Weekend reading: Mental health discrimination; A doctor faces hard questions; Long-term outlook for health care jobs

Feb 9 2013

Every week Ankita Rao selects interesting reading from around the Web.

The CT Mirror: In Mental Illness, Is 'Stigma' The Wrong Word? What About 'Discrimination?'
"When I had cancer, I got cards and flowers," Karen Kangas' sign reads. "When I was diagnosed with bipolar disorder, I got no cards and a pink slip." A picture of Kangas holding the sign hangs in the state Capitol complex, part of an exhibit called "Discrimination: A Roadblock to Recovery." The title is no accident. People often talk about the stigma of mental illness. But some, including Patricia Rehmer, prefer the term "discrimination." It's stronger. It makes people uncomfortable (Arielle Levin Becker, 2/5).

The New York Times' Opinionator blog: Depression and the Limits of Psychiatry
Current psychiatric practice is guided by the "Diagnostic and Statistical Manual of Mental Disorders" (DSM). Its new 5th edition makes controversial revisions in the definition of depression, eliminating a long-standing "bereavement exception" in the guidelines for diagnosing a "major depressive disorder." ... psychiatric practice makes essential use of moral (and other evaluative) judgments. Why is this dangerous? Because, first of all, psychiatrists as such have no special knowledge about how people should live (Gary Gutting, 2/6).

Consumer Reports: The Cancer Tests You Need – And Those You Don't
Early detection saves lives. That's the assumption that drives aggressive cancer-screening campaigns. It's what persuades women to host "mammogram parties" where they gather friends for wine, cheese, massages, and breast-cancer screenings. It's what persuades men to offer up blood for prostate-cancer tests at hockey games or onboard a huge red bus parked at sporting-goods stores. But the big red bus and other direct-to-consumer screening efforts raise big red flags, our experts say. ... the message that you have nothing to lose and everything to gain from being screened-;that is, to be tested for a cancer before you have any symptoms of it-;simply isn't true (March 2013).

The New York Times: A Doctor's Struggle With Numbers
Oncologists are notoriously bad at predicting survival, and none of us wants to be known as "the doctor who told me I would be dead by now," the doctor who made a prediction of imminent demise, sending a family into a terrifying tailspin of goodbyes, only to be proven wrong and subsequently mocked for years to come. One of my patients, upon being told by another doctor that she had two months to live, held Christmas in April so she could spend one last holiday with her grandchildren. She survived to see two more Christmases. At the same time, we need to be truthful and give guidance to people who want time to prepare (Dr. Mikkael Sekeres, 1/31).

National Journal: Health Care: Great For The Economy Today, Terrible Later
Health care is the leading-edge of a nationwide trend. The number of jobs in this sector is climbing steadily, in contrast to the erosion in so many other areas of the economy. Since the Great Recession began in December 2007, health care jobs are up nationwide by 10.5 percent. … If health care jobs had plunged like those in other sectors, U.S. unemployment would be a staggering 10.8 percent. ... But the long term may not be as rosy-;for Pittsburgh or for the country. The growth in the health care sector also produces ever-growing costs (Margot Sanger-Katz, 2/2).

American Medical News: HIPAA Gets Tougher On Physicians
A revised set of federal privacy rules is expected to have a significant impact on the way physicians run their practices. Revised privacy notices will need to be displayed in prominent areas of doctors' offices and on practices' websites. Patients will be able to ask for copies of their electronic health records or restrict the information given to health plans if they self-pay for services. And perhaps most important, practices might be subject to serious fines if any of their business associates cause security breaches (Jennifer Lubell, 2/4). 

The Atlantic: What The Sunshine Act Means For Health Care Transparency
Curious whether a prescription or medical device your doctor is recommending comes from a manufacturer who has been paying your doctor? Good news, then: The federal government has finally developed a plan for how the Physician Payments Sunshine Act will work. The Sunshine Act, made federal law as part of the Affordable Care Act in 2010, was designed to allow anyone -- patients, doctors, journal editors -- to look up which doctors are getting how much from which companies. ... Although transparency about financial ties does not "cure" influence, it at least helps us understand it. There may, of course, be legitimate reasons for a physician to be paid by a pharmaceutical company -- for example, for conducting a study -- but watchdogs like Angell, Goldacre, and Brody see no reason why such relationships should be obscured (Alice Dreger, 2/6).