Longer looks: How doctors treat patients; myths about Obamacare; curing cancer

May 23 2014

Each week KHN reporter Marissa Evans finds interesting reads from around the Web. 

The New York Times: When Doctors Treat Patients Like Themselves 
Many years ago I spent a lunch hour in a doctors' dining room eavesdropping on two white-coated men of a certain age idly discussing a colleague who worked at the city hospital next door. While they themselves saw mostly insured patients, she worked exclusively among the destitute, a de facto one-woman charitable health organization. Most of the hospital community thought she was a saint. These two doctors, to put it mildly, were not impressed. "It's easy to do that kind of work," one concluded, putting down his napkin and standing up. "The hard thing is taking care of patients who are exactly like you" (Abigail Zuger, 5/19).

California Healthline: Poised For Growth, Commercial ACOs Also Face Considerable Challenges
The Affordable Care Act pushes the health care industry to find new and more innovative ways to deliver quality, cost-efficient care. Accountable care organizations -- designed to reward health care providers for keeping their patients healthy -- seem like the logical answer to such a mission. But are accountable care organizations formed between private insurers and health care delivery systems actually being held accountable? As of January, more than 600 ACOs existed across the public and private sectors -- up by more than 200 since January 2013. In that time, provider groups, not-for-profit community groups, practice management companies and other organizations increasingly have sponsored ACOs -- with providers leading the way (Michelle Stuckey, 5/21). 

The Weekly Standard: Obamacare Myth-Making
With enrollment in the Obamacare exchanges now closed, Democrats and their friends in the media are ebullient. Obamacare is an enormous success, they say, and conservatives have been humiliated. On closer inspection, however, things seem decidedly less bullish for President Obama's signature achievement. Among the many exaggerations and inaccuracies the law's defenders are touting, five stand out (Jay Cost, 5/19). 

The New York Times: Doubts Raised About Off-Label Use Of Subsys, A Strong Painkiller
Behind [the painkiller Subsys'] business success is an unusual marketing machine that may have pushed Subsys far beyond the use envisioned by the Food and Drug Administration. The F.D.A. approved Subsys only for cancer patients who are already using round-the-clock painkillers, and warned that it should be prescribed only by oncologists and pain specialists. But just 1 percent of prescriptions are written by oncologists, according to data provided by Symphony Health, which analyzes drug trends. About half of the prescriptions were written by pain specialists, and a wide range of doctors prescribed the rest, including general practice physicians, neurologists and even dentists and podiatrists (Katie Thomas, 5/13).

Forbes Magazine: Is This How We'll Cure Cancer?
For 85% of kids with a terrible cancer called acute lymphoblastic leukemia, chemotherapy is a cure–but not for Emily Whitehead. Diagnosed at 5, she suffered an infection from her first round of chemo and nearly lost her legs. Then the cancer came back .... There was nothing else to try. Nothing except a crazy experimental treatment never before given to a child .... scientists at the University of Pennsylvania used a modified HIV virus to genetically reprogram those white cells so that they would attack her cancer, and reinjected them (Matthew Herper).

Reader's Digest (Canada): Screen Tests: The Dilemmas Of Predicting Diseases
In 1985, the first HIV test came on the market. It was a crucial moment in the fight against AIDS, and a turning point for medicine as a whole. For the first time, doctors could tell healthy people-;who weren't showing any symptoms-;if they were going to get sick. And for the first time, patients had to ask if the benefits of knowing outweighed the emotional and social risks of ignorance. That question soon grew far beyond HIV, as the Human Gen­ome Project-;an international research initiative that successfully mapped out a blueprint of human DNA-;increased the number of screening tests available, which now total more than 2,000. Today, people at high risk of breast and colon cancers, inherited heart disease and Huntington's disease, among others, have the chance to glimpse their future health. But first they have to decide: do I really want to know? (Vanessa Milne).

Pacific Standard: Medicine's Dirty Secret: Fecal Transplants Are The Next Big Thing In Health Care  
This is how far a mother will go. Your daughter has been sick for more than four years with a severe autoimmune disease that has left her colon raw with bloody ulcers. After multiple doctors and drugs have failed, you are frantic for her to get better. Then you send her disease into remission, virtually overnight, with a single act of love. "Who wouldn't do that for their daughter?" you say. It's like a miracle, you say. "An overnight magic wand." ... Here are the specifics: You were the donor in a fecal microbiota transplant. You gave your daughter your poo (Bryn Nelson, 5/20).