Letters to the Editor is a periodic Kaiser Health News feature. KHN聽welcomes all comments and will publish a selection. We edit for length and clarity and require full names.
On Building Empathy For Patients
As a nurse practitioner for 18 years and someone who has a chronic illness, I am intimately aware of the issues that Dr. Rana Awdish brings up for improving communication between physicians and patients (鈥Terrifying Brush With Death Drives Doctor To Fight For Patients,鈥 Jan. 2). I see both the nursing and medical side of patient care, and I have to say that physicians could learn a lot from nurses. Listening to patients and being a patient advocate is at the core of what nurses have been doing for a hundred years. Thankfully, society is changing and realizing that the physician is not a 鈥済od-like鈥 figure. Physicians are nothing more than real people, ones who make mistakes and have trouble with communication and feelings, just like everyone else. I wish the journalism world would realize how the nursing perspective is what has given patients the 鈥渃are鈥 they need and seek.
鈥 Timothy Ray, Madison, Ohio
In your excellent interview with Dr. Rana Awdish, she discusses several 鈥渟ystem鈥 barriers to enhancing the patient-doctor relationship 鈥 such as productivity demands, the upkeep of electronic medical records, dealing with insurance. But she seems to separate physicians from the 鈥渟ystem.鈥 Such separation is itself a significant barrier to the communication space that the doctor challenges her colleagues to create. Breaking down system barriers requires a system-wide effort, among physicians, nurses, aides, administration and information technology officials 鈥 even insurance carriers.
鈥 Paul Shirilla, Traverse City, Mich.
How Hospitals Game The System
In regards to the 鈥減oor and sloppy reporting鈥 from the Chicago hospital suing over a rating agency鈥檚 contested grade (鈥In Era Of Increased Competition, Hospitals Fret Over Ratings,鈥 Dec. 11): Such scores do not reflect the quality of hospital operations. They reflect the ability of a person to write the best report. This can be compared to financial success of hospitals. The hospital that knows how to game the system 鈥 getting more money from the Centers for Medicare & Medicaid Services and insurance carriers by maximizing billing 鈥 beats the hospital that is focused on good care.
鈥 Bob Schmidt, Atlanta
Dispense Your Words Carefully
I鈥檓 certainly not a fan of PhRMA but, in the interest of accurate reporting, Jay Hancock should choose his words more carefully (鈥Drug Industry Spent Millions To Squelch Talk About High Drug Prices,鈥 Dec. 19). An organization with a $220 million budget can hardly be said to 鈥渓avish鈥 support on a group of organizations when it spends a total of $2 million across 鈥渟cores of organizations,鈥 and the largest gift was $260,000. But the word 鈥渓avish鈥 would be entirely appropriate when describing PhRMA鈥檚 gift of $6.1 million to the American Action Network.
鈥 Worth Gretter, Menands, N.Y.
The woman featured in your article 鈥Opioids After Surgery Left Her Addicted. Is That A Medical Error?鈥 (Dec. 11) was not 鈥渁ddicted.鈥 She was 鈥渄rug-dependent.鈥 Yes, the docs should have educated her better, but you ought to be technically accurate.
鈥 Sally Satel, M.D., Washington, D.C.
Missing A Killer App Opportunity For Painkillers
In reporting on the opioid epidemic, Michelle Andrews provided insight on her personal experience being overprescribed Percocet for a minor knee injury (鈥Doctor鈥檚 Rx For A Stiff Knee: A Prescription For 90 Percocet Pills,鈥 Nov. 21). She noted how electronic prescribing systems make prescribing more pills simpler than prescribing fewer, as they generate the maximum prescription 鈥 in this case, 90 pills of Percocet, a relatively strong opioid for a minor knee surgery.
An automated prescribing system based on procedures would allow more accurate pain medicine allocation, while aligning with the behavioral workflow of physicians. Why not apply the sophisticated algorithms and big data 鈥 which Silicon Valley frequently capitalizes on 鈥 to the opioid crisis, by developing user-friendly software for physicians to quickly prescribe appropriate doses according to the procedure and weight of the patient?
鈥 Ariel Cooper, Oakland, Calif.
Docs Not Inoculated Against Runaway Vaccine Costs
Prevnar鈥檚 high price tag (鈥The Ratcheting Price Of The Pneumococcal Vaccine: What Gives?鈥 Nov. 29) is only part of the problem. Its manufacturer, Pfizer, unlike other vaccine companies, refuses to offer a refund for expired doses of Prevnar if the 10-dose package has been opened (doses are in separate, prefilled syringes). So, the pediatrician who orders a large supply when Pfizer offers a couple of months鈥 worth at the old price then gets stuck with unused vaccine ($1,000 worth this summer for me, for having six of 10 doses left in the second package 鈥 they had early expiration dates). I鈥檓 stuck with Prevnar, but I use Pfizer鈥檚 competitors for all other vaccines now.
鈥 PL June, M.D., Moultrie, Ga.
New Light Shed On Sickle Cell Disease
Thanks for the piece on sickle cell disease (鈥Sickle Cell Patients Suffer Discrimination, Poor Care 鈥 And Shorter Lives,鈥 Nov. 6). I remember hearing stuff on TV about sickle cell growing up in the 鈥70s, but hadn鈥檛 heard anything since biochemistry class in college. I鈥檇 assumed that, because of the earlier attention, treatments had become so good that it was no longer an issue. I guess that was naive, given the ensuing deterioration of our health care system in general.
鈥 Linda Wilson, Georgetown, Texas
I wanted to thank the Kaiser Health News team for writing a story about sickle cell disease. My older brother, Marqus, has sickle cell disease. The story echoed our lives and managed to capture over 100 years of discrimination.
The good news is that Marqus survived his seizures and the two of us to try and improve policy efforts and quality of life for sickle cell patients. We even went to the Food and Drug Administration last year and testified about the need for drug development, ultimately aiding in the FDA approval of a sickle cell drug. Thank you for validating our cause and shedding some light on disparities for sickle cell disease.
鈥 Ashley Valentine, co-founder and president of , Washington, D.C.
Help For Millennials Peering Over Insurance Cliff
Your recent article reporting that millennials are struggling to enroll in health plans (鈥Challenges Abound For 26-Year-Olds Falling Off Parental Insurance Cliff,鈥 Dec. 8) profiled one young woman who found a plan after consulting a health insurance broker. More first-time enrollees should consider following her lead. Eighty-four percent of consumers who sought guidance from health insurance agents and brokers when shopping on the exchanges found them helpful 鈥 a higher satisfaction rating than any other source of assistance.
鈥 Janet Trautwein,聽CEO, National Association of Health Underwriters,聽Washington, D.C.
Weeding Through Facts On Marijuana聽
It鈥檚 interesting that the article 鈥Teaching Teens The Perils Of Pot As Marketplace Grows鈥 (Nov. 29) completely left out the federal study released in September 2017 showing that 鈥渋n 2016, rates of marijuana use among the nation鈥檚 12- to 17-year-olds in more than two decades, according to federal survey data released.鈥
鈥 Jason Barker, LECUA Patients Coalition of New Mexico, Albuquerque
You guys keep pushing reefer madness articles to NPR. You published an article about a teenager who was speculating that legal marijuana makes it harder to talk to teens about marijuana. Maybe instead of what some random kid thinks, look at the numbers that show usage .
And your article on cannabinoid hyperemesis syndrome (鈥Wrecked And Retching: Obscure Vomiting Illness Linked To Long-Term Pot Use,鈥 Jan. 2) is nothing more than a scare piece. What are you afraid of, ? This condition, which is stated in the article to be rare, goes away once the person ceases use. Get with the times. Your coverage is the same old only-negative drug war nonsense.
鈥 Chad Spratt, Austin, Texas