Viewpoints: Overlapping Surgeries; Fighting Depression; Diabetes’ High Pricetag

JAMA: The Evolving Story Of Overlapping Surgery
In December 2015, a Boston Globe investigation of Massachusetts General Hospital (MGH) sparked investigations into concurrent and overlapping surgery. Overlapping surgery refers to operations performed by the same primary surgeon such that the start of one surgery overlaps with the end of another. A qualified practitioner finishes noncritical aspects of the first operation while the primary surgeon moves to the next operation. This is distinct from concurrent surgery, in which “critical parts” of operations for which the primary surgeon is responsible occur during the same time. There is general agreement that concurrent surgery is ethically unacceptable and is prohibited for teaching hospitals under the Medicare Conditions of Participation. Overlapping surgery is common, ranging from having trainees open and close incisions to delegating all aspects of the operation except the critical parts. (Michelle M. Mello and Edward H. Livingston, 6/28)

Miami Herald: Be Vigilant In The Fight Against Depression
In recent months, I lost two great personal and professional friends to depression and, ultimately, suicide — Raul Valdes-Fauli and Ervin Gonzalez. Both seemed to have the world in the palms of their hands: loving families, financial security, and professional success as a banker and lawyer, respectively. Now I know they also shared a similar mental anguish that became too much for each of them to bear. (Marlon A. Hill, 6/28)

The Des Moines Register: Being Diabetic Is Becoming Unaffordable
Egyptian medical texts dated around 550 B.C. contain the earliest known descriptions of diabetes. Treatments for the disease throughout history included having patients drink their own urine, bleeding them, blistering them and administering opium to “reduce the despair” of impending death. (6/28)

JAMA Forum: Some States Are Trying To Bolster Abortion Rights
On June 8, 2017, Delaware’s Democratic governor, John C. Carney, Jr, signed into law the first state abortion rights bill since the conclusion of the presidential campaign during which candidate Trump called for the abolition of Roe v Wade. Designed to ensure the legality of abortion in Delaware in the event that the landmark ruling is overturned by a reconstituted Supreme Court, Senate Bill 5 (SB 5) expunges a long-standing if unenforceable state abortion ban dating back to 1953. (Eli W. Adashi, 6/28)

RealClear Health: Fears Aren’t Facts: E-Cigarettes
There can no longer be any dispute: electronic cigarettes, also known as “vapes,” are significantly less harmful to health than traditional combustible cigarettes. Not only are they less harmful, they are more effective in helping adults quit their deadly cigarette habit than any other nicotine-replacement therapy. Despite this, some within the public health community continue efforts to eliminate these potentially life-saving products. San Francisco just passed a ban on the sale of flavored tobacco products, in part over concerns that fruit and candy-flavored e-cigarettes appeal to kids. But fears aren’t facts, and such efforts could have devastating consequences for public health. (Michelle Minton, 6/29)

JAMA: Porous Boundaries
Each fall, first-year medical students are introduced to the basics of confidentiality. The question is posed: “How many of you would friend a patient?” Watching from the back of the auditorium, I have yet to see a single hand flutter, much less shoot confidently into the air. I am waiting, I think, for the moment when the culture shifts before my eyes. Like my students, I feel a crawling discomfort at the thought of invading cyberspace to contact a patient online. I came of age with the internet: that is, old enough to have attended college Facebook-free but young enough to have been regularly chastised about the professional perils of social media. Unlike my students, however, I no longer hear it as a polar question. I accepted a friend request from a patient’s parents, and it forever changed my understanding of the practice of medicine. (Amy E Caruso Brown, 6/27)

JAMA: Acupuncture And The Complex Connections Between The Mind And The Body
Almost 50 years ago, New York Times reporter James Reston had an emergency appendectomy while traveling in China. His subsequent report that acupuncture produced substantial relief from his postoperative discomfort is widely credited with launching Western interest in acupuncture, although many Western medical practitioners have remained skeptical. Nevertheless, there has been steady progress in application of the methods of evidence-based medicine and modern neuroscience to these ancient practices, suggesting that acupuncture may have therapeutic benefit. (Josephine P. Briggs and David Shurtleff, 6/27)

Los Angeles Times: In Blocking A Bad Single-Payer Healthcare Bill, Assembly Speaker Anthony Rendon Was Not ‘Cowardly’ – Quite The Opposite
California badly needs political heroes, and we just got one: Assembly Speaker Anthony Rendon. “Heroic” is not an adjective normally associated with a politician. But regardless of your politics, Rendon should be saluted. (George Skelton, 6/29)

Cincinnati Enquirer: When Perceived Hope Is Lost
Your Congress has made it illegal for Medicare to negotiate drug prices. Drugs can be bought from Canada for less than the co-pay for your Medicare, meaning, you are paying several times the retail price; plus, you are paying for the insurance that is supposed to cover the cost; plus, taxpayers are also paying for the cost of the program. (James Baker, 6/28)

Los Angeles Times: Fairview Site Could Be A Cornerstone For Addiction And Mental Health Services
You can’t talk about addressing the mental health crisis in this county without including the issues of homelessness and addiction. This is why a coalition of addiction and mental health experts from Hoag and St. Joseph hospitals, as well as local and state government officials, have been meeting to come up with a plan. No one facility or community can bear the burden, but networked campuses countywide just might. (Barbara Venezia, 6/28)