Longer Looks: 3-D Medical Printing; Healthier Hospitals; Early Cancer Detection Pitfalls
Each week, KHN's Shefali Luthra finds interesting reads from around the Web.
The New Yorker:
How 3-D Printing Is Changing Medicine
Almost every day, I receive an e-mail from my hospital’s press office describing how yet another colleague is using a 3-D printer to create an intricately realistic surgical model—of a particular patient’s mitral valve, or finger, or optic nerve—to practice on before the actual operation. Surgeons are implanting 3-D-printed stents, prosthetics, and replacement segments of human skull. The exponents of 3-D printing contend that the technology is making manufacturing more democratic; the things we are choosing to print are becoming ever more personal and intimate. This appears to be even more true in medicine: increasingly, what we are printing is ourselves. (Jerome Groopman, 11/24)
A Doctor Explains Why She Won’t Text Patients Their Test Results
If communicating the outcome of routine medical tests seems relatively straightforward, offering results about serious or even terminal diseases via digital technologies is an altogether different proposition. Such diagnoses must be accompanied by reassurance, prognostic information and a treatment plan. If the news is that weighty or complex, however, shouldn’t the whole conversation be had in person? Or have we arrived at an age when everything—even professional sympathy and support—can be conveyed electronically? (Esther Choo, 11/21)
Why Are America’s Poorest Toddlers Being Over-Prescribed ADHD Drugs?
Thousands of the nation’s poorest children under the age of four are being prescribed stimulants like Ritalin and Adderall for ailments they’re too young to even have. A first-ever Centers for Disease Control study estimates that under the Medicaid health care program, doctors have given some 10,000 American toddlers a diagnosis of ADHD and treated them with ADHD drugs that have not been shown to be effective or safe in children that young. The news that amphetamine-based drugs like Adderall and the methylphenidate Ritalin are being used to medicate, at a minimum, one out of every 225 toddlers nationwide outraged some medical professionals when it was first announced in May at the Georgia Mental Health Forum. (Josiah Hesse, 11/21)
Building Healthier Hospitals
The Dyson Centre, finished in 2011 and funded in part by Sir James Dyson, of vacuum cleaner fame, is an example of a new and different type of healthcare design. Deliberately distancing itself from the traditional hospital look, feel and smell, this and other places like it are drawing on a growing body of research that shows that buildings themselves can speed the recovery of patients, as well as boosting the health and happiness of the staff who work in them. (Lucy Maddox, 11/25)
The New York Times:
Debate Persists Over Diagnosing Mental Health Disorders, Long After ‘Sybil’
The notion that a person might embody several personalities, each of them distinct, is hardly new. The ancient Romans had a sense of this and came up with Janus, a two-faced god. ... But few instances of the phenomenon captured Americans’ collective imagination quite like “Sybil,” the study of a woman said to have ... 16 different personalities. ... Sybil Dorsett, a pseudonym, became the paradigm of a psychiatric diagnosis once known as multiple personality disorder. ... Pre-"Sybil,” the diagnosis was rare, with only about 100 cases ever having been reported in medical journals. Less than a decade after “Sybil” made its appearance, in 1980, the American Psychiatric Association formally recognized the disorder, and the numbers soared into the thousands. (Clyde Haberman, 11/23)
The Case Against Early Cancer Detection
The harder we look for cancer — any cancer — the more we find. But most of these extra cases are ones like papillary thyroid cancers that never pose a threat. Researchers have a name for this — overdiagnosis, and it leads to another problem, overtreatment. Most people diagnosed with thyroid cancer get their thyroids surgically removed and must take hormone replacement drugs for the rest of their lives. (Christie Aschwanden, 11/24)
Why Are Patients Drawn To Certain Doctors?
If people can’t choose a doctor based on performance, how do they choose? For those of us who live in towns or cities with more than one doctor, social networks are still important. But what about when people can’t get a recommendation? Or when they get conflicting recommendations? And what makes people decide to stay with a doctor after an initial visit? (Eric Horowitz, 11/24)
The New York Times:
How To Arrive At The Best Health Policies
Randomized controlled trials are increasingly popular in designing international development programs overseas, and trials have been used in the United States to see if policies increase voter turnout or improve homelessness assistance. They have a long history in fields like employment training. But there has been less appetite for using them in health care settings. Sometimes, the hesitation is because of ethical considerations: If we think we know a certain approach will be better, should we really withhold an intervention from some people? Sometimes it’s just practically and politically difficult to design trials. (Margot Sanger-Katz, 11/21)