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A nearly year long joint NPR/ProPublica investigation into the rising rate of maternal deaths in the U.S. has uncovered the pivotal role that midwives play in the safe delivery of babies. Mothers in the U.S. are dying at a rate three times greater than that of the next closest industrialized country. According to ProPublica, maternal death rates per 100,000 live births are as follows:

  1. United States = 26.4%
  2. France = 7.8%
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Purdue Pharma, maker of OxyContin and lesser known MS Contin, is facing scrutiny after several recent articles exposed information from a Justice Department investigation into the company. The investigation focused on evidence that showed Purdue’s legal council and executives were aware of the addictive nature of their drugs, including their popularity with drug seekers. Despite knowing their drugs were being misused, the company continued a false marketing campaign that promoted the drug as safer than other opioids because it was less likely to be abused or cause addiction. The company still maintains that they weren’t aware of users abusing their drugs until Maine’s attorney general issued an alert about the drug in 2000, despite federal investigators finding proof that company salespeople were aware as early as 1997, just a year after the release of OxyContin.

The federal investigation ended in 2007 with Purdue Pharma pleading guilty to a felony charge of deceptive advertising and 3 top executives pleading guilty to misdemeanor charges. The company paid $635 million in fines to the government, while the execs did community service and avoided jail time. According to many familiar with the case, Purdue’s executives were given a proverbial hall pass, missing a potentially huge opportunity to throw a roadblock in the now public health crisis that is America’s opioid crisis. Many have called drug company executives behind opioids at the center of the crisis “suited drug pushers,” no better than street drug dealers. Others have said that if they were a minority in street clothes selling these drugs, they’d be locked up. Instead, drug company executives who knowingly market these drugs and force their sales reps to push them on doctors with false claims of safety and less addictive formulations are skating by, continuing to receive large bonuses and stock options while fueling the ongoing drug crisis.

Internal Emails Reveal Awareness of OxyContin’s Street Reputation

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In fall 2015, stories began circulating that a study had shown that chemo wasn’t already required as part of breast cancer treatment. But after awhile, the conversation started to dwindle. That is until now. Today in Chicago, attendees of the annual meeting of the American Society of Clinical Oncology are hearing study findings that chemotherapy may no longer be required for all women diagnosed with breast cancer. The study, called TAILORx, was a team effort by the U.S. and Canadian governments, as well as several charitable organizations.

Chemo Found to Have No Impact on Early-Stage Breast Cancer Survival Rates

TAILORx began in 2006 and followed 6,800 women from age 18-75 who had received an early stage breast cancer diagnosis, defined as tumors that have not spread to the lymph nodes and range between 1-5 cm. The women must also have tested negative for HER2, a protein found to be a major contributor to breast cancer.

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A joint effort by the Houston Chronicle and ProPublica has shared disturbing news of a former top heart transplant center’s failure rate. In January, the Centers for Medicare and Medicaid Services (CMS) cited Baylor St. Luke’s Medical Center in Houston, Texas for having twice the expected number of deaths between 2014-2016 in post transplant patients. CMS has given the facility until August to improve their outcomes before they are deemed ineligible to receive federal funding. The citation caught the attention of the Houston Chronicle, who began asking questions of former cardiologists, transplant patients and the loved ones of those patients who had died at the facility. Investigative journalists also spoke to patients with success stories. However, despite several successes, the number of fatal mistakes and omissions of truth made by the surgical team, and in particular its lead surgeon, Dr. Jeffrey Morgan, are astonishing.


Hospital Acquisition the Beginning of Turmoil

Baylor St. Luke’s, the adult teaching hospital for Baylor College of Medicine, has long been seen as one of the best heart transplant centers in the country. Some of the first heart transplants ever performed were done at the hospital in the 1960s, and the surgeon credited with surgically implanting one of the first LVADs (Left Ventricle Assisted Device) is the founder of the heart transplant program at the hospital. For decades the facility enjoyed a reputation as one of the top heart transplant centers in the country, if not the world. Patients would travel from all over to be treated there, and the hospital’s website features their doctors bragging about the hospital’s accomplishments. But most of those were in the past.

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The health insurance giant’s ‘avoidable E.R.’ policy has their insured customers playing doctor and deciding between the emergency room or toughing it out at home or at urgent care.

Anthem, the second largest health insurance provider in the country, is under fire from doctors, hospital groups, health policy experts, politicians, and especially its customers for a new policy that aims to cut back on E.R. visits. The policy is now in effect for Anthem customers in Connecticut, Georgia, Indiana, Kentucky, Missouri, Ohio and New Hampshire. According to an Anthem spokesperson, the idea behind the policy is to help keep healthcare costs down for everyone. The company says that 5% of all E.R. visits are unnecessary and that (unneeded) emergency care costs 10 times more in an E.R. than it does in an urgent care or retail healthcare setting.


E.R. Flu Visits Not Covered Under Policy

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An April 10th report by a Goldman Sachs analyst has been making the rounds in the media. The report, entitled “The Genome Revolution,” advised pharmaceutical companies to consider making and selling drugs that treat, not cure, diseases. Why? Making drugs so effective that they eradicate a condition or disease isn’t a profitable business model in the long run.


Drug Companies Hold Our Future in Their Hands

The opioid crisis has put a national spotlight on drug companies for their role in creating and distributing drugs that have caused many in this country to spiral into devastating addiction. These companies have the knowledge and financial means to create drugs that can destroy lives. They also have the ability to save lives and help many struggling with diseases and conditions live pain-free, symptom-free, or at least better than they would without pharmaceutical intervention. Cancer patients are living longer and people with debilitating or problematic conditions and diseases are able to manage and treat symptoms, thanks to big pharma. Drug companies are not all bad. Except that we must remember that they are, at their core, a business. And businesses exist to make money.

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The American College of Obstetricians and Gynecologists (ACOG) just released guidelines advising all OBs in this country to change the way they care for mothers in the 3 month period following childbirth. Instead of the traditional 6 week postpartum visit, the new guidelines recommend seeing all mothers no more than 3 weeks following childbirth, or within 3 days if the mother had severe hypertension during pregnancy, childbirth or immediately following. ACOG also recommends a 12 week final visit that assesses the mother’s overall health and well-being, with attention focused on future family planning, sexual issues, and emotional stability. ACOG’s guidelines also urge OBs to discuss the long term risks associated with certain conditions suffered during pregnancy, such as preeclampsia and gestational diabetes. After leaving the hospital, many mothers feel as though their health and needs are essentially forgotten. We know now that overlooking a woman who has just given birth can have tragic consequences.

More Mothers Die in America Than Other Developed Countries

A 6 month long NPR/ProPublica investigation last year found that the maternal death rate in the U.S. is higher than in any other developed country and that it is on the rise. Black mothers fare the worst.  A black mother is 3 to 4 times more likely to die during pregnancy, childbirth, or during the postpartum period than a white mother. Our blog has previously touched on the reasons why: black women have higher rates of heart disease and other health conditions that impact pregnancy, and they are subjected to more stress than white women.

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The University of Illinois at Chicago and Dr. Nagamani ‘Mani’ Pavuluri, widely considered an expert on bipolar disorder in children, have both been accused of violating medical ethics during a clinical study that studied the affects of lithium on children suffering from bipolar disorder. This past November, Dr. Pavuluri and UIC were ordered to repay all $3.1 million granted to them by the National Institute of Mental Health (NIMH), something many experts say is unprecedented.

Doctor Violated Protocol  

Dr. Pavuluri’s study took place between 2009-2013 and involved 103 children, some as young as 10 years old. The aim was to examine how a young brain functioned during a manic phase of bipolar disorder, then compare it to the brain after an 8 week course of lithium. After an initial review of Dr. Pavuluri’s grant application for the study, she was told by NIMH to correct several things before they would approve her for a grant. Dr. Pavuluri amended her application to correct the below listed flaws and was approved for $3.1 million in funding to conduct her research. However, she was found to have violated each of the things she specifically agreed to change in order to receive funding.

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A study of 440 emergency department doctors found that examinations are less thorough when ERs are so crowded that patients are treated in the hallway. Conducted at a 2015 Boston medical conference, the study revealed that 75% of physicians surveyed copped to obtaining less thorough medical histories of patients under these circumstances. Of that 75%, nearly all admitted that they also changed their standard procedure for conducting a physical exam.

Women who presented with genital or urinary problems were found to be the most underserved group, with the majority of doctors admitting that these issues impacted the way they conducted a physical exam or took a patient’s medical history. Interestingly, the majority of physicians surveyed also said that even in a private room, the presence of someone else known to the patient impacted the questions they asked and the way in which they went about an exam.

The issue of privacy is multilayered. In addition to the majority of doctors being surveyed acknowledging that the presence of others affects their practice of medicine, patients also are believed to withhold information when spouses, family members, friends, and strangers are present.

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It seems unbelievable, but it’s true: Last year, the Illinois Department of Financial & Professional Regulation (IDFPR) did not conduct a single National Practitioner Database (NPDB) background check on any physician applying for a license in the state. Information obtained from the NPDB is considered a fundamental part of the review process in granting a physician a license. The federally-sponsored database includes information on infractions, including citations for improper conduct by state medical boards and hospitals. Information regarding malpractice lawsuits are also included. By federal law, these groups must submit physician data to the NPDB, something other databases containing physician information cannot claim.

It’s Always About Money

According to a Chicago Tribune investigation, half of penalties handed out by the IDFPR in 2012 were for actions another state’s medical board had already disciplined them for. 100 physicians were disciplined based on another state’s information. That same year, less than 30 doctors were penalized after being cited for failure to diagnose a patient or committing some other form of medical error or oversight within Illinois. According to experts, the reason is due to costs. It is easier to go after a physician when another state has already done the leg work and the IDFPR simply does not have the time, nor resources to do a thorough investigation.