Patients

If you haven't visited Carroll Hospital Center recently, you might want to know that the emergency department has relocated toward the front of the hospital, saving you the drive around the parking lot. Three years ago the hospital underwent an $80 million renovation, during which the space formerly occupied by the emergency department was transformed into an award-winning outpatient center. The ED doubled in size, and added televisions to every room in the 30,000-square-foot space. A five-story tower was built with the latest medical technology and efficient layouts.

They're not asking for a soul shake, but most patients want their physician to at least shake their hand when first introduced and about half prefer to be addressed by their first name, according to new research from Northwestern University in Chicago. The study, published last week in the Archives of Internal Medicine, involved a nationwide telephone survey of 415 adults. In it, researchers at Northwestern found that 50.4 percent of the respondents preferred to be addressed by their first name; 23.6 percent wanted to be addressed by first and last name; and 17.3 percent preferred to be addressed by last name.

WASHINGTON -- Under pressure from the federal government, drug makers are revising the labels on Ambien, Lunesta and other popular sleep aids to warn that the pills may result in driving, eating and even having sex while sleeping, health officials said yesterday. The manufacturers of the 13 popular medications are also preparing information bulletins for users that will highlight the possibility of bizarre nighttime side effects. The Food and Drug Administration requested the action to discourage patients from taking higher than recommended doses or combining use with alcohol consumption.

Human Genome Sciences Inc. reported clinical trial data yesterday showing that Albuferon, a hepatitis C drug the Rockville biotech is developing, is comparable to a current therapy and may do less damage to patients' quality of life during treatment. It also had a benefit of particular interest in the United States, where a large percentage of patients are overweight: The drug appeared to work better in heavier people than its alternative, a drug called Pegasys made by Hoffmann-La Roche Inc. But Albuferon, one of two drugs the company is relying on for eventual revenue, also had higher rates of patient discontinuation because of adverse events - particularly at the higher dosing levels.

For eons doctors have advised patients to take two aspirins and call back in the morning. Now researchers are trying to find out whether the patient would do as well to skip the aspirin but, yes, call back.The placebo effect, the nonspecific reason people respond to treatments that are not proven to work on their disease -- treatments as simple as talking to a doctor -- has suffered from a bad reputation. But a small but stalwart group of researchers are looking for ways to convince medical researchers to pay it homage.

AN EARLY look at the HMOs that contract to provide medical care for Maryland's Medicaid recipients has turned up disturbing problems.In a state-funded audit, the independent Delmarva Foundation evaluated the nine HMOs providing medical treatment for some 300,000 Medicaid patients under the state's 19-month-old HealthChoice program. Among the failings identified: Six months into the program, not one HMO was providing the care required for new patients or diabetics. Only two HMOs provided required prenatal services.

Consumer advocates and physicians applauded Gov. Parris N. Glendening yesterday for responding to widespread complaints about managed health care by proposing a "bill of rights" for Maryland patients.Health insurers warned that the governor's legislation could raise medical costs and lead to loss of coverage for some people.Making good on a campaign promise, Glendening pledged Thursday during his State of the State speech to push for more consumer protections against refusals by health insurance companies to pay for the medical care that patients seek.

WASHINGTON -- A coalition of 25 health maintenance organizations said yesterday that it was willing to accept substantial federal regulation -- much more than the Republican leaders of Congress want.In a move that they said should restore public confidence in their industry as it is buffeted by sharp partisan attacks, the HMOs endorsed a series of guarantees, including coverage of emergency room care, grievance and appeal procedures for patients, and assured access to specialists.But the group said it opposed one major provision demanded by Democratic congressional leaders: a wide expansion of patients' ability to sue HMOs and insurance companies when medical benefits are improperly denied.

Publicized complaints about a medical transport firm have prompted the Anne Arundel County Health Department officials to "take a closer look" at Southeast Transit/Metro Access, they say, though they remain convinced the firm is performing satisfactorily.The department's response Friday fell short of what was wanted by some patients, employees and county officials who called for a full investigation into the company. They have accused Metro Access of leaving patients needing rides to wait for hours, failing to pay staff on time and punishing them for revealing shortcomings of the operation.

A drug that doctors feared would hurt heart-failure patients has turned out to be the very medicine that might save their lives.In preliminary results reported yesterday at the American Heart Association meeting, researchers from the University of zTC Maryland Medical Center found that adding an old drug -- the beta-blocker metoprolol -- to the treatment of heart-failure patients increased survival by about 35 percent.The evidence was so strong that physicians overseeing the international study of nearly 4,000 patients had to stop it almost three years early.

Raymond P. Srsic, a longtime Anne Arundel County pediatrician and professor of medicine whose practice spanned 50 years, died Thursday of amyotrophic lateral sclerosis, commonly known as Lou Gehrig's disease, at Johns Hopkins Hospital. He was 81 and lived in Queenstown. Dr. Srsic, the son of a saloonkeeper and a homemaker, was born and raised in Pittsburgh. He was allowed to skip his senior year at North Catholic High School and enrolled at the University of Notre Dame, where he earned his bachelor's degree in 1948.

Until recently, the sagging economy wasn't a subject Dr. Mary Newman routinely discussed during office visits. But after a steady stream of longtime patients confided that they had been laid off, were about to lose their health insurance or that their pay had been slashed, she added the recession to her standard checklist of questions. "It's hitting people I hadn't expected," said Newman, an internist who practices in Lutherville. "If a person is in financial hardship, we help them." Doctors are encountering more patients struggling to pay for care.

Maryland hospitals are sharing the pain as people who have lost jobs and health insurance in the economic downturn find it harder to pay medical bills. Some institutions have had to cut services, lay off employees and reduce subsidies paid to doctors and nurses to keep them on staff. Bon Secours Hospital, a venerable West Baltimore institution since 1881, has been especially hard hit. Most of the hospital's clients are poor and rely on Medicare and Medicaid to pay for health care. Many patients with chronic illnesses - such as diabetes, kidney disease and asthma - lack health insurance that would allow them to see a primary care physician for regular check-ups and preventive treatment.

Officials at Bon Secours Hospital are asking the state for $5 million to keep the struggling hospital afloat for a year while they devise a new strategy to offer health care to a troubled West Baltimore community. The company and the religious order that oversee Bon Secours have not ordered its closure. But executives say the hospital needs an infusion of cash and a new vision to avoid shutting its doors. "We are losing millions to an old system that cannot be sustained in the future," said Richard J. Statuto, CEO of the hospital's parent company, Marriottsville-based Bon Secours Health System Inc. The hospital lost $22 million last year - the largest loss in a decade, according to the state agency that sets the rates that hospitals can charge.

A state proposal to set income standards for charity care that Maryland hospitals provide - and are reimbursed for by the state - is welcome and overdue. A report on how Maryland hospitals provide treatment for indigent and uninsured patients found that collection policies on unpaid patient bills vary widely and are unclear. And that needs to change. A series in this newspaper last year detailed the lengths some hospitals will go to collect bills despite the state reimbursements. That included placing liens on the homes of people with few assets but for the house they live in. The practice left many patients at the mercy of collection agencies.

Delegate John A. Hurson wanted to make Maryland's system for setting hospital rates fairer to poor people. As chairman of the House health committee, he was in a powerful position to make those changes happen. But he couldn't get several proposals through his own panel. They were watered down or removed from bills after the rate-setting agency and the powerful trade group representing hospitals teamed up against them. Hurson's experience was a testament to how sacred rate regulation remains in Maryland, more than 30 years after it was created.

Diana Moore learned the news through the neighborhood grapevine. Her family's primary-care physician of seven years would no longer accept Moore, her husband and daughter as patients - unless the family paid a $4,500 annual fee. The physicians at Charter Internal Medicine in Columbia are overhauling the practice, ditching the insurance-dependent model and instead charging a flat yearly fee in exchange for the promise of 24-hour access to doctors, unhurried...

Trauma system puts needs of patients first It is not an exaggeration to say that Maryland has the finest pre-hospital trauma system in the nation and perhaps the world. Is the system perfect? No. Can the system be improved? Yes. Are all of us who work in trauma care committed to making it even better? Absolutely. But in the wake of the recent helicopter tragedy, I fear that we will forget that the genius of Maryland's system is its singular focus on doing what is best for the patient, not what is best for an individual trauma center, medical school or the medevac fleet.

Dr. John C. Norton Jr., a retired Baltimore obstetrician and gynecologist who during his 46-year career delivered an estimated 7,000 babies, died Monday of complications from a stroke at his Catonsville home. He was 91. Dr. Norton, whose father was a Baltimore obstetrician and gynecologist, was born in Baltimore and raised on Montrose Avenue in Catonsville. By the time he was 9 years old, Dr. Norton had settled on a medical career. "It was a lofty dream, considering he spent two years of his early age sick with rheumatic fever," wrote Suzanne M. Dieringer, a daughter who lives in Davidsonville, in a eulogy for her father.

Baltimore has doubled the number of people using the medication buprenorphine to shake off heroin addiction but has struggled to keep them in treatment. As the Baltimore Buprenorphine Initiative has accepted more hard-core drug addicts dealing with complications such as mental illness, more drop out. At the start of the initiative in October 2006, officials had picked mostly highly motivated participants. The retention rate dropped to 52 percent for the year that ended June 30 compared with 65 percent in fiscal year 2007.