Longer looks: Too many pills for dad; Genetic secrets; A supermarket's dietitian

Sep 1 2012

Every week Shefali S. Kulkarni selects interesting reading from around the Web.

ABC: New Study Highlights Dangers Of Over-Medicated Seniors
My father was a great doctor, a fine magician and a mean saxophone player. But around the time he turned 77 years old, he started slurring his words and spending long periods of time sitting and staring into space. I suspected he had begun a gradual slide into dementia. ... Then I happened to take a glance at his medicine cabinet. There were over 100 bottles of pills, in an astounding array of shapes, colors and sizes. ... I sorted the pills into more than a dozen unique prescriptions ordered by four separate doctors. Then I cross referenced each drug against all the others as well as with his various supplements and medical conditions. After that, I called his doctors and demanded they walk me through his entire drug regimen. In the end, I was able to trim his daily medication list in half, and within a few days my father came back to us. ... This is such a common occurrence that it even has a name: Polypharmia. That's the shorthand used to describe older patients who take more drugs than they actually need. Now a new study shows just how much of a problem it really is (Liz Neporent, 8/23).

Time: Is Your Doctor Burned Out?
Job burnout can strike workers in nearly any field, but a new study finds that doctors are at special risk. Nearly 1 in 2 U.S. physicians report at least one symptom of burnout, with doctors at the front line of care particularly vulnerable, the study found -- a significantly higher rate than among the general working population. Overtaxed doctors are not only at risk for personal problems, like relationship issues and alcohol misuse, but their job-related fatigue can also erode professionalism, compromise quality of care, increase medical errors and encourage early retirement -- a potentially critical problem as an aging population demands more medical care (Alexandra Sifferlin, 8/23).

The New York Times: Employing Dietitians Pays Off For Supermarkets
Lois E. Florence recently left her doctor's office with a diagnosis of colitis, an intestinal disorder, and a complicated set of instructions for changing her diet. After several setbacks she had a chance conversation with the pharmacist at her local Hy-Vee grocery store here that changed everything. He referred her to the store's dietitian, Dawn Blocklinger, and on a recent sunny morning, the two of them spent almost an hour compiling a list of the foods Mrs. Florence, 79, could eat and alternatives for the ones she couldn't, like rye bread to replace wheat and Tofutti instead of ice cream. Then they went shopping. Hy-Vee is the only grocery chain in the country that posts a registered dietitian in almost every one of its 235 stores. In rural areas, some of its more than 190 dietitians serve a cluster of stores. That puts it at the forefront of a phenomenon sweeping the grocery business as it tries both to capitalize on growing consumer awareness of the role food plays in health and wellness and to find new ways to fend off competition from specialty markets like Whole Foods and big-box stores like Walmart (Stephanie Strom, 8/24).

The New York Times: Genes Now Tell Doctors Secrets They Can't Utter
Dr. Arul Chinnaiyan stared at a printout of gene sequences from a man with cancer, a subject in one of his studies. There, along with the man's cancer genes, was something unexpected -; genes of the virus that causes AIDS. It could have been a sign that the man was infected with H.I.V.; the only way to tell was further testing. But Dr. Chinnaiyan, who leads the Center for Translational Pathology at the University of Michigan, was not able to suggest that to the patient, who had donated his cells on the condition that he remain anonymous. In laboratories around the world, genetic researchers using tools that are ever more sophisticated to peer into the DNA of cells are increasingly finding things they were not looking for, including information that could make a big difference to an anonymous donor. The question of how, when and whether to return genetic results to study subjects or their families "is one of the thorniest current challenges in clinical research," said Dr. Francis Collins, the director of the National Institutes of Health. "We are living in an awkward interval where our ability to capture the information often exceeds our ability to know what to do with it" (Gina Kolata, 8/25).

The Atlantic: Increased Access To Health Care May Decrease Abortions
As the controversy over Missouri Rep. Todd Akin continues to burn, it seems we won't have a resolution to our national abortion debate any time soon. From Massachusetts, though, comes growing evidence that the quest for lower abortion rates may not be at a standstill -- and the key may be better insurance coverage. As the number of insured has gone up in Massachusetts, new state data show a corresponding decline in the number of abortions performed there since 2006 (Brian Fung, 8/24).

WBUR: A Checkup On One Of America's Most Expensive Patients
Sue Beder is 66 and has had multiple sclerosis since she was 18. She sees half a dozen doctors, takes 21 prescribed medications, and is typically in and out of the hospital twice a year. ... Beder is one of the 5 percent of patients we often hear about who account for half of all health care dollars in the United States. As one of the most expensive patients, Beder is at the epicenter of Massachusetts' efforts to save money while improving her care. Late last year, Beder signed up with an agency, Senior Whole Health, that receives the money Medicare and Medicaid expect to spend on Beder and pools that into one budget. It's an approach the state plans to expand to 110,000 disabled patients across Massachusetts. Senior Whole Health pledges to spend less than the government would spend and, in exchange, the agency gets to decide how best to spend the money to keep Beder healthy. Beder couldn't have been happier with the move. The agency put handrails in her bathroom and started buying all her vitamins and lotions. It supplied adult diapers so that she wouldn't get out of bed at night and risk a fall. The agency is doing all this to help Beder stay home. That's where she wants to be, and it's cheaper than moving her into a nursing home (Martha Bebinger, 8/24).