Too Many Surgeries: One out of three elderly adults insured via Medicare will undergo surgery in the last year of their life, and one in five during the last month. That sounds surprisingly high to me, but even more startling? Many of these surgeries are unhelpful, unwanted or unnecessary. A new study published in the British medical journal Lancet says a host of factors, such as Medicare reimbursement, location and the availability of hospital beds, weigh more heavily on a doctor’s decision to operate than a patient’s needs, wants or whether surgery will improve their quality of life.
“While some of these surgeries are clearly needed and helpful to patients, probably a substantial portion are not,” Ashish Jha, a researcher with the Harvard School of Public Health and lead study author, told Reuters.
More physicians need to have frank discussions with patients about how the patients want to spend their final days, he says.
Time’s Meredith Melnick notes that “while the researchers did not examine whether individual surgeries were necessary or whether they improved patients’ quality of life—many surely did—the data suggested they did not improve outcomes overall. Areas of the country that had high rates of surgery also had high rates of death.” Maybe that’s because any surgery is dangerous (and especially these four)?
The study, which looked at data from more than 1.8 million Medicare beneficiaries who died in 2008, also found that the number of patients receiving surgery toward the end of their lives is higher in regions with higher Medicare spending. Amy Kelley, a professor of geriatrics and palliative medicine at Mount Sinai School of Medicine, said doctors and hospitals may have a financial incentive to operate on dying older adults “regardless of the patient’s preferences or goals,” because Medicare is guaranteed to pay for the procedure.
Suing Bosses Over 401(k) Losses: If you invest your money in a retirement account such as a 401(k), and the stocks tank, you’re out of luck, right? Maybe not. Reuters reports that a growing number of 401(k) plan participants are bringing lawsuits against their employers (who administer the plans) for allowing poorly-performing and/or overly-expensive funds into their retirement portfolios. In the latest lawsuit, filed last week, workers are seeking class action status against their employer, Ameriprise Financial Inc., which they say pushed employees into expensive, untested mutual funds that wound up costing them more than $20 million.
Friday Quick Hits:
- Palliative care programs (programs that focus on patient comfort, rather than solely on medical treatment) are growing rapidly in hospitals, the National Palliative Care Research Center reports.
- Routine PSA blood tests that check for prostate cancer do healthy men more harm than good, says the U.S. Preventative Services Task Force (echoing the advice of many cancer specialists).
- Chief Justice John Roberts invokes Jimi Hendrix in copyright case.
- By 2020, more than 11 million cancer survivors in the United States will be 65+, the National Cancer Institute says, and the projected cost of their health care is ‘sobering.’ While these individuals may stay cancer free, most will have other health conditions that may be complicated by past cancer treatments, the organization notes.
- An Americans for Secure Retirement poll found 88 percent of respondents said they were concerned about maintaining a comfortable standard of living in retirement, up from 73 percent last year.
- And President Obama challenges Republicans in Congress to explain their opposition to his jobs plan.
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