The University of Maryland Medical Center and Anne Arundel Medical Center were among 65 hospitals on a “Top Hospitals” list compiled by the Leapfrog Group, which was founded in 2000 by the Business Roundtable, a group of chief executives.

The executives wanted to influence the quality of health care and Leapfrog, which is now a separate nonprofit, began ranking hospitals.

The group says the list of hospitals take steps to prevent medical errors, reduce mortality for high-risk procedures and reduce hospital readmissions. It assesses their success based on how the patients do, the resources used and management practices to promote safety and quality.

Jeffrey A. Rivest, president and chief executive at Maryland, which has been on the list for six years, said in a statement, “The fact that this recognition has continued for six years in a row is testimony to the culture of excellence that drives the medical center’s approach to patient care and helps sustain the highest standards of treatment in the midst of rising expectations.”

Said Victoria Bayless, president and chief execuitive at Arundel Medical Center, a list newcomer: “Among the goals in our organization’s strategic vision of Living Healthier Together is to provide efficient, responsible and affordable care.  This award recognizes the strides we have made to streamline processes to offer high quality care at a lower cost.”

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Four area scientists are among the 65 new members of the Institute of Medicine, a premier independent scientific advisory panel created by the National Academy of Sciences. Membership is an honor, as new members are recognized for their major professional achievement in medical sciences, health care and public health by the 1,870 existing members. They volunteer their service to conduct analyses and make recommendations.

The new members and a snapshot of their achievements are:

+Claire Fraser-Liggett, director of the Institute for Genome Sciences and a faculty member in the departments of medicine and microbiology and immunology at the University of Maryland School of Medicine. She and her team launched the field of microbial genomic by sequencing a bacterium, Haemophilus influenzae, for the first time and creating a foundation for new approaches to personalized medicine.

+Richard Huganir, director of the Solomon H. Snyder Department of Neuroscience, co-director of the Johns Hopkins Medicine Brain Science Institute and an investigator with the Howard Hughes Medical Institute. He recently discovered a method to erase memories in mice that could eventually be used to treat humans.

+Dr. Jeremy Nathans, professor of molecular biology and genetics, neuroscience, and ophthalmology at the Johns Hopkins School of Medicine and an investigator in the Howard Hughes Medical Institute. He has made fundamental discoveries in basic and clinical vision science.

+Dr. Peter J. Pronovost, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins, senior vice president for patient safety and quality for Hopkins and a professor of anesthesiology and critical care medicine and surgery at the Johns Hopkins University School of Medicine. He’s known for his research into medical errors and is methods to end bloodstream infections are used in hospitals around the world.

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A new food safety training facility aimed at foreign lab technicians has opened in the University of Maryland’s Joint Institute for Food Safety and Applied Nutrition. The goal is to improve the safety of imported food.

The facility located in Maryland’s M-Square research park in College Park is a collaboration among the school, the U.S. Food and Drug Administration and the Waters Corp., which makes high-tech lab testing equipment. It will use federal regulators as teachers for the foreign techs. They will get hands-on training in the latest technology and food safety methods and standards.

“The more we can strengthen scientific expertise in foreign food labs and harmonize their procedures with U.S. requirements, the greater the likelihood of safe foods reaching the U.S. and global markets,” said Janie Dubois, who directs the new International Food Safety Training Laboratory, in a statement. “Federal regulators can only inspect a tiny fraction of imports, so foods should be well-tested and comply with U.S. requirements when they arrive in the country.”

Training began Sept. 12 with a class of techs from China and Indonesia. Classes focused on detecting pesticide contamination. About 200 professionals are expected to train a year. Officials said other developing countries have expressed interest in the training that can improve food safety at home and abroad.

Photo courtesy of the University of Maryland

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The Abell Foundation has released a report that chronicles the difficulties of those with sickle cell disease, from history to pain to mistreatment, and concludes that much more needs to be done to improve access to care and to improve the relationship between patients and doctors.

Sickle cell disease is a lethal genetic blood disorder that afflicts mostly poor city black people, making it a big problem in Baltimore. It’s chronic and sometimes so excruciatingly painful that it prevents sufferer from working and going to school, leaving them in constant crisis.

Doctors can prevent and mitigate the symptoms but discrimination and fear often leave sufferers feeling blamed for their disease, the report says. Treatment often involves constant use of opioids, generating negative stereotypes.

“This disease is a prototype example of how social, health, and economic issues combine to create an environment where poor quality of care yields poor health outcomes and death, as well as poor outcomes in other spheres of life,” says Cynda Hylton Rushton, a nurse, expert on compassionate care, and bioethicist at Johns Hopkins Berman Institute of Bioethics, in the report.

The report concludes that doctors, patients, as well as educational and business groups and the general public need to be educated about the disease and existing treatments to overcome discrimination and negative judgment. Better efforts need to be made to keep sufferers in treatment, as well as trials for new treatments.

Government also needs to step up its efforts to support disease resources and research, the report concludes. That includes better and age appropriate care, support programs and outreach.

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St. Joseph Medical Center tapped a veteran health care manager to replace its president and chief executive, who resigned last month without explanation.

Charles W. Neumann was a senior operations executive in the Boston-based FTI Healthcare Group. Previously he’d served as senior vice president of operations for Bon Secours Health System Inc. in Marriottsville for five years. He will start Aug. 23.

He replaces Jeffrey K. Norman, who had been brought in as a crisis manager in the fall of 2009 after a doctor was accused of placing unnecessary stents in hundreds of patients. Towson cardiologist Dr. Mark G. Medei stopped practicing at the hospital two month previously and has since lost his license to practice medicine.

“The board immediately recognized Chuck’s passion for quality and his commitment to work with the medical community,” said Edward J. Gilliss, chairman of St. Joseph’s board of directors, in a statement. “The transition in leadership will be seamless. The board thanks Jeff Norman for his good work and service to St. Joseph Medical Center. Over the past two years, we’ve built a strong base for Chuck to lead our medical staff, employees and board forward with a keen focus on delivering quality services to our patients.”

In a statement, Neumann said: “I know St. Joseph Medical Center and I admire its mission, its outstanding physicians and its commitment to the community for quality care and outstanding clinical programs. Healthcare in the United States is in transition and I look forward to developing and implementing strategies and operational improvements that assist St. Joseph Medical Center in achieving its full potential.”

Update: Read the full story here. 

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Educators who become preceptors for young doctors are missing opportunities to teach them about medical ethics, according to a new study.

Physicians in training face all sorts of bioethics questions during their day – from what do about a patient who can’t afford medicine to a patient that refuses treatment. But doctors who oversee residents don’t always take time to talk about the issues, say bioethicists at the Johns Hopkins Berman Institute of Bioethics.

“Teaching about ethics and professionalism in real time is a very important part of the training experience,” said Dr. Joseph Carrese, the study's lead author and a core faculty member at the Berman Institute, in a statement. “It appears from our findings that opportunities to identify those issues and teach about them were missed.”

The ethicists conducted a two-week observational study of 53 internal medicine residents and the 19 preceptor physicians overseeing them. Findings were described in the July issue of Medical Education. Preceptors taught about ethical issues only12 percent of the time. 

The main hurdle to discussing issues more often is time, Carrese said. But he said strategies can be developed to streamline difficult conversations. One idea is a checklist that can help doctors assess a patient’s decision-making ability in an emergency or other clinical situations.

It goes by the acronym, CURVES: Choose and Communicate, Understand, Reason, Value, Emergency and Surrogate.

“If we better understand what the barriers and needs are,” Carrese says, “then we as ethics faculty are going to be in a better position to help preceptors and enhance how they teach trainees about ethics in real time.”

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One of the top doctors at Johns Hopkins is laying down his scalpel. Dr. Patrick Walsh performed his last, and 4,567th, radical prostatectomy yesterday.

Walsh is probably best known for his time directing the Brady Urological Institute, where he served from 1974-2004, and for pioneering work in the development of the anatomic approach to radical prostatectomy. That involves a technique that spares nerves and reduces the probability of impotence and incontinence.

Officials at Hopkins also say he’s made major contributions to the medical world’s understanding of benign and malignant neoplasm of the prostate. He’s treated many people over the years, including Sen. John Kerry, the Massachusetts Democrat and presidential candidate.

He’s also on the editorial board of the New England Journal of Medicine and is a member of the National Academy of Science’s Institute of Medicine, an influential advisory panel. He’s earned many awards and has authored best-selling books on the prostate for non-medical people.

Walsh plans to continue seeing patients.

Watch a video of an interview with him on the Charlie Rose Show.

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Dr. Gordon Tomaselli, a Hopkins professor and director of the division of cardiology, will become the next president of the American Heart Association on July 1.

Tomaselli will be the seventh Hopkins faculty member to head the association, the leading health association on cardiovascular disease and stroke.

In his 25 years at Hopkins, the doctor has become known for his research on preventing sudden cardiac death by identifying genetic and other factors that put people at risk. Sudden cardiac death is a swift killer, with few surviving long enough to reach medical attention.

Tomaselli has focused on arrhythmias. More than 250,000 Americans die of the potentially fatal heart rhythm disturbances a year.

 “This is a tremendous honor for Dr. Tomaselli and Johns Hopkins. It underscores his contributions and role as a world leader in the study of the causes and potential therapies to prevent sudden cardiac death,” Dr. Edward D. Miller, dean of the medical faculty and chief executive of Johns Hopkins Medicine, said in a statement.

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Wonder what geniuses think about?

Johns Hopkins is launching a free speaker series today with seven recipients of MacArthur “genius” fellowships from Maryland, Virginia and Washington.

The first annual event, open to the public, will center on communication, specifically how the geniuses get peers, policymakers and the public to pay attention to their work and ideas. Organizers at Hopkins say they aim to inspire lively exchange and creative collaboration.

No reservations or tickets are required for the panel discussion, question-and-answer session and reception this evening from 4 p.m.-6 p.m. at the Anne and Mike Armstrong Medical Education Building of the Johns Hopkins University School of Medicine, 1600 McElderry St. in Baltimore. Parking is available in the McElderry Street Garage. See a map.

On the panel, chaired by Atul Nakhasi, a first-year Johns Hopkins medical student, and moderated by Joann Rodgers, veteran science journalist and senior communications advisor at the Johns Hopkins Berman Institute of Bioethics:

+Marin Alsop, conductor, Baltimore Symphony Orchestra (MacArthur Fellow ’05)
+Dr. Lisa Cooper, internist and epidemiologist, the Johns Hopkins University (MacArthur Fellow ’07)
+Ruth DeFries, environmental geographer, University of Maryland (MacArthur Fellow ‘07)
+Janine Jagger, epidemiologist, University of Virginia (MacArthur Fellow ’02)
+Liz Lerman, choreographer and founder, Dance Exchange (MacArthur Fellow ’02)
+Dr. Peter Pronovost, patient safety expert, the Johns Hopkins University (MacArthur Fellow ’08)
+Adam Reiss, astrophysicist, the Johns Hopkins University (MacArthur Fellow ’08)

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Categories: General Health, Health care professionals
        

States aren’t adequately protecting consumers from bad doctors, according to a new study from the advocacy group Public Citizen.

The group looked at state medical boards and found the rate at which doctors are disciplined has dropped during the past decade: In 2010, the boards took 2.97 serious actions per 1,000 physicians, down three percent from last year and 20 percent from 2004, a peak year when the rate was 3.72 per 1,000 physicians.

If the rate had stayed consistent from 2004, there would have been 745 more actions last year. (The rates are an average based on the past three years.)

Maryland’s board took 79 serious actions last year for a rate of 2.55 – for a rank among the states of 39th. That was an improvement in rank from previous years. It was 43rd in 2009, down from 48 in 2003, the group said.

The least active state last year was Minnesota, with a rate of 1.29. Others near the bottom were South Carolina, Wisconsin and Connecticut.

The most active state was Louisiana, with a rate of 5.98. Others near the top were Alaska, Ohio and Oklahoma.

“One reason for medical boards’ declining rate of discipline is likely tighter state budgets,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group, in a statement. “The ability of certain states to rapidly increase or decrease their rankings, even when calculated based on three-year averages, can only be due to changes in practices at the board level.”

So, is it possible that fewer doctors acted improperly? 

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MedChi, the Maryland state medical society, adopted principles Saturday that the group’s leaders say will protect patients' access to care. The principles will guide the group’s legislative efforts.

The doctors' group, which tussles with cost-conscious insurers over coverage, wants to establish itself as the primary decision makers for patients.

“MedChi has increasingly heard from our physician members about the significant intrusion of health insurance plans into the patient-physician relationship, and about the adverse impact that these barriers to care can have on patient health,” said Gene Ransom, chief executive of MedChi, in a statement.

Ransom claims insurers have a “well-established track record of implementing complex requirements” that end up being such a burden some doctor quit their practices.

Ransom said the move to electronic records around the state will be an opportunity to improve communications with insurers.

The principles are on the next page.

Continue reading "Doctors to push for control of patients' access to care" »

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Many hospitals are making efforts to improve the quality of care but there isn’t consensus on how to measure the progress, says Dr. Peter J. Pronovost, Johns Hopkins patient safety expert.

In the April issue of the journal Health Affairs, Pronovost calls for more attention to the accuracy and reliability of the measures. Without this, patients can’t be sure any improvements have been made.

“There is bipartisan support behind efforts to start paying for value rather than volume,” Pronovost said. “This is great, but we act as if there's a whole library of reliable outcome measures for us to use, and the fact is that serious work needs to be done to create them. We can't shrink from doing this science. We need to be guided by it.”

Pronovost said there are still shortcomings in hospital quality and patients are still being needlessly harmed. This is increasing health care costs.

And past efforts at assessing improvement have not always proven consistent or useful.

Pronovost said some hospitals measure overall death rates but they are not always a reflection on the quality of care. And other research that compared four different measurement services found that they reported the same data differently – 43 percent of hospitals showed higher-than-expected mortality in one metric and lower-than-expected in another.

He and a fellow researcher called for the creation of an independent agency to create standardized measures. “The goal is to make the process of determining quality standard and transparent, and make data meaningful for consumers and usable by clinicians, ultimately improving patient outcomes,” Pronovost said.

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Categories: Consumer health, Health care professionals
        

A University of Maryland doctor is one of five people appointed recently by President Obama to the National Cancer Advisory Board, an advisory committee to the U.S. National Cancer Institute.

Dr. Kevin J. Cullen is director of the University of Maryland Marlene and Stewart Greenebaum Cancer Center and professor of medicine at the University of Maryland School of Medicine. He’s a head and neck cancer specialist.

The appointment lasts six years. The 18 members review and recommend grants, among other activities.

“These dedicated individuals bring a wealth of experience and talent to their new roles and I am proud to have them serve in this administration. I look forward to working with them in the months and years to come,” Obama said in a statement.

Cullen also serves on the national board of the American Cancer Society and on the external advisory boards of several Cancer Institute-designated cancer centers (such as the Greenebaum Center).

He came to Maryland from the Lombardi Cancer Center at Georgetown University in Washington, where he worked for 15 years.

Photo of Dr. Cullen courtesy of the University of Maryland

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While no doctor wants to make a mistake, they if they acknowledge them, they can learn from them. That’s the conclusion of researchers who reviewed the notes of one of Johns Hopkins Hospital’s groundbreaking neurosurgeons Harvey Cushing.

Cushing documented his own surgical mistakes and made suggestions for preventing them in the future. The researcher say, in the February Archive of Surgery, that the open documentation may have helped spur groundbreaking medical treatment advances back then. They could also do the same thing today.

“Acknowledging medical errors is evidently something that doctors identified early on as critical to advancement a very long time ago,” said principal author Katherine Latimer, a medical student at Hopkins School of Medicine, in a statement.

She and fellow researchers looked through the archives for notes on 878 patients that Cushing treated between 1896 to 1912, and they picked 30 to explore. (Apparently, he had terrible handwriting and used lots of abbreviations).  They included such things as operations on the wrong side of the brain, dropping instruments into surgical wounds, lacking enough or appropriate tools.

Malpractice lawsuits were a growing concern back then and were a threat to doctors’ reputations. But the researchers believe Cushing thought innovating and fixing problems was most important, so being upfront about his shortcomings was necessary.

Dr. Alfredo Quinones, a Hopkins associate professor of neurosurgery and senior author of the study, said that medical errors still have a huge impact on patients and their families and recognizing them can lead to better patient care.

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It's a trend that persists: Newly trained female physicians earn lower salaries than their male counterparts, a new study suggests.

Only now, the reason isn’t clear. The researchers said traditionally women had chosen to be family doctors, who make less. But in the study, they said the gap – about $17,000 – isn’t explained by choice of specialty, practice type or working hours.

The study, published in the February issue of Health Affairs, shows that the disparity has been growing since 1999, when the difference was $3,600, to $16,819 in 2008. The data is based on doctors leaving programs in New York State, which has more residency programs and resident physicians than any other state (1,073 programs). It included 4,918 men and 3,315 women.

The dollar figure and the percentage have continued to grow: Women earned an average of $151,600 to start in 1999, while men earned $173,400, or 12.5 percent more. Women started at an average of $174,000 in 2008, while men got $209,300 in 2008, or 17 percent more.

The gap was present in nearly all specialties – female heart surgeons made $27,103 less, female otolaryngologists made $32,207 less and felmale pulmonary disease specialists made $44,320 less -- according to Anthony Lo Sasso, a professor and senior research scientist at the School of Public Health of the University of Illinois at Chicago, and the study coauthors.

He said the finding were significant since women now make up almost half of all U.S. medical students and are projected to comprise about a third of all practicing physicians at the beginning of this decade.

“It is not surprising to say that women physicians make less than male physicians because women traditionally choose lower-paying jobs in primary care fields or they choose to work fewer hours,” Lo Sasso said in a statement. “What is surprising is that even when we account for specialty and hours and other factors, we see this growing unexplained gap in starting salary. The same gap exists for women in primary care as it does in specialty fields.”

The authors said they could not rule out gender discrimination or that women may not be as good at negotiating salaries. But they also may be seeking greater flexibility into their schedules to accommodate family and settling for less pay.

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The state’s director of the Office of Minority Health and Health Disparities has been appointed to a federal board that focuses on minority health.

Dr. Carlessia A. Hussein has been appointed board president of the National Association of State Offices of Minority Health as of Jan 12.

“The National Association is fortunate to have someone of Dr. Hussein caliber at its helm,” said Dr. Joshua M. Sharfstein, secretary of the Maryland Department of Health and Mental Hygiene, in which Hussein’s office falls. “She is a tireless champion for reducing unacceptable health disparities.”

The board announcement says she will “develop and implement innovative partnership, advocacy and communication strategies to build the capacity of the organization as a vehicle for transforming the health of racial and ethnic minority communities, tribal organizations and nations.”

The state reports that Hussein has held senior positions for 14 years. In her current position she promotes state efforts to eliminate health disparities – in areas including cancer and smoking, infant mortality and cardiovascular disease.

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John M. Colmers, the state’s former secretary of the Department of Health and Mental Hygiene, has landed at Johns Hopkins.

When Colmers, 57, left the agency after four years in charge he said he wanted to continue working in the health care arena, specifically on health care reform, for which he had developed an expertise as the co-chair of the panel implementing the reform law in the state.

At Hopkins, he’ll be vice president for health care transformation and strategic planning. That means he’ll be “strategically positioning the expanding Hopkins system to respond to health care reform and other near-terms and long-term market forces,” according to the medical system.

“As we prepare for the inevitable changes resulting from new health care reform laws and other market forces, it is imperative that we do so in a thoughtful, effective and strategic manner,” said Dr. Edward D. Miller, dean of the medical faculty and chief executive of Johns Hopkins Medicine, in a statement. “There are few individuals who are as qualified as John Colmers to help guide and shape our response to these sweeping changes.”

As head of the $9 billion state health department, Colmers expanded Medicaid, mental health services and dental care and cut smoking rates. Prior to that leadership role, he worked in other top health-related positions for the state government including executive director of the Maryland Health Care Commission and the Health Services Cost Review Commission, which oversees Maryland's hospital rate-setting system.

“I am thrilled to join Johns Hopkins Medicine where I can apply what I have learned over the years in public service and in the private sector,” said Colmers, who received his bachelor’s degree from Hopkins as well as a master’s in public health from the University of North Carolina, Chapel Hill. “I'm looking forward to being a part of an enterprise that is embracing the challenges of reform and strives to lead the nation in fulfilling the promise of the Affordable Care Act as it was enacted or may evolve.”

Photo courtesy of Johns Hopkins

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Some 6 percent of surgeons reported having suicidal thoughts in the last year, but many are reluctant to seek help because they feared it would impact their medical license, according to a new study in the Archives of Surgery.

The study, based on an anonymous survey of nearly 8,000 surgeons, found suicidal thoughts were tied to doctors' worries about making an error, a history of depression and burnout on the job. 

Researchers at the Mayo Clinic found of the 6 percent who reported having suicidal thoughts in the previous year, just 26 percent sought help. Concerns about the impact on a license is real; 80 percent of state medical boards ask about prior mental illness and 47 percent ask about it during application renewal, the study said.

Older surgeons were more likely to contemplate suicide -- those 45 and older had one and a half to three times the rate as the general population. Being married and having kids were associated with lower rates, the study said.

The grim study also mentions that doctors in general have a higher rate of suicide than the general population. But they tend to have the same rate of depression as the population at large. Clearly more study is done to figure out what surgeons' risk factors are and how to get them help, the study states.

Continue reading "Surgeons with suicidal thoughts unlikely to seek help" »

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Maryland scored a nine out of 10 in a new report aimed at gauging the emergency health preparedness of the states.

The states in general got their highest scores in the eighth annual report, by the Trust for America’s Health and the Robert Wood Johnson Foundation. But the groups said the gains are under threat of budget cuts.

The report is called Ready or Not? Protecting the Public from Diseases, Disaster and Bioterrorism. And the groups looked at key indicators of public health preparedness. Fourteen states scored nine or higher. Three scored a 10 – Arkansas, North Dakota and Washington state.

Another 25 states and Washington, D.C. scored seven or eight. No state scored lower than five.

The groups said since the Sept. 11, 2001 and anthrax attacks, there has been a lot of progress and the nation is now better able to prevent, identify and contain disease outbreak and bioterrorism threats. And responses are quicker to natural disasters and outbreaks. The H1N1 flu pandemic is an example.

But public health staffing and budget cuts may become a problem, the groups say. Thirty three states have already made cuts.

 “There is an emergency for emergency health preparedness in the United States,” said Jeff Levi, executive director of the Trust for America’s Health, in a statement. “This year, the Great Recession is taking its toll on emergency health preparedness. Unfortunately, the recent and continued budget cuts will exacerbate the vulnerable areas in U.S. crisis response capabilities and have the potential to reverse the progress we have made over the last decade.”

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In the aftermath of the shooting of a Johns Hopkins Hospital doctor in September by the distraught son of a patient, a pair of Hopkins researchers looked into how common such an event is. They determined that shootings are rare. Other assaults are higher, though.

The rate of assaults on workers in U.S. healthcare settings is four times higher than other workplaces, they found. The rate of assaults in all private-sector workplaces is two per 10,000, compared to eight per 10,000 in healthcare settings, according to Dr. Gabor D. Kelen and Dr. Christina L. Catlett.

They wrote about this in a commentary to be published in the Dec. 8 issue of the Journal of the American Medical Association.

They concluded that hospital shootings get all the media attention, but security experts say there should be more of a focus on preventing the assaults. That’s why installing magnetometers and other expensive high-tech devices isn’t called for, said Kelen, professor and chair of Hopkins’ Department of Emergency Medicine.

That echoes statements made around the shooting by Hopkins security officials, who said that it wasn’t practical and wouldn’t necessarily improve safety to install gun detection technology at the hospital. At the time, the officials and hospital representatives said it would also not be welcoming for patients and visitors.

Continue reading "Assaults more common than shooting in hospitals" »

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In response to the shooting of one of its doctors, Johns Hopkins Hospital will file a report on its security measures to the panel that accredits U.S. hospitals on Tuesday.

The report was required by the Joint Commission, the independent, nonprofit panel that offers accreditation for more than 18,000 health care organization and programs around the country. It requires hospitals involved in “sentinel events” such as postoperative complications or medical errors to review what happened and say what, if anything, should be done to improve safety and quality of care.

The doctor, David B. Cohen, was shot by the distraught son of a patient Sept. 16 and continues to recover from his wounds. The shooter killed himself and his mother.

The commission reported that there have been almost 7,000 sentinel events since 1995. A category called “assault/rape/homicide” was the eighth most common type of problem.

A spokesman for the commission has said the confidential report will be reviewed and the hospital will be followed for a few months to ensure implementation of the plan.

There may be no changes to security necessary, and Hopkins officials have already said that metal detectors at all entrances and screening would be logistically difficult and unwelcoming. Some 80,000 workers and visitors come and go a week.

The officials still said security would be reassessed. And sometimes, magnetometer “wands” are used to check visitors during high-risk situations in the emergency rooms.

Have you been to Hopkins or another hospital recently? Think security is sufficient?

Photo of David B. Cohen courtesy of Hopkins

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The homeless faces all sorts of health problems. And doctors at Mercy Medical Center have seen just about all of them.

On Tuesday, as part of a national event, doctors from the Institute for Foot and Ankle Reconstruction plan to head to the Helping Up Mission in Baltimore to look at some feet.

They will provide foot screenings, as well as footwear, to residents. While the doctors have been to the mission before, this effort is sponsored by Our Hearts to Your Soles, a nonprofit founded by a Pittsburgh teen in 2005.

Dr. Clifford Jeng, Dr. Rebecca Cerrato and Dr. John T. Campbell, as well as medical fellows from the Institute, will offer their services to the mission, at 1029 E. Baltimore St. from 1 p.m.-3 p.m.

“With people more health conscious these days, we're walking more, running, hiking--always on our feet,” said Jeng in a statement. “We take healthy feet for granted. But for those who can't afford proper footwear or don't have access to good medical care for their feet, it's a different story. This program helps by providing shoes and foot screenings and by raising awareness, encouraging people to help those less fortunate.”

For more information about Our Hearts to Your Soles, visit www.heartstosoles.com.

Baltimore Sun file photo of a homeless man wearing two different shoes/Chiaki Kawajiri

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CareFirst BlueCross BlueShield is expanding the role of nurse practitioners in its network.

The state's largest insurer said this week it will allow nurses to participate in its healthcare provider network as primary care physicians. Until now, CareFirst has only permitted nurses to practice independently of physicians in underserved areas with limited access to doctors.

The insurer is making the change as health care reform is expected to add hundreds of thousands of people to the rolls and put tremendous pressure on primary physicians when it is fully implemented in 2014. Many believe nurses will take on many of the roles of these doctors.

The Associaton of Medical Colleges projects that by 2015, there will be a shortage of nearly 63,000 doctors across all specialties.

Nurses will need to meet CareFirst credentialing standards and become nationally certified to enroll in the CareFirst network as primary care providers. The nurse must also form a collaboration with a physician within the health insurer's network.

Posted by Andrea Walker at 10:26 AM | Permalink | Comments (0)
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Anyone who works long hours knows that it can take a toll – burn-out, depression, career dissatisfaction, work-home conflicts. What if that toll is being taken on your surgeon?

A new Johns Hopkins-Mayo Clinic study, published in the November issue of the Journal of the American College of Surgeons, shows that the long hours and multiple night on-call are leading to personal and patients safety problems.

“Increasing hours and nights on call results in surgeon distress using every variable we have,” said Dr. Charles M. Balch, a professor of surgery at the Johns Hopkins University School of Medicine and the study's lead author, in a statement. “There's a strong correlation between workload and distress, which comes out in the personal and professional lives of surgeons.”

The researchers looked at data from a 2008 survey of 7,905 surgeons. Of those working more than 80 hours a week, half met the criteria for burnout, 39 were depressed and 11 percent said they’d made a significant medical error in the past 3 months. About 20 percent said they would have become a surgeon if they had it to do over.

The researchers, however, are not advocating for a shorter work week because it’s not clear that would satisfy doctors or lead to better care – doctors don’t like to punch time clocks, Balch said. Instead, he said, is better monitoring of doctors at risk for burn out. They could be referred for counseling or they could have their scheduled tailored to meet their needs, for example.

The American College of Surgeons also has begun another study of burnout to collect more information.

In the meantime, what would you want your doctor to do?

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Categories: Health care professionals
        

There are some 12 million nurses working in 125 countries, the largest group of healthcare professionals in the world.

Their job is to provide care, teach others to provide care and direct policies to better administer care, according to Johns Hopkins’ dean of the School of Nursing.

But Martha N. Hill says there is a shortage of nurses and it’s growing.

To address the needs of many nations, such as Haiti, where the earthquake 6 months ago destroyed a nursing school, Hopkins has opened a new international center that aims to share what they and others know.

“The world’s most serious health threats—maternal and infant death, new and resistant infections, cardiovascular and other chronic diseases, malnutrition, natural disasters, and man-made conflicts—call for this global nursing perspective,” she said.

Among other things, the center, Hill said, will partner with other academic institutions to help develop new curriculums, enhance the skills of practitioners and support research. It will help the United Nations meet its goals of improving the health of women and children.

It will also promote innovation and best practices in nursing, as well as help create global standards for nursing. It will encourage faculty and student exchanges and partner with international organizations to leverage resources.

Hill says all of this will be no small task. But nurses, she said, “are among the world’s thinkers, decision-makers, innovators, and trail blazers who are on the front lines in dealing with national and international health issues. And they are poised to address—and capable of resolving—the world’s most pressing health concerns.”

Baltimore Sun file photo of child waiting for medical care after the earthquate in Haiti/Kim Hairston

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Categories: Health care professionals
        

Every wonder what global health aid workers do to improve life in some really downtrodden places that have suffered from war and famine and natural disasters?

Baltimore photographer David Snyder spent 57 days on assignment for the U.S. Centers for Disease Control and Prevention Foundation. About 75 of his 6,800 pictures from Kenya, Brazil, Peru, Haiti, India and Tanzania, as well as field notes, will go on display beginning this Saturday at the CDC’s Global Health Odyssey Museum.

Among the pictures are images of “Mama Sprinkles,” who distributes micronutrient packets to families in Kenya’s Nyanza Province, and CDC scientists who conducted disease surveillance after the earthquake in Haiti.

“Over the past year, I have seen CDC and other public health professionals in action and I have been struck by the commitment and dedication of these individuals who are creating a safer, healthier world for all of us,” said Snyder in a statement. “I spent hours in the field interacting with people who benefit from public health programs – from kids on a playground in Tennessee to tuberculosis patients in Lima, Peru.”
 
The pictures are an effort to show the importance of such international aid work, according to the CDC Foundation.

The photo exhibit runs through Jan. 14. For more information and to see the photos, go to infocus.cdcfoundation.org.

The CDC Foundation was created by Congress to help the CDC form partnership with companies and other foundations to benefit public health programs around the country and world.

Photo of men collecting clean drinking water from a foundation program in India courtesy of the CDC Foundation

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Categories: Health care professionals
        

The Johns Hopkins doctor who was shot by the son of a patient is in fair condition today, a hospital spokesman said.

David B. Cohen was shot yesterday after a tense discussion with the son, who was distraught about his mother's condition. The shooter, Paul Warren Pardus, then locked himself in the room with his mother and fatally shot her and himself.

People who went to Cohen for medical care describe him as patient and reassuring, taking time to explain problems and find the best treatment.

"When I found out about the shooting my heart sank to the floor," said Elizabeth Coxe of Phoenix, who has seen Cohen for her back pain. "He's a very fine surgeon and person. Why him? He's done so much good for people."

The incident caused a day-long panic at the hospital, where many people were evacuated and others were told to stay in their offices and rooms. The doctor was taken into surgery and his condition, initially listed as critical, improved. His injuries were not considered life threatening, according to police.

 

Hopkins officials will not release any more information on the doctor, citing patient privacy.

Such an event is rare and it doesn't seem like the hospital plans a big overhaul of security. And in the meantime, lot of colleagues and patients of Dr. Cohen are talking about the doctor. They say he is well liked and considered a real professional.

So, what do you make of the situation? You think the hospital ought to up security to protect doctors and staff -- and even patients? Do you have a personal experience with this doctor or have a story about a tense situation with another doctor?

Here's the latest Sun story, and we'll have updates throughout the day at baltimoresun.com.

Baltimore Sun photo/Kenneth K. Lam

Posted by Meredith Cohn at 11:23 AM | Permalink | Comments (5)
Categories: Health care professionals