Longer looks: Limits on doctor training; a woman's campaign for end-of-life choices

Each week, KHN finds interesting reads from around the Web.

The Minneapolis Star Tribune/McClatchy: Can Brain Surgery Be Taught In An 80-Hour Workweek
Dr. Dino Terzic got lucky the other day. In his seventh and final year as a neurosurgery resident at the University of Minnesota, the 32-year-old Bosnian got to operate on a rare type of brain aneurysm that required a special approach through the patient's forehead. As Terzic prepared to slice into the patient's scalp, he was asked if he'd ever seen this type of flaw in an artery, which occurs in just 2 to 3 percent of aneurysm cases. "On a video," Terzic replied with a chuckle. Terzic's hands-on experience shows why the nation's medical schools are beset by a nagging controversy over rules that limit the number of hours residents can work (Dan Browning, 10/8).

The New York Times: Learning From Fungi: Of Medicine And Mushrooms
Each medical case, like each mushroom, is a diagnostic puzzle. As I gained confidence in identifying both mushrooms and diseases, I realized that whether confronting a puzzle in a green field or a sterile hospital, my mind worked to solve it in the same way, homing in on subtle hints to tell look-alikes apart. The word "diagnosis" actually means "to know apart from," or "to distinguish," and this is both the physician's and the forager's task. Learning to diagnose diseases or identify mushrooms also means learning ecology. Just as an experienced forager knows which mushrooms to expect based on region, climate, season and recent rainfall patterns, the sort of tree overhead and forest duff underfoot, a physician understands that diseases have an ecological context of season and geography (Dr. Joseph Reisman, 10/4).

People Magazine: Terminally Ill 29-Year-Old Woman: Why I'm Choosing To Die On My Own Terms
For the past 29 years, Brittany Maynard has lived a fearless life – running half marathons, traveling through Southeast Asia for a year and even climbing Mount Kilimanjaro. So, it's no surprise she is facing her death the same way. On Monday, Maynard will launch an online video campaign with the nonprofit Compassion & Choices, an end-of-life choice advocacy organization, to fight for expanding death-with-dignity laws nationwide (Nicole Weisensee Egan, 10/6).

Reason: The Obamacare Glitches Continue
Obamacare, you may have heard, is working just fine. "It turns out it's working pretty well in the real world," President Barack Obama said of the health law in a speech at a fundraiser last week. If so, the public hasn't caught on yet. ... It's true that the worst-case scenarios that seemed plausible last year, when the exchange system crashed, failed to occur, and also the law has posted some successes in recent weeks: low premium growth, 7.3 million paid enrollments, an increase in insurer participation in the exchanges. But the law has also continued to generate a steady stream of bad news-;more glitches, more failures, more misfires, more unhappy providers and customers, with more challenges on the way as the second open enrollment period begins. And even the success stories are not quite as positive as the headlines make them out to be (Peter Suderman, 10/6).

Morning Consult: The ACA In The Context Of The 2014 Election
With Election Day less than a month away, we wanted to review and reflect on the ACA in the context of the election. ... Obamacare is "baked into" voters' attitudes. Among potential Republican voters, it is a compelling and convincing reason why to vote Republican. Opposition to Obamacare unites the Republican base and will draw some center-right Independents to vote Republican. ... this is one of the top issues in the cycle with one out of ten campaign ads revolving around Obamacare. (Bill Mcinturff and Elizabeth Harrington, 10/7).

Mother Jones: Are Your Chicken Nuggets Ruining Your Antibiotic Ointment?
Last week, the FDA released a report on the gross amount of antibiotics purchased by the livestock industry in 2012. The results are a bit startling. Between 2009 and 2012-;a period of increasing awareness about the perils of antibiotic use in livestock facilities-;the FDA found purchases of the drugs rose 16 percent. Over the same period, annual production of beef, chicken, and pork barely budged, suggesting that the industry was becoming more antibiotic-intensive each year. Worse still, the FDA deemed 61 percent of the antibiotics sold to the meat industry in 2012 as "medically important"-;meaning that they're commonly used in human medicine, and thus in danger of losing their effectiveness through resistance (Tom Philpott, 10/8).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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