Consumer Health Digest #18-01
Your Weekly Update of News and Reviews
January 7, 2018
Consumer Health Digest is a free weekly e-mail newsletter edited by William M. London, Ed.D., M.P.H., with help from Stephen Barrett, M.D. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making. Its primary focus is on health, but occasionally it includes non-health scams and practical tips.
Consumer Health Digest editors swap roles. As of this issue, Dr. London has become the primary author of this newsletter and Dr. Barrett will continue to co-edit and contribute occasional articles. The focus will remain the same.
Manitoba chiropractic regulator issues directives against improper advertising. Last March, a CBC News analysis of Web and Facebook pages of chiropractors in Manitoba revealed dozens of inappropriate health claims. In response, the Manitoba Chiropractors Association (MCA), which regulates the province's chiropractors, issued a statement directing "its members to not provide advice on the topic of vaccination and immunization." Last month, MCA issued a practice directive that says chiropractors must not respond with advice, opinions, or recommendations on topics outside the chiropractic scope of practice (with vaccination and immunization, and use of pharmaceuticals or surgery given as specific examples). So far, five chiropractors have been asked to change content on their sites. [Kubinec V. Nicholson K. Some chiropractors forced to adjust websites after association cracks down on health messaging. CBC News, January 5, 2018]
CFI complains about CVS's homeopathy marketing. The Center for Inquiry has filed a complaint with the D.C. Department of Consumer and Regulatory Affairs to keep CVS Health from deceptively marketing homeopathic products as proven treatments or displaying them alongside FDA-approved medicines. CFI suggests creating a new homeopathy section in physical and online stores with clear warnings that the products lack evidence of effectiveness for treating any ailment or condition. [CVS must stop marketing homeopathic pseudoscience as real medicine in D.C. Center for Inquiry press release, December 22, 2017]
Neglect of home hospice patients reported. Hospice services, which attempt to provide comfort and alleviate suffering, are available through Medicare to patients with critical illness who are expected to die within six months and who agree to forego further curative treatment. KHN reports that an estimated 1.4 million patients received hospice benefits through Medicare in 2015 and Medicare pays nearly $16 billion per year on hospice services. Private insurance, Medicaid, and the U.S. Department of Veterans Affairs also pay for hospice services. Terminally ill people are often tempted to pursue aggressively promoted, but non-validated, "alternative" treatments touted as potential cures when they would likely suffer much less with hospice care.
A report by Kaiser Health News (KHN) provides perspective on problems in home hospice care in the United States. [Aleccia J. Bailey M. 'No one is coming': hospice patients abandoned at death's door. Kaiser Health News. October 26, 2017] The report notes:
- KHN's analysis of 20,000 government inspection records found 3,200 complaints of substandard care with state officials in the past five years that led to problems uncovered in 759 hospices with more than half cited for missing visits or other promised services.
- Punishments were rare for hospices providing poor care.
- Many family members may be too traumatized or not upset enough to complain about substandard care.
- According to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey designed by the Centers for Medicare & Medicaid Services, 1 in 5 respondents said their hospice agency did not always show up when they needed help.
- CAHPS data from 2015 to 2016 from 2,128 hospices indicate high satisfaction with 80 percent of families responding rating hospice a 9 or 10 out of 10.
- The Center for Medicare & Medicaid Services (CMS) identified deficiencies in more than half of 4,453 hospices from January 1, 2012 to February 1, 2017 and 17 hospices were terminated during that time.
- According to CMS, 21 percent of hospices serving over 84,000 patients failed to perform continuous care or inpatient care in 2015 even though these two levels of crisis care are among the four levels of care required for receiving hospice Medicare payments.
- A study of 661,557 Medicare hospice beneficiaries in federal fiscal year 2014 found that 12.3% received no visits from skilled caregivers in the last two days of life. [Teno JM and others. Examining variation in hospice visits by professional staff in the last 2 days of life. JAMA 176(3):364-370, 2016]
- Providing hospice care has become a lucrative business for for-profit companies.
- While the quality of most hospice care is good, the notable exceptions reported by KHN are unacceptable.
This page was posted on January 7, 2018