Monday, November 21, 2016

On Call by Casey Ross

Good Morning! Bob Tedeschi here, sitting in for Casey Ross for one more day. Here’s the Monday buzz from the world of hospitals and healthcare. For more, follow us @statnews on Twitter or like us on Facebook

FDA punts on closing a lab test loophole

So much for scientific rigor.

After warning for months of the dangers of unregulated laboratory diagnostics, the FDA on Friday backed off plans to issue new rules for the industry. Given President-elect Trump's antipathy to regulation, there's a good chance such guidelines will never materialize.

The FDA already regulates tests that are sold to multiple hospitals or labs. But it doesn't have jurisdiction over tests developed by and performed in a single lab, including cancer screenings and DNA analyses marketed directly to consumers. FDA has long been concerned about the accuracy of those tests; last fall, a top official wrote that federal oversight “would help ensure that tests are supported by rigorous evidence.”

Trade groups representing testing companies cheered the FDA's move, as did top Republicans in Congress.

Read more here.

Calling out hospitals with poor safety records

Hospital infections have been dropping steadily, but still rank as the eighth-leading cause of death in the US, just behind diabetes.

So Consumer Reports examined central-line infection rates at nearly 2,000 teaching hospitals.

It name-checks 32 of the highest-performing hospitals, and profiles two success stories: Shore Medical Center in New Jersey and Mount Sinai St. Luke’s in New York.

It also names the 31 worst offenders, including notables such as Dartmouth- Hitchcock Medical Center in New Hampshire, Robert Wood Johnson University Hospital in New Jersey and Ronald Reagan UCLA Medical Center in Los Angeles.

Given that central-line infections are largely preventable, “there are no excuses for poor performance on this metric,” said Doris Peter, who directs Consumer Reports’ Health Ratings Center.

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Zag of the day: Building expertise in palliative care

Interest in palliative care is growing across the US health care system, but palliative specialists are in woefully short supply, and many mid-career clinicians don't know enough about it to implement key practices.

Massachusetts General Hospital in Boston is trying to change that.

Earlier this month, it rolled out the Palliative Care Continuum Project, in which doctors and nurses throughout the hospital get training in techniques like pain management and end-of-life care discussions.

The training materials were created with input from both generalists and palliative specialists, and Mass General will spend the next year testing and refining them, according to Dr. Vicki Jackson, chief of palliative care and geriatrics.

“We want to develop a deep bench," Jackson said, “so that nurses and doctors across the institution have the skills and resources they need to care for seriously ill patients, and know when to refer to palliative care subspecialists if needed.”

Our latest poll: Saving (parts of) Obamacare

President-elect Trump has sent mixed signals about his plans for the Affordable Care Act, but the status quo is clearly out the door.

What would medical professionals tell him is the single most important ACA element to retain?

We asked our polling partner, Figure 1, to find out, and the results were mostly predictable. Topping the list: Mandatory coverage of pre-existing conditions and coverage of family members under 26.

Among the more interesting responses:

  • “The ability to keep your insurance when you drop below full time. I'm an LPN and in my second year of RN school and I was able to keep my medical, just not my voluntary dental and vision, when I dropped below full time.” — Licensed Practical Nurse

  • “The Prevention and Public Health Fund, which expands and sustains investment in prevention and public health (including the National Health Service Corps)!” — Physician Assistant Student

  • “The name. Makes me giggle every time.” — Emergency Medicine Physician


  • A Rhode Island law, a doctor and the homeless man who keeps returning to the ER (Washington Post)
  • Researchers have overlooked women’s concussions...until now. (STAT)
  • In depressed rural Kentucky, worries mount over Medicaid cutbacks (NPR)
  • Inside the race for a Zika vaccine  (New York Times)

Have a news tip or comment you want to send me?

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Thanks everyone. Casey's back tomorrow. Have a great day. 
— Bob

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