Resources: Contest Entries

Place: Honorable Mention

Ostrom's collection of work includes a look at the "facility fee" imposed on patients seen in clinics and doctors' offices operated by hospitals, the increasing use of costly surgical robot, a 30-year story of a cystic-fibrosis breakthrough and a local study that found early signs of autism in babies' brains and allowed Ostrom a chance to look broadly at the state of autism research.

Place: First Place

The story showed how Scott Crawford, a 41-year-old heart transplant recipient in Maryland, became one of the most expensive Americans on Medicare. The Wall Street Journal used a Medicare database and health records to chronicle his 10-month stay in intensive care and offer a window into the forces driving up health spending. The analysis of Medicare's billing records found that a sliver of expensive patients account for the majority of the program's cost. The story illustrates the tense fight between doctors, nurses and his family over whether to keep Crawford alive as his condition deteriorated.

Place: Second Place

The European Union's single market, combined with a lack of political integration, has had unexpected results in the sale of pharmaceuticals. In "Medicine Man," Bloomberg reporter Andrea Gerlin shows these surprises in her profile of EurimPharm CEO Andreas Mohringer published in Bloomberg Markets. While the European Commission approves drugs for sale across the 27-nation bloc, individual nations still play the dominant role in setting prices, leading to a wide variation in drug prices across the EU. Gerlin reports,it also created opportunities for entrepreneurs such as Mohringer to buy inexpensive products in one market and sell them in another at a higher price. Gerlin's article also illuminates the anomalies in drug company pricing. As Mohringer points out, the parallel trade would dry up if pharmaceutical makers priced drugs consistently across Europe. Gerlin shows how the Austrian pharmacist undercut drug companies' prices on their own products to build a business so successful that it provided the means to indulge his love of rare Ferraris.

Place: Second Place

Plain Dealer reporters Dave Davis and Sarah Jane Tribble explored the world of medical billing and revealed the business side of medicine that doesn't work for patients. Through monthly stories, including one special section, Plain Dealer readers learned how hundreds of people are involved in the creation of a single patient's bill, and the potential for error inherent in the process. They read how patients' suffering often starts all over again after leaving a hospital's care, as confusion and anger over hospital billing are often overwhelming. The Plain Dealer also revealed common pricing strategies, such as the extra facility fees that are commonly charged just because a doctor's office is part of a larger health system.

Place: Third Place

As part of six-installment series on prescription drug addiction in Kentucky, medical writer Laura Ungar examined the exploding problem of babies born suffering from drug withdrawal because of their mothers' addictions. Hospitalizations for Kentucky babies born addicted to drugs – primarily prescription pills – rose 2,400 percent in just over a decade, from 29 in 2000 to 730 in 2011.The stories not only detailed the numbers but also showed the human impact – babies who cry almost non-stop, sucking desperately on pacifiers to soothe themselves as they suffer through painful drug withdrawal. The stories also examined the difficulties pregnant addicts have in getting the help they need.

Place: Third Place

The Chicago Tribune's series revealed how a decades-long campaign by the chemical and tobacco industries brought toxic flame retardants into our homes and into our bodies, despite the fact that these dangerous chemicals don't even work as promised. The investigation found a lobbyist planted with the National Association of State Fire Marshals, a phony consumer group that stoked the public's fear of fire to protect and expand the use of flame retardants, lies told by a noted burn surgeon who served as a star witness for the manufacturers of flame retardants before state legislatures, the industry's distortortions of findings in a study and a government agency that wasnt' testing crib mattresses for chemicals.

Place: First Place

With her frail and elderly father suffering and doctors doing everything they can, reporter Lisa M. Krieger learns it is hard to reject care, even as expenses soar. Krieger's series took the lessons she learned, as well as wisdom offered by readers to write about how to start that difficult conversation to accepting the end. She explored end-of-life planning, advanced directives and POLSTs, palliative care and how our technological ability to stave off death creates dilemmas unimaginable decades ago.

Her look at caregiving finds that, while it can be immensely rewarding, it is also exhausting, expensive and poorly supported by a medical system that delivers life-prolonging miracles, but little help for loving care at home in life's fragile years. She uses data to explore the differences in how hospitals treat chronically ill patients at the end of life.

She follows the final three months in the life of a woman diagnosed with kidney failure who rejects life-prolonging dialysis for a life-affirming ending with adventures to the beach, zoo, aquarium and favorite restaurants. The year-long series concludes with eight steps we can take to make our final years of life easier, kinder and less expensive.

Place: Honorable Mention

Johnson's narrative, "Outbreak baffled doctors until they saw common cause," recounts how doctors pieced together baffling cases of meningitis, finally connecting the infections to a tainted drug produced by a Massachusetts compounding pharmacy. "Girl named Grace a gift to family, science" follows one family's journey to find the genetic cause of their children's disabilities. "Harvard vows changes after 4th monkey death" is one of a number of stories that examined ongoing problems at Harvard Medical School's primate research facility, which was rocked by animal deaths and injuries. "Researchers put selves under the microscope in self-experiments" examined the growing ability of scientists and others to track their own bodies using new tools, providing information that could help understand their own health or ask broader research questions.

Place: Third Place

This project determined the rate of foreign-trained doctors in all California counties, something that hadn't been publicly available previously. The analysis revealed major discrepancies between physicians' backgrounds in Kern County, an underserved area in the poor Central Valley, and doctors elsewhere in California and the United States. Reporters also analyzed the board certification rates of international medical graduates within Kern County and compared it to rates for U.S. medical graduates there. The project also looked at the influx of Caribbean-trained American physicians into the county and the impact, including cultural differences that can emerge between physicians and patients, and followed the personal journeys of physicians from the Philippines, Sudan and India who eventually landed in Kern County.

Place: Second Place

This series of stories examines the scope and impact of an epidemic of health care-associated infections plaguing hospitals, clinics, nursing homes, and other medical facilities across the country. It finds that health care-related deaths and illnesses among patients in these settings are far more common than government statistics suggest. Some of the most persistent infections are becoming more prevalent even though there are proven strategies for cutting incidence rates. Meanwhile, the emergence of new, antibiotic-resistant superbugs in health care facilities is bringing an added layer of threats, raising the risk that patients who seek care for basic ailments will contract illnesses that cannot be treated. Still, many medical institutions have not heeded urgent recommendations from government agencies and public health officials on how to control these infections.

Place: Honorable Mention

America has waged war on cancer for more than 40 years, but in developing countries the fight has barely begun. This radio and online series features patients, doctors, and public health advocates on the front lines. What political, cultural, and logistical obstacles make tackling cancer so difficult across most of the globe? Correspondent Joanne Silberner reports from Uganda, Haiti, and India on innovative programs that are improving cancer prevention, detection, and treatment.

Place: Special Judges' Citation

The Affordable Care Act requires pharmaceutical companies to publicly report all payments to physicians by September 2013. Some drug companies have already compiled – but few consumers know that the information is available or how to access it. This story discloses – for the first time – for Connecticut consumers how many doctors in Connecticut are high-prescribers of certain psychotropic and pain medications, the cost of written prescriptions, how many of these doctors received payments from drug companies and the amounts that the doctors received from the drug companies. It also reported that only three doctors on the high-prescribing drug list have been disciplined by the state Medical Examining Board.

Place: Second Place

Jordan Rau explored one of the most challenging endeavors in health care, the effort to measure the quality of hospitals and other providers and make them financially accountable for how their patients fare. Rau analyzed and reported on Medicare's new readmissions penalties, which affected 2,217 hospitals, finding that hospitals that treat low-income patients were more likely to be punished. He revealed how new bonuses and penalties affected nearly 3,000 hospitals, providing the first public list of how each hospital did and analyzed Medicare's measure of hospital efficiency, finding that essentially similar patients cost the government far more at some hospitals than at others. The examination of Medicare's new measures of patient safety showed that they might be skewed against teaching hospitals. Stories analyzed how hospitals in different states and regions in the country performed on some of these metrics and identified hospital outliers.

Place: Third Place

The Texas Tribune, in conjunction with its content parter The New York Times, has been covering women's health, from state lawmakers' efforts to force Planned Parenthood out of business in Texas to their sweeping budget cuts for contraception and cancer screenings. The two stories featured here ran in The New York Times and The Texas Tribune concurrently. They highlighted the dramatic closures of reproductive health clinics for poor immigrant women along the Texas-Mexico border, and the behind-the-scenes political drama that led hundreds of thousands of the state's neediest women to lose access to birth control and cancer screenings.

Place: Second Place

Cracking the Codes documented how thousands of medical professionals have steadily billed Medicare for more complex and costly health care over the past decade – adding $11 billion or more to their fees – despite little evidence elderly patients required more treatment. The series also uncovered a broad range of costly billing errors and abuses that have plagued Medicare for years – from confusion over how to pick proper payment codes to apparent overcharges in medical offices and hospital emergency rooms. The findings strongly suggest these problems, known as "upcoding," are worsening amid lax federal oversight and the government-sponsored switch from paper to electronic medical records. This was an extremely complex topic that required deep immersion in the arcane specialties of medical coding and health information technology. Very few academics or other researchers had approached this topic using Medicare billing data, especially over such a long period of time, and so there wasn't much in the way of roadmaps to help guide this project.

Place: Honorable Mention

While certain political groups do not have to disclose their contributors, sometimes those contributors must disclose in other ways. Aetna Inc., like other insurance companies, must self-report a series of general interrogatories to the National Association of Insurance Commissioners. Sean P. Carr and Wayne Dalton gave that data a careful review to determine how companies spend money on lobbying activities. Aetna proved to be a unique case. The health insurer outspent all other insurance companies. Its disclosure of massive spending to groups opposed to the Affordable Care Act came after conciliatory remarks about the health reform law by its CEO and after the company spurned a call by some shareholders to reveal more information about its political activities.

Place: First Place

This project explores the under-reported story of tens of millions of Americans who lack access to dental care. Unlike health care, there are no safety nets for dental care, even though the pain can be excruciating and even fatal. Stepping into that void are fast-growing corporate dental chains owned by private equity firms, which promise lower-income people affordable dental care. "Dollars and Dentists" documented how these chains prey on people with few other options.

Place: Second Place

The story is about a local couple who donated the brain of their autistic 4-year-old son to research, soon after he escaped their apartment and drowned in the closed pool at their complex. The piece follows several strands, including the sense of devastating loss and haunting second-guessing that any parent losing a child goes through. In addition to explaining how the accident happened, the story gives all readers a sense of what it's like to raise a child with autism, particularly those with severe impairments and those who try to run off any chance they get. Finally, the piece looks at how the boy's brain will be used for studying autism, the state of research into the disorder and the challenges, as well as the hope, of that work. A sidebar explains more about the mission of the "bank" storing brains for researchers and how readers can make donations, and a chart shows autism rates that had been recently revised upward by the Centers for Disease Control and Prevention.

Place: First Place

As providers brace for major reductions in reimbursement from Medicare and Medicaid, a number of initiatives are quietly targeting high utilizers of care in both programs. But can grassroots experimentation adequately address a growing national consensus that spending is too high? This three-part series took a detailed look at health care's costliest 1 percent.

Place: Second Place

Touch is perhaps our most valuable sense. It allows us to grasp delicate objects, detect our limbs in space, and caress the cheek of a loved one. Well, most of us. There are no prosthetic hands available, commercially or in clinical trials, that provide a sense of touch. Though tactile feedback might do the most to improve upper-limb prosthetics, the majority of the prosthetics research community is instead putting its effort into making arms with wider ranges of motion and more powerful motors. This article chronicles the challenges of incorporating touch into prosthetics, and follows the work of a small group of researchers pursuing that tantalizing goal via cutting edge new approaches, such as rewired nerves and bionic fingertips.

Place: Third Place

This report investigated the shortage of certified doctors prescribing the drug buprenorphine (brand name: Suboxone) to treat herion and opiate pain pill addiction in the United States. It revealed that one unintended consequence of this shortage is that addicts have taken to self-medicating by buying Suboxone illegally on the street. The Morning Edition report examined the doctor shortage. It focused on New Mexico, which has the highest fatal drug overdose rate in the country and remains one of the most underserved areas. A drug dealer revealed his supply chain and profit model. Local health professionals and law enforcement agents described the benefits and disadvantages of this black market. The Planet Money podcast explained the demand through interviews with opiate addicts who buy Suboxone illegally. It also took an in-depth look at the history of buprenorphine's development, which was subsidized by taxpayers, and the federal government's complicated stance on opiate addiction treatment in the decades before and after the drug was brought to market.

Place: First Place

At first there were four deaths and more than 25 people in five states infected with fungal meningitis, a disease so rare most doctors never see it. Investigators had linked the illnesses to a compounding pharmacy in suburban Boston, which made the injectable steroid given to all the patients. As the number of deaths and cases and states rapidly mounted, The Boston Globe deployed a team of reporters to not just report the news but to explain what had gone so terribly wrong. The story was unfolding fast, it was competitive, and it was complicated, involving medicine, a heretofore obscure corner of the pharmaceutical industry, and a complex patchwork of state and federal regulations. Explanatory journalism is most difficult under such circumstances, when there's little time to think and analyze, but that's when it's most necessary. Even as The Boston Globe unearthed new information, staffers made what could have been a dense subject thoroughly absorbing, writing in a narrative style worthy of a detective novel. Reporters dissected documents and tracked down victims and salespeople, customers and competitors of New England Compounding Center to answer the many questions raised by the outbreak. 

Place: Special Judges' Citation

This story showed that malfunctioning pain pumps are a common problem. A patient in a local hospital died when he was overdosed with one of these pumps, prompting a more in-depth look.

Place: Third Place

Seven years after Roanoke-based Carilion Clinic borrowed money to expand its flagship hospital, the nonprofit hospital system is still tallying how much it lost in a series of complex financial transactions related to the $308 million in tax-exempt bonds it issued on Dec. 14, 2005. In court papers, the losses were pegged at "many millions of dollars." The decision has continued to wreak havoc on Carilion's financial performance and forced the organization to refinance its bonds to try to repair the damage. Carilion blames the Wall Street firms it hired to facilitate the loan and advised Carilion to structure the bonds as auction rate securities.

Place: First Place

These examples of reporting from the disaster public health beat looked at the impact of hurricanes in New York City and New Orleans in 2012. The stories showed ways that major lessons from previous hurricanes were not learned, including that significant portions of the cities' health care infrastructure remain highly vulnerable to flooding. The stories also revealed areas for future focus, including better preparedness to meet the needs of elderly and disabled residents of high-rise complexes in prolonged power outages.

Place: First Place

The Gazette examined West Virginia's frightening chronic disease and obesity rates, reporting that: One in four West Virginia fifth-graders has high blood pressure and cholesterol. One in four is obese. One in three adult West Virginians is obese, at high risk of chronic disease. West Virginia is in the top three states in diabetes, stroke, heart attacks, obesity, early death and a wide range of other costly chronic diseases. Seven in 10 of West Virginia's health dollars are already spent on chronic disease. Chronic disease costs will double in West Virginia within ten years if nothing changes, health economists warn.

Place: Third Place

In some cases, private food inspectors have financial ties to executives at companies they're reviewing. AIB International, a Manhattan, Kan., inspection company that awarded top safety marks to producers who sold toxic food, has had board members who are top managers at clients including the maker of Wonder Bread, Tastykake, Entenmann's pastries and Sara Lee baked goods.

Place: Second Place

In California's economically challenged Stanislaus County, where unemployment and poverty rates are among the state's highest, help for the mentally ill has virtually disappeared. County mental health has lost more than 200 positions, about 37 percent of staff. Hospital emergency rooms are clogged with mentally ill patients, with several reporting double the numbers of five years ago. The county jail is also suffering effects from the cuts, with a nearly 50 percent increase in mentally ill inmates in the past 6 years. ER doctors and sheriff's deputies have become de facto mental health crisis workers. Meanwhile, the mentally ill are left to cope largely on their own, with advocacy groups and a few mental health professionals trying innovative approaches to cast light in a dark tunnel of need. The team's work included up-close-and-personal photos and audio of this very sensitive subject.

Place: First Place

Publicly accessible automated external defibrillators (AEDs) can seem near-miraculous in their ability to pull sudden cardiac arrest victims back from sure death. Not surprisingly, stories of their successes have a strong emotional appeal in a country where more than 900 people die of cardiac arrest every day. But actually measuring and analyzing the national scope and impact of this "bystander" AED emergency response model remains an elusive goal for policy makers and the nation's health care research community. The goal of this story project was to take a comprehensive look at all aspects of AEDs use and actual health impact across the country. Findings include: Even as governments, corporations and individuals purchase and install an estimated $500 million worth of AEDs each year there is a lack of central registries at the city, state and national level capable of routinely gathering data about AEDs' exact locations or battery power levels or overall operational status. Also unknown are the criteria used to place many of them, or how many times they are used by members of the public, or what the outcomes of those emergency response events are, or how the bystander AED model's overall national benefits compare to its overall costs. And even when the device malfunctions that caused those failure are identified, there is no way to contact the owners of all similar AED models or recall and repair those models. Those faulty AEDs simply remain hanging on the wall until the next cardiac arrest victim collapses nearby and dies as a result of a non-functional AED.

Place: Third Place

This series investigated nursing homes' use of antipsychotic medications on the elderly, a practice the U.S. Food and Drug and Administration has long warned against because of potentially fatal side effects in people with dementia. The Boston Globe analyzed data from 15,600 nursing homes nationwide and found that about 185,000 residents received antipsychotics in 2010 alone, despite not having a medical condition that warranted such use. The series also revealed that Massachusetts nursing homes commonly use antipsychotics to control agitation and combative behavior in elderly residents who should not be receiving the powerful sedatives, yet state regulators seldom use their authority to reprimand or penalize facilities for this practice. Documents from the few state inspections that did result in citations highlighted instances in which residents were so over-medicated, they were unable to open their mouths to eat, or to do much of anything besides sleep.

Place: First Place

This article chronicles tales of mismanagement, ineffective boards of trustees and exceptionally poor judgment. The board of Wyckoff Heights Medical Center brought in a new CEO, Ramon Rodriguez, in late 2011 to save the debt-ridden Brooklyn hospital. He immediately caused a major stir, not least because he fired nine doctors, replaced half the board and fought the Cuomo administration's efforts to merge the hospital with two other Brooklyn institutions.

Barbara Benson explains why New York hospitals are hemorrhaging money and why fixing the system is proving to be so difficult. Her Wyckoff story details the derailing of a potential merger deal that could save the hospital from financial ruin, and Rodriguez's depression and penchant for penning outrageous emails that blast his own board and top doctors. Financially troubled hospitals aren't victims of low reimbursement rates alone. Their fiscal health is equally vulnerable to human error, as this article illustrates.

Place: Second Place

The two newspapers investigated the practices of North Carolina's nonprofit hospitals. The hospitals generated huge profit margins during the Great Recession, amassed billions in reserves and paid top executives million-dollar salaries. The hospitals made substantial profits by inflating prices for drugs and procedures. Hospitals pursued patients aggressively through collection agencies and some sued patients to put liens on their homes. Many failed to provide sufficient charity care to offset their nonprofit status. The hospital protected their positions with one of the most effective lobbies in the state. Later stories showed how hospitals made huge profits off cancer drugs, pocketing 5, 10 or even 50 times average sales price. Another showed how hospitals run up the price of routine services after acquiring doctor practices.

Place: First Place

This project explored the impact of trauma on people living with HIV. A recent epidemic of attacks on women, transgender women and people with HIV exposes a link as toxic as the virus itself: Trauma not only fuels HIV, it also makes living with it harder. But HIV-positive women and their allies in the realms of science, medicine and social justice are ready to fight back – with programs, education and lifesaving advocacy.

Place: Honorable Mention

This story revealed the central role of a Canadian businessman at the center of the international drug distribution enterprise that channeled counterfeit versions of the cancer drug Avastin to dozens of U.S. medical practices. It shows how the Winnipeg-based international pharmacy executive – under pressure from drug makers and regulators – built a network of companies that exposed American patients to the risks of fake medicines, widely considered a third-world hazard. The executive, Kris Thorkelson, had for years sold foreign drugs channeled through this network to American customers through his websites, vexing pharmaceutical manufacturers and law enforcement officials, before turning to the even riskier business of supplying physicians with overseas versions of lifesaving treatments. The story unearthed documents and human sources close to Thorkelson's business that showed how this grey market system exposed vulnerabilities in the American drug supply, prompting what a senior law enforcement official called "a watershed moment" for American authorities that believed the U.S. was sufficiently protected against counterfeit medicines.

Place: Second Place

This story looks at how a bunch of ex-Marines affiliated with Camp Lejeune may hold the key to understanding breast cancer. It describes the complicated epidemiology behind this cluster of male breast cancers and the extensive contamination of the base by solvents. This story helped support legislation to compensate victims.

Place: Second Place

A lot has been written about human papillomavirus (HPV) status in the context of cervical cancer, but less about its impact for head and neck malignancies. A flurry of recent data, though, has highlighted two key trends. On the one hand, these malignancies are proliferating, as HPV infection becomes more common in the U.S. population. More positively, the survival rates appear better for this category of malignancies, and early findings indicate that treatment might not need to be as toxic. By interviewing current and former patients, Charlotte Huff was able to put a face on this seldom-discussed malignancy. The article was packaged with several graphics, showing the location of various head and neck cancers, the DNA mutations linked to tobacco use, as well as a chart detailing ongoing clinical trials. A sidebar describes the two available HPV vaccines.

Place: Second Place

Melding narrative and investigative technique, The Times set out to examine the country's devastating shortage of donor organs, particularly kidneys, and to explore leading-edge solutions to the inequity between supply and demand. Significant findings include the discarding of hundreds of potentially viable kidneys each year because of shortcomings in the country's organ-matching system and the emergence of kidney transplant chains that begin with a Good Samaritan donor and enable live-organ matches for otherwise incompatible recipients.

Place: Honorable Mention

With no licensing or certification, anyone can practice in-home elder care in California – and in wealthy Marin County, opportunity for fraud abounds. Dovey called every elder care agency in the county and gathered information about how much they pay, spoke with a home care agency that hired a fraudulent worker, a worker who gets paid very little and has difficulty living in such a wealthy area and an elderly disabled woman who was unable to pay high costs for her elder care.

Place: Honorable Mention

With her frail and elderly father suffering and doctors doing everything they can, reporter Lisa M. Krieger learns it is hard to reject care, even as expenses soar. Krieger's series took the lessons she learned, as well as wisdom offered by readers to write about how to start that difficult conversation to accepting the end. She explored end-of-life planning, advanced directives and POLSTs, palliative care and how our technological ability to stave off death creates dilemmas unimaginable decades ago.

Her look at caregiving finds that, while it can be immensely rewarding, it is also exhausting, expensive and poorly supported by a medical system that delivers life-prolonging miracles, but little help for loving care at home in life's fragile years. She uses data to explore the differences in how hospitals treat chronically ill patients at the end of life.

She follows the final three months in the life of a woman diagnosed with kidney failure who rejects life-prolonging dialysis for a life-affirming ending with adventures to the beach, zoo, aquarium and favorite restaurants. The year-long series concludes with eight steps we can take to make our final years of life easier, kinder and less expensive.

Place: Third Place

Connecticut is in the midst of an aggressive effort to move seniors and people with disabilities out of nursing homes and into home- or community-based settings where they can receive care. This comes as the state's population of people 65 and older is projected to grow dramatically, while the working-age population shrinks. These stories were intended to explore how these changes will affect two major parts of the long-term care system – the workforce and the unpaid caregivers.

Place: Honorable Mention

By using the Freedom of Information Act and a considerable amount of scientific research, this ABC News investigation revealed never-before-known dangers of DHA, the main ingredient in the very popular spray-on tan. It also prompted some of the nation's top dermatologists and scientists to no longer recommend spray tans as the "safe" alternative to other forms of tanning. Through use of a concealed camera, the investigation also revealed false and misleading safety information manufacturers and salons were giving to consumers, such as claiming that the DHA in spray-tan was "food grade" and approved to eat by the FDA.

Place: Honorable Mention

A growing number of health care services are being outsourced not only to domestic companies but also to those based overseas in a process called "offshoring." These range from coding and billing to patient lab results, intensive care unit monitoring, documentation, eligibility determination, and front office services. These actions are being taken largely for business purposes. What does this mean for physical therapists, their patients, and the health care system? What are the trade-offs between less expensive services and quality of patient care?

Place: Third Place

The series looked at a very small number of places or industries in the world that have successfully kept infections and death from AIDS to an absolute minimum, and how they did it. It also explored ways that other places – or even the whole United States – might do the same if some changes were made. One important lesson: each venue is different, but the most essential element is constant testing for HIV and aggressive follow-up of all sexual contacts of infected people. Sex education is also important.

Place: Honorable Mention

With estimates for waste, unnecessary care and fraud in health care in the hundreds of billions, 60 Minutes' investigation into hospital emergency room practices provides a window into the kind of conduct that causes health care costs to go out of control. For more than a year, reporters looked into the admission and billing practices of Health Management Associates, the fourth largest for-profit hospital chain in the country with revenues of $5.8 billion last year, finding that the company relentlessly pressured its doctors to admit more and more patients.

Place: First Place

More than a decade ago an article in a scientific journal warned that people living near hundreds of forgotten lead factory sites could be in danger from toxic lead fallout deposited on nearby properties. The researcher gave the U.S. Environmental Protection agency his list of 464 potential lead factory sites in 2001. But USA Today's 14-month investigation of the sites on that list found federal and state officials left thousands of families in harm's way, doing little to examine the properties or warn residents of the danger posed by lead-contaminated soil in their yards.

In addition to publishing traditional investigative stories detailing the newspaper's findings, a centerpiece of the project is a massive, multi-dimensional digital interactive that has empowered communities and government officials to explore in detail the danger USA Today has documented at each of more than 230 confirmed factory sites.

The series examined the lack of access to health care across Oklahoma, and particularly in rural areas, which leads to poor health outcomes and large health disparities. Fewer doctors practice in rural areas and specialists are even harder to find. Public policies aiming to correct this problem are rare and are having little effect.

The shutdown of a geriatric mental health unit in a local hospital could have been a 10-inch inside story, but instead this reporter took a look at the impact of the closure on the last patient on the unit, the big-picture trends that led to the shutdown, and the paucity of care for mental health patients, especially older, low-income ones. The insight of the psychiatrist who worked on the unit gave an inside view of a population that is rarely seen by the public as we followed his clientele from hospital to assisted living units.

South Carolina Gov. Nikki Haley dictated the conclusions of a committee charged with deciding how the state should implement federal health care reform before the group ever held its first meeting. In a March 31 email thread that included Haley, her top advisers and the committee member who eventually penned the report, Haley wrote, "The whole point of this commission should be to figure out how to opt out and how to avoid a federal takeover, NOT create a state exchange." The Health Planning Committee's report, released in November, mirrored that directive.

Documents show a first-term Republican administration focused on public perception of its handling of the Democratic health care reform law. They also reveal the tight control Haley and her top aides exercise over other state agencies, requiring media inquiries to various state departments to pass through the governor's office for inspection. News of the fixed conclusion enraged consumer advocates, who met in good faith with the committee more than 30 times over seven months. Taxpayer watchdogs were infuriated that the state used a $1 million federal "exchange planning" grant to reach a pre-determined conclusion.

The stories focused on the extraordinary changes affecting medical practice, including the decline of the solo practitioner, the disappearance of talk therapy in psychiatry, the rise of shift work, the increasing emphasis on social skills and doctors' changing politics.

The piece explores the environmental and health consequences of the Toxic Substances Control Act. Intended to protect Americans from toxic chemicals, the law is, in fact, so weak that out of the 84,000 chemicals currently in use only 5 have been regulated because of toxicity. "Toxic Law?" demonstrates how lax laws and weak policy leads to poor health outcomes.

This story explores what makes a good end-of-life journey, how attitudes and practices are evolving and what changes are needed to put palliative care on the public agenda. It also exposes a lack of national policies and funding for palliative care in Canada that has resulted in a failure to meet the needs of the dying in this country.

The recession and natural disasters around the country have increased the number of patients with anxiety, depression and substance abuse problems. Meanwhile, budget cuts and the longstanding split in funding for psych patients who also have medical problems mean there are fewer psychiatric beds in hospitals. As a result, psychiatric patients are crowding emergency departments and hospitals are struggling to find the best and cost-effective ways to treat these patients. Charlotte Huff sought facilities around the country that are using innovative ways to treat this population. Solutions included pooling Medicaid dollars, fast-tracking evaluations, integrating treatment, aggressive case management and offering non-medical forms of assistance.

Residents of the poor and isolated Northern California community of Clearlake undergo two common heart procedures at exorbitant rates, between five and six times more than average Californians. This was the conclusion of a complex data analysis that showed dramatic variation across California in the use of elective angioplasty and elective angiography. The analysis also drove home the point that where you live can help determine how likely you are to go under the knife.

Children's hospitals relentlessly promote the good care they provide, but they don't like to talk about how they contribute to the escalating cost of the U.S. health system. "Building Ambitions" documented the industry's multibillion-dollar building boom as an example of government's faltering efforts to control spiraling medical spending. The series, published at a time of heightened public interest in the rising cost of care, marked the first in-depth examination of the finances of children's hospitals.

These articles are part of a collection of stories about the dangers of hydrocodone, the key ingredient in Vicodin and the nation's second most-abused medicine. For years the problem of hydrocodone abuse was overshadowed by concern over oxycodone, its chemical cousin. Oxycodone came in stronger versions, like OxyContin, and so it grabbed most of the headlines. This series of articles was prompted by a violent pharmacy robbery on Long Island. The robber took thousands of pills containing hydrocodone. Data from a DEA database show how pharmacy robberies rose 81 percent in four years. A package of two articles revealed how the DEA and FDA have been dragging their feet for 12 years on a review over whether to close a regulatory loophole that has fed hydrocodone addiction. Another story revealed that four companies are quietly developing pure hydrocodone drugs. This story alarmed drug control experts nationwide and dominated headlines.

Being sued successfully over and over again won't necessarily get a doctor disciplined in Kansas or Missouri, even when patients' lives are lost. "Bad Medicine" detailed the history of a Kansas City area neurosurgeon who has a long history of malpractice cases involving paralysis, disfigurement and deaths yet maintains a spotless Kansas medical license.

The story includes statistics gleaned from a federal database to show that this doctor's case isn't a fluke: he is one of 21 doctors in Kansas and Missouri who had 10 or more malpractice payments made on their behalf but had never been disciplined. While licensing boards in 17 states make information about doctors' malpractice histories available to the public, the Kansas and Missouri boards do not.

This series examines the methadone industry in Washington state and analyzes the effects of the drug's availability and potency. 

This story covers a family's struggle to hold a nursing home accountable for grief suffered when an strange man was found shirtless without explanation in their loved one's apartment.

The article showed how allegations of patient neglect and Medicare fraud have tracked hospice care's change from a largely charitable cause into a for-profit business, dominated by large corporations. It also showed how patients who are not dying are being admitted to hospices and -- having given up their rights to curative care -- are being subjected to neglect at the most vulnerable times of their lives, sometimes to the point of death. Shares in Chemed Corp., which owns the largest U.S. hospice chain fell in the weeks after Waldman's story and were down substantially for the year.

Instant, cup-style soups sends injured patients -- mostly children -- to the hospital every day, often with serious injuries. The problem seems to be the cup's design: they are tall, lightweight and top-heavy.

Deadly Deception is a one-hour documentary that revealed evidence of toxic testing at homes and schools in some North Birmingham communities. This months long investigation uncovered evidence of deception by city, county, state and federal environmental regulators as well as elected officials. 

Reporter William Dubois' assignment is to look diabetes care -- from the day-to-day mechanics, to difficult medical concepts, to the mind-set and culture of diabetes patients -- and to provide education to readers. These four samples look at issues around sharps (i.e. needles and lancets), blood glucose meters, tips for young persons with diabetes going off to college for the first time, and the divide between the two major types of diabetes patients.

See the stories here. 

"Side Effects" investigates conflicts of interest in medicine.

Reporter Yuk-Hang Ng has covered tobacco control in Hong Kong and Asia for years. This year, the reporter exposed how tobacco companies lobbied the government just prior to the announcement of the annual budget, which violated WHO guidelines. This sparked anger among health professionals. Ng also called attention to two areas that required the government's urgent action: banning smoking outside building entrances and regulating electronic cigarettes that do not contain nicotine. In the final clip, Ng produced a one-page feature to coincide with the WHO World No Tobacco Day, which analyzed the state of tobacco control in Asia and reported on Hong Kong's performance in quit-smoking schemes. There was also an additional story filed by co-reporter Zhuang Pinghui on tobacco use in China.

See the stories here. 

Reporter Sandra Jordan assesses the progress of diversity at St. Louis-based BJC Healthcare in the newspaper's annual diversity special section. In a series of three stories, she also examined diversity and inclusion efforts at two other top healthcare corporations of similar size and scope to BCJ: Partners Health in Massachusetts and Duke Health in North Carolina.

See the story here. 

Michael Booth's 2011 beat reporting focused on the surpluses of Colorado nonprofit health insurers, the high cost of healthcare for chronic patients and Colorado's biggest financial swap of the year. He sought unpublished documents on a $1.45 billion deal between the largest health foundation and the largest hospital chain and forcing public hearings; under community pressure, the state attorney general crafted major new consumer protections into his approval. Finally, Booth's reporting on the largest food-borne illness outbreak in nearly 100 years culminated in this heartbreaking piece about one victim's family.

See the stories here. 

These four stories examine wrong-site surgeries, a fatal overdose in hospital, blood glucose meters and a breast cancer fund-raising warning.

These stories cover a range of issues discussed at medical meetings held in Chicago in 2011: Society for Interventional Radiology (SIR), American Roentgen Ray Society (ARRS), American Medical Association (AMA), and Radiological Society of North America (RSNA).

Reporter Milton Correro's stories in The Morning Call cover Blue Cross' reinstatement of mental health insurance coverage for 9,000 patients. Correro also profiles three individuals with serious medical concerns: A boy who passed away from leukemia, a man who lost and then regained his eyesight, and a 19-year-old who blogs about the lighter sides of living with a disability.

This beat includes stories about music therapy and massage replacing antipsychotic medications at a non-profit nursing home, a breaking piece about a boy's suicide following hypnosis by his school principle, an expose about a Florida nursing home choking death, and the emergency department of the Sarasota, Flo.-area's largest hospital.

Reporter Marni Jameson covers topics from addiction after gastric bypass surgery to epigenetics to Big Pharma buyoffs in her reporting for the Orlando Sentinel.

This series revealed systemic problems in care and cases of patient harm, even death, at Parkland Memorial, one of the country's prominent public hospitals. Parkland and its academic affiliate, the University of Texas Southwestern Medical Center, allowed doctors in training, and even students, to practice on Dallas' most vulnerable patients, often with little or no supervision. The consequences of such lapses in care were especially acute and tragic in Parkland's psychiatric ER. This series tells stories of patients and families harmed in the unit.

Reporter Miriam E. Tucker covers physician sensitivity to LGBT diabetes patients, athletes with type 1 diabetes, crowdsourcing in diabetes treatment development and the cost of treating diabetes.

These four stories chronicle the events leading up to, and including, the United Nations High-Level Meeting on Noncommunicable Disease.

These stories by JoNel Aleccia covered: FDA oversights that allowed problems with medical prep products blamed for deaths and infections nationwide; Christian Longo, an Oregon death row inmate who wants to change federal and state rules that bar inmates from donating organs after death; the impact of medical errors on the caregivers who make them, the so-called "second-victim" effect; and the FDA's little-known practice of allowing food firms to "rework" products that are imperfect, mislabled or contaminated.

Soldiers smoke more than civilians. An independent, year-long, investigation by reporter Sally Herships has uncovered the military's failure to comply with its own tobacco pricing restriction selling millions of dollars of tobacco products for well beneath legal limits. This broken restriction sickens soldiers and leaves tax payers with an enormous financial burden. The Department of Defense spends over 1.5 billion dollars on tobacco related expenses. Herships' objective was to determine the depth of the military's failed tobacco pricing restrictions and to measure its impact in terms of scope and healthcare costs.

Reporter Amy DePaul's beat is health disparities and medical issues facing the largely immigrant, (and often underserved) low-income communities of Orange County, Calif. Stories include food truck nutrition in Santa Ana, Calif., peer health educationin Orange County, a local professor's findings that Latinos do not rely unduly on emergency rooms and a new youth obesity clinic in a city where children lack access to nutritional foods and safe open spaces.

This submission includes a series of investigative stories about the extensive problems plaguing New Jersey's medical marijuana program.

These stories explore the intersection of evidence and medical decision-making. The pieces examine how medical research is translated into practice, and how narratives influence the way that evidence is interpreted by patients and their doctors. Breast Cancer's False Narrative explores how the stories we tell about medical research can lead us astray. Kiddie Cholesterol shows how conflicts of interest and dependence on surrogate endpoints can result in practices that may cause more harm than good. Avastin and the Power of Hope looks at what happens when evidence fails to affirm hope. The Change in Mammogram Guidelines examines how controversial breast cancer screening guidelines are being put into use in the real world.

This beat answers practical questions relevant to ordinary people: When will a treatment become available? How much will a technology cost? And how does it compare to existing options?

This three-part serial narrative follows a woman who, at 29 weeks pregnant, is run over by a car in a downtown crosswalk. A broken ankle is the least of her hit-and-run-caused problems. Doctors discover a huge clot lodged in her heart's tricuspid valve, threatening her and her unborn child. They disagree about when, how and whether to remove the clot, then, given her fragile state, puzzle out the best way to deliver a healthy child. The story illustrates, among other things, how physicians work through varying opinions during difficult cases.

In Luxembourg, there is no legal requirement for companies in the private sector to provide the working conditions to prevent psychological harassment ("harcèlement moral") from taking place. The article focuses on the Luxembourg financial sector, the Grand Duchy's main economic pillar, where since the start of the financial crisis and the consequent lay-offs, employees have been subjected to increasing pressure to deliver results, while job security has been considerably lowered. The story covers the legal and psychological issues surrounding Luxembourg's workplace policies.

The stories describe how hospice care in America, once a charitable cause, has been dominated by businesses that maximize profits by enrolling long-stay patients who aren't dying, scrimping on care and often neglecting patients at the most vulnerable period of their lives. The stories uncovered allegations of neglect and fraudulent behavior against the nation's biggest hospice providers, who receive 90% of their revenues from Medicare.

The misuse and abuse of prescription drugs have become an alarming trend in Santa Barbara County. Drug- and alcohol-related deaths nearly doubled in Santa Barbara County between 2005 and 2009, and records from the Coroner's Office show that it's no longer unusual to find in decedents' bodies as many as a dozen different prescription medications, in addition to cocaine, heroin or methamphetamines, and alcohol and marijuana. This article explored the drugs' availability and controls (or lack thereof); revealed a lack of regulatory oversight; helped calculate the cost to our community -- including the challenge of funding a comprehensive response in an era of severe budget distress; and told the personal stories of some of those whose lives have been caught in the middle. 

This business of healthcare beat focused on Michigan health systems and icluded stories about changes to the state's Medicaid funding, hospital hiring policies that discriminate against tobacco users, mandatory hospital employee flu shots and a cost-management plan that helped treat high-risk hospital employees with chronic medical conditions. 

State employees with long histories in the state's alcohol and drug treatment division in South Dakota were quietly demoted and fired earlier this year, and replaced by state employees from the mental health side. This happened during the first half of 2011 when South Dakota's state agencies were reorganized under an executive order from Gov. Dennis Daugaard. This story covers the evolution in access to treatment for people with substance abuse disorders.

These stories explore the dynamics between hospitals in the Capital Region of New York. One story looks at how competing cardiac programs improve quality of care for patients. Another story looks at how mergers tend to increase health care costs. Two more stories look at problems that occurred in the pediatric and maternity units after the merger. The merger was a major concern for local residents.

This story covers a meta-analysis of SRI clinical trials in children, which showed that studies with negative findings are often published with significant delay. The researchers state that this time-lag bias, while not exclusive to child psychiatry research, has the potential to alter perceptions of antidepressants' efficacy in children. Authors and other experts cite several factors as contributing to time-lag bias, from industry influence to journal editors' preferences.

These stories sought to help readers understand the effects of changes to Tennessee state policies regarding its Medicaid program (TennCare) and other government programs. The reporter hoped to give context to these changes and allow readers to see how the changes would affect people in their own communities.

This story covered a shortage of specialized surgeons at Carilion Roanoke Memorial Hospital, Southwest Virginia's only Level 1 Trauma center and the region's largest hospital. That shortage meant the hospital didn't have the right surgeons available to meet state requirements for maintaining its Level 1 trauma status.

North Orange County, Calif., has an acute shortage of parks, playing fields and other safe open spaces while South Orange County has an abundance of wide open public areas and school yards. In just 50 years, Orange County went from orange groves and open fields to a divided county in which those who live in the north have few places where there is room for children to run. This series tells what happened, how children cope today and what's in store for the future.

These stories put a human face on the issue of faulty metal-on-metal hip replacements, explore what a peaceful death is using the reporter's father as example, reveal the impact of stingy Medicare/Medicaid payments on the mental health care and expose the phenomenon of ever-increasing deductibles on health insurance and the impact that has on consumers.

These stories expose a price disparity between two local medical clinics, revealed a suicide at a regional psychiatric hospital, disclosed threats posed by a hospital's shortcuts in instrument sterilization, and analyzed financial information and payroll expenses at the region's largest hospital system.

Working seven days a week, 12 hours a day, Dr. Megan Coffee directs a team of volunteer doctors and Haitian and American nurses who care for a vulnerable population in a country afflicted with the highest TB infection rate in the Western hemisphere. In two portable buildings and a tent surrounded by the ruins of Port-au-Prince, Coffee treats patients diagnosed with both HIV and TB. She -- and a constantly evolving staff of volunteer doctors and physicians -- save lives for pennies a day. Coffee's infectious disease clinic occupies two small temporary buildings and a tent on a corner in the middle of a still-collapsing University Hospital in Port-au-Prince, Haiti. Here, 45 patients who would normally require medical regimens running many thousands of dollars in the United States are saved with a simple regimen of inexpensive, antibiotics administered over a six to eight month period in combination with food supplements and when necessary, HIV medications.

These stories cover: the issue of dual eligibles -- patients who receive both Medicaid and Medicare -- and how their care has long been costly and uncoordinated; the effort by Los Angeles County to begin implementing health reform by expanding coverage to the uninsured; a night in of the nation's busiest safety net hospitals' ERs; and one young woman's battle with cancer and the health care system.

This entry includes stories from the Atlanta Journal-Constitution's "Danger in our hospitals" series and its "Physician in Transition" series. The first series analyzed CMS patient safety data and discovered shortcomings in some highly-regarded Atlanta hospitals. The second series looked beyond the debate of the health care law and explained in detail the changes already occuring in the health care delivery system -- especially changes in how doctors practice medicine.

A one-page feature on nutrition in Asia, with a sidebar on breastfeeding in Hong Kong. Although Asia is getting wealthier, a lot of children remain undernourished and require governments' immediate action. This feature explores the main nutritional threats that are becoming rampant in Asia, as well as possible ways to tackle them.

Hospitals and doctors are major employers in Springfield, the capital of Illinois, and health care recently surpassed state government as the largest employer. In this entry, reporter Dean Robert Olsen covers the business side of health care as well as health policy at the state level, new technology, patient safety and scientific research. 

Each column answers two consumer health care questions. The pieces cover: limits of advance care directives, the search for medical prices, financial help to pay for COBRA when HIV , storing health information, health reform's impact on the low-income and uninsured, how to change a death certificate, medical groups imposing annual fees and whether states can opt out of health reform. Each column provides solutions to real-life problems readers face in accessing and paying for care/insurance coverage or the need to correct a mistake.

This series focuses on how public health is affected by individual behavior, healthcare providers, government agencies, environmental factors, insurance and drug companies and other corporations. Recurring themes include: efforts to expand and improve primary care; to reduce the costs of Medicaid and deliver better care, particularly for those with complex health needs; to stabilize struggling hospitals and preserve the public health 'safety net'; to prevent and contain chronic and communicable disease; to implement federal health care policy on the New York metropolitan area, and more.

These stories cover the California Legislature's decision to eliminate the state's adult day health care program as a Medi-Cal benefit. That decision, coupled with the governor's veto of a proposed replacement program, prompted the state to devise a new way to deliver subsidized care for about 35,000 low-income Californians, many of them frail and elderly. The state's plan was challenged in court. A new, smaller statewide program was formed as part of a settlement of the lawsuit.

This beat helps readers understand health insurance, hospital growth, Medicaid bureaucracy and more. In "Treatment Denied," the reporter identifies a legal loophole denying men Medicaid coverage under a program that provides breast cancer treatment for the uninsured. The federal law excludes men based on their gender alone. "Hospital Wars" delves into the business of hospitals, helping readers understand what's behind the explosion of health care growth in the Charleston area. "Blue Cross wins big in repeal" exposes how Blue Cross Blue Shield of South Carolina manipulated the state Legislature to guard its power. "'Proviso' keeping docs paid" examines a 2008 state law that shields doctors from Medicaid rate cuts, even as Medicaid patients face a variety of service reductions. The reporting shows that South Carolina is among the only states in the country where the Medicaid agency could not lower provider rates.

This series covers legal highs available on the American market. The first news story was on research on the effects of bath salts. The second news story covered the decision of the Drug Enforcement Administration (DEA) to declare "bath salts" illegal. We also learned that by the middle of 2011, U.S. poison control centers had received 4,137 calls about bath salt "exposures," up from 303 such calls in 2010. The reporter revealed a multifaceted world of drug use, and that researchers are discovering medical uses for some of these compounds, though they do not encourage lay use of illicit and/or illegal drugs. WebMD warned that the products contained unknown, unlabeled, and potentially lethal amounts of dangerous compounds.

In the wake of the 9/11 attacks, more than 50,000 rescue and recovery workers converged at the World Trade Center. Among them were the 62 members of Missouri's FEMA Urban Search and Rescue task force. The experience at ground zero made many workers sick, with health problems ranging from asthma to post-traumatic stress disorder. Although Missouri's search and rescue team spent only ten days at the World Trade Center site, this report found that some workers are still experiencing health problems a decade after 9/11.

This beat explores both the business of health care and ethical issues surrounding HIV and AIDS. 

The Texas Tribune spent two weeks on the Texas-Mexico border to report on the health conditions among residents of the colonias, and the bureaucracy and red tape standing in the way of public health. This story reports that, despite decades of new laws and regulations aimed at improving the colonias, nearly 45,000 people still live in neighborhoods without running water, wastewater treatment, paved roads or solid waste disposal. Kids -- and their parents -- are often sick, and have few resources to get the care they need.

This project examines the environmental factors that can affect children from becoming healthy, quantifies some assumptions about the correlation between poverty and obesity by using body-mass index data from a local school district, and mapping these BMI rates with food deserts, fast-food restaurants, grocery stores and parks.

The story demonstrated that the risk from cryptosporidium -- a protozoa that causes diarrhea -- are minimal in Portland's water system, though EPA rules were forcing Portland to spend up to $500 million to combat it.

A look at the factors contributing to diabetes, which include poverty, race and rural areas, and an interview with a nurse who helps people manage the disease in their own home.

This series covers KV Pharmaceutical's extraordinary pricing of pre-natal drug Makena, the merger of two giant pharmacy benefit managers -- Express Scripts and Medco -- and the tax-exempt status of St. Louis area non-profit hospitals.

This story explores the many affordable and underpublicized interventions that can be delivered cheaply throughout the developing world. 

This piece examines how a warming climate is already affecting human health, from making allergies worse to affecting the spread of infectious diseases and pushing the extremes of killer weather. It explores ways in which public health experts and city planners are beginning to prepare for the health threats resulting from our rapidly warming climate.

This series covers prescription drug abuse in Kentucky, which has one of the nation's worst problems. In three installments, they looked at the growing problem in Kentucky and the lack of funding to fight it; the pain-pill pipeline from Florida to Kentucky that supplies most of Kentucky's pills; and the failure of the Kentucky Board of Medical Licensure to keep some rogue doctors from inappropriately prescribing narcotics. The stories showed that prescription drug abuse is tearing apart many Appalachian communities, that efforts in Florida to curb the pipeline have not stopped the flow of pills and that more needs to be done to keep rogue doctors from operating in Kentucky.

In this business piece, Fortune reporter Katherine Eban investigated the rising problem of organized criminal gangs in the U.S. stealing prescription medicine in increasingly audacious heists. 

Analyzing state vaccination data collected from 5,500 Illinois public and private schools, the reporters identified clusters of unvaccinated or partially-vaccinated schoolchildren across the state. The team took the data a step further by building a searchable database of vaccination rates for each school in the state along with a searchable map identifying pockets of children who had not been fully vaccinated. The story revealed that the number of schools with lower rates had increased in recent years, especially among schools serving large numbers of low-income children and private schools serving the affluent. See the database here.

Marie Claire Features Director Lea Goldman spent three months analyzing the tax returns from hundreds of breast cancer non-profits to uncover all too frequent instances of conflicts of interest, wastefulness, even malfeasance. Goldman also investigated dozens of companies marketing pink products and found that, despite claims to the contrary, many weren't donating a cent to breast cancer research or awareness.

This five-part series explores what has become a national epidemic, through voices of children who struggle with obesity.

This story provides a solutions-oriented look at Milwaukee's infant mortality rates. Milwaukee ranks seventh worst among big cities when it comes to infant mortality. Black infants die at a rate about 2.5 times that of whites. In some neighborhoods, the rate rivals that of Third World countries. The reporters examined critical issues, from the science of stress and its affect on prematurity, the way America's health care system is structured and health literacy, among other issues.

The full extent and impact of the disaster at Fukushima that began in the Spring of 2011 remain obscure. This essay pieces key details of the Fukushima disaster into a coherent picture and places them in historical context with previous nuclear disasters at Three Mile Island and Chernobyl. The essay traces the personal, human, and environmental impacts of the Fukushima disaster and similar disasters on regional and global populations and examines the psychological, social, financial, and political effects of these disasters.

This series examines Utah's nutritional supplements industry, which typically relies on multilevel marketing to sell its therapeutic fruit juices and other products. The team found that despite widespread support for the industry from political and economic leaders in Utah, some companies' health benefit claims are dubious at best and multilevel marketing in general builds wealth for a few on the backs of thousands who lose money.

The first part of this series chronicled the increase in doctors from other medical specialties branching into cosmetic surgery as their insurance reimbursements decline. The second part took a hard look at the board-certified plastic surgeons working at high-volume cosmetic surgery clinics where safety can take a back seat to profits. This entry showed how a public increasingly fixated on being trim and youthful leaves no shortage of patients for doctors with questionable credentials. 

This series of three articles looked at the two biggest disease "killers" -- cancer and heart disease -- from three vantage points: new drugs in development, funding for research, and public profile/fundraising. Cancer far outstrips heart disease in all three areas. The story attempted to look at how drugs, money, and glory are intertwined and why the gains made in treating heart disease may soon fall behind cancer.

This story looks at how HIV impacted the infectious disease community as a whole, including how it changed the specialty; how it forced doctors to confront their fears and prejudices; how it liberated some medical personnel to "come out"; how it created questions about treating the whole person rather than the disease; and how it impacted the way drugs are tested and approved in the US. The Point/Counterpoint accompanying the story explores whether the US is allocating resources appropriately for effectively managing the disease in all affected communities.

This news story explores the impact of the current economy on dermatologists' practices. What are dermatologists doing to keep their businesses strong? How are patients' changing attitudes toward healthcare affecting the bottom line for dermatologists? The story also examines the current state of reimbursement and how dermatologists are interacting with insurance companies to keep their practices going.

Providence Health & Services, a major West Coast health care organization, opened a new $460 million medical tower in 2011, its biggest-ever construction project. It was one of several health care organizations nationally making significant building investments in 2011. This story looked at the financial risks and potential benefits of such an investment.

Invasion of the Body Hackers traces a group of powerful Silicon Valley technology executives and engineers as they attempt to introduce computer programs and electronic devices they originally built to monitor and improve their own health into the mainstream consumer market. Through the stories of tech entrepreneurs and health experts, this piece explains this "self-tracking" health technology and how it works, while exploring the corporate uses, consumer benefits, and downfalls.

Accountable care, as defined by the ACA, is having a major impact on hospital facility planning and design. This story examines how hospitals and health systems will need to accelerate the migration of patients from the hospital into the lowest cost appropriate settings and emphasize primary care.

This story investigates an invasive placebo procedure -- called sham brain surgery -- in which researchers mimic the surgical intervention they are testing as closely as possible, putting the patient under general anesthesia, drilling a hole in the skull, and in some cases penetrating the white matter of the brain without actually delivering an intervention. Some neurologists say sham surgery is imperative to eliminate research bias, but others say the procedure is theatrical and potentially dangerous. A group of patient activists is going further, claiming that sham surgery is actually killing off valuable therapies. This story aimed to examine ideas and assumptions about the value of placebo controls as well as the kinds of risks patients are willing to take in participating in clinical trials.

While the Patient Protection and Affordable Care Act emphasizes new models of care delivery and payment, many hospitals are focusing on the fundamentals of reform -- cost containment, physician alignment and coordinated care -- rather than its formalities, such as forming an accountable care organization. This story profiled three hospitals that are attacking these challenges.

This article examines the influx of interest and money from big pharmaceutical companies, the government and small biotechs to find treatments for rare diseases. With recent advances demonstrating that developing drugs for rare diseases can be a profitable and sustainable endeavor, business is booming.

Hospitals are under immense pressure to cut costs and reduce waste. At the same time, there is growing scrutiny on the quality of care provided at hospitals. This article looks at how some hospitals are bringing their expenses under control as they prepare for major changes to the reimbursement model.

This story asks the community to ask questions about charities before committing to charity races, which often fund private, nonprofit interests.

Global leaders in the fight against smoking stress that cardiologists and other physicians must become politically active to help counteract the immense power of the tobacco industry. Big tobacco aggressively targets women and children in emerging nations as their next smokers. This story explains why doctors must use their voices -- which have clout -- to stop this from happening.

Health policy is driving two strong trends that affect hospitals and physicians: the need to be transparent about quality of care provided and the growing demand for quality to be measured by outcomes, rather than processes. This story documents how a few cancer care institutions are beginning to report outcomes, such as five-year survival statistics for a given cancer type. It also discusses the potential problems with reporting and relying on outcome measurements. 

Substance abuse treatment providers, like all health care providers, need to have electronic health records in order to be paid by Medicaid or health insurance exchanges under health care reform in 2014. But substance abuse treatment providers have a special problem -- they must comply with federal confidentiality regulations (42 CFR Part 2) that forbid giving information about patients treated for alcohol or drug abuse without the patient's consent, which must follow a specific format and be in writing. This story includes interviews with the top federal official from the Substance Abuse and Mental Health Services Administration (SAMHSA), which promulgates 42 CFR Part 2, as well as one of the biggest vendors, and to an official with the company that has a SAMHSA grant to help behavioral health (mental health and substance abuse) providers implement EHR. The federal official and the vendor both pointed out that there are still many unanswered questions about how substance abuse providers implementing EHR will be able to comply with 42 CFR Part 2. The federal official additionally outlined the pitfalls of buying the wrong program, noting that one state spent $6 million on the wrong one.

This eight-day narrative told the story of incredible humanity and compassion in the midst of life-saving decision making during a single day at the Cleveland Clinic Miller Family Heart & Vascular Institute.

This story documented an effort by an academic cardiology group to start a controversial program to obtain pacemakers that had been removed from deceased patients, clean and sterilize them, test for function and send them to hospitals overseas to be re-implanted in patients who may not otherwise have access to the expensive devices.

This story covers Douglas Walker, a founder of the field of mitochondrial genetics, and his controverial mission to increase research on mitochondria -- the furnace of human cells -- and its role in common, complex diseases such as cancer and Alzheimer's. 

The Prostate Specific Antigen (PSA) test is one of the most controversial tests in medicine. This story examines the source of the controversy and the history of how the test came to be widely used before it was validated, and the acrimonious debate it has triggered within the medical and patient advocacy communities. The story explains the trade-offs involved in the test and the downstream treatments to which it commonly leads.

This story answers the questions: What do you die of when you die in your sleep, and is it as peaceful as everyone assumes?

This story explores the trauma that afflicts nurses, doctors and other highly skilled health workers in the aftermath of medical mistakes. It examines the little-known "second victims" of medical errors, the highly-skilled professionals whose momentary lapses in skill, attention or vigilance can have devastating effects, not only for their patients, but for the health workers themselves. Reporter JoNel Aleccia found that 92 percent of doctors surveyed reported near-miss medical mistakes and 57 percent admitted actual serious errors.

On May 13, 2011, Derek Boogaard was found dead of an accidental overdose of prescription drugs and alcohol. He was 28. Boogaard, in his six seasons in the National Hockey League, had scored all of 3 goals. But then his job wasn't to score, or, in truth, even to play very much. His job was to fight. Nightly, and bare fisted. He did that job well. And at great cost. For this story, Reporter John Branch spent six months exploring the life and death of Derek Boogaard -- his childhood in rural Saskatchewan; his unlikely rise to the NHL; his fights and his injuries, his broken fingers and damaged brain, and the addiction to prescription drugs that helped kill him.

This pair of stories chronicle the challenges of the first sizable generation to come of age with a diagnosis of autism. While much has been written about children with autism, little has explored the lives of young adults. This cohort, diagnosed earlier and having benefitted from growing awareness of the neurological condition, is better-equipped than their predecessors to live full and independent lives. But will they succeed? 

This story studied the devastating consequences for one American family with a rare form of inherited Alzheimer's that can show up as early as age 40. 

In the wake of the January 8, 2011 shooting in Tucson, AZ that claimed six lives and left Rep. Gabrielle Giffords grievously wounded, early coverage brushed quickly past her survival and focused on what appeared to be her remarkable recovery. Melissa Ann Healy quickly embarked on a series of articles and profiles designed to explore both survival and recovery from penetrating brain injury in greater depth and with less breathless optimism.

In this article, playwright Darci Picoult weaves a personal, revealing, and uplifting story about her diagnosis of vulvar cancer and subsequent major surgeries. The topic of vaginal and vulvar cancer is very rarely talked about in mass media, despite the fact that more than 7,000 women will likely be diagnosed with one of the diseases in 2012, according to the American Cancer Society. These cancers also appear to be on the rise, making it even more important to bring attention to this difficult topic right now.

This story takes a hard look at how osteoporosis is treated today and finds that while younger women are vastly over-screened, overdiagnosed and overtreated, older women are dangerously neglected. 

This piece, which ran after the shooting of Rep. Gabrielle Giffords, D-Ariz., tells the stories of four people who survived gunshot wounds to the head.

Nearly 4.5 million Americans age 50-plus use elicit drugs, and that number is growing. This story helps AARP readers cope with the effects of addiction, reassures them that others are struggling with the same issues and to awaken the nation to this growing problem.

Sufism, Kabbalah, Reiki, and even mystical Christianity have made their way into mainstream facilities in high profile medically advanced metropolitan areas, such as Cleveland, Minneapolis, Houston, and New York. While the healing efficacies of these spiritual disciplines are not well documented with empirical data, large numbers of patients have come forward with anecdotal reports of pain relief and rapid healing after serious injury or major surgery.

Patient advocates can help you navigate the medical maze of treatment decisions, health-care billing and insurance coverage - and help patients fight for their rights. This story outlines patient advocate systems for readers.

A man who had lost his vision spent eight years in the dark, reconstructing his life. During that time, he changed careers, married and conceived a child. When he had just about given up on the idea of recuperating his vision, he started to see again.

This story reports that restaurants in Muskegon County, Mich. racked up thousands of food code violations between 2007 to 2010, some of which could make the public sick. And Muskegon County's enforcement system allowed many of the most frequent violators to continue to operate for years without facing serious consequences.

This story reported on a mother who had been court ordered to follow a treatment plan that she disagreed with for her autistic son. It explored the contentions between medical evidence and legal standards.

Diagnostic errors are a significant problem but are often overlooked by physicians and hospitals. Because of confidentiality rules and a virtual code of silence among doctors, details of specific cases rarely come to light except in malpractice lawsuits. This story profiled a woman who was fatally misdiagnosed and also showed how a doctor bold enough to intervene in a diagnostic error -- even when he did so to save a life -- can face professional scrutiny and potential retribution.

The March 2011 Japan earthquake focused new attention on seismic dangers. Hospitals closest to the southern San Andreas Fault, pinpointed by scientists as most dangerous fault area in the state, have a 59 percent chance of at least one catastrophic quake in the next 30 years. More than 40 buildings at 10 hospitals close to that fault were rated by the state as "highly collapsible." Most hospitals are planning fixes, but state records show that most still won't be able to function after a major quake.

This entry examines the pain management industry and seeks to determine why patients with chronic pain remain unsatisfied with treatment.

Parents who adopt children from Eastern Europe face a 50-50 chance of getting a child affected by fetal alcohol syndrome. This story examines the trend.

A cross-section of all the kinds of foods schools give children during the day, especially in areas where there are higher concentrations of students who depend on that food for economic reasons. The goal was to describe those foods to the public, but also to take the findings back to health experts for them to evaluate the nutrition of the local school lunches. The report found local schools were actually doing better than most, but also found there were some confusing messages being sent about nutrition which was likely to lead some students to believe eating fortified "Honey Buns" or high fat foods -- like nachos -- every day of the week is OK.

Patients typically complain about being released from the hospital sooner than they would like. Over the last two decades, U.S. hospitals have reduced the average length of stay from 7.2 days in 1989 to 5.4 days in 2009, according to the American Hospital Association. However, uninsured and underinsured patients who need long-term care are often stuck in hospitals after being medically ready for discharge. They can't go to another facility or home with a nurse if they can't pay their bills. "Stuck in the Hospital" explains the toll of delayed discharge on patients, the health-care system and the general public as well as the potential impact of health-care reform.

A five-day series shedding light on a new approach for improving patient care in Canada.

Place: Special Judges' Citation

This article and sidebars expose the domination of Blue Cross Blue Shield in the South Carolina health insurance market and its effect on consumers. Before this report, the insurance giant brushed off criticism as unfounded. Among the newspaper's findings:

• Blue Cross Blue Shield sits on far more capital reserves than it needs – money that should have been returned to policyholders through rebates or lowered premiums – even as it continually hikes rates.
• The state Department of Insurance does not review rate increases and the agency's former director (he resigned in December) took a caviler approach to regulation.
• The nine members of Blue Cross Blue Shield's board of directors have more than doubled their reported salaries in the past year.
• Almost all state lawmakers involved in legislative insurance committees receive sizable campaign contributions from Blue Cross Blue Shield.

• S.C. Blue Cross flush with cash
• S.C. regulators question little
• S.C. Blue Cross target of federal investigation

Judges’ comments: An ambitious and courageous effort by a small-market newspaper which revealed that South Carolina’s dominant health insurer was flush with reserves and was paying executives and board members handsomely while consistently winning rate increases from less-than-vigilant regulators.

Place: Honorable Mention

This investigation found that DaVita's use of the anemia drug Epogen – a drug found to be dangerous at high levels – was higher than any other company when Medicare was reimbursing the kidney dialysis firm per dosage. Two weeks before the government stopped reimbursing per dosage, company protocol changed drastically – in a significant shift, levels of the drug were kept lower in kidney dialysis patients than ever before. Fortune's reporting showed a direct correlation between the drug's usage and its money-making potential. It also found DaVita used high amounts of the drug when it was profitable despite several key studies and FDA warnings that raised cause for concern.

Judges’ comments: A commendable look at a major public employer in the coverage area with questionable business practices.

Place: Third Place

Fortune tells the inside story of the abrupt downfall of the leader of one of the world's largest and most important companies. Jeff Kindler, named CEO of Pfizer at the age of 51, was a brilliant litigator who harbored ambitions to join Barack Obama's cabinet or launch his own political career. Instead, he found himself out of a job, the target of a sophisticated palace coup. Kindler departed with a $25 million severance package, even as the company's stock declined 36 percent under his watch.

Judges’ comments: A laudatory behind-the-scenes narrative of palace intrigues at the world's biggest drugmaker, with a gripping, wonderfully detailed narrative and well-paced tick-tock.

Place: Second Place

With medical costs spiraling upward and state-paid insurance coverage evaporating, why are hospitals building expensive emergency rooms and encouraging patients with sprains and cuts to come there for care? To try to answer that question, Ostrom looked at the building boom, the incentives offered hospitals in the state (almost all of which are nonprofit), insurance reimbursements, a state program that helps float tax-exempt bonds for hospital construction, property-tax exemptions and, briefly, at the state's Certificate of Need program. She also talked to hospital CEOs and other officials about why they're building new ERs and how they calculate that such construction is good for their bottom line.

Place: First Place

This two-part series details how Houston leads the nation in the number of private ambulance companies, number of vehicles and their connection to for-profit mental health clinics. This series noted Medicare spending in the Houston area for both areas – EMS and for-profit mental clinics were the largest for these provider areas. Stories also noted how Medicare does not police the spending well, how Medicare overpayments to EMS companies in Texas is the No. 1 problem for the Medicare contractor, TrailBlazer Health Enterprises. This series also noted the problems in city and state regulation of private EMS companies.

• Private ambulances take Medicare, taxpayers for a ride
• Doctors who oversee EMS companies sanctioned
• Medicare dollars mean payday for clinics
• Home health care firms breaking rules, raking in Medicare dollars

Judges’ comments: A very nice distillation of a big problem in health care that could easily been done with a "ripping off the taxpayers" treatment. Instead, the writers and editors personalized the tale by showing how the poor, sick and mentally vulnerable are pawns in a much bigger game. In a time of dwindling resources at big city newspapers, the judges also commend the time and manpower commitment devoted to the series.

Place: Third Place

This is a story about the sex lives of women after they have undergone treatment for breast cancer. It is a frank discussion of their situation, enlightening, heartbreaking and still empowering. It reveals there are not many resources for these women but that they still attempt and succeed in some cases to have intimacy with their partners.

Judges’ comments: This is a sensitive subject rarely covered in consumer articles about breast cancer survivors, but one that must surely weigh heavily on the minds of women diagnosed with the disease. Georgie Binks treats it with dignity and compassion through interviews with Canadian breast cancer survivors whose experiences indicate that there are relatively few resources available to help women with the sexual problems they may face but that some can still succeed in regaining intimacy with their partners.

Place: Second Place

The story offers a window into the human impact of traumatic brain injury while exploring some of the mysteries of survival from catastrophic injury. It relates the astonishing experience of 30-year-old Deborah Shurson, who plummeted 2,600 feet to Earth in a skydiving accident in 1982. She suffered staggering injuries: a punctured lung, damaged spleen and multiple fractures to her ribs, pelvis, legs and sternum. But it was her brain injury that ultimately would prove to be the greatest threat to her life. Her rescuers found her unconscious and never expected her to survive the night, much less walk, talk or return to normal life. The story follows Deborah's progress in the decades following the accident, as she stumbles through rehabilitation and ultimately meets another brain-injured patient, Gary Fairchild, who becomes her partner in renewal. 

Judges’ comments: Ruthann Richter met the subject of her riveting article in 2000 and finally told her remarkable tale more than a decade later. Deborah Shurson fell 2,600 feet to earth in a 1982 skydiving accident and astonished her doctors, friends and loved ones by surviving. Richter followed Shurson through decades of struggle with rehabilitation, through a divorce, and ultimately into a loving and mutually beneficial relationship with a brain-injured man whose limited abilities complemented her own. There’s no fairy-tale ending here – but a sympathetic and truthful description of the struggles that begin once doctors have exhausted their magic.

Place: First Place

"His Final Choice" follows Robert Good through terminal cancer and his choice to fill a prescription for drug that would end his life. The story delves into the emotions surrounding physician aid in dying, including the anger, compassion and acceptance of Good's life partner Eve Syapin. Good gives insight into the fear and pain of throat cancer in its final phase. Most of all, the story highlights the comfort Good felt by having the choice to end his life within an arm's reach, without the stigma of suicide. (Under the Washington State Death With Dignity law, physician aid in dying is not considered a suicide). Though the story set out to be one of following someone using the prescription, what emerged is a narrative about the comfort of having the choice. The side story "Controversy and choices: Doctors, activists stand on both sides of the issue" explores the more political side of Death With Dignity, the law that allows physician aid in dying. While voters passed the law with a large margin in 2008, many doctors, or entire organizations, will not prescribe the medication due to personal, ethical or religious beliefs. The story also explains the logistics of using the medication and some of the difficulties people have finding a doctor who will prescribe them the drug.

Judges’ comments: There have been many stories about the legislative, legal and ethical arguments surrounding Washington’s Death With Dignity legislation, but few that have presented the emotional impact of the decision on a patient and his partner with the direct elegance of “His Final Choice” from the Skagit Valley Herald. Tahlia Honea’s sympathetic but honest treatment of Robert Goode’s terminal cancer, his long and loving relationship with Eve Syapin, and above all, the comfort he drew from knowing he could end his life on his own terms – even though he put off taking his pills until death was very near – highlight one impact of the law that few have spoken about. It took skill and determination to follow this story to its sad but emotionally satisfying end. Scott Terrell’s straightforward photographs – in particular his appealing cover portrait – added detail and depth to our understanding of the major characters. Details about the law itself, the difficulty people have finding doctors who will prescribe life-ending drugs, and inclusion of opinions from people on both sides of the issue added the proper context to a first-rate report and a fine example of character-based storytelling.

Place: Honorable Mention

This series examined the impact of California's elimination of the Medi-Cal Adult Day Health Care (ADHC) benefit on minority communities. ADHC provides meals, therapy and medical care, as well as companionship and a sense of community, to 38,000 poor elderly and disabled Californians. The centers also provide jobs for hundreds of local residents and relief to thousands of families of loved ones who participate in the program. The project was the result of a partnership between the CHCF Center for Health Reporting and nine Los Angeles area ethnic media organizations. In many of these communities, local media are residents' sole means of finding out about local issues. Under the direction of the Center, with coordinating help from New America Media, the collaboration produced 10 print stories in four languages (English, Spanish, Chinese and part of one story in Tagalog), three audio slideshows and a photo gallery.

• Bibiana Viernes: Her Center, Her Life (Video)
• Mary Sanchez: I Only Have Two Hands (Video)
• Photography Gallery: Adult Health Center Cuts Devastate Elderly, Disabled
• A Partnership With Ethnic Media on Senior Health Stories

Judges’ comments:  Because of deep budget cuts in California, the Adult Day Health Centers were slated for elimination. This series looked at the impact on the seniors and disabled people who count on ADHC services. Across California, nearly 40-thousand people depend on these centers for meals and medical care as well as a sense of community.

The project was a partnership between the California Health Care Foundation’s Center for Health Reporting and nine Los Angeles area ethnic media organizations. In many Los Angeles communities, local media are residents’ only means of following the news. With coordinating help from New America Media, this multi-lingual partnership yielded 10 print stories in four languages, three audio slideshows and a photo gallery.

This is local news at its finest — right at the community level.  It is also foundation-backed journalism at its finest. The Center for Health Reporting stayed with the story as ADHC was slated to be eliminated on February 29, 2012. But at the last moment, the state relented and replaced ADHC with a new program — still the state says only half the current participants will be able to continue to receive services. The Center for Health Reporting says that the advocacy community read the stories produced and used them in its efforts to save the ADHC program.

Place: Third Place

This yearlong series pinpoints billions of dollars of waste in four areas of the nation's health care system.

Judges’ comments:  This yearlong series from the Pittsburgh Tribune-Review pinpointed billions of dollars of waste in the nation’s health care system. Spanning the nation from Maine to Miami and from New York to California, with in-depth and investigative reporting by Luis Febregas, Andrew Conte; the Tribune-Review highlighted critical spending issues from unnecessary readmissions to billions being spent on new facilities without review or proof of need.

This series utilized poignant humanization… great photography, striking graphics and an extensive interactive web presentation to drive home the points of the investigation.

Within days of their pointing out that Pennsylvania was one of only 14 states nationwide without a Certificate of Need review process for new hospitals and other equipment, Pennsylvania legislators were drafting new legislation to reinstate the process.

The extensive travel, weeks of data analysis and follow-up reporting in this entry made a difference in the nation’s health care spending practices.

Place: Second Place

This story explores the perils of cancer screening, the process of searching for cancer in asymptomatic people. It is something most Americans consider life-saving, but Kate Pickert pulled back the curtain to explain this is not always the case. Screening can, in fact, be life threatening and is big business for powerful sectors of the U.S. health care system. It may be better not to find some cancers at all, given that many are inconsequential and the impulse to treat them with surgery, radiation or chemotherapy is so great. Pickert delved into the entire cancer screening apparatus and looked at other misguided screening protocols that get far less attention.

Judges’ comments: Kate Pickert asks the multimillion dollar question … “Are some cancers better left undiscovered?’ As she powerfully illustrates, simply asking the “C” (cancer) question can be life threatening and is big business for powerful sectors of the U.S. health care industry.  Pickert points out that it may be better off to not find some answers, given that many cancers are inconsequential and the impulse to treat is so great.               

This article raised important issues about a number of tests and broke new ground by looking at several screening protocols that are on the rise and might save one life while harming thousands of others, forcing many to endure myriad unrelated interventions to treat innocuous findings.

Time used strong graphics to drive its points home and left readers with solid advice on which tests readers should undergo and gave important questions to ask before screenings.

Place: First Place

Each of the five stories tells the personal story of an individual who has been living with a secret – a severe mental illness – while living what appears from the outside to be a normal, successful life.

• Expert on Mental Illness Reveals Her Own Fight
• Learning to Cope With a Mind’s Taunting Voices
• Executive With Schizoaffective Disorder Uses Job to Cope
• Man Uses His Schizophrenia to Gather Clues for Daily Living
• Ex-Convict Uses Battle With Addiction and Mental Illness to Help Others

Judges’ comments: Benedict Carey breaks new ground in the understanding of living with severe mental illness. As Carey reveals in five portraits told over six months, people with severe mental illness can live successful and fulfilling lives. But more than inspirational stories, Carey’s reports are crafted to share each person’s coping strategies in dealing with inner voices or compulsions. For people with severe mental illness, medications and therapies alone are not enough. Carey has found the real experts in the field and his reporting has had an impact.

 As Carey tells us in his application, “The series resulted in changes in curriculum in some federal mental health programs – the stories became part of the program, as teaching tools. University professors, as well as dozens of mental health programs across the country, are also using them as educational material – to show how people can cope with severe diagnoses.”

Carey’s reporting has given new hope to scores of people living with diseases many thought barred them from living successful lives. We are delighted to award “Lives Restored” the first-place award.

Place: Honorable Mention

Using data from the Center for Medicare & Medicaid Services, Lisa Chedekel reported that the state-funded University of Connecticut's John Dempsey Hospital was administering combination CT scans of the chest to almost half of all patients who received the procedure – which was nearly 10 times higher than the national average. In addition, more than 72 percent of patients who received CT scans for the abdomen received double scans. Her story was reported at a time when combination scans were under scrutiny because they may expose patients to excess radiation. The head of UConn's radiation department admitted that the numbers were "staggering'' and added that "radiation safety is very high on our list of concerns. The story disclosed that most of the state's 30 hospitals were below the national average on combination CT scans. 

Judges’ comments: Lisa Chedekel packs a powerful punch in a small space with this story pointing out that John Dempsey Hospital's used combination CT scans 10 times more than the national average and sent roughly three-quarters of patients for double scans. Such practices expose patients to excess radiation. Faced with Chedekel's questions, the hospital's radiation chair said he would be contacting doctors to push for change.

Place: Third Place

These stories examined a prominent local company, Bioletics, and its founder, Dr. Richard Cohen, concluding that the company likely did not live up to its promises of science-based performance enhancement and that Cohen had violated portions of Oregon law that prohibits people from portraying themselves as a physician without proper licensing.

• History of sanctions: Bioletics founder has been cited in the past
• Athlete buyers, beware: Experts question company's approach
  

Judges’ comments: Betsy Q. Cliff shines the light on one of the many companies that makes claims about nutritional supplements – in this case, specifically promising to improve athletic performance. Cliff explains to readers why Bioletics can make claims about athletic performance but cannot promise medical improvements. She also gives Bioletics "doctor" consultant plenty of opportunity to explain the benefits of his product, explanations that ring hollow when Cliff then cites medical evidence from other experts. And then comes the coup de grace, when Cliff explains that the consultant, Richard Cohen, is licensed to practice medicine on only his own family and that this license applies in only one state.

Place: Second Place

Bloomberg Markets magazine senior writer Michael Smith identified and reported the stories of impoverished victims, brokers and doctors involved in illicit organ transplant trafficking in Latin America, Europe and Africa. Smith traveled for much of 2011 in poor neighborhoods and hospitals in Colombia, Ecuador, Mexico, Nicaragua and Peru, as well as former Soviet republics in Eastern Europe. He documented how illegal networks of brokers and physicians exploit the poor and profit from wealthy Americans, Europeans and Israelis in need of kidney transplants. The result is often injury, sometimes death and usually a life of humiliation for both those selling and buying kidneys.

• Desperate Americans Buy Kidneys From Peru Poor in Fatal Trade
• Delmonico Says Many Hazards in Illicit Organ Transplants  
• Organ Gangs Force Poor to Sell Kidneys for Desperate Israelis
• Organ Traffickers Coerce, Intimidate Impoverished 

Judges’ comments: Bloomberg Markets makes its worldwide reach felt with these thorough reports on the human toll of the illicit trade in organs. Senior writer Michael Smith (Santiago) called upon a legion of reporters to track down donors, recipients and government officials. This team identified the nations whose citizenry play the largest role in perpetuating this trade. They showed the vast disparity between what is paid and what the donor receives. And, they documented the debilitating – and sometimes tragic – losses suffered by both donors and recipients.

Place: First Place

During the 10 years he worked at St. Luke's hospital, Dr. Stefan Konasiewicz performed more neurosurgeries than any other doctor in Duluth and became the city's highest-paid physician. Yet he also amassed scores of patient complaints and numerous lawsuits, eventually leading insurance companies to deem him uninsurable.

The News Tribune identified nearly 90 cases of alleged patient harm by Konasiewicz, beginning with eight malpractice suits which the hospital settled for at least $3.2 million. The newspaper also showed that St. Luke's, which went from operating at a deficit to a healthy surplus during Konasiewicz's tenure, kept him on staff despite numerous warnings from other physicians about the quality of his care.  By going to court to release a sealed document, the News Tribune showed that the state medical board only took action against the physician after a county medical examiner wrote the board asking for an investigation to determine "if Dr. Konasiewicz is incompetent or reckless."

Finally reprimanded by the state medical board for causing permanent patient harm and deaths, Konasiewicz left Minnesota for Texas, where he faced no restrictions on his license and continued to garner patient complaints.

• As Duluth hospital reaped millions, surgeon racked up complaints
• Multiple allegations against former St. Luke's doctor
• Ailing patients speak out about former Duluth doctor
• Wisconsin restricts former Duluth doctor’s license
• In Texas, former Duluth surgeon may be sanction-free
• Federal database of malpractice cases doesn't make public doctors' names, or where they practice

Judges’ comments: Writer Brandon Stahl and the Duluth News Tribune showed exceptional doggedness and courage in chronicling malpractice allegations against one physician and the defense mounted by hospital administrators despite warnings from their own staff. The News Tribune fought vigorously to have records made public and, although confronted by a libel suit, the newspaper continued its reporting. When Konasiewicz moved to Corpus Christi, Texas, Stahl found an ally in a local TV station and was able to identify Texas patients with complaints about the care they'd received. Stahl and the News Tribune then went further, explaining why these patients would not likely be able to sue in Texas because of the impact of tort reform in that state. The coverage showed impressive and laudable commitment by the reporter and the newspaper, and we believe it speaks volumes to the medical community about the media's tenacity when it comes to defending the voiceless.

AHCJ resource: Reporter Q&A: Duluth News Tribune exposes malpractice allegations

Place: Honorable Mention

This Palm Beach Post investigation found that Florida was restraining jailed children with heavy doses of potent antipsychotic drugs, medications that can turn troublemakers into "zombies" and cause serious health problems in kids. The stories also showed that a third of the psychiatrists hired by the state to evaluate and prescribe drugs for jailed children had taken speaker fees or gifts from the companies that make antipsychotic drugs. The stories also showed that Florida had hired psychiatrists to work in state juvenile jails even after the psychiatrists had used delinquents to defraud Medicaid, or had medicated children until the children overdosed and died.

Judges’ comments: Michael LaForgia used data analysis to show that children in juvenile-justice facilities were being kept docile through heavy doses of powerful antipsychotic drugs that can cause serious health problems. He also found that psychiatrists writing the prescriptions were in many cases paid “consultants” to drug manufacturing companies. The story made waves in Florida. The Department of Juvenile Justice assigned investigators to do an exhaustive review, and the Legislature is getting involved.

Place: Second Place

Prime Healthcare Services has a reputation for turning around financially troubled hospitals, reporting profits in the tens of millions. But a more troubling trend has emerged, according to this investigation by California Watch. Prime tends to take over hospitals and then dramatically boost the rate of Medicare patients being admitted for care. And the hospitals report that the Medicare patients they see are far sicker than those at neighboring hospitals. Does the chain attract the toughest cases, or are the hospitals exaggerating patient conditions for profit?

• Video: Tapping into Medicare's gold mine?
• Prime Healthcare reports outsized rates of unusual conditions
• In their own words: Turmoil, turnover among medical coders
• Graphic: More seniors with Medicare admitted after Prime Healthcare takeover

Judges’ comments: Wow. A tenacious reporter scoured public records and developed a sweeping review of how aggressive Medicare billing practices went undetected in a business-as-usual mode for a California hospital company. This exhausting effort serves as a grand model for news organizations in other states.

Place: Second Place

60 Minutes' nine-month investigation of counterfeit prescription drugs reveals how the dangerous and sometimes deadly fakes get into the nation's drug pipeline.

• The difficult fight against counterfeit drugs
• The fight against counterfeit drugs 

Judges’ comments: The scope of the story was impressive, including a trip to Peru for a police raid on a source of fake drugs, and interviews with FDA and U.S. immigration officials admitting they can’t screen out all the fake drugs and that even when they grab a shipment, they can’t arrest anyone; all they can do is send the pills back. This story tells a chilling tale that will make viewers look askance at their pill bottles. After it aired, Congress held hearings and the FDA drew up a new plan to monitor safety of imported drugs.  

Place: First Place

An ongoing investigation in the Milwaukee Journal Sentinel found that alcohol wipes, sterile and nonsterile, can be dangerously contaminated, and federal regulators were not adequately protecting the public. When there are recalls, the public does not know because of lax communications and weak tools for regulators. Over the course of nine months, the Journal Sentinel found that, for a decade, a Wisconsin company routinely violated federal rules for making sterile products, but the U.S. Food and Drug Administration took little action. The contaminated wipes surfaced as the suspected culprit behind numerous illnesses and deaths in hospitals in several states. Among other findings, the newspaper found that there are several thousand drug and device makers that have not been inspected by the FDA in at least five years and hundreds have not seen an FDA inspector in 10 years or more.

Judges’ comments: In this comprehensive examination of a serious health threat, the Milwaukee Journal Sentinel uncovered an equally significant danger posed by the breakdown of the government agencies that are supposed to be protecting us. While the FOI effort alone could constitute a first-place award, the reporting was humanized and made intensely relevant when the writers introduced us to the Kothari family's loss. Overall, this effort exemplifies best practices in multimedia storytelling, with graphics, compelling photos and riveting video. This will become a hallmark for how to accomplish public service reporting.

Place: Third Place

Where once they died young, most of the 1 percent of children born with congenital heart defects in the western world now survive to adulthood and need to be followed long term. But the majority falls off the radar when they become young adults, in part due to a lack of doctors skilled in adult congenital heart disease. This will have devastating consequences for these young adults, many of whom will not get the care they need. As a result, many will suffer unecessarily or even die prematurely.

Judges’ comments: This was an interesting, well-reported story about how congenital heart disease patients are falling through the system as adults. It identifies the need to provide these patients with more coordinated care and perhaps even develop a new cardiac specialty devoted to their care.

Place: Second Place

Hospital-based skilled nursing facilities have been on the decline since CMS changed its payment rules. Hospitals have always argued that this is because CMS isn't paying enough, so the units are money losers. But is that really true? Evidence suggests that these units, which operate more and more as mini-hospitals as patients leave hospital beds quicker and sicker, support themselves just fine. But because they can't support the rest of the hospital, they are being targeted for cuts – and patients are suffering for it.

Judges’ comments: Coverage of long-term care usually focuses on the aging of baby boomers or their parents' situation. This was a fresh perspective. The reporter thoroughly explained how skilled nursing facilities play a crucial role, and how a nationwide trend of closures endangers the health of many at-risk patients.

Place: First Place

This three-part series examines a few of the kinds of security risks facing modern hospitals and some of the latest countermeasures. Risks included attacks on clinicians and building fires, while security measures ran the gamut from security cameras to data analysis.

Judges’ comments: This took on a too-rarely-covered topic: criminal hazards in the places where workers should be safest, medical care facilities. We were impressed with the quality of the writing, editing and lively packaging of this sweeping series.

Place: Honorable Mention

This project examined the seeming contradictions in Medicare's kidney transplant program and its effects on patients' lives. More than 144,000 kidney transplant patients nationally have seen the Medicare benefit for drugs they will need throughout their lifetimes expire. The drugs, known as immunosuppressives, allow the body to accept the transplanted organ – at a cost of $17,000 year. But Medicare pays for the drugs for only 36 months, leaving transplant patients in a desperate scramble. Meanwhile, policymakers have chosen to provide kidney patients a lifetime of dialysis treatments, which funnels them to part-time lives in a dialysis chair and leaves taxpayers with a $71,000 annual Medicare tab for each patient – four times the expense of the anti-rejection drugs. Reversing the policy has been vigorously opposed by the influential dialysis industry.

Judges’ comments: A powerful and jarring account of health care policy gone bad. It's worth noting that a small paper, the Ventura County Star, went after the largest private employer in the county, Amgen, which is also the nation's second-biggest drug lobbyist in Congress. The first-hand accounts of kidney patients are riveting. This clear and persuasive work evokes outrage over the needless suffering and death of kidney transplant patients who lose government coverage for their expensive and essential anti-rejection drugs.

• Multimedia: Kidney transplant patients face a desperate scramble  
• Editorial: Wasting taxpayer dollars, ruining lives  
• Woman featured in kidney story dies
• BLOG: To know Sheryl Glatt and Kidney Disease

Place: Honorable Mention

Prevention reports that women are charged as much as 84 percent more than men for health insurance – or turned down outright – simply for being women, and that discriminatory practice is alive and well and legal in 37 states, where 95 percent of companies take full advantage of it. Prevention delved into the roots of "gender rating" and the insurance companies' rationale: that women use more preventive health-care services. The practice is scheduled to be outlawed by the Patient Protection and Affordable Health Care Act in 2014, but this piece showcased real women who had been charged unaffordable rates or flat-out denied coverage for reasons ranging from having given birth by Cesarean section to being a survivor of rape or domestic abuse to being proactive about controlling conditions such as fibromyalgia.

Judges’ comments: Outstanding research. Glaring flaw in health care coverage ... has been written about elsewhere, but this article nails it. This well-written investigative story …. brought new light to  an often overlooked policy issue that affects millions.

Place: Third Place

Reporter Hal Bernton returned from a 2009 embed in Kandahar, Afghanistan, with a basic question about a big element of life for ground troops: Are the soldiers carrying too much weight? Over and over again, he heard tales of back, shoulder, ankle and other injuries that were dogging the soldiers as they often went on patrols with 90, 100 or more pounds of gear. In long wars in Afghanistan and Iraq, what type of toll could that weight take on soldier and Marines who deployed again and again? He set out to answer those questions in a cooperative effort with KUOW that found that Army and Marine leaders had long known that soldiers were overloaded but up until recently had done very little to lighten the load. The result has been an avalanche of injuries and long-term disablilties that will afflict many service members over their lifetimes and cost taxpayers billions in disability payments.

Judges’ comments: These articles crack wide open a disturbing and unexplored part of health care policy. The problem of American soldiers forced to carry outrageously heavy burdens, as described in this outstanding, nuanced work, cries out for policy attention and innovation.

Place: Second Place

Across America, toxic air pollution continues to punish communities 21 years after Congress amended the Clean Air Act in a push to curb the most hazardous of releases. This Center for Public Integrity/NPR investigative report exposed the regulatory failures that cause millions of Americans to continue breathing unsafe air. "Poisoned Places" publicly revealed the EPA's internal "watch list" of the nation's most troublesome air polluters – 400 facilities from Texas to Iowa, New York, Arizona, Oklahoma, Louisiana. These refineries, steel mills, incinerators, cement kilns and pharmaceutical plants polluted communities with solvents that cause cancer, metals that cause brain damage. The project disclosed how rarely the EPA uses its biggest hammer in dealing with air polluters: criminal prosecution.

Judges’ comments: Amazing stuff.  The amount of work that went into this is commendable in these days of shrinking newsrooms. Top-quality journalism. We were impressed by the ambition and great commitment of the two news organizations to revealing major flaws in enforcement of the Clean Air Act and their human costs.

Place: First Place

A 40-year-old lawsuit decided in federal court in Milwaukee revolutionized mental health care in America. The story examines how the lawsuit set a new commitment standard for those with mental illness: that a person is an imminent danger to himself or others. That standard has proven to be tragically inadequate, a fact borne out by tragedies such as Virginia Tech and Tucson. The project examined how best to be sure those who need care are able to get care. The work exposes flaws, identifies shortcomings, holds the system accountable and points to solutions.

Judges’ comments: A tour-de-force of a medical issue that gets little attention. Exposes shortcomings in the mental health system in a compelling way. This submission showed the power of fine storytelling and narrative journalism to deepen understanding of a complex and topical health policy issue.

Place: Third Place

The children of Alameda County, Calif., have some of the worst teeth in the nation – a problem the surgeon general calls the "silent epidemic." It was documented in 2006, when a dental health assessment outlined the crisis in a study. KTVU discovered that the problem had actually gotten worse. This series looks at how bad the problem is, what contributed to it and what the community is doing about the crisis in the wake of heavy budget cuts in the state's health care programs.

Judges’ comments: This piece highlights an important problem, and in an engaging and effective way outlines the causes and potential solutions. It also draws parallels with larger problems in the United States – poor diet, a lack of access to care, and poor education about the need for healthy diets and better hygiene. It's an under-reported problem and yet the team showed a great deal of insight, and, moreover, accurately reported it.

Place: Second Place

Imagine recovering from major surgery or suffering from advanced cancer without any painkillers. That's the reality for patients in half the countries in the world, but unlike so many global health problems, this one is not about money or a lack of drugs. Morphine, the gold standard for medical pain treatment, is cheap and simple to make, and it's easy to distribute. The reporters traveled to Ukraine, Uganda and India to find out why so many patients needlessly suffer the torture of medical pain and to document the human toll of this hidden human rights crisis.

Judges’ comments: This piece was very, very effective. The reporter found people directly affected – tear-jerking footage of them, doctors trying to help, advocates, government officials and relatives. The problem is clearly outlined and there's accurate reporting of the barriers and potential solutions. It's a unique look at a problem not normally addressed in the context of an emerging nation such as India. This is a problem that affects Americans as well – access to painkillers in the context of the illegal drug trade.

Place: First Place

It's estimated that about 25 million adults in the United States have diabetes, a disease that's preventable in most cases. Diabetes is hitting hardest in communities of color, where access to health care and health choices can be limited by income, education and geography. This 54-minute radio broadcast and associated multimedia web page examines how three ethnic communities in California are dealing with diabetes and how culturally-based approaches to health care are lengthening and saving lives.

• Dealing with diabetes
• Part 1: Coping
• Part 2: Choosing
• Part 3: Teaching

Judges’ comments: This piece, it was immediately clear to the judges, was a standout. It's an unbelievably important issue and will affect a huge proportion of the U.S. population. It looks at a variety of communities and really makes human how hard it is to understand and cope with diabetes. It goes straight to the underlying problems and the costs. It is very well done. The radio medium is exploited to best effect, with numerous interviews; the writing and narrative is lively and engaging.

Place: Honorable Mention

Rau covers health care providers, including hospitals and hospices. These stories looked at trends that influence the cost and quality of health care providers and how efforts by the federal government may help or backfire. Many of the pieces were based on new data analyses. Two stories looked at new government penalties against hospitals with high re-admission rates and how places that treat many poor patients may end up being excessively punished for things beyond their control. Another story examined how efforts to judge and pay hospitals based on the views of their patients may penalize those places in large urban areas and those that treat extremely complex cases. A fourth story looked at how for-profit hospices are pushing up the costs of Medicare’s hospice benefit, in part because those hospitals were admitting patients who weren’t dying and keeping them for long periods of time.

• Medicare Prepares Rule To Penalize Hospitals With High Readmission Rates
• When TLC Doesn't Satisfy Patients, Elite Hospitals May Pay A Price
• Medicare Penalties For Readmissions Could Be A Tough Hit On Hospitals Serving The Poor
• Growing Hospice Care Costs Bring Concerns About Misuse

Judges’ comments: By pulling together government databases and other source materials, Jordan Rau presents an informed analysis of how efforts by the federal government to rein in health care costs may produce unintended effects.

Place: Third Place

Weisman covers the health care business beat in a state that has become a national laboratory for medical innovation and health policy. His coveraege includes news about the sale of the company that defined the Massachusetts biotech cluster, the affordability push by the state’s largest health insurer to the marketing of a new blockbuster drug and the plight of financially strained hospitals.

• Hospitals in Mass. feel fiscal squeeze, July 10, 2011
• Genyme deal survived a culture clash, Feb. 20, 2011
• Insurer battles identity crisis, March 20, 2011
• New Vertex ads focus on disease, not treatment, June 28, 2011

Judges’ comments: Robert Weisman writes with authority about the business aspects of health care in his coverage area. His reporting is strong and his writing is confident.

Place: Second Place

Tsouderos examined vaccination data from 5,500 Illinois public and private schools to find pockets of low vaccination rates in two types of schools: public ones serving low-income students and private ones serving wealthier students. She explained how one research paper cannot answer a scientific question and what happens when patients, scientists and physicians forget that. Tsouderos examined 12 years of funding at the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, and found the center had spent $1.2 billion, some of it on research of dubious value and quality. One of her main findings was that there was a mismatch between the way the center interpreted studies on dietary supplements and the way it interpreted studies on “mind and body” therapies. That offered an opportunity to discuss the placebo effect, and the role of the placebo in studies.

Judges’ comments: In her four submitted pieces, Trine Tsouderos reports on how members of the public and, in some cases, medical practitioners don't follow evidence-based science in adopting health practices. She uses the medical literature and extensive sourcing to buttress her strong reporting.

Place: First Place

Armstrong reported on the booming business of pain treatment – a $300 billion market characterized in many places by high prices, aggressive marketing and bogus advances that have harmed some patients and fleeced others. In laser spine surgery, Armstrong found that one of the busiest back surgery centers in the country was owned by the surgeons who operate there and earned huge margins by charging premium prices for a procedure of dubious efficacy. Several patients, lured to the center by online ads, say they were hurt by the operation. In the story "Chiropractor Backing Romney" Armstrong revealed how pain clinics are profiting from treating car crash victims with a variety of expensive therapies that are of limited or no help to people in pain. One clinic operator has been so successful with this model that he travels in his own private jet and recently built a 30,000-square-foot oceanfront mansion.

• Laser Spine Surgery's Profits Beat Google's Amid Complaints
• Chiropractor Backing Romney Expands Empire on $23,000 Patients
• Epidurals Linked to Paralysis Seen With $300 Billion Pain Market
• Video: Scantily Clad Women, Cash Used in Pain Service Ads

Judges’ comments: This is a classic example of beat reporting. David Armstrong deconstructs the $300 billion pain management market and the medical entrepreneurs who are fueling its growth. He tells personal stories and also provides a look at a troubling big picture. This work is fair, important and a great service to readers.

Jonathan Lapook

This story profiled a New Orleans grandma with advanced Alzheimer's, her 50 year-old daughter with early onset, and her 30 year-old daughter, about to become pregnant and haunted by the question - should she get a gene test, and would she really want to know if she was its next victim?

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Accompanying Story

This story follows one man as he becomes the first person to test an artificial heart in a clinical trial as he searches for a suitable heart donor.

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In the months following Katrina, the devastation -- teamed with a culture that doesn't seek help for their anxieties -- led to mental health issues nearly doubling. Officials also saw a spike in alcohol and drug abuse as well as reports of domestic violence. The statistics following the oil spill are very similar. Mental health professionals have found their biggest challenge is finding a way to treat uncertainty. In PBS NewsHour's piece entitled "How is the Gulf Coast Mentally Coping with Devastation of Two Disasters?," Health Correspondent Betty Ann Bowser and Producer Bridget DeSimone present an in depth look at the toll Hurricane Katrina and the BP oil spill are taking on the mental health of Gulf residents.

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In June 2010, the former director of surgery at Australia's Bundaberg Base Hospital was convicted of manslaughter, in connection with the deaths of three patients. A fourth patient was found to have suffered grievous bodily harm. But that was just the tip of the proverbial iceberg. Australian authorities had linked Dr. Jayat Patel to many more deaths, accusing him of hundreds of botched procedures, unnecessary operations, misdiagnoses and conducting surgeries he wasn't even qualified to perform. And perhaps most notably, he was accused of hiding his long history of similar complaints in the United States. He had been reprimanded, sued and accused of harming and carelessly killing patients long before he ever got to Australia. World's Untold Stories follows the long trail that took Dr. Jayant Patel from the operating room to an Australian prison cell.

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Jennifer Ashton

CBS News Medical Correspondent Dr. Jennifer Ashton spoke to Harry Smith about the effect of repeated concussions on both student and professional football players and what can be done to prevent permanent damage to the brain.

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To celebrate the release of her book, "The Body Scoop for Girls: A Straight-Talk Guide to a Healthy, Beautiful You," CBS News Medical Correspondent Dr. Jennifer Ashton sat down with some typical teenagers from the New York area to give them the scoop on their health on everything from body image to contraception.

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Marilyn Werber Serafini

This story is about how The Patient Protection and Affordable Care Act could spur big changes in the way that physicians are organized and eliminate solo practices.

Elizabeth Svoboda & Patrick Perry

The article addressed breakthroughs in stem cell technology and explained why their research is worth keeping an eye on, including its impact in type 1 diabetes, bone fractures and cardiomyopathy. The reporters interviewed Dr. Zannos Grekos in person about his use of stem cells and how the experimental procedure helped an individual patient. The Saturday Evening Post also provided their readership basic information to provide a framework for the otherwise controversial field.

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Noelle Robbins

This article addresses a global public and environmental health issue that impacts millions around the world on a daily basis: the production and use of toilet paper. There are organizations that correlate the use of toilet paper with access to improved sanitation in developing countries. The consumption of toilet paper - whether manufactured from virgin pulp or recycled paper content - will be a continuing global need as population growth adds to the more than 2 billion world citizens currently estimated to be lacking access to sanitation.

See this story online.

David Whelan

This story examines chelation, a medial treatment that's purpose is to remove poisonous metals from patients such as ones who've been in industrial accidents or otherwise exposed. Yet the therapy has been promoted by some doctors to heart patients, autistic kids and just as a general detoxification therapy--without any medical evidence that it works.

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Katie Drummond; Additional credit Sophia Banay Moura and Ying Chu.

The Hunger Diaries expose a new and subtle type of eating disorder support: the "healthy living" community. This community of young female bloggers is led by a group known as the "big six." These six twenty-something professional women have hundreds of thousands of readers for their personal sites, where they post photos and descriptions of every meal they eat and share every nuance of their intense workouts. They run regular races, including marathons, or complete athletic feats like 100-mile bike races, despite recurring injuries. Though they present themselves as advocates for health and "balance," the bloggers' extreme approach to food and exercise is alarming.

See this story online.

Six months after the devastating earthquake, the PBS NewsHour's global health team returned to Haiti to highlight the country's on-going challenges, as well as the resilience of its people. One of the most urgent concerns for medical officials immediately after the quake was caring for the thousands who needed amputations. Six months later emergency care was largely over, but as NewsHour Producer Merrill Schwerin and Senior Correspondent Ray Suarez describe, a long journey of recovery was just beginning for many who lost limbs.

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Part 1
Part 2

Beatrice Politi

Energy drinks are a 5-billion dollar industry. They promise to charge you up, but are they safe? This investigation put energy drinks to the test and examined the emerging research around the drinks which suggests even low levels of caffeine can potentially lead to heart attacks. We also revealed the aggressive nature of marketing in this industry and the gaping holes in Health Canada's policy and enforcement.

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In the year of concussion awareness relating to professional sports and athlete injuries, the reporters went in-depth to explain concussion, separate fact from myth and show who's most at risk. The goal was to give parents, coaches and the athletes themselves valuable news they could use.

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One in ten Asian Americans have chronic hepatitis B, but few are aware of it. The disease can cause liver cancer which is rarely detected until it's too late. As many as 2 billion people worldwide may be infected, and yet there is little public awareness about hep B and not much media attention. The PBS NewsHour, as part of its commitment to global health reporting, delved into the large numbers of Asians in the Bay Area who have hep B.

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The story was part of an ongoing series "Where America Stands." The goal was to provide a look at the state of the science, without the politics, speak to the leaders in the field, while at the same time talk about the potential impact on patients.

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This series analyzed: who would get the Medicare rebate checks, why they were needed, and showed opposing perspectives as to whether this would help fix the Medicare issue; who the North Carolina state-run high-risk insurance pool would help and how it would work; and why dozens of North Carolina doctors were opting out of Medicare and not accepting new Medicare patients.

Lynne Friedmann

Pathologists, lab managers, administrators, and technologists are taking to heart lessons learned during the 2009 H1N1 influenza pandemic as they prepare for the forthcoming 2010-11 influenza season in North America. Among those lessons: The need for better surveillance, improved rapid testing, enhanced molecular testing methods, and to invest in planning for the unexpected.

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Acting on a tip from inside the government, this story exposed the fact that the only office responsible for investigating fraud in federally funded research had been leaderless for more than a year. This important office was being neglected. As a result of this story, HHS finally advertised the job.

Hospital trustees are meant to represent their communities, yet most boards don't bear much of a resemblance to their patient base. This can diminish the trust patients have in the institution and hinder the board's decision-making and planning. This story uses data and interviews to explain the value of trustees that represent minority groups and offers tips on ways to recruit them.

The Food, Drug and Cosmetics Act of 1938 and the Amendments of 1962 charged the Food and Drug Administration (FDA) with approving drugs that are safe and effective. Many medications being sold before the Act are still available, although unapproved. One, of these unapproved medications, colchicine, had been available for years and used in the treatment of for acute gout and Familial Mediterranean Fever (FMF) among others. In June of 2006, the FDA and its Center for Drug Evaluation and Research (CDER) undertook the Unapproved Drugs Initiative to bring more medications into compliance. Under the provisions of the Act the FDA in July of 2009, awarded URL Pharma of Philadelphia approval to market a form of colchicine for acute gout and Familial Mediterranean Fever (FMF). They were given three-year marketing exclusivity for gout and a 7-year term for FMF as an orphan drug. As a result of the exclusivity, the branded version called Colcrys ® sells for about $5.00 a tablet or roughly 50 times the price of the unapproved version. In addition, all other versions of colchicine being marketed were pulled off the market, leaving Colcrys as the only available option. The article reported on the firestorm of protest from the Rheumatologists and patients using colchicine who were now required to pay these higher prices. It looked into the UDI program, what were the insurance implications, the views of URL on the controversy, what programs were put in place by URL and others to help patients pay the higher prices, and the legal underpinnings behind the approval and subsequent removal of other forms of colchicine from the market.

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Joanne Che, Martha McPhee, Judith Newman, Gale Konop Baker and Carmen Peleaz

The package, which appeared on the heels of the heated debate over new mammogram guidelines, explored the multitude of ways women, men, and society in general have viewed breasts over the centuries, with the goal of putting the revised mammogram controversy into perspective. It pulled from sociology, psychology, history, law and pop culture.

Sophia Banay Moura; Additional credit: Ying Chu and Anne Fulenwider

The Savvy Girl's Guide to Contraception condenses countless doctor interviews and academic reports into a comprehensive but fun-to-read guide to modern birth control. The Big Bang takes on female sexual pleasure in the wake of the controversy around Flibanserin, or "female Viagra."

Lane DeGregory; Additional credit: Suzanne Riss

When the Rolling Stones sang about "mother's little helper" in 1967, the anti-anxiety drug Valium had just hit the market: "And it helps her on her way, gets her through her busy day." Today, Xanax and cabernet are the new Valium, and working moms increasingly depend on them to cope with mounting stresses. The rise is unmistakable: Alcohol abuse among women 30 to 44 has doubled over the past decade, while prescription drug abuse has quadrupled.

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Mark Fuerst

Bobby Brown was not only a great ballplayer and role model, but left his mark on the game even after he hung up his cleats when he banned Minor League players from using smokeless tobacco as President of the American League. Just as this cover story was going to press, Major League Baseball announced it would consider a smokeless tobacco ban when players' contracts are renegotiated this year. Thanks to Brown, ballplayers and the youngsters who idolize them no longer think baseball and tobacco go together like peanut butter and jelly.

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Joshua Kor; Additional credit Roane Carey

After Sergeant Chuck Luther was seriously wounded by mortar fire while serving in Iraq, doctors pressed him to sign fraudulent documents saying his blindness was caused by a pre-existing condition, making him ineligible for disability and medical benefits. When Luther refused to sign, Army doctors put him in a closet and held him there for over a month, with armed guards enforcing sleeping deprivation -- keeping the lights on all night, blasting heavy metal music at him all through the night.

When Luther tried to escape, he was pinned down, injected with sleeping medication and dragged back to the closet. Finally, after over a month, the sergeant was willing to sign anything -- and he did, signing his name to discharge documents saying he had a pre-existing illness.

Luther's case was by no means an isolated incident. Military doctors have pressed thousands of other soldiers wounded in Iraq and Afghanistan into signing phony discharge papers for a "pre-existing" condition, saving the military billions of dollars in disability and medical benefits.

See this story online.

Jason Roberson

Baylor Health Care System, a Dallas-based not-for-profit hospital system, is working to become an accountable care organization by 2015. Reaching that goal will not be easy. Like others exploring ACOs, Baylor must contend with decades-old federal and state laws once written to protect patients but now outdated for new-age payment models. Internally Baylor still must manage an imminent cultural shock of physicians' wages being determined by stacks of quality data.

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Michael Schroeder

One in 50 health care providers are practicing without a license. The majority of Angie's List members -- 91 percent -- who took our online poll say it's crucial their providers be licensed, yet half never check. Those who practice without a license either never had one, had it suspended or revoked or allowed it to lapse. While the latter is most common, consumer experts recommend not taking a health care provider's word. One report reveals two-thirds of doctors who made 10 or more malpractice payments between 1990 and 2005 faced no serious consequences, such as losing their license. Others just went to another state to practice.

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Michael Schroeder; Additional credit Kristy Broering and Sue Wiltz

Twenty percent, or roughly 60 million people, sleep fewer than six hours a night, up from 12 percent in 1998. Lack of sleep is attributed to 100,000 car accidents and 1,500 deaths on the road each year, but researchers say you're also at increased risk of heart disease, high blood pressure, diabetes or stroke if you regularly get less than seven to nine hours a night.

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Jordan Lite

Accumulating research demonstrates that information users post on social-networking sites accurately reflects their real-life behaviors, such as sexual activity and possibly mood, violence, alcohol and substance abuse. The findings raise ethical dilemmas about whether and how that information should be utilized by health-care providers.

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Rhonda Koulermos

Richard Groat, executive at a TV station in Columbus, Ohio, developed early-onset Alzheimer's at age 52. His wife Gloria served as his primary caregiver while running a small business and caring for their aging parents. This is the story of their 16-year journey with Alzheimer's.

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Rebecca Adams

This article examined three central questions of comparative effectiveness research for the health care debate: How will the results factor in coverage decisions by insurance companies and government health programs?, how will the results of broad-based studies of large populations sort with the movement toward personalized medicine?, and will doctors and patients, and the political establishment, accept the research?

Peter Aldhous, Jim Giles & Brad Stenger

They are billed as "healthcare professionals who spend years building expertise in their fields." Using materials grounded in science, they educate their peers in the risks and benefits of drugs. This is how Pfizer, the pharmaceuticals giant, describes the experts it hires to lead forums in which doctors are lectured on the use of its products. Research found that some of Pfizer's experts have been disciplined by state medical boards for deficiencies in patient care, while others have been reprimanded by the U.S. Food and Drug Administration for how they conducted drug research trials. These findings added to a growing controversy surrounding the pharmaceutical industry's efforts to market drugs by influencing patterns of prescribing.

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This story examined and analyzed the compensation of more than 100 CEOs of not-for-profit hospitals in California. The total average compensation was more than $730,000 a year, raising questions as to whether pay was excessive and whether the institutions were providing enough charity care to the surrounding communities.

This Special Report looks at the potential and current use of fraud-fighting technologies such as predictive modeling and analytical software by the Medicare program to root out Medicare billing fraud and stop payment before claims are filed. Health care fraud in the Medicare and Medicaid programs is a multi-billion dollar a year problem and James Swann spoke with industry experts about why such techniques are important, what is being used today by the Department of Health and Human Services, what can be expected in the future, and outlines congressional interest in the matter.

Respiratory care professionals are well-versed in ventilator care in the acute setting, but few are fully aware of the serious challenges that families of children who need long-term mechanical ventilation face once they transition to home care. This article describes the clinical, emotional, and logistical difficulties of home care and gives dramatic personal examples of life-threatening situations that families have encountered. More families than ever before must confront these issues as technological advances allow more medically complex infants to survive. It offers possible solutions that include thorough patient education and professional training. It also describes a legislative initiative that would empower respiratory therapists to contribute their unique combination of knowledge, technical skills, and compassion to fill significant gaps in skilled staffing in the home care setting.

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A review of state laws and regulations by the Investigative Reporting Workshop found that 12 states and the District of Columbia do not require medical X-ray operators to be credentialed or to meet specific competency standards. Of the 38 states that do license or accredit technologists, requirements vary greatly - from a mere 12 hours of operator training to a two-year accredited radiography program. The Workshop's survey also found that some states do not conduct routine inspections of medical imaging machines. The lack of standardization increases a patient's risk of misdiagnosis and excess exposure to radiation, at a time when regulators struggle to keep up with new types of imaging equipment.

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This article provides a discussion of five best practices for the successful employment of physicians: 1) maintain the culture of private practice, 2) involve physicians in governance, 3) productivity-based compensation, 4) dedicated management team and 5) clear and transparent objectives.

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For years, "live case demonstrations" have been signature features of certain medical meetings. In a live-case, a real-live patients, with real, often life-threatening disease, undergo procedures with the cameras rolling, a remote panel of expert 'moderators' asking questions of the operators or providing suggestions, and an audience of physicians, sometimes thousands, watching everything unfold in real time. In recent years, the American College of Surgeons (ACS) has banned live cases from its meetings, and the American Association for Thoracic Surgery (AATS) and the Society of Thoracic Surgeons (STS) issued a statement prohibiting live case broadcasts to the general public and discouraging the use of live demonstrations to audiences of any kind when taped cases could be used instead. By contrast, interventional cardiology meetings are relying even more heavily on what I call the "technological, logistical, and medical wizardry" that are live-case demos and for the first time have issued a set of controversial guidelines. This story explore the pros and cons of live-case demos.

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"Homeless with Cancer" reveals stories about living with a life-threatening disease on the streets of Birmingham, Alabama. The reporter sought to give voice to men and women in Birmingham who find themselves facing yet one more challenge with far fewer resources than most of us have within our reach. The result was a year-long immersion in a community few people are aware of.

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A review of state laws and regulations by the Investigative Reporting Workshop found that 12 states and the District of Columbia do not require medical X-ray operators to be credentialed or to meet specific competency standards. Of the 38 states that do license or accredit technologists, requirements vary greatly - from a mere 12 hours of operator training to a two-year accredited radiography program. The Workshop's survey also found that some states do not conduct routine inspections of medical imaging machines. The lack of standardization increases a patient's risk of misdiagnosis and excess exposure to radiation, at a time when regulators struggle to keep up with new types of imaging equipment.

See the story on the web.

At a time of national concern over health care costs, hospitals are becoming marketplace powerhouses that dictate higher prices to insurers and employers. This phenomenon is especially evident in northern California. Prominent hospitals and networks, especially those in the San Francisco Bay Area, can keep raising prices beyond inflation because their sizes or reputations give them clout in negotiating rates with insurers, researchers say. Yet high prices don't always equate with superior care. Through new construction and expanding its doctors' groups, Sutter Health is enhancing its position as one of the most dominant hospital systems in California. In addition, Sutter is further ahead of many competitors in fashioning itself into a so-called accountable care organization, responsible for coordinating care between hospitals, specialists and primary doctors. KHN extensively analyzed California hospital prices and interviewed dozens of experts and hospital executives to illustrate the impact of Sutter Health, the priciest chain. Working with public radio station KQED, KHN had several text stories, photos, a radio story and an interactive chart that compared hospital prices and quality by hospital system, location and year.

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When the ground shook in Port-au-Prince, Haiti, on Jan. 12, the magnitude-7 earthquake left behind up to 4,000 instant amputees in a land where there's little mercy for disability. The tragedy there highlighted a grim global reality: In the United States and around the world, the number of amputees is rising dramatically, driven by war, disease and natural disaster. In the iterative blog Haiti's Amputees: Building A Life Worth Living, a team of msnbc.com journalists - medical reporter JoNel Aleccia and multimedia producers John Brecher and Carissa Ray - explored a unique community forged out of tragedy in the rural heart of Haiti.

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The Affordable Care Act "the new law that overhauls the way health insurance is provided in the U.S." has surfaced as an issue in the Kansas gubernatorial race. Republican nominee Sam Brownback has been critical of the plan, but the documentation he uses to support his position has come under fire.

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Part 1
Part 2
Part 3
Part 4
Part 5

This piece investigates why an ever-increasing number of Kansas children are being prescribed psychotropic medications intended for adults.

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Part 1
Part 2
Part 3
Part 4
Part 5

Hospitals are reporting sharp increases in uncompensated care, and some report that the stereotype of uncompensated care patients being mostly homeless no longer applies. A more accurate description would be "A 30- or 35-year-old without health insurance who two months ago worked at Sprint," according to a Kansas City hospital official. This two-story package explores the trend in uncompensated care, and focuses on one patient who fits that new description.

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Part 1
Part 2

Sandra Fryhofe, M.D., discusses legalizing medical marijuana from a historical, pharmacological and legal perspective.

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Sandra Fryhofer, M.D., addresses a recent study on NSAIDs and cardiovascular risk, she discusses the efficacy of e-cigarettes in smoking cessation, and reports on a study that links nuts to cholesterol and triglyceride levels.

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Jennifer Wolff Perrine; Additional credit: Lucy S. Danziger, Sara Austin

Half of all Americans, at some point in their lives, will experience a life-altering trauma -- a debilitating injury, a tragic loss, a brush with death. How one addresses a tragedy can make an enormous difference in how one recovers. Researchers now describe the aftermath of such events as "post-traumatic growth," and say that the majority of people who live through such traumas actually report that their lives become richer and more meaningful. Major findings include that the most common form of life-altering incidents - traffic accidents - actually injures more women than men every year. Two-thirds of people who live through a traumatic event report that their lives are actually improved by the experience.

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Fernanda Moore; Additional credit: Kristen Dold and Sascha de Gersdorff.

This story delves into the rising rates of medical misdiagnoses, statistics that come at frightening costs: Up to 40 percent of patients are misdiagnosed every year and, of those, some 100,000 will die as a direct result. In "Survive Your Doctor," Fernanda Moore investigates why young women are at particular risk and examines how a perfect storm of fixable factors -- outdated medical school teaching, lazy patients, a focus on specialists, doctor fatigue -- is endangering their lives. Through a series of anecdotes and analysis, Moore shows readers how to be their own health advocates. A series of four service sidebars hits home the story's overall message: The smartest patients enter the exam room prepared.

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Gretchen Voss; Additional credit: Lisa Bain

In late 2009, Women's Health identified and began reporting on a disturbing sexual health trend: the reemergence and rise of casual, unprotected sex among young adults. The carefree, "don't' ask, don't tell" attitude seemed particularly jarring in light of the statistics -- STD rates were skyrocketing (thanks, in part, to this ill-advised blasé behavior), with human papillomavirus (HPV), gonorrhea, and herpes infections at modern highs. "I don't ask questions that I don't want to know the answer to," says one of the sources interviewed for the piece. By digging into psychology, biology, and social norms, Voss paints a clear, crucial picture of a major health threat, and arms women with what they need to know to stay safe.

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Gretchen Voss; Additional credit: Lisa Bain

In "How Stress Messes With Memory," Gretchen Voss explains how tension tampers with the inner workings of the brain, in a way that's both intricately riveting and easy to understand. The article delves into research proving that gender plays a major role in how people deal with pressure -- groundbreaking, up-to-the minute information that even many neuroscientists didn't know at the time the article was reported. Inventive graphic sidebars enhance the overall service, with clear strategies for how to better remember things when your nerves are jangled (even all those computer passwords!), and ways to find the sweet spot between mellow and meltdown when our brains are able function at optimum capacity.

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Bob Drury; Additional credit: Leah Flickinger

The U.S. Defense Department specifically prohibits women from direct combat missions. But in the Iraq and Afghanistan combat zones, there are no front lines, and as Bob Drury writes in Invisible Soldiers, "the piece of ground you occupy can, at any moment, turn into a battlefield." Thus for the first time in U.S. history, women soldiers are facing the same dangers as men -- but unlike their male counterparts, they come home to a society that can't comprehend what they've been through and an outdated veterans' support system that's scrambling to meet their needs. With vivid scenes and scathing personal stories from three women who served, this article describes the alarming affects of post-traumatic stress disorder on female soldiers (and how it's been under-studied by the military). It also discusses serious mental-health issues and sexual trauma.

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Susan Crandell, Ginny Graves, and Emily G. W. Chau and Julie Bain

In Part 1 of the series, top dermatologists helped readers learn the signs of basal cell, squamous cell and melanoma skin cancers, what the lesions look like and what the latest treatments are. In Part 2, experts talk about what's so seductive about the perfect tan even though it's dangerous. They acknowledged the pleasure factor and body-image aspects of tanning, but also provided good reasons why you should let it go, plus advice on how to do that. In Part 3 the focus was on prevention, with advice on how to examine your own skin between yearly appointments with your dermatologist. The piece used a model's body and included tips sprinkled over the appropriate body parts. It also showed how to spot a pre-cancer.

Habiba Nosheen and Hilke Shellmann; Additional credit: Cindi Leive

This piece shows a little-known yet explosive corner of the practice: the growing phenomenon of military wives serving as surrogate mothers. (Even though active-duty armed forces members are less than one percent of the U.S. population, military wives constitute roughly 19 percent of all surrogate moms, according to one survey.) And as "The Most Wanted Surrogates in the World" revealed, such mothers are hotly in demand. While civilian insurance companies generally don't cover surrogate births, the taxpayer-funded insurance provided to all military families does often pay for surrogacy -- making military wives a low-cost alternative for would-be parents.

See this story online.

Lorenzo Benet; Additional credit: Nancy Jeffrey

If there is a single heartbreaking reminder of the costs of war, it lies in the burned and maimed faces of the young men and women injured in Iraq and Afghanistan. Since 2007 Dr. Timothy Miller, a prominent plastic surgeon at UCLA Medical Center, has devoted his skills to helping these soldiers heal, physically and emotionally, by restoring their faces -- often feature by feature over multiple surgeries. As co-founder of the nonprofit Operation Mend, Dr. Miller and his team have performed some 150 operations on more than 30 wounded warriors, with impressive results that his patients say helped them start their lives anew.

Amanda Williamson; Additional credit: Nancy Jeffrey, Lorenzo Benet

How do adolescents with autism manage in high school, where youngsters can be subject to ridicule and exclusion for the most trivial of reasons? That question led us to Joey Hersholt, a 17-year-old California teen with mild autism and obsessive-compulsive disorder, enrolled by his parents in a promising program at UCLA. Its goal: To teach teens with autism the building blocks of friendship. Following Joey and his family through four-months of classes, reporter Lorenzo Benet and photographer David Butow gained unusual access to the hopes, dreams and struggles of a boy who is different -- and chronicled his gradual social awakening.

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Linda Marsa

Many Americans anxious and confused when the Affordable Care Act -- President Barack Obama's health care reform law -- was enacted in March 2010. This story explained the major implications of the law so that Family Circle readers could learn what the changes mean for them and their families.

Marina Khidekel; Additional credit: Cindi Leive, Wendy Naugle.

"I Sued My Ex for Giving Me an STD -- and I Won" tells the story of a young woman, Karly Rossiter, who filed a groundbreaking and highly controversial civil lawsuit against her ex-boyfriend for infecting her with human papillomavirus. HPV is the most common sexually transmitted infection. This piece raised important questions about trust, integrity, personal responsibility and how far women should go to protect their sexual health. Rossiter took her case all the way to the Iowa Supreme Court, which upheld that her ex Alan Evans, a dentist, had been negligent and acted in willful and wanton disregard for her health. Evans was ordered to pay Rossiter $1.5 million in damages -- one of the largest known monetary awards in an STD case.

See this story on the web. 

Jennifer Wolff Perrine; Additional Credit: Lucy S. Danziger and Sara Austin

"This woman has a secret" details the vastness of the infertility industry and explains the consequences of its ongoing secrecy: without openness, there is little financial or political support for research that can improve couples' chances of conception, and a lack of emotional support structures that can salve the consequences of an expensive and emotionally wrenching medical process. Research for the story found 1.1 million American women undergo fertility treatment each year, and 12 percent of couples will experience fertility problems. Insurance companies refuse to cover infertility, classifying as an elective procedure akin to cosmetic surgery. Fifty-seven percent of in vitro fertilization cycles fail. Pregnancy rates at one clinic increased after several mind/body sessions helped ease depression and anxiety.

See this story on the web.

Roxanne Patel Shepelavy; Additional credit: Lucy S. Danziger and Sara Austin

Kirby Brown, a healthy, athletic, 41-year-old woman, turned to self-help guru James Arthur Ray to help her find spiritual, financial and relationship fulfillment. Instead, she--and two other followers--wound up dying during a deliberately intense sweat lodge ceremony at a Ray retreat in October 2009. "When Self-Help Harms" explores the events that led to Brown's frightening death, and exposes the follies of the unregulated, unfettered self-help industry, where a charismatic leader like Ray can make millions off the faith of his followers, with increasingly little regard to their mental or physical well-being.

See this story online.

Taffy Brodesser-Akner; Additional credit: Lucy S. Danziger, Sara Austin

Following the author's first childbirth delivery, which was life-threatening and psychically traumatic, she explored the line between holistic and medical births in preparation for my second delivery. She wanted to know how much control she could have over the birth of her child  --  how much any mothers can have  --  and how much to cede to my caregivers and to fate. Research found extremists on both ends of the spectrum  --  vigilant homebirthers and women who were grateful for the technology that allowed them a safe and healthy delivery.

See this story on the web.

Molly Triffin

In the piece, Cosmo gives readers an insider look at the female-unfriendly field of cosmetogynecology. It explains the type of cosmetic (and often totally medically unnecessary) procedures doctors perform, like tightening the walls of the vagina or shortening the labia and/or skin around the clitoris. 

Cheryl Platzman Weinstock

This story also pulls together new research about factors influencing the rise of depression in menopausal and perimenopausal women's age brackets, including a cultural shift in midlife women reflecting on their life and, if that doesn't measure up to some standard, they feel like they failed. Also, the extent to which genetics and other temporary health issues, such as postpartum depression, can predispose someone to midlife depression is evaluated. Most importantly, many midlife women don't realize they're depressed because many symptoms of menopause and depression look and feel the same and can confuse women. This story gives readers the tools to help distinguish between the two and get the medical attention that could change their life.

See this story on the web.

Marina Khidekel; Additional credit: Cindi Leive, Wendy Naugle

This story introduced readers to the new and little-reported phenomenon of kidney transplant chains. It tells the story of Christina Do, a young woman who decided to donate a kidney to a complete stranger and ended up saving 11 people's lives -- and of the 22 people whose lives she touched forever. Christina Do sparked the longest kidney chain ever started by a woman and the second longest ever at the time the March 2010 issue went to press.

See this story on the web. 

Katharine Davis Fishman

The article reports on whether and when bisphosphonates are safe to take. It describes the author's experience, explains osteoporosis (and osteopenia) for the lay reader and tells what bispohosphonates do to treat it, reports on the history of the drugs and their approval by the FDA, reports on studies that have been done on bisphosphonates and their risks, and in two sidebars explains the FRAX test and medicines now in the pipeline. It concludes that bisphosphonates should be used for osteoporosis, not osteopenia, unless the patient's FRAX score indicates high 10-year-risk of hip and or other osteoporotic fractures, and that if she then takes the bisphosphonates she should be checked at 3 to 5 years to determine whether she still needs it.

See this story on the web. 

This story explores LDL cholesterol, and points out that LDL cholesterol is actually an umbrella term for 11 different subtypes. Standard cholesterol blood tests do not distinguish between these subtypes, yet according to a series of recent findings, only three of these subtypes are associated with heart disease. This has profound implications for cholesterol control and diet. For instance, we are told to restrict our intake of saturated fat, advice which generally leads us to eat more carbohydrates. Yet while saturated fat from dairy and very likely red meat increases LDL, it essentially only increases the 8 largely benign forms of LDL. Conversely, carbohydrates in the diet increase the three forms which are dangerous, and lowers good cholesterol. Thus, "healthy eating" in the form of low fat foods that are comprised largely of carbohydrates, increases the risk of developing heart disease. Moreover, we are medicating millions of Americans with cholesterol reducing drugs despite the likelihood that many of them only have elevated forms of LDL that are benign.

See this story on the web.

Kevin Cook

"Sleep Is a Battlefield" is an account of the latest research and findings in sleep science, from military and law-enforcement applications to news to help readers sleep better.

Tim Darragh

Based on a vague tip, Darragh, who was assigned the Business of Healthcare beat in August, began probing reports of a CMS investigation at Lehigh Valley Hospital. He found that the hospital was under fire for arming its security guards with Tasers. They used the weapons at least four times on patients. The hospital decided to disarm its security workers, but the news prompted an uproar among readers and health professionals.

See this story on the web. 

Julia Hunter; Additional credit: Elizabeth Lawyer, Jeffrey Aaron

After several drug companies made their first disclosures of the physicians on their payrolls -- many required to do so following government settlements -- 17 medical professional practicing locally showed up on the lists. Of the regional doctors, a physician speaking on Attention Deficit Disorder topped the list, bringing in $32,600 in a nine-month span. Doctors argued the practice was necessary, while opponents argued it created a conflict of interest.

Jennifer M Molin, Chip Hunt

The Healthy State Collaborative Local Journalism Center (LJC) is a two year project aimed at strengthening collaboration among six public broadcasting stations geographically centered in Florida. The partnership provides the opportunity to super serve the residents of this region with an intense journalistic commitment to the unifying topic of health care.

The primary goal of the Healthy State Collaborative is to grow the collective audience through the creation of high quality journalism locally delivered through multiple platforms. Significant attention will be directed to engaging a younger, well-educated audience (ages 20-45) in addition to the core public radio audience (ages 45-65) through compelling content and community engagement opportunities that include audio, video, text, photos, blogs, social networking, dynamic syndication, and mobile applications.

See this website.

Julia Hunter

Twenty-five babies in the region had died in the last five years unnecessarily. Although, historically, these type of deaths would have been attributed to Sudden Infant Death Syndrome, a local medical examiner's scrutiny revealed that's actually almost never the case.

See this story on the web.

Julia Hunter

Three doctors in the local coverage area had been hired as spokesmen for national pharmaceutical companies despite previous black marks on their records. The doctors and their employers seemed unconcerned, asserting this wasn't an issue, even though one of the doctors was accused of fondling himself in front of a patient. Drug companies tout that they hire the best of the best, but these findings, show this is a questionable statement.

See this story on the web.

Jennifer Gordon

Thirty years ago, St. Joseph had two hospitals but has since gone down to only one. This article explores why St. Joseph decided to consolidate its medical facilities and the challenges a new hospital would have if it tried to come into the community. Ag new hospital would lower insurance premiums for residents but could not make enough of a profit off of a blue-collar, Medicare-heavy community.

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Erin Carlyle

Dan Buettner spent years exploring the world's "Blue Zones" -- hotspots of longevity, from Okinawa, Japan, to Nicoya, Costa Rica -- where people live to be 100 at astonishing rates. Now he's distilled the wisdom of these cultures into nine ways to prolong your life, spelled out in his best-selling book, "Blue Zones." But Buettner didn't stop there. His next step was to get an entire community to adopt the principles. Albert Lea, Minnesota, is the first intentionally created Blue Zone.

See this story on the web.

Chris Vogel

This story reveals that Houston residents are victim to industrial polluters located in residential areas and that state and local regulators routinely fail to protect citizens, instead leaving people with no recourse other than to seek protection from the courts on their own dime, effectively ensuring that most residents never receive relief from environmental and health hazards. Houston is unique in that the city does not have zoning laws, meaning that a strip club, convenience store or industrial plant is allowed to set up shop in residential neighborhoods. Vogel's story examines several examples of how citizens have tried to safeguard themselves and get the polluters to move from their neighborhood  --  mostly in vain.

See this story on the web.

Deborah Schoch and Danielle E. Gaines

The foreclosure of a home is more than a financial transaction. It also is a hidden human drama, with potentially devastating psychological consequences for those involved. For Ethelda Lopez, it ended her lifelong dream of a home to retire in. Her story is one of literally thousands in Merced County, which with 8,389 filings ranked first in California for foreclosures in 2009, and sixth among counties nationwide. Psychological problems, including anxiety, sleeplessness and depression, wreaked havoc during the foreclosure crisis.

See this story on the web.

Emily Bazar, Julie Lynem

Even in idyllic San Luis Obispo County, on California's Central Coast, the economic crisis has hit families hard, and children especially hard. As families become unmoored, their kids act up in school and at home, self-medicate with drugs and alcohol, and suffer mental health problems such as depression and anxiety. Meanwhile, institutions that serve families  --  schools, county agencies, churches and nonprofits  --  are grappling with budget cuts and unprecedented demand. This is what an 11-week partnership between the Center and the San Luis Obispo Tribune News uncovered.

See this story on the web.

John Gonzales and Tom Kisen

The nation's 75 million baby boomers are certainly not immune from the crisis in health care, and even those in relatively rich Ventura County are feeling the pressure of spiraling costs of both medical procedures and insurance. That is, if they still have insurance. Many Ventura County middle-class baby boomers have been pummeled by the economy, with jobs lost and health insurance disappeared, and the safety net they paid into during better times not designed to help them.

See this story on the web.

Jim Doyle

"Drugmaker's quick slide from the top" is a blow-by-blow account of KV Pharmaceutical Co. downfall, including its checkered history, family ownership interests and squabbles, executives' key mistakes, and a corporate ethic gone awry. "Hospitals tangled in owners' troubles" is an investigative story of a failing St. Louis area hospital, a rare glimpse into the hidden financial world of distressed hospital chains and a scandal involving the potential loss of $500 million in investor funds. "Area hospitals battle infections" is a close examination of the infection rates (surgical site and central line) of two dozen hospitals in the St. Louis area, based on five years of data. "Cases shed light on drug firm's tactics" offers the story-behind-the-story of Forest Laboratories' criminal guilty plea that resulted from its aggressive marketing of unapproved antidepressants that were prescribed by pediatricians to children.

Megan Ogilvie

In "Homeless and pregnant," Ogilvie writes about the people who care for society's most downtrodden and desperate after earning the trust of her sources. The story chronicles the Homeless At-Risk Prenatal Program, the only one of its kind in North America. For the story, "A young abortion doctor's dilemma," Ogilvie wanted to find out who were the young doctors of today taking up medicine's most controversial surgery. It took six months to research and write the story because so few doctors at first would speak to her about abortion training and practice. "An uncommon gift," tells readers about the people who agree to take part in transplant's most ethically precarious surgery. Toronto General Hospital has the only program in North America that allows people to donate half of their liver to a stranger. The story took a year to complete.

Guy Boulton

Six stories comprise this series that covers the Republican health care proposal, health insurance providers, bad hospital debt and more.

"GOP health plan takes small steps"
"Insurers alone can't be blamed for rates, economists say"
"Health care tries to figure out what works best"
"Research key in slowing health care spending"
"Providers of health care in recovery"
"No big increase in health charity with job losses"

Jordan Rau's pair of stories on surging California hospital prices explores the national discussion of rising health care spending. He spent weeks analyzing hospital data compiled by state regulators and interviewed a broad range of experts, hospital executives, employers and others. The stories reached state and national audiences when they were picked up by the Bay Area News Group chain of newspapers, KQED radio and NPR. In another story, Rau reported evidence that areas of the country widely praised for restraining medical spending were in fact becoming more expensive. This story cast doubt on the widely-held belief that lower-priced areas could be models for the rest of the country. In addition, Rau used his data-gathering skills to identify a significant problem among people who have insurance: balance billing. Then, he crafted a poignant story about one family facing the burdens balance billing imposes.

"California Hospitals: Prices Rising Rapidly, But Quality Varies"
"As Hospital System Expands, Patient Advocates Worry"
"Medical Spending Spiking In Once Thrifty Areas"
"The Price They Paid"

Jason Kane, Betty Ann Bowser, Bridget DeSimone

The PBS NewsHour's Health Beat explores some of the main health issues facing our country today: insurance coverage, food sources and mental health. Formerly financially nimble communities now lack goods and services for their residents, resulting in obesity, diabetes and high blood pressure. Bowser and DeSimone also went to Massachusetts to see what lessons that state could offer for the national debate on health care. Finally, a segment from New Orleans: After Hurricane Katrina, life for citizens in the Gulf became about tending to basic needs: food, shelter and the next paycheck. Processing heartache, frustration and the enormity of devastation would have to wait. Then the BP oil spill dealt Gulf residents another blow. These two catastrophes created a climate for depression and domestic violence. DeSimone and Bowser speak with survivors and question why so few mental health care services are available.

Find this story on the web.

Julie Rovner

These stories represent Rovner's in-depth coverage of the final debate, passage and early implementation of the Patient Protection and Affordable Care Act. The first story points out that the most controversial element of the measure, the requirement that most individuals have health insurance, was an idea originally introduced by Republicans, not Democrats. The second story is one of several segments on All Things Considered where Rovner researched and answered specific listener questions about how the law could affect them. These segments proved highly popular with listeners and also provided an opportunity to highlight elements of the measure that might not have merited an entire radio piece. The third story is Part 3 of a series on how provisions of the law are aimed at improving the provision of primary care medicine. This piece looks at the role of mid-level health. Parts 1 and 2 of the series examined "medical homes" and solo practitioners. The final story was one of several examining the backlash against the law. This one pointed out that while Republicans were running on a platform urging repeal, many of their usual allies in the business community weren't necessarily on board.

See this story on the web.

Marilyn Serafini; Additional credit: Bara Vaida

These stories lead up to and follow the health care reform efforts in 2010 and highlight the numerous issues that important both to passage and to the effects on the various stakeholders.

Betsy Q. Cliff

This beat is primarily concerned with helping readers make decisions about their own health. Under that charge, the reporter concentrated on reporting on health trends, developments or issues that make a difference in the lives of readers.

This is a series of news stories about how salt intake is excessive in most countries around the world, and the keyrole that salt plays in hypertension, leading to higher risk of stroke, heart attack and premature death. It also covers attempts in different places to reduce sodium in the diet, and the cost-savings this would generate. And the series includes a feature article about whether the US will join other countries that have already successfully implemented population-wide salt reduction policies.

See the story on the web.

Women who are diagnosed with breast cancer may feel rushed to make decisions such as to have a lumpectomy or a mastectomy, or to have reconstructive surgery immediately, later or not at all. This feature looks at all these choices and gives helpful information about each of these procedures, as well as expert opinions on their pros and cons.

See the story on the web.

Certain osteoporosis drugs can put women at risk for other skeletal problems. This story looked at the benefits and often serious risks of bone preservers (biophosphates), bone stimulators (teriparatide), estrogen impersonators (such as raloxifene), calcium savers (calcotonin) and other osteoporosis drugs on the horizon.

See the story on the web.

An estimated 26 million Americans suffer from back pain. While doctors have treated back pain for decades with surgeries, research shows that this is no better, and sometimes worse, than low-tech treatments. On the flip side, research shows that many people who suffer from back pain do NOT receive treatment that does work. This feature takes a close look at simple treatments that do work to help.

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Parija Kavilanz

"Kids caught in the Medicaid pay crossfire" brings to light a troubling trend of pediatricians and pediatric specialists who are either no longer taking new Medicaid patients or even dropping existing ones because they felt that the payment from the government program was not adequately covering their business costs. "Tylenol recall: Serious side effects investigated," "Tylenol plant: From bad to worse" and "Behind the ‘phantom recall' of Motrin" investigated a Johnson & Johnson's McNeil unit recall of more than 50 children's versions of these non-prescription Tylenol, Motrin, Benadryl and other drugs on April 30, 2010, for serious quality and safety concerns The company remained tight-lipped about the specific problems with those drugs, manufacturing problems at the plant that made those recalled drugs and consumers complaints received about the recalled drugs.

Chronic inflammation is associated with an abundance of fat cells in the belly. Irritants spewed out by fat cells drive white blood cells and inflammatory chemicals to stay in high gear. This can trigger autoimmune diseases, cancer, heart disease and Alzheimers. By cutting back on sugar, keeping weight down and exercising regularly, women can avoid chronic inflammation and its consequences.

See the story on the web.

This story points out that even when family members are in agreement and even when end-of-life issues have been discussed long beforehand, difficult decisions remain.

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This investigation found that while the overall number of deaths of inmates in California state prisons decreased, the number of inmates whose deaths might have been prevented with better care actually increased. It also found that independent reviews of medical facilities conducted by California's inspector general for prisons revealed that California's prisons routinely violated medical policies and protocols, leading to delays and denials of treatment for inmates. Also, California officials' repeated refusal to fund the receiver's turnaround plan delayed construction of sanitary medical facilities, computerization of health records and hiring independent executives to oversee medical care at prisons. The report also found that the lack of infrastructure improvements and systemic change contributed to lapses in care for inmates that range from dangerous to deadly.

See the story on the web.

The story marks the 25th anniversary of the first heart transplant in Oklahoma, a night born of tragedy but propelled by hope and orchestrated by the charismatic Dr. Nazih Zuhdi.

See the story on the web.

This series examined issues surrounding the EPA and its regulation of toxic chemicals in the United States. 

See the story on the web.

Whether people were for or against the new health care law, one issue seemed universal: few people understood it. With that in mind, WebMD decided to tackle health care reform confusion through a variety of channels that included taking reader questions directly to the White House. Here are some highlights of what we did:

1. Got Health Insurance: What Health Reform Means. This story outlined in an easy-to-read fashion the changes that were already in affect from the new law and those that were upcoming.

2. Health Care Reform: Your Questions Answered. HHS Secretary Kathleen Sebelius answers questions on video from WebMD readers about the changes to health care that took effect Sept. 23 of last year.

3. Health Insurance Navigator. Because health care questions are ongoing, we established this blog to help readers better understand how to get the most out of their health insurance along with changes from the new health care reform law. This particular post was the most popular from last year.

This story discussed the problem of the growing trend for Big Pharma to outsource clinical drug trials overseases and enroll in countries with poor oversight. Current Medicine also interviewed in July the author of the OIG report, Joyce Greenleaf, Regional Inspector General for the HHS. Subsequent to our coverage, Vanity Fair and other national sources issued their own stories.

Marilynn Preston

Four stories comprise this submission. "Dashboard Delirium" is based on the news coming out of the Consumer Electronics Show of 2010, and deals with an accelerating consumer health issue: driving while distracted. The column blends news, commentary and expert opinion, helping readers steer clear of a growing public safety problem. "When Haiti Hits Home" links the tragic news about the earthquake in Haiti to the stresses felt by people around the globe, even Americans. The column helps people frame the tragedy and cope with it, giving readers stress reduction skills they can use in their everyday life. "Bored With Health Care Reform?" calls attention to the need for more focus on prevention and wellness, and speaks to the importance of not only reducing costs of medical care but also reducing demand. In "Ride Your Bike to Work! Spin You Can Believe In," I call attention to National Bike to Work Day and month and encourage people to ride more, build strength, save fuel, lower stress.

Shuka Kalantari

Health Dialogues hears the story of a young Iraqi refugee and asks what services are made available to people fleeing conflict countries.

Listen to the story on the web.

Sue Pondrom

Four stories comprise this body of work. "Best Intentions Gone Awry" describes how Congress attempted to support experimental trials of islet transplantation for Type 1 diabetes, yet the unintended  consequences of their action are fewer islet recipients and increasingly fewer islet transplant centers in the U.S. In "Can Generics Be Trusted?," transplant physicians are concerned about the safety of generic versions of the mainstay immunosuppressant drugs organ recipients need to stay alive, but, concerns have been based on anecdotes, not published studies. The final story, "Survival Rates Increase in Bowel Transplantation," explores the field of bowel transplantation, which has remained relatively unknown by both the public and medical professionals who could potentially refer patients. "AMR: A Difficult Problem With No Easy Solution" explores Food and Drug Administration discussions on Acute Antibody-Mediated Rejection, the primary cause of organ rejection in transplant recipients.

Diane Suchetka

Brie Zeltner

Brie Zeltner's stories provide consumers information about the epidemic of vitamin D deficiency in the nation and the debate over changing the daily recommended allowance; told a moving, personal story of the difficulties of living with the chronic pain of migraines; warned readers about the link between sedentary time and early death; and identified the most commonly misdiagnosed illnesses and how to spot the signs before it's too late.

Molly Hennessy-Fiske

These beat entries investigate one of the Los Angeles area public hospitals, Olive View-UCLA Medical Center.

"Hospital put babies at risk, audit finds" and "Infant care at hospital probed" showed hospital staff not only endangered babies by running a makeshift beauty salon in the neonatal intensive care unit, they also violated state regulations by keeping babies in the unit rather than transfer them to better equipped hospitals. "Death spotlights gaps in surgery center oversight" highlights the case of Maria Garcia, a mother of five who died after she was operated on by two surgeons later investigated by the state medical board. In "A journey of risk, hope," the treatment of Dylan Catania, who was born with a rare brain defect that required radical surgery, is chronicled with a multimedia presentation including photographs, videos, graphics, a glossary and Q&A with Dylan's pediatric neurologist.

See these stories on the web.

William Heisel; Additional credit: Jenn Harris, Barbara Feder Ostrov

This entry takes a state-by-state analysis of how doctors are disciplined and how the public is informed. With the help of intern Jenn Harris, William Heisel found that medical boards from coast to coast are inconsistent, inefficient and ill equipped to monitor the hundreds of thousands of doctors licensed under their watch. There are some standouts, but overall they do not adequately protect patients and inform the public. The 51 doctors profiled were responsible for injuring or killing 290 patients. The majority of these doctors are still in practice and most have had licenses in more than one state. An interactive Google map created for the series shows people exactly where the doctors practice. This, we believe, is the first map of its kind. Because physician oversight is so fragmented, it is nearly impossible for patients to go to one spot and check to see if their doctor has been in trouble.

The beat | The Google map

JoNel Aleccia

At MSNBC.com, reporter JoNel Aleccia has crafted the consumer health beat to discover, analyze and explain pressing health issues with significant impact in readers' daily lives. In these four representative stories, Aleccia exposed the lack of regulation and accountability for veterinarians who make medical errors; revealed a little-known provision of the health reform law that exempts faith-based medical exchanges from 'play-or-pay' insurance mandates; reported on growing rates of infections transmitted by transplanted organs; and was the first national outlet to report on an alarming shortage of vital drugs in the United States.

See the beat on the web.

Kaiser Health News' occasional series of stories explores important trends transforming the hospital industry. For example, we've examined the struggles of community hospitals to remain independent, the acquisition of nonprofit hospitals by for-profit companies, the effect of the new health law on physician-owned hospitals and the failed attempts by regulators to make hospital prices transparent. And, most importantly, at a time of national concern over rising health care spending, hospitals are consolidating, often in concert with physician practices, and becoming marketplace powerhouses that dictate higher prices to insurers and employers. This phenomenon, a growing contributor to the upward spiral of health care spending, is especially evident in northern California. KHN extensively analyzed California hospital prices and interviewed dozens of experts and hospital executives to illustrate the impact of Sutter Health, the priciest chain. By year's end, KHN was far ahead of the media pack in reporting on changes in the biggest-spending component of the health system: America's hospitals.

See the story on the web.

The story was based on a research study in JAMA concerning women who may carry the BRCA1 or BRCA2 genes, which increase their likelihood of breast and ovarian cancer. The study determined that preventive surgery to remove the ovaries, fallopian tubes, and breasts did save lives. But this story also had a personal side: an interview with a woman who had to decide whether to get tested, and then when she found out she carried the gene, what to do next. The study came down on the side of preventive surgery, as did the woman in DeNoon's story. But the use of the personal story amplified the study, and DeNoon also clearly laid out, through the personal interview and expert sources, a path towards a decision, and the best way for woman in this grueling position to make an informed decision.

See the story on the web.

The legend of New England Baptist Hospital physician Dr. A. Razzaque Ahmed, a specialist in rare blistering diseases, has been echoing around the Boston medical world for years, with some professionals dismissing him as a quack and many patients calling him their savior. To get to the bottom of the story, Robert Weisman interviewed dozens of patients, colleagues and former colleagues, Medicare and law enforcement officials, as well as Ahmed himself, and painted a portrait of a man who is both a convicted felon and is credited for saving the lives and sight of hundreds of people.

See the story on the web.

This feature story explores the effect that antidepressants can have in treating depression, in the wake of a study published in The Journal of the American Medical Association suggesting that antidepressants work best for people with severe depression. The story also explores the expectations that some people have about what antidepressants will do for them, the reality that's more likely, and the lifestyle and therapy measures that are also needed.

See the story on the web.

Individual mandates, high-risk insurance pools, small business tax credits and cost-sharing subsidies. Those are just a few of the many provisions in the new federal health law and changes confronting - and confusing - consumers. After the enactment of the health care overhaul last March, Kaiser Health News began a weekly column - "Insuring Your Health" - that is dedicated to explaining insurance issues and the effects of the law. We felt it was important to get beyond the white-hot national political debate that surrounded the legislation and provide readers with a clear view of how insurance currently works and what issues would be addressed by the health law. The feature, written by Michelle Andrews, has dealt with major changes brought by the legislation - such as the establishment of insurance pools for people with medical problems and getting coverage for adult children. But she has also highlighted a number of lesser known problems, some of which may not be solved by the law. The column runs on the KHN website and is used by a number of our partners, including The Washington Post, the Tribune Co. websites and MSNBC.

See the story on the web:

Part 1

Part 2

Part 3

Part 4

One of the mysteries of American medicine is why Americans pay twice as much for health care as consumers in other developed nations while getting outcomes that are no better, and often worse. Simple over-consumption does not explain the numbers: Americans have fewer doctor visits and shorter hospital stays, for example, than patients in many European countries. But, as a team of Star Tribune reporters found, the American health care system is riddled with perverse incentives that can lead doctors and hospitals to recommend too much of the wrong kind of medicine, often the most costly and technology-intensive medicine. The result drives up health care costs and often produces inferior care.

See the story on the web.

Maggie Fox, Julie Steenhuysen and Ben Hirschler Kate Kelland in London, videographer Kevin Fogarty, Lisa Richwine in Washington, Ransdell Pierson in New York and Tan Ee Lyn in Hong Kong also contributed.

This special report looked at the new science of whole genome sequencing and how it does -- and doesn't -- affect people's health.

See the story on the web.

Robert Weisman

Last March, The Boston Globe broke the story of the most significant change in the region's health care landscape in years: the sale of Caritas Christi Health Care, a Boston area chain of six Catholic community hospitals, to a New York buyout firm. The paper reported throughout the year on the man behind the deal, ambitious Caritas chief executive Ralph de la Torre, and the wide-ranging impact of the deal on the people and communities in the region. Among other things, the deal created an opening for the expansion of for-profit health care in a state long dominated by non-profit hospitals.

Less than a month after Johnson & Johnson's McNeil unit recalled more than 50 children's versions of these non-prescription Tylenol, Motrin, Benadryl and other drugs on April 30, 2010 for serious quality and safety concerns, the company remained tightlipped about the specific problems with those drugs, manufacturing problems at the plant that made those recalled drugs and consumers complaints received about the recalled drugs. CNNMoney.com was the first to report the extent of the manufacturing problems at the McNeil's plant in Fort Washington, Pennsylvania where the recalled drugs were made. CNNMoney.com was the first to report that the recalled children's possibly contained small metal parts and that the Food and Drug Administration had received at least 775 consumer complaints about McNeil's recalled drugs. CNNMoney.com was also among the first to report how McNeil may have attempted a secret recall of some Motrin products in 2009 buy hiring a contractor to clandestinely remove the drugs from store shelves without fully disclosing its actions to the FDA.

See this story on the web.

There's no strong scientific evidence that chronic Lyme disease exists. Yet doctors are treating it with drugs that put patients and the public at risk. While Lyme disease is real, some doctors tell patients with symptoms as common as fatigue, eye twitching and pain that they have a chronic version of Lyme. These doctors then prescribe months, even years, of intravenous antibiotics, sometimes two or three or four at a time. Such treatment is dangerous and has killed some patients. Moreover, these drugs can cost tens of thousands of dollars a month and are not covered by insurance when used for this purpose, forcing some desperate patients to cash in retirement accounts and mortgage their homes to pay for treatment that four clinical trials have shown to be risky and ineffective for their conditions. This Tribune investigation exposed how some promoters of the chronic Lyme plague are criminals, and luminaries in this world have been disciplined by medical boards for harming patients. Yet the chronic Lyme movement has gained such traction with the public that advocates have raised millions of dollars to fight the condition and have succeeded in getting laws passed to shield chronic Lyme doctors from the actions of medical boards.

See the story on the web.

This is a letter of advice from one cancer survivor to future cancer survivors.

See the story on the web.

This entry is a personal column written by the reporter when she lost her hair to chemotherapy during cancer treatment.

See the story on the web.

A data analysis of Lobbying Disclosure Act filings by the Center for Public Integrity, "Lobbyists Swarm Capitol to Influence Health Reform," found that businesses, trade groups and other interests hired more than eight lobbyists for each member of Congress to influence health reform legislation. The list of organizations that worked to put their imprint on health reform bills ranged from health care interests and advocacy groups to giant corporations without apparent ties to the healthcare industry, small businesses, American Indian tribes, religious groups, and universities. Together, the businesses and organizations spent $1.2 billion on their lobbying efforts. The money, experts say, was well spent, with lobbyists winning massive concessions and bonuses for industry players in the final health reform law. The prolonged health reform battle was also a boon to Washington lobby firms, which recruited heavily from the U.S. Department of Health & Human Services and other federal agencies and used their experts to draw down record profits, according to the Center report, "Washington Lobbying Giants Cash in on Health Reform Debate."

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McClatchy provided the most exhaustive and independent coverage of the Gulf oil spill and its effects in stories that warned of the devastating consequences; exposed BP's failures to measure the amount of oil spilled and the reasons for the disaster; and uncovered the Obama administration's inability to assess the damage, to halt drilling as the president ordered or to protect cleanup workers.

Through sources at UCLA hospital, the Los Angeles Times learned of a newborn baby who had been diagnosed with a seizure disorder that required radical brain surgery. Reporter Molly Hennessy-Fiske contacted his parents and doctors and persuaded them to allow her, a photographer and videographer to follow them before, during and after surgery to explain the science involved.

See the story on the web.

Internal searches of WebMD showed a sudden spike in people lookng for information for "K2." It didn't take long to find out that K2 was one of the "legal highs" offered for sale at head shops and internet sites. A check with NIDA's chemistry chief confirmed that the drug is one of several synthetic cannabinoids. So are these drugs merely marijuana in disguise? As it turned out, only recently had anyone determined exactly which compounds were in the drugs -- a German toxicologist who finally managed to tease out the active substance. In an astonishing interview, this scientist described to DeNoon his own experience testing the drug on himself. But how bad could a mere cannabis-drug be? To find out, DeNoon tracked down the chemist who created most of these compounds in his lab -- as reagents. Never intended for human consumption, they were based on carcinogenic compounds. And they were vastly more potent than marijuana. Formated as an FAQ, the story nevertheless carries a powerful narrative line. The article avoids ain't-it-awful moralizing while delivering a powerful safety message to potential users of these substances, which at the time of writing remained easily available. It was among the most-read WebMD articles of 2010.

See the story on the web.

It seemed to be the perfect antidote to heartburn - a harmless pill that you can pop once a day and keep misery at bay. That's how Prilosec and its cousins became blockbuster drugs, with over 100 million prescriptions a year in the U.S. alone. This story examines the flipside of that trend: the growing evidence that heartburn drugs are vastly overused, wasting billions of dollars and possibly doing more harm than good.

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One of the mysteries of American medicine is why Americans pay twice as much for health care as consumers in other developed nations while getting outcomes that are no better, and often worse. Simple over-consumption does not explain the numbers: Americans have fewer doctor visits and shorter hospital stays, for example, than patients in many European countries. But, as a team of Star Tribune reporters found, the American health care system is riddled with perverse incentives that can lead doctors and hospitals to recommend too much of the wrong kind of medicine, often the most costly and technology-intensive medicine. The result drives up health care costs and often produces inferior care. These perverse incentives are well-known to health care analysts, but we wanted to make them plain to the general public while giving our readers the tools to be informed consumers in their own care. Star Tribune staff focused on three conditions and procedures that millions of Americans encounter each year, that have clear clinical evidence of overuse, and that are amenable to change at the behest of consumers or policymakers: childbirth, back pain and digestive distress.

See the story on the web.

One of the mysteries of American medicine is why Americans pay twice as much for health care as consumers in other developed nations while getting outcomes that are no better, and often worse. Simple over-consumption does not explain the numbers: Americans have fewer doctor visits and shorter hospital stays, for example, than patients in many European countries. But, as a team of Star Tribune reporters found, the American health care system is riddled with perverse incentives that can lead doctors and hospitals to recommend too much of the wrong kind of medicine, often the most costly and technology-intensive medicine. The result drives up health care costs and often produces inferior care.

See the story on the web:

Part 1

Part 2

The three stories that are part of the entry represent our coverage of medical issues related to the devastating earthquake in Haiti. In each case, they forge a link between the efforts of health professionals in New England and the survivors of the calamity.

See the story on the web.

This project was a partnership between the California HealthCare Foundation Center for Health Reporting and the Sacramento Bee. This story examines how California health care providers (and California patients) will respond when the leading edge of the Baby Boomers generation reaches the age of 65.

See the story online.

The Dallas Morning News completed a yearlong investigation into patient harm and doctor training. The investigation focused on lax supervision of doctors-in-training, patient harm and alleged billing fraud at Dallas' premier medical school complex and its primary teaching hospital, which are financed largely by taxpayers. We also examined more broadly questions about medical training, patient care and healthcare fraud at teaching hospitals around the United States.

See this story on the web.

This series contains three breaking news stories about FDA complaints against pharma giant Pfizer.

This project examined an often-overlooked type of health care provider - certified athletic trainers working in secondary schools. Only about a third of the nation's schools have professional athletic trainers regularly available to students. Beyond saving lives or careers, the report showed that sports medicine specialists ensure that injured athletes receive levels of care appropriate to their condition, utilizing data from a unique government surveillance system. Specifically, we found that in locations where there were high concentrations of athletic trainers, athletes were more likely to present to emergency departments with more severe injuries, like concussions and fractures, and less likely to show up for treatment of abrasions and sprains which the trainers can usually assess and treat on site. The reverse was true in locations that had a lighter concentration of athletic trainers among the schools -- places where coaches, EMTs handle injuries were more likely to refer lesser injuries and less likely to send along more serious cases to an ER. The stories also explored the role played by school athletic trainers in providing health services beyond sports, and the considerable savings in time and money the trainers bring by offering treatment and rehabilitation services in schools during and after class hours. In effect, athletic trainers serve as front-line community health providers in their schools and often in the surrounding community.

See the story on the web.

An investigation by The Dallas Morning News found that a criminal probe into two former workers accused of abusing seven residents in the Alzheimer's disease unit at a state-owned veterans home languished for more than two years because of confusion over who should investigate, and conflicts among local police, state officials, and veterans home administrators.

See the story on the web.

While much has been written and reported about the growing shortage of primary care doctors in the United States, this story highlights one important aspect of the problem that isn't well-known and hasn't received much attention: shortage of country doctors. Many of the nation's designated Health Professional Shortage Areas (HPSA) are actually located in rural America. This story presents some eye-opening statistics. While 20% of the U.S. populations lives in rural areas, only 9% of the physician population practice in these area. The story profiles a country doctor - the only primary care internist for a community of 1,500 people - who shut his practice in a HPSA area after the recession further bruised his ability to stay competitive with the larger area hospitals. The story highlights the fact the U.S. has about 66 million people living in HPSA areas and close to 7,500 primary care physicians needed to bridge the physician shortfall in these doctor-starved areas.

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The series follows Shannon and Kip Brooks, a young Charlotte-area couple who are devastated to learn their unborn baby has a fatal birth defect, anencephaly. They continue the pregnancy, instead of having an abortion, hoping to meet their baby Skylar and find some good in their tragedy by donating her organs. When the Brookses confront resistance from friends and the donor community, they persevere. The result: They spent 99 minutes with Skylar on the day of her birth, surrounded by loving relatives, friends and health-care providers. They call her birthday, Aug. 7, 2010, the "best day of our lives." And they persuaded the Charlotte-area donor procurement agency to accept Skylar's liver cells for donation. Shannon and Kip Brooks were chosen to represent other donor families on the "Donate Life" float in the Tournament of Roses Parade on Jan. 1, 2011.

See the story on the web.

This is a four-part series on the impact of concussions in high school athletics and beyond.

See the series on the web.

"The Vanishing Mind" tackled the subject of Alzheimer's, reporting about the worldwide struggle to find answers - the breakthroughs, frustrations and setbacks in diagnosis, care giving and treatment of this terrifying illness.The stories describe a watershed year in Alzheimer's disease research and in understanding the needs of people with the disease and their caregivers. They include a package of stories from a remote region of Colombia that is home to the world's largest family to experience Alzheimer's.

See the series on the web.

1. A Syracuse University professor overseeing efforts to rid the health insurance payment system of conflicts of interest had a conflict of her own -- she was a director of insurer Excellus BlueCross BlueShield.

2. A merger may be the best chance of survival for a Syracuse hospital in deteriorating financial health.

3. A look at Central New York doctors who get paid by drug companies to talk up their products.

4. New York rarely takes disciplinary action against dentists, even one deemed a public threat.

This story uncovered unfathomable sexual abuses that occurred against severely mentally disabled men at a number of Florida care facilities. St. Petersburg Times reporter Justin George delves deep into the issue in this investigative piece. 

See the story and the sidebar on the web.

This piece explores the psychological terrain of one family and their decisions regarding genetic testing to determine whether they have Huntington's Disease, an incurable brain disorder.

See this story on the web.

This series provides an intimate portrait of the family of infant Christopher Schroeder, who was born with a number of heart defects that made a heart transplant his only chance for survival. The reporter and photojournalist followed the family for more than six months, including the anxious months waiting for an organ donor and afterward. They witnessed the transplant surgery and chronicled the many highs and lows of the baby's long recovery. The series included several other stories to educate readers about different aspects of organ donation, associated laws and procedures.

See the series on the web: 

Part 1

Part 2

Part 3

This Dallas Morning News story discusses the potential benefits of travel following a cancer diagnosis or during the treatment process.

See the story on the web.

This story and sidebar provided an in-depth look at the U.S. government's struggle to police pharmaceutical companies' increasingly aggressive efforts to market pills and other therapeutics to consumers. The story was inspired by a Food and Drug Administration letter that chided one company for throwing a Tupperware-like party pitch for an implanted birth-control device. The reporters revealed tactical, financial and technological problems that limit the FDA's ability to rein in misleading claims amid a swelling number of promotions.

See this story on the web.

This piece for the Bay Area pages of the New York Times investigated why - although dental disease is preventable - it is not unusual for California children to suffer crippling and disabling cases of it. By the age of 5, according to reports used for this article, more than 28 percent of California children have untreated tooth decay. Journalist Laurie A. Udesky reveals why in this investigative story.

See this story on the web.

In the Health and Wellness segment, "The Challenges of Breastfeeding," CBS News discusses the health benefits of breastfeeding and consults experts who provide tips on how to make the breast feeding process easier.

See this video on the web.

Less than a month after Johnson & Johnson's McNeil unit recalled more than 50 children's versions of these non-prescription Tylenol, Motrin, Benadryl and other drugs on April 30, 2010 for serious quality and safety concerns, the company remained tight-lipped about the specific problems with those drugs, manufacturing problems at the plant that made those recalled drugs and consumers complaints received about the recalled drugs. CNNMoney.com was the first to report the extent of the manufacturing problems at the McNeil's plant in Fort Washington, Penn., where the recalled drugs were made. In the story, "Tylenol plant: From bad to worse," CNNMoney.com was the first to report that FDA inspection reports going back to 2003 chronicles a build up of problems at McNeil's plant in Fort Washington, Pa., at the center of the widespread recall of Tylenol, Motrin, Benadryl and other over-the-counter drugs. CNNMoney.com was also the first to report that Government safety inspectors pushed for a recall of the children's medicines at least three months before Johnson & Johnson removed the products from store shelves.

See this story on the web.

Parija Kavilanz

Less than a month after Johnson & Johnson's McNeil unit recalled more than 50 children's versions of these non-prescription Tylenol, Motrin, Benadryl and other drugs on April 30, 2010, for serious quality and safety concerns, the company remained tight-lipped about the specific problems with those drugs, manufacturing problems at the plant that made those recalled drugs and consumers complaints received about the recalled drugs. CNNMoney.com was the first to report the extent of the manufacturing problems at the McNeil's plant in Fort Washington, Pennsylvania where the recalled drugs were made. CNNMoney.com was also the first to report that the recalled children's possibly contained small metal parts. This story was the first to report that the Food and Drug Administration had received at least 775 consumer complaints about McNeil's recalled drugs from Jan. 1, 2008, through April 30, 2010. The story also revealed that the FDA had received several hundred more consumer complaints about the children_s drugs after it was recalled in April, 2010.

See this story on the web. 

Parija Kavilanz

This story brought to light a troubling trend of physicians - specifically pediatricians and pediatric specialists - who are either no longer taking new Medicaid patients or even dropping existing Medicaid patients because the felt that the payment from the government program was not adequately covering their business costs. The story illustrated the trend through the real life example of Dr. Jaquelin Gotlieb, an Atlanta-area pediatrician who still accepts Medicaid patients while many of her peers no longer do. Her frustration as a doctor is the difficulty she faces in finding specialists for her young Medicaid patients because many specialists in her area also no longer accept Medicaid. This story is being played out nationally, with many young children being caught in the reimbursement crossfire between doctors and the government-run healthcare programs.

See the story on the web.

Timothy  Noah

1) "How Insurers Reject You" used a confidential document from BlueCross BlueShield of Texas (exclusively obtained by Slate) to examine the ludicrous extent to which insurers in the non-group market count even the most trivial preexisting conditions against people applying for health insurance, a practice now being phased out under the new health reform law.

2) "Unreconciled" explains how the reconciliation process, which health reform opponents claimed was never used for substantive legislation, had actually been used to pass the most substantive domestic bill of the Clinton administration (and one dear to those same opponents' hearts) welfare reform. This column was much-cited after it appeared.

3) "Why Stupak Is Wrong" which was cited even more widely, explained why Rep. Bart Stupak's claim that the Senate-passed health reform law would let taxpayer funds pay for abortions was not a matter of ideological disagreement, but simply incorrect, and tried to explain Stupak's flawed logic more fully than Stupak had been able to do for himself.

4) "Author, Author" eviscerated the Heritage Foundation's self-serving denial that Obamacare was substantially influenced by policies earlier developed at ... Heritage.

The title of the first story - Amid Nanotech's Dazzling Promise, Health Risks Grow - pretty much sums up the issues. The series focused on the fact that the government spends hundreds of millions to create new uses of this often amazing technology, but research did show that only a small fraction of the money went to researching the potential health hazards of the from human contact with the material. The reporter also documented that many of the nanoparticles being sold commercially use nanoparticles that scientists - including from the government - have shown to be lethal.

See the series on the web:

Part 1

Part 2

Part 3

Sidebar 1

Sidebar 2

The story recounted the strange rise and fall of a promising young surgeon, John Christian Gunn, whose eventual arrest and sentencing for bank robbery led to questions of how his poor performance during residency and his bizarre behavior in practice didn't raise more warning flags.

See the series on the web:

Part 1

Part 2

Connecticut's statewide respite care program was established in 1989 for patients with Alzheimer's, dementia-related disorders and their caregivers. The thinking was that caregivers could care for their loved ones at home instead of a nursing facility and save money in the process, while their loved ones could remain at home and retain their independence. In an assessment by the Center on Aging at the University of Connecticut in 2007, the estimated cost for an individual in a nursing facility, on average, was $119,000 per year; by contrast, a live-in home companion will cost around $70,000. Since Connecticut has a budget shortfall like most states, the cost of living for our elderly population is going to be a big issue in coming fiscal years. In April 2009, Connecticut's General Assembly unanimously passed an extension of this program and Gov. Rell signed it in May 2009. Caregivers received a yearly allowance of $3,500 for their loved ones under the old law for basic necessities such as food. The extension would have boosted that figure to $7,500 if the caregiver could demonstrate "additional need for services." What caregivers didn't know was that the program had been closed to new people with these illnesses two weeks before Rell signed the bill and would be closed for the remainder of 2010 because of the budget shortfall. More importantly, DSS quietly required that people who had been screened and in the system receive a maximum of $3,500. This series documents the struggle to balance the budget while maintaining an important social program for Connecticut residents. James Zipadelli was the primary reporter on this series for the national Web site OurParents.com. No attempt was made to influence these stories in any way by OurParents.com.

See the story on the web.

The story examines unethical practices of using the gastric band on obese teens (for whom the device is not approved) and how some doctors have glossed over complications with the device amid a lack of long-term data. The story also shines light on the relationships between the device manufacturers, doctors/researchers and those charged with overseeing medical standards. It highlights the fact that the FDA was unaware of ethical issues surrounding the NYU surgeon who submitted to FDA clinical results using Allergan's Lap-Band.

See the story on the web.

Stories are part of an on-going series on conflicts of interest in medicine.

The March 14 story was about the pharmaceutical industry using more private doctors to do promotional speaking for its drugs as universities banned such activities.

The May 30 story was about academic physicians being used by drug companies to conduct clinical trials while those companies controlled the clinical trial data.

The July 14 story was the result of a Wisconsin Open Records lawsuit filed by the Journal Sentinel against the University of Wisconsin School of Medicine to obtain emails of doctors' comments about UW's conflict of interest policy.

The August 29 story was about the FDA's approval of a revolutionary back surgery device based on clinical research by several orthorpedic surgeons who stood to benefit financially.

The November 28 story was about the FDA's approval of jaw joint replacement devices despite flimsy clinical trial data from doctors who had financial ties to the companies that made the devices.

See the series on the web.

Central Florida schools are continually battling mold -- some of it the most potentially dangerous, toxin-producing types. Over the past three years, local school districts have received thousands of complaints from teachers, students and others about moldy smells, mold-infested walls and furniture and health problems thought to be related to poor indoor air quality. The state has acknowledged and university research shows that such problems are widespread in Florida. Yet there are no state laws to govern how schools should prevent, monitor and fix these problems. A grand jury in South Florida urged legislators almost a decade ago to force schools to make improvements, but nothing has changed. The last time the Florida Legislature considered tougher regulations - in 2004 - it learned that identifying problems would be expensive and would make the state vulnerable to lawsuits. Since then, some schools have made matters worse by shutting off the air-conditioning to save money during weekends and summers in one of the hottest, most humid states in the country. And because maintenance funding has dwindled over the past few years, schools are putting off repairing and replacing roofs and air-conditioning systems -- the primary means for controlling the moisture that mold needs to grow and thrive indoors.

See this series on the web.

Christina Sanchez

At 38, Dawn Gusty could barely walk. The mother of two had been fighting multiple sclerosis for 12 years. Her condition was degenerating, and doctors could only offer her injections to reduce her symptoms. They didn't work. She knew if she just followed their advice she would soon be immobile. She couldn't accept that and decided against the advice of her neurologist to go to Mexico to get what the United States wouldn't allow her to have a stem cell transplant. In "Her last chance to walk," The Tennessean reporter Christina Sanchez tells the story of Gusty's journey, from the first twinges of her disease through her decision to risk everything on unorthodox therapy abroad.

See this story on the web. The Story | Video | Infographic I | Infrographic II | Slideshow

Chuck  Kurtz

The articles looked at several aspects of the then just-passed health care reform legislation: public health agencies and who they serve; the insured and the uninsured; the impact to family physicians; reaction from local and federal elected officials; and the impact to pharmacies and prescription drugs and their customers, especially senior citizens. The most significant finding was in interviewing pharmacists and their claims of pharmacy benefit managers being the main reason for the high cost of prescription drugs.

Pedro Fernando Frisneda

This three-part series was about diabetes and how this disease is affecting the Mexican-immigrant community in New York City. Type 2 diabetes represents a major health challenge and threat for this group, in which both new cases of the disease an the risk of associated complications are greater than in other communities. Health authorities and many doctors in the United States already classified diabetes as an "epidemic" and Latinos have two times higher risk of developing this disease than people of any other race. Diabetes ranks first among health problems affecting Hispanics in this country (10.2% of all U.S. Latinos). The Mexican community is at highest risk, representing 24% of all cases and the worst part is that half of them do not know they are ill.

See this story on the web: Part I | Part II | Part III

Lisa Chedekel

Lisa uncovered that several doctors were practicing freely in Connecticut after being disciplined or sanctioned in the neighboring states of Massachusetts, Rhode Island and New York. She also found that Connecticut often takes no action against doctors who are disciplined neighboring states in contrast to medical boards in those other states, which do impose their own reciprocal sanctions after Connecticut takes disciplinary action. Also some doctors sanctioned in other states have relocated to Connecticut, with no license restrictions.

See this story on the web.

Tracey Ann O'Shaughnessy

The advent of gene testing makes it possible for people to peer into their medical future. But what does one do when confronted with the knowledge that a lethal disease is very likely in one's future? One Connecticut family, battered by cancer, believed it was taking preemptive measures when it began to test members and those members began having healthy tissues removed.

See this story on the web.

Heather  May

This explores why Latinos have up to double the rate of neural tube defects despite an inexpensive vitamin that can drastically reduce the risk. While many women know to take prenatal vitamins during pregnancy, most don't know to take it before pregnancy. The reasons for the health disparity are lack of education and the government's failure to fortify corn masa flour, a staple of the Latin diet.

Hiran Jayantha Ratnayake

"Insurance Claims Approved, Payments Denied" focused on how health insurance companies can approve claims but then drag their feet in paying the claim, especially in situations where the onus was on the policyholder to make sure their treatment provider was paid in a timely fashion.

"Treatment Brings New Hope for Hand Disease" investigated how hand surgeons who were considered the authorities on a specific hand-related disease were withholding information on another treatment option.

"Law Curbs Teen Tanning" focused on how lawmakers and cancer doctors were using misleading statistics to drive home the message that indoor tanning is highly dangerous to consumers.

"Generics Cheaper, But Not Often Cheap" looked at wide differences in the cost of the same generic medicines. Generics can cost $200 more at one pharmacy than another but the only way customers will find out is by actively shopping for generics the same way they do for other products.

Sonya Colberg

Patients are waking up during surgery and others are dying because health care workers are forced to stretch or substitute drugs that are in critically short supply. This story looks at the causes and outcomes to this issue which affects not only Oklahoma but health care facilities nationwide. This story looks to numerous health professionals who said they were concerned.

See this story on the web.

Sonya Colberg

Brendon Mathis began the fight of his life when doctors discovered the teen had an extremely rare form of Hodgkin's lymphoma. Fortunately, Brendon went into remission after his chemotherapy. But the next battle began when his doctor determined that only Procure Proton Therapy offered Brendon his best chance of staying healthy. The family and doctors began a passionate struggle to try to get the family's insurance company to cover the life-saving treatment. With the clock ticking, Brendon got the treatment though the insurance company continued to delay. To this day, the family isn't sure how much, if any, of the more than $100,000 treatment will be paid by the insurance company. Though the insurance commission figures show that more complaints are lodged against Blue Cross Blue Shield than any other company, the issue is common in the insurance industry.

Edmond teen's family seek answers

Heather May

This story is about the parallel paths of one family waiting for a liver transplant for their toddler and another family saying goodbye to their 12-year-old who would become the donor. Donor families and recipients don't usually connect so quickly. These families did at the donor's funeral.

See this story online.

Greg Barne, Jennifer Cahoun, John Ramsey

For years, studies have shown that soldiers fighting in Iraq and Afghanistan are suffering from mental health problems caused by multiple deployments and the horrors of war, but they fail to put a human fact to the soldiers, families and their communities. 

The Fayetteville Observer pored over the studies and reams of information from the Army and Fort Bragg through the Freedom of Information Act. Reporters interviewed countless soldiers and their spouses, health providers, Army officials and community activists. The result was a five-part series in which soldiers and their spouses reflect on how the hidden wounds of war have taken a toll on their lives, and how the Army and society are ill-prepared for the mental health issues that are only now begining to present themselves.

See this story on the web.

Kay Ellen Schwebke

Every year, an estimated 250,000 central-line associated bloodstream infections, or CLABSI, occur in U.S. hospitals and 30,000 to 62,000 people die as a result. Although a successful prevention model exists, there has been no national improvement in reducing these infections. "On the CUSP: STOP Blood Stream Infections (BSI)," a model developed by researchers from the Johns Hopkins University Quality and Safety Research Group, eliminated CLABSI in more than 70 Michigan hospitals and more than 103 intensive care units that participated in a study published in 2006. This success has been sustained for more than four years, saving thousands of lives and millions of dollars.

This story explored the low level of participation in Minnesota. Although several Minnesota organizations seemed to believe there was no need to participate since the problem was under control, staff from non-participating hospitals were unwilling to release their infection rates. Meanwhile, staff from participating hospitals reported value, shared their infection rates, and encouraged other Minnesota hospitals to join them.

See this story on the web.

The health care system in Grand Junction, Co., is one of the highest-quality and lowest-cost in the nation. In short, it is health care reform that works. Colorado Public News explored what Grand Junction is doing to achieve such amazing results, in a five-part series with text, video, photos, and charts. The package includes interactive charts showing the quality and cost of health care in 300 cities around the nation.

View the 13-part package:
Part 1 Main | Find your city's rank in health care spending | Find your city's rank in health care quality | Medicare spending by state | Hospital care varies widely in Grand Junction and McAllen | Part 2 Main | Ready access highlights health care in grand junction | Grand Junction's multifaceted health care approach | Opting for exercise over surgery in grand junction | Grand Junction or McAllen: Who is healthier? | Can other communities replicate the grand junction model? | Just how much less expensive?

Indiana nursing homes may be the worst in country. They have fewer aides per patient than nursing homes in any other state. Fifty-two of what the Government Accountability Office considers to be the country's worst 510 nursing homes are in Indiana. Our projects team at The Indianapolis Star looked into why that is. This series found that Indiana had handed out more than $100 million of Medicaid money to nursing homes in a quality incentive program that officials later admitted was flawed. The program was pitched as a way to incentivize quality but all homes got the same amount of money no matter how poor their care. Local county health department had bought up 39 nursing homes and then diverted more than $200 million in Medicaid funding from them in order to build a hospital -- even as the quality of care at those homes dropped. Indiana was failing to take such basic safety measures as doing background checks on the people to whom it issued nurses licenses. The attorney general had largely ignored his obligation to discipline administrators of dangerously bad nursing homes -- even after the homes were flagged by the health department many years in a row.

See this story on the web. 

Yet, until our series of stories about dialysis, few outside of it were aware that despite massive outlays by U.S. taxpayers Americans endure some of the worst results for dialysis care in the industrialized world. Two years of investigating found a system infected by lax and ineffective oversight, provider profits that trumped patient needs and a cloak of secrecy hiding the real human costs. In the most egregious cases, dialysis patients had been killed by the very therapy meant to sustain them.

See this story on the web.

A Tribune investigation into a Chicago care center for disabled children revealed 13 deaths due to neglect or unexplained circumstances. Illnesses were ignored, life-support alarms went unanswered and kids with complex medical issues were left unattended. Instead of cracking down, lawmakers and regulators allowed problems to worsen. Rules were weakened, deaths not fully investigated and fines dropped or reduced. One child became a focus of the Tribune's reporting: Jeremiah Clark, a 9-year-old boy whose death followed two days of neglect.

See this story on the web.

Project Director: Jim Morris

Reporting Team: Steve Bradshaw Ana Avila Murali Krishnan Roman Shleynov Scilla Alecci Te-Ping Chen Dan Ettinger Carlos Eduardo Huertas Shantanu Guha Ray Marcelo Soares Abhishek Upadhyay

Editors: David E. Kaplan and Marina Walker Guevara (ICIJ)

This nine-month, cross-border investigation, conducted by the International Consortium of Investigative Journalists in partnership with the BBC, revealed that a global network of industry groups has spent nearly $100 million in public and private money since the mid-1980s to keep asbestos -- a known killer banned or restricted in 52 countries -- on the market.

Based in Montreal, Mexico City, New Delhi and other cities and backed by industry-funded scientists, these groups share information and coordinate public-relations initiatives touting "controlled use" of asbestos. Public health authorities say that controlled use of the toxic fiber is nearly impossible in developing nations, where workplace and environmental standards are weak. The industry campaign, they say, is helping create new epidemics of asbestos-related disease in countries such as China and India. Independent scientists believe that between five to ten million people will die from asbestos-related disease by 2030, a toll increasingly centered in the developing world. A follow-up story published Dec. 20 revealed that Japan is using a questionable scientific method to test buildings for asbestos.

See this story on the web.

Over the past year, McClatchy's coverage of historic water contamination at Marines Base Camp Lejeune, N.C., has drawn new attention to a decades-old case that could prove to be among the military's most widespread environmental disasters to date. Former residents link the poisoned water to kidney cancer, childhood leukemia, lymphoma, reproductive cancer, miscarriages and a spate of more than 65 known cases of male breast cancer. Following McClatchy's stories, the Navy agreed to fund a million-dollar scientific study. Congress opened new investigations. And the Department of Veterans Affairs acknowledged in September that the increased attention has led more ill Marines to seek disability compensation.

See this story on the web.

This piece covers years of Illinois public listings and selected the names of doctors whose offenses appeared to be of a sexual nature. It takes available public records such as complaints, suspension orders and transcripts of hearings, on to area courthouses and police stations, where relevant criminal and civil records were found. The Attorney General's office has yet to make determinations some of the cases.

See this story on the web.

This piece addresses several health care issues such as (1) patients being kept in the dark about problems with doctors and hospitals. Also, (2) hospitals either don't sanction dangerous or incompetent doctors, or find ways to avoid federal reporting rules. (3) The health care system does more to protect doctors' livelihoods than patients. (4) Missouri's regulation of doctors is among the most lax and secretive in the nation.

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Headlines everywhere have described the storm of foreclosures that continue to overwhelm the housing market. Less noticed has been the impact on single-family homes that are used as lucrative care facilities for the elderly. In California, residents of such homes pay an average of $2,500 a month for a shared bedroom and $3,500 a month for a private bedroom. But as my article and accompanying blog show financial overreaching by proprietors has led to foreclosures of these homes and often the fragile residents and their families are the last ones to hear about it  --  when an eviction notice has been posted to the door.

This investigation for the Bay Area pages of the New York Times found that an astonishing 16 percent of the 1,600 San Francisco Bay Area properties licensed as small residential-care homes for the elderly had been in some stage of foreclosure since June 2006, including 100 homes that had been under foreclosure in the six months prior to the article's publication. The story also provided a look at the shadowy side of the business of buying and selling properties for licensed elder care. In addition, it revealed loopholes in the law, which made it possible for owners of homes used for elder care to keep secret that their properties had fallen into financial ruin.

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Two wars and multiple deployments have caused enormous strains within the military ranks, contributing to a rising divorce rate that outpaces that of civilians, a record numbers of suicides and a sharp increase in mental health problems. After nearly 10 years of constant war, these burdens are straining military families to the breaking point, yet their plight has received scant attention outside of the military community.

In this 5-part series, The Dallas Morning News looks at how repeated combat tours have broken up families and contributed to a record number of suicides. How the two signature injuries of these wars -- post-traumatic stress disorder and traumatic brain injury -- are wreaking havoc in many military families. And how citizen soldiers and their families, including the National Guard, are deploying at numbers not seen since World War II. These issues are explored through the personal stories of individual service members and their families. They generated strong response from readers via phone calls, comments and letters to the editor and helped raise awareness within the civilian community about the struggles facing military families today.

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Lauran Neergaard, Marilynn Marchione, Lindsey Tanner, Randolph Schmid

For months, politicians and ordinary Americans argued about health care and whether to expand access to millions of uninsured people and how to do it. What that debate mostly ignored is a stunning and contrary idea: Many Americans are actually getting too much health care and are sicker for it. Four members of The Associated Press medical and science team investigated that phenomenon in a six-part series. Among the findings: Thousands who got stents for blocked arteries should have tried medicine first. Americans get the most radiation in the world, mostly from repeated CT scans, raising the risk of cancer. People with back pain have too many tests and too many operations when exercise and no treatment at all is often the best remedy. Extreme measures are taken far too often on people who are dying, making their final days even more excruciating, isolating them from their families.

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The story tested the claims that were made to sell a 2004 law giving California nursing homes a major pay raise. California Watch found that nursing homes saw a funding increase of nearly a billion dollars over five years. Yet more than 230 homes either cut staff, wages or let caregiver levels slip beneath a state-mandated minimum. Reporters throughout California put a heartbeat to the problem, telling the stories of local patients who suffered harm in homes that reaped profit but cut care.

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These eight articles are the major stories published during FactCheck.org's year-long look at false claims being made by politicians and political groups about the health care law. This piece of legislation -- both before and after it was passed -- has been the subject of the biggest falsehoods over the past two years. From the bogus assertion that the law institutes government-run health care to President Obama's over-reaching promise that everyone can keep their health insurance to hysterical Internet claims that patients will be required to get implanted microchips, Americans have seen it all when it comes to the health care law. The midterm elections also brought false and hyperbolic claims from outside groups that targeted seniors with scary messages saying the law "threatens [seniors'] lives" or could cause them to "lose their doctors." The reporters also tackled more sober claims about the impact on Medicare, insurance premiums and abortion coverage, giving  readers detailed information on what the law said and what it would likely do.

See the eight-part, year-long series below:

Still on the Table?

Health Care Summit Squabbles

A Final Weekend of Whoppers

More Malarkey About Health Care

Misleading Onslaught by 60 Plus

Pataki's Bogus Health Care Claims

Health Care Spin Again

The Truth About Health Insurance Premiums

The story shows how a McDonald's version of a 400-year old tobacco-containing snack has become widely popular and has made India the oral cancer capital of the world. Sales of chewing tobacco in the second-most-populous nation are predicted to reach $9 billion by 2014 and doctors are finding evidence that the product, known locally as gutka, can give users cancer in as little as five years. Narayan's exclusive reporting highlights the human cost of gutka and shows how gutka's affordability, questionable advertising and weak regulatory control have ensnared millions of nicotine addicts. Use of smokeless tobacco in school children is rising even in the U.S., and experts caution that the situation in India could be a harbinger for other countries as tobacco companies respond to smoking bans with products that are sucked, snorted and chewed.

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Liz Welch, writer

The average Redbook reader is in her very early 40s, facing a critical decision: whether to start regular mammography screening at 40, as the American Cancer Society suggests, or wait until age 50, as the United States Preventive Services Task Force (USPSTF) recommended in a highly controversial shift in 2009. Many news outlets covered the USPSTF's report and the ensuing backlash, but none explained what women should do next. One year later, the mammography debate was still raging and women were more confused than ever. No other magazine had taken on the issue, but Redbook plunged in and guided women through the contradictory information surrounding one of the biggest health debates of the decade: when to begin regular mammography. In her research, National Magazine Award -- winning reporter Liz Welch uncovered a poll by the American College of Physicians that found that 67 percent of doctors said they would stop recommending routine mammography at age 40, and documented through interviews with radiology centers a previously unreported 20-percent decrease in women seeking screening.

Rachael Moeller Gorman

Even though doctors have been telling us for decades that salt is one of the villains in our diet and public health leaders in NYC have started a crusade to slash salt from the food supply, there is no definitive proof that cutting salt will reduce risk of stroke or heart disease. NYC's salt-cutting crusade follows a long line of action preceding evidence, often with unfortunate results.

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Douglas Podolsky, senior editor Leslie Ware, editor at large Kimberly Kleman, deputy editorial director, editor in chief, Consumer Reports Linda Greene, program leader, foods and sensory sciences Karen Rauen, director, health & consumer science operation David Schipper, research associate.

Consumer Reports' investigation -- including tests of 382 fresh, whole broilers -- found that two-thirds of birds tested harbored salmonella and/or campylobacter, the leading bacterial causes of food-borne disease. Findings show that most companies' safeguards are inadequate.

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