Storm barrels through U.S. Midwest with snow and frigid temperatures

Satellite image from the National Weather Service. 2-9-18

By Brendan O’Brien and Suzannah Gonzales

MILWAUKEE, Wis./CHICAGO (Reuters) – A major winter storm barreled into Chicago and Milwaukee early on Friday, dumping heavy snow and dropping temperatures well below freezing as it forced schools to close and threatened to leave travel at a stand still across the Midwest.

The storm system stretches from western Montana across the Dakotas and parts of Minnesota, Wisconsin and Illinois, and reaches as far east as southern Michigan. The storm could drop up to 14 inches (36 cm) of snow in some areas, the National Weather Service said.

Chicago was anticipating six to 12 inches of snow early on Friday morning with more snow expected over the weekend, according to the service’s weather forecast.

“The city is ready for this,” Chicago Mayor Rahm Emanuel said during a news conference about the city’s preparedness on Thursday. “Make no mistake though, this is a heavy snow, heavier than we’ve seen in a number of winters.”

City officials announced school closures in Chicago, Detroit and Milwaukee because of the weather.

Wind chill temperatures were expected to drop below 0 Fahrenheit (-18 C) in many areas across the region, and officials warned of limited visibility on roads.

Chicago’s O’Hare and Midway international airports canceled more than 200 flights on Thursday before the storm hit, and several airlines were also anticipating delays or cancellations.

United Airlines said on Twitter that waivers were in effect for snow-hit areas this week allowing travelers to change flights without charges, and Delta Air Lines offered to rebook flights on Friday for 18 Midwest cities.

Winter weather across the United States this week killed several people in accidents in the Midwest, including six in Iowa, two in Missouri and one in Montana, local media in those states reported.

(Editing by Peter Graff)

Counting the costs: U.S. hospitals feeling the pain of physician burnout

Counting the costs: U.S. hospitals feeling the pain of physician burnout

By Julie Steenhuysen

ANN ARBOR, Mich. (Reuters) – Dr. Brian Halloran, a vascular surgeon at St. Joseph Mercy Ann Arbor, starts planning his garden long before spring arrives in southeast Michigan.

His tiny plot, located in the shadow of the 537-bed teaching hospital, helps Halloran cope with burnout from long hours and the stress of surgery on gravely ill patients.

“You really have to find the balance to put it a little more in perspective,” he said.

Hospitals such as St. Joseph Mercy Ann Arbor have been investing in programs ranging from yoga classes to personal coaches designed to help doctors become more resilient. But national burnout rates keep rising, with up to 54 percent of doctors affected.

Some leading healthcare executives now say the way medicine is practiced in the United States is to blame, fueled in part by growing clerical demands that have doctors spending two hours on the computer for every one hour they spend seeing patients.

What’s more, burnout is not just bad for doctors; it’s bad for patients and bad for business, according to interviews with more than 20 healthcare executives, doctors and burnout experts.

“This really isn’t just about exercise and getting enough sleep and having a life outside the hospital,” said Dr. Tait Shanafelt, a former Mayo Clinic researcher who became Stanford Medicine’s first chief physician wellness officer in September.

“It has at least as much or more to do with the environment in which these folks are practicing,” he said.

Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors and leads doctors to leave a profession they once loved.

For a graphic, click http://tmsnrt.rs/2zMlmuy

Hospitals can ill afford these added expenses in an era of tight margins, costly nursing shortages and uncertainty over the fate of the Affordable Care Act, which has put capital projects and payment reform efforts on hold.

“Burnout decreases productivity and increases errors. It’s a big deal,” said Cleveland Clinic Chief Executive Dr. Toby Cosgrove, one of 10 U.S. healthcare CEOs who earlier this year declared physician burnout a public health crisis.

WHAT TO DO?

Hospitals are just beginning to recognize the toll of burnout on their operations.

Experts estimate, for example, that it can cost more than a $1 million to recruit and train a replacement for a doctor who leaves because of burnout.

But no broad calculation of burnout costs exists, Shanafelt said. Stanford, Harvard Business School, Mayo and the American Medical Association are working on that. They have put together a comprehensive estimate of the costs of burnout at the organizational and societal level, which has been submitted to a journal for review.

In July, the National Academy of Medicine (NAM) called on researchers to identify interventions that ease burnout. Meanwhile, some hospitals and health insurers are already trying to lighten the load.

Cleveland Clinic last year increased the number of nurse practitioners and other highly trained providers by 25 percent to 1,600 to handle more routine tasks for its 3,600 physicians. It hired eight pharmacists to help with prescription refills.

Atrius Health, Massachusetts’ largest independent physicians group, is diverting unnecessary email traffic away from doctors to other staffers and simplifying medical records, aiming to cut 1.5 million mouse “clicks” per year.

Insurer UnitedHealth Group, which operates physician practices for more than 20,000 doctors through its Optum subsidiary, launched a program to help doctors quickly determine whether drugs are covered by a patient’s insurance plan during the patient visit. It is also running a pilot program for Medicare plans in eight states to shrink the number of procedures that require prior authorization.

Similarly, Aetna Inc this year began a behavioral health program that eliminates prior authorization requirements for admission to some high-performing hospitals.

DOCTOR OVERLOAD

Experts define burnout as a syndrome marked by emotional exhaustion, cynicism and decreased effectiveness. Many burned out doctors cut back their hours to cope, and a disturbing number commit suicide.

A landmark 2015 Mayo Clinic study found that more than 7 percent of nearly 7,000 doctors had considered suicide within the prior 12 months, compared with 4 percent of other workers. About 400 a year go through with it.

Driving the burnout symptoms is the burden of data entry on clumsy electronic medical records systems that doctors must use to prove the quality of their care, said Dr. Christine Sinsky, vice president of professional satisfaction at the American Medical Association.

Sinsky recently conducted an experiment in her own internal medicine practice in Dubuque, Iowa. She asked a staff member how many mouse clicks it takes to order and record a single patient’s flu shot in their electronic medical record. The answer: 32.

She has visited some practices where a doctor had to record flu shots for more than 1,000 patients because only the doctor was allowed to enter the order.

Such mandates reflect an overly strict interpretation of federal health reforms designed to encourage doctors to use electronic medical records, such as the 2009 Health Information Technology for Economic and Clinical Health Act that required doctors to demonstrate “meaningful use” of the systems.

“We have to recognize the exacting toll that the first generation of electronic health records have had on physicians,” Sinsky said. “I would identify it as one of the most important drivers of physician burnout.”

Pre-approval requirements from health insurers for many services and quality metrics built into Obamacare have added to doctors’ administrative duties.

“We’ve got this measurement mania. We’ve got to back off of that,” said Dr. Paul Harkaway, chief accountable care officer for Michigan’s St. Joseph Mercy Health System, a part of Trinity Health, a national not-for-profit Catholic healthcare system.

As a result of these requirements, primary care physicians spend more than half of their 11.4 hour workday performing data entry and other tasks, according to a September AMA/University of Wisconsin study published in the Annals of Family Medicine.

To manage, doctors often finish work at home in the evening, a part of the day known as “pajama time.”

COSTS TO THE HEALTHCARE SYSTEM

Doctors’ suffering can take a direct toll on patients. In a 2010 study, Shanafelt and colleagues found that the more burned out a surgeon was, the more likely he or she was to report a major medical error. Other studies have shown that burnout drives up rates of unnecessary testing, referrals to specialists and hospital admissions.

When doctors quit, it costs an estimated $800,000 to $1.3 million in recruitment, training and productivity costs, depending on the specialty.

Even when physicians don’t leave, they can contribute thousands of dollars in costs each year “just as a matter of inefficient functioning,” said Dr. Colin West of the Mayo Clinic.

The trend has medical malpractice experts concerned. CRICO, the malpractice carrier for Harvard University’s two dozen affiliated hospitals, recently had to settle a handful of cases because doctors were too burned out to fight, even though CRICO believed it could win.

“The clinician just wanted it to go away,” said Dr. Luke Sato, CRICO’s chief medical officer. Sato estimates that an average breast or colorectal cancer malpractice case might cost $750,000 to $1 million to settle.

The crisis has Harkaway worried for his colleagues in Michigan, and for his profession.

“Working with doctors every day, you see it,” he said. “They are just beat down.”

(Reporting by Julie Steenhuysen; Editing by Michele Gershberg and Editing by Edward Tobin)

Reuters finds 3,810 U.S. areas with lead poisoning double Flint’s

Reuters finds 3,810 U.S. areas with lead poisoning double Flint’s

By M.B. Pell and Joshua Schneyer

(Reuters) – Since last year, Reuters has obtained neighborhood-level blood lead testing results for 34 states and the District of Columbia. This data allows the public its first hyper-local look at communities where children tested positive for lead exposure in recent years.

While the number of children with high lead levels has plummeted across the U.S. since lead paint and gasoline were phased out in the 1970s and 1980s, many communities remain exposed to the toxic heavy metal, the data show.

In all, Reuters has identified 3,810 neighborhood areas with recently recorded childhood lead poisoning rates at least double those found across Flint, Michigan, during the peak of that city’s water contamination crisis in 2014 and 2015. Some 1,300 of these hotspots had a rate of elevated blood tests at least four times higher than Flint’s.

Reuters defined an elevated result as any test higher than the Centers for Disease Control and Prevention’s current reference number of 5 micrograms per deciliter, the level at which the agency recommends a public health intervention.

The news agency obtained the data, broken down by census tract or zip code, from state health departments or the CDC through records requests. U.S. census tracts are small county subdivisions averaging 4,000 residents. Zip codes have average populations of 7,500.

This newest map reflects additional data obtained this year, and includes some changes to data initially published by Reuters in a map last December.

The map now includes testing data for additional states and cities: Kansas, Georgia, Tennessee, Vermont, North Carolina, New York City and Washington, DC.

The newly identified communities with high rates of elevated childhood lead levels include a historic district in Savannah, Georgia, areas in Rutland, Vermont, near the popular skiing mountain Killington, and a largely Hasidic Jewish area in Brooklyn.

The updated map includes other minor changes. Recently, the CDC provided testing results to correct data it previously released to Reuters for Pennsylvania, Ohio, New Jersey, Virginia and Louisiana. Responding to earlier records requests, the CDC mistakenly released test results for all children under 16, though the news agency requested testing results for children under six – the age group most likely to be affected by lead exposure.

Still, even with the updated CDC data, the number of areas with high rates of elevated lead tests increased or remained about the same in each state.

The map now features zip code level data for Los Angeles County, California, provided by the state’s Department of Public Health. An earlier version featured census tract level results, but reporters discovered the county’s epidemiologist had misclassified some of them. The county has declined to provide corrected data.

(Editing by Ronnie Greene)

Listeria risk prompts Meijer to recall produce in six U.S. states

Listeria risk prompts Meijer to recall produce in six U.S. states

NEW YORK (Reuters) – Retailer Meijer Inc said it was recalling packaged vegetables in six U.S. states because of possible contamination from Listeria monocytogenes bacteria, which can cause fatal food poisoning in young children, pregnant women and elderly or frail people.

Meijer, based in Grand Rapids, Michigan, said there were no illnesses reported as of Sunday.

The recall affects 35 products and includes vegetables such as broccoli, cauliflower and asparagus as well as party trays sold in Meijer-branded plastic or foam packaging in Michigan, Ohio, Indiana, Illinois, Kentucky and Wisconsin between Sept. 27 and Oct. 20, the company said on Saturday.

In February, Meijer recalled its Meijer-branded Colby and Colby Jack cheese sold through its deli counters because of potential contamination with Listeria monocytogenes.

The U.S. Centers for Disease Control and Prevention estimated that 1,600 people develop a serious form of infection known as listeriosis each year, and 260 die from the disease, making it the third most deadly form of food poisoning in the United States.

“The infection is most likely to sicken pregnant women and their newborns, adults aged 65 or older and people with weakened immune systems,” the CDC said on its website. Symptoms include fever and diarrhea and can start the same day of exposure or as much as 70 days later.

(Reporting by Alwyn Scott; Editing by Lisa Von Ahn and Peter Cooney)

Michigan governor denies misleading U.S. House on Flint water

Michigan Governor Rick Snyder is seen at a bill signing event in Detroit, Michigan, U.S. on June 20, 2014. Picture taken on June 20, 2014. REUTERS/Rebecca Cook

By David Shepardson

(Reuters) – Michigan Governor Rick Snyder denied Thursday that he had misled a U.S. House of Representatives committee last year over testimony on Flint’s water crisis after lawmakers asked if his testimony had been contradicted by a witness in a court hearing.

The House Oversight and Government Reform Committee wrote Snyder earlier Thursday asking him about published reports that one of his aides, Harvey Hollins, testified in a court hearing last week in Michigan that he had notified Snyder of an outbreak of Legionnaires’ disease linked to the Flint water crisis in December 2015, rather than 2016 as Snyder had testified.

“My testimony was truthful and I stand by it,” Snyder told the committee in a letter, adding that his office has provided tens of thousands of pages of records to the committee and would continue to cooperate fully.

Last week, prosecutors in Michigan said Dr. Eden Wells, the state’s chief medical executive who already faced lesser charges, would become the sixth current or former official to face involuntary manslaughter charges in connection with the crisis.

The charges stem from more than 80 cases of Legionnaires’ disease and at least 12 deaths that were believed to be linked to the water in Flint after the city switched its source from Lake Huron to the Flint River in April 2014.

Wells was among six current and former Michigan and Flint officials charged in June. The other five, including Michigan Health and Human Services Director Nick Lyon, were charged at the time with involuntary manslaughter stemming from their roles in handling the crisis.

The crisis in Flint erupted in 2015 when tests found high amounts of lead in blood samples taken from children in the predominantly black city of about 100,000.

The more corrosive river water caused lead to leach from pipes and into the drinking water. Lead levels in Flint’s drinking water have since fallen below levels considered dangerous by federal regulators, state officials have said.

(Reporting by David Shepardson; Editing by Jonathan Oatis)

Michigan to charge state’s top medical official in Flint water deaths

Reuters finds 3,810 U.S. areas with lead poisoning double Flint’s

(Reuters) – Michigan’s top medical official will be charged with involuntary manslaughter for her role in the city of Flint’s water crisis, which was linked to an outbreak of Legionnaires’ disease that caused at least 12 deaths, state prosecutors said on Monday.

Dr. Eden Wells, the state’s chief medical executive who already faced lesser charges, would become the sixth current or former official to face involuntary manslaughter charges in connection with the crisis.

The state intends to add involuntary manslaughter and misconduct in office to the other charges of obstruction of justice and lying to police that Wells already faces, a spokeswoman for Michigan Attorney General Bill Schuette said.

Jerold Lax, an attorney for Wells, said he first learned of the proposed additional charges at a pre-trial hearing on Monday when special prosecutor Todd Flood announced the state’s intention to file them.

Flood “indicated on the record that he would be providing us some additional information in relation to the charges,” Lax said, adding that he had no further comment.

The charges stem from more than 80 cases of Legionnaires’ disease that were believed to be linked to the water in Flint after the city switched its source from Lake Huron to the Flint River in April 2014.

Wells was among six current and former Michigan and Flint officials charged in June. The other five, including Michigan Health and Human Services Director Nick Lyon, were charged at the time with involuntary manslaughter stemming from their roles in handling the crisis.

Involuntary manslaughter is a felony that carries a sentence of up to 15 years in prison.

In court documents, prosecutors had previously said Wells lied to police about when she became aware of the Legionnaires’ outbreak and that she threatened a team of independent researchers who were studying the source of the disease.

Flood said Monday he was seeking the new charges based on new review of documents and testimony that came out last week, the Detroit Free Press reported.

The crisis in Flint erupted in 2015 when tests found high amounts of lead in blood samples taken from children in the predominantly black city of about 100,000.

The more corrosive river water caused lead to leach from pipes and into the drinking water. Lead levels in Flint’s drinking water have since fallen below levels considered dangerous by federal regulators, state officials have said.

(Reporting by Peter Szekely in New York; Editing by Bill Trott and Grant McCool)

Michigan to charge top medical official in Flint water deaths

A sign is seen next to a water dispenser at North Western High School in Flint, a city struggling with the effects of lead-poisoned drinking water in Michigan, May 4, 2016.

(Reuters) – Michigan’s top medical official will be charged with involuntary manslaughter for her role in the city of Flint’s water crisis, which was linked to an outbreak of Legionnaires’ disease that caused at least 12 deaths, state prosecutors said on Monday.

Dr. Eden Wells, who already faced lesser charges, would become the sixth current or former official to face involuntary manslaughter charges in connection with the crisis.

The state intends to add involuntary manslaughter and misconduct in office to the other charges of obstruction of justice and lying to police that Wells already faces, a spokeswoman for Michigan Attorney General Bill Schuette said.

An attorney for Wells, the state’s chief medical executive, could not immediately be reached by Reuters but Jerold Lax, one of her attorneys, told the Detroit Free Press they only learned of the proposed additional charges at a pre-trial hearing on Monday.

The charges stem from more than 80 cases of Legionnaires’ disease that were believed to be linked to the water in Flint after the city switched its source from Lake Huron to the Flint River in April 2014.

Wells was among six current and former Michigan and Flint officials charged in June. The other five, including Michigan Health and Human Services Director Nick Lyon, were charged at the time with involuntary manslaughter stemming from their roles in handling the crisis.

Involuntary manslaughter is a felony that carries a sentence of up to 15 years in prison.

In court documents, prosecutor had previously said Wells lied to police about when she became aware of the Legionnaires’ outbreak and that she threatened a team of independent researchers who were studying the source of the disease.

Special prosecutor Todd Flood said Monday he was seeking the new charges based on new review of documents and testimony that came out last week, the newspaper said.

The crisis in Flint erupted in 2015 when tests found high amounts of lead in blood samples taken from children in the predominantly black city of about 100,000.

The more corrosive river water caused lead to leach from pipes and into the drinking water. Lead levels in Flint’s drinking water have since fallen below levels considered dangerous by federal regulators, state officials have said.

 

(Reporting by Peter Szekely in New York; Editing by Bill Trott)

 

U.S. medic awarded Medal of Honor for Vietnam War heroism

U.S. President Donald Trump awards the Medal of Honor to James McCloughan, who served in the U.S. Army during the Vietnam War, during a ceremony at the White House in Washington, U.S. July 31, 2017. REUTERS/Joshua Roberts

By Ian Simpson

WASHINGTON (Reuters) – A 71-year-old former Army medic from Michigan who saved wounded comrades under fire during the Vietnam War was given the highest U.S. military award by President Donald Trump in a White House ceremony on Monday.

James McCloughan, a retired high school teacher and coach from South Haven, received the Medal of Honor for his valor in saving the lives of 10 members of his platoon at the Battle of Nui Yon Hill in May 1969.

“Jim, I know I speak for every person here when I say that I am in awe of your actions and your bravery,” Trump said before fastening the medal with its star and blue ribbon around the white-haired veteran’s neck.

It was Trump’s first award of the Medal of Honor since taking office in January.

Ten men from McCloughan’s unit attended the medal ceremony, including five he saved, the president said.

McCloughan was 23 and serving as an Americal Division medic when he returned to the battlefield multiple times over 48 hours of fighting to retrieve the wounded soldiers, despite being hit himself with grenade shrapnel and gunfire, his citation said.

He refused to be evacuated to treat his wounds and held a strobe light in an open area at night for a resupply air drop, it said. He also destroyed a North Vietnamese Army position with a grenade.

The Medal of Honor generally must be awarded within five years of the actions that justify it. A former platoon leader began campaigning in 2009 for McCloughan to get the award, resulting in an act of Congress in December to waive the time limit.

President Barack Obama signed the act, making McCloughan eligible for the medal before he left office.

McCloughan left the service with a rank of specialist five and returned to Michigan. He taught psychology and sociology at South Haven High School and coached football, wrestling and baseball.

He is a member of the Michigan High School Coaches Hall of Fame. South Haven is about 180 miles (290 km) west of Detroit.

(Editing by Jeffrey Benkoe and Steve Orlofsky)

Michigan sues Flint over failing to approve long-term water deal

FILE PHOTO - The Flint Water Plant tower is seen in Flint, Michigan, U.S. on February 7, 2016. REUTERS/Rebecca Cook/File Photo

By Suzannah Gonzales and Chris Kenning

(Reuters) – Michigan sued the city of Flint on Wednesday in federal court over its failure to approve a long-term drinking water source for residents.

Flint switched its water supply in 2014, sparking a crisis that was linked to an outbreak of Legionnaires’ disease and at least 12 deaths, as well as exposure of residents to dangerously high lead levels. Since October 2015, the city has obtained its water from the Great Lakes Water Authority.

But the Flint city council’s refusal this week to approve a long-term agreement with the supplier, negotiated by the city’s mayor, without proposing a reasonable alternative, will “cause an imminent and substantial endangerment to public health in Flint,” according to the lawsuit filed by the Michigan Department of Environmental Quality in U.S. District Court in Detroit.

The state is asking the court to bar Flint from changing water sources and adopt the long-term agreement.

“While disappointing that the state and federal government are now involved in making a decision we as city leaders should be making for Flint, I cannot say that I am surprised,” Flint Mayor Karen Weaver said in a statement. She added that her plan was best option.

Instead of approving the long-term agreement, the city council voted on Monday to extend until September its contract with the Great Lakes Water Authority, local media reports said.

City Council President Kerry Nelson told the Detroit News the state’s June 26 deadline was too rushed for council members, who needed more time to examine the deal.

Michigan Governor Rick Snyder and state officials on Wednesday called on the council to approve the mayor’s deal.

“The city is well on its way to a full recovery, and to hinder that progress now would be a major and costly setback for residents,” Snyder’s spokeswoman, Anna Heaton, said.

The crisis erupted in 2015 after tests found high amounts of lead in blood samples taken from children in the industrial city of about 100,000, whose population is predominantly black.

The city had started using the Flint River for water in 2014. Water to Flint from the Great Lakes Water Authority comes from Lake Huron.

The more corrosive river water caused lead to leach from pipes and into the drinking water. Lead levels in Flint’s drinking water have now fallen below levels considered dangerous by federal regulators.

Earlier this month, six current and former Michigan and Flint officials were criminally charged for their roles in the crisis.

(Reporting by Suzannah Gonzales and Chris Kenning in Chicago; Editing by G Crosse, Matthew Lewis and David Gregorio)

Suspect in Michigan airport stabbing to make court appearance

By Steve Friess

FLINT, Mich. (Reuters) – A man charged with stabbing an airport police officer in an attack federal investigators are probing as an act of terrorism is expected to appear in a Michigan federal court on Wednesday.

Amor Ftouhi, 49, of Quebec, Canada, was charged in federal court with violence at an international airport for stabbing officer Jeff Neville at the Bishop International Airport in Flint on June 21. Neville underwent surgery and has left the hospital, local media reported.

Ftouhi, originally from Tunisia and who holds dual Tunisian-Canadian citizenship, is expected to appear before U.S. Magistrate Judge Stephanie Dawkins Davis at the federal courthouse in Flint on Wednesday morning.

Ftouhi legally entered the United States from Lake Champlain, New York, on June 16 before making his way to Flint, the Federal Bureau of Investigation said. Officials said Ftouhi targeted a city with an international airport, but declined to say why Flint was chosen.

Ftouhi, who was not on the radar of U.S. or Canadian authorities before the attack, was in Michigan as early as June 18, the FBI said. U.S. and Canadian investigators are probing his travel before the attack.

According to the criminal complaint, Ftouhi yelled in Arabic “Allahu akbar” (God is greatest) before stabbing Neville.

He also said something to the effect of “You have killed people in Syria, Iraq and Afghanistan, and we are all going to die,” the complaint said.

Ftouhi attempted to buy a gun before the attack, but was unable to do so, the FBI said.

FBI officials declined to provide details on where Ftouhi attempted to buy the gun or what type of gun he tried to purchase. The 12-inch, serrated knife Ftouhi used in the attack was bought in the United States.

(Additional reporting and writing by Timothy Mclaughlin in Chicago; Editing by Andrew Hay)