KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Longer Looks: Doctor Guilt; An Abortion Provider’s Hidden Record

Every week reporter Ankita Rao selects interesting reading from around the Web.

The Atlantic: When Doctors Make You Feel Guilty
Okay, I know I'm a health writer, but I really don't like going to the doctor. Part of it is an unshakeable, irrational certainty that they will find something horribly wrong with me that I'd rather not know about, and part of it is a rational certainty that they will find something mildly wrong with me that is my fault and chastise me for it—drinking too much, not exercising enough, whatever. One should be able to talk to one’s doctor about these things—the aspects of one's lifestyle that maybe aren't so great. ... But in 2009, a study by researchers at the University of California, San Diego found that half of the patients surveyed had experienced shame as a result of something a doctor said to them. In a new study, forthcoming in Basic and Applied Social Psychology, the researchers expand on that work to figure out why people react either positively or negatively to doctor-induced guilt (Julie Beck, 1/22).

The New Yorker: A Botched Operation
May of 1990, several hundred physicians gathered in a conference hall at an Atlanta hotel, as uniformed guards stood at the door. … It was the annual gathering of the National Abortion Federation, or N.A.F., a professional association with a beleaguered membership. ... There was at least one younger face at the conference: Steven Chase Brigham. A handsome, genial man in his mid-thirties, with a square jaw and sandy brown hair, Brigham was a recent graduate of Columbia University's medical school. Articulate, well dressed, and polite, he seemed unusually relaxed and upbeat for an abortion provider. "You sort of notice the newbies, and he seemed like a very personable young man," Dr. Suzanne Poppema, a former director of N.A.F., recalls. ... Dr. Curtis Boyd, one of N.A.F.'s founders, says, "He knew all the right things to say. He's very charming." By the mid-aughts, Brigham was the owner of a large chain of abortion clinics, American Women's Services (Eyal Press, 2/3).

The New York Review Of Books: On Breaking One's Neck
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. … What did this experience teach me about the current state of medical care in the US? Quite a lot, as it turns out (Arnold Relman, 2/6).

60 Minutes: Nowhere To Go: Mentally Ill Youth In Crisis
Last November 19th, Virginia State Senator Creigh Deeds was slashed and stabbed repeatedly by his own son. Gus Deeds was 24 years old and had been struggling with mental illness. He and his father had been in an emergency room just hours before the attack but didn’t get the help that they needed. The story of what went wrong with his medical care exposes a problem in the way that America handles mental health. ... In the decades after the 1960s most large mental institutions were closed. It was thought that patients would get better treatment back in their communities. But adequate local facilities were never built. The number of beds available to psychiatric patients in America dropped from more than half a million to fewer than 100,000. That leaves many kids in crisis today with one option: the emergency room (Scott Pelley, 1/26).

The Wall Street Journal: Agonizing Choices For Lives Saved By Miracle Drugs
Sixteen-year-old Megan Crowley lay facedown on an operating table last June as her surgeon tried to straighten her spine, badly contorted by a genetic disease that nearly killed her as a little girl. The doctor had warned Megan that she stood a 5% chance of dying from the risky surgery, but she eagerly chose it anyway. Her 15-year-old brother Patrick, stricken with the same rare disease, refused the procedure and awaited news of her at home. ... Megan's and Patrick's choices are the kind of agonizing ones now confronting a generation of Americans like them whom biotech breakthroughs have kept alive—but haven't fully cured. The two have Pompe disease, which progressively weakens muscles. Until about a decade ago, heart failure killed most babies with Pompe within a few years (Geeta Anand, 1/24).

The New York Times: Playing With Toys And Saving Lives
How do [Third World hospitals] normally get medical equipment?  For the most part, they don’t — some public hospitals can't even afford IV tubing or gloves.  Often, they get donations from rich-country hospitals, which give away last year's technology. But these machines tend not to last long. They might need parts that are only available a continent away, or no one knows how to repair them.  Sometimes it's just that the electricity has gone out — or there was no electricity to begin with. Equipment destined for a productive life in a third-world hospital is equipment adapted for local circumstances, rugged, fixable locally, with available parts (Tina Rosenberg, 1/29).

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