Health Care

Patient surveys and the opioid epidemic

August 31, 2016

I spent a few hours back in June shadowing Dr. S. Michael Keller, the emergency room director at Marion General Hospital in Marion, Ind. The photos were for a story in The New York Times about patient satisfaction surveys and their effect on the opioid epidemic. Under the Affordable Care Act, hospitals’ Medicare reimbursements were tied to patient satisfaction surveys. The idea of this was to encourage quality care, but many health care professionals argue the surveys incentivized doctors to prescribe powerful and potentially addictive painkillers such as opioids to patients in order to score well on the surveys. Marion General bucked the trend by cutting opioid prescriptions, leading to a drastic drop in the patient satisfaction surveys.

Dr. S. Michael Keller, director of Marion General Hospital’s emergency department and ambulance services, examines William Joseph, a patient from Van Buren, Ind., in the Emergency Room on Wednesday, June 15, 2016, in Marion, Ind. Marion General Hospital urged its doctors to limit opioid prescriptions resulting in lowered patient satisfaction scores, particularly in pain management. As part of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) incentivizes quality care by rewarding hospitals that score well on patient satisfaction surveys. (James Brosher for The New York Times)

Dr. S. Michael Keller, director of Marion General Hospital’s emergency department and ambulance services, speaks with Deseric Inman, a patient from Marion, Ind. experiencing eye discomfort, in the Emergency Room on Wednesday, June 15, 2016, in Marion, Ind. (James Brosher for The New York Times)

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Shortage of primary-care physicians in the United States

May 30, 2016

A few weeks back, I spent a morning doing rounds with a group of pediatric residents in the postpartum unit at Franciscan St. Francis Hospital in Indianapolis. The photos were for a story in the Desert News looking at the shortage of primary-care physicians – which include family doctors, general internists and pediatricians – in the United States. The supply of primary-care physicians is so low the average wait time for an appointment is nearly two months.

Gerold Butler, Ninah Clegg, Evan Catteron — Ninah Clegg, a third-year medical student from Marian University, consults Dr. Gerold Butler, a pediatric hospitalist, as she examines Evan Catterton, a 16-day-old newborn from Brown County, Ind., on Thursday, April 28, 2016, at Franciscan St. Francis Hospital in Indianapolis. (James Brosher / For the Deseret News)

Dr. Ryan Taylor, a first-year resident from Chicago, listens to Dr. Gerold Butler, not pictured, a pediatric hospitalist, as they speak with a patient during rounds on Thursday, April 28, 2016, at Franciscan St. Francis Hospital in Indianapolis. (James Brosher / For the Deseret News)

Dr. Pardeep Kumar

October 7, 2015

Last month I photographed Dr. Pardeep Kumar, an internist in Terre Haute, Ind., for a story in The New York Times about a new medical coding system that went into effect on Oct. 1. The new system, ICD-10, is causing health care providers anxiety because it will change the fundamental way they describe illnesses and injuries in their computer systems. As Dr. Michael R. Marks, a Connecticut orthopedic surgeon, describes it in the story: “On Oct. 1, we will be speaking a new language. It’s like switching to German, after speaking English for 30 years.”

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Dr. Richard Fogel

April 27, 2015

Earlier this month I photographed Dr. Richard Fogel, a heart doctor at St. Vincent Heart Center in Indianapolis, for a Wall Street Journal story outlining a recent dramatic increase in the price of a pair of heart medications, Isuprel (Isoproterenol) and Nitropress (Nitroprusside Sodium). The price hikes were not a result of improvements but rather the ownership: the prices rose drastically after the rights to the drugs were acquired by Valeant Pharmaceuticals in earlier this year.

The skinny dream

July 2, 2012

For the past 10 months, the South Bend Tribune photo staff has been documenting the journey of a local woman, Kimmie Trethewey, who underwent bariatric surgery. My predecessor at the Tribune, Marcus Marter, shot a great deal of the story in the early stages, and I’ve had the opportunity to photograph Kimmie the past few months. The story is currently running in the paper as a series so I thought I’d share a few of my favorite frames of Kimmie.

Kimmie Trethewey shares a hug with a member of her walking group after finishing the Sunburst 5K Walk on Saturday, June 2, 2012, at Notre Dame Stadium. (James Brosher/South Bend Tribune)

After realizing how much weight she has lost since a previous visit, Kimmie Trethewey starts to cry as she talks with her dietitian on Wednesday, May 9, 2012, at Memorial Weight Loss and Bariatric Surgery Center in Granger. (James Brosher/South Bend Tribune)

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