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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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Entries in COVID-19 (3)

Monday
Oct252021

SWJPCC Associate Editor Featured in Albuquerque Journal

Dr. Dona Upson forwarded an article from Sunday’s edition of the Albuquerque Journal featured Michel Boivin, a SWJPCC Associate Editor, in an article titled, “Exhaustion in the ICU: Doctors reflect on state’s nearly 5,000 COVID-19 deaths” (1). Boivin and his wife Teri Heynekamp, a married couple who were many years at the University of New Mexico, shared their thoughts last week on New Mexico nearing 5,000 COVID-19 deaths (Figure 1).

Figure 1. Lovelace doctors Michel Boivin and Teri Heynekamp, a married couple, walk through the intensive care unit at Lovelace Medical Center in Albuquerque. They and other doctors shared their thoughts last week on New Mexico nearing 5,000 COVID-19 deaths. (Eddie Moore/Albuquerque Journal)

Yesterday was Day 587 of the COVID-19 pandemic in New Mexico, just another brief hospital scene amid 19 months of loneliness, fatigue and grief. “We feel exhausted,” Heynekamp said in an interview, “like a type of exhaustion that I’ve never experienced in my life.” Doctors and other health care providers say their workload has hardly let up. Even the arrival of safe, effective vaccines, some doctors say, has provided little relief, introducing a new dynamic instead — the knowledge that most of today’s COVID-19 deaths are preventable. People who weren’t fully vaccinated accounted for 96% of the deaths in a recent four-week period.

Dr. Steve McLaughlin, chairman of the Department of Emergency Medicine at the University of New Mexico School of Medicine, said hospital leaders throughout the country are trying to address burnout among their workforce and “moral injury” — a concept usually applied to refugees and soldiers in wartime. In health care, moral injury refers to the distress endured by doctors and others as they’re forced to provide less care than normal. The preventable nature of most COVID-19 deaths, some doctors say, has added to the psychological toll.

Heynekamp said they and other providers have faced patients and family members who doubt the severity of the disease. Some families ask for a specific medicine, such as ivermectin, an anti-parasite drug not approved for COVID-19 treatment. A recent ICU patient, Heynekamp said, insisted his COVID-19 infection wasn’t worse than the flu. Others want to go home against medical advice, she said, and some families reject vaccination even after a loved one dies. “There’s so much anger toward health care providers,” Heynekamp said. “There’s so much animosity. There’s so much mistrust. “We’ve never dealt with that before.” Boivin put it this way: “The way that social media rewards disinformation and spreading lies at the expense of people’s lives has been unbelievably frustrating, as well as time consuming.”

The stress on health care providers goes well beyond coronavirus infections. New Mexico has had a long-standing shortage of doctors and nurses, especially in rural areas, and fewer beds per capita than the nation as a whole. Dr. Michel Boivin, a critical care physician at Lovelace, said a key challenge now is the scarcity of space available in larger hospitals to accept patients from smaller ones. “I had a guy who needed a pacemaker,” Boivin said, “and he was sitting in a rural New Mexico hospital for a whole day with his heart barely beating.” Before the pandemic, he said, there would have been no wait for a pacemaker-related transfer.

According to Dr. Sarah Medrick at the University of New Mexico, their state has one of the highest vaccination rates in the country (Table 1) (2).

Table 1. Vaccination Rate by State (2).

They urged people to get vaccinated, wear masks indoors and wash their hands. “I feel a lot of empathy for the families who are still losing their loved ones,” McLaughlin said. “I think it’s important to remind people that the pandemic is not over, and we have to continue to focus on the things we know can keep people safe and prevent additional deaths.” As Heynekamp walked through the seventh-floor ICU at Lovelace, she noted that she had stood in many of the rooms and watched patients say goodbye, often through a video call to loved ones.

It was, she said, a lonely way to die.

References

  1. McKay D. Exhaustion in the ICU: Doctors reflect on state’s nearly 5,000 COVID-19 deaths. Albuquerque Journal. October 24, 2021. Available at: https://www.abqjournal.com/2440183/doctors-reflect-on-states-nearly-5000-covid19-deaths.html (accessed 10-25-21).
  2. COVID-19 Vaccine Statistics. Our World in Data. Available at: https://www.google.com/search?q=covid-19+vaccination+rate+in+Arizona&rlz=1C1GCEA_enUS969US969&ei=jdF2YeeSEZ-e0PEP7MCJCA&ved=0ahUKEwinjYi49OXzAhUfDzQIHWxgAgEQ4dUDCA4&uact=5&oq=covid-19+vaccination+rate+in+Arizona&gs_lcp=Cgdnd3Mtd2l6EAMyBggAEBYQHjIFCAAQhgMyBQgAEIYDOgcIABBHELADOgUIABCABEoECEEYAFCl3hJYmuUSYK_sEmgBcAJ4AIABnAGIAbgGkgEDMS42mAEAoAEByAEIwAEB&sclient=gws-wiz (accessed 10-25-21).

Cite as: Robbins RA. SWJPCC Associate Editor Featured in Albuquerque Journal. Southwest J Pulm Crit Care. 2021;23:104-6. doi: https://doi.org/10.13175/swjpcc049-21 PDF 

Friday
Aug272021

CDC Warns of Increased Ivermectin Overdoses

The US Centers for Disease Control and Prevention (CDC) is warning of an increase in cases of ivermectin overdose due to people self-prescribing the drug in an effort to prevent or treat COVID-19 (1). Ivermectin is used to treat river blindness and intestinal roundworm infection in humans and to de-worm pets and livestock. 

A study published earlier this year showed that ivermectin killed SARS-CoV-2 in cells in vitro. The authors proposed that the medication be investigated as a cheap and easily available treatment for COVID-19. However, subsequent studies have failed to find any benefit in humans (3).

In a new communication to its Health Alert Network, the CDC says cases of overdose and misuse are rising (1). More than 88,000 prescriptions were written for the drug ivermectin in the week ending August 13, an increase of 2400% over the weekly average prior to the COVID-19 pandemic (Figure 1).

Figure 1. Ivermectin prescriptions by week (from CDC, reference 1).

Unfortunately, the signs of overdose are nonspecific but can include gastrointestinal symptoms (nausea, vomiting, and diarrhea), hypotension and altered mental status (change in consciousness, confusion, hallucinations, seizures, coma).

The CDC is asking doctors to alert their patients to the risks of ivermectin, particularly ivermectin products intended for veterinary use. Physicians might suspect ivermectin in a patient with unexplained symptoms and are encouraged to contact their local poison control for assistance.

References

  1. CDC. Rapid Increase in Ivermectin Prescriptions and Reports of Severe Illness Associated with Use of Products Containing Ivermectin to Prevent or Treat COVID-19. August 26, 2021. Available at: https://emergency.cdc.gov/han/2021/han00449.asp (accessed 8/27/21).
  2. Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral Res. 2020 Jun;178:104787. [CrossRef] [PubMed]
  3. Popp M, Stegemann M, Metzendorf MI, Gould S, Kranke P, Meybohm P, Skoetz N, Weibel S. Ivermectin for preventing and treating COVID-19. Cochrane Database Syst Rev. 2021 Jul 28;7:CD015017. [CrossRef] [PubMed]

Cite as: Robbins RA. CDC Warns of Increased Ivermectin Overdoses. Southwest J Pulm Crit Care. 2021;23(2):62-3. doi: https://doi.org/10.13175/swjpcc038-21 PDF 

Tuesday
Apr212020

Healthcare Layoffs During the COVID-19 Pandemic

Despite overcrowding of the ICUs with patients infected with coronavirus (COVID-19, SARS-CoV-2), hospitals have halted or downsized other operations. Phoenix-based Banner Health, which is Arizona's largest private employer, will impose "short-term" furloughs and pay cuts for some employees (1). Other major hospitals and hospital systems including the Mayo Clinic Arizona, Dignity Health, Tucson Medical Center and Carondelet have announced similar cost-cutting reductions. Banner Health, which has approximately 43,000 employees in Arizona, is starting the furloughs this week. The nonprofit company anticipates that the measures will affect 5% to 7% of its workforce, or up to 3,000 Arizona employees. The company says the furloughs are temporary and employees will be eligible for unemployment benefits, including an extra $600 per week provided by Arizona via the federal CARES Act. All senior leaders, including senior vice presidents, presidents, vice presidents and CEOs, will take up to a 20% reduction in pay beginning in May, Banner said. The company will pause hiring for most non-clinical, non-revenue-generating positions across the organization. This includes newly created jobs as well as vacant roles in the corporate office and facilities. The company will continue to post and recruit for positions that are essential to meet the needs of COVID-19.

An analysis by the Arizona Hospital and Healthcare Association shows Arizona hospitals are reporting revenue losses of 30% to 40% because of the cancellation of elective procedures and a reduction in emergency department visits. Hospitals had an operating margin, the difference between revenues and expenses, that averaged 2.7% in 2016 (2). The hospital association has asked Arizona’s governor, Doug Ducey, to relax his executive orders on halting elective surgeries and on expanding hospital bed capacity, citing recent modeling projections that indicate Arizona will not be as hard-hit by the disease as previously was predicted.

It is unclear how other healthcare organizations other than hospitals are managing during the COVID-19 pandemic. Our small pulmonary practice has been shut down since mid-March although we are doing some telemedicine. Yet compared to the large healthcare systems, we have managed to retain all our employees at a full-time basis as of today. Our group did apply for a small business loan to the Federal government which was denied.

Richard A. Robbins, MD

Editor, SWJPCC

References

  1. Innes S. Banner Health, Arizona's largest health system, to implement pay cuts and furloughs. Arizona Republic. April 20, 2020. Available at: https://www.azcentral.com/story/money/business/health/2020/04/20/banner-health-implement-pay-cuts-and-furloughs-arizona-coronavirus-covid-19/5165992002/ (accessed 4/21/20).
  2. Moody's Investors Service. Moody's: preliminary FY 2016 US NFP hospital medians edge lower on revenue, expense pressure. Moody's. 16 May 2017. https://www.moodys.com/research/Moodys-Preliminary-FY-2016-US-NFP-hospital-medians-edge-lower--PR_366813 Accessed 4/21/20.

Cite as: Robbins RA. Healthcare layoffs during the COVID-19 pandemic. Southwest J Pulm Crit Care. 2020;20(4):135-6. doi: https://doi.org/10.13175/swjpcc029-20 PDF