…] about Medicare pays for a kidney transplant, but not the drugs to keep it viable
By Christina Jewett
Kaiser Health News
Five years ago, Dr. Ira Kirschenbaum, an orthopedic surgeon in the Bronx who replaces more than 200 knees each year, would have considered it crazy to send a patient home the same day as a knee replacement operation.
And yet there he was this year, as the patient, home after a few hours. A physician friend pierced his skin at 8 a.m. at a Seattle-area surgery center. By lunch, Kirschenbaum was resting at his friend’s home, with no pain and a new knee.
“I’m amazed at how well I’m doing,” Kirschenbaum, 59, said recently in a phone interview, nine weeks after the operation.
What felt to Kirschenbaum like a bold experiment may soon become far more standard. Medicare, which spends several billions of dollars a year on knee replacements for its beneficiaries — generally Americans 65 and over — is contemplating whether it will help pay for knee replacement surgeries outside the hospital, either in free-standing surgery centers or outpatient facilities.
The issue is sowing deep discord in the medical world, and the debate is as much about money as medicine. Some physicians are concerned that moving the surgeries out of hospitals will land vulnerable patients in the emergency room with uncontrolled pain, blood clots or other complications.
But proponents of the change say it can give patients more choice and potentially better care, as well as save Medicare hundreds of millions of dollars. Already, an “overwhelming majority” of commenters said they want to allow the surgeries out of hospitals, according to recent rule-making documents. [Read more…] about Hospitals and surgery centers play tug-of-war over America’s ailing knees
Medical Device Employees Are Often In The O.R., Raising Concerns About Influence
Kaiser Health News
They are a little-known presence in many operating rooms, offering technical expertise to surgeons installing new knees, implanting cardiac defibrillators or performing delicate spine surgery.
Often called device reps — or by the more cumbersome and less transparent moniker “health-care industry representatives” — these salespeople are employed by the companies that make medical devices: Stryker, Johnson & Johnson and Medtronic, to name a few. Their presence in the OR, particularly common in orthopedics and neurosurgery, is part of the equipment packages that hospitals typically buy.
Many “people who don’t work in health care don’t realize that industry reps are sometimes in the OR,” said Josephine Wergin, a risk management analyst for the ECRI Institute, a Pennsylvania nonprofit that conducts research on medical subjects for the health care industry. “A lot of times they are the real experts on their products.”
Unlike rotating teams of nurses and surgical techs, reps are a consistent presence, experts say, often functioning as uber-assistants to surgeons with whom they cultivate close relationships and upon whom their six-figure salaries depend.
Although they don’t scrub in, reps are expected to be intimately familiar with the equipment they sell, making sure it is at the ready for the surgeon and poised to answer technical questions.
Who’s The Expert?
But how much influence do reps wield, how necessary and costly are their services and does their presence in the OR, which may not be disclosed to patients, raise ethical questions about informed consent? [Read more…] about Medical device company representatives may be helping out with your surgery