Health Care - James Brosher Photography

Patient surveys and the opioid epidemic

James Brosher — Wed, 31 Aug 2016 19:17:55 +0000

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)

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

A pain assessment tool hangs on a wall as Dr. Michael Keller, director of Marion General Hospital’s emergency department and ambulance services, speaks with a patient in the Emergency Room on Wednesday, June 15, 2016, in Marion, Ind. (James Brosher for The New York Times)

Dr. S. Michael Keller, director of Marion General Hospital’s emergency department and ambulance services, examines 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)

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

Dr. Michael Keller, left, director of Marion General Hospital’s emergency department and ambulance services, and Ann Vermilion, the hospital’s administrative director, pose outside of 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

James Brosher — Mon, 30 May 2016 18:54:47 +0000

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.

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)

Doctors Ryan Taylor, left, and Anthony Zabel laugh as they do hospital rounds on Thursday, April 28, 2016, at Franciscan St. Francis Hospital in Indianapolis. Taylor and Zabel are both pediatric residents at the hospital. (James Brosher / For the Deseret News)

Dr. Ryan Taylor, left, a first-year resident from Chicago, watches as Dr. Gerold Butler, a pediatric hospitalist, holds Melody Davis, a newborn girl, during hospital rounds in the postpartum unit on Thursday, April 28, 2016, at Franciscan St. Francis Hospital in Indianapolis. (James Brosher / For the Deseret News)

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Dr. Pardeep Kumar

James Brosher — Wed, 07 Oct 2015 18:27:53 +0000

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.”

Dr. Pardeep Kumar listens to a patient before a check up on Wednesday, Sept. 9, 2015, in Terre Haute, Ind. Kumar and doctors nationwide are preparing to switch to a new medical coding system, ICD-10, for tracking diagnoses on Oct. 1. (James Brosher for The New York Times)

Dr. Pardeep Kumar listens to a patient’s breathing using a stethoscope on Wednesday, Sept. 9, 2015, in Terre Haute, Ind. (James Brosher for The New York Times)

Dr. Pardeep Kumar performs a diabetic foot exam on a patient on Wednesday, Sept. 9, 2015, in Terre Haute, Ind. (James Brosher for The New York Times)

A computer screen shows the medical coding for a patient’s diabetic foot exam on Wednesday, Sept. 9, 2015, in Terre Haute, Ind. Doctors nationwide are preparing to switch to the new medical coding system, ICD-10, more than two decades after it was completed by the World Health Organization in 1992. (James Brosher for The New York Times)

Dr. Pardeep Kumar poses for a portrait in the office of his internal medicine practice on Wednesday, Sept. 9, 2015, in Terre Haute, Ind. (James Brosher for The New York Times)

Dr. Pardeep Kumar examines a patient’s knee on Wednesday, Sept. 9, 2015, in Terre Haute, Ind. (James Brosher for The New York Times)

Dr. Pardeep Kumar shares a laugh with a patient during a check up on Wednesday, Sept. 9, 2015, in Terre Haute, Ind. (James Brosher for The New York Times)

Dr. Pardeep Kumar is seen on Wednesday, Sept. 9, 2015, in Terre Haute, Ind. (James Brosher for The New York Times)

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Dr. Richard Fogel

James Brosher — Mon, 27 Apr 2015 19:06:02 +0000

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.

Dr. Richard Fogel poses for a portrait on Friday, April 3, 2015, at the St. Vincent Heart Center in Indianapolis. Ascension Health, which operates 131 hospitals across the country including St. Vincent, estimates price hikes to a pair of life-saving heart drugs, Isuprel (Isoproterenol) and Nitropress (Nitroprusside Sodium), will triple its spending on the medications this year. 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 February. (James Brosher for The Wall Street Journal)

Dr. Richard Fogel, right, speaks with a patient Deanna Chrysler, of West York, Ill., during an appointment on Friday, April 3, 2015, at the St. Vincent Heart Center in Indianapolis. (James Brosher for The Wall Street Journal)

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The skinny dream

James Brosher — Mon, 02 Jul 2012 13:00:18 +0000

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)

Kimmie Trethewey listens to her doctor, Dr. R. Gregory Credi, during a visit on Wednesday, May 9, 2012, at Memorial Weight Loss and Bariatric Surgery Center in Granger. (James Brosher/South Bend Tribune)

Kimmie Trethewey, right, walks with her walking group through Battell Park on Tuesday, May 22, 2012, in Mishawaka. (James Brosher/South Bend Tribune)

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