Author Archives: Charles Ornstein

Charles Ornstein

About Charles Ornstein

Charles Ornstein is a senior reporter with ProPublica in New York. The Pulitzer Prize-winning writer is a member and past president of the Association of Health Care Journalists' board of directors and a member of its Right to Know Committee.

Use caution with new data on doctor payments from drug, device companies

Photo by **Mary** via Flickr

Photo by **Mary** via Flickr

This article originally appeared on ProPublica’s website.

The government’s new website on drug and device company ties to doctors will be incomplete and may be misleading – for now.

The government’s release today of a trove of data detailing drug and device companies’ payments to doctors has been widely hailed as a milestone for transparency. But it is also something else: a very limited window into the billions in industry spending. Before you dive in and search for a specific doctor, here are five caveats to keep in mind: Continue reading

AHCJ disappointed with ACGME’s response on transparency

ACGME-Response8-12-2014-1The Accreditation Council for Graduate Medical Education has rejected a request from AHCJ to publicly release additional information about the successes and failures of physician training programs nationwide.

Earlier this month, AHCJ called upon ACGME to release details about residency programs with less than full accreditation, as well as the rates at which graduates of residency programs pass their board certification examinations. ACGME posts decisions on favorable or less-than-favorable accreditation status but not the reasons for them.

Replying to AHCJ’s Aug. 5 letter, ACGME executive director Thomas J. Nasca, M.D., wrote that the organization would not provide the requested information, citing the confidentiality of ACGME’s review and decision process.

AHCJ president Karl Stark said he was disappointed by ACGME’s response. Continue reading

AHCJ pushes for more data on residency programs

The Association of Health Care Journalists has called upon the accreditor of physician residency programs to be more transparent with its data so the public can be better informed about the quality of graduate medical education programs in their communities.

In a letter sent last week to the Accreditation Council for Graduate Medical Education, AHCJ praised the group for having a website that includes accreditation decisions for institutions and their individual training programs.

Karl Stark

Karl Stark

But it called on ACGME to publish additional information, echoing a similar call by an Institute of Medicine panel for greater transparency in graduate medical education.

“We believe ACGME can play an even greater leadership role by providing additional information or advocating for its release,” said the letter, signed by AHCJ president Karl Stark. “Doing so would be in keeping with the new Institute of Medicine report, which called for ‘transparency and accountability of GME programs.’” Continue reading

Caution in order when tackling newly released Medicare data

AHCJ hosted a webcast about the CMS data, featuring several CMS officials and Charles Ornstein, a senior reporter at ProPublica and member of AHCJ’s board of directors.

The federal government is expected Wednesday to release data on the services provided by – and money paid to – 880,000 health professionals who take care of patients in the Medicare Part B program. For 35 years, this data has been off limits to the public – and now it will be publicly available for use by journalists, researchers and others.

While the data offers a huge array of stories, which could take weeks or months to report out, it also has some pitfalls. Here are six things to be aware of before you dig in:

Have a strategy for storing and opening the data. This data set is big. About 10 million rows, from what I hear. Because of that, you won’t be able to analyze it in Microsoft Excel and you might not be able to open it in Microsoft Access. You’ll want to upload it onto a data server and analyze it in a more powerful program such as SQL or SPSS. This could well serve as a barrier to entry for smaller news organizations. You may want to partner with an academic institution or another news outlet to analyze the data. Continue reading

Fight for access to Medicare payments to physicians nearly over

(Editor’s note: This is a revision of the original post, which is available on Ornstein’s Tumblr site.)

The Centers for Medicare and Medicaid Services (CMS) said yesterday that it will soon begin releasing data on payments to individual physicians in the Medicare program.

Why is this such a big deal?

Because it overturns a longstanding agency policy that for more than three decades had barred the release of this very information. And, it follows advocacy for greater transparency by numerous news organizations, including the Association of Health Care Journalists.

CMS-9-3-13-1AHCJ’s board of directors last September sent a letter of comment to CMS asserting the public’s interest in release of this information. “As long as patient confidentiality is protected, we see no reason why taxpayers should not know how individual physicians are spending public dollars,” said the letter, signed by AHCJ executive director Len Bruzzese.

Some background:

In 1979, a federal court in Florida granted an injunction that prohibited the U.S. Department of Health, Education and Welfare (the predecessor to the Department of Health and Human Services) from releasing data on how much physicians earned under the Medicare program.

A year later, the HEW department adopted a policy that stated, “the public interest in the Department’s disclosure of the amounts that had been paid to individual physicians under the Medicare program was not sufficient to compel disclosure under the Freedom of Information Act.” Continue reading

Should journalists cover hospital ratings?

(Editor’s note: This was originally published on Ornstein’s Tumblr site and re-published here with his permission.)

Few things in health journalism make me cringe more than news releases touting hospital ratings and awards. They’re everywhere. Along with the traditional U.S. News & World Report rankings, we now have scores and ratings from the Leapfrog Group, Consumers Union, HealthGrades, etc.

I typically urge reporters to avoid writing about them if they can. If their editors mandate it, I suggest they focus on data released by their state health department or on the federal Hospital Compare website. I also tell reporters to be sure to check whether a hospital has had recent violations/deficiencies identified during government inspections. That’s easy to do on the website hospitalinspections.org, run by the Association of Health Care Journalists (Disclosure: I was a driving force behind the site.)

Last week, I got an email from Cindy Uken, a diligent health reporter from the Billings (Mont.) Gazette. She was seeking my thoughts on covering hospital ratings. I sent her a story written by Jordan Rau of Kaiser Health News about the proliferation of ratings. Two of every three hospitals in Washington, D.C., Rau reported, had won an award of some kind from a major rating group or company. He pointed out how hospitals that were best-in-class in one award program were sometimes rated poorly in another.

This got me thinking: What should reporters tell their editors about hospital rankings, ratings and awards. I sought advice from Rau, ProPublica’s Marshall Allen, Steve Sternberg of U.S. News & World Report and John Santa of Consumers Union. Here’s what they told me: Continue reading