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Southwest Pulmonary and Critical Care Fellowships
In Memoriam

News

Last 50 News Postings

 (Click on title to be directed to posting, most recent listed first)

Former US Surgeon General Criticizing $5,000 Emergency Room Bill
Nurses Launch Billboard Campaign Against Renewal of Desert Regional
   Medical Center Lease
$1 Billion Donation Eliminates Tuition at Albert Einstein Medical School
Kern County Hospital Authority Accused of Overpaying for Executive
   Services
SWJPCCS Associate Editor has Essay on Reining in Air Pollution Published
   in NY Times
Amazon Launches New Messaged-Based Virtual Healthcare Service
Hospitals Say They Lose Money on Medicare Patients but Make Millions
Trust in Science Now Deeply Polarized
SWJPCC Associate Editor Featured in Albuquerque Journal
Poisoning by Hand Sanitizers
Healthcare Layoffs During the COVID-19 Pandemic
Practice Fusion Admits to Opioid Kickback Scheme
Arizona Medical Schools Offer Free Tuition for Primary Care Commitment
Determining if Drug Price Increases are Justified
Court Overturns CMS' Site-Neutral Payment Policy
Pulmonary Disease Linked to Vaping
CEO Compensation-One Reason Healthcare Costs So Much
Doctor or Money Shortage in California?
FDA Commissioner Gottlieb Resigns
Physicians Generate an Average $2.4 Million a Year Per Hospital
Drug Prices Continue to Rise
New Center for Physician Rights
CMS Decreases Clinic Visit Payments to Hospital-Employed Physicians
   and Expands Decreases in Drug Payments 340B Cuts
Big Pharma Gives Millions to Congress
Gilbert Hospital and Florence Hospital at Anthem Closed
CMS’ Star Ratings Miscalculated
VA Announces Aggressive New Approach to Produce Rapid Improvements
   in VA Medical Centers
Healthcare Payments Under the Budget Deal: Mostly Good News
   for Physicians
Hospitals Plan to Start Their Own Generic Drug Company
Flu Season and Trehalose
MedPAC Votes to Scrap MIPS
CMS Announces New Payment Model
Varenicline (Chantix®) Associated with Increased Cardiovascular Events
Tax Cuts Could Threaten Physicians
Trump Nominates Former Pharmaceutical Executive as HHS Secretary
Arizona Averages Over 25 Opioid Overdoses Per Day
Maryvale Hospital to Close
California Enacts Drug Pricing Transparency Bill
Senate Health Bill Lacks 50 Votes Needed to Proceed
Medi-Cal Blamed for Poor Care in Lawsuit
Senate Republican Leadership Releases Revised ACA Repeal and Replace Bill
Mortality Rate Will Likely Increase Under Senate Healthcare Bill
University of Arizona-Phoenix Receives Full Accreditation
Limited Choice of Obamacare Insurers in Some Parts of the Southwest
Gottlieb, the FDA and Dumbing Down Medicine
Salary Surveys Report Declines in Pulmonologist, Allergist and Nurse 
   Incomes
CDC Releases Ventilator-Associated Events Criteria
Medicare Bundled Payment Initiative Did Not Reduce COPD Readmissions
Younger Smokers Continue to Smoke as Adults: Implications for Raising the
   Smoking Age to 21
Most Drug Overdose Deaths from Nonprescription Opioids

 

 

For complete news listings click here.

 

The Southwest Journal of Pulmonary, Critical Care & Sleep periodically publishes news articles relevant to  pulmonary, critical care or sleep medicine which are not covered by major medical journals.

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Thursday
Dec222016

Most Drug Overdose Deaths from Nonprescription Opioids

The Centers for Disease Control (CDC) is reporting in Morbidity and Mortality Weekly that the number of people dying from an opioid overdose rose 15.5% from 2014 to 2015, but the increase had little to do with prescription painkillers such as oxycodone or hydrocodone (1). Roughly 52,000 people died from drug overdoses in 2015 and of those deaths 33,091 involved an opioid. The increases in “death rates were driven by synthetic opioids other than methadone (72.2%), most likely illicitly-manufactured fentanyl, and heroin (20.6%)”. Deaths from methadone, which is usually prescribed by physicians, decreased 9.1%.

The largest increase in deaths occurred in the South and Northeast with 3% and 24% increases in deaths from synthetic opioids from 2014 to 2015. In the Midwest and West, there were more modest 17% and 9% increases during the same period. States in the Southwest with “good” to “excellent” reporting included Colorado, Nevada, and New Mexico which showed 33%, 14% and 30% decreases respectively.

Earlier this year, CDC Director Tom Frieden, MD, MPH, said "The prescription overdose epidemic is doctor-driven…It can be reversed in part by doctors' actions” (2). That characterization has rung in some physicians' ears as blame for the entire opioid crisis, including deaths from heroin and illegal fentanyl. The data in the present article suggests that characterization is inaccurate and that efforts by a number of State Boards to limit physician opioid prescribing may be marginally or non-effective in reducing overdose deaths.

Richard A. Robbins, MD

Editor, SWJPCC

References

  1. Rudd RA, Seth P, David F, Scholl L. Increases in drug and opioid-involved overdose deaths - United States, 2010-2015. MMWR Morb Mortal Wkly Rep. 2016 Dec 16;65. Published on-line. [CrossRef]
  2. Lowes R. CDC issues opioid guidelines for 'doctor-driven' epidemic. Medscape. March 15, 2016. Available at: http://www.medscape.com/viewarticle/860452 (accessed 12/21/16).

Cite as: Robbins RA. Most drug overdose deaths from nonprescription opioids. Southwest J Pulm Crit Care. 2016;13(6):316. doi: https://doi.org/10.13175/swjpcc145-16 PDF

Saturday
Dec172016

Lawsuits Allege Price Fixing by Generic Drug Makers

Two years after high generic drug prices became a public controversy, Reuters is reporting that 20 states filed a lawsuit Thursday against Mylan, Teva Pharmaceuticals and four other generic drug makers (1). The suit alleges the companies conspired to fix prices or allocated markets to prop up prices. The civil lawsuit, led by antitrust investigators in Connecticut, comes one day after the U.S. Department of Justice filed criminal charges against two former executives of the generic drug maker, Heritage. The states attorneys general asked the court to order the companies to disgorge ill-gotten gains, which were not defined, pay attorneys' fees and stop collusion. Of the states in the Southwest only Nevada is participating in the lawsuit.

The cases are part of a broader generic drug pricing probe that remains under way at the state and federal level, as well as in the U.S. Congress. In 2014, media reports of sharply rising drug prices led to Congressional hearings. "We believe that this is the tip of the iceberg," Connecticut Attorney General George Jepsen told Reuters in an interview. "Price fixing in the generic industry is widespread and pervasive, and it involves many other drugs and a number of other companies."

Both former Heritage CEO Jeffrey Glazer and former Heritage Vice President of Commercial Operations Jason Malek are expected to plead guilty. According to Reuters, it is typical for the Justice Department to file one lawsuit about an ongoing issue and use evidence from those defendants to build subsequent cases against others. Several companies have publicly disclosed receiving subpoenas from the Justice Department related to generic drug pricing including Mylan, Allergan, Lannett, Impax, Par, Sun and Mayne.

The drugs involved in the Justice Department lawsuit include two older drugs, doxycycline hyclate and glyburide. Doxycycline rose from $20 for 500 tablets to $1,849 between October 2013 and May 2014.

Richard A. Robbins, MD

Editor, SWJPCC

Reference

  1. Bartz D, Lynch SN. U.S. states sue Mylan, Teva, others for fixing drug prices. Reuters. December 16, 2016. Available at: http://www.reuters.com/article/us-usa-drugpricing-idUSKBN14420C (accessed 12/17/16).

Cite as: Robbins RA. Lawsuits allege price fixing by generic drug makers. Southwest J Pulm Crit Care. 2016;13(6):313. doi: https://doi.org/10.13175/swjpcc142-16 PDF 

Friday
Dec162016

Knox Named Phoenix Associate Dean of Faculty Affairs

Dr. Kenneth S. Knox

The University of Arizona College of Medicine-Phoenix has announced the appointment of nationally recognized physician-scientist Kenneth S. Knox, MD, as the associate dean of faculty affairs. Dr. Knox who has been at the University of Arizona-Tucson since 2008, will oversee the Faculty Affairs Office whose charge is to promote an engaged, diverse community of faculty and scholars that sustain a culture of engagement, professionalism and inclusion. He also will serve as director of research at the Banner Lung Institute.

Dr. Knox is a pulmonologist known for his research in sarcoidosis, fungal diagnostics and immunologic lung disease. His work includes developing treatments for HIV, AIDS and valley fever. The division chief of Pulmonary, Allergy, Critical Care and Sleep Medicine in Tucson, Knox was responsible for dramatic growth. His accomplishments include increasing the number of clinical and basic science faculty from five to 30 and fellowship trainings from six to 20, rekindling the sleep program, establishing a section of allergy and revamping the teaching model in the intensive care unit. He also served as vice chair for education in the Department of Medicine.

Dr. Knox is co-principal investigator on the Arizona portion of a $9.7 million National Institutes of Health-funded clinical trial to test the use of fluconazole as an early treatment for valley fever. Additional grants for more than $6 million have been submitted for efforts to develop a valley fever vaccine. He has received continuous funding since 2001 for his research on the use of bronchoalveolar lavage for immunodiagnostics and lung immunity. He is NIH-funded to perform longitudinal translational studies correlating immunological findings and the lung microbiome with clinical disease in HIV as his lab seeks to understand the role of pulmonary inflammation in the development of HIV-related lung diseases.

A native of Youngstown, Ohio, Dr. Knox graduated cum laude with a bachelor’s degree in microbiology from Miami University in Oxford, Ohio. He completed his medical degree and residency training in Internal Medicine at Ohio State University and a fellowship in Pulmonary/Critical Care/Sleep Medicine at Indiana University where he remained on faculty for eight years, serving as educational director and director of the immunologic lung disease program before coming to Tucson. Dr. Knox is an associate editor of the SWJPCC and has edited the highly successful “Medical Image of the Week” section since its inception.

Richard A. Robbins, MD
Editor, SWJPCC

Cite as: Robbins RA. Knox named Phoenix associate dean of faculty affairs. Southwest J Pulm Crit Care. 2016;13(6):311-2. doi: https://doi.org/10.13175/swjpcc141-16 PDF

Thursday
Dec152016

Rating the VA Hospitals

USA Today is listing the star rating system for the Department of Veterans Affairs medical centers based on the quality of care. The website has a link that allows searches for individual medical centers. The ratings have been done for years but the VA has refused to release the ratings saying they are meant for internal use only.

The top-rated hospitals received a 5 and the lowest a 1. According to the star ratings the best hospitals are in the Northeast and upper Midwest.  In the Southwest the ratings are not so good with the top-rated hospital Palo Alto and the lowest a tie between Phoenix and Albuquerque (Table 1).

Table 1. Southwest VA medical center star compare VA hospitals ratings.

Quality can be difficult to measure and it is not clear what metrics were used in the VA ratings. For this reason, the VA star ratings were compared to another hospital rating service Compare VA Hospitals (2). This scale uses a 1-100 scale with 100 being the best. In this scale the Palo Alto turned out to be the best in the country with Phoenix and the VA being more in the middle of the pack. There was no correlation between the ratings (r=0.2386, p>0.05). This is consistent with a previous publication in the SWJPCC which showed no or little correlation between the various hospital ratings.

The lack of correlation between rankings and not knowing the metrics which determine the rankings suggest that the VA is right, the rankings should remain for an internal use rather than adding to the confusion already generated by the various hospital rankings.

Richard A. Robbins, MD

Editor, SWJPCC

References

  1. Slack D. Exclusive: Internal documents detail secret VA quality ratings. USA Today. December 7, 2016. Available at: http://www.usatoday.com/story/news/politics/2016/12/07/internal-report-details-secret-quality-ratings-veterans/94811922/ (accessed 12/14/16).
  2. Health Grove by Graphiq. Compare VA hospitals. Available at: http://va-hospitals.healthgrove.com/ (accessed 12/14/16).
  3. Robbins RA, Gerkin RD. A comparison between hospital rankings and outcomes data. Southwest J Pulm Crit Care. 2013;7(3):196-203. [CrossRef]

Cite as: Robbins RA. Rating the VA hospitals. Southwest J Pulm Crit Care. 2016;13(6):309-10. doi: https://doi.org/10.13175/swjpcc138-16 PDF 

Friday
Dec092016

Garcia Resigns as Arizona University VP

Dr. Joe G.N. "Skip" Garcia resigned his administrative duties as senior vice president for health sciences at the University of Arizona. Garcia said he would devote his full attention as a professor at the UA College of Medicine-Tucson according to the Arizona Republic (1). "After much thought and reflection, I have decided that the time is right for me to take a step back and focus on my continually growing research commitments," Garcia said. "Please know that this decision was an exceptionally difficult one and not reached lightly, and that I am humbled by all of your support during my time as senior vice president."

Garcia was hired in 2013 to oversee the university's medical schools in Phoenix and Tucson, as well as the schools of nursing, pharmacy and public health. Shortly after Garcia was hired, he reorganized UA health sciences, recruited a roster of academics and tightened oversight of the Phoenix medical school. However, after Dr. Stuart Flynn, the Phoenix medical school's longtime dean, and most of his leadership team resigned to join the staff of a newly created medical school in Fort Worth, Texas, Garcia faced increasing scrutiny and criticism. The departures prompted the Arizona Medical Association, a physicians' organization with 4,000 members, to ask the Arizona Board of Regents to interview the departed leaders as part of an investigation of the school's management.

In August, the regents' health affairs committee held public hearings in Tucson and Phoenix to gather input from medical-school stakeholders. The regents also hired an independent consultant to evaluate concerns about the two medical schools. The consultant delivered a report to the regents, who concluded in October following a closed-door meeting that no further action was needed. Even though the Board of Regents spent $179,653 in public funds on the report, the regents have refused to provide a copy of the report to the public, citing attorney-client privilege and work-product protections.

UA President Ann Weaver Hart who previously announced she would leave the president’s post in 2018 praised Garcia's track record. "The work accomplished by Dr. Skip Garcia in just three short years as the senior vice president for health sciences has had a profound impact on the future of the College of Medicine-Tucson, the College of Medicine-Phoenix, and the Colleges of Pharmacy, Nursing and Public Health at the University of Arizona," Hart said in a statement released by the university.

Garcia is a pulmonary physician whose research focused on the genetic basis of lung disease and the prevention and treatment of inflammatory lung injury (2). He had previously served in academic positions at the University of Texas Health Center at Tyler, Indiana University School of Medicine, Johns Hopkins University School of Medicine, the University of Chicago, and the University of Illinois at Chicago before coming to Arizona. He has been continuously funded by the NIH since 1988 and has authored or co-authored more than 400 peer-reviewed publications and over 35 book chapters. In 2016, Dr. Garcia received the Trudeau Medal from the American Thoracic Society in recognition of his lifelong major contributions to the prevention, diagnosis and treatment of lung disease through leadership in research, education and clinical care.

Richard A. Robbins, MD

Editor, SWJPCC

References

  1. Alltucker K. Joe 'Skip' Garcia, the embattled University of Arizona med-school chief, quits his VP post. Arizona Republic. December 8, 2016. Available at: http://www.azcentral.com/story/news/local/arizona/2016/12/08/embattled-ua-med-school-chief-quits-vp-post-to-return-to-teaching-and-research/95156932/ (accessed 12/9/16).
  2. The University of Arizona Health Sciences. Joe G. N. “Skip” Garcia, MD biography. Available at: http://uahs.arizona.edu/senior-vice-president-health-sciences/joe-garcia-bio (accessed 12/9/16).

Cite as: Robbins RA. Garcia resigns as Arizona university VP. Southwest J Pulm Crit Care. 2016;13(6):305-6. doi: https://doi.org/10.13175/swjpcc137-16 PDF