Morning Rounds: Americans put faith in nurses as overall confidence in health care ebbs

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Good morning. Today we take a look at how health care happens outside the exam room: in a kitchen, in politics, in the courts, and in poetry.

Abortion restriction narrow choices for pregnant cancer patients

Pregnant cancer patients have always faced an impossible dilemma: Their life-saving cancer treatments could harm their unborn children. That’s a nearly impossible choice, but in post-Dobbs America, restrictions on abortion access may take that decision out of patients’ — and their doctors’ — hands. Cancer complications may also force decisions on whether to prioritize the life of the mother or the fetus. Oncologist Katherine Van Loon recalls a patient urging her to remember her two other children at home.

“We are being limited in terms of our ability to do our best job in caring for our patients,” Van Loon said about continued abortion restrictions, including a potential mifepristone ban. “Pregnancy is a joyful time in most women’s lives. When it is catastrophized by a cancer diagnosis, these are some of the worst moments that I have shared with patients.” STAT contributor Shravya Pant of the Medill News Service has more.

American taxpayers pay as much for health care as other countries do for universal coverage

The U.S. government spent more on health care last year than the combined governments of Germany, the U.K., Italy, Spain, Austria, and France did on universal health care coverage, according new CMS data. Their populations add up to a total of 335 million people, compared to the U.S. population of 331 million.

The $1.8 trillion in federal and state health care expenditures in 2022 funded by taxpayers last year — about 41% of the nearly $4.5 trillion in both public and private health care spending — calls to mind an argument made by economists Amy Finkelstein and Liran Einav. “We’re already paying as taxpayers for universal basic automatic coverage, we’re just not getting it,” Finkelstein said at the STAT Summit in October. Read more from STAT’s Annalisa Merelli.

Teaching kitchens put food as medicine on the table

When STAT intern Anika Nayak was exploring a story about food as medicine, I thought about Boston Medical Center’s food pantry, one more way the safety-net hospital thinks broadly about the factors that shape health, from housing to legal aid. I jumped at the opportunity to learn more at the hospital’s teaching kitchen. That’s where I met five-year-old Tony McKoy Jr., wearing a black chef’s hat and still amazing his mother after his transformation from a kid who was not eating well enough to grow into an eager class member.

Since 2008, participants have been gathering in a glass-walled partition off the hospital cafeteria for 25 classes a month that are medically tailored programs for specific patient groups, from dealing with anemia in pregnancy to cooking without dairy. “We have a lot of families in shelters and a lot of families who don’t have consistent access to shelf-stable food,” dietitian Lisa Burke told Anika. “So in all our in-person classes, the majority of the food can be found in the food pantry or through WIC benefits.” Read our story here.

Finding ways to be fine, through poetry

When Leena Danawala’s poem “chronicity” was published in JAMA last month, it offered a rare public view into her life with a form of small vessel vasculitis called granulomatosis with polyangiitis. Through her poetry, the 34-year-old rheumatologist said, she can better see how her illness has changed her. She recently spoke with STAT’s Isabella Cueto.

You wrote in 2013 about finally getting your diagnosis.

I went through all the stages of grief during that time. The hardest part of getting a diagnosis is a loss of your sense of self — who you were as a person is no longer the same.

The final line in “chronicity” says, “perhaps someday god will tell me i am fine.” 

I’m always, constantly trying to find ways to be fine. It’s very much a balance between pretending you’re OK and then letting yourself not be OK.

Read the full interview.

Americans put faith in nurses as overall confidence in health care ebbs

Gallup polls earlier this year indicated that Americans’ level of faith in their country’s health care system is the lowest it’s been in a decade. But if you want to take a glass-half-full perspective, the latest Gallup survey indicates that faith in nurses is still fairly high. Results released yesterday say 82% of Americans rated nurses’ medical care as excellent or good — down six percentage points from 2010, but far better than the 69% who said the same of doctors (down 15 percentage points).

Entities with middling scores included hospitals (58%), walk-in or urgent care clinics (56%), and telemedicine or virtual doctor visits (52%). Faring worse were hospital emergency rooms (47%), pharmaceutical or drug companies (33%), health insurance companies (31%), and nursing homes (25%).

Opinion: The U.S. must raise federal alcohol taxes

Cara Poland, an addiction medicine physician at Michigan State University College of Human Medicine, tells a harrowing, heartbreaking story of losing her 24-year-old brother, who was a university graduate and former law student, to a self-inflicted gunshot wound. His death, two days before Christmas, followed a decade of hard and continuous drinking interspersed with addiction and mental health treatment, but he could not sustain his recovery.

“Like so many others who survived the loss of someone dear from the chaos of severe substance use disorder, I am too familiar with unspeakable grief,” she writes in a STAT First Opinion about what her work has taught her. “To help stop the addiction crisis that has brought so much sorrow to families like mine, policymakers must prioritize prevention at all levels and support evidence-based prevention initiatives — including raising federal excise taxes on alcohol.” Read more on how that has worked and why it needs an update.

If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.

What we’re reading

• Court rejects claims linking Tylenol to autism, ADHD, Wall Street Journal
• How a fight over data made South Dakota’s bad syphilis outbreak worse, Vox
• An American girlhood in the Ozempic era, The Cut
• Exclusive: Amy Abernethy to step down as Verily’s chief medical officer in latest departure from company, STAT
• FDA finds ‘extremely high’ lead levels in cinnamon in applesauce at Ecuador plant, Washington Post
• 3 trends to watch in biotech in 2024, STAT