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March 16, 2010

With Medicaid Cuts, Doctors and Patients Drop Out

Carol Y. Vliet’s cancer returned with a fury last summer, the tumors metastasizing to her brain, liver, kidneys and throat. As she began a punishing regimen of chemotherapy and radiation, Mrs. Vliet found a measure of comfort in her monthly appointments with her primary care physician, Dr. Saed J. Sahouri, who had been monitoring her health for nearly two years.

She was devastated, therefore, when Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid.  Dr. Sahouri said that his reimbursements from Medicaid were so low – often no more than $25 per office visit – that he was losing money every time a patient walked in his exam room.

The final insult, he said, came when Michigan cut those payments by 8 percent last year to help close a gaping budget shortfall.  ”My office manager was telling me to do this for a long time, and I resisted,” Dr. Sahouri said. “But after a while you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”  Continue at The New York Times.

Your bacteria may be more accurate than fingerprints

According to a study published online Monday, bacteria that live on a person’s hands could one day accurately identify that individual. This could come in handy to track down a criminal who has worn gloves, removed prints and other personal physical evidence, or touched surfaces such as fabric on which a fingerprint wouldn’t show up, the researchers said.

The concept, outlined in a paper in the Proceedings of the National Academy of Sciences, relies upon the fact that human beings leave a trail of bacteria on objects they touch and that the mix of microbes on each person’s hand is highly individualized. “There’s a rain forest of bacteria on your skin,” said lead author Noah Fierer, an assistant professor of ecology and evolutionary biology at the University of Colorado at Boulder. A human hand can contain on average about 100 different species of bacteria, he said, and only about 13% of that makeup is shared between any two people.

Fierer and colleagues compared the bacteria found on people’s computer mice with a database of bacteria collected from the hands of 270 individuals. The bacterial colonies from the computer mice most closely matched those of the owner’s hands, the scientists found. The technique was 70% to 90% accurate overall, but this could be sharpened as technology becomes more sophisticated, Fierer said.  More at The LA TImes.

Cancer and the Media: How do patients get their information

The next time your cancer patient refers to a report they saw on Dateline or read in People magazine, tell them to read this article by Dr. David Casarett, who participated in a study of cancer and the media:

“Cancer is a serious, life-threatening illness that kills more than half a million people every year in the U.S. alone.  But you’d never know that if you get most of your information from newspapers and magazines. This is the surprising result of a study that was published this week in the Archives of Internal Medicine.  A group of researchers (of which I was one) examined more than 400 articles about cancer and cancer treatment that appeared in publications with a national and international readership. We looked in magazines like People, Time, and Newsweek, as well as in newspapers like the Chicago Tribune and the New York Times. And what we found surprised us.

For instance, we discovered that although 95 percent reported exclusively on aggressive treatments like chemotherapy, radiation therapy and bone marrow transplants, only 13 percent mentioned that those aggressive treatments can fail. Moreover, less than a third mentioned the adverse effects–like nausea, hair loss, immune suppression, and fatigue–that these treatments can cause.

These results are disappointing, because it’s clear that these articles aren’t providing readers with the information they need. Imagine if you, or someone you love, have cancer. Now imagine that you’re reading one of these articles, looking for advice and guidance about the side effects of treatment. Maybe you want to know if a problem or a symptom is normal. Or maybe you want a sense of what other problems might be lurking around the corner. You’re not going to get that information from the articles that we found.” Continued at The Huffington Post.

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