Since 2006, Alice Proujansky has photographed childbirths around the world
for a project entitled 'Birth Culture.' Her intent is to highlight
'the universal aspects of childbirth, elements that are culturally-specific and the struggle to provide women with safe, respectful maternity care.' Images: Photographer's site
. NYTimes Gallery
. Some photos may be NSFW.
A timeline of diseases and vaccines
[warning: graphic photo of cutaneous diphtheria at year 1975]. Categories are: diphtheria, measles, polio, smallpox, yellow fever, and 'others'. You can select one keyword to view only that subject's timeline. From the History of Vaccines
website (about page
). Similar timelines at the same site for pioneers
, science and society
, and there's an En Español
timeline, too. [more inside]
"If an NHS trust proposed today that it was going to introduce Viagra sales reps into men's genitourinary wards, or reps for walking aids to orthopaedic wards, the very least you'd expect would be some stout resistance. It is a measure of the strength of the association between "motherhood" and "buying stuff" that the presence of commercial representatives on maternity wards has been tolerated for so long." [more inside]
On Breaking One's Neck
. Dr. Arnold Relman
, former Editor in Chief of the New England Journal of Medicine, gives a first-hand account of a catastrophic accident, intensive care, and rehabilitation--as a patient. I am a senior physician with over six decades of experience who has observed his share of critical illness--but only from the doctor's perspective. That changed suddenly and disastrously on the morning of June 27, 2013, ten days after my ninetieth birthday, when I fell down the stairs in my home, broke my neck, and very nearly died. Since then, I have made an astonishing recovery, in the course of which I learned how it feels to be a helpless patient close to death. I also learned some things about the US medical care system that I had never fully appreciated, even though this is a subject that I have studied and written about for many years.
In the Shadows.
The healthcare and human rights challenges of the LGBT populations of Malawi -- where homosexuality is outlawed. Via
The Rising Cost of Cancer Drugs
: "New drugs could extend cancer patients’ lives—by days. At a cost of thousands and thousands of dollars. Prompting some doctors to refuse to use them."
More than half the population of small, rural Madras, Oregon (population: ~6059) and its surrounding community is served by one clinic: Madras Medical
. At the beginning of 2006, the clinic's doctors and nurses decided to ban pharmaceutical reps from visiting their practice. No more free lunches. No more free drug samples. No more gifts. And yet.... "It's made us better doctors." (Via) [more inside]
How to Charge $546 for Six Liters of Saltwater
- a brief story of the humble bag of saline solution given intravenously at ERs and hospitals, and how one unit of it can be marked up from 86 cents to $91 when given to patients
John Green: "Why Are Americans Health Care Costs So High?
" A quick, handy little overview of common misconceptions on the US healthcare system. (SLYT)
Because of nationwide shortages, Washington hospitals are rationing, hoarding, and bartering critical nutrients premature babies and other patients need to survive. Doctors are reporting conditions normally seen only in developing countries, and there have been deaths. How could this be allowed to happen? [more inside]
"India's supreme court has ruled against Swiss drug giant Novartis in a landmark case
that activists say will protect access to cheap generic drugs in developing nations." [more inside]
Two-year-old Emma wanted to play with blocks, but a condition called arthrogryposis meant she couldn't move her arms. So researchers at a Delaware hospital 3D printed a durable custom exoskeleton with the tiny, lightweight parts she needed
In less than an hour, the Supreme Court will hand down its final judgment in what has become one of the most crucial legal battles of our time: the constitutionality of President Obama's landmark health care reform law.
The product of a strict party line vote following a
of debate, disinformation
, and tense legislative wrangling, the Affordable Care Act
would (among other popular reforms
) require all Americans to buy insurance coverage by 2014, broadening the risk pool
for the benefit of those with pre-existing conditions.
The fate of this "individual mandate," bitterly opposed by Republicans despite its similarity to past plans touted by conservatives
(including presidential contender Mitt Romney
) is the central question facing the justices today
. If the conservative majority takes the dramatic step
of striking down the mandate, the law will be toothless, and in danger of wholesale reversal, rendering millions uninsured
, dealing a crippling blow to the president's re-election hopes, and possibly endangering the federal regulatory state
But despite the pessimism of bettors
, some believe
the Court will demur, wary of damaging
its already-fragile reputation
with another partisan 5-4 decision
. But those who know don't talk, and those who talk don't know
. Watch the SCOTUSblog liveblog
for updates, Q&A, and analysis as the truth finally comes out shortly after 10 a.m. EST.
encourages physicians and patients to discuss whether certain medical tests and procedures are unnecessary, especially those that can cause harm. The site offers nine lists of Five Things Physicians and Patients Should Question
about the most appropriate care for a patient, including lists for cardiology and oncology. [more inside]
This morning marked day two of marathon proceedings
in what's likely the most momentous
Supreme Court case since Bush v. Gore
: the effort to strike down President Obama's landmark health care reform law
. While yesterday was a sleepy affair of obscure technical debate
, today's hearings targeted the heart of the law -- the individual mandate
that requires most Americans to purchase insurance by 2014. With lower courts delivering a split decision
before today, administration lawyers held some hope that at least one conservative justice
could be persuaded to uphold the provision, which amortizes the risk that makes universal coverage possible
. But after a day of deeply skeptical questioning
by swing justice Anthony Kennedy
and his fellow conservatives [transcript
], the mandate looks to be in grave trouble
, with CNN legal analyst Jeffrey Toobin going as far as calling the day "a train wreck"
for the administration. But it's far from a done deal
, with a third day
of hearings tomorrow and a final decision not expected until June.
It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little.
How Doctors Die
is a non-profit publisher of books and newsletters for community-based health care, mostly aimed at the third world. Their first book, Where There Is No Doctor, A Village Health Handbook
, has been translated into 88
languages and is one of the most widely used
training and work manuals for community health care in the world. They have now made 20 of their publications available for free download, many of which can now also be browsed online through their website
using an "Ebrary
" in-browser interface. [more inside]
The public’s experience is that we have amazing clinicians and technologies but little consistent sense that they come together to provide an actual system of care, from start to finish, for people. We train, hire, and pay doctors to be cowboys. But it’s pit crews people need.
- Atul Gawande’s commencement address at Harvard Medical School.
injections have been used to reduce the likelihood of premature births in at-risk pregnant women for years. Up until now, the drug was custom-compounded by wholesale and specialist pharmacies, legally, but without federal approval. These injections cost between $5 and $15 a dose and were regularly reimbursed by insurance companies and Medicaid.
Last month, the FDA announced their approval
of a commercially produced version of the compound, to be marketed under the brand name Makena by a company called KV Pharmaceuticals.
No stranger to controversy and trouble, KV barely survived a rash round of layoffs and wrongful termination lawsuits
. Their former chief executive now faces criminal charges
surrounding the company's failure to notify the FDA that they were producing oversized morphine tablets. (He could also do for a shave, it appears.)
Now, KV has announced that the new drug will be available at a cost of $1,500 per dose
, bringing the total pregnancy term cost of treatment to $25,000-$30,000
, from its former cost of $250-$300, a 100-fold increase
—but it gets worse... [more inside]
The Hot Spotters
examines the possibilities of a strange new approach to health care: to look for the most expensive patients in the system and then direct resources and brainpower toward helping them. — by Atul Gawande [more inside]
Although the Stupak amendment was defeated, women in the new high risk pools will be denied coverage for abortion.
The "clarification" from the administration comes in the wake of a scuffle
over Pennsylvania's plan to provide abortion coverage
. Hopefully, building criticism
will have an effect.
— How medical supply behemoths stick it to the little guy, making America’s health care system more dangerous and expensive. [more inside]
What US Health Care Needs Medical doctor and writer Atul Gawande gave the commencement address recently at Stanford's School of Medicine. In it he lays out very precisely and in a nonpartisan way what is wrong with the institution of medical care in the US — why it is both so expensive and so ineffective at delivering quality care uniformly across the board.
Atul Gawande offers a way
for health care to be improved through experimentation and pilot programs, much as agriculture was in 20th century
How American Health Care Killed My Father After the needless death of his father, the author, a business executive, began a personal exploration of a health-care industry that for years has delivered poor service and irregular quality at astonishingly high cost. It is a system, he argues, that is not worth preserving in anything like its current form. And the health-care reform now being contemplated will not fix it. Here’s a radical solution to an agonizing problem.
) [more inside]
A simple question shows how complex the issue is.
Chris at "Cynical C" asks his fellow citizens where they get thier health care (insurance) from and the incredible diversity of the current options and situations is immediately apparent. Quite spontaneously (but surely not unexpectedly), the question of "How much does it cost you?" becomes an essential part of the answers. Outsiders opine and tell stories and commiserate. [more inside]
Search for an Rx
- We asked Johns Hopkins administrators, physicians, and researchers about the health of a system Americans rely on to keep them healthy.
Afterall, an ounce of prevention
... [more inside]
What's wrong with primary care in the US? With a new survey
suggesting that nearly half of all primary care physicians would leave medicine if they had a viable alternative, and with American medical schools not generating nearly enough new doctors
going into primary care, in this
, their first issue to hit doctors' desks since the election, the New England Journal of Medicine has devoted their entire editorial section to exploring yet another challenge that threatens the stability of the US health care system. Video
of the roundtable discussion. Individual
essays, at times touching
, at times hopeful
, from various primary care perspectives in the US and Britain
. [more inside]
Two years since Massachusetts instituted major statewide healthcare reform
, the statistics
are coming in. 340,000
residents, roughly half the state's previously uninsured, are now insured. The state says that 95%
of its population is now covered, based on Department of Revenue estimates. However, a large portion of them are enrolled through state-subsidized insurance programs, and those program's rate of enrollment have far outpaced estimates
. This has led lawmakers to forsee a budget shortfall
. Premiums and co-pays are going up
, cigarette taxes have increased
, and a cost control
proposal is making its way through the legislature. Assessments have been all over the map
Sick Around the World
, the newest documentary piece
produced by PBS's Frontline
asks: "Can the U.S. learn anything from the rest of the world about how to run a health care system?" Having previously shared a Pulitzer Prize
with The New York Times
, and produced such quality programs as Bush's War
, this should be well worth a mere hour of your time.
The state of Oregon is holding a health insurance lottery
where 91,000 hopeful enrollees will be competing for a couple thousand spots under the Oregon Health Plan, the state's Medicaid program. OHP was created to cover those who made too much to enroll in traditional Medicaid but too little to afford market healthcare, and this development comes as a result of budget cuts and a subsequent enrollment closure in July of 2004. It's a far cry from the universal health care coverage that the plan was suppose to lead to, and marks a dramatic turn
for the state's once-ambitious health care reforms.(Previously in dystopic health care developments)
Cancer Cure Patented
A group of researchers claim that they are patenting a possible cure for cancer involving nothing more than sugar and short-chain fatty acid combination.
Coverage with Evidence Development.
Never heard of it? Me neither, until today. It's what they call this idea: if you want to be covered by Medicare, you're forced to participate in medical research.
The AMA approves
(article abstract only). So much for informed consent.
about 17,000 American medical students and almost as many foreign trained doctors learn what types of doctors they will be. Yes, it’s Match Day
. Ok, while most people probably could care less about this post, it presents an intriguing look into the forces
(i.e. how the ratio between specialists and generalists arises and to note: more specialists equals more procedures and costlier health care) that shape American health care today.
And, it represents the strange culmination of years of study (at least 8+ years after high school) that many students take just to leave it up to a strange algorithm
that is under a anti-trust lawsuit
as they wake up one day in March and learn where they will be spending the next (at least) three years of their life. Also, if you see a recent graduate of an "ADORE+P" residency
-- Anesthesiology, Dermatology, Orthopedics/Optho, Radiology, ENT/Emergency Room medicine (plus, of course, Plastic surgery) -- (the professions that work great hours and make the most money) -- congratulate her or him on being the best (statistically) of the crop.