Longer looks: 'Reckless' drug prescriptions lead to patient deaths; The struggles to reopen NY hospitals

Dec 14 2012

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

Los Angeles Times: Reckless Prescribing Of Narcotics Endangers Patients, Eludes Regulators
Dr. Carlos Estiandan was up to no good, and the medical board of California was on to him. He prescribed powerful painkillers to addicts who had no medical need for them, conducted sham examinations and appeared to be a key supplier for drug dealers, according to court records. He wrote more prescriptions than the entire staffs of some hospitals and took in more than $1 million a year. ... By the time the medical board stopped Estiandan from prescribing, more than four years after it began investigating, eight of his patients had died of overdoses or related causes, according to coroners' records. It was not an isolated case of futility by California's medical regulators. The board has repeatedly failed to protect patients from reckless prescribing by doctors, a Los Angeles Times investigation found (Lisa Girion and Scott Glover, 12/9).

The New York World: Emergency At The Emergency Room
The sign at the entrance to Beth Israel Medical Center on First Avenue at 16th Street screams "EMERGENCY ROOM," but five hours into her wait to be seen for sharp pain in her ribs, it didn't feel that way to Yamira Velazquez. Her regular hospital, Bellevue Hospital Center, shut down after Hurricane Sandy ripped through the northeast. So did NYU Langone Medical Center next door. Bellevue won't reopen its emergency room until at least February, and NYU has not yet announced a date. And so, like thousands of others seeking immediate medical care, she ended up in the emergency room at Beth Israel, the last standing hospital for two and a half miles in any direction. ... Before it closed, psychiatric patients and arrested criminals went to Bellevue. Now, they're showing up at Beth Israel (Curtis Skinner, 12/6).

Modern Healthcare: Recovery Mode
As superstorm Sandy made landfall, the water that surged toward Long Beach (N.Y.) Medical Center knocked through bricked-over windows and punched holes through walls, easily pouring over a 3-foot-high concrete barrier along the hospital's northern wall built 20 years earlier to keep out floodwaters from an adjacent channel. Until late October, the 142-bed hospital had withstood decades of hurricanes and nor'easters, largely without flooding. ... Now, as hospitals severely damaged by the storm race to rebuild and reopen their inpatient services, hospital executives are drafting plans to better defend against future forceful storms as experts convened by state and city officials work to devise recommendations in coming months that could force hospitals to meet new standards for storms (Melanie Evans, 12/8).

The New York Times: A Tense Compromise On Defining Disorders
This month, the American Psychiatric Association announced that its board of trustees had approved the fifth edition of the association's influential diagnostic manual -; the so-called bible of mental disorders -; ending more than five years of sometimes acrimonious, and often very public, controversy. The committee of doctors appointed by the psychiatric association had attempted to execute a paradigm shift, changing how mental disorders are conceived and posting its proposals online for the public to comment. And comment it did: Patient advocacy groups sounded off, objecting to proposed changes in the definitions of depression and Asperger syndrome, among other diagnoses. Outside academic researchers did, too. ... But the deeper story is one of compromise (Benedict Carey, 12/10).

The Atlantic: A Social Network For People With Prediabetes
[D]iabetes is preventable -- through modest weight loss, it's possible to step back from the brink of disease. This suggests a unique opportunity for intervention. A solution that helps prediabetics make a few key lifestyle changes could save literally millions of lives -- not to mention billions of dollars. Fortunately, such a solution may already exist. The Diabetes Prevention Program, a landmark clinical research study led by the National Institutes of Health (NIH) and supported by the Centers for Disease Control and Prevention (CDC), demonstrated that intensive coaching in behavior modification reduces the risk of progression from prediabetes to diabetes by nearly 60 percent. Even more remarkably, 10 years after the trial ended, the benefits of the intervention persisted (Rena Xu, 12/12).

CQ HealthBeat: Remembering Alec Vachon
Many were the days when hunting for news and wary of being scooped, I picked up my phone, punched Alec Vachon's number and heard a clipped greeting at the other end of the line: "Vachon." Just like the sound of his name, Vachon, who died Dec. 5 after a long illness, was terse and to the point. He was razor-sharp, a focused thinker who had no patience for baloney. ... A consultant for many years and a GOP aide on the Senate Finance Committee before that, Alec was an important but not terribly well-known figure in the health policy community. His memory deserves to be honored ... Vachon worked on physician payment and other Medicare issues during his tenure on Senate Finance in the 1990s. ... But for me, what really makes Alec's career notable is that it's a reminder that the health policy world really is a community and of how rewarding it can be because of the relationships involved and the stimulating work that people do (John Reichard, 12/11).