5-Star Friday: Movers & shakers

There are voices in healthcare that don’t get heard nearly enough; certainly the general public may not even know they exist.

That’s understandable in a time when many of us feel swamped by too much information coming at us from too many directions. It can be difficult to sift through all the choices and separate the substantive from the superficial.

In this 5-Star Friday we feature a few of the movers and shakers who consistently write thoughtfully and substantively about pivotal health care issues. Enjoy!

Gary Schwitzer | Founder & Publisher

Professional Societies Should Abstain From Authorship of Guidelines and Disease Definition Statements • by John P.A. Ioannidis, MD • Circulation: Cardiovascular Quality and Outcomes

Gary Schwitzer, Publisher

We don’t usually write about journal articles in this feature, but when Dr. John Ioannidis of Stanford makes such a strong statement in a specialty journal, we think it should be distributed more widely.  And the theme of his journal article aligns with themes we address constantly about special interests polluting the flow of health care information to the public.

He explains how medical guidelines from professional medical societies may create millions of new patients overnight by redefining diseases. These changes may raise care costs overnight by billions of dollars.  “Should the specialists of the respective field be the developers for such influential articles?” he asks. But beyond the financial conflicts, he points to “hundreds and thousands of designated guideline coauthors (sharing) in the society-wide power game” of getting on a prestigious guideline-setting panel and thereby advancing one’s own visibility and career.  “This creates,” he wrote, “a massive, clan-like, group self-citation network.”

Bottom line:  “Do they improve medicine or do they homogenize biased, collective, and organized ignorance?” Ioannidis asks.

He offers many suggestions to improve this picture, including the simple suggestion that professional societies should “listen to what more impartial stakeholders think about their practices.”  He urges the inclusion of more methodology specialists, patients, specialists from different fields to add more rigor, patient-centeredness and impartiality.

It’s a thoughtful piece in a long tradition of writing on this same topic by people such as Ray Moynihan, Jeanne Lenzer, Shannon Brownlee, Rita Redberg, Gordon Guyatt, Paul Glasziou and others whose work is listed by Ioannidis in his References section.

John P.A. Ioannidis, MD

I will fail if I try to capture the entire gist of Ioannidis’ latest journal gem.  Please read it and think about the impact of what he writes on the quality of health care information that reaches the public. And for news consumers, this piece is a reminder that if you read news or hear news stories about new medical guidelines, consider the source of those guidelines.  As one doctor often said to me, “If you want pizza, go to the pizza man.”  In this context, if you read about guidelines on cardiology or any other specialty, read further to see if only cardiologists took part in the process.  And while conflicts of interest are not necessarily automatic, it’s a rational question to raise.

Ioannidis, who just this week was elected to the prestigious National Academy of Medicine, is an important voice in health care and one whose past research and writing has changed the thinking of many health care observers.  But this article has already met with some predictable opposition, as MedPage Today captured.

Jill U. Adams | Associate Editor

No, LaCroix Isn’t Poisoning You Like You’re A Giant Cockroach • by Christie Aschwanden • FiveThirtyEight

Jill U. Adams

Apparently there was some news last week about LaCroix canned seltzer containing an insecticide. The chemical under scrutiny is a compound called linalool. It is indeed found in LaCroix naturally flavored seltzers, and it also is found in some cockroach control products.

Even if you don’t drink LaCroix products, this helpful explainer is worth your time. In it, science journalist Christie Aschwanden answers some key questions for consumers of packaged food (that is, practically everyone) and deflates some of the mystique that food makers peddle. Regarding linalool, the compound occurs naturally in fruits such as blueberries and, truth be told, is integral to blueberries’ taste. Linalool also can be synthesized. Key point: Whether it’s synthesized in a lab or extracted from blueberries, the final product is the same.

Another key point, which Aschwanden uses as her kicker:

Turns out, there’s no way around it: All the products we buy contain chemicals.

Mary Chris Jaklevic | Reporter-Editor

1,495 Americans Describe the Financial Reality of Being Really Sick • by Margot Sanger-Katz • The New York Times

Mary Chris Jaklevic

Remember a decade or so ago, when the news churned out stories of uninsured Americans facing financial ruin because they got seriously ill or hurt? The Affordable Care Act was supposed to help fix that by getting more people onto insurance rolls. This piece shows how it hasn’t quite worked out.

The Times, the Commonwealth Fund, and the Harvard T.H. Chan School of Public Health surveyed the “sliver of the American population who use the health care system the most” — people hospitalized twice in the last two years who used at least three doctors. It found more than 20% of those who were insured had trouble paying for basic necessities and 36% had used up most of their savings due to factors like rising deductibles, uncovered expenses, and lost income.

That outcome isn’t a total surprise given the law didn’t do much to foster competition and price transparency among hospitals, doctors, and drug companies. Still, this story illuminates the cost of a system that leaves consumers to fend — as one business professor put it — with “complicated systems that don’t always have your best interest at heart.”

Joy Victory | Deputy Managing Editor

Why do many gynecologists require a pap smear be done in order to prescribe or renew prescriptions for hormonal birth control? • by Jen Gunter, MD • for The New York Times

Joy Victory

In six quick paragraphs–one of which is simply “Insert angry emoji”–Gunter explains why there is simply no *good* reason for doctors to insist that patients get a Pap smear before they receive a birth control prescription. Yet many women have encountered this (I know I have), which she says is “hopelessly patriarchal.”

The post is part of an ongoing series by Gunter where she answers readers’ questions, and often helps shed light on medical misinformation. I’ll admit I grazed through nearly all of them (and her blog is a must-read for anyone interested in women’s health).

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.

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