Daily Briefing Blog

What Gawande got right

May 8, 2015

Dan Diamond, Executive Editor

Atul Gawande already has too many titles.

He's a prominent surgeon at a celebrated hospital. An award-winning writer. A Harvard professor and a frequently featured thinker in the Daily Briefing.

Still, it's tempting to add another label this week: Prescient prognosticator.

Monday's issue of the New Yorker featured Gawande's return to McAllen—the Texas town he'd made famous (or infamous) in 2009, as the poster province for America's wildly rising health care costs.

Compared to nearby El Paso, Gawande wrote six years ago, McAllen had become an unbelievable outlier—"the most expensive town in the most expensive country for health care in the world."

And he concluded that doctors deserved much of the blame.

"The primary cause of McAllen’s extreme costs was, very simply, the across-the-board overuse of medicine," Gawande wrote. In every community in the United States, "there are the physicians who see their practice primarily as a revenue stream … McAllen seems simply to be the community at one extreme."

But the McAllen that Gawande found this year wasn't the McAllen he'd left.

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Vaccine rates aren't just state problems. They're community issues.

May 4, 2015

Sam Bernstein, Daily Briefing

On April 17, California health officials declared an end to a high-profile measles outbreak that sickened 147 people in six states. But public health officials still worry that measles—once thought to be completely eradicated from the United States—could stage a permanent comeback because of declining rates of vaccination in certain communities.

How one sick visitor at Disneyland became a multi-state measles outbreak

State immunization rates vary, but remain generally high

The World Health Organization (WHO) estimates that between 83% and 94% of community members must be vaccinated to achieve heard immunity against measles. By that metric, all 50 states have immunization rates for the mumps, measles, and rubella (MMR) vaccine that should protect young children from the disease.

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Good news for Maine, bad news for DC: Where hospitals got the best Leapfrog scores

May 1, 2015

Clare Rizer, The Daily Briefing

Forty-five hospitals saw a change of at least two letter grades in the Leapfrog Group Hospital Safety Scores released on Thursday—but not all the changes were positive.

While 33 of those hospitals saw a significant jump in their scores, 12 saw marked declines in their scores. And it's easier than ever to see those trends: Leapfrog has started displaying every grade that a hospital has received since the group first started scoring hospital safety in June 2012.

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The cancers that patients are most likely to survive

April 28, 2015

Juliette Mullin, senior editor

Research has shown for some time that the prognosis for someone diagnosed with cancer today is better than it was even just 20 years ago. But new data published in JAMA Oncology show just how much better it really is: An adult ages 50 to 64 diagnosed with cancer between 2005 and 2009 was 39% to 68% less likely to die from the disease within five years than someone diagnosed between 1990 and 1994.

But, despite major improvements, survival rates still vary significantly based on age, gender, and—most of all—cancer type.

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What to know about current foodborne illness outbreaks

April 27, 2015

Sam Bernstein, Daily Briefing

Blue Bell Ice Cream is suspending all of its manufacturing operations starting today, following an outbreak of listeria linked to its products that has sickened 10 and killed three. But the Blue Bell outbreak is only the latest in a series of foodborne illness outbreaks in the news.

Listeria outbreaks in multiple states

Listeria is a type of bacteria found in soil and water that can be carried by animals. It is commonly found in unpasteurized cheese and milk, as well as processed meats. Listeria can be particularly difficult to eradicate because it grows very well in cold temperatures.

Most people exposed to Listeria do not become ill. However, exposure to the bacteria can lead to listeriosis; people with compromised immune systems, elderly individuals, and pregnant women are most at risk. Early symptoms of infection include fever, muscle aches, and gastrointestinal symptoms.

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Why physicians are more burned out and dissatisfied than ever

April 24, 2015

Juliette Mullin, senior editor

If I had one takeaway from this year's physician compensation survey from Medscape Medical News, it's that doctors are making more money than ever—but they're also more dissatisfied than ever about their career choices.

Survey breakdown: Two physician specialties saw compensation drop last year

In recent years, doctors have consistently reported dissatisfaction with their choice of specialty and practice setting. In the most recent iteration of Medscape's survey, which included 19,500 physicians polled between December 2014 and March 2015, the majority of doctors (64%) said they would choose medicine as a career if given the chance for a life do-over. But just 45% of them would pick the same specialty, and just 24% of would choose the same practice setting. 

For some specialties, the dissatisfaction is even more evident. For example, just 25% of internal medicine doctors said they would pick the same specialty again, compared with 73% of dermatologists.

It's clear that David Bornstein was on to something when he wrote in the New York Times in 2013 that "[m]edicine is facing a crisis, but it's not just about money; it's about meaning," Bornstein writes.

So what's driving this burnout and disengagement among this critical part of the health care workforce?

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What happens when a hospital closes

April 23, 2015

Juliette Mullin, senior editor

On Tuesday, "Amazing Grace" played in the halls of Doctors Medical Center (DMC) as its staff members hugged and talked about the 60-year-old hospital's closure and the end of an era for the city of San Pablo, California, which will now go without a hospital or access to timely emergency care.

But the moment came as no surprise. In fact, the closure was the culmination of years of efforts to keep the facility open, and then months of work to shut it down.

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67 hospitals earn spots in the second round of the BUILD Health Challenge

April 20, 2015

More than 300 city-based partnerships from 41 states submitted applications for the inaugural round of the BUILD Health Challenge. Each submission included at least three partners from a low-income urban neighborhood: a hospital or health system, a local health department, and a community-based nonprofit.

The applications revealed a diverse understanding of what it means to address the upstream causes of health, highlighting issues as varied as stress remediation, food system assessments, immunization programs, housing, education, and more.

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