Medicare regulation revives end-of-life planning

From the Associated Press:

 new health regulation issued this month offers Medicare recipients voluntary end-of-life planning, which Democrats dropped from the monumental health care overhaul last year.

The provision allows Medicare to pay for voluntary counseling to help beneficiaries deal with the complex and painful decisions families face when a loved one is approaching death.

But the practice was heavily criticized by former Alaska Gov. Sarah Palin and some other Republicans who have likened the counseling to “death panels.”

The “voluntary advance care planning” is included in a Medicare regulation issued Dec. 3 that covers annual checkups, known as wellness visits. It goes into effect Jan. 1.

The new regulation was first reported by The New York Times.

For years, federal laws and policies have encouraged Americans to think ahead about end-of-life decisions and make their wishes known in advance through living wills and similar legal documents. But when House Democrats proposed last year to pay doctors for end-of-life counseling, it touched off a wave of suspicion and anger.

Opponents said end-of-life planning should be left to families, while proponents said doctors’ advice was a basic element of health care.

Prominent Republicans singled it out as a glaring example of government overreach. Palin’s use of the phrase “death panels” solidified GOP opposition to the health care bill.

The Joint Commission Appoints New CMO


The Joint Commission said Wednesday it appointed Dr. Ana Pujols-McKee as its new executive vice president and chief medical officer.

McKee will work on developing policies and strategies that promote patient safety and improve quality in health care. Her responsibilities will include supporting The Joint Commission’s Patient Safety Advisory Group and offer clinical guidance for the organization’s Center for Transforming Healthcare.

“Ana has a well-deserved reputation as a dynamic leader who forms strong, effective partnerships that promote health care quality and patient safety,” Dr. Mark Chassin, the organization’s president, said in prepared remarks. “Her talents will serve The Joint Commission well as it continues to focus on helping health care organizations excel in providing the highest quality and safest care that Americans expect and deserve.”

McKee currently serves as the CMO and associate executive director for Penn Presbyterian Medical Center, University of Pennsylvania Health System. She is also an associate professor of medicine at the University of Pennsylvania School of Medicine in Philadelphia.

Obese Drivers at Higher Risk of Death in Car Crashes: Study

From US News and World Report:

Here’s another reason not to pile on too many excess pounds: A new study finds that the obese and very obese are at raised risk of death in severe car crashes.

According to the research, published in the American Journal of Emergency Medicine, a moderately obese driver is 21 percent more likely to die in a severe motor vehicle crash compared to non-obese drivers, while being severely obese hikes the risk of death by 56 percent.

However, being just slightly overweight seemed to lower the odds for death in a severe crash: these drivers were actually less likely to die than either underweight or normal-weight drivers, according to researchers at the University at Buffalo School of Medicine and Biomedical Sciences.

In the study, the researchers analyzed data from the national Fatality Analysis Reporting System involving almost 156,000 drivers in severe motor vehicle crashes occurring between 2000-2005. The researchers included all fatalities occurring within 30 days of a crash.

Docs warn some: Step away from the shovel

From the Boston Herald:

That’s heart-attack snow out there, heavy and wet, the experts say.

Docs say the best way to shovel for both your heart and your back is to pay a 16-year-old. But if you insist on moving the stuff yourself, here are some things to think about.

“A lot of people are out of shape and don’t realize how heavy the (physical) demand is,” said Assaad Sayah, chief of emergency medicine for Cambridge Health Alliance.

He said the messy, wet snow dropped around Boston overnight is exactly the kind that health-care professionals fear . . . it raises the likelihood that they’ll have some heavy lifting to do themselves in the ER today.

Couch potatoes who pick up their shovels without taking precautions account for an increase of up to 20 percent in the number of patients showing up in emergency rooms with heart attacks.