By ELYN R. SAKS
The New York Times - Opinion
Published: January 25, 2013
THIRTY years ago, I was given a diagnosis of schizophrenia. My prognosis was “grave”: I would never live independently, hold a job, find a loving partner, get married. My home would be a board-and-care facility, my days spent watching TV in a day room with other people debilitated by mental illness. I would work at menial jobs when my symptoms were quiet. Following my last psychiatric hospitalization at the age of 28, I was encouraged by a doctor to work as a cashier making change. If I could handle that, I was told, we would reassess my ability to hold a more demanding position, perhaps even something full-time.
Then I made a decision. I would write the narrative of my life. Today I am a chaired professor at the University of Southern California Gould School of Law. I have an adjunct appointment in the department of psychiatry at the medical school of the University of California, San Diego, and am on the faculty of the New Center for Psychoanalysis. The MacArthur Foundation gave me a genius grant.
Although I fought my diagnosis for many years, I came to accept that I have schizophrenia and will be in treatment the rest of my life. Indeed, excellent psychoanalytic treatment and medication have been critical to my success. What I refused to accept was my prognosis.
The entire article is here.
Saturday, February 9, 2013
Budding designer from Paramus left "suicide diary," according to newspaper report.
Englewood-Englewood Cliffs Patch
Originally posted February 7, 2013
A 22-year-old aspiring fashion designer originally from Paramus jumped off the George Washington Bridge Wednesday and left behind a list of five girls she did not want at her funeral, the New York Post reported.
Riders on a jitney bus saw Ashley A. Riggitano plunge from the New Jersey-bound lanes at around 4:40 p.m., the report said. She reportedly left a Louis Vuitton bag containing pages of notes in a "suicide diary" on the bridge walkway.
Riggitano was apparently bullied by friends in the fashion industry, according to the Post report. The girls banned from her funeral were reportedly from work and college.
“All my other ‘friends’ are in it for gossip,” she wrote in the letter, the Post reported. “Never there.”
Riggitano had attempted to commit suicide before, the newspaper reported.
The entire story is here.
Friday, February 8, 2013
Physicians and Malpractice Data
On Average, Physicians Spend Nearly 11 Percent Of Their 40-Year Careers With An Open, Unresolved Malpractice Claim
By Seth A. Seabury, Amitabh Chandra, Darius N. Lakdawalla, and Anupam B. Jena
Abstract
The US malpractice system is widely regarded as inefficient, in part because of the time required to resolve malpractice cases. Analyzing data from 40,916 physicians covered by a nationwide insurer, we found that the average physician spends 50.7 months—or almost 11 percent—of an assumed forty-year career with an unresolved, open malpractice claim. Although damages are a factor in how doctors perceive medical malpractice, even more distressing for the doctor and the patient may be the amount of time these claims take to be adjudicated. We conclude that this fact makes it important to assess malpractice reforms by how well they are able to reduce the time of malpractice litigation without undermining the needs of the affected patient.
The research can be found here.
Thanks to Ken Pope for this information.
By Seth A. Seabury, Amitabh Chandra, Darius N. Lakdawalla, and Anupam B. Jena
Abstract
The US malpractice system is widely regarded as inefficient, in part because of the time required to resolve malpractice cases. Analyzing data from 40,916 physicians covered by a nationwide insurer, we found that the average physician spends 50.7 months—or almost 11 percent—of an assumed forty-year career with an unresolved, open malpractice claim. Although damages are a factor in how doctors perceive medical malpractice, even more distressing for the doctor and the patient may be the amount of time these claims take to be adjudicated. We conclude that this fact makes it important to assess malpractice reforms by how well they are able to reduce the time of malpractice litigation without undermining the needs of the affected patient.
The research can be found here.
Thanks to Ken Pope for this information.
Medical malpractice: Why is it so hard for doctors to apologize?
Fixing a system built on blame and revenge will require bold ways of analyzing mistakes and a radical embrace of openness.
By Dr. Darshak Sanghavi
The Boston Globe
Originally posted on January 27, 2013
DANIELLE BELLEROSE WENT THROUGH HELL for two years trying to conceive, undergoing nine rounds of fertility treatments before she finally got pregnant with twins in late 2003. Shortly thereafter, the then 28-year-old nurse and Massachusetts native developed a complication that required months of bed rest at home. Suddenly, on a June night nearly three months before her due date, Danielle’s uterus began bleeding profusely. At 4:56 a.m. she had an emergency caesarean section at Beth Israel Deaconess Medical Center. Her daughters, Katherine and Alexis, entered the world weighing only about 3 pounds each.
Everything seemed to go well until the end of the first week. When Danielle and her husband, John, visited the unit, Alexis looked fine, but Katherine appeared mottled and pale. Panicked, Danielle found a nurse, and testing confirmed that Katherine was in profound shock due to necrotizing enterocolitis, a devastating intestinal complication that affects premature babies. The infant’s blood had turned acidic. An X-ray indicated a tear in her bowel. Just after midnight, Katherine was taken by ambulance to Children’s Hospital Boston.
Extremely premature infants such as Katherine and Alexis are entirely unprepared to live outside their mother’s womb. After only 30 weeks of gestation, the newborn heart isn’t fully developed, and the intestines can’t easily digest breast milk or formula. At that age, a baby’s brain often doesn’t remember to breathe. In 1963, when President John F. Kennedy’s son, Patrick, was born prematurely, the only thing to do was “monitor the infant’s blood chemistry,” as a newspaper of the day put it. Patrick Kennedy died after two days. By the time Katherine Bellerose was being cared for in the same hospital, however, new treatments had increased survival rates in very low birth weight infants to 96 percent.
Still, at Children’s Hospital, Katherine struggled to survive. Surgeons made a last-ditch effort to save her life by removing her colon, in the hope that this would halt further damage. She failed to improve. Multiple rounds of CPR were performed.
The rest of the story is here.
Thursday, February 7, 2013
Grief Over New Depression Diagnosis
By Paula Span
The New York Time Blog - The New Old Age
Originally published January 24, 2013
When the American Psychiatric Association unveils a proposed new version of its Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric diagnoses, it expects controversy. Illnesses get added or deleted, acquire new definitions or lists of symptoms. Everyone from advocacy groups to insurance companies to litigators — all have an interest in what’s defined as mental illness — pays close attention. Invariably, complaints ensue.
“We asked for commentary,” said David Kupfer, the University of Pittsburgh psychiatrist who has spent six years as chairman of the task force that is updating the handbook. He sounded unruffled. “We asked for it and we got it. This was not going to be done in a dark room somewhere.”
But the D.S.M. 5, to be published in May, has generated an unusual amount of heat. Two changes, in particular, could have considerable impact on older people and their families.
First, the new volume revises some of the criteria for major depressive disorder. The D.S.M. IV (among other changes, the new manual swaps Roman numerals for Arabic ones) set out a list of symptoms that over a two-week period would trigger a diagnosis of major depression: either feelings of sadness or emptiness, or a loss of interest or pleasure in most daily activities, plus sleep disturbances, weight loss, fatigue, distraction or other problems, to the extent that they impair someone’s functioning.
The entire blog post is here.
The New York Time Blog - The New Old Age
Originally published January 24, 2013
When the American Psychiatric Association unveils a proposed new version of its Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric diagnoses, it expects controversy. Illnesses get added or deleted, acquire new definitions or lists of symptoms. Everyone from advocacy groups to insurance companies to litigators — all have an interest in what’s defined as mental illness — pays close attention. Invariably, complaints ensue.
“We asked for commentary,” said David Kupfer, the University of Pittsburgh psychiatrist who has spent six years as chairman of the task force that is updating the handbook. He sounded unruffled. “We asked for it and we got it. This was not going to be done in a dark room somewhere.”
But the D.S.M. 5, to be published in May, has generated an unusual amount of heat. Two changes, in particular, could have considerable impact on older people and their families.
First, the new volume revises some of the criteria for major depressive disorder. The D.S.M. IV (among other changes, the new manual swaps Roman numerals for Arabic ones) set out a list of symptoms that over a two-week period would trigger a diagnosis of major depression: either feelings of sadness or emptiness, or a loss of interest or pleasure in most daily activities, plus sleep disturbances, weight loss, fatigue, distraction or other problems, to the extent that they impair someone’s functioning.
The entire blog post is here.
Proposed DSM-5 Changes To Assessment Of Alcohol Problems
Medical News Today
Originally posted January 24, 2013
Proposed changes to the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will affect the criteria used to assess alcohol problems. One change would collapse the two diagnoses of alcohol abuse (AA) and alcohol dependence (AD) into a single diagnosis called alcohol use disorder (AUD). A second change would remove "legal problems," and a third would add a criterion of "craving." A study of the potential consequences of these changes has found they are unlikely to significantly change the prevalence of diagnoses.
Results will be published in the March 2013 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Updating the DSM could be advantageous if changes are made based on improvements in our understanding of a disorder's etiology, and/or if changes improve the accuracy of the diagnosis," said Alexis C. Edwards, assistant professor in the Department of Psychiatry at Virginia Commonwealth University School of Medicine as well as corresponding author for the study. "It would probably be a little disappointing if no changes were ever made, because that might suggest that we haven't made much headway in understanding and accurately diagnosing psychiatric disorders, despite all our efforts."
Originally posted January 24, 2013
Proposed changes to the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will affect the criteria used to assess alcohol problems. One change would collapse the two diagnoses of alcohol abuse (AA) and alcohol dependence (AD) into a single diagnosis called alcohol use disorder (AUD). A second change would remove "legal problems," and a third would add a criterion of "craving." A study of the potential consequences of these changes has found they are unlikely to significantly change the prevalence of diagnoses.
Results will be published in the March 2013 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Updating the DSM could be advantageous if changes are made based on improvements in our understanding of a disorder's etiology, and/or if changes improve the accuracy of the diagnosis," said Alexis C. Edwards, assistant professor in the Department of Psychiatry at Virginia Commonwealth University School of Medicine as well as corresponding author for the study. "It would probably be a little disappointing if no changes were ever made, because that might suggest that we haven't made much headway in understanding and accurately diagnosing psychiatric disorders, despite all our efforts."
Wednesday, February 6, 2013
Legal showdown over gay conversion therapy waged in 2 states
At issue is whether states can ban the therapy on minors and whether counselors who conduct the therapy can be held liable for consumer fraud.
By ALICIA GALLEGOS
amednews.com
Posted Jan. 21, 2013
The patient’s anguish was clearly visible to psychiatrist Jack Drescher, MD, as the man spoke about his experience undergoing so-called gay conversion therapy.
Such therapy often is rooted in the claim that poor parenting is the cause of same-sex attractions, and that patients can change if they truly wish to be heterosexual. Methods of “repairing” patients can include instructing them to beat effigies of their mothers, touch themselves while naked in front of counselors and be subjected to mock locker room scenarios in which therapists scream anti-gay epithets at them.
After attending a religious-based therapy six times a week and experiencing no change in his sexuality, the patient was left feeling ashamed, depressed and suicidal, Dr. Drescher said.
“I felt sad[ness] and also anger, because sometimes a therapist would say things that were very hurtful to the patient,” said Dr. Drescher, an author and medical expert on gay conversion therapy. He also is president of the Group for the Advancement of Psychiatry, a think tank that analyzes issues in the field of psychiatry. “It’s distressing when you see professionals, regardless if they are well-meaning or otherwise, deliver intentional or inadvertent harm to a patient.”
Physicians and health professionals across the country have reported treating patients for the problems they have after conversion therapy. In recent years, physician organizations including the American Medical Association have developed policy opposing the use of “reparative” or “conversion” therapy that the AMA describes as “based upon the assumption that homosexuality per se is a mental disorder or … that the patient should change his/her homosexual orientation.” The potential serious risks of reparative therapy include depression, anxiety and self-destructive behavior, said an American Psychiatric Assn. position statement.
The entire story is here.
By ALICIA GALLEGOS
amednews.com
Posted Jan. 21, 2013
The patient’s anguish was clearly visible to psychiatrist Jack Drescher, MD, as the man spoke about his experience undergoing so-called gay conversion therapy.
Such therapy often is rooted in the claim that poor parenting is the cause of same-sex attractions, and that patients can change if they truly wish to be heterosexual. Methods of “repairing” patients can include instructing them to beat effigies of their mothers, touch themselves while naked in front of counselors and be subjected to mock locker room scenarios in which therapists scream anti-gay epithets at them.
After attending a religious-based therapy six times a week and experiencing no change in his sexuality, the patient was left feeling ashamed, depressed and suicidal, Dr. Drescher said.
“I felt sad[ness] and also anger, because sometimes a therapist would say things that were very hurtful to the patient,” said Dr. Drescher, an author and medical expert on gay conversion therapy. He also is president of the Group for the Advancement of Psychiatry, a think tank that analyzes issues in the field of psychiatry. “It’s distressing when you see professionals, regardless if they are well-meaning or otherwise, deliver intentional or inadvertent harm to a patient.”
Physicians and health professionals across the country have reported treating patients for the problems they have after conversion therapy. In recent years, physician organizations including the American Medical Association have developed policy opposing the use of “reparative” or “conversion” therapy that the AMA describes as “based upon the assumption that homosexuality per se is a mental disorder or … that the patient should change his/her homosexual orientation.” The potential serious risks of reparative therapy include depression, anxiety and self-destructive behavior, said an American Psychiatric Assn. position statement.
The entire story is here.
Tuesday, February 5, 2013
Why We Should Talk About the Football Coach's Salary When Faculty are Let Go Read
by John Warner
Inside HigherEd - Blog - Just Visiting
Originally published January 23, 2013
Bowling Green State University recently announced that it would be cutting 100 faculty positions for next fall, more than 10% of the total number of full-time faculty.
I found out this news via Facebook, which really does seem to be the source (along with Twitter) of the majority of news and information that crosses my mental desk on any given day. A debate/discussion cropped up underneath the posting, and as happens someone invoked the salaries of football coaches, and how it seems unfair that 100 teachers will lose their jobs when coaches are making so much.
There was a debate/discussion about this, and it was generally agreed that maybe it was too simplistic or counterproductive to lament these imbalances as they are a fact of the way universities operate. Academics and athletics are separate, football programs bring in money that they get to use for themselves, and in the end, these realities are just a reflection of society’s values.
I agree that the situation at BGSU is a reflection of society’s values, which is why I think we need to bring up football and athletic departments every time faculty are cut, or furloughed, or denied raises for years on end, or we’re told that the treatment of adjunct faculty is “unlikely to change.”
The entire story is here.
Inside HigherEd - Blog - Just Visiting
Originally published January 23, 2013
Bowling Green State University recently announced that it would be cutting 100 faculty positions for next fall, more than 10% of the total number of full-time faculty.
I found out this news via Facebook, which really does seem to be the source (along with Twitter) of the majority of news and information that crosses my mental desk on any given day. A debate/discussion cropped up underneath the posting, and as happens someone invoked the salaries of football coaches, and how it seems unfair that 100 teachers will lose their jobs when coaches are making so much.
There was a debate/discussion about this, and it was generally agreed that maybe it was too simplistic or counterproductive to lament these imbalances as they are a fact of the way universities operate. Academics and athletics are separate, football programs bring in money that they get to use for themselves, and in the end, these realities are just a reflection of society’s values.
I agree that the situation at BGSU is a reflection of society’s values, which is why I think we need to bring up football and athletic departments every time faculty are cut, or furloughed, or denied raises for years on end, or we’re told that the treatment of adjunct faculty is “unlikely to change.”
The entire story is here.
Monday, February 4, 2013
Physician Study Finds Similar Outcomes From In-Person, Telehealth Consultations
By Jonathan Field
Managing Editor - The Institute for HealthCare Consumerism
Thanks to health care reform and technological innovations in the private sector, the telehealth market is booming. And it is having a direct impact on the physician-patient relationship and on the health costs associated with an employer-sponsored health plan.
The industry predicts continued, strong growth. According to a recent market analysis by IMS Research, the telehealth market will grow by 55 percent in 2013 after growing only 5 percent from 2010 to 2011 and 18 percent from 2011 to 2012. And a 2012 report by BCC Research, the Wellesley, Mass.-based market research firm, predicted that the global telehealth market was expected to double from $11.6 billion in 2011 to over $27 billion in 2016.
InMedica, leading independent provider of market research and consultancy to the global medical electronics industry, predicts that in by 2017 the telehealth market will reach 1.8 million patients -- up from 300,000 in last year. The research firm attributes growth to four sectors of demand: federal, provider, payer and patient. For more details on the projected growth of telehealth market, view InMedica's new report The World Market for Telehealth – An Analysis of Demand Dynamics – 2012.
The entire article is here.
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