How The Stigma of HIV Can Linger and Keep People from Care

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Lenworth Poyser (left) works with a colleague at Children’s Hospital Los Angeles. Poyser is a health educator for a project focused on reaching young, gay men of color who are HIV-positive. (Susan Valot/KQED)

Editor’s Note: Lack of health insurance isn’t the only barrier to getting medical care. The stigma and fear around HIV can keep people from seeking help. As part of our ongoing health series Vital Signs, we hear from Lenworth Poyser. He was homeless and living with HIV. Now, Poyser helps young HIV-positive men support each other through a group at Children’s Hospital Los Angeles. 

By Lenworth Poyser

When I first came out, when I was still in Texas, I left my mother’s house. At the time I was 18. What she was basically saying is: You can be in this house, just don’t be gay in this house. And I couldn’t do it. So, I threw my clothes into a trash bag and got out.

My sister had invited me to move out to L.A., move out to L.A. And, when HIV hit, I was like, “Oh, life is too short.” So, I decided to just do it. Continue reading

Prescription: Take New Medicare Data With A Dose of Caution

The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.(Getty Images)

The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.   (Getty Images)

By Mark Memmott, NPR

The headlines about one of Wednesday’s big stories — the release of data from 2012 about Medicare payment to doctors around the nation — are certainly serious sounding:

— “Sliver of Medicare Doctors Get Big Share of Payouts.” (The New York Times)

— “Small Slice of Doctors Account for Big Chunk of Medicare Costs.” (The Wall Street Journal)

— “Release of Medicare doctor payments shows some huge payouts.” (Los Angeles Times)

Here’s how The Associated Press sums up the news: Continue reading

In San Francisco, Brain Surgeons Explore Their Practice Through Art

Neurosurgeon Katherine Ko stands next to her painting "Craniotomy in G Sharp," a depiction of her drilling a skull in preparation for brain surgery. "It's kind of a self portrait," she says. (April Dembosky/KQED)

Neurosurgeon Katherine Ko stands next to her painting “Craniotomy in G Sharp,” a depiction of her drilling a skull in preparation for brain surgery. “It’s kind of a self portrait,” she says. (April Dembosky/KQED)

SAN FRANCISCO — Most of the Moscone Center exhibit hall is full of looming medical machines: brain scanners and brain mappers. Men in suits wait for the wandering neurosurgeon to pass by so they can pounce with their pitch for the latest, greatest technology that will change brain surgery forever.

“Patterns repeat themselves over and over in nature. We see that in our work and in anatomy.” 

But back at exhibit booth 630, it’s a different scene. An art show. Paintings and photographs depict abstract interpretations by neurosurgeons of their work, portraits of neurosurgery patients and natural landscapes that offer a striking resemblance to the human brain.

“Music, art, the visual, the senses — matches and melds with medicine,” says Dr. Katherine Ko, a neurosurgeon from New York who curated the show. “We like to see that left brain, right brain cross over. It’s a respite where you don’t have to concentrate. You can just let your eyes roam.” Continue reading

San Francisco’s Elderly Chinese Suffer from Nursing Home Closure

Mission Bay Convalescent Hospital closed in February. (Vinnie Tong/KQED)

The Mission Bay Convalescent Hospital was home to 35 elderly Chinese immigrants. Only two found a new place in San Francisco. Some have passed away since the move.  (Vinnie Tong/KQED)

By Vinnee Tong

Too often people don’t spend a lot of time thinking about who’s going to take care of them at the end of their life.

It’s not hard to imagine why: It’s scary and stirs up all kinds of emotion.

People appreciated Mission Bay because it was familiar, geared to its Chinese-speaking residents.

At the same time, financial pressures can make the whole topic even harder to deal with. For starters, if you need a bed in a home with full-time care, the decent ones are hard to find and cost a lot.

That’s why the closure of one small place in San Francisco’s Potrero Hill neighborhood is being felt so acutely. The Mission Bay Convalescent Hospital served a community of elderly Chinese, most of whom didn’t speak English. Now the building’s been sold, its occupants scattered, and the city’s supply of affordable nursing home beds is even smaller. Continue reading

School Nurses on Front Lines to Raise Vaccine Rates

(Jane Meredith Adams/EdSource)

Robyn Ettl, Grass Valley Unified school nurse, gives a vision test to second grader Chase Littlejohn at the Grass Valley Charter School. (Jane Meredith Adams/EdSource)

By Jane Meredith Adams, EdSource

In her 33 years as a school nurse, Robyn Ettl has listened, sometimes quietly, sometimes not, to parents in rural Nevada County explain why their children don’t need vaccinations against contagious and potentially fatal diseases, including polio, diphtheria, measles and pertussis.

Parents must now meet with health provider before opting-out of vaccines for their children.

Now, with nearly a half a million children in California registering for kindergarten in the fall, school nurses like Ettl are more invested than ever in a delicate task: trying to change the minds of parents intent on opting out of school-entrance immunizations.

Under a state law that took effect Jan. 1, parents may no longer simply file a letter to opt-out of vaccines. Instead, they are required to consult with a health practitioner –- doctor, naturopath or credentialed school nurse –- before they’re allowed to obtain what’s known as a “personal-belief exemption” from their child’s required immunizations. Continue reading

California ‘Death with Dignity’ Advocates Launch New Campaign

Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)

Jennifer Glass of San Mateo, undergoing chemotherapy last year for lung cancer. (Courtesy: Mary Thomas)

A new campaign is underway to legalize physician-assisted suicide in California. Advocates launched a series of online ads last week to begin raising awareness. Still, it could take years for the effort to yield any results.

“Having choice helps me feel I have some control.” 

Since the early 1990s, lawmakers and activists have tried and failed several times to pass a death with dignity law in California. Under such a law doctors could prescribe lethal medications to patients who are terminally ill. Oregon and Washington permit the practice.

“California is a large state. It’s a politically complicated state,” says Barbara Coombs Lee, president of Compassion and Choices. Her advocacy group is leading the effort to try again to pass a law through the legislature or ballot proposition that would make aid in dying accessible in California. Continue reading

Your Doctor’s Skill at Colonoscopy May Reduce Your Later Colon Cancer Risk

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If you’re going to go to the trouble of having a colonoscopy, you’d probably prefer that you get as much as you can out of the screening test. A new study this week shows that a doctor’s rate of finding and removing adenomas — these are pre-cancerous growths — is linked to the patient’s lower risk of developing colon cancer later.

For every 1 percent increase in adenoma detection there was a 3 percent decrease a person’s colon cancer risk. 

Colonoscopy is one of the recommended screening tests for colon cancer. Yet doctors have differing rates at how often they find these adenomas. This is the first study in the U.S. to look at the association between finding adenomas and later cancer risk, as part of a national review funded by the National Cancer Institute. It was published in the New England Journal of Medicine.

In the study, researchers at Kaiser Permanente Northern California reviewed more than 300,000 colonoscopies performed by 136 gastroenterologists between 1998 and 2010. Continue reading

Why is Fort Hood Shooter’s ‘Mental Health’ Constantly Reported?

Television news live trucks at the front gate of Fort Hood, Texas. (Joe Raedle/Getty Images)

Television news live trucks at the front gate of Fort Hood, Texas. (Joe Raedle/Getty Images)

To state the obvious, the shooting at Fort Hood is a tragedy. But in press reports the alleged shooter, Ivan Lopez, cannot be mentioned without reference to his recent evaluation and treatment for mental health issues.

As NPR correctly points out, the fact of the shooter’s treatment could not have predicted that the violent event would have occurred. Worse, the press reports wrongly scare people into thinking that mental illness is easily linked to violent behavior.

It’s not. From NPR:

One national survey in 2006 found that most Americans — 60 percent — believed people with schizophrenia were likely to be violent. But the vast majority of people with psychiatric disorders are not violent. In fact, another study found they are far more likely to be the victims of violence, and that 1 in 4 experience violence every year. Continue reading

Covered California Now Above 1.2 Million Enrollees — with More Coming

Screenshot from CoveredCA.com, the website of Covered California.

Screenshot from CoveredCA.com, the website of Covered California.

Covered California executive director Peter Lee testified before Congress Thursday morning. He used his 5-minutes to give a quick recap of what’s gone right on the nation’s biggest state-based exchange.

First, Lee released numbers of where Covered California stands as of Monday, the day open enrollment formally ended (although those who could not finish due to technical problems have until April 15 to finish):

  • 1.2 million people enrolled in Covered California
  • 1.9 million newly-enrolled in Medi-Cal
  • 800,000 people are likely eligible for Medi-Cal but waiting to be confirmed

“This is close to four million Californians,” Lee told the House Committee on Oversight Government Reform. “As of three days ago, California had brought coverage to more than 50 percent of those subsidy-eligible in the exchange.” Continue reading

Obama Signs Law to Fix Medicare Rate Gap in California

Under the new law San Diego, pictured above, will no longer be categorized as "rural." (vinhdicated/Flickr)

Under the new law San Diego, pictured above, will no longer be categorized as “rural.” (vinhdicated/Flickr)

A new federal law will change how doctors get paid in California, making it easier for patients in 14 California counties to find a doctor who accepts Medicare.

The law, signed by President Obama on Tuesday night, fixes an outdated Medicare formula that set rates based on urban or rural designations established in the 1960s, with places like San Diego, Sacramento, and Santa Cruz falling into the “rural” category.

So even as rent for office space and other costs of practicing medicine rose with the local economy in those places, doctors were still paid the same rates as doctors in remote, rural areas like Humboldt or Modoc. Continue reading