Tag Archives: investigative reporting

New article looks at investigation of the dark side of hospice care

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Photo: PJ Johnson via Flickr

Hospice care is supposed to ease the final days for those at the end of their life, as well as their families. Sadly, it is not always the case. When hospice caregivers don’t show up, desperate calls to agencies go unanswered and loved ones are in pain, it is family caregivers who must cope, frightened and alone.

The result is what Kaiser Health News Executive Editor Elisabeth Rosenthal calls “DIY hospice care:” It is not an issue that has received much attention, but a recent investigation by KHN reporters JoNel Aleccia and Melissa Bailey found that it happens more frequently than many suspect. Continue reading →

Liz Seegert is an independent health journalist and AHCJ’s topic leader on aging. She covers older adults, baby boomers, health policy, and social determinants of health, as well as many other health issues. Her bylines include stories for PBS/NextAvenue.org. the American Journal of Nursing, TIME Health, Medscape, Consumer Reports, and Medical Economics, as well as dozens of other trade and mainstream media. Her articles have been syndicated in Forbes.com, the Los Angeles Times, the Hartford Courant, the Saturday Evening Post and other major outlets.

Investigative series on troubling death casts a wider net over hospice care

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A well-known, prominent California physician. Allegations of a suspicious death. Family feuds. A recovering addict and possible affair. Elder abuse. A controversial investigation by the coroner.

Charles Piller

While it may sound like a made-for-TV movie or the latest John Grisham novel, this life-and-death true story took journalist Charles Piller more than 10 months to investigate. Not only did Piller track and verify conflicting accounts of Jerome Lackner’s final months, but he also had to somehow navigate privacy roadblocks thrown up by hospitals, providers, the hospice facility and lawyers.

In this fascinating “How I did it,” Piller describes his five-part Sacramento Bee investigative series that may raise as many questions as it answers. He explains his efforts to answer basic questions about the roles and responsibilities of caregivers, hospitals, and hospices, and how he had to unravel a web of finger pointing by family, ex-spouses, friends and health professionals.

Without seeming to take sides, how does a reporter sift through mounds of conflicting evidence to create an engaging and coherent narrative? How can you track down reluctant key players in such a saga? How do you separate fact from fiction when family members accuse caregivers of indifference, neglect – or worse? Read about how Piller did it when investigating the death of Dr. Jerome Lackner.

Liz Seegert is an independent health journalist and AHCJ’s topic leader on aging. She covers older adults, baby boomers, health policy, and social determinants of health, as well as many other health issues. Her bylines include stories for PBS/NextAvenue.org. the American Journal of Nursing, TIME Health, Medscape, Consumer Reports, and Medical Economics, as well as dozens of other trade and mainstream media. Her articles have been syndicated in Forbes.com, the Los Angeles Times, the Hartford Courant, the Saturday Evening Post and other major outlets.

Get support to pursue major health reporting project

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Health journalists have a rare chance to get support for work on an in-depth reporting project related to the U.S. health care system.

The AHCJ Reporting Fellowships on Health Care Performance offer financial support as well as training and personalized guidance from experienced journalists as they delve into subjects that affect local and national health outcomes.

Past projects have included: Continue reading →

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Even in treatment guidelines, pharma conflicts abound

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As part of the ongoing Milwaukee Journal Sentinel and MedPage Today series “Side Effects” John Fauber and Ellen Gabler “examined 20 clinical practice guidelines for conditions treated by the 25 top-selling drugs in the United States” and unearthed yet another tactic by which “pharmaceutical companies, with billions in sales at stake, exert a powerful but often unrecognized influence over the practice of American medicine.”

Issued by leading medical associations and government institutions, treatment guidelines are supposed to be based on rigorous science. But the committees that write them have been dominated by doctors who have worked as paid speakers, consultants or advisers for companies selling the recommended drugs.

In their investigation, the duo found:

  • Nine guidelines were written by panels where more than 80 percent of doctors had financial ties to drug companies.
  • Four panels did not require members to disclose any conflicts of interest. Of the 16 that did, 66 percent of doctors on the panels had ties to drug companies.
  • Some guidelines written by conflicted panels recommend drugs that have not been scientifically proven to safely treat conditions, leading to inappropriate or over prescribing. Medical experts have raised such questions about guidelines for anemia, chronic pain and asthma.

For extensive anecdotes and examples, dig into the full piece.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Reporter tracks top prescribers’ ties to drugs they prescribe

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A while back, Sen. Charles Grassley wrote to state health officials, asking for lists of top Medicaid prescribers of certain drugs. When her state released its, Lisa Chedekel of the Connecticut Health Investigative Team took it and ran with it, using all manner of public data to assemble a portrait of Connecticut’s prolific prescribers and the conflicts of interest that may drive them.

Speaking of conflicts of interest, Chedekel found that 43 of the 108 high prescribers (some broke into the top 10 for multiple drugs) earned money, meals or other benefits from the very companies whose drugs they were subscribing in such large quantities. She profiles a number of these physicians, but my personal favorite is one whose records show a curious correlation:

Dr. Kathleen Degen of Norwich was not among the top prescribers of Eli Lilly’s Zyprexa in 2008, but was the seventh-highest prescriber in 2009 (with 255 prescriptions), when Eli Lilly paid her $24,950 in speaking fees. Her prescribing fell off slightly in 2010, and she received $5,291 from Eli Lilly for speaking and travel. She disappeared from the high prescriber list in 2011 and received just $16 in meals from Eli Lilly, records show.

To better understand the problems that could arise from situations like these, Chedekel talked with academics, as well as a number of physicians named in the story. She also took a look at the drugs themselves, many of which Grassley had selected due to their controversial nature. The piece is a blueprint for reporting state-by-state on similar lists. The story also aired on Fox Connecticut.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.