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No Mandatory Ebola Quarantine In Massachusetts

CommonHealth (WBUR) - 3 hours 34 min ago

A licensed clinician participates in a CDC training course in Alabama earlier this month for treating Ebola patients. (Brynn Anderson/AP)

Massachusetts has no plans to follow New York and New Jersey in requiring a 3-week quarantine for health care workers and others who have had contact with Ebola-stricken patients.

“It’s probably a step further than we need here in the Commonwealth,” Governor Deval Patrick said in comments provided by his press office, “but we’re prepared. It’s certainly a step further than what the CDC has recommended.”

Patrick said his counterparts, Andrew Cuomo in New York and Chris Christie in New Jersey, may have more reason to be concerned about Ebola.

“I understand why they are going to the extent they are going to, because two of the five receiving airports are in New York and New Jersey,” Patrick said.

Illinois Governor Pat Quinn joined Cuomo and Christie Friday in imposing a quarantine on travelers who could be infected with Ebola.

A nurse placed under quarantine in New Jersey Friday described a chaotic scene at Newark Airport.

In Massachusetts, Patrick and Boston Mayor Marty Walsh have focused on calming public fear about Ebola.

“I understand that folks are anxious,” Patrick said again on Saturday. “We have worked very hard to make sure that our medical professionals have all of the guidance that we have, and that training is happening where and as it should, that public safety officials are fully briefed and prepared. From all accounts from the professionals, the risk is very, very low in Massachusetts.”

That assessment is based on the expectation that there is not much travel between Boston and West Africa right now, that Ebola does not easily spread, and that hospitals are prepared to handle any cases that may arise.

“It is obviously dangerous,”  Patrick said, but “you have to be directly exposed to the bodily fluids of someone who is showing symptoms of Ebola, not someone who has been near somebody with Ebola. If people are showing any of those symptoms — nausea, high fever — they should get themselves to an emergency room quickly, and there are protocols for testing.”

Categories: Health Care

Gottlieb Leaving Partners HealthCare For Partners In Health

CommonHealth (WBUR) - 22 hours 22 min ago

Partners CEO Dr. Gary Gottlieb

Here’s the press release – more to come…

Partners In Health Names Gary Gottlieb Chief Executive Officer   Ophelia Dahl Remains Chair of the Board  

BOSTON (Oct. 24, 2014)—Partners In Health announced today that it will name Dr. Gary Gottlieb as the organization’s next CEO, effective July 1, 2015. Gottlieb, currently the president and CEO of Partners HealthCare, was recruited by Partners In Health to assume the role long held by Ophelia Dahl. Last May, Dahl announced she would step down as executive director but would remain deeply involved in the organization’s work and serve as chair of the board.

Dahl has led Partners In Health since 2000, an organization she co-founded in 1987 with Dr. Paul Farmer, World Bank President Dr. Jim Yong Kim, Todd McCormack, and Tom White. Over the past three decades, Partners In Health has grown from a rural clinic in Cange, Haiti, to a leading global health organization delivering high-quality health care on four continents.

“I cannot imagine anything more fulfilling than being involved in a mission that links social justice and health care,” said Dahl. “Together we have taken significant steps to improve access to health care in poor communities around the world. But there is more work to do to leverage service with research and teaching, and that is why I am thrilled Gary Gottlieb will take the helm of the organization. Gary brings a passion for social justice and vast experience in the health care field. I look forward to working closely with Gary toward advancing our mission and amplifying our impact across all the places we work.”

Gary Gottlieb has served as president and CEO of Partners HealthCare since 2010. Throughout his career, Gottlieb has focused on disparities in health care and been an active member on Partners In Health’s Board of Governors for nearly a decade. By joining Partners In Health as CEO, Gottlieb will have the opportunity to continue this work as a champion for social justice and access to health care in a full-time capacity.

“Expanding and improving access to health care has been the most challenging and important work of my life,” said Gottlieb. “I’m eager to take on this inspiring role to tackle global health issues with Partners In Health. There is still much work to do to bring high-quality health care to poor and marginalized communities across the globe. I’m honored to join this top-notch team, and humbled by the challenge.”

“Ophelia has been our guide for the better part of two decades, and one of the reasons PIH has continued to grow over the years, the other being an immense and still unmet need, as Ebola reminds us,” said Dr. Paul Farmer, co-founder and chief strategist of Partners In Health.

“The mission of PIH—to link the delivery of health care for the poor to the tasks of training ‘local’ partners to do so and to generate new knowledge—comes from the model of academic medicine,” Farmer said. “So those of us who founded PIH almost three decades ago, including Ophelia, were hoping and praying for a leader from academic medicine, someone with a commitment to social justice and to improving the management of health systems, some of the most complex institutions in the world, even in settings of great privation.”

“Gary is a dream come true. He weds deep affection for PIH—through many trips to Haiti and Rwanda, but also as a board member and the former or current boss of scores of our volunteers from Harvard’s teaching hospitals—with the sort of management and clinical skills needed to bring PIH to the next level,” said Farmer. “There’s no place from which to see this more clearly than West Africa right now.”

About Partners In Health: Partners In Health is a global health organization relentlessly committed to improving the health of the poor and marginalized. We build local capacity and work closely with impoverished communities to deliver high-quality health care, address the root causes of illness, train providers, advance research, and advocate for global policy change. For more information please visit

About Gary Gottlieb, MD: Dr. Gary Gottlieb has served as president and CEO of Partners HealthCare since 2010. Dr. Gottlieb is a professor of psychiatry at Harvard Medical School and is a member of the Institute of Medicine of the National Academies. He served as president of Brigham and Women’s Hospital, as president of North Shore Medical Center, and as chairman of Partners Psychiatry. Dr. Gottlieb has also served as executive vice-chair of psychiatry and associate dean for managed care at the University of Pennsylvania Medical Center, and as director and CEO of Friends Hospital in Philadelphia. Throughout his career, Gottlieb has focused on disparities in health care and been an active member on Partners In Health’s Board of Governors for the past eight years. By joining Partners In Health as CEO, Gottlieb will have the opportunity to continue this work as a champion for social justice and access to health care in a full-time capacity.

Categories: Health Care

Chia Seed Alert: Superfood, Yes, But They Landed One Man In The ER

CommonHealth (WBUR) - Fri, 10/24/2014 - 5:06pm

photo: Rachel Zimmerman/WBUR

Confession: I eat chia seeds everyday. I feed them to my children. They make me feel full and satisfied and, yes, I’m a sucker for foods touted as “super” even though I know deep down it’s just marketing.

I may be crazy, but I’m also trendy: chia seeds are everywhere, in energy bars and smoothies, atop yogurt parfaits and at the core of crunchy kid snacks. Good Morning America called chia seeds the “it” food of 2013.

And they really are good for you: “a rich source of fiber, protein and heart-healthy omega-3 fatty acids,” according to an NIH publication.

But this week, my chia euphoria took a hit. “Despite potential health benefits, chia seeds may pose a risk if they are not consumed properly, according to new research,” said the Medline headline.

A case report presented by a North Carolina GI doctor describes a scary case of chia seeds gone bad: a 39-year-old man spent several hours in the emergency room under anesthesia after eating no more than a teaspoon of dry chia seeds followed by a glass of water.

The seeds, which can absorb up to 27 times their weight in water, apparently expanded post-ingestion and completely blocked the man’s esophagus, according to the doctor who handled the case, Rebecca Rawl, MD, MPH, a gastroenterology fellow at Carolinas Medical Center in Charlotte, North Carolina.

I spoke to Rawl, and she told me the story of the chia seed blockage — believed to be the first report of its kind. She presented the case earlier this week at the American College of Gastroenterology’s annual meeting in Philadelphia. It began innocently enough, she said:

The man arrived at the hospital and said he had this feeling of pain at the top of his stomach and couldn’t swallow anything — “not even his own saliva.” Hospital staff took him in for an upper endoscopy and the imaging clearly showed the culprit: puffed up chia seeds.

What did it look like?

Rawl said:

It was a gel of these seeds, the consistency was similar to Playdoh — not solid, but not a liquid.

That’s what made it very difficult to remove the obstruction — we initially tried using an adult endoscope…We tried to push the mass or gel of chia seeds through to the stomach. But because of the consistency, the seeds would just go around the scope.

After trying unsuccessfully with a variety of other medical implements to move the sloshing mass of seeds, Rawl said she switched to a neonatal or baby endoscope with a smaller diameter: “And we were able to get past the obstruction to see what was ahead and we used the tip of instrument to push a few seeds at a time into the stomach,” she said.

Little by little, then, over several hours, doctors were able to clear the man’s esophagus. “Afterwards, she said, “he was fine.”

The Michael Pollan-y moral here would go something like this:

Beware Chia.
Eat Them Wet
Chew A Lot.

A more nuanced moral, from Rawl, also urges caution:

“Nobody should be eating these seeds dry,” said Rawl, who has never personally eaten a single one of the tiny, oval-shaped seeds. “I don’t think it’s a good idea. Let them expand fully in some kind of liquid first — especially for people who have this sensation of food getting stuck. Chia seeds are tiny, so people would not necessarily think there are problems, but some people do have underlying “strictures” or narrowing of the esophagus.”

And of course, added Rawl, whose primary research focuses on irritable bowel disease, anyone who has recurring swallowing problems — whether from hot dogs or chicken or chia — should see a doctor.

But chia seeds — “which come from a species of flowering plant in the mint family native to central and southern Mexico and Guatemala” — are already so pervasive in the foodosphere, it may be hard to get that “proceed with caution” message across.

Nina Manolson, one of my go-to health coaches here in the Boston area told me she loves, loves, loves chia seeds. Here’s her response to the quasi-ominous medical report:

Chia seeds live up to their superfood name. They are high in Omega 3’s (healthy fat that is an anti-inflammatory), they are an antioxidant, contain important micro-nutrients like magnesium, calcium and manganese and they are also loaded with protein. But possibly Chia’s biggest claim to fame is its fiber content. In 1 oz of chia seeds there are 11 grams of fibre – including both soluble and insoluble fiber.

Insoluble fiber is the kind of fiber that acts like a scrub brush in your colon. Soluble fibre absorbs water so it creates bulk and it makes us feel full.

The interesting thing about Chia seeds is that it can absorb A LOT of water – claims vary from 8-27X their weight in water, which makes it a great food to add to your diet if you’re looking to feel satisfied for a long time without needing to eat a lot – as in trying to lose weight.

Chia seeds are also great at keeping dehydration at bay because it holds so much liquid. However, if you eat dry chia seeds, without giving them any liquid to absorb before ingesting them, they’ll absorb the water within your system and potentially cause a blockage. I can imagine, although I’ve never seen it happen, if you ate a lot of chia seeds without any liquid and they got stuck in your throat or windpipe, it could cause a blockage. But so could flax seeds, which also absorbs water and become gelatinous.

But the fact that you could choke on chia seeds – really, you could choke on any food – should definitely NOT be a reason to avoid them.

Chia seeds (and flax seeds) have huge nutritional benefits, and should definitely be included in a healthy diet. But, they should be eaten accompanied by a liquid, either while eating them or allowing them to soak in advance.

My favorite recipe: Raspberry chia seed pudding

Photo: Nina Manolson

I must say, after reading about the medical case, I’ve taken a bit of a chia seed hiatus. And at $19.99 for a 15-ounce package at my neighborhood Whole Foods, maybe I’ll go seedless for a little while longer.

Categories: Health Care

Family Doctors Push For A Bigger Piece Of The Health Care Pie

Kaiser Health News - Fri, 10/24/2014 - 3:39pm

Family medicine doctors are joining forces to win a bigger role in health care – and be paid for it.

Eight family-physician-related groups, including the American Academy of Family Physicians, have formed Family Medicine for America’s Health, a coalition to sweeten the public perception of what they do and advance their interests through state and federal policies.

The launch of their five-year, $20 million campaign Thursday comes at a critical time for primary-care doctors. Thanks to the health law, millions more people can seek care with newly gained insurance.  But there’s growing debate about whether nurse practitioners and physician assistants should provide a lot more basic care, either on their own or as part of clinics sponsored by pharmacies or other businesses. Some major doctor groups have challenged the ability of lesser-trained medical professionals to independently treat patients.

Glen Stream, chairman of the new coalition, said that it plans to focus on:

– Paying primary-care doctors for more than just office visits, including the time they spend making referrals to specialists, checking in with patients about treatment regimens, being available 24/7 and calling and emailing patients. Specialty doctors generally are paid more for their time and for procedures they do.

– Creating additional incentives for medical school students to go into primary care and tying medical schools’ federal funding to the primary care training they provide.

– Making electronic health records less burdensome, freeing more time for conversation with patients.

– Getting doctors to switch to a team-based, patient-centered “medical home” format, with a payment structure that reflects the work that goes into coordinating care for a patient.

– Persuading private and public employers with health plans to lean on insurers to increase compensation for primary care services.

“If we don’t spend enough on primary care, outcomes in the future will suffer because much of the chronic diseases that drive spending are preventable,” said Stream, a family physician and former president of the American Academy of Family Physicians. He added that larger employers could negotiate higher payment rates for primary care when picking an insurance company.

While the campaign is touted as helping patients, it’s also about asserting that family doctors are important.

This KHN story can be republished for free (details).

“It’s always a question of what motivates groups to do these kind of campaigns — is it looking out for patients or your own interests, and generally it’s a combination of both,” said Atul Grover, chief public policy officer at the Association of American Medical Colleges.

In September, the American Academy of Family Physicians announced recommendations on medical school funding, saying teaching hospitals should provide more primary care training as a condition of continuing federal funding at the same level. But Grover said the kind of training medical students receive doesn’t drive what type of doctor they become. The reimbursement system – which typically pays specialists at higher rates – is more important.

Grover also said that while primary care is important, taking funding away from specialty training isn’t necessarily a solution because an aging population will need more specialty care.

Other groups in the coalition are the American Academy of Family Physicians Foundation, American Board of Family Medicine, American College of Osteopathic Family Physicians, Association of Departments of Family Medicine, Association of Family Medicine Residency Directors, the North American Primary Care Research Group and the Society of Teachers of Family Medicine.

Categories: Health Care

Baseball and the Law – Pic of the Week

In Custodia Legis - Fri, 10/24/2014 - 3:15pm

I have to admit that, at the end of September, it was difficult for me to think about anything besides baseball.  The Nationals were first in their Division (no comments from Giants fans, please) and, at the last game of the season, I saw my first no-hitter.

View from my seats at Nationals Park

Being thus preoccupied I, figured I had to find a way to turn my baseball thoughts into working thoughts.

Normally when I think of baseball and the law, I think of antitrust laws and famous cases such as the Black Sox Scandal in 1921.

But what else connects baseball and law?

I began to search the Library’s catalog for law titles pertaining strictly to baseball.  Because, really, what true baseball fan can think of other sports come October?  But was there even a subject heading for baseball in the K class schedule?  Well, no.  In fact, the only specific sports I found mentioned were Prizefighting, Horse Racing and Lotteries/Gambling.

So I limited my search to items in the Law Library’s collection using ‘baseball’ as a term appearing anywhere in the bibliographic record.   Not the most brilliant search ever, but I did get 53 hits (which was more than what I thought would come up).

I diligently pulled all the volumes from the stacks and took them to my office for research.

And then – tragedy struck!

Not only did my beloved Washington Nationals not make it through the first round of the playoffs, but the Baltimore Orioles likewise fell short of their World Series goal (no comments from Royals fans either, thank you).  My thoughts turned dark, and I began to wonder what was the point of writing a blog post now?

The books stayed in my office, taunting me, and eventually, with a deadline looming, I had to face up to my own personal nightmare.  So I began to peruse the books – still somewhat bitter.

Subjecting Professional Baseball Clubs to the Antitrust Laws: Hearing on S.J. Res 133 Before the S. Comm. on the Judiciary, 83rd Cong. (1954)





A dozen Congressional  hearings – all about antitrust laws.  No, not today.







Twenty-five or so treatises dealing with antitrust, one titled Courting the Yankees. Um, no thank you.

259 US 200 (1922)




Another 10 volumes on case law.  Yawn.






A biography of Justice Sonia Sotomayor?  Interesting.

Phyllis Raybin Emert, Sonia Sotomayor, (Lucent Books 2011)


I flipped to the Table of Contents and there it was – “Chapter 4 Federal Judgeship: the Savior of Baseball“.  How could I not be drawn in?  I read that chapter and went on to the next.  Pretty soon I’d read to the end and then went back to the start to see what I’d missed in the first three chapters.

When I finished the entire book, I looked at the remaining titles on the truck and knew I had my answer.

Not to my blog post quandary but to the age-old question about what to do during the off-season.

The answer?  Return all those other books to the shelves and read through the Law Library’s collection of biographies on Justice Sotomayor.

Categories: Research & Litigation

Save the date...

Massachsuetts Trial Court Law Library - Fri, 10/24/2014 - 2:53pm
Join us for the Fifth Annual Honorable Daniel F. Toomey Lecture on Tuesday, October 28, 2014 at 4:00 p.m. at the Worcester Trial Court Complex.  The Honorable Michael A. Ponsor of the U.S. District Court will present "Thirty Years on the Bench: A Witness to Criminal Justice Unraveling".
Categories: Research & Litigation

House GOP Probes Missteps On Ebola

Kaiser Health News - Fri, 10/24/2014 - 11:42am
Categories: Health Care

First Edition: October 24, 2014

Kaiser Health News - Fri, 10/24/2014 - 10:10am
Categories: Health Care

Review: ‘Ether Dome’ Play Won’t Put You To Sleep But Could Use Scalpel

CommonHealth (WBUR) - Fri, 10/24/2014 - 9:49am

Greg Balla, Lee Sellars (seated), Tom Patterson and Richmond Hoxie act in a scene from “Ether Dome.” (Courtesy T. Charles Erickson/Huntington Theatre)

Ouch. That’s what I was saying during several of the graphic tooth-pulling and surgery scenes of “The Ether Dome,” a play about the origins of modern anesthesia now running at the Calderwood Pavilion in the South End through Nov. 23.

And that’s also what I said when I read this devastating but (in my opinion) perfectly on-point line in Carolyn Clay’s review of the show on WBUR’s arts blog, “The Artery”: “…it seems clear that the dramatist needs to administer some pain balm to herself, pick up scalpel and saw, and hack a few limbs off baby.”

Clay’s review begins:

BOSTON — You won’t require anesthesia to get through “Ether Dome,” Elizabeth Egloff’s relatively new play built on the introduction of ether — right here at Massachusetts General Hospital in 1846 — to alleviate the horrific pain of surgery. But neither will you be held to the edge of your lecture-hall seat (we the audience are medical-student observers in the dome). The three-act play is so diffuse, with at least four questionable protagonists, that there is really no one to root for — except, of course, the ether, which both transformed Hippocratic barbarism into a pretty smooth ride and started the medical ball rolling in the direction of big business.

As an utterly amateur theater-goer who was drawn to the show by the medical history, I humbly concur. It was a great pleasure to watch some of the grand old men of Massachusetts General, men whose names now grace the hospital’s buildings, brought to life in all their quirky, grumpy, brilliant glory. But I did wish for more of an editorial scalpel. Read the full “Artery” review here: The Huntington’s Ether Dome Won’t Put You To Sleep.

Categories: Health Care

Pre-Med Stress Hits New Heights As MCAT Exam Changes Loom

CommonHealth (WBUR) - Fri, 10/24/2014 - 9:28am

By Alvin Tran
Guest Contributor

Becoming a doctor was never easy. There’s stress, there’s no sleep, there’s life and death. But now, that already tough career path will get even more complicated with the introduction of a new, far longer version of the Medical College Admission Test, aka, the MCAT.

Just ask premed Charles Denby, who panicked when he recently went online to sign up for the test and found all the sites in the U.S. were booked into January 2015. Why is that a problem? Well, that’s when the old, familiar four-hour MCAT takes a short hiatus and then morphs into a newfangled, nearly 7-hour version of the test that most students must take in order to get into medical school.

Denby, a 36-year-old consultant who is now pursuing a medical career, was not amused by the prospect of facing the new test. It’s “a curveball I wasn’t expecting,” he said in an interview from his home in Providence, R.I.  Denby is hoping someone local will opt out of taking the test at the last minute so he can get a spot; though he briefly considered getting on a plane to avoid the new exam. “Germany and Israel are available for January right now,” he said.

Marquette University/flickr

Germany? Israel? Isn’t the MCAT stressful enough without getting on a plane and switching time zones?

Barbara Moran, a pre-med student in Brookline, Mass., who recently completed Kaplan’s MCAT prep class, was stunned to hear that her classmates were planning to travel to Indiana and South Dakota to take the exam. Moran, who took the exam October 21, had reserved her seat in Boston months ago. “I suddenly realized I was sitting on the hottest ticket in town,” said Moran. “It was like having a seat at a Yankees-Boston World Series game.”

The soon-to-be-extinct four-hour exam now tests students’ knowledge of chemistry, physics, biology, organic chemistry and verbal reasoning; and also their nerves, as they watch the clock tick down while struggling to recall obscure equations. Now they’ll have to endure that anxiety even longer: the new test is nearly 7 grueling hours long.

The Association of American Medical Colleges (AAMC), which administers the MCAT, approved changes to the test in 2012.


One of the most significant changes is the inclusion of the new section that tests students’ understanding of the socio-contextual determinants of health — essentially asking students to think beyond the specifics of the patient’s body, and consider how income and social status, education, home and work environments and other factors shape health outcomes.

“Testing students’ understanding of these areas is important, because being a good physician is about more than scientific knowledge,” Dr. Darrell Kirch, AAMC President and CEO, stated in a 2012 online letter to premed students. It is about understanding people — how they think, interact, and make decisions.”

Other big changes to the MCAT include new introductory biochemistry questions and a section that asks students to critically analyze written passages from non-medical arenas — humanities and social sciences, philosophy and ethics.

“The new exam is really designed to help medical school admissions people select students who are academically prepared for the curriculum they’ll experience in 2016,” said Karen Mitchell, the AAMC’s senior director of admissions testing services. “The exam kind of shifts the focus from testing what students know to testing how well they can use what they know.”

Still, she acknowledges the impulse to take the more familiar exam: “The devil you know is better than the one you don’t,” she says.

Moran, of Brookline, says that many of her fellow students are desperate to take the current exam, because nobody knows exactly what the new MCAT holds in store. “I talked to a pre-med advisor about it and she said, ‘No matter what you do, take the current exam.’” Also, she adds, “seven hours, seriously? I’d pass out from dehydration!”

The AAMC surveyed more than 2,700 medical faculty, residents, and students to help formulate the new test, Mitchell says.

“It’s good practice in standardize testing to look at your test every 10 or 15 years to make sure that it continues to measure the most important things in the most capable ways and that time had come for the MCAT,” Mitchell said.

The AAMC did, in fact, announce a new date for the old test: December 6th, 2014. Now, it seems, due to popular demand, more spots for the old test may open up.

From the website:

To address the recent spikes in registration for the current MCAT exam, the AAMC added one additional administration date on Saturday, December 6. With this additional date, we will have added 50,000 seats between September 2014 and January 2015 to accommodate examinees who wish to take or re-take the current version of the exam. Nearly all of these seats have been available for registration since February 2014 so that students could plan accordingly. We will also be adding a very limited number of additional seats to the existing January exam dates in key locations to meet the high demand listed below. Adding seats takes time to set up and will be added to the MCAT Scheduling and Registration System in early November. We will send out an announcement via Twitter (@AAMC_MCAT) when these seats become available. The last administration of the current exam will be January 23, 2015.

And on Wednesday night, this message appeared on Twitter:

UPDATE: Adding #MCAT seats takes time to set up. ALL seats for Jan dates will be added in ~2 weeks & will be announced accordingl[y]

According to Eric Chiu, Kaplan Test Prep’s executive director of pre-medical programs, students generally take their MCAT in the spring semester of their third year of college. This year, however, he’s seeing many students scrambling to take the test before it changes.

Barbara Moran said her experience with the Oct. 21 MCAT underscored just how seriously the test is taken. She and her fellow wannabe doctors were searched and finger-printed as they entered the testing room, she said; her socks were checked, and her sleeves, and she was told that she could bring in an extra pony-tail holder on her hair or her wrist, but not in her pocket.

“I felt like a criminal,” she said.

But all that is behind her now. “Thank God I’m done,” she said. “I’m so glad I never have to think about that test again..”

Categories: Health Care

Forget Ebola And Get A Free Flu Shot

Kaiser Health News - Fri, 10/24/2014 - 5:00am

Take a break from worrying about Ebola and get a flu shot this fall. While the Ebola virus has so far affected just four people in the United States, tens of millions are expected to get influenza this season. More than 200,000 of them will be hospitalized and up to 49,000 will likely die from it, according to figures from the Centers for Disease Control and Prevention.

A new HuffPost/YouGov poll of 1,000 adults found that the flu is perceived as only slightly more threatening than the Ebola virus, however. Forty-five percent of people polled said that the flu posed a bigger threat to Americans than Ebola, but a substantial 40 percent said it was the other way around. Fifteen percent said they weren’t sure.

Aaron Lemma receives a flu shot from Dr. Sassan Naderi at the Premier Care walk-in health clinic which administers flu shots on in 2013 in New York City. (Photo by Spencer Platt/Getty Images)

“Ebola is new, mysterious, exotic, highly fatal and strange, and people don’t have a sense of control over it,” says William Schaffner, a professor of preventive medicine and infectious disease at Vanderbilt University.

Influenza, on the other hand, is a familiar illness that people often think they can easily control, Schaffner says. “They think, ‘I could get vaccinated, I could wash my hands’ and prevent it.”

Yet that familiarity may lead to complacency. Flu shots are recommended for just about everyone over six months of age, but less than half of people get vaccinated each year.

Now there’s even more reason to get a shot. The health law requires most health plans to cover a range of preventive benefits at no cost to consumers, including recommended vaccines. The flu shot is one of them. (The only exception is for plans that have been grandfathered under the law.)

This KHN story can be republished for free (details).

The provision making the vaccine available with no out-of-pocket expense is limited to services delivered by a health care provider that is part of the insurer’s network.

Depending on the plan, that could include doctors’ offices, pharmacies or other outlets.

Medicare also covers flu shots without patient cost sharing.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

Categories: Health Care

Study Raises Questions About Military Service Causing Chronic Suicidal Tendencies

CommonHealth (WBUR) - Thu, 10/23/2014 - 7:09pm

A new study commissioned by the U.S. Army has found that the mental health of soldiers isn’t as different from civilians as the researchers previously thought.

Earlier this year, researchers said that soldiers, who were surveyed at different times during their Army careers, had higher rates of mental disorders before they enlisted than the rates of mental illness in the general population.

The new study says the soldiers are more likely to have only certain mental illnesses. But it raises questions about military service causing suicidal tendencies to become chronic.

One of the researchers, Ronald Kessler, a professor of health policy at Harvard Medical School, joined WBUR’s All Things Considered to discuss the findings. Listen to the full conversation above.

Related Coverage:

Categories: Health Care

Uber Pilots Program To Bring Flu Shots To Your Door

CommonHealth (WBUR) - Thu, 10/23/2014 - 4:51pm

A smartphone with the Uber app is mounted on the glass of an Uber driver. (Rafiq Maqbool/AP)

If you used Uber in Boston today, you may have noticed a new feature. The car service company was offering what it calls UberHEALTH to bring free flu shots to users’ doors.

The service was part of a one-day pilot program in Boston, New York and Washington D.C., the company announced on its blog.

“We thought Boston, D.C., New York are big health care hubs [with] high populations of people and we are all experiencing the same nor’easter as we speak, signalling the start of flu season, so we thought this could be a few interesting cities to launch an Uber health program and see how it went,” Uber Boston general manager Meghan Joyce said in an interview.

The pilot lasted from 10 a.m. to 4 p.m. Here’s how it worked: When you opened the Uber app there was a health option in addition to the regular car service options. If you selected the health option and requested a car, a driver would arrive at your location with a registered nurse from Passport Health, which provides mobile immunization services. At that point you would receive a flu prevention pack and could get a flu shot from the nurse. According to Uber, each car request could serve up to 10 people and the flu shots were available for those ages 4 and up. Any paperwork and consent forms were handled by the nurses. Uber said it would donate $5 to the Red Cross for every shot given.

It is unclear how well the program did. Joyce said they “don’t release specific numbers,” but said the demand was overwhelming. She said the company will discuss extending the pilot program.

A screenshot of the UberHealth service. (Zeninjor Enwemeka/WBUR)

(Note: I tried to access UberHealth for more than two hours today, but was unable to request the service. It appears I’m not the only one either and others could not access it.)

For today’s health program, Uber collaborated with medical professionals around Boston, including Dr. John Brownstein, an associate professor at Harvard Medical School. Brownstein runs a research group that created a tool called Vaccine Finder, which provides information about where you can get a vaccine. The UberHEALTH project has been in the works for months and his research group collaborated with the Centers for Disease Control, the U.S. Department of Health and Human Services and Passport Health. Brownstein said his group decided to connect with Uber to utilize the reach of their platform and deliver health care in a different way.

“This is really an exciting mechanism to take through, where you can distribute this kind of prevention or medical care without having to have the population move around the city and crowd in places or deal with lack of supply in particular locations,” Brownstein said. “This is really a paradigm shift in the way we think about distribution of prevention.”

A spokeswoman for the Massachusetts Department of Public Health said the agency was not involved in UberHEALTH and state approval was not needed for the program. The spokeswoman also said the department encourages everyone 6 months of age or older to get a flu shot.

While this is the first time Uber has offered such a health program, the company has used the app to offer everything from lunch to ice cream to pharmacy goods in other cities, Joyce said. Last summer Uber Boston partnered with Boston Harbor Cruises to offer UberBOAT, which provided water transportation services.

Did you try UberHEALTH today? If so, tell us about your experience in the comments below.

Categories: Health Care

Outbreak Deja Vu: Rumor, Conspiracies, Folklore Link Disease Narratives

CommonHealth (WBUR) - Thu, 10/23/2014 - 1:02pm

A licensed clinician participates in a CDC training course in Alabama earlier this month for treating Ebola patients. (Brynn Anderson/AP)

By Jon D. Lee
Guest Contributor

Nearly five years ago, during the peak of the H1N1 — Swine Flu — pandemic, a joke appeared on the Internet based on the nursery rhyme “This Little Piggy.”

The joke (clearly for public health insiders) was intended to comment on the similarities between Swine Flu and Avian Flu, and it concluded this way:

And this little piggy went “cough, sneeze” and the whole world’s media went mad over the imminent destruction of the human race, and every journalist found out that they didn’t have to do too much work if they just did “Find ‘bird’, replace with ‘swine’” on all their saved articles from a year ago, er, all the way home.

The punch line makes an important point about the recycling of stories. But for all of its insight into this phenomenon, the joke doesn’t end up taking the lesson far enough.

Because it’s not just the media that recycles stories — it’s all of us.

In An Epidemic of Rumors: How Stories Shape Our Perceptions of Disease, I conducted an extensive study of the narratives — the rumors, legends, conspiracy theories, bits of gossip, etc.—that circulated during the H1N1, SARS, and AIDS pandemics.

The results showed that all three pandemics were rife with rumors that, though created decades apart, had striking similarities. Every disease had a story claiming a government conspiracy or cover-up. Every disease had a list of sure-fire cures and treatments “they” don’t want you to know about. Every disease had false and inaccurate stories about where it had spread to and who was infected.

But mostly, and perhaps most damaging, every disease had stories about who was ultimately to blame, and these usually devolved into racism and xenophobia with terrifying rapidity. AIDS was blamed on homosexuals, SARS was blamed on the Chinese, H1N1 was blamed on Latinos. And the members of those groups were stigmatized and treated differently as a consequence.

One SARS story came from a woman in Toronto, Canada, who said when her Chinese roommate (who did not have the disease) “was on the subway…she’d describe several times sitting down beside somebody and having them get up and move over.” I collected similar stories from Latinos during H1N1. And anyone who lived through the ’80s will remember the stories about AIDS being a punishment from God against the gay community.

When I began the research for this book, I was surprised at the amount of narrative repetition I uncovered. But I ultimately concluded that such repetition makes sense: when confronted with an unfamiliar disease, it seems only logical that, consciously or unconsciously, we return to the narratives of familiar diseases to learn how to cope with the unfamiliar.

Now a new disease has captured our attention: Ebola. The media coverage is everywhere, as is the public panic — there have been at least 5,000 Ebola false alarms since late September. The disease has even become so important that some political pundits claim that November’s general elections may be won by whichever party appears to be better controlling (or perhaps just assuaging the public’s fear about) the outbreak.

When I wrote An Epidemic of Rumors, the current Ebola epidemic hadn’t even begun. But the similarities I found between the AIDS, SARS, and H1N1 narratives are quickly mapping themselves onto this new disease, and the stories people are telling are unsurprisingly familiar.

Consider the conspiracy theories alone. In August and September of this year, a rumor spread throughout Nigeria blaming Europe and America for creating the disease. A similar story from Liberia specifically points its finger at the U.S. Department of Defense for funding Ebola trials on humans.

Closer to home, both right-wing radio talk show hosts Michael Savage and Rush Limbaugh have claimed on air that President Obama is deliberately encouraging the outbreak — Savage because it’s part of Obama’s “war on white people”, and Limbaugh because Obama is getting back at Americans for their history of slavery. Right-wing commentator Morgan Brittany takes the discussion one step further by claiming that Obama is attempting to create a national panic so that he can declare martial law, seize Americans’ guns, and control the population.

These stories bear a marked resemblance to the rumors that Saddam Hussein and/or the New World Order created SARS to decimate and control the world, that the spread of H1N1 was similarly encouraged by the government to control the population, and that the AIDS virus was purposely introduced into the gay community to control its spread.

Another Ebola conspiracy theory states that the outbreak is being encouraged by pharmaceutical companies as a money-making scheme, as well as a smokescreen to cover up new studies which “prove” that the MMR vaccine causes autism. At least the former claim was also made during H1N1, with rumors that then-Secretary of Defense Donald Rumsfeld was stimulating the outbreak because of his status as the former CEO of Gilead, producer of a key H1N1 vaccine.

At the heart of many of these conspiracy theories, as well as other Ebola rumors, are deep-seated overtones of racism and blame. The Obama-Ebola links alone providing overwhelming evidence of this, but it extends far beyond the President. Similar racist narratives have peppered almost every major modern outbreak: in September of 2012, when the World Health Organization first identified the MERS-CoV outbreak in Saudi Arabia, one of the first CNN news articles detailing the story had as its opening reader comment, “More proof that Muslims are dirty people ruining the planet.” And I collected dozens of SARS narratives warning people to “Avoid going to ASIAN areas!!!”

Of course, what underlies all of these narratives, regardless of the disease, is a single emotion: fear. It’s fear that drives the creation of these stories, fear that leads to their continued circulation, and fear that will bring around the next batch of rumors for the next big outbreak, whatever that happens to be.

And I’ll bet those rumors are going to be eerily familiar as well.

Jon D. Lee has a Ph.D. in Folklore, and lectures at Suffolk University and Stonehill College.

Categories: Health Care


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