This detailed animated heart was created by a team of doctors from the Heart Hospital in London and computer animation experts from Glassworks. The virtual heart can be manipulated using a computer mouse or keyboard. New Scientist says the computer simulated heart is the most realistic to date. Take a look:

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Yale cardiologist Harlan Krumholz has an important piece in the Washington Post, “Which Docs Measure Up?” (alternatively headlined online as “We Need A Consumer Reports for Doctors.”) Excerpt:

“Need a new hip? A hernia repair? You’re out of luck if you want to look at a doctor’s track record or an institution’s success rates. Results vary by surgeon and by hospital; you just have no way of knowing which one is best. And often, neither do they.”

He frames the article, though, around the story of a patient who turned to him (a cardiologist) for advice after being diagnosed with prostate cancer.

“This patient had nowhere to turn to figure out which doctors and hospitals had the best results and the lowest risk of these complications. His dilemma is the same one that virtually every patient — and the entire health-care system — is facing: How can you measure quality in an area in which your life may be at stake?”

Of course what Krumholz didn’t address was the fact that maybe this man’s life wasn’t at stake. A diagnosis of prostate cancer may not mean a death sentence. It may mean that you’ve been labeled with a “cancer” that wouldn’t have killed you and that you really didn’t need to know about.

What happened to the guy? Krumholz concludes:

“He went to a doctor his internist recommended. He heard that the doctor used a fancy new robotic surgery device and assumed that this meant that he was good. Six months later, he occasionally loses control of his bladder, and his sexual function is not what it was. He is left wondering whether he made the right choice. Meanwhile his experience is not being tracked to help the next person choose or the surgeon and the hospital improve.”

Ah, the robot. I’ve found newspaper headlines that promote it in a cheerleading fashion:

• Robot doctor – surgery of tomorrow

• Da Vinci puts magical touch on the prostate

• Cancer survivors meet lifesaving surgical robot

• Robotic surgeon’s hands never tremble

• Da Vinci is code for faster recovery

• Surgical Maestro

• DA VINCI ROBOT IS SURGERY WORK OF ART

• Hospital hopes robot surgery will lure patients

The last one may come closest to the truth.

And, as Krumholz points out in his Post article, how are patients to be guided? The headlines about “which docs measure up” or “we need a Consumer Reports for doctors” do not do justice to the broader discussion of quality measurement, inexplicable variations in health care across the US, and profound uncertainties that exist in much of the underlying medical science.

But Krumholz didn’t write the headline, and he should be applauded for his important article – and the Post should be applauded for publishing it.

On the Respectful Insolence blog. Excerpt:

“No one, and I mean no one, brings pseudoscience, quackery, and antivaccine madness to more people than Oprah Winfrey does.”

On a trip to NYC last week, I visited Ivan Oransky at Scientific American. This week he announced he is leaving SciAm to become executive editor of Reuters Health.

I also visited Diana Mason, editor of the American Journal of Nursing. She announced that yesterday was her last day on that job.

Diana will have an endowed chair at the Hunter–Bellevue School of Nursing at the City University of New York. She will launch a center for health media and policy.

Ivan and Diana are two good friends, and two terrific journalists, both headed to exciting new opportunities. We wish them both the best.

Thanks to kind #followfriday plugs from @medpagetoday and from @kevinmd I now have 400 followers on my Twitter page.

I just started Tweeting four months ago. It’s become quite a helpful tool for me.

Interesting look at international coverage of the H1N1 flu story in a new analysis by the Project for Excellence in Journalism.

They studied 12 days of front-page newspaper coverage in seven countries around the world.

Key points from their summary:

• The three major U.S. papers studied offered some of the broadest coverage of the outbreak of any country studied, and all stories were staff-generated, as opposed to wire copy. Despite complaints in some quarters of excessive media hype, the level of coverage was relatively moderate when matched up against the number of confirmed U.S. cases.

• The number of cases of swine flu in a given country had little to do with the volume of coverage around the world. China, for example, had the fewest confirmed cases of any of the countries studied (1), but the paper studied, People’s Daily, offered about as much front-page coverage as the average paper in the U.S., which had over 2000 cases.

• In Mexico, extensive coverage by El Universal (20 front-page stories over the 12 days) cut across a broad range of issues, from the impact on businesses to the history of the virus. But the Mexican paper largely skipped any close assessment of its own government’s response.

• The French paper Le Figaro was more restrained but also controversial in its coverage. The paper ran just two stories on the front pages, but sparked an outcry by terming the outbreak “the Mexican flu.”

• In the Spanish-language papers in the U.S., one of the most striking findings was a heavy reliance by two of the three—El Diario and El Nuevo Herald—on U.S. wire service copy to fill their pages.

New projections in an article in Health Affairs.

Wow, what an article by Atul Gawande in the June 1 issue of The New Yorker.

He visits McAllen, Texas, “the most expensive town in the most expensive country for health care in the world.”

There are dozens of vital themes in the article:

• Nobody there seemed to know that they were cost outliers.
• Everyone seemed to blame someone else for being cost outliers.
• Except one surgeon who said, “Come on, We all kow these arguments are bullshit. There is overutilization here, pure and simple.”
• Doctors owning strip malls, imaging centers, surgery centers…with “entrepeneurial spirit.” One surgeon said, “It’s a machine, my friend.”
• “Medicine has become a pig trough here,” one surgeon said. “We took a wrong turn when doctors stopped being doctors and became businessmen.”

Gawande concludes:

“Whom do we want in charge of managing the full complexity of medical care? We can turn to insurers (whether public or private), which have proved repeatedly that they can’t do it. Or we can turn to the local medical communities, which have proved that they can. But we have to choose someone—because, in much of the country, no one is in charge. And the result is the most wasteful and the least sustainable health-care system in the world.”

This is a must-read.

The Minnesota Nurses Association posted that headline on its website, followed by an article that asserts:

“As the world sits on the brink of a pandemic flu outbreak, Minnesota’s hospitals are attempting to reduce the ranks of personnel most skilled to address emergency health needs.

Minnesota Nurses Association, the union representing more than 20,000 Registered Nurses in 89 bargaining units across the state, has received demands from nine hospitals to reopen contracts regarding wages. In the metro area, more than 100 MNA members have been laid off from their jobs since December 2008. The economic situation sounds dire as employers raise concerns about rising uncompensated care, proposed state budget cuts and dips in census and investments.

“We’re not buying it,” said MNA President Linda Slattengren. “Yes, we are pushing back at a time when our family and friends have all suffered from layoffs in this economic downturn. Yes, we are saying no to these demands from our employers.”

Why? Call nurses cautious – skeptics perhaps. As 24/7 bedside providers, nurses know patient census fluctuates, sometimes wildly, as in the case of a pandemic. The hospital industry has not proven their case to MNA members, who express doubts because hospital administrative judgment has proven to be, all too often, less than stellar when it comes to the safety of patients in our care.

“North Memorial Hospital, where I work, enjoyed a nearly $179 million net profit over the last six years said Pam Scott, RN. “But due to decisions like purchasing NowCare for $3 million in 2008 and reporting a $4 million loss in the latest financial statement, we have our doubts about the wisdom of administrative choices. “My question: Isn’t the purpose of reserves to accommodate more unexpected circumstances, such as economic pressures?”

The medical arms race is alive and well in Minnesota, as hospitals have rushed to compete with each other by providing the latest gadgetry or architecturally-inspired surroundings. “They’ve projected at least $300 million in construction costs for the next three years at Children’s Hospitals and Clinics,” said Melissa Hansing, RN, MNA Tri-Chair and staff nurse in Children’s emergency department. “My questions: Bricks and mortar may impress financiers, but what is going on behind the walls? Aren’t critically ill patients being attended to by overworked, fatigued nursing personnel who simply do not have enough colleagues on each shift? How do you justify cutting corners on skilled personnel at the bedside, when studies conclusively prove the increased risk to patients when staffing is not adequate?” …

Our question: what cuts in salary have the administrative staffs taken recently?”

I meant to post this on Memorial Day.

But, in keeping with the theme, better late than never.

One of our health journalism grad students, Dr. Kay Schwebke, had a terrific article in the American Journal of Nursing in May, “The Vietnam Women’s Memorial: Better Late Than Never.” The article was based on her capstone project in our graduate program.

There are also podcasts related to the article online.

More recently, Schwebke had an important article posted on MinnPost.com, “As recession bites, Minnesota hospitals struggle with unpaid bills.” It profiles some of the “hundreds of Minnesota hospital and clinic employees laid off within the past eight months, largely because of rising costs of uncompensated care.”

Kay is a role model for new physician-journalists – diligent, health-policy-minded, inquisitive, able to think like a journalist writing for her audience – not just like a doctor.