5-Star Friday: Put these gems on your weekend reading list

Journalists as watchdogs.

Safeguarding the public’s interests.

We need you now more than ever. If only because the medical industrial complex sometimes has a different set of priorities. Different interests.

William Mayo, one of the founders of the Mayo Clinic, once said: “The best interest of the patient is the only interest to be considered.”

It’s sad that this simple phrase now feels sentimental, or endangered. The excellent writing we feature below goes a long way toward refocusing our attention on the interests that matter.

Gary Schwitzer | Founder & Publisher

For Cancer Centers, Proton Therapy’s Promise Is Undercut by Lagging Demand • by Jay Hancock • Kaiser Health News, in the New York Times

Gary Schwitzer, Publisher

Six years ago, oncologist and bioethicist Ezekiel Emmanuel, MD, wrote that the proliferation of proton beam therapy machines in the U.S. was “crazy medicine and unsustainable public policy.”  If that was the case then, it’s even crazier today.  And Jay Hancock helps readers track the craziness. He reports that: “There are 27 proton therapy centers now operating in the United States. Nearly as many are being built or planned….Nearly a third of the existing centers lose money, have defaulted on debt, or have had to overhaul their finances.”

The headline clumsily seems to pin this on patients’ “lagging demand.”  But Hancock’s reporting points to the supply side of the supply-and-demand equation: hospital administrators buying far too many machines that they hoped to put to work in far too many unproven uses. Hancock wrote: “(proton beam’s) pinpoint precision has not been shown to be more effective against breast, prostate and other common cancers.”

So for Americans who hang on to the chauvinistic belief that U.S. health care is best in the world, proton beam machine proliferation is one achievement for which they may wave the flag and chant, “We’re Number One!”  But it may not be one for which they should be especially proud.  Kudos to Hancock for keeping us up-to-date on one factor behind another America #1 claim – spending a far greater percentage of our gross domestic product on health care than any other country on earth (often without a return on that investment).

Mary Chris Jaklevic | Reporter-Editor

Mary Chris Jaklevic

The Pain Hustlers • by Evan Hughes • New York Times Magazine

Illustrated like a noir comic, this story lays out the extreme sales-maximizing strategies of opioid maker Insys Therapeutics, detailing its use of well-known pharma tactics (“speaker” fees for prescribing doctors) and some you might not have heard of before (hiring “prior authorization specialists” who mislead insurers about a patient’s condition).

Hughes reveals the mindset behind the operation, drawing on court documents and interviews with former employees. He also visits an addicted vet whose life has devolved to the point of sleeping under a desk and a high-prescribing Sarasota doctor who says the Insys speaker program “suited his ego.” With former company officials now facing criminal and racketeering charges, this story connects the dots between greed and patient harms.

Jill U. Adams | Associate Editor

There’s a New 12-Step Group: Medication-Assisted Recovery Anonymous • by Jillian Bauer-Reese • Slate

Jill U. Adams

This story shows that stigma against opioid users is everywhere — even in the addiction treatment community. Kudos to reporter Bauer-Reese for including patient voices to reveal a nuanced portrait of people trying to overcome addiction, while also revealing yet another barrier to treatment.

Here’s the news: A new 12-step program has emerged specifically for people taking medication, such as buprenorphine and methadone, to help them recover from their addictions. These folks are snubbed in traditional 12-step programs, overtly or subtly:

One member shared a story of working up the nerve to tell her AA sponsor that she’s on 45 mg of methadone, something that is too often discouraged in the AA model. When she shared, the compassion was audible; this kind of concern is all too common.

The evidence for medication-assisted treatment is strong: the meds reduce opioid deaths by 50%, decrease criminal activity, and increase the number of people who say in treatment. Another member:

“Why should I feel ashamed for doing something that’s saved my life? I was putting a needle in my arm every 10 minutes—methadone saved my life.”

But taking the meds often is framed as substituting one opioid for another. The story brings in an addiction expert to reframe:

“I think it’s heartbreaking because if a person had cancer or had any other chronic illness and they were valiantly managing it, people in their lives would be supporting them and encouraging them to take their medication every day to stay healthy.”

Michael Joyce | Writer-Producer

There’s No Such Thing as ‘Sound Science’ • by Christie Aschwanden • fivethirtyeight

Is science being used to hijack science?

Michael Joyce

Aschwanden provocatively takes us from the present — where scientists are removed from the EPA advisory panel, and President Trump’s pick to head NASA claims “global temperatures stopped rising 10 years ago” — back to the days when big tobacco usurped a basic tenet of science, uncertainty, to essentially give momentum to doubt.

The end result? The emergence of two brands of science using the same language for very different reasons.

Whereas the “open science” movement aims to make science more reliable, reproducible and robust, proponents of “sound science” have historically worked to amplify uncertainty, create doubt and undermine scientific discoveries that threaten their interests.

If you’re someone fascinated by cherry-picked evidence, “scienceploitation,” the malleability of “fact,” or the interplay between values and fact, then this gem of an article will have you enthralled.

Please Note: These stories have not been subject to our rigorous, 10-criteria systematic review for accuracy, balance, and completeness. Rather, they represent pieces of health care journalism and opinion writing that members of our staff found compelling and wanted to share with others.

5-Star Friday is a regular feature on HealthNewsReview.org. You can find a list of previous installments HERE.