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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
Boston Globe Health and Science staff:
Scott Allen
Alice Dembner
Carey Goldberg
Liz Kowalczyk
Stephen Smith
Colin Nickerson
Beth Daley
Karen Weintraub, Deputy Health and Science Editor, and Gideon Gil, Health and Science Editor.
 Short White Coat blogger Ishani Ganguli
 Short White Coat blogger Jennifer Srygley
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Monday, November 12, 2007

I'll take minimally invasive surgery for $1,200, Alex

The doctors don’t know the questions. Even the category is a secret.

But anesthesiologist Dr. David Feinstein and surgeon Dr. Jonathan Critchlow do know the answers that Jeopardy’s Tournament of Champions contestants will be puzzling over tonight.

Back in June, the gowned and masked Beth Israel Deaconess doctors demonstrated some procedures for the game show’s traveling Clue Crew in the hospital’s Carl J. Shapiro Simulation and Skills Center. The idea was to gather on film some medical clues for questions on surgery.

The mystery will be solved, in the form of a question, at 7:30 p.m. on WSBK-TV 38.

Posted by Elizabeth Cooney at 03:23 PM

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Wednesday, November 7, 2007

A long life of caring

Rose%20Finkelstein%2085.bmpA beloved volunteer who soothed newborns and their mothers for 50 years as a nurse’s aide and volunteer at Beth Israel Deaconess Medical Center died Sunday night.

Rose Finkelstein (left) of Brookline was 101 years old. She regularly won awards for the most hours volunteered after retiring in 1976, including 582 hours this year, the hospital said.

In 2004 she told Globe columnist Eileen McNamara her philosophy.

“Activity, attitude and determination, that’s it. All you need to keep going,” she said. “Oh, and you’ve got to have a sense of humor, or you’re licked.”

She would sing to babies in the nursery or to staff on the desk, Deirdre Woolley, nurse manager of obstetrics, said in a memo sent to hospital staff by Rabbi Terry Bard, director of pastoral care and education.

“We were the lucky ones that Rose chose to work with and we are better for it every day,” she said.

Posted by Elizabeth Cooney at 02:14 PM

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Thursday, November 1, 2007

Grand Rounds gets personal

Paul Levy says his blog Running a Hospital gets the most responses not when he talks policy or science, but when he shares personal stories he comes across as CEO of Beth Israel Deaconess Medical Center. That's why, when his turn came to host this week's edition of medical blogging's Grands Rounds, he solicited entries about personal experiences that changed the writer's behavior or beliefs.

Sometimes the writer is a patient, sometimes a caregiver and sometimes both. A Philadelphia nurse anesthetist writes about her harrowing experience as a patient with what is benignly titled "awareness under anesthesia."

"My horrific experience under anesthesia has empowered me to become a strong listener, a better CRNA, a more genuine patient advocate, and a more caring person," Terry Freemark writes on her blog, Counting Sheep. "I try to tune in to my patients’ preoperative anxieties, and I pay particular care and diligence to ensuring that their anesthetic experience is optimized to their comfort, well-being, and safety. To do anything less for my patients would be diminishing to the standards of my profession, to what I’ve lived through, and to who I am."

She'll be hosting next week's Grand Rounds. The subject is pain.

Posted by Elizabeth Cooney at 11:03 AM

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Tuesday, October 30, 2007

Scientists rate Mass. General best place to work

Massachusetts General Hospital is the best place to work in academia, according to a survey of scientists by The Scientist. Beth Israel Deaconess Medical Center ranked 10th and Dana-Farber Cancer Institute came in 34th in the magazine's list of top 40 US academic institutions.

The poll asked respondents to rate their working environment. Mass. General scored high in job satisfaction, peers, management and policies, and infrastructure and environment, the magazine reports in its November issue, which will go online tomorrow.

The Top 15 institutions in the U.S.:

1. Massachusetts General Hospital, Boston, MA
2. National Cancer Institute-Frederick, Frederick, MD
3. Clemson University, Clemson, SC
4. Purdue University, West Lafayette, IN
5. Trudeau Institute, Saranac Lake, NY
6. St. Jude Children's Research Hospital, Memphis, TN
7. The J. David Gladstone Institutes, San Francisco, CA
8. University of Nebraska - Lincoln, NE
9. University of Texas Southwestern Medical Center, Dallas, TX
10. Beth Israel Deaconess Medical Center, Boston, MA
11. University of Texas M.D. Anderson Cancer Center, Houston, TX
12. Duke University, Durham, NC
13. Wadsworth Center, Albany, NY
14. Georgia Institute of Technology, Atlanta, GA
15. Mayo Clinic, Rochester, MN

Posted by Elizabeth Cooney at 10:36 AM

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Wednesday, October 24, 2007

Patients and doctors struggle separately with medical errors, Journal authors say

Doctors aren’t the only ones who can become paralyzed by guilt, fear and isolation after medical errors occur.

Patients and families also struggle with these emotions, Dr. Tom Delbanco and Dr. Sigall K. Bell discovered when they made a documentary about the impact of medical errors. They write about the parallel experiences in tomorrow’s New England Journal of Medicine.

“I had no idea, frankly, and I’ve been a primary care provider for 36 years,” Delbanco said in an interview. He and Bell are both from Harvard Medical School and Beth Israel Deaconess Medical Center. “It had never entered my mind that family members could feel the same kind of guilt that we as doctors feel. It had never entered my mind they would say, ‘If only I’d been more assertive with the doctor before this happened’ or ‘If only I’d listened to my instincts.’ ”

Another surprise, Delbanco said, was how reluctant people are to speak up, afraid that they will get worse care, particularly if they are from disadvantaged immigrant groups.

Doctors don’t talk for three different reasons, he said.

“We tend to run away from people we hurt rather than get close to them, we just plain don’t know what to say, and we’ve been told by lawyers to keep our mouths shut and that someone will take care of this,” he said. “We drift away rather than reach out to the people who need us.”

Building bridges to injured patients would be a first step, after the taboo of mentioning mistakes is dispelled, the authors write. They also suggest teaching healthcare providers about preventing errors and how to respond when they do happen. Their 2006 documentary has been shown to third-year medical students at Harvard.

"Everyone involved needs an organized structure that restores communication and supports emotional needs," they write. "The yield from working in partnership could be enormous, both improving people's experience with medical errors and preventing harm from occurring in the future."

Posted by Elizabeth Cooney at 05:16 PM

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Boston group to share genetic data on autism

A Boston group is sharing genetic information from families affected by autism with other researchers to promote understanding of the developmental disorder.

The Autism Consortium, whose members include hospitals, medical schools and universities in the Boston area, will transfer profiles of 500,000 genetic variations found across the genomes of 700 families with two or more children who have autism. The data will be held by the Autism Genetic Resource Exchange, a program of the advocacy organization Autism Speaks. Scientists can apply to the exchange, which gathered DNA from the families. The samples have been scanned for sequences where there are deletions or extra copies of DNA segments. The consortium is sharing the genetic variations it found.

"We returned all of the raw data to AGRE so they can distribute it to any other investigtors who want to begin exploring what may be the genetic underpinnings of autism," Mark Daly, a consortium member from Massachusetts General Hospital and the Broad Institute of MIT and Harvard, said in an interview. "Understanding the genetics underlying a complex disease is not an easy problem to solve. So there's no excuse for hoarding your data when much more can be learned by sharing."

Only a small percentage of autism arises from a recognizable genetic cause, such as Fragile X syndrome, Daly said. Recent research suggests that some families with autism might have higher rates of genomic abnormalities, but very few of these abnormalities have been conclusively identified.

"There's very strong heritability to autism but very little of the heritability has been explained by specific mutations of specific genes," he said. "What we hope is that this data is a starting point. We need to perform collaborative research in the spirit of the Human Genome Project to deliver on the trust the public has placed in us."

Members of the Autism Consortium are Beth Israel Deaconess Medical Center, Boston Medical Center, Boston University, Boston University School of Medicine, the Broad Institute of MIT and Harvard, Cambridge Health Alliance, Children’s Hospital Boston, Harvard University, Harvard Medical School, Massachusetts General Hospital, Massachusetts Institute of Technology, McLean Hospital and Tufts-New England Medical Center.

Posted by Elizabeth Cooney at 11:37 AM

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Tuesday, October 23, 2007

Who needs sleep?

Just as weary but exhilarated Red Sox fans head into the World Series on two days' rest, the New York Times devotes its Science section to the subject of sleep.

“To do science you have to have an idea, and for years no one had one; they saw sleep as nothing but an annihilation of consciousness,” Dr. J. Allan Hobson, a professor of psychiatry at Harvard, told the Times. “Now we know different, and we’ve got some very good ideas about what’s going on."

Boston researchers are prominent in the story, beginning with cognitive neuroscientist Robert Stickgold of Harvard and Beth Israel Deaconess Medical Center. He and postdoctoral student Matthew Tucker are studying the effect of naps on memorized words. Matthew Wilson of MIT is investigating what happens to mice cells when they record memories. Subimal Datta of Boston University School of Medicine is looking at the chemicals that bathe the brain while we sleep.

“During waking we have a thousand things happening at once, the library is filling up, and we can’t possibly process it all,” Datta says in the Times story. “It’s during sleep that we have this special condition to clear away this overload."

Something to sleep on before tomorrow night's Game 1.

Posted by Elizabeth Cooney at 10:34 AM

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Thursday, October 11, 2007

Four Boston doctors named Howard Hughes investigators

From left, Daley, Engle, Haber and Karumanchi

Four Boston physician-scientists have been selected by the Howard Hughes Medical Institute in an initiative to promote patient-oriented research.

Dr. George Daley and Dr. Elizabeth Engle, both of Children’s Hospital Boston, Dr. Daniel Haber of Massachusetts General Hospital, and Dr. S. Ananth Karumanchi of Beth Israel Deaconess Medical Center are among 15 new HHMI Investigators. Boston has the most winners in this new group.

Daley is a world leader in hematopoetic and embryonic stem cell research; Engle has identified genetic factors behind disorders that limit patients’ control over their eye movements; Haber studies how individuals’ genetic mutations affect their response to cancer drugs; and Karumanchi has identified the soluble proteins produced by the placenta that can trigger pre-eclampsia in a pregnant mother.

HHMI received 242 applications from eligible candidates. The 15 selected physician-scientists from 13 institutions will receive a total

of about $150 million in their first five-year terms.

Posted by Elizabeth Cooney at 07:00 AM

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Monday, October 1, 2007

Beth Israel Deaconess, Red Sox sign new deal

Here's one contract the American League East champions have all wrapped up for next year.

BIDMC%20First%20Aid%20Team%20150.bmpThe Boston Red Sox and Beth Israel Deaconess Medical Center have agreed to a second five-year relationship, the hospital said. Under the arrangement, Beth Israel Deaconess pays the team an undisclosed annual fee to remain the "official hospital of the Boston Red Sox." It also staffs the first aid station at Fenway Park with the team at left and sponsors 25 students annually as Red Sox Scholars.

Posted by Elizabeth Cooney at 11:47 AM

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Wednesday, September 19, 2007

Beth Israel Deaconess wins safety award for improving obstetrics care

Beth Israel Deaconess Medical Center has won a national safety and quality award for the changes it made in its obstetrics department after the death of a newborn baby in 2000.

The National Quality Forum and The Joint Commission chose the hospital for its John M. Eisenberg Patient Safety and Quality Award in the category of innovation at the national level. The Beth Israel Deaconess program has also been honored by state groups for its efforts.

The baby’s death after a series of medical mistakes spurred Dr. Benjamin Sachs to revamp how the department cared for its patients, from how patients are monitored to how long doctors are on call. Sachs, who will leave the hospital in November to lead Tulane’s medical school, wrote about the case in the Journal of the American Medical Association two years ago, calling it a “burning platform” for “a major reorganization of the way cared is provided.”

The hospital borrowed principles from military and commercial aviation to reduce judgment errors and miscommunication. By its own measure, adverse outcomes fell by 25.4 percent and the severity of these events dropped by 13.4 percent after the new approach was adopted, according to the Joint Commission statement announcing the award.

Posted by Elizabeth Cooney at 02:58 PM

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Monday, September 17, 2007

On the blogs: Storrow Drive, endangered white coats

On Running a Hospital, Beth Israel Deaconess CEO Paul Levy strays from hospital administration to consider Storrow Drive, once envisioned as a parkway but now a heavily traveled route in need of repair. He digs back to his days in what he calls the "infrastructure arena," when he was commissioner of public utilities under Governor Michael Dukakis, directed the Arkansas Energy Department under Governor Bill Clinton and then ran the cleanup of Boston Harbor for the Massachusetts Water Resources Authority. After a chat with fellow MIT alum and former transportation secretary Fred Salvucci, he offers what he thinks might work, for both the Longwood and MIT sides of the Charles.

"Opportunities like this come along but rarely, and I think we should ask the question: Do we need Storrow Drive?"

Across the pond, the BBC reports that the days of the traditional white coat may be numbered. Cuffs can carry infection and make it difficult for doctors to properly wash their hands and forearms, so as of next year, the long-sleeved coats will have no place in hospital care, the story says. That goes for long-sleeved shirts, jewelry and watches, too.

"I'm determined that patient safety, including cleanliness, should be the first priority" of every National Health Service organization, British Health Secretary Alan Johnson said.

Posted by Elizabeth Cooney at 12:36 PM

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Thursday, September 13, 2007

Fenway authors write book on LGBT health


To fill a gap in clinical textbooks, doctors from Fenway Community Health have written a book about the healthcare needs of lesbian, gay, bisexual and transgender people.

The Fenway Guide to Lesbian, Gay, Bisexual and Transgender Health, to be published Sept. 30 by the American College of Physicians, is intended for physicians, other healthcare providers and educated consumers interested in specific issues related to LGBT people, co-author Dr. Harvey Makadon said in an interview.

"There is no comprehensive textbook," he said. "We try to go through what the issues are, what we know and what we don't know, and how clinicians can work with patients in a nonjudgmental way."

In the book Makadon and his co-authors Dr. Ken Mayer and Hilary Goldhammer of the Fenway Institute at Fenway Community Health and Dr. Jennifer Potter of Beth Israel Deaconess Medical Center discuss topics of particular concern for LGBT people. As a group they are more likely to smoke, LGBT youth are at higher risk for depression and suicide, and certain cancers are more common, such as anal carcinomas in gay men and breast cancer in lesbians.

"We realized this was an important area that wasn't being covered," Dr. Steven Weinberger, senior vice president for medical education and publishing of the American College of Physicians, said in an interview. "It has not been taught in medical school. Residents can take an elective to work in an environment where they are exposed to LGBT patietns, but it sort of falls through the cracks in terms of the standard curriculum."

In 2003 the University of Toronto Press published "Caring for Lesbian and Gay People: A Clinical Guide," by Allan D. Peterkin and Cathy Risdon, but the ACP thought it was more specific to Canadian than US healthcare, Tom Hartman of the US publisher said.

A companion web site for the Fenway book, with downloadable forms, will be available Oct. 15 at the ACP site.

Posted by Elizabeth Cooney at 11:21 AM

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Tuesday, September 11, 2007

Teaching brain pathology by hand

joseph%20and%20student85.bmpThe advent of magnetic resonance imaging means neurologists in training no longer spend hours dissecting spinal cords and brains, psychiatrist Dr. Elissa Ely writes in today's New York Times. And she thinks that will be a loss.

"From a distance, brain autopsies seem an afterthought on life. Insurance does not cover them. They serve no lucrative purpose, so hospitals have a financial disincentive to do them," she writes. "As a result, the field of neuropathology is shrinking and its atrophy may diminish the entire field of neurology."

Dr. Jeffrey T. Joseph (at right in bottom photo with first-year resident Dr. Scott Wenson) has conducted a weekly neuropathology seminar at Beth Israel Deaconess Medical Center for 12 years, but he's leaving in the fall for the University of Calgary in Alberta, the story says.

"It's part diagnosis, part entertainment," he says about the seminars in the story. "I like to make them look. The brain is like a geode -- you don't know what's inside."

Posted by Elizabeth Cooney at 12:53 PM

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Monday, September 10, 2007

Levy and SEIU tangle again on union drive

What does "free and fair" mean?

When it comes to union elections, Beth Israel Deaconess Medical Center CEO Paul Levy and the Service Employees International Union don't appear to be on the same page.

They have been at odds at least since November, when on his blog Running a Hospital, Levy warned of the union's "aggressive tactics to discredit the management and the boards of hospitals who don't give in." Seven months later the union alleged the hospital had higher emergency care costs than other major Boston hospitals, and made greater use of a state pool to be reimbursed for free care it provides uninsured patients.

This time Levy is responding to letters SEIU sent to Beth Israel Deaconess physicians. In the Aug. 21 messages, the union says it has asked the hospital to promise not to spend patient-care funds on anti-union activity, as part of a "free and fair election code of conduct" during its campaign to represent health-care workers.

"While it is awkward to impute another's motivation, it appears that the letter has three purposes," Levy wrote in his Friday night post. "First, to obfuscate the statements made by management of hospitals about this issue. Second, to present a revisionist view of what the union itself has said in other forums -- like in the US Congress, where it has strenuously argued for an elimination of elections. Third, to attempt to drive a wedge between the management and a hospital's physicians by using these mischaracterizations and appealing to the doctors' underlying sense of fairness and fondness for the workers in the hospital."

Levy says that the election process is already governed by National Labor Relations Board rules as well as hospital guidelines that support "a free and fair election," posting the hospital policy on union activities. He also refers to union efforts to replace secret ballot elections with a card-check process, in which workers would sign a card to certify a union.

The union responded this afternoon, saying Levy "continues to parrot the Bush Administration's talking points in the way he mischaracterizes Senator Kennedy's ... bill, which was not the subject of our letter."

"Despite Mr. Levy's attempts to obfuscate what many hospital workers throughout Boston are actually asking for, our message is clear," SEIU executive vice president Mike Fadel said in an e-mail. "Hospital workers across the city are calling for free and fair union secret ballot elections, which include a code of conduct agreed to by employers to ensure their right to vote is not interfered with by hospital management."

Posted by Elizabeth Cooney at 06:46 PM

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Halamka not worried by report linking microchips to tumors

halamka%20150.bmpDr. John Halamka (left) is used to fielding questions about the radio frequency identification chip embedded in his arm, and not just when he sets off security alarms at Home Depot.

The chief information officer at Beth Israel Deaconess Medical Center, who had the microchip containing his medical data implanted in 2004, says he isn't worried by an Associated Press report that the US Food and Drug Administration ignored studies linking the chips to cancer in mice when it approved the devices.

"The chip is ceramic, surrounded by medical-grade glass that is, to my knowledge, invisible to the immune system," he said in an e-mail today. "Thus, I cannot imagine how a chip could induce tumors."

Halamka said he has talked to veterinarians who have implanted thousands of the chips into dogs and cats, with no side effects. He suspects that the studies of mice are not applicable to humans because mice are predisposed to developing tumors at the site of any injection.

"I've had no side effects or tumors," he said. "Should I ever develop any issues with my implanted chip, you'll be the first to know!"

Posted by Elizabeth Cooney at 04:12 PM

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Friday, August 24, 2007

Beth Israel Deaconess to train medical microbiology fellows

Beth Israel Deaconess Medical Center will launch two new fellowship programs in medical microbiology, the hospital said.

Both are designed to teach doctors to understand bacterial agents, parasites and viruses and to run academic, hospital or public health laboratories. The fellows will train at Children's Hospital Boston and the Massachusetts Department of Public Health as well as Beth Israel Deaconess.

Posted by Elizabeth Cooney at 10:13 AM

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Thursday, August 16, 2007

New physician-scientists win Howard Hughes awards

Seven Boston physicians who spent a year or more away from medical school doing research have won grants to continue their dual roles as scientists and clinicians.

The Howard Hughes Medical Institute has given Early Career Awards of $375,000 each over five years to 20 doctors to make sure they have the time and financial support for research early in their careers, it said in a statement. Their institutions agreed to allow these tenure-track physician-scientists to devote at least 70 percent of their time to research.

The winners are alumni of either HHMI's research scholars or training fellowship programs, which bring students to the National Institutes of Health or other institutions. They are:

Dr. Sarah Fortune, Harvard University School of Public Health
Dr. Aram Hezel, Massachusetts General Hospital
Dr. Farouc Jaffer,
Massachusetts General Hospital
Dr. Eric Johannsen, Brigham and Women's Hospital
Dr. Sridhar Ramaswamy,
Massachusetts General Hospital Cancer Center
Dr. Manish Sagar, Brigham and Women's Hospital
Dr. Sean Savitz, Beth Israel Deaconess Medical Center

Posted by Elizabeth Cooney at 01:49 PM

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Wednesday, August 15, 2007

Six Mass. hospitals recognized for performance improvement

Six Massachusetts hospitals have made a consulting company's list of 100 US hospitals that have improved their performance.

Beth Israel Deaconess Medical Center, Brigham and Women's Hospital and Caritas St. Elizabeth's Medical Center in Boston; UMass Memorial Medical Center in Worcester; NSMC Union Hospital in Lynn and Lowell General Hospital were recognized by Thomson Healthcare for better clinical outcomes, safety, financial stability and growth from 2001 to 2005.

The unranked 2006 list appeared in last week's Modern Healthcare magazine.

Posted by Elizabeth Cooney at 08:44 AM

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Tuesday, August 14, 2007

On the blogs: Harvard hospital hiring, medical home

On Running a Hospital, Beth Israel Deaconess Medical Center CEO Paul Levy compares the participation of other Harvard teaching hospitals in the search for a new chief of OB/Gyn at his hospital to asking Toyota, Honda, General Motors and Chrysler to sit in on Ford's hiring process for a new division manager.

"What would be odd elsewhere is the norm here at the Harvard hospitals," he writes about the search to replace Dr. Benjamin Sachs, who is leaving to become dean at Tulane Medical School. "The Harvard medical system has an odd assortment of customs and norms. One of (the) oddities surrounds the search for a chief of any of the clinical departments at BIDMC, MGH, Brigham and Women's, Children's Hospital, and the other Harvard affiliates."

On WBUR's CommonHealth, Lynn Community Health Center's Lori Abrams Berry asks what happened to the idea of medical home as the state's new healthcare law gets implemented.

"No one should ever be auto-assigned away from an existing primary care relationship," she writes about people who did not choose a plan. "That is not what healthcare reform is all about."

Posted by Elizabeth Cooney at 02:04 PM

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Doctors becoming 'knowledge navigators,' Halamka says

Like presidential candidates, Google and Microsoft have plans to improve health care, a story in today's New York Times says.

Their proposals to combine better Internet search tools, the vast resources of the Web and online personal health records promise to accelerate a shift in power to consumers in health care, just as Internet technology has done in other industries, the story says.

jhalamka85.bmpDr. John D. Halamka (left), the chief information officer at Beth Israel Deaconess Medical Center who serves on the 24-member Google Health Advisory Council, told the Times giving much more control to individuals is inevitable.

"Patients will ultimately be the stewards of their own information," he said. "The doctor is becoming a knowledge navigator. In the future, health care will be a much more collaborative process between patients and doctors."

Posted by Elizabeth Cooney at 10:42 AM

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Friday, August 10, 2007

Beth Israel Deaconess posts inspection results

By Liz Kowalczyk, Globe Staff

Following the lead of Boston's other large teaching hospitals, Beth Israel Deaconess Medical Center today released results of its inspection by a national oversight organization -- results usually kept secret by hospitals across the US.

Beth Israel Deaconess posted on its website its report from the Joint Commission, which has told the hospital to improve in nine areas.

In the past few months, five academic medical centers in Boston have released their results, and several said more problems were found than in the past under a revised inspection system. The Joint Commission, based in Illinois and the country's primary inspector of hospitals, now conducts surprise visits, rather than telling hospitals weeks in advance when inspectors will arrive.

This year, the commission issued Massachusetts General Hospital 10 requirements for improvement; Brigham and Women's Hospital, nine, Dana-Farber Cancer Institute, which does not have overnight patients, three; and Children's Hospital Boston, three. Boston Medical Center initially received eight requirements for improvement but disputed two.

At Beth Israel Deaconess, inspectors found several instances of nurses or doctors failing to ask patients to list their medications, or to otherwise update patients' medication lists. In at least two cases, doctors did not update the electronic list of patients' medications, creating discrepancies between computer and paper records. In another case, a patient was transferred to another hospital without a complete list of medications.

Updating medication records is done to ensure patients are not given drugs or treatments that could cause dangerous reactions, or to "reconcile" their medications as they are transferred or discharged. Massachusetts General and Brigham and Women's hospitals and Boston Medical Center all were cited for this shortcoming.

In five other instances at Beth Israel Deaconess, nurses or doctors did not properly assess patients' pain levels, or record them in their medical records. This is important partly so caregivers can determine whether a treatment is working to improve a patient's pain.

Hospital President Paul Levy said in a letter to staff today that doctors now will be required to use the electronic medication reconciliation system.

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Thursday, August 9, 2007

Beth Israel Deaconess names research operations head

mason150.bmpBeth Israel Deaconess Medical Center has named Randy Mason (left) vice president of research operations, the hospital said today.

He comes to Beth Israel Deaconess from Partners HealthCare, where he was chief of staff to the chief academic officer and director of research operations. Before that he had been chief administrative officer for the Harvard/Partners Center for Genetics and Genomics and budget director and comptroller for Partners Corporate.

Mason will be responsible for research administration functions, including grant administration, research facilities and clinical trial operations. He received a bachelor's degree in biology from the University of Albany and an MBA in health care administration from the Baruch College Zicklin School of Business/Mount Sinai School of Medicine.

Posted by Elizabeth Cooney at 05:40 PM

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Beth Israel Deaconess takes over cardiothoracic surgery at St. Vincent

Beth Israel Deaconess Medical Center has taken over the cardiothoracic surgery program at St. Vincent Hospital previously run by Tufts-New England Medical Center and is starting a transplant referral program at the Worcester hospital, the hospitals said.

BIDMC physicians already staff the 348-bed medical center's emergency and radiation oncology departments. The change in cardiothoracic surgery took place July 1, when Dr. Robert M. Bojar, a surgeon based at St. Vincent, switched from Tufts-NEMC to BIDMC. Bojar and Dr. David C. Liu, another BIDMC surgeon, now operate in Worcester.

Tufts-NEMC spokeswoman Brooke Tyson Hynes said yesterday the cardiothoracic surgery change came about because of BIDMC's new surgical residency program at St. Vincent. On July 1, seven surgical residents began the first BIDMC rotations at the Worcester hospital, a year after University of Massachusetts Medical School and its clinical partner, UMass Memorial Medical Center, ended their surgical residency programs at St. Vincent.

Under the new arrangement for transplant patients, St. Vincent specialists will refer patients to BIDMC for kidney, liver or pancreas transplants, Dr. Douglas W. Hanto, chief of transplantation at BIDMC, said yesterday. Most St. Vincent patients had previously been referred to UMass Memorial, which provides kidney, liver and pancreas transplants through a joint program with the Lahey Clinic.

Posted by Elizabeth Cooney at 08:16 AM

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Wednesday, August 1, 2007

Beth Israel Deaconess CEO and union lock horns

By Elizabeth Cooney, Globe Correspondent

The head of Beth Israel Deaconess Medical Center and the union trying to organize workers at Boston teaching hospitals are trading accusations of unfair tactics.

Beth Israel CEO Paul Levy says that the Service Employees International Union uses a strategy that includes attacking the reputations of hospitals, its senior management and its trustees. In an item posted on his blog Monday called "Pages from the Playbook," Levy says one part of the approach is to accuse hospitals of not carrying out their public service mission.

Last week, union Local 1199 sent a report to Beth Israel trustees alleging that the hospital made "potentially misleading representation of charity care" in its financial statements.

This follows a report from the union last month that said Beth Israel has higher emergency room costs than other major hospitals in Boston and as a result uses more of the state's uncompensated care pool to gain reimbursement for free care to uninsured patients, according to this Globe story. Beth Israel said then that it follows the rules and regulations governing the pool and had not received any indication to the contrary from the state.

In an e-mailed statement responding today to a request for comment, Local 1199 executive vice president Mike Fadel called Levy's blog entry "intellectually dishonest" and a "tired rhetorical device of attacking the messenger."

"The tactic of decrying critics of an institution's policies as being somehow disloyal is something that we might expect from the Bush administration. It is not something that should be coming from the leader of one of Boston's most important healthcare institutions," Fadel said. "The act of demanding a community institution uphold its social mission and obligations is not something that warrants a broadside attack."

While not responding to the charity care allegations, Levy wrote that the SEIU attempts to pressure hospitals into agreeing to the "card check" method of organizing workers rather than holding an election to see if they want the union to represent them. He also says union researchers pore through financial documents for inconsistencies that will embarrass trustees.

"The key is to pick a topic that garners a headline and public concern, like provision of care to poor people," Levy wrote. "It is also helpful to pick an arcane accounting issue that few understand, so that a cogent and concise rebuttal by the hospital is virtually impossible in the regular media."

The union said the hospital lowered by 30 percent the figures it had reported for un-reimbursed charity care in 2005, without providing an explanation for the change.

"BIDMC's financial reporting with respect to charity care may deny board members necessary information to evaluate the extent of the hospital's charitable activity," Fadel wrote in the July 26 letter sent to trustees with the union's report.

Levy said his colleagues at the hospital are wondering whether SEIU is preparing for a union drive at Beth Israel.

"Or is it sending a message to other hospitals in the city that it will attack anybody who has the nerve to speak out against its tactics?" he said they are asking.

Posted by Elizabeth Cooney at 06:27 PM

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Wednesday, July 25, 2007

Hospice care misunderstood and underused, journal authors say

Hospice care for dying patients has entered mainstream medicine, but it is still misunderstood and underused, according to two opinion pieces in tomorrow’s New England Journal of Medicine. Attitudes and economic constraints are the reasons why, the authors say.

The median length of time a patient receives hospice care is 26 days; one-third of patients enter hospice in the week before they die. That means they have less time to have their unnecessary pain relieved or their families’ care-giving burden eased, both reviews said.

Physicians who equate death with professional failure or think hospice is appropriate only for people near death send patients to hospice too late, Dr. Gail Gazelle of Brigham and Women’s Hospital writes, citing previous research. And patients often think that hospice is only for people dying of cancer, although 40 percent of hospice admissions are for people with conditions such as advanced cardiac disease and dementia.

Patients and doctors alike may not realize that Medicare pays for home hospice care in 80 percent of cases, and private insurers also provide coverage.

But the limits of what hospice payments cover create another barrier, forcing patients to choose between medical treatments and palliative care, Dr. Alexi A. Wright of Dana-Farber Cancer Institute and Dr. Ingrid T. Katz of Beth Israel Deaconess Medical Center say in the other perspective appearing in the journal.

Citing the case of a Massachusetts woman dying of colon cancer, they say hospice care meant she had to give up the chemotherapy and intravenous feeding that kept her comfortable. Only large hospices –- with at least 400 patients -– are economically able to add patients’ current medical treatment to hospice care, but this option is not available in Massachusetts, the doctors write.

Only 2.5 percent of the country’s hospices have an average patient census of 400 or more that can sustain the costs of medical treatments using Medicare’s payment formula, they write.

While health experts worry that open access might bankrupt Medicare, "patients will simply have to hope for access to a hospice that is large enough to help them," Wright and Katz conclude.

Posted by Elizabeth Cooney at 05:00 PM

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Sachs to help rebuild New Orleans healthcare as Tulane dean

By Carey Goldberg, Globe Staff

benjamin sachs on rounds150.bmpDr. Benjamin Sachs (left), chair of the obstetrics department at Beth Israel Deaconess Medical Center for the last 18 years, is leaving to become senior vice president of Tulane University and dean of its medical school.

He writes in an e-mail:

"Two years ago, the Gulf region was devastated by hurricanes Katrina and Rita and yet people today are still struggling. What attracted me to this position was the opportunity to help rebuild the healthcare system of New Orleans and the Gulf coast. Both a redesigned medical system that provides high quality care for all and a marked growth in world class biomedical research are vital for the region's economic recovery. Tulane is absolutely committed to these goals and to continuing to play a major role in the region's recovery."

A native of London, Sachs came to Boston 29 years ago to complete his residency at Brigham and Women's Hospital. He married and raised two sons here. He helped develop new clinical and research programs, and became a national leader on ways to use team-training to improve patient safety.

"I am deeply saddened by the thought of leaving all my friends and colleagues," he writes. "At the same time, I am energized by the idea that I have been asked to help lead a great university, and strive to make a difference in the lives of so many Americans that live on the Gulf coast."

Paul F. Levy, president and CEO of Beth Israel Deaconess, told staff in a memo this morning about Sachs's departure.

"Those of you who know Ben knows that he would not leave us for a "standard" academic appointment at another institution," he wrote. "Here, he is taking on a mission of great humanitarian import."

Sachs will begin his new job in November, Levy wrote. He said that Dr. DeWayne Pursley would step in as interim chair of the obstetrics department, while retaining his current post as chief of neonatology. The hospital will conudct a nationwide search for a replacement for Sachs, he said.

Here is Sachs's e-mail, followed by Levy's memo:

I am writing to let you know that I have accepted a new position as Senior Vice President of Tulane University and Dean of the Medical School. Tulane’s medical school was founded in 1834 and has a rich history of many major accomplishments.

Two years ago, the Gulf region was devastated by hurricanes Katrina and Rita and yet people today are still struggling. What attracted me to this position was the opportunity to help rebuild the healthcare system of New Orleans and the Gulf coast. Both a redesigned medical system that provides high quality care for all and a marked growth in world class biomedical research are vital for the region’s economic recovery. Tulane is absolutely committed to these goals and to continuing to play a major role in the region’s recovery.

Tulane University is the largest employer in the city. Under the extraordinary leadership of President Scott Cowen, Tulane is playing a vital role in the rebuilding process. In just 2 years, Scott has led Tulane through a dramatic recovery and has undertaken a major redesign of the entire university. I believe that as a result of all the changes that Tulane is better prepared to meet the challenges of the 21st century than most major research universities in the USA.

To give you a flavor of Tulane: at the graduation ceremony this spring the commencement speaker, Brian Williams, asked all the students who had volunteered to help the region to recover from the storm to stand and be recognized. I understand that almost all the students stood up. One of the parents said to me that one could not pay for this kind of education. The university had instilled into the very souls of the students the concept of public service. In fact, Tulane is the only major research university in the country that has public service as an integrated component of the undergraduate experience. In this environment, the faculty can educate the next generation of physicians not only in the science of medicine but also by example, to truly demonstrate humanitarian values

As you know, I was born and raised in London, England and came to Boston 29 years ago to complete my residency at the Brigham and Women’s Hospital. Meeting Vickie and the rich intellectual life at Harvard were powerful influences in my decision to stay in Boston. For the past 24 years, my professional home has been at the Beth Israel Deaconess Medical Center and for the past 18 years I have been the department chair. We are very fortunate that our hospital is now run by a talented and visionary leader, Paul Levy.

It has been a great privilege to live in Boston. I have had the opportunity to work for Harvard and one of the greatest academic medical centers. These institutions have given me the opportunity to hold many leadership positions, help develop new clinical and research programs in women’s health and spearhead nationally, team-training as a new way to improve patient safety. They also gave our department the support needed to develop women’s health centers in Philippines, Armenia and Ukraine. Lastly, I have been privileged to have had the opportunity to contribute to the life of our city and the Jewish community.

We are blessed by having raised two wonderful sons in Beantown. Alex has just graduated from Emory with a major in economics and a minor in Arabic and is now pursuing graduate studies in biology. Jonathan is continuing his studies at Boston University having just graduated from Boston University Academy.

I am deeply saddened by the thought of leaving all my friends and colleagues. At the same time, I am energized by the idea that I have been asked to help lead a great university, and strive to make a difference in the lives of so many Americans that live on the Gulf coast.

We will be keeping a home in Boston so please stay in touch and please visit.

Kindest regards,


From: Levy,Paul (CEO,Beth Israel Deaconess)
Sent: Wednesday, July 25, 2007 10:34 AM
To: BIDMC Community
Subject: Dr. Sachs on the move


Another transition here at BIDMC. First, Herb Kressel, our chief of radiology, stepped down to become editor of the most respected radiology journal in the country. Then, Jeff Flier accepted an offer to become Dean of our local medical school. Now, Ben Sachs, our distinguished chief of obstetrics and gynecology, has announced that he has accepted an offer to become Senior Vice President of Tulane University and Dean of the Medical School.

Those of you who know Ben knows that he would not leave us for a "standard" academic appointment at another institution. Here, he is taking on a mission of great humanitarian import. As he says in a letter to his friends today:

"Two years ago, the Gulf region was devastated by hurricanes Katrina and Rita and yet people today are still struggling. What attracted me to this position was the opportunity to help rebuild the healthcare system of New Orleans and the Gulf coast. Both a redesigned medical system that provides high quality care for all and a marked growth in world class biomedical research are vital for the region's economic recovery. Tulane is absolutely committed to these goals and playing a major role in the region's recovery. I am energized by the thought that I can help make a difference using the skills and experience I have gained over the last 3 decades."

This assignment is so consistent with Ben's philosophy of life and his prior good deeds throughout the world (e.g., in Ukraine, where he was driving force for improvements in the medical system), that we cannot be surprised. Of course, here at BIDMC, Ben has also been known for running a superb department, with an outstanding record in clinical care, education, and research. He has been an innovator in everything from team training to encouraging young researchers in fields like preeclampsia.

All of us at BIDMC take some pride when one of our senior medical leaders - in this moment Dr. Sachs, and also recently Drs. Flier and Kressel - move on to be of service to a broader audience. We wish Ben well and look forward to receiving his favorite recipes for jambalaya!

Ben takes over his new post in November. Doctor DeWayne Pursley will step in as interim chair, in addition to retaining his post as chief of neonatology, while we conduct a nationwide search for a new chief.



Paul F. Levy
President and CEO

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Monday, July 23, 2007

On the blogs: Joint Commission visit, euphemisms, privacy for immigrants

Surprise: On Running a Hospital, Paul Levy, president of Beth Israel Deaconess Medical Center, says the Joint Commission, which accredits hospitals, showed up this morning for an unannounced visit. Until last year, these periodic reviews of safety and quality were scheduled in advance, but now hospitals get no warning. The accrediting body, which used to be called the Joint Commission on Accreditation of Healthcare Organizations, will spend a week at the hospital.

"And, yes, we will publish our results once they go through the process of review at the Joint Commission headquarters," Levy writes.

Sugarcoating: On Healthy Children, Boston Medical Center pediatrician Dr. Steven Parker explores how doctors use euphemisms. Their intentions may be good, but they can end up creating confusion, he says.

"I know why this happens so often. Nice guys and compassionate to a fault, we pediatric providers hate to give bad news and avoid it when we can," he writes. "We think we are doing the family a favor: doesn't 'developmentally delayed' sound so much more hopeful, so much nicer, than 'mentally retarded?' "

HIPAA help: On WBUR's CommonHealth, Lori Abrams Berry of the Lynn Community Health Center worries that undocumented immigrants are being told that community health centers must report them to immigration officials if they seek health care.

"We need to find as many ways as we can to put the word out that community health centers are NOT obligated to report undocumented patients to immigration authorities," she writes. "On the contrary, HIPAA regulations actually prohibit us from giving information about our patients to anyone without their permission. (Who knew how handy this would turn out to be?)"

Posted by Elizabeth Cooney at 04:32 PM

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Friday, July 20, 2007

Beth Israel Deaconess makes leadership changes

By Liz Kowalczyk, Globe Staff

Curious changes are afoot among department heads at Beth Israel Deaconess Medical Center.

Dr. Carol Warfield, chief of anesthesia, sent an e-mail to colleagues on Wednesday, saying that hospital chief executive Paul Levy had dismissed her as chair effective immediately.

"To say the least, I was shocked," Warfield wrote. She said that she was planning to return from sabbatical in two weeks and that Levy, whom she said notified her by e-mail, gave her no reason for the dismissal.

She took over eight years ago when the department was in turmoil, and said in her e-mail that it is in "excellent financial health" today.

"After being here for 30 years, I hope to continue as a member of the department," Warfield wrote, "but since this was so sudden I have no specific plans right now."

Warfield could not be reached for comment. Hospital spokeswoman Judy Glasser said Warfield has stepped down, but she couldn't say more.

"We can't comment on personnel issues," she said.

The change in the anesthesiology department comes a week after Dr. Josef Fischer, chairman of surgery, wrote a letter to surgeons, saying that he is so busy he needs help running the department. Since October, Fischer has served as chairman of the Board of Regents for the American College of Surgeons.

With Levy's "approval and encouragement," Fischer said, he has formed an executive committee of four doctors to help run the department -- an unusual arrangement at an academic medical center.

Fischer continued to say that since he would be away a lot over the next year, a member of the executive committee will accompany him to all major meetings "so there is no loss of continuity of conversation, analysis or decision-making."

Levy and Fischer, through a hospital spokeswoman, both declined to comment on the new arrangement.

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Tuesday, July 17, 2007

Consumer group criticizes hospital chief's blog

By Liz Kowalczyk, Globe Staff

The Center for Science in the Public Interest, a consumer-advocacy group in Washington, D.C., took Boston hospital president Paul Levy to task this week over a recent posting on his popular blog, Running a Hospital. Levy, chief executive of Beth Israel Deaconess Medical Center, wrote on July 8 about a potential new treatment for asthma that uses catheter-delivered heat to reduce bronchial muscle spasms, which he said could be a huge development in treatment of the disease.

The center criticized Levy on its website,, saying he had not disclosed that Beth Israel Deaconess is a clinical trial site for the treatment and a consultant to the company that makes the device, Asthmatx Inc. of Mountain View, Calif.

"The blogosphere operates without rules, even when the blogger runs one of the nation's leading teaching hospitals," the center wrote.

It's not that simple, however. Beth Israel Deaconess is not a clinical trial site, having decided not to participate when its data coordinator left, and it referred all patients it recruited to Brigham and Women's Hospital. The hospital received about $21,500 from the company for study administration and patient screening costs, according to the company. Dr. Armin Ernst, who was to be the principal investigator, was paid $1,500 in fees and expenses for speaking at an Asthmatx symposium in May 2006.

Levy said he did not know about any of this background when he wrote his blog item, but he said he agrees with the general principle raised by the center -- and yesterday he amended his July 8 blog entry.

"It has come to my attention that BIDMC has had commercial relationships with the company engaged in these trials. I was not aware of this before today, and I apologize for not mentioning it in my original post," he wrote. "I will consult with the BIDMC contracts office from now on before discussing new therapies and devices on this blog."

In an e-mail, he told the Globe, "The CSPI is exactly right that bloggers should disclose commercial relationships on items like this. I appreciate their bringing it up as an issue and will make sure to be more careful about it in the future."

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Friday, July 13, 2007

On the blogs: Levy ponders surgeons' report card Catch-22

Public reporting campaign meets surgical caution on Running a Hospital today.

In this week's New England Journal of Medicine three Harvard doctors argue that making mortality rates public for individual cardiac surgeons could end up harming patients if the rankings push surgeons to avoid operating on high-risk patients.

Today Paul Levy responds in detail to the White Coat Notes post about the opinion piece in the journal, written by Dr. Thomas H. Lee of Partners Health Care, Dr. David F. Torchiana of Massachusetts General Hospital and Dr. James E. Lock of Children’s Hospital Boston.

As readers of the Beth Israel Deaconess CEO's blog know, Levy is a champion of transparency, urging other hospitals to join his in posting their performance measures. He responds to the doctors' contention that public reporting is too flawed (not adequately adjusted for risk, too small a sample) to be valid. (He also asks many questions -- it's a long entry.)

"So here's our Catch-22: No reporting method is statistically good enough to be made public," he writes. "But if a method is statistically good enough, we won't allow it to be made public."

Then Levy issues a challenge to health care providers:

"The medical profession simply has to get better at this issue. If they don't trust the public to understand these numbers, how about just giving them to referring primary care doctors? Certainly, they can trust their colleagues in medicine to have enough judgment to use them wisely and correctly."

And another to insurers:

"We hear a lot about insurance companies wanting to support higher quality care. When is an insurance company going to demand that the hospitals in its network provide these data to referring doctors in its network? How about this for an idea? If a hospital doesn't choose to provide the data, it can still stay in the network, but the patient's co-pay would be increased by a factor of ten if he or she chooses that hospital."

Posted by Elizabeth Cooney at 04:46 PM

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MGH, Brigham make US News honor roll

Massachusetts General Hospital and Brigham and Women's Hospital held on to their honor roll positions in the annual rankings by U.S. News & World Report called "America's Best Hospitals." Nine Boston hospitals are featured in the guide.

Mass. General finished fifth in the standings, down one rung from last year, and the Brigham took tenth place, up one from last year. Once again, Johns Hopkins Hospital and the Mayo Clinic finished first and second. UCLA Medical Center moved up to third from fifth and the Cleveland Clinic slipped to fourth from third.

The magazine evaluated 5,462 hospitals in 16 specialties, excluding pediatrics, and came up with 173 hospitals that met standards in one or more specialties based on reputation, care-related factors such as nursing and patient services, and mortality rate. Eighteen hospitals scored at or near the top in at least six specialties to make the honor roll.

Other hospitals were ranked in the specialty areas, but not in a cumulative score. Beth Israel Deaconess Medical Center was in the top 50 for 10 categories: diabetes (in conjunction with the Joslin Clinic); digestive disorders; respiratory care; heart and heart surgery; cancer care; kidney diseases; geriatrics; gynecology, urology; and ear, nose and throat care.

Boston-area hospitals known for their specialties also made the top 50. Dana-Farber Cancer Institute placed fifth in the list for cancer care. Joslin Clinic, with its partner Beth Israel Deaconess, was ranked 12th for endocrinology. New England Baptist Hospital was 17th for orthopedics and Spaulding Rehabilitation Hospital ranked eighth for rehabilitation. Massachusetts Eye and Ear Infirmary placed fourth in ophthalmology and in the ear, nose and throat specialty.

Boston Medical Center was ranked 41st in geriatrics.

Mass. General's winning specialty areas were cancer; digestive disorders; ear, nose and throat; endocrinology; geriatrics; heart and heart surgery; gynecology; kidney disease; neurology and neurosurgery; orthopedics; respiratory disorders; urology; psychiatry; and rheumatology.

The Brigham's top specialties were cancer; digestive disorders; ear, nose and throat; endocrinology; geriatrics; gynecology; heart and heart surgery; kidney disease; neurology and neurosurgery; orthopedics; respiratory disorders; urology; and rheumatology.

Posted by Elizabeth Cooney at 06:27 AM

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Wednesday, July 11, 2007

It's official: Flier is new Harvard medical dean

By Liz Kowalczyk, Globe Staff

It's official.

Harvard just announced that Dr. Jeffrey S. Flier, a prominent diabetes and obesity researcher at Beth Israel Deaconess Medical Center, has been named dean of Harvard Medical School.

Harvard University President Drew Gilpin Faust said in a telephone interview that Flier has wide ranging experience across the university, developed during his nearly 30 years there. She said she was impressed that Harvard leaders and faculty in vastly different roles -- basic science researchers, academic leaders, and physicians -- all spoke highly of him.

"All brought the same sense of deep respect," she said this afternoon.

Flier succeeds Dr. Joseph Martin, who stepped down as dean last month.

Flier was selected after the head of the National Heart Lung and Blood Institute, Dr. Elizabeth Nabel, a cardiologist, withdrew as a finalist, two Harvard officials said, citing a desire to stay in Washington where her husband works. Just as Faust is the first female president of Harvard, Nabel could have been the first female dean of the medical school.

"The timing was not right for her family, but Dr. Nabel congratulates Dr. Flier and wishes him great success in his new position as dean," said NHLBI spokeswoman Susan Dambrauskas.

Flier, 59, lives in Newton; his wife, Dr. Eleftheria Maratos-Flier, also is a leading diabetes researcher at Beth Israel Deaconess.

Flier, who is known for his research into the molecular mechanisms of insulin action and insulin resistance, has served for the past five years as chief academic officer of Beth Israel Deaconess. He has been closely involved in recent discussions of the future of Harvard-wide science, as a founding member of the Harvard University Science and Engineering Committee.

"It's pretty clear we're starting from a very high base line," said Flier, who begins as dean Sept. 1. "The challenge is finding areas where this incredible institution can be strengthened," he said in an interview.

He said that his areas of focus will include implementing Harvard Medical School's new curriculum, which pushes students to better understand patients' experiences in the health care system; helping plan the university's new Allston campus and the future of science at Harvard; and increasing collaboration among researchers across the system, particularly in the area of translating basic research into treatments for patients.

Asked how he pitched himself for the job, considering the dozens of candidates, Flier recounted, "I said that I've been in this system my whole career. I've seen the system on the patient care end, the researcher end, the teaching and the academic leadership end. I know I've been successful in those areas."

Dr. James Thrall, head of radiology at Massachusetts General Hospital and a member of the search committee, said "it was very clear in the proceedings that all of the people in the Harvard community who had worked with him (Flier) held him in very high regard. Given the nature of the academic world that is refreshing. People are pretty tough and judgmental. Having the right personality is important; trust and respect become very important when (people) have legitimate disagreements."

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Monday, July 9, 2007

On the blogs: Beth Israel CEO has some advice for Caritas Christi

On Running a Hospital, Paul Levy compares the troubles of the Caritas Christi Health Care system to the ones he faced when he took over at Beth Israel Deaconess Medical Center. It was January 2002 and Attorney General Tom Reilly was pushing to sell the hospital to a for-profit company. Levy says reorganizing the Beth Israel Deaconess board in relation to its parent Caregroup was key to its survival.

"The marvelous hospitals of the Caritas Christi system and the caring and thoughtful staff in those hospitals need to be governed by the communities they serve," Levy writes. "Local board members who are held accountable for their actions will have the business sense and the dedication to make the decisions needed to ensure that the faith-based mission of their institutions is successful."

Posted by Elizabeth Cooney at 10:20 AM

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Saturday, June 30, 2007

Halamka gets Googled

halamka 150.bmpDr. John D. Halamka is nothing if not connected.

The chief information officer at Beth Israel Deaconess Medical Center has a radio frequency identification chip implanted in his body that points to his personal health information. He belongs to a statewide group working on ways to connect medical records throughout different health care systems. He has championed technology as critical to patient safety at Beth Israel.

Now he's part of a new Google Health Advisory Council. The search-engine giant's announcement says the 24 experts it has convened -- including well-known diet book author Dr. Dean Ornish, former NIH head Dr. Bernardine Healy and former FDA commissioner Dr. David Kessler -- will "broadly help us better understand the problems consumers and providers face every day and offer feedback on product ideas and development."

The council move its causing a bit of a stir for two reasons, at least as reflected on the Wall Street Journal's Health Blog and Kevin, MD. One fear is that patient privacy will be compromised if it goes online in some fashion. The second wave of criticism came from nurses, medical librarians and even medical bloggers disappointed not to be represented on the panel.

Halamka is traveling in Japan, his out-of-office e-mail reply said earlier today. Known for being almost as tightly attached to his Blackberry as his RFID chip is to him, he won't surprise anyone if he comments later.

Update: Here's Halamka's response from a Buddhist temple on Mt. Koya, where he was not immediately able to access the critical comments:

"Google's mission in the healthcare area is to empower consumers to make better health decisions. They can accomplish this by helping patients search better and helping them manage their personal health information," he wrote. "If patients provide aspects of their medical history during the search process (with appropriate privacy protections, of course) then the relevance of the refined search results is likely to be much higher."

Posted by Elizabeth Cooney at 08:06 AM

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Friday, June 22, 2007

Harvard researcher wins MERIT Award from NIH

Lin100.bmpXihong Lin (left), professor of biostatistics at the Harvard School of Public Health, has won a MERIT Award from the National Institutes of Health.

Lin will develop statistical methods for analyzing cancer research data, including long-term and family data as well as genomic and proteomic information in epidemiological studies and population sciences, NIH said in a statement.

Fewer than 5 percent of NIH-funded investigators are selected to receive the awards.

Current MERIT recipients in Massachusetts and their instituions are:

Beth Israel Deaconess Medical Center: Benjamin G. Neel
CBR Institute for Biomedical Research: Timothy R. Springer
Children's Hospital Boston: Michael Klagsbrun and Bruce R. Zetter
Dana-Farber Cancer Institute: Stanley Korsmeyer and David M. Livingston
Harvard: John Blenis, Stephen C. Harrison, Peter M. Howley and Andrew G. Myers
Massachusetts General Hospital: Daniel Haber
MIT: Michael R. Lieber, Stephen J. Lippard and Alexander Rich
Tufts: John M. Coffin
Whitehead Institute for Biomedical Research: Rudolph Jaenisch

Posted by Elizabeth Cooney at 11:05 AM

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Thursday, June 21, 2007

Heart care beats US average at four Mass. hospitals, new Medicare rankings say

By Liz Kowalczyk, Globe Staff

A patient's chance of survival after suffering a heart attack or heart failure is better than average at four Massachusetts hospitals -- Cape Cod Hospital, Southcoast Hospital Group, Beth Israel Deaconess Medical Center and Brigham and Women’s Hospital -- according to newly-released data from the federal government.

Medicare, the national insurance program for the elderly, today added a new element to its website Consumers now can check the survival rate for a hospital's patients within 30 days of being treated for a heart attack or heart failure.

All other Massachusetts hospitals showed survival rates -- adjusted for how sick the patients were before they were hospitalized -- equal to the average US rates. No Massachusetts hospital scored worse than the national rates. But four did better -- Beth Israel Deaconess, the Brigham and Southcoast showed mortality rates better than the national average for heart failure; the US 30-day mortality rate for these patients is 11 percent.

Cape Cod Hospital had a better than average mortality rate for heart attack patients; the US 30-day mortality rate for these patients is 16 percent.

Posted by Elizabeth Cooney at 05:32 PM

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Thursday, June 14, 2007

Hospital Association chairman takes gavel

Robert G. Norton, president and CEO of North Shore Medical Center in Salem, became chairman of the Massachusetts Hospital Association's board of trustees today, the group said.

Norton came to the Partners HealthCare hospital from Shands Jacksonville Medical Center in Florida after being executive vice president at Beth Israel Deaconess Medical Center.

Other MHA officers are Winchester Hospital president and CEO Dale M. Lodge, chairman elect; Tufts-New England Medical Center president and CEO Ellen M. Zane, treasurer; and Cambridge Health Alliance president and CEO Dennis Keefe, secretary.

Posted by Elizabeth Cooney at 04:07 PM

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Wednesday, June 13, 2007

Beth Israel Deaconess posts performance data online

By Liz Kowalczyk, Globe Staff

On a portion of its website labeled, "We're putting ourselves under a microscope," Beth Israel Deaconess Medical Center today began publicly comparing its performance -- both good and bad -- in key areas of quality and safety with that of hospitals nationally and to internal goals.

The Harvard teaching hospital reports that it's not meeting its own goals for preventing patients from falling and that it scores below top hospitals nationally in giving pneumonia patients in the emergency room antibiotics within four hours. But on many measures, Beth Israel Deaconess reports it is meeting or exceeding its own goals and the performance of its peers, including in many aspects of cardiac care and orthopedics.

A growing number of hospitals are posting performance data on their websites, part of a new "transparency" movement pushed by employers, insurers and government agencies, which believe more openness will lead to better care and lower costs.

But few hospitals -- Dartmouth-Hitchcock Medical Center in New Hampshire and now Beth Israel Deaconess among them -- include areas where they need improvement as well as those where they shine.

New England Baptist Hospital posts some limited quality indicators on its website, though they're hard to find and the hospital has selected ones only where it does well. Mount Auburn Hospital also shares a limited amount of information comparing how it does preventing four types of infections, but again, in all cases the hospital compares positively to national standards.

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Monday, June 11, 2007

On the blogs: lab waste, hospital competition

lab bucket100.bmpOn Nature Network Boston, Anna Kushnir lets us in on a dirty little secret: Labs are an environmentalist's nightmare.

"The amount of waste that my lab generates every day makes paper mills look Earth-friendly," she writes reluctantly (while noting it's not her waste bucket at left). "There is nothing I can do about it. I am not willing to risk my samples being contaminated and my experiments failing to save a pair of gloves or spare a pipette."

A Healthy Blog's John McDonough of Health Care For All and Running a Hospital's Paul Levy of Beth Israel Deaconess Medical Center are engaged in a back-and-forth on hospital competition, cost and quality. This follows previous discussions about the power of Partners HealthCare to influence payment rates.

Levy asks. "Since BIDMC has and will continue to have an excellent clinical reputation and very good relationships with community hospitals, multi-specialty groups, and other referring physicians, should we abandon our call for structural changes in the payment system? Would we be better off just living with the current arrangement, i.e., receiving rates that are just below those provided to the dominant provider network?"

McDonough lists financial data for Beth Israel Deaconess and two Partners hospitals, Massachusetts General and Brigham and Women's.

"Yes, BIDMC’s major competitors are bigger and badder," he writes. "Doesn’t seem, though, that BIDMC is doing too shabbily itself. Doesn’t seem like it’s time to take the hankies out."

That said, McDonough asks how to measure quality in hopes of moving the converstation forward.

"There are literally hundreds and hundreds of quality indicators, and each provider would like to get paid for those things it does well, and not get penalized for the things it does poorly," he says. "Who should decide which indicators matter, and which do not?"

Posted by Elizabeth Cooney at 03:52 PM

« Harvard study explains how aspirin might prevent some colon cancers | Main | Today's Globe: Spence at DSS, neonatal units, medical marijuana, mammograms »

Wednesday, May 23, 2007

Harvard close to hiring medical school dean

By Liz Kowalczyk, Globe Staff

Harvard University's incoming president, Drew Gilpin Faust, is close to making a key hire, dean of Harvard Medical School, and the finalists include a nationally-known cardiologist and a leading Harvard diabetes researcher, according to several Harvard doctors and officials with knowledge of the search.

Dr. Elizabeth Nabel, a cardiologist who trained at Brigham and Women's Hospital and is director of the National Heart Lung and Blood Institute, is a top finalist for the position, according to two of the sources.

Nabel and the agency's spokeswoman did not return calls asking for comment. While at the University of Michigan during the 1980s and 1990s, she rose to chief of the Division of Cardiology and became known for her research into the molecular genetics of cardiovascular diseases, according to the institute's website.

The sources said that Dr. Jeffrey Flier, chief academic officer at Beth Israel Deaconess Medical Center and a nationally-known researcher on diabetes and obesity, also is a serious contender for the job. He said through a spokeswoman that he would not comment on the search.

Harvard University spokesman John Longbrake said the university would not comment on the search until it is completed.

The next dean of Harvard Medical School will replace Dr. Joseph Martin, who steps down next month, ending a 10-year tenure during which he oversaw dramatic changes to the school's curriculum. Martin, a neurologist, plans to take a sabbatical for one year and then increase his work with the Harvard Center for Neurodegeneration & Repair, a group that is trying to develop new drugs for Parkinson's and Alzheimer's disease and other neurological disorders.

Interim Harvard University president Derek Bok convened a faculty search committee to recommend potential replacements for Martin. But he left the final decision to Faust, partly because of the medical school's importance -- it has 11,000 faculty members and $1.2 billion in National Institutes of Health research grants awarded to the medical school and its affiliated hospitals. The medical school dean also will have a key role in the development of Harvard's new Allston campus, where a major stem cell research institute and other scientific laboratories will be located.

The search committee evaluated an initial list of several hundred candidates, the sources said, but the committee is advisory; Faust conducts the final interviews, makes the ultimate decision, and negotiates the new dean's salary, resources, and fund-raising responsibilities.

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Monday, May 21, 2007

On the blogs: Swiss healthcare parallels, latest hospital infection rates

On WBUR's CommonHealth, Béatrice Schaad Noble, a Swiss journalist who is getting her master’s in public health at the Harvard School of Public Health, explains how Switzerland approached universal health insurance coverage.

"Switzerland has gone through the same problems Massachusetts is facing now. Eleven years ago, pockets of resistance were strong. Some people deeply disliked being forced to buy coverage," she writes. "Today resistance has completely disappeared. Last March Swiss have even refused in a vote to shift to a single payer system."

On Running a Hospital, Beth Israel Deaconess CEO Paul Levy posts the latest report on central line infection rates. In the past he has challenged other hospitals to do the same.

"The overall quarterly trend is in the right direction, but as you can see ..., there is troublesome variation from time to time," he writes. "The up's and down's, I guess, are normal, but we all wish they stay down."

Posted by Elizabeth Cooney at 11:22 AM

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Friday, May 18, 2007

On the blogs: No fleas; an easy decision

On Dr. Flea's blog, well, there's nobody home. The Boston-area pediatrician had been chronicling his malpractice trial in either fearless or foolish fashion, depending on your point of view, but now the site has gone dark. Kevin, M.D., thinks it's no coincidence.

On Running a Hospital, Paul Levy shares a letter he receives each year from one of Beth Israel Deaconess Medical Center's doctors when he solicits nominations of people who advocate for the gay and lesbian community for recognition at a hospital event.

"We are again disappointed and frankly disgusted to see the leader of the medical center endorsing an inherently unhealthy, risky lifestyle" the letter says. "We remind you that this is offensive to members of the BIDMC who hold to moral principles and traditional values."

Levy does not name the writer, but gives his response and then makes this comment:

"I made it very clear that this program will continue. Yes, every now and then, the CEO gets to make a decision. This one is easy."

Posted by Elizabeth Cooney at 04:24 PM

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Monday, May 7, 2007

CIMIT awards $5m to medical device researchers

Proposals to build new devices to help premature infants, to inject medicine without breaking the skin and to guide surgeons operating on the brain were among projects to win $5 million in grants from the Center for Integration of Medicine and Innovative Technology, the consortium announced today.

CIMIT, composed of Boston-area teaching hospitals and engineering schools, made 37 grants that range from $40,000 to $100,000. Twenty-two have military applications, acording to CIMIT, which receives support from the US Department of Defense as well as its members.

Dr. Riccardo Barbieri of Massachusetts General Hospital won a grant to develop a computational tool based on a premature infant's heartbeat to predict episodes when they stop breathing.

Mark Horenstein of Boston University will demonstate a way to inject medications through the skin using nanoparticles, leaving no wound behind.

Dr. Nobuyuki Nakajima of Brigham and Women's Hospital will work to improve how instruments can be navigated to diagnose and treat brain injury or disease.

"Our goal ... is to bring life-changing technology to patients as quickly as possible," Dr. John Parrish, CIMIT founder and director and Vietnam War battlefield surgeon, said in a statement. "We are especially aware of the needs of soldiers wounded on the battlefield."

Posted by Elizabeth Cooney at 06:56 AM

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Friday, April 27, 2007

This week in Science

Two papers in Science, including one by Harvard researchers, were among four published yesterday in Science and Nature Genetics on genetic risk factors for developing diabetes. Alice Dembner describes them in today's Globe.

Reseachers from Massachusetts General Hospital, Dana-Farber Cancer Institute, Beth Israel Deaconess Medical Center and Brigham and Women's Hospital are part of an international team reporting on a new mechanism involved in resistance to "smart" cancer drugs Iressa and Tarceva that target lung cancer cell growth.

Scientists have identified a new gene that helps regulate the body's clock and Giulio F. Draetta of Merck
Research Laboratories
in Boston and colleagues report on a molecular component of this clock involved in the
length of the circadian period.

A team that includes researchers from the CBR Institute for Biomedical Research and Harvard Medical School in Boston reveal how the influence of micro-RNAs, small RNA molecules that regulate gene expression, extends to the immune system.

Posted by Elizabeth Cooney at 02:24 PM

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Thursday, April 26, 2007

Aronson, Rosenbaum honored for career achievements

Dr. Mark D. Aronson of Beth Israel Deaconess Medical Center and Dr. Jerrold F. Rosenbaum of Massachusetts General Hospital are being honored for liftime contributions to their fields.

Aronson has won the Society of General Internal Medicine's Career Achievement in Medical Education Award. He founded Beth Israel's hospital medicine program, incorporating it into the residency curriculum and into continuing education and graduate medical education at Harvard Medical School.

Rosenbaum, chief of psychiatry at MGH, has won the C. Charles Burlingame Award from the Institute of Living in Hartford. He specializes in treatment-resistant mood and anxiety disorders, focusing on drug treatments for those conditions.

Posted by Elizabeth Cooney at 01:14 PM

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Tuesday, April 17, 2007

Former Channel 5 anchor joins Beth Israel in online venture with station

Beth Israel Deaconess Medical Center's marketing department already looked a little like Channel 5 with the arrival of former senior health producer Rhonda Mann and former writer and news producer Zineb Marchoudi in January.


But now the television station's website,, is looking a little like the hospital with former news anchor Heather Kahn's (left) arrival as a Beth Israel spokeswoman for a sponsored spot on the WCVB health page.

Outlined in purple, the monthly BIDMC "Hot Health Topic" and video from Kahn appear on either side of Channel 5 news stories - making it hard to tell where the ads end and the news begins.

The online feature debuted yesterday with text reports about weight-loss surgery written by Mann, the hospital's marketing director, and a patient's video story told by Kahn.

Kahn, who used to work with Mann on WCVB's health unit and now lives in Philadelphia, will also appear in television spots promoting the venture, the hospital said. The videos are shot at the station's studios in Needham.

Channel 5 also has sponsored arrangements with Mount Auburn Hospital and Tufts Health Plan, whose advertisements appear on the health page.

Posted by Elizabeth Cooney at 03:26 PM

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Monday, April 16, 2007

On the blogs: dogs and handwashing, dumb movie science

On Running a Hospital, Paul Levy says Beth Israel Deaconess Medical Center has joined Boston Children’s Hospital, Tufts-New England Medical Center and MGH in offering a pet therapy program. Trained dogs and volunteers visit patients who give written consent. A dozen comments include praise as well as concern about allergies, infection and fears, plus Levy's replies with hospital policies on screening for the therapy dogs.

In the next post down, Levy vents frustration over hand hygiene stats at the hospital that show some improvement but not enough.

"Trust me, the irony of putting these two posts next to each other was not lost on me," he writes.

On Nature Network Boston, Harvard virology graduate student Anna Kushnir lists her favorite dumb movie science moments and invites more.

"When I think about the fact that I have spent 23/28ths of my life in school, I have difficulty controlling my gag reflex," she writes. "However, the (exceedingly) rare swells of intellectual superiority I experience when watching really (really) dumb movies make those 23 years worth it."

Posted by Elizabeth Cooney at 11:00 AM

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Friday, April 13, 2007

On the blogs: healthcare law link, falls on the way home

A Healthy Blog points the way to a new website launched with the Massachusetts Hospital Association and the Massachusetts League of Community Health Centers to provide information and outreach materials about the state's new healthcare law.

On Running a Hospital, Beth Israel CEO Paul Levy reveals an interesting pattern that a hospital staffer noticed about patients who fall at the end of their stays, when they sitting on the edge of their hospital beds, dressed to go home.

"We think that our staff members were receiving a subliminal message: They would see a healthy, dressed person in the room and might not have paid the same degree of attention to the patient as they would have an hour earlier when he or she might have been sitting on the edge of the bed in a hospital gown," he wrote. "Slight dizziness or instability of this person would then lead to the fall."

Posted by Elizabeth Cooney at 10:09 AM

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Thursday, April 12, 2007

Harvard team identifies protein from a dinosaur

By Colin Nickerson, Globe Staff

Scientists at Harvard Medical School have for the first time isolated and identified protein from a dinosaur -- a Tyrannosaurus rex that perished in Montana 68 million years ago and was partly preserved under tons of sandstone. Some of the protein identified in the Cretaceous era predator match that of modern-day chickens, the research revealed.

The findings, being published tomorrow in the journal Science, upset the long-held assumption that protein and other basic materials of life could not possibly survive in detectable amounts for more than a few hundred thousand years. They also raise the possibility that scientists might eventually recover DNA from prehistoric beasts, allowing for even more sophisticated analyses of ancient organisms and the processes of evolution.

"People are going to be looking differently at prehistoric bones because now we see they may carry tissue and information that nobody believed could still exist," said Mary H. Schweitzer, a paleontologist at North Carolina State University and a coauthor of both articles.

In all, scientists at Harvard were able to isolate seven tiny strips of collagen protein from soft tissue found in the thigh bone of a Tyrannosaurus rex recovered earlier in the decade from beneath 60 feet of sandstone ledge in Montana's Hell Creek formation.

"At the very least, this breakthrough shows we can look at [protein] sequences that are many, many millions of years old," said John M. Asara, director of the mass spectrometry core facility at Beth Israel Deaconess Medical Center and one of the authors. "That's a first."

Paleontologists not involved in the the T.rex protein research said it represented an astonishing piece of scientific sleuthwork.

"This research might be creating a whole new field of molecular paleontology," said Lawrence M. Witmer, a paleontologist at Ohio University. "This research has opened a door we didn't even suspect was there."

But some scientists doubted whether the experiment will have much practical effect on the study of prehistoric life. Many seemed to believe that the surviving soft tissue found in the Montana T. rex was a fluke -- and that there will never be enough material for the sort of fullbore scientific scrutiny that would allow large conclusions to be drawn about the animals.

"If there were regular opportunities for this kind of matching and comparison, [these] techniques might add important evidence to genuine conundrums -- outstanding questions about the origin and relationships of various vertebrate groups," said Farish A. Jenkins Jr., a Harvard professor of zoology and internationally-recognized expert in vertebrate paleontology. "But the reality remains that finding soft tissues preserved with actual soft tissue structure intact is outside the realm of common expectation, so the applicability of their techniques is very limited."

Similar skepticism was expressed by Mark A. Norell, a paleontologist with the American Museum of Natural History: "This is a very cool experiment. But I don't think curators are going to start grinding up their fossil bones to obtain the really minuscule bits of protein that might be available. There probably just isn't going to be enough of this material" to conduct major research.

"Science requires replication," he said. "You need thousands of comparisons. Not dozens."

Still, buzz surrounded the the mind-boggling findings that protein dating back tens of millions of years can be identified at all. Until now, the oldest positively-identified proteins were recovered from the bones of a wooly mammoth reckoned to be a couple hundred thousand years old, according to Schweitzer. DNA has been taken from the 38,000 year-old bones of a Neanderthal, believed to be a prehistoric relative of modern humans.

Several of the T. rex protein snippets captured at Harvard matched sequences in modern chickens, which the authors of the Science articles say lends more credence to the increasingly accepted view among paleontologists that birds are descended from dinosaurs. "We've added molecular evidence to evidence based on the architecture of bones," said Asara.

The research marked an unusual collaboration between field paleontologists -- famous for rough expeditions to remote places in search of rare fossils -- and medical researchers more familiar with finicky lab equipment and computer readouts than sharp pickaxes, smelly sleeping bags, and battered sifting trays.

Lewis Cantley, professor of systems biology at Harvard Medical School and one of the authors, said the techniques used in sequencing the dinosaur protein from minuscule amounts of material could be useful for researchers who need to find the tiny molecular changes that lead to cancer. "We're creating a cross-discipline of biomedical researchers and paleontologists."

The T. rex femur at the center of the research was found in 2003 by John Horner, a paleontologist with Montana's Museum of the Rockies and reknowned fossil hunter. Schweitzer, analyzing the bone, found evidence that the big bone still contained actual bone and vascular tissue. In most preserved dinosaur remains, minerals have replaced all organic matter, the process known as fossilization.

Scientists were quick to discount any suggestion that the sequencing of protein from a T. rex might represent a toddling first step toward cloning dinousaurs, as in Michael Crichton's novel Jurassic Park and the movies that followed. Cloning would require DNA, which deteriorates more rapidly than protein. Collagen, the sort isolated from the t. rex, is a notably durable protein.

"The idea of cloning prehistoric animals from genetic materials remains science fiction," said Ohio University's Witmer. "But keep in mind, until very, very recently, just the idea of obtaining any genetic material at all from animals so old was dismissed as pure science fiction."

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Wednesday, April 11, 2007

On the blogs: Defensive medicine, a matter of degrees

On Kevin, M.D., Dr. Kevin Pho, a Nashua primary care physician, wrestles with defensive medicine and how to keep it from driving health care costs higher and potentially harming patients.

"Defensive medicine is expensive, has no basis in evidence-based study, and exposes the patient to a host of complications," he writes. "Contrary to popular opinion, more medicine does not equal better medicine."

On Running a Hospital, Beth Israel Deaconess CEO Paul Levy tells a college student that law degrees are best for people planning to become lawyers, not hoping to get better educated, and master's degrees in public health are not appreciated as much as they should be.

"I don't believe it ought to be the case, but the degree is sometimes not valued in hospital settings," he writes. "I think it is because hospitals are dominated by doctors, who often view an MPH as a poor substitute for a medical degree and think people who get one were not smart enough to get into medical school."

Posted by Elizabeth Cooney at 10:00 AM

« On the blogs: variations in end-of-life care, manipulating data | Main | Two new state health officials appointed »

Tuesday, April 10, 2007

Beth Israel rolls out in-house ambulance service


Beth Israel Deaconess Medical Center rolled out its own ambulance service today with two vehicles to transport patients between its east and west campuses and from its hospital in Needham to the downtown medical center. A $250,000 gift from Robert and Carol Mayer of Chestnut Hill will pay for launching the service.

Beth Israel sends patients on 6,000 trips a year, just between its two campuses along Brookline Avenue, in "often complicated and costly transfers," the hospital said.

Most of the transfers -- 93 percent -- are to move patients to beds and the rest are for procedures and tests, hospital spokesman Jerry Berger said. The cost comes to more than $1 million a year.

Ambulance staff will be trained by Beth Israel and Cataldo Ambulance, and a dispatcher will work in the hospital’s emergency department, Dr. Mark Zeidel, chair of medicine, said in a hospital statement.

Posted by Elizabeth Cooney at 04:42 PM

« Canadian medical grads lured to US | Main | Beth Israel rolls out in-house ambulance service »

On the blogs: variations in end-of-life care, manipulating data

On Running a Hospital, Beth Israel Deaconess CEO Paul Levy considers whether the variation in how care is delivered, particularly near the end of life, reflects "overuse, underuse, misuse, and waste in the health care system." He cites a Dartmouth study that said the amount of resources spent didn't change the outcomes, then wonders what should be done. He's gotten 16 answers so far.

On Nature Network Boston, Corie Lok writes about scientific fraud, from ignoring data that don’t fit to falsifying images.

Posted by Elizabeth Cooney at 11:50 AM

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Wednesday, April 4, 2007

Computers don't increase mammogram accuracy and may hurt, study says

Computer-aided detection systems not only failed to detect more breast cancer in women who had screening mammograms, researchers report in tomorrow's New England Journal of Medicine, but it also may have harmed them by generating a higher number of false-positive readings, resulting in significantly more call-backs for repeat mammograms and biopsies.

Dr. Joshua J. Fenton of the University of California, Davis, and his co-authors studied CAD in 429,345 mammograms, the largest trial to date since it was approved by the Food and Drug Administration in 1998. They found that about 157 women would be called back for another mammogram and 15 women would undergo biopsies in order to detect one additional case of cancer, possibly a ductal carcinoma in situ, which is noninvasive and highly treatable.

Fenton's results "constitute a substantial hit to this technology," Dr. Ferris M. Hall of Beth Israel Deaconess Medical Center writes in an editorial in the same issue. Early studies had said CAD helped detect 10 to 15 percent more cases of breast cancers.

CAD programs analyze digitized mammograms and mark suspicious areas for review by radiologists.

CAD picks up a disproportionate number of clustered microcalcifications, which are the sign of ductal carcinoma in situ. DCIS makes up 25 percent of breast cancers diagnosed in the United States, Hall writes, but DCIS may never progress to cancer in a woman's lifetime.

"CAD does find a few more cancers in DCIS, so it's got some usefulness, but in all likelihood it's not going to save many lives," he said in an interview.

A study of CAD and mortality will take more time, Hall said, as it did for screening mammography.

"Mortality is the gold standard," he said. "Finding extra cancers does not prove that you have affected anything. You may have found a cancer that you would find next year anyway."

MRI screenings do a better job, Hall said, but cost and the need for interpretive expertise are delaying its adoption, as they did for mammography before it was accepted, he said.

Posted by Elizabeth Cooney at 05:00 PM

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Wednesday, March 28, 2007

Beth Israel wins prize for reducing medical errors

By Liz Kowalczyk, Globe Staff

The state's largest health insurer has awarded Beth Israel Deaconess Medical Center a $100,000 prize for its "groundbreaking approach to reducing medical errors" after the death of a newborn in 2000.

The hospital's department of obstetrics and gynecology is the first recipient of Blue Cross and Blue Shield of Massachusetts' Health Care Excellence Award, which will be presented to physicians at a health care conference in Boston on Monday.

Blue Cross president Cleve Killingsworth said in a statement that the hospital "successfully changed its culture and achieved significant results" through an initiative that borrowed team work and communication improvements from military and commercial aviation. More than 40 hospitals and other health care organizations competed for the award.

In August 2005, Dr. Benjamin Sachs, chief of obstetrics and gynecology at Beth Israel Deaconess, described numerous judgment errors and miscommunications in the baby's case in an article in the Journal of the American Medical Association. His report highlighted how medical mistakes occur, often because of an accumulation of smaller miscues, and the changes his department adopted in the aftermath.

The case, which occurred in November 2000, became a "burning platform," he wrote, resulting in "a major reorganization of the way care is provided." The hospital used "crew resource management" techniques to train the staff in teamwork and conflict resolution, and limited obstetricians' workloads. The obstetrics department also made major changes in the way it monitored patients. Rather than doctors and nurses knowing the medical situations only of patients directly under their care, the entire department now is knowledgeable about all patients.

Since then, fewer mothers and their babies have suffered complications during childbirth, and legal claims also have declined, though it's not certain that the changes caused the drop. Between 1999 and 2005, the department experienced a 35 percent reduction in "adverse events" among patients and a 50 percent decline among high-risk patients, Sachs said.

The mother in the 2000 case, referred to in the article as Mrs. W, suffered massive blood loss, required an emergency hysterectomy, and spent three weeks in the hospital. In the article, Sachs apologized to the family, taking the unusual step of admitting mistakes and apologizing for them in a public forum.

The $100,000 award will pay for obstetrics nurses to attend a national patient safety conference in May, development of an online continuing medical education course in crew resource management, and research in patient safety.

« State climate for physicians getting worse, MMS says | Main | Aspirin linked to lower risk of death in women, but study authors urge caution »

Monday, March 26, 2007

Drugs may be just as good as surgery for clogged arteries

By Stephen Smith and Liz Kowalczyk, Globe Staff

Patients with clogged arteries who have not yet had a heart attack benefit just as much from medications as angioplasty, according to a study released today.

Specialists representing different camps in cardiology have long argued about the best way to handle patients who have potentially life-threatening narrowing of arteries. Decisions about how to treat heart disease, the nation's number one killer, have significant ramifications, medically and economically.

A large team of researchers from across North America, who presented their findings today at the American College of Cardiology's annual meeting in New Orleans, studied nearly 2,300 patients suffering coronary artery disease.

"The results are very striking," said Dr. Steven Nissen, chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic. "This is important for patients because it does now mean patients have choices. If your symptoms aren't so severe and aren't interfering with your lifestyle, you can afford to wait."

Half of the patients took medication and underwent angioplasty, a procedure that involves using a tiny balloon and metal scaffolds called stents to prop open arteries. The other half received only medication, including drugs to lower cholesterol, relax blood vessels, slow heart rate, and prevent blood clots.

After tracking the patients for an average of four-and-a-half years, in a trial nicknamed COURAGE, the team, including some scientists from Connecticut, found that there was no difference in outcomes between the groups.

The study should help patients and doctors make sure they're using angioplasty for the right reasons, said Dr. William Maisel, a cardiologist at Beth Israel Deaconess Medical Center.

"To place a stent to reduce the chances of a heart attack or to prevent someone from dying, those are not reasons to put in a stent," Maisel said.

The study, to be published in the New England Journal of Medicine, found that among patients experiencing angina -- chest pain that occurs when the heart muscle doesn’t get enough blood -- angioplasty provided more relief than drugs.

The report does not address how well angioplasty helps heart attack patients. Nissen said that angioplasty remains the treatment of choice for patients with a fully blocked artery, and that campaigns are underway to make sure patients having heart attacks are taken to hospitals that can swiftly perform the procedure.

"COURAGE helps us understand we may well have gone too far with angioplasty and that we may have abandoned bypass surgery too quickly," said Nissen, who was not involved in the study. Bypass surgery, in which a surgeon reroutes, or "bypasses," blood around clogged arteries, is more complicated and has a longer recovery time than angioplasty.

In Boston, because of the conservatism of local doctors, the rate of angioplasty is lower than it is nationally, according to Dr. Frederic S. Resnic, director of the cardiac catheterization laboratory at Brigham and Women's Hospital.

At the Brigham, he wrote in an e-mail, "We have always been very careful to have detailed discussions with our patients with stable coronary artery disease, to make sure that they are comfortable and understand that we are considering the procedure to relieve the
symptoms of angina, and reduce the number and amount of medications needed.

"We have also been careful to say that angioplasty has not been shown to reduce heart attacks or prolong life in these very stable patients," he wrote. "Angioplasty for stable patients is really an effective option for relieving symptoms quite completely; but should not be "sold" to patients as a life-saving procedure."

Posted by Karen Weintraub at 02:02 PM

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Contrast agent may shed light on breast cancer diagnosis

Researchers at Beth Israel Deaconess Medical Center and Harvard Medical School are reporting preliminary success with a new way to screen for breast cancer that one day might supplement mammography, according to the American Chemical Society.

resized frangioni.bmp
Crystals resembling those in human breast cancer.

Dr. John Frangioni and researchers in his lab have developed a way to make a contrast agent that after being injected into the bloodstream binds to a particular calcium salt called hydroxyapatite.

That salt is found in malignant micro-calcifications in the breast, but not in benign ones, according to an ACS statement. The contrast agents are designed to be used with optical tomography, an imaging method that sends near-infrared light through the body. Frangioni said it would likely be a few years before the compound is tested in human trials.

Kumar R. Bhushan, a postdoctoral fellow in Frangioni's lab, is scheduled to present the details today at the ACS meeting in Chicago.

Posted by Elizabeth Cooney at 11:20 AM

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Friday, March 23, 2007

Top scientists gather for metastasis meeting

Cancer researchers from Boston and around the world have gathered in Houston for a symposium today and tomorrow to talk about metastasis -- how cancer spreads -- and to honor Dr. Isaiah J. Fidler, the scientist who confirmed a 100-year-old theory of how cancer kills.

Speakers at the symposium include Dr. M. Judah Folkman of Children's Hospital Boston and Harvard Medical School, Robert Weinberg of the Whitehead Institute for Biomedical Research at the Massachusetts Institute of Technology, Dr. Harold Dvorak of Beth Israel Deaconess Medical Center and Harvard, and Richard Hynes of Howard Hughes Medical Institute and MIT.

Fidler, whose recent research focuses on prostate and pancreatic cancer, is stepping down as chair of cancer biology at The University of Texas M. D. Anderson Cancer Center in September.

Posted by Elizabeth Cooney at 06:03 PM

« Harvard scientist to lead Stanford's Bio-X program | Main | Social workers to gather on Beacon Hill Monday »

On the blogs: BU biolab image and who's watching?

On SciBos, Corie Lok takes issue with the Globe's front-page coverage of the evacuation of a Boston University biomedical lab on Tuesday.

"Even though the fire department said no contamination occurred, all the proper precautions were taken and that the smoke probably was due to an electrical issue, the specter this incident conjured up of disease-causing bacteria being unleashed on the community and the image of men in protective suits are enough to make front-page news in this town," she writes. "Doesn’t exactly help BU’s image. Doesn’t really help science’s image either, I think."

On Running a Hospital, Paul Levy asks, "If you are a patient in an academic medical center, who is watching over you in the middle of the night?"

Posted by Elizabeth Cooney at 11:17 AM

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Thursday, March 22, 2007

Creatine to be studied in new Parkinson's trial

By Carey Goldberg, Globe Staff

Federal researchers announced early today that they’re launching a nationwide trial to see whether creatine, a supplement long favored by body-builders, can slow the effects of Parkinson’s Disease.

The National Institute of Neurological Disorders and Stroke is aiming to enroll more than 1,700 Parkinson’s patients at sites around the country, including two in Boston: one at Brigham and Women’s Hospital and one at Beth Israel Deaconess Medical Center.

Parkinson’s is a degenerative illness that affects more than a million Americans. Initial studies suggest that creatine may slow the degeneration. Some drugs can help relieve the tremors and other symptoms of Parkinson’s, but none seems able to stop the disease from progressively worsening.

Patients in the clinical trial will be expected to participate for from five to seven years.

More info: 1-800-352-9424;

Posted by Karen Weintraub at 12:12 AM

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Wednesday, March 21, 2007

Ouch! Groopman dissed by Stephen Colbert

As Dr. Jerome Groopman is learning, the price of a book tour that includes an appearance on Comedy Central's "The Colbert Report" is unlimited razzing by the host. On Monday night, Stephen Colbert joked with his guest, the Beth Israel Deaconess Medical Center doctor/writer, that while many doctors think they're God, the white-bearded Groopman looks like God.

Then at the start of tonight's show, after telling his audience that singer Willie Nelson would be the guest, Colbert quipped: "Sorry Jerome Groopman fans, you missed him by one day."

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Monday, March 19, 2007

Sellke elected president of thoracic surgeon group

Dr. Frank W. Sellke, professor of surgery at Harvard Medical School and a thoracic surgeon at Beth Israel Deaconess Medical Center, has been elected presidenct of the 46-member Massachusetts Society of Thoracic Surgeons.

Dr. Frank W. Sellke

Sellke was also named chairperson of the Research Project in Cardiothoracic Surgery of the National Heart, Lung, and Blood Institute, Special Emphasis Panel.

Posted by Elizabeth Cooney at 03:13 PM

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Friday, March 16, 2007

Why Beth Israel and the Red Sox play ball

Ever wondered why a medical center becomes the official hospital of a sports team?

Today on his blog, Beth Israel Deaconess Medical Center chief Paul Levy explains why his hospital pays the Boston Red Sox an annual fee for the right to join their names together, inside and outside Fenway Park.

"In our case, finding ourselves engaged in a successful turnaround after almost going out of business because of a botched merger between 1996 and 2001, we were looking to remind people in Boston that we were alive and well," Levy wrote. "We wanted to portray a sense of permanence for our hospital, which had been badly beaten up in news reports and in community perception for several years."

BIDMC offers first aid in the park, sponsors 25 students as Red Sox Scholars and works with the American Red Cross to encourage blood donations.

Levy didn't say in his blog how much the naming rights cost each year and he declined to give up the stat when the Globe asked for it in an e-mail.

"Sorry, that is not public -- unlike our infection rates!"

Posted by Elizabeth Cooney at 04:38 PM

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Tuesday, March 13, 2007

Cancer doctors will soon be in short supply

By Scott Allen, Globe Staff

The United States faces a looming shortage of cancer specialists by the year 2020 as aging Baby Boomers become increasingly cancer-prone and medical schools can't train enough new oncologists to keep up with them, according to a national survey released this afternoon.

The report from the American Society of Clinical Oncology forecasts a 48 percent increase in need for cancer treatment by 2020, while the number of oncologists will rise by only 14 percent, leaving a need for 2,550 to 4,080 more cancer specialists nationwide.

"This is a problem for the whole cancer care delivery system and everyone who is involved with it," said Dr. Michael Goldstein of Beth Israel Deaconess Medical Center, who chaired the society's Workforce in Oncology Task Force. "The whole work force is going to be challenged 10 to 15 years from now."

In a way, oncologists are victims of their own success. As cancer treatment has become more successful, deaths from cancer have begun to decline, leaving more people living with cancer -- and still needing care. In addition, more than half of oncologists are already at least 50 years old, raising the prospect of mass retirements in the decades ahead.

So far, the shortage of oncologists is little more than an inconvenience for the doctors who are seeing an increased workload, but Goldstein and other cancer specialists say action needs to be taken now because it takes so many years to train new physicians. The Society of Clinical Oncology is already developing recommendations to ease the coming shortage, such as delegating more care to nurses and other medical staff, persuading older oncologists to delay retirement, and reducing the paperwork that keeps doctors away from patients.

Posted by Karen Weintraub at 06:07 PM

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Friday, March 9, 2007

On the blogs: philanthropy and science, hospital quality measures, health care law, paying doctors more to teach

Corie Lok connects the $100 million windfall for the Broad Institute's new psychiatric research center with other grants to the Harvard-MIT venture, suggesting they account for the dominance of the Broad in papers published in Nature journals. But the effect of philanthropy doesn't stop there.

"To me, this is more evidence that Boston research is greatly benefiting from philanthropic sources of funding," she writes. "I find it interesting that people who became millionaires through businesses that have nothing to do with science are quickly becoming the benefactors of science."

Paul Levy, president and CEO of Beth Israel Deaconess Medical Center, repeats his call for hospitals to make public their rates of central line infections, which can occur after tubes are inserted into patients. An anonymous poster asked about another safety issue:

"What about the NY Times story just the other day on how rapidly the various hospitals react when someone enters the emergency room with what looks like a heart attack?" the writer says. "Boston Medical Center (is) way ahead of the BID (and all others in the Boston area). Are we working on this (and other things we are low on on the HHS measures)?"

John McDonough of Health Care For All reports on yesterday's Commonwealth Health Insurance Connector board meeting that celebrated meeting milestones, having enrolled more than 52,000 people and approving seven health plans to sell Commonwealth Choice coverage to people who don't qualify for subsidized plans.

"Working nurse" sounds a note of caution, however, saying 48,000 of those people were automatically given insurance paid for through the state budget, and the other 4,000 had state subsidies for their coverage.

"More folks having true affordable quality coverage is a very good thing," the post says. "It should be pointed out that in the big picture what’s been accomplished thus far has been the easy part."

On WBUR's CommonHealth, Jonathan Gruber, professor of economics at MIT and member of the Connector Board, asks whether health insurance can be compared with food.

"Most Americans think of health insurance as medical prepayment: you buy an up-front premium and in return all of your medical expenses are covered," he writes. "But such a system has an inherent flaw: any time something is free, it will be overused. This should not be a controversial statement to anyone who has ever gone to an all-you-can-eat buffet. Having paid at the door, you always end up eating more than if you were paying for each item your ordered."

Based on research of how insurance is used, he argues that individuals should pay for some of their health care costs, according to their income.

"Coming back to the buffet analogy, it is clearly harmful to not allow individuals to eat –- but less critical that you allow them to eat as much as they want."

Kevin, M.D. got this comment on Liz Kowalczyk's Globe story about Harvard sweetening rewards for doctors who teach:

"Great, so now my tuition goes up $10,000."

Posted by Elizabeth Cooney at 11:34 AM

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Thursday, March 8, 2007

Beth Israel Deaconess hires new COO

Beth Israel Deaconess Medical Center has named Eric Buehrens its new chief operating officer, the hospital said today.

Buehrens has been the deputy provost for administration at Harvard University. Before that he was executive dean for administration at Harvard Medical School, and associate dean for planning and facilities at HMS.

He will succeed Dr. Michael F. Epstein, who said last month he would be leaving May 1.

Posted by Elizabeth Cooney at 07:05 PM

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Wednesday, March 7, 2007

Soliciting organ donations undermines fairness of waiting list, surgeon writes

Soliciting organ donations, whether on billboards or on the Internet, raises ethical questions and threatens the fairness of how organs are allocated, Dr. Douglas W. Hanto writes in tomorrow's New England Journal of Medicine.

Organs from deceased donors go to the people at the top of the waiting list maintained by the United Network for Organ Sharing, which is regulated by the federal government. The only exception is made for family members of deceased donors.

But when it comes to living donors who may come forward to give a kidney or part of a liver, there are no policies regulating directed donations, writes Hanto, chief of transplantation at Beth Israel Deaconess Medical Center and professor of surgery at Harvard Medical School.

"We don't have enough organs for everybody," he said in an interview. "I would like to see the system change so those donations are directed to the top of the waiting lists, after family, friends and pre-existing relationships."

Most organs from living donors go to friends or family members, according to UNOS figures, but there are increasing numbers of prospective donors with no relationship to the potential recipient. Between 1996 and 2006, the percentage of living donors without close ties rose from 6.5 percent to 23 percent.

Websites such as Canton-based were created to connect people who need transplants with live organ donors. Phone messages seeking comment today were not returned, but on its website, says "there are thousands of wonderful, altruistic and compassionate people willing to help a fellow human being. It is our belief that many of the potential donors would have never considered live organ donation if it wasn’t for the increased awareness due to our site."

Hanto urges development of rules to guard against unfair allocation of organs from living donors that will protect donors and recipients alike. He points to a study in Minnesota of altruistic donors, whose desire to donate was unaffected by knowing who would receive their gift compared with their organ going to the person at the top of a waiting list.

Hanto also cites concerns that organs will go to people with more advantages (as shown by their access to the Internet), that the potential for illegal payment is greater without previous close ties, and that recipients might be vulnerable to later demands from donors.

Dr. Francis L. Delmonico, a transplant surgeon at Massachusetts General Hospital, medical director of the New England Organ Bank and past president of UNOS, agrees that solicitation of living donors raises concerns, but he thinks that there is no legal basis to regulate how people find or identify a donor, through or other groups.

"It is not for us to tell people how they can make relationships," he said in an interview. "But it is for UNOS and for the transplant centers to exercise some caution."

Transplant centers perform a psychosocial as well as a medical evaluation of any potential donor.

"I would say this has to be done in a more heightened way," Delmonico said about screening. "The risks that are associated with donors that come along under the circumstances of solicitation are greater in having misunderstanding by the donor and misunderstanding as to what is being derived for the recipient."

Hanto does endorse the New England Kidney Exchange, an effort to pair living donations in cases where one potential donor might not be a match for the loved one they hope to help, but that organ can be exchanged for a match with another pair in the same situation who can provide a compatible organ.

"I think that's a terrific idea," he said. "It's not going to solve the whole problem, but it's a great solution."

Posted by Elizabeth Cooney at 07:29 PM

« Hot stuff: Three local researchers rank high | Main | $100 million to be spent unlocking the genetic mysteries of mental illness »

Beth Israel hires spine neurosurgery chief

Dr. Michael W. Groff has been named chief of the neurosurgical spine service and co-director of the Spine Center at Beth Israel Deaconess Medical Center.

He comes to BIDMC from Indiana University School of Medicine, where he was director of spinal surgery and co-director of the spinal cord injury center.

Groff received his medical degree from the University of Pittsburgh School of Medicine in Pittsburgh, and completed intern and residency training at Mount Sinai Hospital in New York, and fellowship training at the Medical College of Wisconsin in Milwaukee.

Posted by Elizabeth Cooney at 03:53 PM

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Friday, March 2, 2007

Beth Israel hires new emergency radiology chief

Dr. Marc A. Camacho, instructor in radiology at Harvard Medical School, has been named chief of the newly established section of emergency radiology in the department of radiology at Beth Israel Deaconess Medical Center.

Camacho received his medical degree from the University of South Florida College of Medicine and a masters of science degree in biomedical engineering from Boston University. He comes to Beth Israel from Virginia Commonwealth University Health System/Medical College of Virginia Hospital in Richmond, Va., where he was chief of the emergency radiology section and an assistant professor at Virginia Commonwealth University.

Posted by Elizabeth Cooney at 07:01 AM

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Thursday, March 1, 2007

Snub of the universe? Postdocs pick elsewhere

Not a single institution on either side of the Charles cracked the Top 15 places to work in a survey of postdoctoral life scientists, the March issue of The Scientist magazine says.

Training and experience matter the most to these researchers, who have finished their Ph.D.s but don't have faculty positions, the survey reports. They ranked access to books and journals next, followed by affordable medical insurance and then equipment and supplies for research.

The closest Boston or Cambridge came was Beth Israel Deaconess Medical Center's 28th-place finish, shooting up from 97th last year.

Harvard Medical School, Brigham and Women's Hospital, Woods Hole Oceanographic Institute and Dana-Farber Cancer Institute also made the top 40. MIT dropped out of the top 40, placing 53rd.

M.D. Anderson Cancer Center in Houston topped the list, zooming up from 29th last year. The J. Gladstone Institutes in San Francisco slid to second place from first. The U.S. Environmental Protection Agency in Research Triangle Park, N.C., stayed in third.

Here's how postdocs ranked area institutions, with the 2006 ranking in parentheses:

Beth Israel Deaconess: 28 (97)
Harvard Medical School: 31 (17)
Brigham and Women's: 35 (41)
Woods Hole: 38 (11)
Dana-Farber: 39 (67)
MIT: 53 (26)
Harvard University: 71 (45)
Massachusetts General Hospital: 81 (64)

A total of 96 institutions in North America were ranked this year. Research centers with too few responses were not listed, including some in the Boston area.

For its "Best Places to Work 2007: Postdocs," the magazine polled its readers about conditions in their research facilities. The Web-based questionnaire pulled in 2,555 usable responses from people who identified themselves as non-tenured scientists working in academia or other non-commercial research organizations.

So, postdocs, White Coat Notes wonders what you think about where you work. Send us your thoughts at

Posted by Elizabeth Cooney at 08:03 AM

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Tuesday, February 27, 2007

High-fat dairy foods may help some women get pregnant

Women having trouble getting pregnant because they aren't ovulating regularly may want to drink a daily glass of whole milk and skip the skim, according to a Harvard study appearing in tomorrow's issue of the journal Human Reproduction.

Dr. Jorge E. Chavarro and his colleagues at the Harvard School of Public Health followed 18,555 women in the Nurses Health Study II for eight years. They found that eating low-fat dairy foods may increase the risk of infertility from a lack of ovulation by 85 percent while eating high-fat dairy foods may decrease the risk by 27 percent.

The findings are important in light of government recommendations to consume three or more daily servings of low-fat milk or other dairy products, the article says, calling it a "strategy that may be deleterious for women planning to become pregnant."

For both high-fat and low-fat foods, the effects showed up with only one or two servings per day, Chavarro said.

"The women in the study really did not consume that much high-fat dairy food, but the level they did had some protective effect at about one serving a day, especially for whole milk and to a lesser extent for ice cream," Chavarro said in an interview. "It was not really high, not going crazy with buckets of ice cream after every meal."

Lack of ovulation is a significant cause of infertility, affecting as many as 1 in 3 women who have difficulty conceiving, said Dr. Alan Penzias, director of the reproductive endocrinology fellowship at Beth Israel Deaconess Medical Center and a professor of obstetrics and gynecology at Harvard Medical School. He was not involved in the study.

A number of conditions, including big swings in weight, can shut down ovulation. If a woman has gained weight recently, she is typically told to go on a diet, he said. But now that advice may be adjusted when it comes to dairy foods.

"Instead of just telling them, lose weight, we may then modify some of our advice," he said. "We may say, 'While trying to have a well-balanced healthy diet, you may want to avoid an excess of low-fat dairy foods.' "

Chavarro said dairy fat -- or something in dairy fat -- is responsible for the benefit. Hormones from cows that are soluble in fat may have an impact on fertility, but further studies will have to be done to be sure, he said. The study also looked at calcium, phosphorus and vitamin D but found no connection to infertility.

Should doctors order ice cream for their patients?

"Ice cream may be great for sensational headlines, but it's not the best dietary advice," Penzias said.

Posted by Elizabeth Cooney at 07:00 PM

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Monday, February 26, 2007

Malpractice discussion gets hot

Paul Levy posted a long item on his blog Saturday about the shame physicians feel when they are sued for malpractice even when they are sure they have done nothing wrong.

"For someone who has spent his or her whole life basking in the gratitude and admiration of individuals and society, this can be a devastating experience," the Beth Israel Deaconess CEO wrote. "Even when the verdict is issued, clearing the doctor of all wrong, it can leave a terrible scar."

Comments continue to pour in, including this one from a less than sympathetic Anonymous:

"Sorry, healthcare is just another service industry. What doctors do is highly risky -- their mistakes are costly." What Levy seems to say is that "doctors are such a superior lot," they shouldn't have to pay, Anonymous writes, adding, "You all a bunch of Albert Schweitzers in Lexuses."

Another anonymous poster had this to say:

"I can certainly feel sympathy for the physician, but truthfully, the bulk of my sympathy is reserved for the patient who is actually injured by the negligence of a physician."

Posted by Elizabeth Cooney at 12:19 PM

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Wednesday, February 21, 2007

Project seeks to limit ties between doctors, drug companies

A new campaign called The Prescription Project seeks to end conflicts of interest that may arise from pharmaceutical company marketing aimed at physicians. It calls for academic medical centers to tighten their policies governing ties with industry.

"We are looking to see that payers, consumers and physicians work together to promote evidence-based medicine and to counter the bias of drug marketing," said Robert Restuccia, the project's Boston-based executive director.

The Prescription Project points to Stanford University Medical School, University of Pennsylvania Health System and Yale University School of Medicine as leaders. While their models vary, the institutions restrict gifts to doctors, drug samples and visits by industry sales representatives.

Boston hospitals surveyed by the Globe during the past week say they require drug company employees and other vendors to register with them before visiting, but other policies vary.

Tufts-New England Medical Center does not allow pharmaceutical sales representatives in clinical areas. Caritas St. Elizabeth's Medical Center says its doctors cannot give patients free samples of medications, but Partners' hospitals, Brigham and Women's and Massachusetts General, do let doctors give free samples to patients at certain approved sites, such as a practice serving a significant number of uninsured patients unable to pay on their own.

Beth Israel Deaconess Medical Center and St. Elizabeth's prohibit on-site meals paid for by drug companies and restrict gifts to under $100. Partners' hospitals have a similar cap on what doctors can accept. Gifts may include nominal-value items related to education or patient care, the Partners' rules say.

A speaker or panelist at a professional meeting may accept payment for expenses if the meeting's purpose is "promoting objective scientific and educational activities," the Beth Israel Deaconess policy states.

"We take this issue very seriously and continue to update our policies," said St. Elizabeth's spokeswomen Melanie Franco. "We will look at what the Prescription Project is saying."

The Prescription Project, funded by $6 million from the Pew Charitable Trusts, is a joint effort of Community Catalyst in Boston and the Institute on Medicine as a Profession at Columbia University. Its impetus was a January 2006 article in the Journal of the American Medical Association that said the $12 billion spent annually on drug marketing influences how doctors prescribe medications, whether they receive free lunches, free samples or free trips from companies.

Posted by Elizabeth Cooney at 01:28 PM

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Friday, February 16, 2007

Beth Israel Deaconess lures hot-shot cancer geneticist

By Scott Allen, Globe Staff

Beth Israel Deaconess Medical Center has successfully lured one of the most promising young cancer geneticists away from Memorial Sloan-Kettering Cancer Center in New York City, making Dr. Pier Paolo Pandolfi the director of its newly created cancer genetics program.

pandolfi.jpg new
Dr. Pier Paolo Pandolfi

The Italian-born Pandolfi, 43, already has won a slew of awards for his research into the molecular and genetic causes of leukemia, lymphoma and other cancers. His work has led to new treatments for a form of blood cancer, acute promyelocytic leukemia.

As both a professor at Cornell University's Weill Medical College and a researcher at the world's largest cancer center, Pandolfi was positioned for a long run in New York. But Beth Israel Deaconess, eager to play a bigger role in the most dynamic area of cancer research, attracted Pandolfi to Boston with the promise of a new program where he will attempt to develop individualized treatments for cancer patients. Pandolfi also will become a professor at Harvard Medical School, for which Beth Israel Deaconess is a major teaching hospital.

In an interview, Pandolfi said he was attracted by the idea of working in Boston's storied Longwood Medical Area, adding that he dreamed of becoming a Harvard professor when he was a boy growing up in Rome. "I have a very good job. Sloan-Kettering is a top institution, but I'm sure we can do as well or better here," he said.

Senior Beth Israel Deaconess officials were full of praise for their new rising star, and one official couldn't resist a little Boston-bests-New York ribbing. "Now they can keep Johnny Damon," he joked.

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Levy issues challenge on infection rates

Beth Israel Deaconess Medical Center CEO Paul Levy says better infection control practices likely saved one life at his hospital in January, and on his blog today he challenged other hospitals and health insurers to share their numbers too.

Levy posted his hospital's monthly rate of central line infections going back to October 2005, a theme first visited in December. A central line is the opening through which a tube delivers medications directly into a patient's bloodstream. An infection can travel this route quickly, causing organ failure.

He urged others to go public with their rates, and the state to make public rates too, arguing that disclosure leads to better results.

"If I can post these rates for BIDMC, why can't people from other hospitals? Cleve, Charlie, and Jim: Why can't the insurance companies (Blue Cross, Harvard Pilgrim, and Tufts) post them? Governor Patrick and Secretary Bigby: Why can't the state of Massachusetts?"

Posted by Elizabeth Cooney at 09:02 AM

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Tuesday, February 13, 2007

Hospital CEO irked by Green Line service

Paul Levy, CEO of Beth Israel Deaconess Medical Center, was so exasperated by his experience commuting to work on the Green Line yesterday morning that he posted a comment on the Universal Hub website. Levy offered a friendly suggestion to MBTA General Manager Dan Grabauskas: "Take down those really big pictures of yourself at the T stations -- you know, the ones of you standing in front of the American flag -- because I fear for the personal abuse you will take if people get to know what you look like and recognize you on the street."

« Beth Israel Deaconess radiology chief to edit journal | Main | Today's Globe: naps, stents, Jon Lester »

Monday, February 12, 2007

Drug-coated stents no better than older models, studies show

By Stephen Heuser, Globe Staff

The most exhaustive studies yet published on drug-coated stents show that the widely used heart devices are no better at preventing heart attacks and death than the older, cheaper devices they replaced, and in some cases may be slightly worse.

A series of studies released today by the New England Journal of Medicine showed that drug-coated stents carried one clear benefit: patients who receive them are less likely to return to the hospital for a repeat heart-clearing procedure.

Viewed over the long term, however, the stents did not improve patients' survival rates.

Dr. William Maisel, a cardiologist at Beth Israel Deaconess Medical Center who chairs the FDA's panel on cardiovascular devices, said the new studies would likely push doctors to be more cautious about using drug-coated stents. "The decision to put in a drug-eluting stent is now a decision, where before it was used in almost any case," he said.

Click here for full story.

« The lifesaving potential of an afternoon nap | Main | Drug-coated stents no better than older models, studies show »

Beth Israel Deaconess radiology chief to edit journal

Dr. Herbert Y. Kressel, radiologist-in-chief at Beth Israel Deaconess Medical Center, will step down at the end of the year to become editor-in-chief for the journal Radiology, the hospital said today.

Kressel will stay on staff one day a week in the radiology department and he will keep his appointment as a professor of radiology at Harvard Medical School. Dr. Vassilios Raptopoulos, who was recently named vice chair of clinical services in radiology, will serve as interim chief if needed. A search committee is being formed to appoint a new chief.

Kressel joined Beth Israel Hospital as radiologist-in-chief in 1993. He was chief medical officer and president for BIDMC until 2000.

Posted by Elizabeth Cooney at 04:40 PM

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MIT research IDs tumor defense mechanism

MIT scientists have identified a new defense mechanism that tumor cells use to survive chemotherapy, a discovery that could lead to drugs that make existing cancer drugs work better at lower doses.

Writing in the cover story of today's Cancer Cell, Dr. Michael B. Yaffe and his biomedical engineering colleagues explain that once tumors lose their ability to repair DNA that has been damaged by drugs or radiation, they turn to a signaling pathway involved in inflammation in order to survive.

"The exciting thing is we can now target this pathway," said Yaffe, who is also a surgeon at Beth Israel Deaconess Medical Center and affiliated with the Broad Institute of Harvard and MIT. "It won't make normal cells any more susceptible to chemo but it will make cancer cells much more sensitive."

The scientists tested their idea by turning off the inflammation pathway in mouse tumors. After they gave low doses of the common cancer drug cisplatin to the mice, their tumors melted away, Yaffe said.

A drug that works against a molecule important in inflammation called MK2 is already being tested. Originally conceived as a treatment for arthritis, it may be modified to thwart just the inflammatory pathway that cancer cells use to survive.

"Our results suggest it might have a second life in helping to treat cancer patients," Yaffe said. "It could mean standard chemotherapy would suddenly become much more effective."

Posted by Elizabeth Cooney at 12:00 PM

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Friday, February 9, 2007

Also in today's Globe: hospital switch, DSS support, autism rates, birth defects and fertility aids

Beth Israel Deaconess Medical Center and New England Baptist Hospital will work together on a suburban expansion. Tufts-New England Medical Center had planned to build a $300 million suburban hospital with New England Baptist but will now proceed alone.

Harry Spence, commissioner of the Department of Social Services, defended how his agency handled the case of 4-year-old poisoning victim Rebecca Riley but said his department needs more medical expertise to help social workers review the diagnoses and drugs prescribed by doctors treating children overseen by the agency. JudyAnn Bigby, secretary of Health and Human Services, said she would appoint an independent physician in the next few days to be on call to help DSS, until the agency develops a medical review system.

About 1 in 150 American children has autism, an urgent public health concern, said US health officials yesterday who reported on the largest study done so far on the disorder. The new numbers, based on 2002 data from 14 states, are higher than previously reported.

Babies conceived through fertility treatments have higher rates of birth defects, but the overall risk is so small that it should not keep couples from having children this way, doctors are reporting.

Posted by Elizabeth Cooney at 06:23 AM

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Friday, February 2, 2007

Beth Israel Deaconess COO leaving

Dr. Michael F. Epstein, executive vice president and chief operating officer of Beth Israel Deaconess Medical Center, is leaving the hospital after five years.

Before coming to Beth Israel to work with CEO Paul Levy on a recovery plan for the then financially troubled hospital, he was a neonatologist and later COO and chief medical officer at Children's Hospital Boston.

The goals of the recovery plan have been achieved with Beth Israel's return to financial stability, he said in a memo to employees. His resignation will be effective May 1.

"There is no other position or job offer that would have lured me away from BIDMC," he wrote. "But the celebration of my 60th birthday a little over a year ago reminded me that there are important connections to family members and friends to nurture, places to visit, books to read, gardens to plant, and marathons to run, and since that birthday, the clock seems to be running a bit more rapidly. So, while the work continues to be exciting and engaging, I have decided it is now time to move on."

Epstein is "a terrific person," Levy said. "I was incredibly lucky to have him with us."
with us.

Posted by Elizabeth Cooney at 09:05 AM

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Wednesday, January 31, 2007

Levy pans joint liver transplant program

Paul Levy has harsh words for the new joint program for liver transplantation between Lahey Clinic and UMass Memorial Medical Center. Both transplant centers will continue to function independently, with surgeons operating in Burlington and Worcester, undermining the promise of collaboration, he writes in his blog today.

"I cannot imagine how asking Lahey doctors to commute to Worcester for a relatively small liver transplantation program will be a good use of their time or will optimize patient care and control costs overall," Levy says. He is president and CEO of Beth Israel Deaconess Medical Center, which has its own liver transplant program.

Levy welcomed word that Dartmouth-Hitchcock Medical Center on the New Hampshire-Vermont border may be canceling plans for its own liver transplantation program because there would be too few patients.

Dartmouth-Hitchcock denied that suggestion.

"DHMC will not be expanding its solid organ transplant program to include liver transplants at this time, but no final decisions have been made," hospital spokesman Jason E. Aldous said.

Posted by Elizabeth Cooney at 06:48 AM

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Tuesday, January 30, 2007

More than half Boston hospital workers got flu shots

More Boston hospital workers may be getting flu shots this season than the national average, but beyond that it’s hard to figure out how they measure up.

Public health officials have been pushing for virtually all hospital workers to get flu shots because they can easily be exposed and infect vulnerable patients. But each of six hospitals that answered a White Coat Notes query today counts health care workers involved in direct patient care in its own way. And they don’t necessarily know who might have gotten a flu shot outside their hospitals' programs.

Here are the results:

Boston Medical Center: 71 percent
Dana-Farber Cancer Institute: 63 percent
Beth Israel Deaconess Medical Center: 60 percent
Massachusetts General Hospital: 59 percent
Brigham and Women’s Hospital: about 48 percent
Tufts-New England Medical Center: more than 50 percent, according to a preliminary count

"The national average is 38 percent," said Dr. Robert Goldszer, associate chief medical officer at Brigham and Women’s. "We feel we’re doing better than average, but we know we don’t have an accurate rate."

Beth Israel has a broad definition of who comes into direct contact with patients. It’s not just the people who have day-to-day hands-on contact, but it also includes people who see patients face-to-face, such as ward secretaries, people who sit at the front desk in clinics, and workers who clean floors in patients’ rooms, said Dr. Sharon Wright, director of the infection control and hospital epidemiology program.

Beth Israel tries to track who gets a flu shot elsewhere, she said, asking employees to use an internal web site to state explicitly why they are declining to get a flu shot.

The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to at least offer flu shots. The Infectious Diseases Society of America recommends that hospitals and other health care facilities mandate flu shots for employees, except for religious or medical reasons.

"JCAHO told us to immunize 100 percent of health care workers who don’t have a contraindication," Beth Israel's Wright said. "We’re trying to get to that 100 percent in three to five years. The goal this year was 60 percent and we did it."

Dr. Al DeMaria, assistant commissioner of the state Department of Public Health, said health care workers are exposed to the flu more often, they are difficult to replace if they get sick, and they put their patients at risk if they have the flu.

"Obviously we think everybody should get vaccinated against the flu, but it’s especially important for health care workers," he said.

Posted by Elizabeth Cooney at 08:32 PM

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Too young to face cancer

Fighting cancer under 40 raises special challenges, the first of which is believing it can happen to you. Dr. Karen Albritton of the Dana-Farber Cancer Institute, Dr. Bruce A. Chabner of Massachusetts General Hospital Cancer Center and Dr. Nadine Tung of Beth Israel Deaconess Medical Center comment in a New York Times story.

Posted by Elizabeth Cooney at 06:11 AM

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Monday, January 29, 2007

Does he get paid too much?

Paul Levy, president and CEO of Beth Israel Deaconess Medical Center, asks this million-dollar question on his blog.

"Here is your chance to send a message to me, my board, or the community at large," he writes. "I promise, all comments will be included (unless you use bad language!)"

Posted by Elizabeth Cooney at 01:41 PM

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Friday, January 26, 2007

A non-MD, new Joslin CEO suits tight times, scientists say

Research money isn't what it used to be. Neither is the leadership of the Joslin Diabetes Center.

But Ranch C. Kimball, Joslin's first non-physician president and CEO, won "surprisingly positive" reviews from scientists when he made the rounds at the Harvard affiliate before being named. A memo summarizing the scientists' impressions of Kimball also said he had "obvious intellectual gifts and understood researchers' needs."

Kimball comes from the Romney administration, where he was secretary of economic development. He takes over from Dr. C. Ronald Kahn, who returned to full-time research in September.

"We realize this is probably an unusual choice of a president," said Dr. Steven E. Shoelson, a Joslin researcher and clinician. "I think it relates to the specific demands of the time. With NIH funding going down and more and more competition for research dollars, the board felt a specific need to strengthen our ability to compete for development dollars."

Joslin's outpatient clinic, run jointly with Beth Israel Deaconess Medical Center, loses money because that kind of primary care -- unlike surgery -- isn't reimbursed very well.

Total revenues and expenses both grew a little over 1 percent from fiscal 2004 to 2005. Its surplus was about $4.6 million both years. Philanthropy has averaged about $12 million over the last four years.

Paul Levy, president and CEO of Beth Israel Deaconess, was on the search committee that nominated Kimball for the Joslin job. Business leaders bubbled to the top, he said.

Joslin holds its own getting NIH funds, said Shoelson, who is associate director of research. Grant support was about the same from 2004 to 2005, but belt-tightening has chilled Joslin and other research centers as fewer proposals survive.

One researcher who asked not to be named said he's getting only 80 percent of the money he used to pull in from NIH.

"I wake up and think, my God, with a 20 percent cut, how can I manage the salaries of my post-docs or my fellows? How do I manage my funds for experiments?"

Kahn did well to combine fund-raising with research, the scientist said, but a single focus on money will be better.

"I think the critical thing for us is to have a happy marriage between the business side and the research side."

Posted by Elizabeth Cooney at 10:08 PM

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Exodus from news media to hospital marketing

Longtime Boston television health reporter and producer Rhonda L. Mann is Beth Israel Deaconess Medical Center's new director of marketing communications.

Rhonda L. Mann

Mann previously managed the health news division at WCVB-Channel 5, doing on-air reporting and producing segments for medical editor Dr. Timothy Johnson.

The hospital said her appointment to fill an open position recognized her gifts as a storyteller. Another television figure turned hospital marketing professional is Peter R. Brown, vice president of public affairs and communications at Brigham and Women's Hospital, who two years ago left a 22-year career at WBZ-Channel 4.

Zineb Marchoudi, who was a writer and producer for Channel 5's 11 p.m. news, will join Mann's department at Beth Israel Deaconess as a media relations specialist. Senior editor Michael Keating is the third member of the department. He had been managing editor/features for Seacoast Media Group in Portsmouth, N.H., which publishes the Portsmouth Herald and

Posted by Elizabeth Cooney at 09:41 PM
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