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Email has become an easy and essential form of communication between patients and physicians — so much so that doctors are deluged daily with messages from patients. Now, some hospitals and health systems have started charging for doctors’ responses to those messages, depending on the amount of work needed to respond. Only a handful of health systems have started billing for these, and those that do say only a tiny percentage of doctor messages cost anything. But advocates say they’re concerned these charges will wind up limiting an option meant to expand patient access to health care. “We already know that even a small dollar amount of cost-sharing results in patients utilizing service less,” said Caitlin Donovan, senior director of the Patient Advocate Foundation. “I worry about anything that’s going to stop patients from contacting and communicating with their providers.” A new study suggests Donovan’s concerns are well-founded. Patient e-messages to University of California, San Francisco (UCSF) doctors slightly declined immediately after UCSF Health started charging for some responses, according to research published recently in the Journal of the American Medical Association. “We started putting this language on our website, on our patient portal that said, as an FYI, there’s a potential that if your message meets the requirements to the clinical question, it may be billed,” said lead researcher A. Jay Holmgren, an assistant… read on > read on >

While you can’t trust everything you read or see on social media, some information is reliable. Researchers from Duke University studied popular videos on the social media site TikTok. The videos offered information on ways to obtain a medication abortion. These were typically informative and useful, the study authors said. “When we started the study, we expected to find more videos with misinformation,” said Dr. Jenny Wu, a resident in obstetrics and gynecology at Duke in Durham, N.C. “After looking at the data, we were surprised by how accurate the videos were. A significant number of videos were created by health care professionals and organizations providing abortion. TikTok says it has internal policies for blocking inaccurate information which might also have helped on this topic.” For the study, the Duke team evaluated the 100 most-viewed TikTok videos tagged #abortionpill, #medicalabortion and #medicationabortion. Those videos often describe the pills, what a medication abortion is and how to get that medication. About 89% of the videos that depicted public health information were mostly accurate, the study found. About 11% were mixed. Of 51 videos that presented scientific claims, about 86% were mostly accurate. About 14% were mixed. Social media platforms can help educate patients and combat the stigma surrounding abortion, according to the researchers. “It’s important that people in more restrictive states have the opportunity to learn… read on > read on >

U.S. health officials are investigating whether a specific brand of over-the-counter eyedrops are behind one death and dozens of bacterial infections in several states. The infections have not been traced to preservative-free EzriCare Artificial Tears, but a majority of people who became ill reported using the drops, the U.S. Centers for Disease Control and Prevention said in a statement. The agency found the bacteria in bottles of the eyedrops, and it’s now testing to see if the strain found in the eyedrop bottles matches that found in patients. CDC officials recommended that “patients immediately discontinue the use of EzriCare Artificial Tears until the epidemiological investigation and laboratory analyses are complete.” At least 50 people in 11 states have been infected with the bacterium Pseudomonas aeruginosa, which is resistant to most antibiotics. One of those infected died after the bacterium entered the patient’s bloodstream. “That’s what’s so concerning,” Dr. Jill Weatherhead, an assistant professor of tropical medicine and infectious diseases at the Baylor College of Medicine in Houston, told NBC News. “Our standard treatments are no longer available” to treat this infection. In 11 cases, people developed eye infections. Three were blinded in one eye. Some of those infected had respiratory or urinary tract infections. P. aeruginosa infections typically happen in hospital settings in people with weakened immune systems, though the bacteria can be found in… read on > read on >

Despite distance and occasional technical glitches, a new study finds that most patients like seeing a surgeon for the first time via video. The study was published Jan. 19 in the Journal of the American College of Surgeons. “We see patients that live hours away. When the COVID-19 pandemic hit, it threw fuel on the fire of our telehealth program,” said study co-author Dr. Alexander Hawkins, associate professor of surgery at Vanderbilt University Medical Center in Nashville, Tenn. “Across the entire health care system, we now do about 20,000 telehealth visits a month,” he said in a college news release. “Previously, there had been concerns about whether we could effectively communicate with patients remotely, but we found that patients are just as satisfied with telehealth visits as in-person appointments.” The study included 387 patients who participated in first-time visits between May 2021 and June 2022 at general surgery clinics across the Vanderbilt system. Researchers used a standard questionnaire to look at the quality of shared decision-making and asked patients and surgeons open-ended questions about their consultations. In all, 77.8% of patients had an in-person visit, while 22.2% saw their doctor remotely. Both groups reported high levels of quality communication during these appointments. Levels of shared decision-making and quality of communication were similar between remote visits and in-person care, the study found. In responding to the… read on > read on >

When people undergo surgery for broken arms or legs, they are often injected with prescription blood thinners to reduce their risk of developing potentially life-threatening blood clots in their lungs and legs. But a large, new study suggests it may be time to rethink this practice. It found that aspirin may be as effective as injections of low-molecular-weight heparin when it comes to staving off blood clots and their related complications. “Patients all over North America who come in for surgery for fractures are at risk for blood clots in their legs and lungs, and the standard treatment is injections of low-molecular-weight heparin in the hospital and for weeks after discharge,” said study author Dr. Robert O’Toole, chief of orthopaedics at the University of Maryland Medical Center’s R Adams Cowley Shock Trauma Center in Baltimore. “It’s a shot given twice a day, and patients hate it,” he said. These heparin shots also have a much heftier price tag than aspirin. The study included more than 12,000 patients with arm or leg fractures that required surgery or pelvic fractures regardless of treatment. They were treated at 21 trauma centers. Of these, half received injections of low-molecular-weight heparin twice a day, and half received low-dose baby aspirin twice daily. All participants were followed for 90 days to see how they fared. Outcomes were similar for both groups.… read on > read on >

While U.S. veterans are already eligible for emergency suicidal crisis care, starting Tuesday they can get it for free. Care available at any VA facility or any private facility will include up to 30 days of inpatient or crisis residential care, the Department of Veteran’s Affairs announced Friday. It will also include up to 90 days of follow-up outpatient care and ambulance rides to hospitals. The veterans will not need to be enrolled in the VA system. “Veterans in suicidal crisis can now receive the free, world-class emergency health care they deserve — no matter where they need it, when they need it or whether they’re enrolled in VA care,” VA Secretary Denis McDonough said in an agency news release. “This expansion of care will save veterans’ lives, and there’s nothing more important than that.” The change will affect more than 18 million veterans, about twice as many as are enrolled in VA medical care, NBC News reported. This change was required by the Veterans Comprehensive Prevention, Access to Care, and Treatment (COMPACT) Act of 2020. “I am thrilled by Secretary McDonough’s announcement,” Rep. Mark Takano, D-Calif., former chair and now ranking member of the House Committee on Veterans’ Affairs, told NBC News. “This new benefit removes cost from the equation when veterans are at imminent risk of self-harm and allows them to access lifesaving… read on > read on >

Military service members who conceal their suicidal thoughts are also more likely to store their guns unsafely, a new study reveals. “These findings highlight a real problem with our suicide prevention system,” said Michael Anestis, lead author of the study and executive director of the New Jersey Gun Violence Research Center at Rutgers University in New Jersey. “We know that firearms account for the large majority of suicide deaths within the military and that unsecured firearms at home dramatically increase the risk for suicide,” Anestis said in a Rutgers news release. “Here, we found that suicidal service members less likely to be seen as high risk — those that hide their thoughts from others and avoid behavioral health care — tend to be the service members with the most ready access to their firearms,” he added. For the study, the researchers surveyed more than 700 gun-owning service members. These included active-duty service members throughout all military branches and those in the National Guard and Reserves. The investigators focused on 180 service members who had experienced suicidal thoughts within the past year and another group of 85 service members who had experienced suicidal thoughts in the past month. Surveys asked whether they had ever told anyone about their suicidal thoughts, if they had attended any behavioral health sessions within the past three months and the specific… read on > read on >

A short but intensive approach to “talk therapy” can help many combat veterans overcome post-traumatic stress disorder (PTSD), a new clinical trial has found. The study tested “compressed” formats of a standard PTSD treatment called prolonged exposure therapy, in which patients learn to gradually face the trauma-related memories they normally avoid. Traditionally, that has meant therapy once a week, over the course of a few months. But while prolonged exposure therapy is often effective for PTSD, there is room for improvement, according to Alan Peterson, a professor of psychiatry at the University of Texas Health Science Center at San Antonio. In general, he said, prolonged exposure (PE) therapy does not work as well for combat veterans as it does for civilians with PTSD. In an earlier trial, Peterson and his colleagues found that about 60% of combat vets still met the criteria for PTSD six months after therapy. So for the new trial, his team tested the effects of two compressed PE formats, where vets attended therapy every weekday for three weeks. It’s a concept that some PTSD programs have been offering in recent years. The general idea, Peterson explained, is that the short time window will help more patients stick with therapy. And the intensity of daily sessions, with patients devoting their time and energy toward getting better, might also boost effectiveness, he suggested.… read on > read on >

Ransomware attacks on America’s health care systems have more than doubled in recent years, disrupting needed medical care and exposing the personal information of millions, a new study reports. These attacks — in which computer systems are locked down by hackers until the victim agrees to pay a ransom — hit all levels of health care, from your doctor’s or dentist’s office up to the largest hospitals and surgical centers, according to the new findings. The annual number of ransomware attacks against health care leapt to 91 reported cases in 2021 from 43 in 2016, the researchers found. These attacks exposed the personal health information of nearly 42 million patients, caused ambulances to be diverted in critical situations, and forced delays or cancellations of scheduled care. “It does seem like ransomware actors have recognized that health care is a sector that has a lot of money and they’re willing to pay up to try to resume health care delivery, so it seems to be an area that they’re targeting more and more,” said lead researcher Hannah Neprash, an assistant professor of health policy and management at the University of Minnesota School of Public Health. For this study, Neprash and her colleagues created a database that tracks health care ransomware events. The database combines information from federal regulators and a private cybersecurity threat intelligence company. “We… read on > read on >

Researchers studying dry eye disease in mice have found that the condition can alter how the cornea heals itself. They have also identified potential treatments. “We have drugs, but they only work well in about 10% to 15% of patients,” said senior researcher Dr. Rajendra Apte, a professor at Washington University School of Medicine in St. Louis. “In this study involving genes that are key to eye health, we identified potential targets for treatment that appear different in dry eyes than in healthy eyes.” Tens of millions of people around the world, including 15 million in the United States, have eye pain and blurred vision as a result of complications and injury associated with dry eye disease, Apte said in a university news release. “By targeting these proteins, we may be able to more successfully treat or even prevent those injuries,” he said. In dry eye disease, the eye can’t provide adequate lubrication with natural tears. Various types of drops can help replace those, but when the eyes are dry, the cornea is more susceptible to injury. The researchers found that proteins made by stem cells that regenerate the cornea may be new targets for treating and preventing such injuries. To study this, the investigators analyzed genes expressed by the cornea in several mouse models. They looked at dry eye disease, diabetes and other conditions.… read on > read on >