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He is the former editor of KQED’s daily news blog, News Fix. In 2014, he won a California Journalism Award for his coverage of ride services like Uber and Lyft and the taxi industry. A veteran blogger, he previously worked for Yahoo! in various news writing and editing roles. Jon is also a playwright whose work has been produced in San Francisco, New York, Italy, and around the U.S. He has written about film for his own blog and studied film at Boston University.","avatar":"https://secure.gravatar.com/avatar/98887f7ed1c876ed414d4c915e969584?s=600&d=blank&r=g","twitter":"jbrooksfoy","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["Contributor","editor"]},{"site":"news","roles":["author"]},{"site":"futureofyou","roles":["administrator"]},{"site":"mindshift","roles":["editor"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["administrator"]},{"site":"quest","roles":["editor"]}],"headData":{"title":"Jon Brooks | KQED","description":"Digital Editor","ogImgSrc":"https://secure.gravatar.com/avatar/98887f7ed1c876ed414d4c915e969584?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/98887f7ed1c876ed414d4c915e969584?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/jbrooks"},"adembosky":{"type":"authors","id":"3205","meta":{"index":"authors_1591205172","id":"3205","found":true},"name":"April Dembosky","firstName":"April","lastName":"Dembosky","slug":"adembosky","email":"adembosky@kqed.org","display_author_email":false,"staff_mastheads":["news","science"],"title":"KQED Health Correspondent","bio":"April Dembosky is the health correspondent for KQED News and a regular contributor to NPR. She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"},"cfeibel":{"type":"authors","id":"11314","meta":{"index":"authors_1591205172","id":"11314","found":true},"name":"Carrie Feibel","firstName":"Carrie","lastName":"Feibel","slug":"cfeibel","email":"cfeibel@KQED.org","display_author_email":false,"staff_mastheads":[],"title":"KQED Contributor","bio":"Carrie Feibel is a former health editor at KQED, where she has also reported for radio and online. Her stories have appeared on the national NPR shows \u003cem>Morning Edition\u003c/em>, \u003cem>All Things Considered\u003c/em>, and \u003cem>Here & Now\u003c/em>, and on the national website, Kaiser Health News. Her print career included stints at the \u003cem>Houston Chronicle\u003c/em>, \u003cem>The (Bergen) Record,\u003c/em> and the Associated Press in New York City. A native of St. Louis, Feibel attended Cornell University, and earned a master's in journalism from Columbia University.","avatar":"https://secure.gravatar.com/avatar/c64a7e3c9a910e1bffd4ad32a5264aa9?s=600&d=blank&r=g","twitter":"KQEDHealth","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"stateofhealth","roles":["administrator"]}],"headData":{"title":"Carrie Feibel | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/c64a7e3c9a910e1bffd4ad32a5264aa9?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/c64a7e3c9a910e1bffd4ad32a5264aa9?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/cfeibel"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_362540":{"type":"posts","id":"stateofhealth_362540","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"362540","score":null,"sort":[1517238007000]},"guestAuthors":[],"slug":"treating-domestic-violence-as-a-medical-problem","title":"Treating Domestic Violence As A Medical Problem","publishDate":1517238007,"format":"audio","headTitle":"Kaiser Health News | State of Health | KQED News","labelTerm":{"term":3007,"site":"stateofhealth"},"content":"\u003cp>Fanny Ortiz, a mother of five who lives just east of downtown Los Angeles, spent nearly a decade married to a man who controlled her and frequently threatened her. Then, she said, his abuse escalated.\u003c/p>\n\u003cp>“He would physically hit me in the face, throw me on the wall,” she recalled.\u003c/p>\n\u003cp>Ortiz, 43, eventually left the marriage, taking her children with her. A few years later, she learned that the East Los Angeles Women’s Center offered domestic violence services at Los Angeles County‐USC Medical Center near her home. Now she goes to the hospital campus for weekly therapy sessions, which she said have helped stop her suicidal thoughts.\u003c/p>\n\u003cp>“I was afraid to talk,” Ortiz said. “Now I am more open to talk about things that I was holding in.”\u003c/p>\n\u003cfigure id=\"attachment_362544\" class=\"wp-caption alignnone\" style=\"max-width: 540px\">\u003cimg class=\"size-full wp-image-362544\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1.jpg\" alt=\"\" width=\"540\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1.jpg 540w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1-520x390.jpg 520w\" sizes=\"(max-width: 540px) 100vw, 540px\">\u003cfigcaption class=\"wp-caption-text\">Fanny Ortiz (right), who left an abusive marriage after nearly a decade, meets weekly with therapist Brittany Martinez at the East Los Angeles Women’s Center. The office is located on the campus of the Los Angeles County-USC Medical Center. \u003ccite>(Anna Gorman/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nearly 1 in 4 women have experienced serious physical violence at the hands of a partner. They often end up in the emergency room or the doctor’s office. But they don’t typically volunteer the reason for their injuries, and doctors don’t always ask about abuse in the home. That failure of communication means the patients may miss out on the help they need.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Yet a growing number of health providers and anti‐abuse agencies in California and around the country are collaborating to identify victims and get them help. More doctors now screen their patients for signs of abuse and more agencies place victims’ advocates inside health centers. Education and counseling for people experiencing violence is also more widely available in clinics and hospitals.\u003c/p>\n\u003cp>About four years ago, the East Los Angeles Women’s Center opened offices on the campus of L.A. County‐USC, a busy public hospital. Since then, center staff members have trained more than 2,500 doctors, nurses, social workers and others to identify victims of domestic violence. They also respond quickly to calls from the medical center’s emergency room, inpatient hospital and outpatient facilities to help patients in crisis.\u003c/p>\n\u003cp>Today, the women’s center has embarked on an innovative approach: In February, it plans to open a short‐term shelter for abuse victims on the medical center grounds. The 10‐bed shelter fills a serious need, said Deirdre Anglin, an emergency room physician at L.A. County‐USC.\u003c/p>\n\u003cp>“We sometimes have patients in the emergency department who don’t have a place to go, and in the evenings and nights all the shelters in L.A. will be filled,” Anglin said.\u003c/p>\n\u003cp>Victims of abuse can suffer long‐term health problems, including chronic pain, frequent headaches, depression, diabetes and asthma. And they have higher health costs than people who have not experienced abuse. So “it makes complete sense to have the health care providers acting as allies and partners in treating domestic violence,” said Peter Long, CEO of the Blue Shield of California Foundation. (The foundation provides support for KHN coverage in California).\u003c/p>\n\u003cp>The foundation has funded 19 partnerships between health centers and domestic violence agencies around the state, including the L.A. County‐USC office of the East Los Angeles Women’s Center. Similar partnerships operate in Illinois, Maryland and other states.\u003c/p>\n\u003cp>Last year, the East Los Angeles Women’s Center served 600 victims of domestic violence at the L.A. County‐USC hospital campus. Nearly one‐third were homeless or couldn’t go back home for safety reasons.\u003c/p>\n\u003cp>Advocates say that hospitals and clinics are ideal settings to respond to the needs of abused women. In the San Gabriel Valley, the YWCA sponsors domestic violence support groups at a community clinic, while the clinic offers health education for survivors of abuse at the YWCA. In Sacramento, a Native American health center works closely with a domestic violence group a few blocks away.\u003c/p>\n\u003cp>Doctors have an “unprecedented opportunity to promote prevention and to respond because they are seeing patients that may not ever reach out to a domestic violence agency or police for help,” said Lisa James, director of health for Futures Without Violence, which runs a national resource center dedicated to improving the response of medical professionals to domestic violence. “They can provide this critical lifesaving intervention.”\u003c/p>\n\u003cp>The proximity of the East Los Angeles Women’s Center to the hospital and clinic buildings on the L.A. County‐USC campus makes it easier for doctors to ask their patients about violence, said Rebeca Melendez, director of programs for the center’s office at the medical center. The medical providers know where to turn for guidance – and that the help is nearby.\u003c/p>\n\u003cp>“They don’t need to know all the answers,” she said. “They just need to call us.”\u003c/p>\n\u003cp>This growing collaboration between the medical profession and anti‐abuse agencies is driven in part by the Affordable Care Act, which requires that health plans cover domestic violence screening and counseling.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force recommends doctors routinely question women about violence in the home and refer them to services if needed. The task force concluded in 2013 that intervention could reduce violence and abuse as well as mental and physical health problems.\u003c/p>\n\u003cp>Organizations such as the American Congress of Obstetricians and Gynecologists and the American Medical Association also recommend routine screening and counseling for domestic violence.\u003c/p>\n\u003cp>In the past, patients would go to health centers with such problems, but providers did not feel comfortable asking questions about abuse at home, said Long, of the Blue Shield of California Foundation.\u003c/p>\n\u003cp>“They didn’t feel they had the time and they didn’t feel they had the resources to do something about it,” he said. Nor did they always have a place to send patients who were abuse victims.\u003c/p>\n\u003cp>Treating patients who are in abusive relationships is “very challenging,” said Anglin, the ER physician. “There is no pill to give.”\u003c/p>\n\u003cp>But asking about violence needs to be part of a physician’s job, she said. “Part of what we need to do is try to identify patients who may be in a dangerous situation… so we are not just sending these patients back to the same situation they were in only to come back worse off another time.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Health care professionals increasingly collaborate with anti‐abuse advocates to identify victims and ensure they get the help they need. In Los Angeles, a women's shelter is opening right on the campus of a large public hospital. ","status":"publish","parent":0,"modified":1517427635,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":1155},"headData":{"title":"Treating Domestic Violence As A Medical Problem | KQED","description":"Health care professionals increasingly collaborate with anti‐abuse advocates to identify victims and ensure they get the help they need. In Los Angeles, a women's shelter is opening right on the campus of a large public hospital. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Treating Domestic Violence As A Medical Problem","datePublished":"2018-01-29T15:00:07.000Z","dateModified":"2018-01-31T19:40:35.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"362540 https://ww2.kqed.org/stateofhealth/?p=362540","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/01/29/treating-domestic-violence-as-a-medical-problem/","disqusTitle":"Treating Domestic Violence As A Medical Problem","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcr/2018/01/HospitalDomesticViolenceGorman180129.mp3","nprByline":"\u003cstrong>\u003ca href=\"https://khn.org/news/author/anna-gorman/\" rel=\"noopener\" target=\"_blank\">Anna Gorman\u003c/a>\u003c/strong>\u003c/br>Kaiser Health News","path":"/stateofhealth/362540/treating-domestic-violence-as-a-medical-problem","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Fanny Ortiz, a mother of five who lives just east of downtown Los Angeles, spent nearly a decade married to a man who controlled her and frequently threatened her. Then, she said, his abuse escalated.\u003c/p>\n\u003cp>“He would physically hit me in the face, throw me on the wall,” she recalled.\u003c/p>\n\u003cp>Ortiz, 43, eventually left the marriage, taking her children with her. A few years later, she learned that the East Los Angeles Women’s Center offered domestic violence services at Los Angeles County‐USC Medical Center near her home. Now she goes to the hospital campus for weekly therapy sessions, which she said have helped stop her suicidal thoughts.\u003c/p>\n\u003cp>“I was afraid to talk,” Ortiz said. “Now I am more open to talk about things that I was holding in.”\u003c/p>\n\u003cfigure id=\"attachment_362544\" class=\"wp-caption alignnone\" style=\"max-width: 540px\">\u003cimg class=\"size-full wp-image-362544\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1.jpg\" alt=\"\" width=\"540\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1.jpg 540w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2018/01/LA-Hospital-womens-shelter1-520x390.jpg 520w\" sizes=\"(max-width: 540px) 100vw, 540px\">\u003cfigcaption class=\"wp-caption-text\">Fanny Ortiz (right), who left an abusive marriage after nearly a decade, meets weekly with therapist Brittany Martinez at the East Los Angeles Women’s Center. The office is located on the campus of the Los Angeles County-USC Medical Center. \u003ccite>(Anna Gorman/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nearly 1 in 4 women have experienced serious physical violence at the hands of a partner. They often end up in the emergency room or the doctor’s office. But they don’t typically volunteer the reason for their injuries, and doctors don’t always ask about abuse in the home. That failure of communication means the patients may miss out on the help they need.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Yet a growing number of health providers and anti‐abuse agencies in California and around the country are collaborating to identify victims and get them help. More doctors now screen their patients for signs of abuse and more agencies place victims’ advocates inside health centers. Education and counseling for people experiencing violence is also more widely available in clinics and hospitals.\u003c/p>\n\u003cp>About four years ago, the East Los Angeles Women’s Center opened offices on the campus of L.A. County‐USC, a busy public hospital. Since then, center staff members have trained more than 2,500 doctors, nurses, social workers and others to identify victims of domestic violence. They also respond quickly to calls from the medical center’s emergency room, inpatient hospital and outpatient facilities to help patients in crisis.\u003c/p>\n\u003cp>Today, the women’s center has embarked on an innovative approach: In February, it plans to open a short‐term shelter for abuse victims on the medical center grounds. The 10‐bed shelter fills a serious need, said Deirdre Anglin, an emergency room physician at L.A. County‐USC.\u003c/p>\n\u003cp>“We sometimes have patients in the emergency department who don’t have a place to go, and in the evenings and nights all the shelters in L.A. will be filled,” Anglin said.\u003c/p>\n\u003cp>Victims of abuse can suffer long‐term health problems, including chronic pain, frequent headaches, depression, diabetes and asthma. And they have higher health costs than people who have not experienced abuse. So “it makes complete sense to have the health care providers acting as allies and partners in treating domestic violence,” said Peter Long, CEO of the Blue Shield of California Foundation. (The foundation provides support for KHN coverage in California).\u003c/p>\n\u003cp>The foundation has funded 19 partnerships between health centers and domestic violence agencies around the state, including the L.A. County‐USC office of the East Los Angeles Women’s Center. Similar partnerships operate in Illinois, Maryland and other states.\u003c/p>\n\u003cp>Last year, the East Los Angeles Women’s Center served 600 victims of domestic violence at the L.A. County‐USC hospital campus. Nearly one‐third were homeless or couldn’t go back home for safety reasons.\u003c/p>\n\u003cp>Advocates say that hospitals and clinics are ideal settings to respond to the needs of abused women. In the San Gabriel Valley, the YWCA sponsors domestic violence support groups at a community clinic, while the clinic offers health education for survivors of abuse at the YWCA. In Sacramento, a Native American health center works closely with a domestic violence group a few blocks away.\u003c/p>\n\u003cp>Doctors have an “unprecedented opportunity to promote prevention and to respond because they are seeing patients that may not ever reach out to a domestic violence agency or police for help,” said Lisa James, director of health for Futures Without Violence, which runs a national resource center dedicated to improving the response of medical professionals to domestic violence. “They can provide this critical lifesaving intervention.”\u003c/p>\n\u003cp>The proximity of the East Los Angeles Women’s Center to the hospital and clinic buildings on the L.A. County‐USC campus makes it easier for doctors to ask their patients about violence, said Rebeca Melendez, director of programs for the center’s office at the medical center. The medical providers know where to turn for guidance – and that the help is nearby.\u003c/p>\n\u003cp>“They don’t need to know all the answers,” she said. “They just need to call us.”\u003c/p>\n\u003cp>This growing collaboration between the medical profession and anti‐abuse agencies is driven in part by the Affordable Care Act, which requires that health plans cover domestic violence screening and counseling.\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force recommends doctors routinely question women about violence in the home and refer them to services if needed. The task force concluded in 2013 that intervention could reduce violence and abuse as well as mental and physical health problems.\u003c/p>\n\u003cp>Organizations such as the American Congress of Obstetricians and Gynecologists and the American Medical Association also recommend routine screening and counseling for domestic violence.\u003c/p>\n\u003cp>In the past, patients would go to health centers with such problems, but providers did not feel comfortable asking questions about abuse at home, said Long, of the Blue Shield of California Foundation.\u003c/p>\n\u003cp>“They didn’t feel they had the time and they didn’t feel they had the resources to do something about it,” he said. Nor did they always have a place to send patients who were abuse victims.\u003c/p>\n\u003cp>Treating patients who are in abusive relationships is “very challenging,” said Anglin, the ER physician. “There is no pill to give.”\u003c/p>\n\u003cp>But asking about violence needs to be part of a physician’s job, she said. “Part of what we need to do is try to identify patients who may be in a dangerous situation… so we are not just sending these patients back to the same situation they were in only to come back worse off another time.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/362540/treating-domestic-violence-as-a-medical-problem","authors":["byline_stateofhealth_362540"],"categories":["stateofhealth_11","stateofhealth_2407","stateofhealth_2746"],"tags":["stateofhealth_3214","stateofhealth_2808","stateofhealth_3215","stateofhealth_2519"],"affiliates":["stateofhealth_3007"],"featImg":"stateofhealth_362543","label":"stateofhealth_3007"},"stateofhealth_362041":{"type":"posts","id":"stateofhealth_362041","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"362041","score":null,"sort":[1511272853000]},"guestAuthors":[],"slug":"wrecked-and-retching-obscure-vomiting-illness-linked-to-long-term-pot-use","title":"Wrecked And Retching: Obscure Vomiting Illness Linked To Long-Term Pot Use","publishDate":1511272853,"format":"standard","headTitle":"California Healthline | State of Health | KQED News","labelTerm":{"term":3036,"site":"stateofhealth"},"content":"\u003cp>For 17 years, Chalfonte LeNee Queen suffered periodic episodes of violent retching and abdominal pain that would knock her off her feet for days, sometimes leaving her writhing on the floor in pain.\u003c/p>\n\u003cp>“I’ve screamed out for death,” said Queen, 48, who lives in San Diego. “I’ve cried out for my mom who’s been dead for 20 years, mentally not realizing she can’t come to me.”\u003c/p>\n\u003cp>Queen lost a modeling job after being mistaken for an alcoholic. She racked up tens of thousands of dollars in medical bills, and her nausea interrupted her sex life. Toward the end of her illness, Queen, who stands 5-foot-9, weighed in at a frail 109 pounds.\u003c/p>\n\u003cp>Throughout the nearly two decades of pain, vomiting and mental fog, she visited the hospital about three times a year, but doctors never got to the bottom of what was ailing her. By 2016, she thought she was dying, that she “must have some sort of cancer or something they can’t detect,” Queen said.\u003c/p>\n\u003cp>But she didn’t have cancer. She had an obscure syndrome called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576702/\">cannabinoid hyperemesis syndrome\u003c/a>, a condition only recently acknowledged by the medical community. It affects a small population — namely, a subset of marijuana users who smoke multiple times a day for months, years or even decades.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There’s no hard data on the prevalence of the illness. But in California and Colorado, which have loosened marijuana laws in recent years, emergency physicians say they’re seeing it more often. One \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469074/\">study\u003c/a> in Colorado suggests there may be a link.\u003c/p>\n\u003cp>Dr. Aimee Moulin, an emergency room physician at UC-Davis Medical Center in Sacramento, said she has seen a rise in the number of cases since California voters legalized recreational marijuana last November. She expects to see another increase after commercial sales are permitted starting in January.\u003c/p>\n\u003cp>Doctors say it’s difficult to treat the condition. There is no cure other than to quit using marijuana, and many patients are skeptical that cannabis is making them sick, so they keep using it and their vomiting episodes continue.\u003c/p>\n\u003cp>Doctors can do little to relieve the symptoms, since traditional anti-nausea medications often don’t work and there are no pills to prevent the onset of an episode. Patients may need intravenous hydration and hospital stays until the symptoms subside.\u003c/p>\n\u003cp>“That’s really frustrating as an emergency physician,” said Moulin. “I really like to make people feel better.”\u003c/p>\n\u003cp>Diagnosing the syndrome can also be frustrating — and expensive. There is no blood test to link the stomach ailment with marijuana use, so physicians often order pricey CT scans and lab tests to rule out other medical problems.\u003c/p>\n\u003cp>Cannabinoid hyperemesis syndrome was \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1774264/\">first documented in Australia\u003c/a> in 2004. Physicians have historically misdiagnosed it as the more generic \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/cyclic-vomiting-syndrome/symptoms-causes/syc-20352161\">cyclic vomiting syndrome\u003c/a>, which has no identifiable cause or, as in Queen’s case, \u003ca href=\"http://www.porphyriafoundation.com/about-porphyria/types-of-porphyria/AIP\">acute intermittent porphyria (AIP)\u003c/a>.\u003c/p>\n\u003cp>“Five years ago, this wasn’t something that [doctors] had on their radar,” said Dr. Kennon Heard, an emergency physician at the University of Colorado in Aurora, who co-authored the Colorado study showing a possible tie between the liberalization of marijuana and a surge of the vomiting illness. “We’re at least making the diagnosis more now.”\u003c/p>\n\u003cp>One surefire sign of the illness is when patients find relief in hot showers and baths. Queen said she would vomit repeatedly unless she was in a hot shower — so she’d stay in there for hours. Toxicologists say the heat may distract the brain from pain receptors in the abdomen but, like the syndrome itself, that phenomenon is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751385/\">not well understood\u003c/a>.\u003c/p>\n\u003cp>The exact cause of the condition is still a mystery. Toxicologists say the chemical compounds in marijuana may throw off the normal function of the body’s \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/18426493\">cannabinoid receptors\u003c/a>, which help regulate the nervous system.\u003c/p>\n\u003cp>Some people may be genetically predisposed to the syndrome, or marijuana’s potency or chemical makeup may have changed over time, said Dr. Craig Smollin, medical director of the San Francisco division of the California Poison Control System, who also works as an emergency physician at Zuckerberg San Francisco General Hospital.\u003c/p>\n\u003cp>The vomiting link to cannabis is counterintuitive to many, because of its widely known reputation as an anti-nausea remedy for cancer patients.\u003c/p>\n\u003cp>“A lot of times, people just don’t believe you,” said Dr. John Coburn, an emergency physician at Kaiser Permanente in south Sacramento. Even after being told that quitting may help, some patients will visit the hospital multiple times before they stop smoking marijuana, Coburn said. “I can’t really tell you why. I mean, why do people ride motorcycles without helmets on?”\u003c/p>\n\u003cp>Cameron Nicole Beard, 19, of East Moline, Ill., said she struggled to believe her doctors about the link between pot and severe vomiting.\u003c/p>\n\u003cp>“Who wants to be told you can’t smoke marijuana, when you think marijuana can help?” said Beard, while recovering from a marijuana-related vomiting episode at a University of Iowa hospital in Iowa City, Iowa, last month. She said she had lost 20 pounds in 10 days.\u003c/p>\n\u003cp>Although there’s still no magic cure for a patient’s marijuana-related hyperemesis, Moulin and other doctors say \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28370228\">they’re getting better at treating\u003c/a> the symptoms, using old anti-psychotic medications and cream for muscle aches.\u003c/p>\n\u003cp>Dr. Heard said the cases in Colorado seem to have leveled off. But without hard data, and because the overall numbers are small, it’s hard to say for sure. Heard said he doesn’t believe cases of the pot syndrome increased after recreational use was legalized in 2012, because chronic users probably already had medical marijuana cards.\u003c/p>\n\u003cp>Chalfonte LeNee Queen is still struggling to completely quit marijuana, but her symptoms are down to a dull stomachache. She now smokes a couple of times a day, compared with her near-constant use in the past. She said it’s the only thing that works for her depression and anxiety.\u003c/p>\n\u003cp>Queen is back to a healthy weight and hasn’t been to the hospital in a year. She said she wouldn’t want to discourage anybody from smoking weed; she just wants people to know heavy use can bring them some serious misery.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Now, if I get sick, as sad as I’ll be and as upset and disappointed with myself as I would be, at least it’s a freaking choice,” she said.\u003c/p>\n\n","blocks":[],"excerpt":"Doctors have only recently begun to acknowledge cannabinoid hyperemesis, an obscure syndrome that can strike heavy pot smokers. ","status":"publish","parent":0,"modified":1511894202,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1127},"headData":{"title":"Wrecked And Retching: Obscure Vomiting Illness Linked To Long-Term Pot Use | KQED","description":"Doctors have only recently begun to acknowledge cannabinoid hyperemesis, an obscure syndrome that can strike heavy pot smokers. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Wrecked And Retching: Obscure Vomiting Illness Linked To Long-Term Pot Use","datePublished":"2017-11-21T14:00:53.000Z","dateModified":"2017-11-28T18:36:42.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"362041 https://ww2.kqed.org/stateofhealth/?p=362041","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/11/21/wrecked-and-retching-obscure-vomiting-illness-linked-to-long-term-pot-use/","disqusTitle":"Wrecked And Retching: Obscure Vomiting Illness Linked To Long-Term Pot Use","nprByline":"\u003cstrong>Pauline Bartolone\u003c/strong>, California Healthline","path":"/stateofhealth/362041/wrecked-and-retching-obscure-vomiting-illness-linked-to-long-term-pot-use","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>For 17 years, Chalfonte LeNee Queen suffered periodic episodes of violent retching and abdominal pain that would knock her off her feet for days, sometimes leaving her writhing on the floor in pain.\u003c/p>\n\u003cp>“I’ve screamed out for death,” said Queen, 48, who lives in San Diego. “I’ve cried out for my mom who’s been dead for 20 years, mentally not realizing she can’t come to me.”\u003c/p>\n\u003cp>Queen lost a modeling job after being mistaken for an alcoholic. She racked up tens of thousands of dollars in medical bills, and her nausea interrupted her sex life. Toward the end of her illness, Queen, who stands 5-foot-9, weighed in at a frail 109 pounds.\u003c/p>\n\u003cp>Throughout the nearly two decades of pain, vomiting and mental fog, she visited the hospital about three times a year, but doctors never got to the bottom of what was ailing her. By 2016, she thought she was dying, that she “must have some sort of cancer or something they can’t detect,” Queen said.\u003c/p>\n\u003cp>But she didn’t have cancer. She had an obscure syndrome called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576702/\">cannabinoid hyperemesis syndrome\u003c/a>, a condition only recently acknowledged by the medical community. It affects a small population — namely, a subset of marijuana users who smoke multiple times a day for months, years or even decades.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There’s no hard data on the prevalence of the illness. But in California and Colorado, which have loosened marijuana laws in recent years, emergency physicians say they’re seeing it more often. One \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469074/\">study\u003c/a> in Colorado suggests there may be a link.\u003c/p>\n\u003cp>Dr. Aimee Moulin, an emergency room physician at UC-Davis Medical Center in Sacramento, said she has seen a rise in the number of cases since California voters legalized recreational marijuana last November. She expects to see another increase after commercial sales are permitted starting in January.\u003c/p>\n\u003cp>Doctors say it’s difficult to treat the condition. There is no cure other than to quit using marijuana, and many patients are skeptical that cannabis is making them sick, so they keep using it and their vomiting episodes continue.\u003c/p>\n\u003cp>Doctors can do little to relieve the symptoms, since traditional anti-nausea medications often don’t work and there are no pills to prevent the onset of an episode. Patients may need intravenous hydration and hospital stays until the symptoms subside.\u003c/p>\n\u003cp>“That’s really frustrating as an emergency physician,” said Moulin. “I really like to make people feel better.”\u003c/p>\n\u003cp>Diagnosing the syndrome can also be frustrating — and expensive. There is no blood test to link the stomach ailment with marijuana use, so physicians often order pricey CT scans and lab tests to rule out other medical problems.\u003c/p>\n\u003cp>Cannabinoid hyperemesis syndrome was \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1774264/\">first documented in Australia\u003c/a> in 2004. Physicians have historically misdiagnosed it as the more generic \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/cyclic-vomiting-syndrome/symptoms-causes/syc-20352161\">cyclic vomiting syndrome\u003c/a>, which has no identifiable cause or, as in Queen’s case, \u003ca href=\"http://www.porphyriafoundation.com/about-porphyria/types-of-porphyria/AIP\">acute intermittent porphyria (AIP)\u003c/a>.\u003c/p>\n\u003cp>“Five years ago, this wasn’t something that [doctors] had on their radar,” said Dr. Kennon Heard, an emergency physician at the University of Colorado in Aurora, who co-authored the Colorado study showing a possible tie between the liberalization of marijuana and a surge of the vomiting illness. “We’re at least making the diagnosis more now.”\u003c/p>\n\u003cp>One surefire sign of the illness is when patients find relief in hot showers and baths. Queen said she would vomit repeatedly unless she was in a hot shower — so she’d stay in there for hours. Toxicologists say the heat may distract the brain from pain receptors in the abdomen but, like the syndrome itself, that phenomenon is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751385/\">not well understood\u003c/a>.\u003c/p>\n\u003cp>The exact cause of the condition is still a mystery. Toxicologists say the chemical compounds in marijuana may throw off the normal function of the body’s \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/18426493\">cannabinoid receptors\u003c/a>, which help regulate the nervous system.\u003c/p>\n\u003cp>Some people may be genetically predisposed to the syndrome, or marijuana’s potency or chemical makeup may have changed over time, said Dr. Craig Smollin, medical director of the San Francisco division of the California Poison Control System, who also works as an emergency physician at Zuckerberg San Francisco General Hospital.\u003c/p>\n\u003cp>The vomiting link to cannabis is counterintuitive to many, because of its widely known reputation as an anti-nausea remedy for cancer patients.\u003c/p>\n\u003cp>“A lot of times, people just don’t believe you,” said Dr. John Coburn, an emergency physician at Kaiser Permanente in south Sacramento. Even after being told that quitting may help, some patients will visit the hospital multiple times before they stop smoking marijuana, Coburn said. “I can’t really tell you why. I mean, why do people ride motorcycles without helmets on?”\u003c/p>\n\u003cp>Cameron Nicole Beard, 19, of East Moline, Ill., said she struggled to believe her doctors about the link between pot and severe vomiting.\u003c/p>\n\u003cp>“Who wants to be told you can’t smoke marijuana, when you think marijuana can help?” said Beard, while recovering from a marijuana-related vomiting episode at a University of Iowa hospital in Iowa City, Iowa, last month. She said she had lost 20 pounds in 10 days.\u003c/p>\n\u003cp>Although there’s still no magic cure for a patient’s marijuana-related hyperemesis, Moulin and other doctors say \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28370228\">they’re getting better at treating\u003c/a> the symptoms, using old anti-psychotic medications and cream for muscle aches.\u003c/p>\n\u003cp>Dr. Heard said the cases in Colorado seem to have leveled off. But without hard data, and because the overall numbers are small, it’s hard to say for sure. Heard said he doesn’t believe cases of the pot syndrome increased after recreational use was legalized in 2012, because chronic users probably already had medical marijuana cards.\u003c/p>\n\u003cp>Chalfonte LeNee Queen is still struggling to completely quit marijuana, but her symptoms are down to a dull stomachache. She now smokes a couple of times a day, compared with her near-constant use in the past. She said it’s the only thing that works for her depression and anxiety.\u003c/p>\n\u003cp>Queen is back to a healthy weight and hasn’t been to the hospital in a year. She said she wouldn’t want to discourage anybody from smoking weed; she just wants people to know heavy use can bring them some serious misery.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Now, if I get sick, as sad as I’ll be and as upset and disappointed with myself as I would be, at least it’s a freaking choice,” she said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/362041/wrecked-and-retching-obscure-vomiting-illness-linked-to-long-term-pot-use","authors":["byline_stateofhealth_362041"],"categories":["stateofhealth_2407","stateofhealth_12","stateofhealth_2746","stateofhealth_1"],"tags":["stateofhealth_3202","stateofhealth_3186","stateofhealth_2808","stateofhealth_2622","stateofhealth_2519","stateofhealth_3185","stateofhealth_3203"],"affiliates":["stateofhealth_3036"],"featImg":"stateofhealth_362042","label":"stateofhealth_3036"},"stateofhealth_358760":{"type":"posts","id":"stateofhealth_358760","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"358760","score":null,"sort":[1501119386000]},"guestAuthors":[],"slug":"yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals","title":"Yelp Wants to Help You With Your Birth Plan","publishDate":1501119386,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>You may check Yelp reviews before deciding where to go to dinner, or which plumber to hire. Now you can use Yelp to decide where to have a baby.\u003c/p>\n\u003cp>The San Francisco-based review site is now adding clinical data on C-sections, episiotomies, and breastfeeding rates to consumer reviews of California hospitals, so women can make more informed decisions about where they deliver.\u003c/p>\n\u003cp>“Just like they're using that kind of information to buy a car, they should be using it to think about where they're getting their health care,” says \u003ca href=\"http://www.chcf.org/about/staff/stephanie-teleki\" target=\"_blank\" rel=\"noopener noreferrer\">Stephanie Teleki\u003c/a>, director of evaluation and impact at the California Health Care Foundation.\u003c/p>\n\u003cp>A woman’s chance of having a C-section depends, in part, on where she delivers, Teleki explains. The more C-sections a hospital does, the more likely a woman delivering there will have one.\u003c/p>\n\u003cp>That’s why the Foundation is partnering with Yelp to publish C-section rates for every hospital in the state - nearly 250 total.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/tcr/2017/07/2017-07-27d-tcr.mp3\" Image=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/08/RS19268_IMG_6407-qut-768x576.jpg\" Title=\"Yelp Adds C-Section Rates and Childbirth Data to Reviews of California Hospitals\" program=\"The California Report\"]\u003c/p>\n\u003cp>Shannon Eis, vice president of communications at Yelp, says this would have been helpful information to have when she gave birth to her son in New York. It was her second baby, everything felt normal, when all of a sudden alarms started going off and she was rushed into an emergency C-section.\u003c/p>\n\u003cp>“I had never considered myself a C-section risk,” she says. \"I later found out I gave birth at a hospital that has the highest emergency C-section rate in all of New York City.”\u003c/p>\n\u003cp>Eis says putting this data on Yelp will help women choose a hospital that is aligned with their birth plan, so they won’t have to negotiate with doctors and make tough choices while they’re in labor.\u003c/p>\n\u003cp>“All these decisions are washing over you so fast, and so if you haven't done the research to put yourself in the right environment, where whatever your decisions are can be honored without the tremendous pressure and fear – women are trying to do more planning around that,” she says.\u003c/p>\n\u003cp>The reaction from the state's hospital industry group was low-key.\u003c/p>\n\u003cp>“We have always supported transparency - this effort simply takes it more directly to consumers,” says Jan Emerson-Shea, from the California Hospital Association. “We'll have to see how it works.”\u003c/p>\n\u003cp>When the data first went public on government and foundation websites a few years ago, hospitals generally responded by trying to improve care for women, Teleki says. But she’s curious to see how hospitals will respond when those statistics are put right in front of consumers, through the online megaphone of Yelp.\u003c/p>\n\u003cp>“For hospitals that are doing well, that’s a good thing,” she says. “For hospitals that need to improve, I'm sure they will feel some heat and perhaps be discouraged about the release.”\u003c/p>\n\u003cp>California is the first state where Yelp is rolling out this data. With one in eight babies born in the US born here, Eis says it’s the perfect place to test the product before rolling it out to other states.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If the state of California can do this with the biggest data set in the country, the biggest birthrate in the country, any other state can do it,” she said.\u003c/p>\n\n","blocks":[],"excerpt":"Now pregnant women can review C-section and episiotomy rates before deciding where to have their baby.","status":"publish","parent":0,"modified":1501202295,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":622},"headData":{"title":"Yelp Wants to Help You With Your Birth Plan | KQED","description":"Now pregnant women can review C-section and episiotomy rates before deciding where to have their baby.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Yelp Wants to Help You With Your Birth Plan","datePublished":"2017-07-27T01:36:26.000Z","dateModified":"2017-07-28T00:38:15.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"358760 https://ww2.kqed.org/stateofhealth/?p=358760","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/07/26/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals/","disqusTitle":"Yelp Wants to Help You With Your Birth Plan","path":"/stateofhealth/358760/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>You may check Yelp reviews before deciding where to go to dinner, or which plumber to hire. Now you can use Yelp to decide where to have a baby.\u003c/p>\n\u003cp>The San Francisco-based review site is now adding clinical data on C-sections, episiotomies, and breastfeeding rates to consumer reviews of California hospitals, so women can make more informed decisions about where they deliver.\u003c/p>\n\u003cp>“Just like they're using that kind of information to buy a car, they should be using it to think about where they're getting their health care,” says \u003ca href=\"http://www.chcf.org/about/staff/stephanie-teleki\" target=\"_blank\" rel=\"noopener noreferrer\">Stephanie Teleki\u003c/a>, director of evaluation and impact at the California Health Care Foundation.\u003c/p>\n\u003cp>A woman’s chance of having a C-section depends, in part, on where she delivers, Teleki explains. The more C-sections a hospital does, the more likely a woman delivering there will have one.\u003c/p>\n\u003cp>That’s why the Foundation is partnering with Yelp to publish C-section rates for every hospital in the state - nearly 250 total.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"audio","attributes":{"named":{"src":"http://www.kqed.org/.stream/anon/radio/tcr/2017/07/2017-07-27d-tcr.mp3","image":"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/08/RS19268_IMG_6407-qut-768x576.jpg","title":"Yelp Adds C-Section Rates and Childbirth Data to Reviews of California Hospitals","program":"The California Report","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Shannon Eis, vice president of communications at Yelp, says this would have been helpful information to have when she gave birth to her son in New York. It was her second baby, everything felt normal, when all of a sudden alarms started going off and she was rushed into an emergency C-section.\u003c/p>\n\u003cp>“I had never considered myself a C-section risk,” she says. \"I later found out I gave birth at a hospital that has the highest emergency C-section rate in all of New York City.”\u003c/p>\n\u003cp>Eis says putting this data on Yelp will help women choose a hospital that is aligned with their birth plan, so they won’t have to negotiate with doctors and make tough choices while they’re in labor.\u003c/p>\n\u003cp>“All these decisions are washing over you so fast, and so if you haven't done the research to put yourself in the right environment, where whatever your decisions are can be honored without the tremendous pressure and fear – women are trying to do more planning around that,” she says.\u003c/p>\n\u003cp>The reaction from the state's hospital industry group was low-key.\u003c/p>\n\u003cp>“We have always supported transparency - this effort simply takes it more directly to consumers,” says Jan Emerson-Shea, from the California Hospital Association. “We'll have to see how it works.”\u003c/p>\n\u003cp>When the data first went public on government and foundation websites a few years ago, hospitals generally responded by trying to improve care for women, Teleki says. But she’s curious to see how hospitals will respond when those statistics are put right in front of consumers, through the online megaphone of Yelp.\u003c/p>\n\u003cp>“For hospitals that are doing well, that’s a good thing,” she says. “For hospitals that need to improve, I'm sure they will feel some heat and perhaps be discouraged about the release.”\u003c/p>\n\u003cp>California is the first state where Yelp is rolling out this data. With one in eight babies born in the US born here, Eis says it’s the perfect place to test the product before rolling it out to other states.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If the state of California can do this with the biggest data set in the country, the biggest birthrate in the country, any other state can do it,” she said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/358760/yelp-adds-c-section-rates-and-childbirth-data-to-reviews-of-california-hospitals","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_2407","stateofhealth_2746"],"tags":["stateofhealth_3138","stateofhealth_2808","stateofhealth_3137","stateofhealth_2519","stateofhealth_2563"],"featImg":"stateofhealth_359030","label":"stateofhealth"},"stateofhealth_323172":{"type":"posts","id":"stateofhealth_323172","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"323172","score":null,"sort":[1493330860000]},"guestAuthors":[],"slug":"network-of-scientists-works-to-help-patients-with-undiagnosed-diseases","title":"Network of Scientists Works to Help Patients With Undiagnosed Diseases","publishDate":1493330860,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>WHITTIER, Calif. -- Lynn Whittaker stood in the hallway of her home looking at the framed photos on the wall. In one, her son Andrew is playing high school water polo. In another, he’s holding a trombone.\u003cbr>\nThe images show no hint of his life today: the seizures that leave him temporarily paralyzed, the weakness that makes him fall over, his labored speech, his scrambled thoughts.\u003c/p>\n\u003cp>Andrew, 28, can no longer feed himself or walk on his own. The past nine years have been a blur of doctor appointments, hospital visits and medical tests that have failed to produce answers.\u003c/p>\n\u003cp>“You name it, he doesn’t have it,” his mother said. \u003c/p>\n\u003cp>Andrew has never had a clear diagnosis. He and his family are in a torturous state of suspense, hanging their hopes on every new exam and evaluation. \u003c/p>\n\u003cp>Recently, they have sought help from the Undiagnosed Diseases Network, a federally funded coalition of universities, clinicians, hospitals and researchers dedicated to solving the nation’s toughest medical mysteries. The doctors and scientists in the network harness advances in genetic science to identify rare, sometimes unknown, illnesses.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/319736138\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>At UCLA, one of the network’s sites, Andrew’s medical team would map his genetic makeup, then bring him in for a week of exams and consultations with specialists.\u003c/p>\n\u003cp>\u003cstrong>Writing A New Disease Encyclopedia\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The Undiagnosed Diseases Network was founded in 2015 with a $43 million grant from the National Institutes of Health (NIH). Building on work already being done at NIH, the initiative expanded to include universities across the country: Duke, Columbia and Stanford are among the other sites. The goals are to provide answers for patients with mysterious diseases and to learn more about the disorders.\u003cbr>\nA proposal last month by President Donald Trump to cut the NIH budget by $5.8 billion could put the program in jeopardy.\u003c/p>\n\u003cp>Even with the best technology and the finest brains at work, progress is slow. Since its launch, the network has received nearly 1,400 applications on behalf of patients. It has accepted 545 for review so far. Just 74 of the cases have been diagnosed, including 11 at UCLA. Andrew Whittaker’s case is among many in progress.\u003c/p>\n\u003cp>It’s like battling “an unknown enemy,” said Euan Ashley, one of the principal investigators of the network’s Stanford University site. “That is a particular form of torment that other patients don’t have.” \u003c/p>\n\u003cp>A diagnosis can end families’ painful odyssey while helping physicians and scientists better understand rare diseases and human physiology, said Rachel Ramoni, former executive director of the network, which is based at Harvard University. \u003c/p>\n\u003cp>Researchers throughout the network use advanced medical technology. For example, to study patients’ gene expression and disease progression, they can make models using nearly transparent zebrafish, whose genetic structure is similar to that of humans. And scientists can conduct whole genome sequencing, which allows the medical team to read a patient’s DNA and identify changes that can reveal what may be causing a disease.\u003c/p>\n\u003cp>“We have powerful techniques to look at every gene that is being expressed as well as every gene that is inherited,” said Stanley Nelson, one of UCLA’s principal investigators and the lead doctor on Andrew’s case. “This is an example of true precision medicine.” \u003c/p>\n\u003cp>Nelson said the network can examine all known genes -- not just the ones believed to have mutations that cause diseases. Doing that can lead to the discovery of new illnesses.\u003c/p>\n\u003cp>“Part of what we have to do is keep building that library, that encyclopedia of what gene and what gene mutations cause what symptoms,” Nelson said. “It’s just incomplete at this moment.” \u003c/p>\n\u003cp>Already the work is helping patients and their families come to terms with their illnesses. In one case, at Stanford, a toddler was diagnosed with two rare diseases, including a connective tissue disorder called Marfan Syndrome, after doctors conducted a form of sequencing that looks for changes in coded genetic segments known as exons. \u003c/p>\n\u003cp>Sometimes answers come from something decidedly lower-tech: collaboration among clinicians and researchers who share experiences, data and expertise.\u003c/p>\n\u003cp>“A lot of times your ability to be diagnosed depends on who is in the room,” Ramoni said. “And what we are doing with the network is we are expanding exponentially the number of people in the room.”\u003cbr>\nDoctors at one institution might think their patient is a unique case, only to learn that colleagues elsewhere have a patient with a similar illness. But even when diseases are diagnosed or gene mutations are discovered, treatments may still not be available. \u003c/p>\n\u003cp>\u003cstrong>A Life-Changing Mystery\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Andrew Whittaker’s odyssey began one afternoon at age 19, when he started trembling and couldn’t speak. Doctors suspected he was suffering from anxiety and prescribed medication to control it. But Andrew said he continued to have “episodes,” during which everything just went blank.\u003c/p>\n\u003cp>“It’s like there’s not enough blood going to your brain,” he said. “You can’t think.” \u003c/p>\n\u003cp>Andrew also started losing his balance and falling off his bicycle. The family visited several hospitals. Doctors discovered that the receptors in his brain were malfunctioning and that he lacked sufficient dopamine, a chemical compound in the body responsible for transmitting signals between nerve cells. As a result, Andrew has some symptoms similar to those of Parkinson’s disease. Doctors also confirmed he was having seizures. \u003c/p>\n\u003cp>Still, Andrew’s symptoms didn’t add up to any known disease.\u003c/p>\n\u003cp>One afternoon last fall at precisely noon, as Andrew sat propped up on the living room couch, Lynn’s phone alarm sounded, signaling it was time for his medication. Lynn pried open Andrew’s hand, which was clenched into a fist, and dropped in the pills. \u003c/p>\n\u003cp>To keep Andrew from falling, the family has lowered his bed and removed carpet from the house. They also bought him a wheelchair. Their precautions don’t always work. One morning, Lynn was in the kitchen when she heard a crash. “I ran in there and he’s laid flat on his back,” she said. \u003c/p>\n\u003cp>Andrew is close to his mom. But he also gets frustrated. He can’t shower or dress without her help. He’s had to give up the things he loved to do: printing T-shirts. Skateboarding. Shooting short films. He’s lost friends and can’t imagine dating anymore.\u003c/p>\n\u003cp>“Girlfriends? Forget about it,” he said, his face twitching as he talks. “They want a guy who can do stuff for them, not the other way around.” \u003c/p>\n\u003cp>\u003cstrong>Running The Medical Gauntlet\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>On a Monday morning in late January, Andrew and his parents were in an exam room at UCLA. Lynn teased her son, saying she was going to put him in a freezer until doctors figured out what was wrong.\u003cbr>\n“Then we’ll pull you back out again,” she said, smiling.\u003c/p>\n\u003cp>“I’ll never get pulled out,” Andrew responded. \u003c/p>\n\u003cp>“Yes, you will,” she said. “You will.”\u003c/p>\n\u003cp>Nelson, Andrew’s main doctor, walked into the room. He told Andrew he’d read through the medical records. “We’re going to try to figure you out.” \u003c/p>\n\u003cp>The work Nelson does is personal. His teenage son, Dylan, has Duchenne muscular dystrophy, a genetic disorder that causes muscle degeneration and weakness. Nelson knows his son’s disease will eventually take his life, but he said having a diagnosis makes all the difference. \u003c/p>\n\u003cp>“My heart very much goes out to the families that don’t even get an adequate diagnosis,” he said.\u003cbr>\nNelson suspects that Andrew’s disease is genetic as well. \u003c/p>\n\u003cp>He asked the Whittakers to describe their son’s journey and he conducted a short physical exam, asking Andrew to push against his hand and touch his own nose. Andrew trembled and his shoulders tensed, but he did it.\u003c/p>\n\u003cp>The rest of the week, Andrew underwent several other diagnostic tests, including a muscle biopsy, an EEG, MRI and a lumbar puncture. He remained upbeat, though running the medical gauntlet clearly wore him out. He also met with UCLA specialists in brain degeneration and muscle and nerve disorders. \u003c/p>\n\u003cp>At week’s end, Nelson sat down with the family to explain what he’d found. He had reviewed Andrew’s genome and compared it with that of both parents. Andrew had one copy of a defective gene that leads to Parkinson’s but the genome sequencing didn’t show a second copy, without which it could not be Parkinson’s.\u003c/p>\n\u003cp>He also explained that Andrew’s illness was clearly progressive and that his brain was shrinking, making it harder for him to process language and information. Nelson said he still didn’t have a diagnosis -- he believed it was a brand-new disease. \u003c/p>\n\u003cp>Nelson planned to continue poring over the test results, conducting additional exams and communicating with others in the network. He also is analyzing Andrew’s muscle, skin and blood to see whether any mutated gene is expressed abnormally. \u003c/p>\n\u003cp>Even in the absence of a clear diagnosis, Nelson said, rare diseases like Andrew’s help educate scientists and may help other patients. “These are the people we as a society will owe a great debt of gratitude,” he said. “They are effectively donating their lives to this process.” \u003c/p>\n\u003cp>Lynn Whittaker was disappointed. “We are still left with just hope that they will come up with something,” she lamented. “What else do we have?” \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Andrew said his relatives have asked if he’s scared the doctors will find something. “I’m more scared if they don’t,” he replied.\u003c/p>\n\n","blocks":[],"excerpt":"An NIH-funded network of hospitals uses advanced genetic science and nationwide collaboration to diagnose rare and sometimes undiscovered diseases.\r\n","status":"publish","parent":0,"modified":1493654325,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":45,"wordCount":1722},"headData":{"title":"Network of Scientists Works to Help Patients With Undiagnosed Diseases | KQED","description":"An NIH-funded network of hospitals uses advanced genetic science and nationwide collaboration to diagnose rare and sometimes undiscovered diseases.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Network of Scientists Works to Help Patients With Undiagnosed Diseases","datePublished":"2017-04-27T22:07:40.000Z","dateModified":"2017-05-01T15:58:45.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"323172 https://ww2.kqed.org/stateofhealth/?p=323172","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/04/27/network-of-scientists-works-to-help-patients-with-undiagnosed-diseases/","disqusTitle":"Network of Scientists Works to Help Patients With Undiagnosed Diseases","nprByline":"\u003cstrong>\u003ca href=\"http://khn.org/news/author/anna-gorman/\"_blank\">Anna Gorman \u003c/strong>\u003c/a>\u003c/br>Kaiser Health News","path":"/stateofhealth/323172/network-of-scientists-works-to-help-patients-with-undiagnosed-diseases","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>WHITTIER, Calif. -- Lynn Whittaker stood in the hallway of her home looking at the framed photos on the wall. In one, her son Andrew is playing high school water polo. In another, he’s holding a trombone.\u003cbr>\nThe images show no hint of his life today: the seizures that leave him temporarily paralyzed, the weakness that makes him fall over, his labored speech, his scrambled thoughts.\u003c/p>\n\u003cp>Andrew, 28, can no longer feed himself or walk on his own. The past nine years have been a blur of doctor appointments, hospital visits and medical tests that have failed to produce answers.\u003c/p>\n\u003cp>“You name it, he doesn’t have it,” his mother said. \u003c/p>\n\u003cp>Andrew has never had a clear diagnosis. He and his family are in a torturous state of suspense, hanging their hopes on every new exam and evaluation. \u003c/p>\n\u003cp>Recently, they have sought help from the Undiagnosed Diseases Network, a federally funded coalition of universities, clinicians, hospitals and researchers dedicated to solving the nation’s toughest medical mysteries. The doctors and scientists in the network harness advances in genetic science to identify rare, sometimes unknown, illnesses.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/319736138&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/319736138'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At UCLA, one of the network’s sites, Andrew’s medical team would map his genetic makeup, then bring him in for a week of exams and consultations with specialists.\u003c/p>\n\u003cp>\u003cstrong>Writing A New Disease Encyclopedia\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The Undiagnosed Diseases Network was founded in 2015 with a $43 million grant from the National Institutes of Health (NIH). Building on work already being done at NIH, the initiative expanded to include universities across the country: Duke, Columbia and Stanford are among the other sites. The goals are to provide answers for patients with mysterious diseases and to learn more about the disorders.\u003cbr>\nA proposal last month by President Donald Trump to cut the NIH budget by $5.8 billion could put the program in jeopardy.\u003c/p>\n\u003cp>Even with the best technology and the finest brains at work, progress is slow. Since its launch, the network has received nearly 1,400 applications on behalf of patients. It has accepted 545 for review so far. Just 74 of the cases have been diagnosed, including 11 at UCLA. Andrew Whittaker’s case is among many in progress.\u003c/p>\n\u003cp>It’s like battling “an unknown enemy,” said Euan Ashley, one of the principal investigators of the network’s Stanford University site. “That is a particular form of torment that other patients don’t have.” \u003c/p>\n\u003cp>A diagnosis can end families’ painful odyssey while helping physicians and scientists better understand rare diseases and human physiology, said Rachel Ramoni, former executive director of the network, which is based at Harvard University. \u003c/p>\n\u003cp>Researchers throughout the network use advanced medical technology. For example, to study patients’ gene expression and disease progression, they can make models using nearly transparent zebrafish, whose genetic structure is similar to that of humans. And scientists can conduct whole genome sequencing, which allows the medical team to read a patient’s DNA and identify changes that can reveal what may be causing a disease.\u003c/p>\n\u003cp>“We have powerful techniques to look at every gene that is being expressed as well as every gene that is inherited,” said Stanley Nelson, one of UCLA’s principal investigators and the lead doctor on Andrew’s case. “This is an example of true precision medicine.” \u003c/p>\n\u003cp>Nelson said the network can examine all known genes -- not just the ones believed to have mutations that cause diseases. Doing that can lead to the discovery of new illnesses.\u003c/p>\n\u003cp>“Part of what we have to do is keep building that library, that encyclopedia of what gene and what gene mutations cause what symptoms,” Nelson said. “It’s just incomplete at this moment.” \u003c/p>\n\u003cp>Already the work is helping patients and their families come to terms with their illnesses. In one case, at Stanford, a toddler was diagnosed with two rare diseases, including a connective tissue disorder called Marfan Syndrome, after doctors conducted a form of sequencing that looks for changes in coded genetic segments known as exons. \u003c/p>\n\u003cp>Sometimes answers come from something decidedly lower-tech: collaboration among clinicians and researchers who share experiences, data and expertise.\u003c/p>\n\u003cp>“A lot of times your ability to be diagnosed depends on who is in the room,” Ramoni said. “And what we are doing with the network is we are expanding exponentially the number of people in the room.”\u003cbr>\nDoctors at one institution might think their patient is a unique case, only to learn that colleagues elsewhere have a patient with a similar illness. But even when diseases are diagnosed or gene mutations are discovered, treatments may still not be available. \u003c/p>\n\u003cp>\u003cstrong>A Life-Changing Mystery\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Andrew Whittaker’s odyssey began one afternoon at age 19, when he started trembling and couldn’t speak. Doctors suspected he was suffering from anxiety and prescribed medication to control it. But Andrew said he continued to have “episodes,” during which everything just went blank.\u003c/p>\n\u003cp>“It’s like there’s not enough blood going to your brain,” he said. “You can’t think.” \u003c/p>\n\u003cp>Andrew also started losing his balance and falling off his bicycle. The family visited several hospitals. Doctors discovered that the receptors in his brain were malfunctioning and that he lacked sufficient dopamine, a chemical compound in the body responsible for transmitting signals between nerve cells. As a result, Andrew has some symptoms similar to those of Parkinson’s disease. Doctors also confirmed he was having seizures. \u003c/p>\n\u003cp>Still, Andrew’s symptoms didn’t add up to any known disease.\u003c/p>\n\u003cp>One afternoon last fall at precisely noon, as Andrew sat propped up on the living room couch, Lynn’s phone alarm sounded, signaling it was time for his medication. Lynn pried open Andrew’s hand, which was clenched into a fist, and dropped in the pills. \u003c/p>\n\u003cp>To keep Andrew from falling, the family has lowered his bed and removed carpet from the house. They also bought him a wheelchair. Their precautions don’t always work. One morning, Lynn was in the kitchen when she heard a crash. “I ran in there and he’s laid flat on his back,” she said. \u003c/p>\n\u003cp>Andrew is close to his mom. But he also gets frustrated. He can’t shower or dress without her help. He’s had to give up the things he loved to do: printing T-shirts. Skateboarding. Shooting short films. He’s lost friends and can’t imagine dating anymore.\u003c/p>\n\u003cp>“Girlfriends? Forget about it,” he said, his face twitching as he talks. “They want a guy who can do stuff for them, not the other way around.” \u003c/p>\n\u003cp>\u003cstrong>Running The Medical Gauntlet\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>On a Monday morning in late January, Andrew and his parents were in an exam room at UCLA. Lynn teased her son, saying she was going to put him in a freezer until doctors figured out what was wrong.\u003cbr>\n“Then we’ll pull you back out again,” she said, smiling.\u003c/p>\n\u003cp>“I’ll never get pulled out,” Andrew responded. \u003c/p>\n\u003cp>“Yes, you will,” she said. “You will.”\u003c/p>\n\u003cp>Nelson, Andrew’s main doctor, walked into the room. He told Andrew he’d read through the medical records. “We’re going to try to figure you out.” \u003c/p>\n\u003cp>The work Nelson does is personal. His teenage son, Dylan, has Duchenne muscular dystrophy, a genetic disorder that causes muscle degeneration and weakness. Nelson knows his son’s disease will eventually take his life, but he said having a diagnosis makes all the difference. \u003c/p>\n\u003cp>“My heart very much goes out to the families that don’t even get an adequate diagnosis,” he said.\u003cbr>\nNelson suspects that Andrew’s disease is genetic as well. \u003c/p>\n\u003cp>He asked the Whittakers to describe their son’s journey and he conducted a short physical exam, asking Andrew to push against his hand and touch his own nose. Andrew trembled and his shoulders tensed, but he did it.\u003c/p>\n\u003cp>The rest of the week, Andrew underwent several other diagnostic tests, including a muscle biopsy, an EEG, MRI and a lumbar puncture. He remained upbeat, though running the medical gauntlet clearly wore him out. He also met with UCLA specialists in brain degeneration and muscle and nerve disorders. \u003c/p>\n\u003cp>At week’s end, Nelson sat down with the family to explain what he’d found. He had reviewed Andrew’s genome and compared it with that of both parents. Andrew had one copy of a defective gene that leads to Parkinson’s but the genome sequencing didn’t show a second copy, without which it could not be Parkinson’s.\u003c/p>\n\u003cp>He also explained that Andrew’s illness was clearly progressive and that his brain was shrinking, making it harder for him to process language and information. Nelson said he still didn’t have a diagnosis -- he believed it was a brand-new disease. \u003c/p>\n\u003cp>Nelson planned to continue poring over the test results, conducting additional exams and communicating with others in the network. He also is analyzing Andrew’s muscle, skin and blood to see whether any mutated gene is expressed abnormally. \u003c/p>\n\u003cp>Even in the absence of a clear diagnosis, Nelson said, rare diseases like Andrew’s help educate scientists and may help other patients. “These are the people we as a society will owe a great debt of gratitude,” he said. “They are effectively donating their lives to this process.” \u003c/p>\n\u003cp>Lynn Whittaker was disappointed. “We are still left with just hope that they will come up with something,” she lamented. “What else do we have?” \u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Andrew said his relatives have asked if he’s scared the doctors will find something. “I’m more scared if they don’t,” he replied.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/323172/network-of-scientists-works-to-help-patients-with-undiagnosed-diseases","authors":["byline_stateofhealth_323172"],"categories":["stateofhealth_2407","stateofhealth_13"],"tags":["stateofhealth_2808","stateofhealth_2519","stateofhealth_3096","stateofhealth_3097"],"featImg":"stateofhealth_323175","label":"stateofhealth"},"stateofhealth_323065":{"type":"posts","id":"stateofhealth_323065","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"323065","score":null,"sort":[1493312653000]},"guestAuthors":[],"slug":"hype-offers-hope-and-risks-to-cancer-patients","title":"Hype Offers Hope -- and Risks -- to Cancer Patients","publishDate":1493312653,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>After Michael Uvanni’s older brother, James, was diagnosed with a deadly form of skin cancer, it seemed as if everyone told the family what they wanted to hear: Have hope. You can beat this, and we are here to help.\u003c/p>\n\u003cp>The brothers met with doctors at a half-dozen of the country’s best hospitals, all with impressive credentials that inspired confidence.\u003c/p>\n\u003cp>Michael Uvanni was in awe when he visited the University of Texas MD Anderson Cancer Center in Houston, one of the world’s most respected cancer hospitals. It was like seeing the Grand Canyon, said Uvanni, 66, of Rome, N.Y. “You never get used to the size and scope.”\u003c/p>\n\u003cp>Even the MD Anderson logo on buses and buildings — with “Cancer” crossed out in red, above the words “Making cancer history” — made the family’s battle seem winnable.\u003c/p>\n\u003cp>“I thought they were going to save him,” said Uvanni, an interior designer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Patients and families are bombarded with the news that the country is winning the war against cancer. The news media hypes research results to attract readers. Drug companies promise “a chance to live longer” to boost sales. Hospitals woo paying customers with ads that appeal to patients’ fears and hopes.\u003c/p>\n\u003cp>“I’m starting to hear more and more that we are better than I think we really are,” said Dr. Otis Brawley, chief medical officer at the American Cancer Society. “We’re starting to believe our own bullshit.”\u003c/p>\n\u003cp>The consequences are real — and they can be deadly. Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.\u003c/p>\n\u003cp>“We have a lot of patients who spend their families into bankruptcy getting a hyped therapy that [many] know is worthless,” Brawley said. Some choose a medicine that “has a lot of hype around it and unfortunately lose their chance for a cure.”\u003c/p>\n\u003cp>Although scientists have made important strides in recent years, and many early-stage cancers can now be cured, most of those with advanced cancer eventually die of their disease.\u003c/p>\n\u003cp>For Uvanni, hope gave way to crushing disappointment when his brother’s health declined and he died from metastatic melanoma in 2014.\u003c/p>\n\u003cp>“You get your hopes up, and then you are dropped off the edge of a cliff,” said Uvanni. “That’s the worst thing in the world.”\u003c/p>\n\u003cp>Caregivers like Uvanni can suffer prolonged grief and guilt if their loved ones are riddled with side effects and don’t survive as long as the family expected, noted Holly Prigerson, co-director of the Center for Research on End-of-Life Care at Weill Cornell Medical College.\u003c/p>\n\u003cp>For decades, researchers have rolled out new cancer therapies with great fanfare, announcing that science has at last found a key to ending one of the world’s great plagues, said Dr. Vinay Prasad, an assistant professor of medicine at Oregon Health & Science University. When such efforts fail to live up to expectations, the cancer world simply moves on to the next big idea.\u003c/p>\n\u003cp>Hyping early scientific results — based on lab tests or animal studies — can attract investors that allow researchers to continue their work. Positive results can lead biotech firms to be bought out by larger drug companies.\u003c/p>\n\u003cp>“It’s in the interest of almost every stakeholder in the health system to be optimistic about these therapies,” said Dr. Walid Gellad, co-director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.\u003c/p>\n\u003cp>Of course, there is plenty of money to be made.\u003c/p>\n\u003cp>The U.S. spent nearly $88 billion treating cancer in 2014, with patients paying nearly $4 billion out-of-pocket, according to the American Cancer Society Cancer Action Network. Spending on cancer, a disease that most afflicts the aging, is predicted to soar as people live longer.\u003c/p>\n\u003cp>“While many people are trying to make patients’ lives healthier and longer and better, there are others that are exploiting their vulnerability,” said Dr. Leonard Saltz, chief of the gastrointestinal oncology service at New York’s Memorial Sloan Kettering Cancer Center.\u003c/p>\n\u003cp>Others argue that the excitement about cancer research is justified. A spokeswoman for the Pharmaceutical Research and Manufacturers of America, an industry group, said cancer patients have good reason for optimism.\u003c/p>\n\u003cp>“We continue to see great strides in identifying the genetic mutations and related factors that can drive the seemingly random formation of abnormal cells in cancer,” spokeswoman Holly Campbell said in a statement. “In the last decade, we’ve seen a number of scientific advances transform the landscape of many cancers.”\u003c/p>\n\u003cp>\u003cstrong>Promises To Cure Abound\u003cbr>\n\u003c/strong>\u003cbr>\nEven the country’s top scientists sometimes get carried away.\u003c/p>\n\u003cp>In 1998, Nobel laureate James Watson — who co-discovered the structure of DNA — told The New York Times that scientists would “cure cancer in two years” using drugs that block tumor blood supplies. At that time, the drugs had succeeded only in mice.\u003c/p>\n\u003cp>In 2003, the director of the National Cancer Institute, Dr. Andrew von Eschenbach, announced a goal of “eliminating suffering and death due to cancer by 2015” by better understanding tumor genetics.\u003c/p>\n\u003cp>Last year, when President Barack Obama announced the Cancer Moonshot, which aims to accelerate and better coordinate research, he said, “Let’s make America the country that cures cancer once and for all.”\u003c/p>\n\u003cp>In a recent interview, von Eschenbach acknowledged he didn’t communicate his goal well.\u003c/p>\n\u003cp>“We all fall into that trap,” said von Eschenbach, now a senior fellow at the Milken Institute, a health and public policy think tank. “We’re offering what we have, but making it appear that it’s more than what it is.”\u003c/p>\n\u003cp>It’s easy to see how patients’ hopes are raised, said Timothy Turnham, former executive director at the Melanoma Research Foundation, an advocacy group. Researchers are frequently overly enthusiastic about early discoveries that have little chance of leading to a new drug.\u003c/p>\n\u003cp>“There is a disconnect between what researchers think is statistically significant and what is really significant for patients,” Turnham said. “Patients hear ‘progress,’ and they think that means they’re going to be cured.”\u003c/p>\n\u003cp>\u003cstrong>A Marketing Blitz\u003cbr>\n\u003c/strong>\u003cbr>\nUvanni said his brother’s experience was nothing like the sunny images in TV commercials, in which smiling cancer patients hug their grandchildren, hike in the mountains and lead dance classes.\u003c/p>\n\u003cp>A TV commercial for the Bristol-Myers Squibb drug Opdivo projects the words “a chance to live longer” on the side of skyscrapers, as a captivated crowd looks on. In much smaller type, a footnote reveals that lung cancer patients taking Opdivo lived just 3.2 months longer than others.\u003c/p>\n\u003cp>A TV ad for Merck’s Keytruda features reassuring images of a smiling, healthy patient hugging her family — not fighting for breath or struggling to walk. Although the commercial notes that the people in the ad are portrayed by actors, the commercial claims the drug provides “a chance for a longer life. It’s Tru.”\u003c/p>\n\u003cp>“Your heart sinks when you see those ads,” Uvanni said. Seeing the family depicted in the ad, he said “makes you wonder if they’re going down the same path that we did.”\u003c/p>\n\u003cp>The Keytruda ad notes that 71 percent of patients given the drug were alive “at the time of patient follow-up,” compared with 58 percent of those who received chemotherapy. The ad doesn’t mention that the “time of follow-up” was 11 months.\u003c/p>\n\u003cp>“It’s not false; it’s just incomplete,” said pharmacist Harold DeMonaco, a visiting scientist at the Massachusetts Institute of Technology in Boston. “They don’t give patients or the patients’ family enough information to make a reasonable decision.”\u003c/p>\n\u003cp>In an interview, Merck senior vice president Jill DeSimone said that the company aims to be responsible with its advertising, noting that the Keytruda ad reminds patients to talk to their doctors. “The physician is the ultimate decider on treatment,” DeSimone said.\u003c/p>\n\u003cp>In a statement, Bristol-Myers’ senior vice president Teresa Bitetti said that Opdivo ads play “an important role in educating patients about new treatment options and fostering informed conversations between patients and their doctors.”\u003c/p>\n\u003cp>Hospitals also have drawn criticism for overstating their success in treating cancer. In 1996, Cancer Treatment Centers of America, a for-profit chain, settled allegations from the Federal Trade Commission that “they made false and unsubstantiated claims in advertising and promoting their cancer treatments.”\u003c/p>\n\u003cp>The company’s current commercials — dozens of which are featured on their website — boast of offering “genomic testing” and “precision cancer treatment.”\u003c/p>\n\u003cp>The commercials don’t tell patients that these tests — which aim to pair cancer patients with drugs that target the specific mutations in their tumors — are rarely successful, Prasad said. In clinical trials, these tests have matched only 6.4 percent of patients with a drug, according to Prasad’s 2016 article in Nature. Because these drugs only manage to shrink a fraction of tumors, Prasad estimates that just 1.5 percent of patients actually benefit from precision oncology.\u003c/p>\n\u003cp>In a statement, Cancer Treatment Centers of America said, “We use national media to help educate cancer patients and their families about the latest diagnostic tools and treatment options. … All of our advertising undergoes meticulous review for clinical accuracy as well as legal approval to ensure we tell our story in an informative and responsible manner, and in compliance with federal guidelines.”\u003c/p>\n\u003cp>Spending on ads for hospitals that treat cancer soared 220 percent from $54 million in 2005 to $173 million in 2014, according to a 2016 article in JAMA Internal Medicine. Ads for Cancer Treatment Centers of America accounted for nearly 60 percent of all total cancer center advertising.\u003c/p>\n\u003cp>\u003cstrong>Targeting Melanoma\u003cbr>\n\u003c/strong>\u003cbr>\nFor more than a decade, the Food and Drug Administration approved no new treatments for metastatic melanoma. Patients typically died within a year of diagnosis.\u003c/p>\n\u003cp>Since 2011, however, the FDA has approved 11 new treatments, including several immunotherapies, which aim to harness the immune system to fight cancer. Last year, doctors leading a clinical trial announced that the median survival of patients taking the drug Keytruda had grown to two years. Forty percent of patients were alive three years later, according to the clinical trial, presented at the American Society of Clinical Oncology.\u003c/p>\n\u003cp>Researchers have tested immunotherapies against a variety of tumors, leading to approvals in lung cancer, kidney cancer, bladder cancer and others.\u003c/p>\n\u003cp>Such success has led doctors to label cancer immunotherapy as a “game changer.” Newspapers and magazines call it a “breakthrough.” And hospitals laud them as “a miracle in the making.”\u003c/p>\n\u003cp>Yet these treatments — which were initially assumed to be gentler than chemotherapy — can provoke fatal immune system attacks on the lungs, kidneys, heart and other organs.\u003c/p>\n\u003cp>And there are no approved immunotherapies for tumors of the breast, colon, prostate and pancreas.\u003c/p>\n\u003cp>Only about 10 percent of all cancer patients can expect to benefit from immunotherapy, Prasad said.\u003c/p>\n\u003cp>Uvanni’s brother — who tried immunotherapy, as well as a number of other approved and experimental treatments — survived 3½ years after his diagnosis. That might lead many oncologists to describe his story as a success.\u003c/p>\n\u003cp>Uvanni sees no reason to celebrate. He wanted more than short-term survival for his brother.\u003c/p>\n\u003cp>“I thought we were going to have a treatment where we’d at least have a good block of quality time,” Uvanni said.\u003c/p>\n\u003cp>But treatments meant to control the cancer only made him sick. Some caused flu-like symptoms, with fever, chills and shakes. Others left him nauseated, unable to eat or move his bowels. Others caused dangerous infections that sent him to the emergency room.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I hope that if something like that happens to me,” Uvanni said, “I would be strong enough to say no to treatment.”\u003c/p>\n\n","blocks":[],"excerpt":"Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.","status":"publish","parent":0,"modified":1493338808,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":56,"wordCount":2090},"headData":{"title":"Hype Offers Hope -- and Risks -- to Cancer Patients | KQED","description":"Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hype Offers Hope -- and Risks -- to Cancer Patients","datePublished":"2017-04-27T17:04:13.000Z","dateModified":"2017-04-28T00:20:08.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"323065 https://ww2.kqed.org/stateofhealth/?p=323065","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/04/27/hype-offers-hope-and-risks-to-cancer-patients/","disqusTitle":"Hype Offers Hope -- and Risks -- to Cancer Patients","nprByline":"\u003cstrong>\u003ca href=\"http://khn.org/news/author/liz-szabo/\" target=\"_blank\">Liz Szabo \u003c/strong>\u003c/a>\u003c/br>Kaiser Health News","path":"/stateofhealth/323065/hype-offers-hope-and-risks-to-cancer-patients","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>After Michael Uvanni’s older brother, James, was diagnosed with a deadly form of skin cancer, it seemed as if everyone told the family what they wanted to hear: Have hope. You can beat this, and we are here to help.\u003c/p>\n\u003cp>The brothers met with doctors at a half-dozen of the country’s best hospitals, all with impressive credentials that inspired confidence.\u003c/p>\n\u003cp>Michael Uvanni was in awe when he visited the University of Texas MD Anderson Cancer Center in Houston, one of the world’s most respected cancer hospitals. It was like seeing the Grand Canyon, said Uvanni, 66, of Rome, N.Y. “You never get used to the size and scope.”\u003c/p>\n\u003cp>Even the MD Anderson logo on buses and buildings — with “Cancer” crossed out in red, above the words “Making cancer history” — made the family’s battle seem winnable.\u003c/p>\n\u003cp>“I thought they were going to save him,” said Uvanni, an interior designer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Patients and families are bombarded with the news that the country is winning the war against cancer. The news media hypes research results to attract readers. Drug companies promise “a chance to live longer” to boost sales. Hospitals woo paying customers with ads that appeal to patients’ fears and hopes.\u003c/p>\n\u003cp>“I’m starting to hear more and more that we are better than I think we really are,” said Dr. Otis Brawley, chief medical officer at the American Cancer Society. “We’re starting to believe our own bullshit.”\u003c/p>\n\u003cp>The consequences are real — and they can be deadly. Patients and their families have bought into treatments that either don’t work, cost a fortune or cause life-threatening side effects.\u003c/p>\n\u003cp>“We have a lot of patients who spend their families into bankruptcy getting a hyped therapy that [many] know is worthless,” Brawley said. Some choose a medicine that “has a lot of hype around it and unfortunately lose their chance for a cure.”\u003c/p>\n\u003cp>Although scientists have made important strides in recent years, and many early-stage cancers can now be cured, most of those with advanced cancer eventually die of their disease.\u003c/p>\n\u003cp>For Uvanni, hope gave way to crushing disappointment when his brother’s health declined and he died from metastatic melanoma in 2014.\u003c/p>\n\u003cp>“You get your hopes up, and then you are dropped off the edge of a cliff,” said Uvanni. “That’s the worst thing in the world.”\u003c/p>\n\u003cp>Caregivers like Uvanni can suffer prolonged grief and guilt if their loved ones are riddled with side effects and don’t survive as long as the family expected, noted Holly Prigerson, co-director of the Center for Research on End-of-Life Care at Weill Cornell Medical College.\u003c/p>\n\u003cp>For decades, researchers have rolled out new cancer therapies with great fanfare, announcing that science has at last found a key to ending one of the world’s great plagues, said Dr. Vinay Prasad, an assistant professor of medicine at Oregon Health & Science University. When such efforts fail to live up to expectations, the cancer world simply moves on to the next big idea.\u003c/p>\n\u003cp>Hyping early scientific results — based on lab tests or animal studies — can attract investors that allow researchers to continue their work. Positive results can lead biotech firms to be bought out by larger drug companies.\u003c/p>\n\u003cp>“It’s in the interest of almost every stakeholder in the health system to be optimistic about these therapies,” said Dr. Walid Gellad, co-director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.\u003c/p>\n\u003cp>Of course, there is plenty of money to be made.\u003c/p>\n\u003cp>The U.S. spent nearly $88 billion treating cancer in 2014, with patients paying nearly $4 billion out-of-pocket, according to the American Cancer Society Cancer Action Network. Spending on cancer, a disease that most afflicts the aging, is predicted to soar as people live longer.\u003c/p>\n\u003cp>“While many people are trying to make patients’ lives healthier and longer and better, there are others that are exploiting their vulnerability,” said Dr. Leonard Saltz, chief of the gastrointestinal oncology service at New York’s Memorial Sloan Kettering Cancer Center.\u003c/p>\n\u003cp>Others argue that the excitement about cancer research is justified. A spokeswoman for the Pharmaceutical Research and Manufacturers of America, an industry group, said cancer patients have good reason for optimism.\u003c/p>\n\u003cp>“We continue to see great strides in identifying the genetic mutations and related factors that can drive the seemingly random formation of abnormal cells in cancer,” spokeswoman Holly Campbell said in a statement. “In the last decade, we’ve seen a number of scientific advances transform the landscape of many cancers.”\u003c/p>\n\u003cp>\u003cstrong>Promises To Cure Abound\u003cbr>\n\u003c/strong>\u003cbr>\nEven the country’s top scientists sometimes get carried away.\u003c/p>\n\u003cp>In 1998, Nobel laureate James Watson — who co-discovered the structure of DNA — told The New York Times that scientists would “cure cancer in two years” using drugs that block tumor blood supplies. At that time, the drugs had succeeded only in mice.\u003c/p>\n\u003cp>In 2003, the director of the National Cancer Institute, Dr. Andrew von Eschenbach, announced a goal of “eliminating suffering and death due to cancer by 2015” by better understanding tumor genetics.\u003c/p>\n\u003cp>Last year, when President Barack Obama announced the Cancer Moonshot, which aims to accelerate and better coordinate research, he said, “Let’s make America the country that cures cancer once and for all.”\u003c/p>\n\u003cp>In a recent interview, von Eschenbach acknowledged he didn’t communicate his goal well.\u003c/p>\n\u003cp>“We all fall into that trap,” said von Eschenbach, now a senior fellow at the Milken Institute, a health and public policy think tank. “We’re offering what we have, but making it appear that it’s more than what it is.”\u003c/p>\n\u003cp>It’s easy to see how patients’ hopes are raised, said Timothy Turnham, former executive director at the Melanoma Research Foundation, an advocacy group. Researchers are frequently overly enthusiastic about early discoveries that have little chance of leading to a new drug.\u003c/p>\n\u003cp>“There is a disconnect between what researchers think is statistically significant and what is really significant for patients,” Turnham said. “Patients hear ‘progress,’ and they think that means they’re going to be cured.”\u003c/p>\n\u003cp>\u003cstrong>A Marketing Blitz\u003cbr>\n\u003c/strong>\u003cbr>\nUvanni said his brother’s experience was nothing like the sunny images in TV commercials, in which smiling cancer patients hug their grandchildren, hike in the mountains and lead dance classes.\u003c/p>\n\u003cp>A TV commercial for the Bristol-Myers Squibb drug Opdivo projects the words “a chance to live longer” on the side of skyscrapers, as a captivated crowd looks on. In much smaller type, a footnote reveals that lung cancer patients taking Opdivo lived just 3.2 months longer than others.\u003c/p>\n\u003cp>A TV ad for Merck’s Keytruda features reassuring images of a smiling, healthy patient hugging her family — not fighting for breath or struggling to walk. Although the commercial notes that the people in the ad are portrayed by actors, the commercial claims the drug provides “a chance for a longer life. It’s Tru.”\u003c/p>\n\u003cp>“Your heart sinks when you see those ads,” Uvanni said. Seeing the family depicted in the ad, he said “makes you wonder if they’re going down the same path that we did.”\u003c/p>\n\u003cp>The Keytruda ad notes that 71 percent of patients given the drug were alive “at the time of patient follow-up,” compared with 58 percent of those who received chemotherapy. The ad doesn’t mention that the “time of follow-up” was 11 months.\u003c/p>\n\u003cp>“It’s not false; it’s just incomplete,” said pharmacist Harold DeMonaco, a visiting scientist at the Massachusetts Institute of Technology in Boston. “They don’t give patients or the patients’ family enough information to make a reasonable decision.”\u003c/p>\n\u003cp>In an interview, Merck senior vice president Jill DeSimone said that the company aims to be responsible with its advertising, noting that the Keytruda ad reminds patients to talk to their doctors. “The physician is the ultimate decider on treatment,” DeSimone said.\u003c/p>\n\u003cp>In a statement, Bristol-Myers’ senior vice president Teresa Bitetti said that Opdivo ads play “an important role in educating patients about new treatment options and fostering informed conversations between patients and their doctors.”\u003c/p>\n\u003cp>Hospitals also have drawn criticism for overstating their success in treating cancer. In 1996, Cancer Treatment Centers of America, a for-profit chain, settled allegations from the Federal Trade Commission that “they made false and unsubstantiated claims in advertising and promoting their cancer treatments.”\u003c/p>\n\u003cp>The company’s current commercials — dozens of which are featured on their website — boast of offering “genomic testing” and “precision cancer treatment.”\u003c/p>\n\u003cp>The commercials don’t tell patients that these tests — which aim to pair cancer patients with drugs that target the specific mutations in their tumors — are rarely successful, Prasad said. In clinical trials, these tests have matched only 6.4 percent of patients with a drug, according to Prasad’s 2016 article in Nature. Because these drugs only manage to shrink a fraction of tumors, Prasad estimates that just 1.5 percent of patients actually benefit from precision oncology.\u003c/p>\n\u003cp>In a statement, Cancer Treatment Centers of America said, “We use national media to help educate cancer patients and their families about the latest diagnostic tools and treatment options. … All of our advertising undergoes meticulous review for clinical accuracy as well as legal approval to ensure we tell our story in an informative and responsible manner, and in compliance with federal guidelines.”\u003c/p>\n\u003cp>Spending on ads for hospitals that treat cancer soared 220 percent from $54 million in 2005 to $173 million in 2014, according to a 2016 article in JAMA Internal Medicine. Ads for Cancer Treatment Centers of America accounted for nearly 60 percent of all total cancer center advertising.\u003c/p>\n\u003cp>\u003cstrong>Targeting Melanoma\u003cbr>\n\u003c/strong>\u003cbr>\nFor more than a decade, the Food and Drug Administration approved no new treatments for metastatic melanoma. Patients typically died within a year of diagnosis.\u003c/p>\n\u003cp>Since 2011, however, the FDA has approved 11 new treatments, including several immunotherapies, which aim to harness the immune system to fight cancer. Last year, doctors leading a clinical trial announced that the median survival of patients taking the drug Keytruda had grown to two years. Forty percent of patients were alive three years later, according to the clinical trial, presented at the American Society of Clinical Oncology.\u003c/p>\n\u003cp>Researchers have tested immunotherapies against a variety of tumors, leading to approvals in lung cancer, kidney cancer, bladder cancer and others.\u003c/p>\n\u003cp>Such success has led doctors to label cancer immunotherapy as a “game changer.” Newspapers and magazines call it a “breakthrough.” And hospitals laud them as “a miracle in the making.”\u003c/p>\n\u003cp>Yet these treatments — which were initially assumed to be gentler than chemotherapy — can provoke fatal immune system attacks on the lungs, kidneys, heart and other organs.\u003c/p>\n\u003cp>And there are no approved immunotherapies for tumors of the breast, colon, prostate and pancreas.\u003c/p>\n\u003cp>Only about 10 percent of all cancer patients can expect to benefit from immunotherapy, Prasad said.\u003c/p>\n\u003cp>Uvanni’s brother — who tried immunotherapy, as well as a number of other approved and experimental treatments — survived 3½ years after his diagnosis. That might lead many oncologists to describe his story as a success.\u003c/p>\n\u003cp>Uvanni sees no reason to celebrate. He wanted more than short-term survival for his brother.\u003c/p>\n\u003cp>“I thought we were going to have a treatment where we’d at least have a good block of quality time,” Uvanni said.\u003c/p>\n\u003cp>But treatments meant to control the cancer only made him sick. Some caused flu-like symptoms, with fever, chills and shakes. Others left him nauseated, unable to eat or move his bowels. Others caused dangerous infections that sent him to the emergency room.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I hope that if something like that happens to me,” Uvanni said, “I would be strong enough to say no to treatment.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/323065/hype-offers-hope-and-risks-to-cancer-patients","authors":["byline_stateofhealth_323065"],"categories":["stateofhealth_2407","stateofhealth_13"],"tags":["stateofhealth_3095","stateofhealth_16","stateofhealth_2892","stateofhealth_2808","stateofhealth_73","stateofhealth_3093","stateofhealth_2519","stateofhealth_3094"],"featImg":"stateofhealth_323067","label":"stateofhealth"},"stateofhealth_321751":{"type":"posts","id":"stateofhealth_321751","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"321751","score":null,"sort":[1493050646000]},"guestAuthors":[],"slug":"consumer-advocates-push-for-over-the-counter-sale-of-hearing-aids","title":"Consumer Advocates Push for Over the Counter Sale of Hearing Aids","publishDate":1493050646,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Four out of five older Americans with hearing loss just ignore it, in part because a hearing aid is an unwelcome sign of aging. But what if hearing aids looked like stylish fashion accessories and could be bought at your local pharmacy like reading glasses?\u003c/p>\n\u003cp>That's the vision of Kristen \"KR\" Liu, who's the director of accessibility and advocacy for Doppler Labs, a company marketing one of these devices. She thinks a hearing aid could be \"something that's hip and cool and people have multiple pairs and it's fashionable.\"\u003c/p>\n\u003cp>Liu, who has severe hearing loss herself, helped design a device designed to let people with hearing loss blend in. One person may be using the technology to stream music or take a phone call, she says. Another may be wearing it to amplify speech and hear the conversation. \"And no one is going to know the difference,\" Liu says. \"So you're wearing technology in your ear, proudly.\"\u003c/p>\n\u003cp>The device is a small circular instrument that fits snugly in the ear. It can be adjusted to individual hearing using a smartphone app to control volume, cut out background noise or turn up the sound in a theater. \"It's pretty much a hearing aid,\" says Liu, except the company isn't allowed to call it that.\u003c/p>\n\u003cp>That's because the Food and Drug Administration, which regulates medical devices, doesn't allow hearing aids to be sold over the counter. So devices sold directly to consumers are marketed as \"personal sound amplification products,\" or PSAPs. They range in price from about $250 to $350 and are considerably cheaper than hearing aids, which can cost up to $6,000 and are typically not covered by Medicare or most private insurance companies. Hearing aids are customized by a hearing specialist such as an audiologist, following a hearing test.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>PSAPs can only be marketed as sound amplifiers for people with normal hearing who want to make things louder, like music or the sounds of birds chirping. Hearing loss advocates believe this means people with mild to moderate hearing loss who could benefit from the devices don't know about them. There are dozens of the devices on the market, but their quality varies wildly, as an analysis of 11 of them last year for hearing care professionals shows. And there's no easy way for potential purchasers to figure out which work best.\u003c/p>\n\u003cp>The Hearing Loss Association of America, a consumer group, wants Congress to create a new category of aids for people with mild to moderate hearing loss by passing the Over-the-Counter Hearing Aid Act of2017. (People with severe hearing loss would still need to be seen by a medical professional.) The bill would direct the FDA to come up with safety and effectiveness standards for these new hearing aids.\u003c/p>\n\u003cp>The FDA is already moving in that direction, and in December said it would no longer require adults to be medically evaluated before buying a hearing aid. Proponents of direct-to-consumer sales hope Congressional action would get the FDA moving faster. A 2016 report from the National Academies of Sciences also endorsed allowing over-the-counter sales.\u003c/p>\n\u003cp>This could be life changing for people with hearing loss, says Richard Einhorn, a composer of modern classical music who is on the board of the Hearing Loss Association of America.\u003c/p>\n\u003cp>Early one morning in 2010, he woke up with his ears ringing — a loud, piercing hiss. \"I hit the panic button,\" Einhorn says. \"I jumped out of bed and immediately fell over onto the floor.\"\u003c/p>\n\u003cp>An inner ear infection, likely a virus, had caused him to lose his balance. He went deaf in his right ear. He already had some hearing loss in his left ear. His hearing aids cost $5,000 and were not covered by insurance.\u003c/p>\n\u003cp>\"I'm a composer, for goodness sake,\" Einhorn says. \"This is not an easy purchase to scrounge up the money for.\"\u003c/p>\n\u003cp>Opening up the hearing aid market would foster competition and drive prices down, says Einhorn.\u003c/p>\n\u003cp>It would also encourage companies to come up with new and better products, says Liu. She envisions a future that solves one of the biggest problems for many people – hearing in a noisy environment, like a party or a busy restaurant. She wants a hearing aid that would automatically adjust to different sound environments, so she could hear the person talking to her and not the background distraction.\u003c/p>\n\u003cp>\"Nothing like that exists today,\" Liu says. \"But I very much see something like that down the road.\"\u003c/p>\n\u003cp>Some audio specialists support rolling back regulations, while others are skeptical.\u003c/p>\n\u003cp>Hearing loss is complex, says Neil DiSarno, chief staff officer for audiology at the American Speech-Language-Hearing Association. This makes it difficult for consumers to \"self-evaluate, self-treat and self-monitor,\" he says. If people buy their hearing aids directly over the counter, they'll miss out on all the skills audiologists can teach them, like how to lip read and how to distinguish high frequency sounds, he says.\u003c/p>\n\u003cp>The market for over-the-counter hearing aids could be huge. More than 35 million Americans have some degree of hearing loss. And for older Americans, not dealing with the problem can have a big impact on age-related cognitive decline, says Dr. Frank Lin, associate professor of otolaryngology at Johns Hopkins University School of Medicine. Lin has done studies looking at the link between hearing loss and cognitive decline.\u003c/p>\n\u003cp>\"The greater the hearing loss, the greater the risk of loss of thinking and memory abilities over time,\" he says, which can lead to feelings of insecurity and social isolation – a known risk factor for dementia.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lin says his findings should serve as a \"wake-up call\" for policy makers. If people have easier access to more affordable hearing aids, he says, that could lead to benefits that go far beyond hearing.\u003c/p>\n\n","blocks":[],"excerpt":"Congress may consider allowing some hearing aids to be sold without a prescription in a measure that could lower costs and increase options for consumers. ","status":"publish","parent":0,"modified":1493138535,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":991},"headData":{"title":"Consumer Advocates Push for Over the Counter Sale of Hearing Aids | KQED","description":"Congress may consider allowing some hearing aids to be sold without a prescription in a measure that could lower costs and increase options for consumers. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Consumer Advocates Push for Over the Counter Sale of Hearing Aids","datePublished":"2017-04-24T16:17:26.000Z","dateModified":"2017-04-25T16:42:15.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"321751 https://ww2.kqed.org/stateofhealth/?p=321751","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/04/24/consumer-advocates-push-for-over-the-counter-sale-of-hearing-aids/","disqusTitle":"Consumer Advocates Push for Over the Counter Sale of Hearing Aids","nprByline":"Patricia Neighmond and Jane Greenhalgh\u003cbr />\u003ca href=\"http://www.npr.org/sections/health-shots/\">NPR Shots\u003c/a> ","path":"/stateofhealth/321751/consumer-advocates-push-for-over-the-counter-sale-of-hearing-aids","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Four out of five older Americans with hearing loss just ignore it, in part because a hearing aid is an unwelcome sign of aging. But what if hearing aids looked like stylish fashion accessories and could be bought at your local pharmacy like reading glasses?\u003c/p>\n\u003cp>That's the vision of Kristen \"KR\" Liu, who's the director of accessibility and advocacy for Doppler Labs, a company marketing one of these devices. She thinks a hearing aid could be \"something that's hip and cool and people have multiple pairs and it's fashionable.\"\u003c/p>\n\u003cp>Liu, who has severe hearing loss herself, helped design a device designed to let people with hearing loss blend in. One person may be using the technology to stream music or take a phone call, she says. Another may be wearing it to amplify speech and hear the conversation. \"And no one is going to know the difference,\" Liu says. \"So you're wearing technology in your ear, proudly.\"\u003c/p>\n\u003cp>The device is a small circular instrument that fits snugly in the ear. It can be adjusted to individual hearing using a smartphone app to control volume, cut out background noise or turn up the sound in a theater. \"It's pretty much a hearing aid,\" says Liu, except the company isn't allowed to call it that.\u003c/p>\n\u003cp>That's because the Food and Drug Administration, which regulates medical devices, doesn't allow hearing aids to be sold over the counter. So devices sold directly to consumers are marketed as \"personal sound amplification products,\" or PSAPs. They range in price from about $250 to $350 and are considerably cheaper than hearing aids, which can cost up to $6,000 and are typically not covered by Medicare or most private insurance companies. Hearing aids are customized by a hearing specialist such as an audiologist, following a hearing test.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>PSAPs can only be marketed as sound amplifiers for people with normal hearing who want to make things louder, like music or the sounds of birds chirping. Hearing loss advocates believe this means people with mild to moderate hearing loss who could benefit from the devices don't know about them. There are dozens of the devices on the market, but their quality varies wildly, as an analysis of 11 of them last year for hearing care professionals shows. And there's no easy way for potential purchasers to figure out which work best.\u003c/p>\n\u003cp>The Hearing Loss Association of America, a consumer group, wants Congress to create a new category of aids for people with mild to moderate hearing loss by passing the Over-the-Counter Hearing Aid Act of2017. (People with severe hearing loss would still need to be seen by a medical professional.) The bill would direct the FDA to come up with safety and effectiveness standards for these new hearing aids.\u003c/p>\n\u003cp>The FDA is already moving in that direction, and in December said it would no longer require adults to be medically evaluated before buying a hearing aid. Proponents of direct-to-consumer sales hope Congressional action would get the FDA moving faster. A 2016 report from the National Academies of Sciences also endorsed allowing over-the-counter sales.\u003c/p>\n\u003cp>This could be life changing for people with hearing loss, says Richard Einhorn, a composer of modern classical music who is on the board of the Hearing Loss Association of America.\u003c/p>\n\u003cp>Early one morning in 2010, he woke up with his ears ringing — a loud, piercing hiss. \"I hit the panic button,\" Einhorn says. \"I jumped out of bed and immediately fell over onto the floor.\"\u003c/p>\n\u003cp>An inner ear infection, likely a virus, had caused him to lose his balance. He went deaf in his right ear. He already had some hearing loss in his left ear. His hearing aids cost $5,000 and were not covered by insurance.\u003c/p>\n\u003cp>\"I'm a composer, for goodness sake,\" Einhorn says. \"This is not an easy purchase to scrounge up the money for.\"\u003c/p>\n\u003cp>Opening up the hearing aid market would foster competition and drive prices down, says Einhorn.\u003c/p>\n\u003cp>It would also encourage companies to come up with new and better products, says Liu. She envisions a future that solves one of the biggest problems for many people – hearing in a noisy environment, like a party or a busy restaurant. She wants a hearing aid that would automatically adjust to different sound environments, so she could hear the person talking to her and not the background distraction.\u003c/p>\n\u003cp>\"Nothing like that exists today,\" Liu says. \"But I very much see something like that down the road.\"\u003c/p>\n\u003cp>Some audio specialists support rolling back regulations, while others are skeptical.\u003c/p>\n\u003cp>Hearing loss is complex, says Neil DiSarno, chief staff officer for audiology at the American Speech-Language-Hearing Association. This makes it difficult for consumers to \"self-evaluate, self-treat and self-monitor,\" he says. If people buy their hearing aids directly over the counter, they'll miss out on all the skills audiologists can teach them, like how to lip read and how to distinguish high frequency sounds, he says.\u003c/p>\n\u003cp>The market for over-the-counter hearing aids could be huge. More than 35 million Americans have some degree of hearing loss. And for older Americans, not dealing with the problem can have a big impact on age-related cognitive decline, says Dr. Frank Lin, associate professor of otolaryngology at Johns Hopkins University School of Medicine. Lin has done studies looking at the link between hearing loss and cognitive decline.\u003c/p>\n\u003cp>\"The greater the hearing loss, the greater the risk of loss of thinking and memory abilities over time,\" he says, which can lead to feelings of insecurity and social isolation – a known risk factor for dementia.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lin says his findings should serve as a \"wake-up call\" for policy makers. If people have easier access to more affordable hearing aids, he says, that could lead to benefits that go far beyond hearing.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/321751/consumer-advocates-push-for-over-the-counter-sale-of-hearing-aids","authors":["byline_stateofhealth_321751"],"categories":["stateofhealth_2407","stateofhealth_14"],"tags":["stateofhealth_2997","stateofhealth_2808","stateofhealth_3083","stateofhealth_2519"],"featImg":"stateofhealth_321754","label":"stateofhealth"},"stateofhealth_314273":{"type":"posts","id":"stateofhealth_314273","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"314273","score":null,"sort":[1491588647000]},"guestAuthors":[],"slug":"california-presses-forward-in-fight-to-regulate-pharma","title":"California Presses Forward in Fight to Regulate Pharma","publishDate":1491588647,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Last November, California voters defeated a \u003ca href=\"http://voterguide.sos.ca.gov/en/propositions/61/analysis.htm\" target=\"_blank\">ballot proposal\u003c/a> that would have given state government more control over drug prices. It was a \u003ca href=\"https://ww2.kqed.org/news/2016/11/09/voters-approve-2-tobacco-tax-but-remain-mixed-on-other-health-measures/\" target=\"_blank\">victory\u003c/a> for pharmaceutical companies, who spent more than $100 million campaigning against the measure. Now the industry is fighting new efforts by state lawmakers to control the industry.\u003c/p>\n\u003cp>Drug makers are watching \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB17\" target=\"_blank\">Senate Bill 17 \u003c/a>in particular. Instead of direct price controls, it takes a different tack: price transparency. Drug companies would have to announce large price hikes and give detailed justifications to explain why the prices are going up.\u003c/p>\n\u003cp>Democratic Assemblyman \u003ca href=\"https://a02.asmdc.org/\" target=\"_blank\">Jim Wood\u003c/a> supported a similar \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billVotesClient.xhtml?bill_id=201520160SB1010\" target=\"_blank\">bill\u003c/a> that failed to move forward a year ago.\u003c/p>\n\u003cp>\"It’s basically an effort to provide some transparency around how drug companies price their products,\" Wood said. \"How do you arrive at these? And what are your practices?\"\u003c/p>\n\u003cp>SB 17 is scheduled for a hearing in the \u003ca href=\"http://shea.senate.ca.gov/\" target=\"_blank\">Senate Committee on Health\u003c/a> on April 19.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Wood chairs the \u003ca href=\"http://ahea.assembly.ca.gov/\" target=\"_blank\">Committee on Health\u003c/a> in the Assembly. \"If you can't understand what's going on, how could you possibly make efforts to change that?\" he said.\u003c/p>\n\u003cp>Pharmaceutical manufactures frequently argue that drug prices are high because it's expensive to conduct the scientific research and development that is necessary to bring a drug to market. But Wood says we can't simply take their word on that.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/316603543\" params=\"auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false&visual=true\" width=\"100%\" height=\"300\" iframe=\"true\" /]\u003c/p>\n\u003cp>\"I would personally love to know how much they spend on advertising and marketing, versus how much they spend on R&D,\" he said.\u003c/p>\n\u003cp>Drug industry representatives and researchers visited the Capitol Wednesday to meet with lawmakers and promote their contributions to the California economy. The pharmaceutical industry employs more people in California than any other state (145,880 jobs), according to Priscilla VanderVeer, a spokeswoman with \u003ca href=\"http://www.phrma.org/\" target=\"_blank\">Pharmaceutical Research and Manufacturers of American. \u003c/a>\u003c/p>\n\u003cp>VanderVeer said SB 17 won't do anything to help consumers. \"If the problem is that patients are having a hard time affording their medicines, which we know they are, then let’s come to the table and talk about solutions that can actually help them,\" she said.\u003c/p>\n\u003cp>VanderVeer said one problem is that consumers often must pay the full list price of a drug, even if they are insured.\u003c/p>\n\u003cp>\"Oftentimes when a patient goes to the pharmacy counter and they haven’t reached their deductible, or they have a co-insurance on their drugs, they’re paying that off the list price, not the negotiated rate their insurance has,\" she said. VanderVeer says that doesn't happen to insured patients in other parts of the health care system.\u003c/p>\n\u003cp>\"I give the example of the hospital. You know the $350 x-ray that your insurance brings down to $50, and then you pay your cost-sharing off the $50. That’s not happening with your drugs, that’s not happening at the pharmacy counter,\" she said.\u003c/p>\n\u003cp>VanderVeer also criticized the bill for ignoring other parts of the pharmaceutical supply chain that also affect prices.\u003c/p>\n\u003cp>\"You’ve also got pharmacy benefit managers and insurers who negotiate the price significantly down, I might say, and then you also got wholesalers who purchase drugs directly and keep them in their warehouses and disseminate them to pharmacies. And then you’ve got pharmacies,\" VanderVeer explained. She said those links in the supply chain account for one-third of the final price.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Assemblyman Wood agrees that California should pay more attention to \u003ca href=\"http://www.investopedia.com/articles/markets/070215/what-pharmacy-benefit-management-industry.asp\" target=\"_blank\">pharmacy benefit managers\u003c/a>, companies that act as middlemen, negotiating purchase contracts with drug manufacturers on behalf of health plans. Wood has introduced a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB315\" target=\"_blank\">different bill\u003c/a> in the Assembly that would require pharmacy benefit managers to be licensed in California. It would also require them to disclose information about their business practices, including rebates and hidden \u003ca href=\"https://www.bloomberg.com/news/articles/2017-02-24/sworn-to-secrecy-drugstores-stay-silent-as-customers-overpay\" target=\"_blank\">\"clawback\" \u003c/a>arrangements that force patients to unwittingly pay more for drugs.\u003c/p>\n\n","blocks":[],"excerpt":"State legislators want to bring transparency to drug pricing and payment arrangements. ","status":"publish","parent":0,"modified":1491923915,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":672},"headData":{"title":"California Presses Forward in Fight to Regulate Pharma | KQED","description":"State legislators want to bring transparency to drug pricing and payment arrangements. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California Presses Forward in Fight to Regulate Pharma","datePublished":"2017-04-07T18:10:47.000Z","dateModified":"2017-04-11T15:18:35.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"314273 https://ww2.kqed.org/stateofhealth/?p=314273","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/04/07/california-presses-forward-in-fight-to-regulate-pharma/","disqusTitle":"California Presses Forward in Fight to Regulate Pharma","path":"/stateofhealth/314273/california-presses-forward-in-fight-to-regulate-pharma","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Last November, California voters defeated a \u003ca href=\"http://voterguide.sos.ca.gov/en/propositions/61/analysis.htm\" target=\"_blank\">ballot proposal\u003c/a> that would have given state government more control over drug prices. It was a \u003ca href=\"https://ww2.kqed.org/news/2016/11/09/voters-approve-2-tobacco-tax-but-remain-mixed-on-other-health-measures/\" target=\"_blank\">victory\u003c/a> for pharmaceutical companies, who spent more than $100 million campaigning against the measure. Now the industry is fighting new efforts by state lawmakers to control the industry.\u003c/p>\n\u003cp>Drug makers are watching \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB17\" target=\"_blank\">Senate Bill 17 \u003c/a>in particular. Instead of direct price controls, it takes a different tack: price transparency. Drug companies would have to announce large price hikes and give detailed justifications to explain why the prices are going up.\u003c/p>\n\u003cp>Democratic Assemblyman \u003ca href=\"https://a02.asmdc.org/\" target=\"_blank\">Jim Wood\u003c/a> supported a similar \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billVotesClient.xhtml?bill_id=201520160SB1010\" target=\"_blank\">bill\u003c/a> that failed to move forward a year ago.\u003c/p>\n\u003cp>\"It’s basically an effort to provide some transparency around how drug companies price their products,\" Wood said. \"How do you arrive at these? And what are your practices?\"\u003c/p>\n\u003cp>SB 17 is scheduled for a hearing in the \u003ca href=\"http://shea.senate.ca.gov/\" target=\"_blank\">Senate Committee on Health\u003c/a> on April 19.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Wood chairs the \u003ca href=\"http://ahea.assembly.ca.gov/\" target=\"_blank\">Committee on Health\u003c/a> in the Assembly. \"If you can't understand what's going on, how could you possibly make efforts to change that?\" he said.\u003c/p>\n\u003cp>Pharmaceutical manufactures frequently argue that drug prices are high because it's expensive to conduct the scientific research and development that is necessary to bring a drug to market. But Wood says we can't simply take their word on that.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='300'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/316603543&visual=true&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false&visual=true'\n title='https://api.soundcloud.com/tracks/316603543'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"I would personally love to know how much they spend on advertising and marketing, versus how much they spend on R&D,\" he said.\u003c/p>\n\u003cp>Drug industry representatives and researchers visited the Capitol Wednesday to meet with lawmakers and promote their contributions to the California economy. The pharmaceutical industry employs more people in California than any other state (145,880 jobs), according to Priscilla VanderVeer, a spokeswoman with \u003ca href=\"http://www.phrma.org/\" target=\"_blank\">Pharmaceutical Research and Manufacturers of American. \u003c/a>\u003c/p>\n\u003cp>VanderVeer said SB 17 won't do anything to help consumers. \"If the problem is that patients are having a hard time affording their medicines, which we know they are, then let’s come to the table and talk about solutions that can actually help them,\" she said.\u003c/p>\n\u003cp>VanderVeer said one problem is that consumers often must pay the full list price of a drug, even if they are insured.\u003c/p>\n\u003cp>\"Oftentimes when a patient goes to the pharmacy counter and they haven’t reached their deductible, or they have a co-insurance on their drugs, they’re paying that off the list price, not the negotiated rate their insurance has,\" she said. VanderVeer says that doesn't happen to insured patients in other parts of the health care system.\u003c/p>\n\u003cp>\"I give the example of the hospital. You know the $350 x-ray that your insurance brings down to $50, and then you pay your cost-sharing off the $50. That’s not happening with your drugs, that’s not happening at the pharmacy counter,\" she said.\u003c/p>\n\u003cp>VanderVeer also criticized the bill for ignoring other parts of the pharmaceutical supply chain that also affect prices.\u003c/p>\n\u003cp>\"You’ve also got pharmacy benefit managers and insurers who negotiate the price significantly down, I might say, and then you also got wholesalers who purchase drugs directly and keep them in their warehouses and disseminate them to pharmacies. And then you’ve got pharmacies,\" VanderVeer explained. She said those links in the supply chain account for one-third of the final price.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Assemblyman Wood agrees that California should pay more attention to \u003ca href=\"http://www.investopedia.com/articles/markets/070215/what-pharmacy-benefit-management-industry.asp\" target=\"_blank\">pharmacy benefit managers\u003c/a>, companies that act as middlemen, negotiating purchase contracts with drug manufacturers on behalf of health plans. Wood has introduced a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB315\" target=\"_blank\">different bill\u003c/a> in the Assembly that would require pharmacy benefit managers to be licensed in California. It would also require them to disclose information about their business practices, including rebates and hidden \u003ca href=\"https://www.bloomberg.com/news/articles/2017-02-24/sworn-to-secrecy-drugstores-stay-silent-as-customers-overpay\" target=\"_blank\">\"clawback\" \u003c/a>arrangements that force patients to unwittingly pay more for drugs.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/314273/california-presses-forward-in-fight-to-regulate-pharma","authors":["11314"],"categories":["stateofhealth_2407","stateofhealth_1"],"tags":["stateofhealth_2892","stateofhealth_2808","stateofhealth_2519","stateofhealth_3038"],"featImg":"stateofhealth_314274","label":"stateofhealth"},"stateofhealth_304974":{"type":"posts","id":"stateofhealth_304974","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"304974","score":null,"sort":[1489604072000]},"guestAuthors":[],"slug":"a-new-diagnosis-post-election-stress-disorder","title":"A New Diagnosis: ‘Post-Election Stress Disorder’","publishDate":1489604072,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Wally Pfingsten has always been a news junkie. But since President Donald Trump was elected, he’s been so anxious about the political tumult that even just having the TV news on in the background at home is unbearable.\u003c/p>\n\u003cp>“It’s been crippling,” said the 35-year-old San Mateo resident and political moderate who has supported both Democratic and Republican candidates in the past. “I feel angry, really, really angry, far more angry than I expected to be.”\u003c/p>\n\u003cp>He’s tried hard to quell his anxiety. First, he shut down his Facebook page to limit his exposure to the daily soaking of news from Washington. But not knowing the goings-on made him anxious, too. He found himself sneaking onto the Facebook account he made for his dog. “I felt like I was cheating,” he said.\u003c/p>\n\u003cp>Pfingsten is not alone in his politics-induced anxiety — it’s so common it’s been given an unofficial name: Post-Election Stress Disorder. Mental health professionals around the country, especially those working in Democratic strongholds, report a stream of patients coming in with anxiety and depression related to — or worsened by — the blast of daily news on the new administration.\u003c/p>\n\u003cp>In the past, therapists say it’s been fairly uncommon for patients to bring up politics on the couch. “It is big money to talk about politics with me ― that is not what we do!” said Maria Lymberis, a psychiatrist in Santa Monica.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But that was before “fake news,” “alternative facts,” “repeal and replace,” contested confirmations, travel bans, protests and suits over travel bans, suspicions about Russian influence and the departures of the acting attorney general and the new national security adviser. Among other things.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/312550437\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Requests for therapy appointments to Talkspace, an online therapy portal based in New York City, tripled immediately following the election and have remained high through January, according to the company. In particular, Talkspace has seen a steady increase in requests from minorities, including Muslim-Americans, African-Americans, Jews, gays and lesbians.\u003c/p>\n\u003cp>“In my 28 years in practice, I’ve never seen anything like this level of stress,” said Nancy Molitor, a psychologist in the Chicago suburbs. She says the vast majority of her patients — from millennials to those in their 80s — are bringing up politics in their therapy sessions. “What we’re seeing now after the inauguration is a huge uptick in anxiety.”\u003c/p>\n\u003cp>Many of her patients say they are having trouble sleeping and focusing at work or are fighting more with family members, she said.\u003c/p>\n\u003cp>“I have people who’ve told me they’re in mourning, that they’ve lost their libido,” Molitor said. “I have people saying the anxiety is causing them to be so distracted that they’re blowing through stop signs or getting into fender benders.”\u003c/p>\n\u003cp>The anxiety appears to be widespread. Fifty-seven percent of Americans report that the current political climate is a very or somewhat significant source of stress, and 40 percent say the same about the outcome of the election, according to an online survey of 1,019 adults conducted by the American Psychological Association after the inauguration. Between August 2016 and January 2017, the overall average stress level increased significantly for the first time since the Stress in America survey began 10 years ago.\u003c/p>\n\u003cp>And it’s not Democrats: a quarter of Republicans report that the outcome of election is a significant source of stress for them.\u003c/p>\n\u003cp>“I’m seeing lot of anxiety and anger on both sides,” says Elaine DuCharme, a psychologist in Glastonbury, Conn. “People who are Republicans are afraid to tell anyone. They’re afraid that everybody thinks that every Republican thinks exactly as Trump does, and support every single thing he does.”\u003c/p>\n\u003cp>She says some of her patients are particularly concerned about maintaining civil relationships with friends and loved ones who have different political opinions. “People are walking on eggshells,” DuCharme said.\u003c/p>\n\u003cp>Karri King, 56, who lives in Buckeye, Ariz., and voted for Trump, says her experiences on social media have left her feeling sad and hopeless. “There’s so much negative from all these stupid Facebook posts acting like the world is going to end. And it’s false. And I can’t do a thing about it.”\u003c/p>\n\u003cp>King said she’s tried to engage civilly with people online who disagree with her, but “every time [Republicans] turn around, we’re bashed.”\u003c/p>\n\u003cp>When you say “a bunch of idiots” voted Trump in, “you’re talking about half of all Americans! We were hopeful at first, and now we’re angry and tired of being blamed,” said King. “Nobody wants to listen anymore, and that’s where my sadness comes from.”\u003c/p>\n\u003cp>Of course, in some parts of the country, especially those that are overwhelmingly Republican and outside big cities, people seem relieved if not uplifted by the new president’s flurry of executive orders and appointments.\u003c/p>\n\u003cp>Kristin Addison-Brown, a psychologist in rural Jonesboro, Ark., says before the election, some of her patients were voicing concerns about a possible Clinton victory. But since then, “it’s pretty much been crickets for my patients. They got their guy, so they’re not stressed anymore.”\u003c/p>\n\u003cp>Nancy Cottle, a Trump supporter in Mesa, Ariz., has been riding high since the election. “We got to go to the inauguration, and, oh, it was a wonderful experience! We got to go to the Trump hotel and have breakfast and then lunch there, and it was just great. The inauguration itself was very inspiring.”\u003c/p>\n\u003cp>Cottle, 64, has been struggling to understand the public outcry about Trump. “It’s like the sky is falling ― but a lot of that is just drama,” she said. “I feel encouraged, I feel hopeful. I can’t wait to wake up and see what the day’s going to bring and what else is going to happen.”\u003c/p>\n\u003cp>That same daily dose of news ― and the uncertainty of what will happen next ― rattles many Trump opponents. But, like Pfingsten, they can’t seem to quit their news consumption cold turkey.\u003c/p>\n\u003cp>“Part of the brain wants to know what’s going on, and you’re drawn to watching CNN or reading the news. And then the other part of you is saying no, no, this isn’t good for me!” says Molitor, the Chicago psychologist. “It’s unfortunately like driving by a car accident ― they know it’s not good for them [to gawk], but it’s hard to stop.”\u003c/p>\n\u003cp>Molitor recommends patients stay engaged but limit the time they spend on Facebook or watching the news. Focus instead on other things you enjoy, she advises ― calling a friend, taking a walk or reading a book.\u003c/p>\n\u003cp>“I never read the Harry Potter books, so I’m reading Harry Potter,” says Matthew Leal, a 34-year-old San Francisco resident who found himself sinking into a depression after the election. “Someone could see this and say I’m being totally escapist right now, but I feel like it’s kind of what I need.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced by KQED partner Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.\u003cbr>\n\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Trump opponents — and even some supporters — say the election and tumultuous early days of the new administration have left them anxious, angry and afraid of Facebook.","status":"publish","parent":0,"modified":1489697060,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1325},"headData":{"title":"A New Diagnosis: ‘Post-Election Stress Disorder’ | KQED","description":"Trump opponents — and even some supporters — say the election and tumultuous early days of the new administration have left them anxious, angry and afraid of Facebook.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A New Diagnosis: ‘Post-Election Stress Disorder’","datePublished":"2017-03-15T18:54:32.000Z","dateModified":"2017-03-16T20:44:20.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"304974 https://ww2.kqed.org/stateofhealth/?p=304974","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/03/15/a-new-diagnosis-post-election-stress-disorder/","disqusTitle":"A New Diagnosis: ‘Post-Election Stress Disorder’","nprByline":"\u003cstrong>\u003ca href=\"http://californiahealthline.org/news/author/jenny-gold/\" target=\"_blank\">Jenny Gold\u003c/a>\u003c/strong>\u003c/br>California Healthline","path":"/stateofhealth/304974/a-new-diagnosis-post-election-stress-disorder","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Wally Pfingsten has always been a news junkie. But since President Donald Trump was elected, he’s been so anxious about the political tumult that even just having the TV news on in the background at home is unbearable.\u003c/p>\n\u003cp>“It’s been crippling,” said the 35-year-old San Mateo resident and political moderate who has supported both Democratic and Republican candidates in the past. “I feel angry, really, really angry, far more angry than I expected to be.”\u003c/p>\n\u003cp>He’s tried hard to quell his anxiety. First, he shut down his Facebook page to limit his exposure to the daily soaking of news from Washington. But not knowing the goings-on made him anxious, too. He found himself sneaking onto the Facebook account he made for his dog. “I felt like I was cheating,” he said.\u003c/p>\n\u003cp>Pfingsten is not alone in his politics-induced anxiety — it’s so common it’s been given an unofficial name: Post-Election Stress Disorder. Mental health professionals around the country, especially those working in Democratic strongholds, report a stream of patients coming in with anxiety and depression related to — or worsened by — the blast of daily news on the new administration.\u003c/p>\n\u003cp>In the past, therapists say it’s been fairly uncommon for patients to bring up politics on the couch. “It is big money to talk about politics with me ― that is not what we do!” said Maria Lymberis, a psychiatrist in Santa Monica.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But that was before “fake news,” “alternative facts,” “repeal and replace,” contested confirmations, travel bans, protests and suits over travel bans, suspicions about Russian influence and the departures of the acting attorney general and the new national security adviser. Among other things.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/312550437&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/312550437'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Requests for therapy appointments to Talkspace, an online therapy portal based in New York City, tripled immediately following the election and have remained high through January, according to the company. In particular, Talkspace has seen a steady increase in requests from minorities, including Muslim-Americans, African-Americans, Jews, gays and lesbians.\u003c/p>\n\u003cp>“In my 28 years in practice, I’ve never seen anything like this level of stress,” said Nancy Molitor, a psychologist in the Chicago suburbs. She says the vast majority of her patients — from millennials to those in their 80s — are bringing up politics in their therapy sessions. “What we’re seeing now after the inauguration is a huge uptick in anxiety.”\u003c/p>\n\u003cp>Many of her patients say they are having trouble sleeping and focusing at work or are fighting more with family members, she said.\u003c/p>\n\u003cp>“I have people who’ve told me they’re in mourning, that they’ve lost their libido,” Molitor said. “I have people saying the anxiety is causing them to be so distracted that they’re blowing through stop signs or getting into fender benders.”\u003c/p>\n\u003cp>The anxiety appears to be widespread. Fifty-seven percent of Americans report that the current political climate is a very or somewhat significant source of stress, and 40 percent say the same about the outcome of the election, according to an online survey of 1,019 adults conducted by the American Psychological Association after the inauguration. Between August 2016 and January 2017, the overall average stress level increased significantly for the first time since the Stress in America survey began 10 years ago.\u003c/p>\n\u003cp>And it’s not Democrats: a quarter of Republicans report that the outcome of election is a significant source of stress for them.\u003c/p>\n\u003cp>“I’m seeing lot of anxiety and anger on both sides,” says Elaine DuCharme, a psychologist in Glastonbury, Conn. “People who are Republicans are afraid to tell anyone. They’re afraid that everybody thinks that every Republican thinks exactly as Trump does, and support every single thing he does.”\u003c/p>\n\u003cp>She says some of her patients are particularly concerned about maintaining civil relationships with friends and loved ones who have different political opinions. “People are walking on eggshells,” DuCharme said.\u003c/p>\n\u003cp>Karri King, 56, who lives in Buckeye, Ariz., and voted for Trump, says her experiences on social media have left her feeling sad and hopeless. “There’s so much negative from all these stupid Facebook posts acting like the world is going to end. And it’s false. And I can’t do a thing about it.”\u003c/p>\n\u003cp>King said she’s tried to engage civilly with people online who disagree with her, but “every time [Republicans] turn around, we’re bashed.”\u003c/p>\n\u003cp>When you say “a bunch of idiots” voted Trump in, “you’re talking about half of all Americans! We were hopeful at first, and now we’re angry and tired of being blamed,” said King. “Nobody wants to listen anymore, and that’s where my sadness comes from.”\u003c/p>\n\u003cp>Of course, in some parts of the country, especially those that are overwhelmingly Republican and outside big cities, people seem relieved if not uplifted by the new president’s flurry of executive orders and appointments.\u003c/p>\n\u003cp>Kristin Addison-Brown, a psychologist in rural Jonesboro, Ark., says before the election, some of her patients were voicing concerns about a possible Clinton victory. But since then, “it’s pretty much been crickets for my patients. They got their guy, so they’re not stressed anymore.”\u003c/p>\n\u003cp>Nancy Cottle, a Trump supporter in Mesa, Ariz., has been riding high since the election. “We got to go to the inauguration, and, oh, it was a wonderful experience! We got to go to the Trump hotel and have breakfast and then lunch there, and it was just great. The inauguration itself was very inspiring.”\u003c/p>\n\u003cp>Cottle, 64, has been struggling to understand the public outcry about Trump. “It’s like the sky is falling ― but a lot of that is just drama,” she said. “I feel encouraged, I feel hopeful. I can’t wait to wake up and see what the day’s going to bring and what else is going to happen.”\u003c/p>\n\u003cp>That same daily dose of news ― and the uncertainty of what will happen next ― rattles many Trump opponents. But, like Pfingsten, they can’t seem to quit their news consumption cold turkey.\u003c/p>\n\u003cp>“Part of the brain wants to know what’s going on, and you’re drawn to watching CNN or reading the news. And then the other part of you is saying no, no, this isn’t good for me!” says Molitor, the Chicago psychologist. “It’s unfortunately like driving by a car accident ― they know it’s not good for them [to gawk], but it’s hard to stop.”\u003c/p>\n\u003cp>Molitor recommends patients stay engaged but limit the time they spend on Facebook or watching the news. Focus instead on other things you enjoy, she advises ― calling a friend, taking a walk or reading a book.\u003c/p>\n\u003cp>“I never read the Harry Potter books, so I’m reading Harry Potter,” says Matthew Leal, a 34-year-old San Francisco resident who found himself sinking into a depression after the election. “Someone could see this and say I’m being totally escapist right now, but I feel like it’s kind of what I need.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by KQED partner Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.\u003cbr>\n\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/304974/a-new-diagnosis-post-election-stress-disorder","authors":["byline_stateofhealth_304974"],"categories":["stateofhealth_2407","stateofhealth_3012","stateofhealth_14"],"tags":["stateofhealth_38","stateofhealth_2808","stateofhealth_2519"],"featImg":"stateofhealth_304976","label":"stateofhealth"},"futureofyou_329795":{"type":"posts","id":"futureofyou_329795","meta":{"index":"posts_1591205157","site":"futureofyou","id":"329795","score":null,"sort":[1486584449000]},"guestAuthors":[],"slug":"what-will-the-next-stage-in-digital-medicine-look-like","title":"What Will Next-Stage Digital Medicine Look Like?","publishDate":1486584449,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>On the health tech beat, you often meet, broadly, two types of people. First, there are lots of very smart people who think we have the know-how to achieve a kind of big-data, perpetual-monitoring, digital-health paradise -- or at least something better than we have now.\u003c/p>\n\u003cp>Then there are some other, equally smart folks who think that particular vision is fueled by too much Silicon Valley dreamin' and too little attention to the basics of health care access and smart policy.\u003c/p>\n\u003cp>Dr. Daniel Kraft is closer to the former category. Dr. Kraft put in an \u003ca href=\"https://ww2.kqed.org/forum/2017/01/24/first-person-daniel-kraft-on-the-next-stage-of-medical-technology/\" target=\"_blank\">appearance\u003c/a> on KQED's Forum radio program recently to discuss cutting edge health tech. Kraft is the chair of medicine at Singularity University, a technology think tank, \u003ca href=\"https://techcrunch.com/2015/09/30/singularity-university-launches-accelerator/\" target=\"_blank\">startup accelerator\u003c/a> and educational organization that looks to \"leverage rapidly accelerating technologies\" to find solutions on a global scale.\u003c/p>\n\u003cp>Kraft and Forum host Michael Krasny talked about the effects of new and prospective technologies, from virtual reality's impact on medical education to the \"Uberization\" of health care. Below are excerpts of Kraft's answers, edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>The Uberization of Health Care\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Everyone is familiar with \u003ca href=\"https://ww2.kqed.org/news/tag/uber/\" target=\"_blank\">Uber as disruptive\u003c/a>. But they couldn’t have existed 10-plus years ago, without smartphones, GPS, online payments--they connected the dots.\u003c/p>\n\u003cp>We all want that ease and transparency of use that we’re used to with Uber. And we’re seeing that kind of mindset come not just to millennials but to \u003ca href=\"https://www.google.com/search?q=senior+citizens+digital+health+care\" target=\"_blank\">older folks\u003c/a> who want access to their clinical data and doctor. There are several companies that have launched apps where you press a button and a doctor will come to you within three hours. Uber itself did a pilot in New York where you press a button and a nurse will come and \u003ca href=\"http://fortune.com/2016/10/25/uber-free-flu-shots/\" target=\"_blank\">give you\u003c/a> a flu shot. This ease-of-access mindset is coming across in many parts of health care, including \u003ca href=\"http://www.cnbc.com/2016/05/16/digital-focused-pharmacy-capsule-opens-in-new-york.html\" target=\"_blank\">delivering your drugs\u003c/a>, whether it's by Uber, Lyft or drone.\u003c/p>\n\u003cp>\u003cstrong>The Potential of Digital Health Data\u003c/strong>\u003c/p>\n\u003cp>We’re in this age of exponential data, but how do you make it useful to you as a consumer, patient and physician? A lot of digital devices get \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/10/fitbit-study/\" target=\"_blank\">left in a drawer\u003c/a> after a month or so; the trick is to make them engaging.\u003c/p>\n\u003cp>We practice sick care today, spending most of our time and money on folks who already have disease. But we can really move to more proactive, continuous health care using some of these tools.\u003c/p>\n\u003cp>In the future we’ll have individualized check engine lights. Your information will be synthesized so that a warning light can say, \"Hey, time to come in for a checkup before you blow a gasket.\"\u003c/p>\n\u003cp>\u003cstrong>Digital Mental Health Tools\u003c/strong>\u003c/p>\n\u003cp>With some wearables and other technologies we can now get a pulse on our behaviors. Right now I’m wearing a couple of devices that \u003ca href=\"http://sleepjunkies.com/features/the-ultimate-guide-to-sleep-tracking/\" target=\"_blank\">track my sleep\u003c/a>. I have a ring that can do this; I have a sensor on my mattress. Just getting insight into how you sleep can have a huge impact on health and wellness over the long term.\u003c/p>\n\u003cp>It’s the same thing for depression and anxiety. We’re seeing companies that can be a platform for mental health progression. For example, for bipolar patients, if you’re depressed and not moving much and staying in the house, some of these \u003ca href=\"http://www.nature.com/news/mental-health-there-s-an-app-for-that-1.19694\">new platforms\u003c/a> allow you to access your care team and your family, so you can get a digital hug when you might need one.\u003c/p>\n\u003cp>\u003cstrong>Virtual and Augmented Reality\u003c/strong>\u003c/p>\n\u003cp>Physicians today spend twice as much time typing in their medical records than they do with patients. So one of the best applications is using Google Glass or a similar product so physicians can see their patients and view data but have someone else act as a virtual \u003ca href=\"http://www.healthcare-informatics.com/article/ehr/how-virtual-scribe-enhancing-doctor-patient-relationship\" target=\"_blank\">scribe\u003c/a>.\u003c/p>\n\u003cp>We’re seeing now how Oculus Rift can help medical students \u003ca href=\"http://www.roadtovr.com/vr-human-anatomy-to-give-medical-students-a-hands-on-using-oculus-touch/\" target=\"_blank\">learn anatomy\u003c/a>, allowing them to fly through the heart or the brain. We’re seeing ways to use VR to \u003ca href=\"https://ww2.kqed.org/futureofyou/2015/05/28/how-virtual-reality-worlds-can-help-reduce-pain/\" target=\"_blank\">treat burn patients\u003c/a> who have undergone painful surgeries; they're put into a cold environment where they get to throw snowballs, and it diminishes their pain and their need for opiates. And kids with autism can now \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/08/google-glass-flopped-but-kids-with-autism-are-using-it-to-learn-emotions/\" target=\"_blank\">put on Google Glass\u003c/a> and learn to recognize facial emotions.\u003c/p>\n\u003cp>\u003cstrong>Health Screening Tools\u003c/strong>\u003c/p>\n\u003cp>Part of the future will be to use new screening tools: app-based eye-tracking devices, blood-based diagnostics, brain scans that might pick up dementia 10 or 15 years early. There are drugs in development that might stop or reverse plaques when you’re at stage 0, before you have symptoms.\u003c/p>\n\u003cp>Even with your 23andme data, primary care doctors could gain some insights--when to screen you or \u003ca href=\"http://www.npr.org/sections/health-shots/2015/09/01/436584534/are-statins-bad-for-me-personalized-medicine-cant-yet-say\" target=\"_blank\">what statin drugs\u003c/a> may work best for you, based on your \u003ca href=\"https://ghr.nlm.nih.gov/primer/genomicresearch/pharmacogenomics\" target=\"_blank\">pharmacogenomics\u003c/a>. The challenge is a lot of this information doesn’t flow to your physicians; they’re not incentivized to use it, and in some cases they're dis-incentivized.\u003c/p>\n\u003cp>\u003cstrong>Health Care vs. Technology Care\u003c/strong>\u003c/p>\n\u003cp>Folks talk about robot physicians or the app \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/07/AI-computers-diagnosis-watson/\" target=\"_blank\">taking over\u003c/a> your medical care. I think it’s going to be more of a blend, not just AI but IA, intelligence augmentation. So in fields like \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/25/technology-radiology/\" target=\"_blank\">radiology\u003c/a> or dermatology or pathology, where clinicians are trained to see patterns, now machine learning can arguably do that faster and better, and that can augment a primary care doctor in screening you for melanoma, for example.\u003c/p>\n\u003cp>We’re seeing the ability to do triage with \u003ca href=\"http://www.theverge.com/2016/10/11/13240434/baidu-medical-chatbot-china-melody\" target=\"_blank\">chatbots\u003c/a>, which you might access from your phone and help you do the first steps. I’ve got a few \u003ca href=\"http://tricorder.xprize.org/teams/final-frontier-medical-devices\" target=\"_blank\">medical tricorders\u003c/a>, inspired by \"Star Trek,\" with me. So at home or in your pocket you can literally pull down advanced vital signs that synch up with your phone and connect to your clinicians, and AI agents can help you understand where you are in your baseline and the way things are moving.\u003c/p>\n\u003cp>We don’t need to replace doctors, but maybe every visit \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/02/03/virtual_care_clinic_usc/\" target=\"_blank\">doesn’t need\u003c/a> to require you to take off half a day of work, sit in the waiting room and fill out the same form. You might use your smartphone for a follow-up appointment to look at a wound from surgery, or to check on a suspicious skin lesion. As cost pressures go, we’ll be seeing more and more payment for some of these \u003ca href=\"http://www.huffingtonpost.ca/jacki-andre/health-care-telemedicine_b_14632688.html\" target=\"_blank\">telehealth\u003c/a> platforms.\u003c/p>\n\u003cp>\u003cstrong>Pediatrics and Technology \u003c/strong>\u003c/p>\n\u003cp>There's a lot of new tech coming for pregnant women and children. A connected otoscope can enable you to track kids with ear infections at home, so you don't have to drag them back to the doctor. We’re seeing sensored cribs or infant ankle bracelets, sort of a Fitbit for babies, which can help reassure worried parents or enable a physician to send a child home earlier when they're at risk of SIDS or asthma.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>More on \u003ca href=\"https://su.org/\" target=\"_blank\">Singularity University\u003c/a> and what it calls \u003ca href=\"https://exponential.singularityu.org/medicine/\" target=\"_blank\">exponential medicine here\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"New and future digital health trends and tools, from Dr. Daniel Kraft of Singularity University.","status":"publish","parent":0,"modified":1486660819,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1219},"headData":{"title":"What Will Next-Stage Digital Medicine Look Like? | KQED","description":"New and future digital health trends and tools, from Dr. Daniel Kraft of Singularity University.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What Will Next-Stage Digital Medicine Look Like?","datePublished":"2017-02-08T20:07:29.000Z","dateModified":"2017-02-09T17:20:19.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"329795 https://ww2.kqed.org/futureofyou/?p=329795","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/02/08/what-will-the-next-stage-in-digital-medicine-look-like/","disqusTitle":"What Will Next-Stage Digital Medicine Look Like?","source":"KQED Future of You","path":"/futureofyou/329795/what-will-the-next-stage-in-digital-medicine-look-like","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>On the health tech beat, you often meet, broadly, two types of people. First, there are lots of very smart people who think we have the know-how to achieve a kind of big-data, perpetual-monitoring, digital-health paradise -- or at least something better than we have now.\u003c/p>\n\u003cp>Then there are some other, equally smart folks who think that particular vision is fueled by too much Silicon Valley dreamin' and too little attention to the basics of health care access and smart policy.\u003c/p>\n\u003cp>Dr. Daniel Kraft is closer to the former category. Dr. Kraft put in an \u003ca href=\"https://ww2.kqed.org/forum/2017/01/24/first-person-daniel-kraft-on-the-next-stage-of-medical-technology/\" target=\"_blank\">appearance\u003c/a> on KQED's Forum radio program recently to discuss cutting edge health tech. Kraft is the chair of medicine at Singularity University, a technology think tank, \u003ca href=\"https://techcrunch.com/2015/09/30/singularity-university-launches-accelerator/\" target=\"_blank\">startup accelerator\u003c/a> and educational organization that looks to \"leverage rapidly accelerating technologies\" to find solutions on a global scale.\u003c/p>\n\u003cp>Kraft and Forum host Michael Krasny talked about the effects of new and prospective technologies, from virtual reality's impact on medical education to the \"Uberization\" of health care. Below are excerpts of Kraft's answers, edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>The Uberization of Health Care\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Everyone is familiar with \u003ca href=\"https://ww2.kqed.org/news/tag/uber/\" target=\"_blank\">Uber as disruptive\u003c/a>. But they couldn’t have existed 10-plus years ago, without smartphones, GPS, online payments--they connected the dots.\u003c/p>\n\u003cp>We all want that ease and transparency of use that we’re used to with Uber. And we’re seeing that kind of mindset come not just to millennials but to \u003ca href=\"https://www.google.com/search?q=senior+citizens+digital+health+care\" target=\"_blank\">older folks\u003c/a> who want access to their clinical data and doctor. There are several companies that have launched apps where you press a button and a doctor will come to you within three hours. Uber itself did a pilot in New York where you press a button and a nurse will come and \u003ca href=\"http://fortune.com/2016/10/25/uber-free-flu-shots/\" target=\"_blank\">give you\u003c/a> a flu shot. This ease-of-access mindset is coming across in many parts of health care, including \u003ca href=\"http://www.cnbc.com/2016/05/16/digital-focused-pharmacy-capsule-opens-in-new-york.html\" target=\"_blank\">delivering your drugs\u003c/a>, whether it's by Uber, Lyft or drone.\u003c/p>\n\u003cp>\u003cstrong>The Potential of Digital Health Data\u003c/strong>\u003c/p>\n\u003cp>We’re in this age of exponential data, but how do you make it useful to you as a consumer, patient and physician? A lot of digital devices get \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/10/fitbit-study/\" target=\"_blank\">left in a drawer\u003c/a> after a month or so; the trick is to make them engaging.\u003c/p>\n\u003cp>We practice sick care today, spending most of our time and money on folks who already have disease. But we can really move to more proactive, continuous health care using some of these tools.\u003c/p>\n\u003cp>In the future we’ll have individualized check engine lights. Your information will be synthesized so that a warning light can say, \"Hey, time to come in for a checkup before you blow a gasket.\"\u003c/p>\n\u003cp>\u003cstrong>Digital Mental Health Tools\u003c/strong>\u003c/p>\n\u003cp>With some wearables and other technologies we can now get a pulse on our behaviors. Right now I’m wearing a couple of devices that \u003ca href=\"http://sleepjunkies.com/features/the-ultimate-guide-to-sleep-tracking/\" target=\"_blank\">track my sleep\u003c/a>. I have a ring that can do this; I have a sensor on my mattress. Just getting insight into how you sleep can have a huge impact on health and wellness over the long term.\u003c/p>\n\u003cp>It’s the same thing for depression and anxiety. We’re seeing companies that can be a platform for mental health progression. For example, for bipolar patients, if you’re depressed and not moving much and staying in the house, some of these \u003ca href=\"http://www.nature.com/news/mental-health-there-s-an-app-for-that-1.19694\">new platforms\u003c/a> allow you to access your care team and your family, so you can get a digital hug when you might need one.\u003c/p>\n\u003cp>\u003cstrong>Virtual and Augmented Reality\u003c/strong>\u003c/p>\n\u003cp>Physicians today spend twice as much time typing in their medical records than they do with patients. So one of the best applications is using Google Glass or a similar product so physicians can see their patients and view data but have someone else act as a virtual \u003ca href=\"http://www.healthcare-informatics.com/article/ehr/how-virtual-scribe-enhancing-doctor-patient-relationship\" target=\"_blank\">scribe\u003c/a>.\u003c/p>\n\u003cp>We’re seeing now how Oculus Rift can help medical students \u003ca href=\"http://www.roadtovr.com/vr-human-anatomy-to-give-medical-students-a-hands-on-using-oculus-touch/\" target=\"_blank\">learn anatomy\u003c/a>, allowing them to fly through the heart or the brain. We’re seeing ways to use VR to \u003ca href=\"https://ww2.kqed.org/futureofyou/2015/05/28/how-virtual-reality-worlds-can-help-reduce-pain/\" target=\"_blank\">treat burn patients\u003c/a> who have undergone painful surgeries; they're put into a cold environment where they get to throw snowballs, and it diminishes their pain and their need for opiates. And kids with autism can now \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/04/08/google-glass-flopped-but-kids-with-autism-are-using-it-to-learn-emotions/\" target=\"_blank\">put on Google Glass\u003c/a> and learn to recognize facial emotions.\u003c/p>\n\u003cp>\u003cstrong>Health Screening Tools\u003c/strong>\u003c/p>\n\u003cp>Part of the future will be to use new screening tools: app-based eye-tracking devices, blood-based diagnostics, brain scans that might pick up dementia 10 or 15 years early. There are drugs in development that might stop or reverse plaques when you’re at stage 0, before you have symptoms.\u003c/p>\n\u003cp>Even with your 23andme data, primary care doctors could gain some insights--when to screen you or \u003ca href=\"http://www.npr.org/sections/health-shots/2015/09/01/436584534/are-statins-bad-for-me-personalized-medicine-cant-yet-say\" target=\"_blank\">what statin drugs\u003c/a> may work best for you, based on your \u003ca href=\"https://ghr.nlm.nih.gov/primer/genomicresearch/pharmacogenomics\" target=\"_blank\">pharmacogenomics\u003c/a>. The challenge is a lot of this information doesn’t flow to your physicians; they’re not incentivized to use it, and in some cases they're dis-incentivized.\u003c/p>\n\u003cp>\u003cstrong>Health Care vs. Technology Care\u003c/strong>\u003c/p>\n\u003cp>Folks talk about robot physicians or the app \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/07/AI-computers-diagnosis-watson/\" target=\"_blank\">taking over\u003c/a> your medical care. I think it’s going to be more of a blend, not just AI but IA, intelligence augmentation. So in fields like \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/25/technology-radiology/\" target=\"_blank\">radiology\u003c/a> or dermatology or pathology, where clinicians are trained to see patterns, now machine learning can arguably do that faster and better, and that can augment a primary care doctor in screening you for melanoma, for example.\u003c/p>\n\u003cp>We’re seeing the ability to do triage with \u003ca href=\"http://www.theverge.com/2016/10/11/13240434/baidu-medical-chatbot-china-melody\" target=\"_blank\">chatbots\u003c/a>, which you might access from your phone and help you do the first steps. I’ve got a few \u003ca href=\"http://tricorder.xprize.org/teams/final-frontier-medical-devices\" target=\"_blank\">medical tricorders\u003c/a>, inspired by \"Star Trek,\" with me. So at home or in your pocket you can literally pull down advanced vital signs that synch up with your phone and connect to your clinicians, and AI agents can help you understand where you are in your baseline and the way things are moving.\u003c/p>\n\u003cp>We don’t need to replace doctors, but maybe every visit \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/02/03/virtual_care_clinic_usc/\" target=\"_blank\">doesn’t need\u003c/a> to require you to take off half a day of work, sit in the waiting room and fill out the same form. You might use your smartphone for a follow-up appointment to look at a wound from surgery, or to check on a suspicious skin lesion. As cost pressures go, we’ll be seeing more and more payment for some of these \u003ca href=\"http://www.huffingtonpost.ca/jacki-andre/health-care-telemedicine_b_14632688.html\" target=\"_blank\">telehealth\u003c/a> platforms.\u003c/p>\n\u003cp>\u003cstrong>Pediatrics and Technology \u003c/strong>\u003c/p>\n\u003cp>There's a lot of new tech coming for pregnant women and children. A connected otoscope can enable you to track kids with ear infections at home, so you don't have to drag them back to the doctor. We’re seeing sensored cribs or infant ankle bracelets, sort of a Fitbit for babies, which can help reassure worried parents or enable a physician to send a child home earlier when they're at risk of SIDS or asthma.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>More on \u003ca href=\"https://su.org/\" target=\"_blank\">Singularity University\u003c/a> and what it calls \u003ca href=\"https://exponential.singularityu.org/medicine/\" target=\"_blank\">exponential medicine here\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/329795/what-will-the-next-stage-in-digital-medicine-look-like","authors":["80"],"categories":["futureofyou_452","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_26"],"featImg":"futureofyou_274615","label":"source_futureofyou_329795"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. 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For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us","airtime":"SUN 2pm-3pm, MON 12am-1am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png","officialWebsiteLink":"https://www.wnycstudios.org/shows/otm","meta":{"site":"news","source":"wnyc"},"link":"/radio/program/on-the-media","subscribe":{"apple":"https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2","tuneIn":"https://tunein.com/radio/On-the-Media-p69/","rss":"http://feeds.wnyc.org/onthemedia"}},"our-body-politic":{"id":"our-body-politic","title":"Our Body Politic","info":"Presented by KQED, KCRW and KPCC, and created and hosted by award-winning journalist Farai Chideya, Our Body Politic is unapologetically centered on reporting on not just how women of color experience the major political events of today, but how they’re impacting those very issues.","airtime":"SAT 6pm-7pm, SUN 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Our-Body-Politic-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://our-body-politic.simplecast.com/","meta":{"site":"news","source":"kcrw"},"link":"/radio/program/our-body-politic","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/our-body-politic/id1533069868","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zaW1wbGVjYXN0LmNvbS9feGFQaHMxcw","spotify":"https://open.spotify.com/show/4ApAiLT1kV153TttWAmqmc","rss":"https://feeds.simplecast.com/_xaPhs1s","tuneIn":"https://tunein.com/podcasts/News--Politics-Podcasts/Our-Body-Politic-p1369211/"}},"pbs-newshour":{"id":"pbs-newshour","title":"PBS NewsHour","info":"Analysis, background reports and updates from the PBS NewsHour putting today's news in context.","airtime":"MON-FRI 3pm-4pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.pbs.org/newshour/","meta":{"site":"news","source":"pbs"},"link":"/radio/program/pbs-newshour","subscribe":{"apple":"https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2","tuneIn":"https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/","rss":"https://www.pbs.org/newshour/feeds/rss/podcasts/show"}},"perspectives":{"id":"perspectives","title":"Perspectives","tagline":"KQED's series of of daily listener commentaries since 1991","info":"KQED's series of of daily listener commentaries since 1991.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Perspectives-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/perspectives/","meta":{"site":"radio","source":"kqed","order":"15"},"link":"/perspectives","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/id73801135","npr":"https://www.npr.org/podcasts/432309616/perspectives","rss":"https://ww2.kqed.org/perspectives/category/perspectives/feed/","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"}},"planet-money":{"id":"planet-money","title":"Planet Money","info":"The economy explained. 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The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.","airtime":"SAT 4pm-5pm","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/reveal300px.png","officialWebsiteLink":"https://www.revealnews.org/episodes/","meta":{"site":"news","source":"npr"},"link":"/radio/program/reveal","subscribe":{"apple":"https://itunes.apple.com/us/podcast/reveal/id886009669","tuneIn":"https://tunein.com/radio/Reveal-p679597/","rss":"http://feeds.revealradio.org/revealpodcast"}},"says-you":{"id":"says-you","title":"Says You!","info":"Public radio's game show of bluff and bluster, words and whimsy. 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