FDA Approves Roche/Genentech Drug Erivedge to Treat Advanced Skin Cancer Not Treatable with Surgery

Basal cell carcinoma is rarely fatal and in many cases surgery is the cure but in some patients is can spread beyond the skin area in to other areas of the body and this is where the new oral drug comes in to help fight and shrink tumors.  When the cancer has metastasized, this is about the only option available.  There are a few side effects like loss of hair and food tasting different but the benefits seem to certainly outweigh. The pill is taken once a day and the cost will be around $7k a month.  I do hope insurers start to cover this as it has been an issue in California with covering oral cancer medications.  BD ...

California Federal Judge Issues Tentative Rule that Blocks Cutting Medicaid Payments

In November of last year the CHA also filed suit against the cutting of Medicaid in California.  Do you know how hard it is to find doctors in California who will honor Medicaid?  Ask a doctor trying to find a referral for a child, it’s hard. California Hospital Association Sues HHS With Kathleen Sebelius Named To Block a 10% Cut With Medi-Cal Reimbursements This has a big impact on hospitals too, many of which are not in the best financial picture to day.  Shoot even a couple weeks ago Cedars decided to no longer support mental health care at the hospital so cut backs are all over the place.  BD A federal judge in...

Komen Foundation Cuts of Funds to Planned Parenthood - Wall Street Was Lit up in “Pink” Last Week For Fund Raising from Hedge Funds and Other Financial Companies

This makes you wonder where in the world philanthropy is going today and how much will remain.  The reasoning is very strange here and if they don’t want to spend the money, be honest and say so.  Planned Parenthood said it was all the anti abortion talk that caused them to withdraw.  We all know that abortion is the “default topic” for all of our digital illiterate Congressmen.  When things with finance and technology come up they just default back to the same old topic because they don’t participate at a very high level if at all in the real world we live in with algorithms driving almost every move and opportunity out...

Right to Know Laws - The Case of Amanda Trujillo

New York and California are, by now, well-known for having "Right-to-Know" laws.  I recall that Arizona (like Maryland, Vermont, and others) had introduced at least one bill to do the same thing.  It sure seems like if there were a case to illustrate the problems that motivated such bills, it is the case of Amanda Trujillo. She writes:  I'm a registered nurse of six years , specializing in cardiology, geriatrics, and end of life/palliative care. Back in April of this year I was caring for a dying patient whom I had discovered had no clue about what they were about to participate in when they agreed to get a major invasive surgery....

Cassell on Callahan: Survival vs. Functional Lives

I liked this language in Eric Cassell's letter-to-the-editor in the Nov-Dec Hastings Center Report:  [T[he contemporary goals of medicine remain disease-oriented, not focused on sick persons.  Success . . . is marked by survival. . . .  But aside from soldiers in combat, most people do not awaken bent on survival.  They want to live functional lives and enjoy well-being sufficient to achieve their goals and purposes. . . .  [T]he current individualism we prize requires a stable nation that we are unlikely to achieve without shared responsibility and reigned-in-gre...

Freddie Mac Found to be Betting Against Home Owners Being Able to Refinance - “Attack of the Killer Algorithms” On Consumers Part Nine–Home Mortgage Style

Ok in the real world today everyone lives off of behavioral analytics so of course they might just have a ton of information to leverage to make their bets, right?   If you look and see how this phenomena is taking place today, it’s not just Facebook, but Hedge Funds, High Frequency Traders and so on.  It’s all about those algorithms as Freddie Mac could not have pulled this off without highly sophisticated formulas to hedge their bets.  High Frequency Traders Using Social Networks and Growing Rapidly With Algorithms That Find, Sort and Leverage-Growing At A Rate Faster Than Facebook Ultimately, market data both on and...

State of Virginia Attaches Amendment to Bill Requiring Women to Have an Ultrasound Before an Abortion That Requires Men to Have A Rectal Exam Before Obtaining A Prescription For Erectile Dysfunction Drugs

Here we are back to the old “default” topic of the digital illiterates, abortions and this is pretty funny as it mocks the ridiculousness of a bill requiring an ultrasound.  You know what, there will be more rectal exams going on I bet than abortions:)  Sad that the amendment didn’t make it through though as it should have but the GOP barely voted it off.   The ultra sound part of the bill is still up for a final vote.  BD Digital Illiteracy Still Plagues Law Makers–Severe Focus on Abortion Rights Proves It–Is This Where Our Lawmaking Knowledge Leaves Off or Even Begins? Scary… Digital Illiteracy Continues With Lawmakers...

Hospital Sentenced for Providing Futile Treatment

In June, I blogged about a French case in which a hospital was fined for providing futile treatment.  Basically, providers at the Hospital of Orange continued resuscitation on a seriously compromised newborn for 25 minutes.  The court concluded that this excessive length was "unreasonable obstinacy."  I learned a lot more about the case from Manaouil, Gignon & Jarde, "A French Hospital Sentenced for Unreasonable Obstinacy," European Journal of Health Law 18(5) (2011): 521-530.  This case, like some others that I discussed in a recent Journal of Clinical Ethics (2011) article, re-frames the  debate from permissive refusal to mandatory refusal, from when may physicians stop futile treatment to when must they...

Context is Everything–More About the Dark Arts of Mathematical Deception–Professor Siefe Lecture Given at Google’s New York Office–Big Healthcare Focus

A great video from Charlie Siefe, Professor at NYU and in his talk at Google.  If you read here enough then you know I am a fan because he’s right and breaks this down to what reality is.  He may have sold a few books from this blog too come to think of it:) What do you think of what you read in the news today?  Listen up here and you might begin to think a little differently. I have my own interpretation on how some of this comes down the hill for consumers which I have called “The Attack of the Killer Algorithms” to take this from his very scientific information down to how it eventually affects all of us as consumers. ...

If I Die - the App

IF I DIE is the first and only Facebook application that enables you to create a video or a text message that will only be published after you die.What will happen to your Facebook profile after your passing?  IF I DIE is the first and only Facebook application that enables you to create a video or a text message that will only be published after you die. It could be your life story, a secret you haven't shared before or even a will.  After installing the app, the user is asked to choose  trustees from his Facebook friends list, those trustees will receive a message about their important task - confirm your death.  Only when...

Sublime Body seeks performers

A newly formed Arts Organisation called Parlour Arts is looking for artists and performers for their upcoming exhibition, "The Sublime Body". The exhibition will take place in the Parlour Space in Kentish Town 27th February- 4th March. They have already begun taking submissions of visual artworks, but are now looking for performers to perform on the closing night of the exhibition. The performance can take any form from spoken word to dance to music to film or short plays. This is a great opportunity for new artists and performers to show off their work and one not to be missed. For more information and to register interest, please contact Fiona...

GE Discontinues Centricity Advance EHR for Small Practices

Doctors using the current Centricity for small practices will have to upgrade and of course I’m sure that mean money and cost.  The GE EHR is probably one of the most expensive products out there for a small practice to purchase.  Just a couple months ago software problems created issues for doctors to attest as you can read below, this is the system they are keeping.  GE Centricity EHRs Need To Fix Their Algorithms (Math)-Some Customers May Not Be Able to Attest Until The End of November After the Software Update June 30th is the D-Day for posting any new data and it becomes a read only from there until the end of the year. ...

Nurse At Arizona Hospital Has Licensed Threatened And Was Fired for Educating Patient on Hospice Care–If You Are A Nurse or a Patient Be Sure and Read This One

This is a post from the Nerdy Nurse and really you must read the entire article and see what has happened here.  When you read through here and see the story as told with the nurse educating the patient about a hospice choice as I am guessing it was near that time, the doctor was upset that the surgery plans were messed up, in other words he was not going to do the surgery after the patient heard about hospice.  This is kind of what we are all talking about right?  Giving the patient their options and allowing dignity here and not putting people through hell as they near the end of life?  Again I am guessing that was the...

Medical Futility and the Courts - Podcast

Here is my interview with the Bioethics Channel on my recent JAMA article with Doug Whi...

FTC Says No to Omnicare Take Over of PharMerica and Files Lawsuit to Block as The Combined Company Would Control 60% of Drugs Supplied to Nursing Homes

Omnicare on its own had revenues of over $6 billion and Pharmericas is just under 2 billion so this would be big financially as well.  We all know what lack of competition does in the pharma world and this probably would be no exception.  Just a few months ago we had Walgreens swap businesses with Omnicare so they got out of the long term care business, so Omnicare picked up business there as well and Walgreens picked up the home infusion business. Walgreens and Omnicare Swap Businesses–Giving Long Term Pharmacy Care to Omni and They Get Omni’s Home Infusion Business This is not the first time the eyes of the government have been...

FDA Approves First and Only Weekly Diabetes 2 Shot Therapy in the US

Bydureon took three tries to make it through approval with the FDA.  The active ingredient comes from a synthetic version of saliva from the Gila Monster.  I am originally from Arizona and I know what those are and way back in 2007 the talk was in the exploration of saliva with lizards.  Bydureon is not insulin and is not for people with diabetes type 1.  Byetta is the non extended version of the drug that has been around for a once a day injection and has been associated with acute pancreatitis, so I would guess the same warnings would apply here as well.  Lizard spit and bongs - Medication Origins and Future BYDUREON...

Participate in New Documentary Film on End-of-Life Care

Red Porcelain Pictures, LLC, is shooting a documentary film on end-of-life care & the future of our Elders in Austin, Texas. Please contact the filmmakers (gigs-uumhf-2819481823@craigslist.org), if you, or someone you know, would like to participate in this film portrait by sharing, on camera, your stories as they pertain to: Hospice care, long-term care facilities, nursing homes, caring for the elderly at home - OR - if you are a Health Care Professional who would like to provide an interview. Please send a brief description of the events that shaped your perspective on these topics, and when you are available to meet with our crew. Of particular interest:Interviews w the ElderlyPatients & Families currently on Hospice services, or stories from prior Hospice experiencesFamilies...

Aneesh Chopra US Chief Technology Officer Resigns to Possibly Pursue A Political Career

Well here’s one more and Mr. Chopra was good and got everybody motivated but time to move into the next phase with implementation and perhaps a little different leader is needed to pass the baton.  We have had the word “innovation” up to our ears and now it’s time to begin some serious efforts with “collaboration” and perhaps a different personality to move to the next level with government IT.  About a year ago I made the post below saying pretty much the same thing.  BD    Innovation Without Collaboration Is Fouling Up The US Healthcare IT System–We Need Both As We Can’t Stand on Innovation Alone Aneesh Chopra,...

Over 100 Cardiac Patients in Pakistan Have Died from Tainted Heart Medicine

This is sad and scary and makes you appreciate the FDA for sure.  I read elsewhere that the chemical content of the drug was ok but now we are left with other compounds, coatings, etc. to be checked as well.  The government shut down 3 companies where the drugs are made and by the way they also export drugs to other companies, US not mentioned as one.  Patients all had a sudden drop of white blood cell count and broke out bleeding in some area of their body.  This all happened over a 3 week period.  The drugs were administered by the government hospital and were free.  Samples of the drug have been sent to London...

Wellpoint to Begin Paying Family Practice Doctors a “Little” More–Enough to Make A Difference? Pay For Their Full Time Billing Expenses and A Lot of Doctors Would Happy

Ok so I made my point in the title and this article too dissects the potential demographics of the situation too as if only 10-20% of the patients are covered by Blue Cross, is there enough incentive for the doctors to make a difference?  On the other hand if the insurer paid all their insurer overhead, now that would make a huge difference and get attention.  Let’s also look at the amount of the investment here since doctors only represent 8% of healthcare expenses. Physician Salaries Represent 8% of Total US Healthcare Cost Certainly the clinical information shared is always of value as knowledge helps all the way around. ...

The Effect on Survival of Continuing Chemotherapy to Near Death

Rarely, but sometimes, a medical intervention is not just qualitatively or quantitative futile but actually physiologically futile.  In the latest issue of BMC Palliative Care, Akiko M Saito and colleagues found: About one tenth (8.5%) of patients who had ever received chemotherapy were still receiving chemotherapy within 14 days of death; this population experienced no survival benefit as determined by three different statistical approaches.  These patients were also much less likely to receive hospice care or and more likely to receive it for three or fewer days. These results suggest that patients receiving chemotherapy within 14 days of death do not benefit from this aggressive approach to treatment, and they may also be deprived of good palliative...

California Legislature Urging Health Insurance Companies to Cover Chemotherapy–Especially With Breast Cancer Treatments

The bill in the legislature will force insurance companies to cover oral cancer chemotherapy instead of making patients take a trip to the hospital for each treatment.  This is especially important with breast cancer as patients can take the medication in the privacy of their own home.  This would allow for patients to spend more time with family.  Patients with good insurance are not covered either as the policies are not covering and they are paying out of pocket.  It’s about time to catch up with the times and science and offer quality of life.  Bi-partisan support has been given in the Legislature.  The costs...