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Your Doctor, Always Available, For A Monthly Fee

For 10 years, Jeff Gold showed up to a job he wanted to love: being a family doctor.

“I was busy as a bee,” says Gold, 39, with up to 2,500 patients, seeing 20 or so a day.

Dr. Jeff Gold runs a direct primary care office in Marblehead. (Martha Bebinger/WBUR)

Dr. Jeff Gold runs a direct primary care office in Marblehead. (Martha Bebinger/WBUR)

Rushing from one patient to the next, calling insurers who wouldn’t approve prescriptions, filling out paperwork that didn’t seem relevant to his patients, Gold kept asking himself, is this what I signed up for?

“I thought I was gonna help everybody and spend time with everybody and it’s impossible to do,” Gold says.

So Gold quit, wrote a business plan to be a doctor who does not take insurance, hired one staff member (a nurse), and borrowed almost $400,000 to outfit a two-exam-room office next to a candy shop and café in Marblehead.

Gold may be the first physician in Massachusetts practicing under a model called direct primary care. For a flat monthly fee, Gold offers patients one-hour same-day appointments, no wait. The doctor is available 24/7 in person, at the office, at the patient’s home, via text, email or Skype. Continue reading

Financial Relief Finally On Its Way For Meningitis Outbreak Victims

A vial of injectable steroids from the New England Compounding Center is displayed in the Tennessee Department of Health back in 2012. (Kristin M. Hall/AP)

A vial of injectable steroids from the New England Compounding Center is displayed in the Tennessee Department of Health back in 2012. (Kristin M. Hall/AP)

Lyn Laperriere, a retired automobile industry worker living in Michigan, was having back pain in the fall of 2012 when he received a dose of steroids produced at the former New England Compounding Center in Framingham.

Lapperiere was a drag racer and was looking forward to the winter bowling season. But a week after receiving the shot he checked into a hospital. Forty-two days later, his wife Penny Laperriere agreed to take him off life support. He was 61.

“We did everything together,” Penny Laperriere recalled. “So when he passed away, life for me came to a screeching halt too.”

Lyn Laperriere was one of 64 people who died after receiving a dose of steroids produced at the former New England Compounding Center in Framingham. (Courtesy Penny Laperriere)

Lyn Laperriere was one of 64 people who died after receiving a dose of steroids produced at the former New England Compounding Center in Framingham. (Courtesy Penny Laperriere)

More than two and a half years after NECC recalled all of its products after steroids the compounding pharmacy produced were linked to a nationwide meningitis outbreak, some financial relief may finally be on its way for the relatives of the 64 who died and the 750 who were sickened as a result of receiving injections of the tainted drugs.

A federal bankruptcy judge on Tuesday indicated he would approve a $200 million settlement to compensate NECC’s creditors, including victims of the outbreak.

‘There’s Been No Financial Help’

Penny Laperriere, who’s now 58, couldn’t afford to keep the house she’d shared with her husband. She had an auction to sell off the couple’s things and moved close to her sister. She’s received lots of bills, but no money to help with what became the deadliest case of contaminated medicine in the country’s history.

“That’s the hard part, there’s been no financial help for me or any of the patients who are still living with this,” she said.

Laperriere started a support group for victims of fungal meningitis who’ve had to cash in retirement funds, file bankruptcy and still face mounting medical bills. Patients and those who lost loved ones will file claims for a share of the $200 million settlement beginning next month.

Laperriere has no idea what to expect. “Anything I get will be a gift,” she said. “I’m not expecting much because there are so many hands in the pot.” Continue reading

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Boston Medical Center And Tufts Medical Center End Merger Talks

(Kalman Zabarsky/BU)

(Kalman Zabarsky/BU)

Boston Medical Center and Tufts Medical Center announced Wednesday that they are ending merger talks.

The two nonprofit hospitals, which had been in talks since last year, said in a statement that both sides “determined that at this time it is best for our medical centers to remain separate.”

Here’s the full statement from BMC President Kate Walsh and Tufts President Michael Wagner:

Over the last several months, Tufts Medical Center and Boston Medical Center have carefully considered how we might combine our two organizations. We have had thoughtful conversations and considered different options for tackling the complex task of integrating two vital, but different, academic medical centers. After much consideration, we have determined that at this time it is best for our medical centers to remain separate. We conclude these discussions with great respect for each organization’s mission and remain open to future opportunities for collaboration as neighboring institutions.

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A Life Filled With Promise Is Overpowered By A Complex Web Of Pain And Trauma

Jamie Neal's family -- her father Bob, mother Debbie and brother Abe -- at their church in Duxbury (Jesse Costa/WBUR)

Jamie Neal’s family — her father Bob, mother Debbie and brother Abe — at their church in Duxbury (Jesse Costa/WBUR)

When Jamie Neal was home on medical leave from Williams College in early 2010, her parents were going to great lengths to try to protect her.

“I knew she was suicidal,” says Jamie’s mother, Debbie Neal. “My husband and I decided we would do everything to keep her alive.”

Several months earlier, in August 2009, the Duxbury resident had made a suicide attempt that left her in a coma for several days.

“The last few months before she died, I had her sleep in my bed next to me,” Debbie Neal explains. “And every single day, I asked her on a [scale of] 1 to 10 how she felt and was she suicidal. And she would tell me that she was a 5 and that she wasn’t suicidal.”

In March of 2010, the 21-year-old killed herself in the family’s home. Suicide had become her desperate attempt to escape a complex web of pain and trauma: not only mental illness, but sexual assault and drug addiction — a dark journey in a life filled with so much promise.

CAPTION

Jamie Neal was a member of three varsity sports teams beginning her freshman year at Duxbury High School. She was recruited to play basketball at Williams College. (Courtesy the Neal family)

Like many other survivors of suicide, the Neals recall a loved one who was outwardly happy — even, in Jamie’s case, “outrageously fun.” She had a ready smile.

“Jamie was always, always smiling,” Debbie Neal says. “It kind of defined who she was. She loved other people who were struggling. And she was very kind, and she had a beautiful heart.”

There were some signs early on that Jamie might have mental health issues. A nursery school teacher noticed the normally cheerful, outgoing girl would sometimes withdraw into a sad state. And the straight-A student was a perfectionist in everything she did.

“That perfectionism drove her and motivated her,” says Jamie’s brother, Abe Neal. “On the other hand, I don’t want to say it necessarily did her in. But it was very difficult for her. You would find her at four in the morning editing some minor paper for an English class. And she was also very hard on herself as things started going downhill with herself.” Continue reading

Colleges Work To Prevent Suicide And Fight Stigma Around Mental Health On Campus

A training session for Worcester Polytechnic Institute’s Student Support Network. The group's more than 400 members are trained to intervene and help students dealing with mental health issues. (Jesse Costa/WBUR)

A training session for Worcester Polytechnic Institute’s Student Support Network. The group’s more than 400 members are trained to intervene and help students dealing with mental health issues. (Jesse Costa/WBUR)

As another academic year winds down, many colleges are reviewing how they raise awareness of mental health issues on campus, and what additional steps they can take to try to prevent suicide among students.

More than 1,000 college students die by suicide every year. Suicide is listed as the nation’s second-leading cause of death for people of college age, though people not enrolled in school take their own lives at a higher rate than those attending college. And research has found about 7 percent of undergraduate and graduate students seriously consider suicide.

Suicide prevention efforts vary greatly among schools. So does the rate of students seeking help from campus mental health services. According to the Association for University and College Counseling Center Directors, college mental health centers see on average about 10 percent of the student body, though mental health providers say the need is much greater. Smaller schools serve a greater percentage of their student body through campus mental health services than large colleges and universities do.

There’s also no consistency in how suicide is tracked in higher education. WBUR reached out to 10 Massachusetts colleges and universities to request information on their suicide rates and suicide prevention programs. Only two, Worcester Polytechnic Institute and Worcester State University, provided data. WPI has experienced one suicide since 2006 (in May 2011) and four in the last 18 years. Since implementing prevention programs several years ago, the school’s suicide rate has dropped below the national average. Worcester State University reports it has had one suicide in the last 10 years.

In the latest installment of our series, “Suicide: A Crisis in the Shadows,” several people involved in and affected by the issue of college suicide prevention joined WBUR to share their thoughts. Below find highlights from that conversation, and listen to it in full above. Continue reading

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After Cluster Of Suicides, MIT Works To Relieve Student Pressure, Raise Awareness

Student climb the steps of the Rogers building at MIT. (Robin Lubbock/WBUR)

Students climb the steps of the Rogers building at MIT. (Robin Lubbock/WBUR)

On a recent sunny spring day, MIT students were lined up at a table grabbing ice cream sundaes, milk and cookies, and, if they were interested, an embrace.

“Yes, giving away ice cream and now hugs,” explained MIT parent Sonal Patel, of Cambridge, as she embraced Miguel Mendez, a native of Mexico who is doing post-doctoral research at MIT.

“It’s always good to know that people around the campus actually care about you as a person,” Mendez said. “This being an institution that expects a lot from you, it can really pass a toll on you sometimes.”

The event was billed as “Stress Less Day,” a chance for people at the university that churns out many of the world’s top engineers and scientists to take a break from problem sets, exams and research.

The snack break was sponsored by the student group Active Minds, which promotes mental health awareness. Volunteers handed out flyers with facts on depression and anxiety, as well mental health resources at MIT.

Active Minds raised awareness about their group during MIT's campus preview weekend for incoming freshman. (Robin Lubbock/WBUR)

Active Minds raised awareness about their group during MIT’s campus preview weekend for incoming freshman last month. (Robin Lubbock/WBUR)

Following six student suicides since March 2014, Active Minds and other student groups have seen increased interest in their events designed to reduce stress, promote a sense of community and reduce stigma.

MIT is not the only higher education institution to struggle with suicide clusters. But the school and its students, widely considered among the world’s most elite, are taking some very open steps to confront the problem. Continue reading

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Ringing In Your Ears? Finally, Researchers Finding New Clues About Tinnitus

Alan Starr, an audio engineer, has tinnitus as a result of the Boston Marathon bombing. (Courtesy of Alan Starr)

Alan Starr, an audio engineer, has tinnitus as a result of the Boston Marathon bombing. (Courtesy of Alan Starr)

By Richard Knox

Alan Starr remembers being blown back by the bomb’s force. He had come to watch a friend cross the Boston Marathon finish line on that fateful April day.

Starr, a 52-year-old audio engineer who makes his living by his ears, suffered no visible injury. But, like at least 70 other marathon bombing victims, he’s left with a never-ending reminder of that moment — a death knell that never stops ringing in his head.

“It’s a very high pitch like a whistle,” he says. “It doesn’t waver. It’s just constant, 24/7.”

It’s called tinnitus, and it’s beginning to get the attention it deserves.

Nearly a million veterans suffer from tinnitus. 

This is partly due to the Boston Marathon bombings. Starr and a few dozen other bombing victims are participating in studies supported by the One Fund, created to help bombing victims, that are aimed at devising an effective treatment.

An even more powerful driver of tinnitus research is the enormous incidence of the problem among Iraq and Afghanistan war veterans who’ve suffered blast damage. Nearly a million veterans suffer from tinnitus. That makes it the leading service-related disability — far outstripping PTSD.

And tinnitus — most often pronounced TIN-uh-tiss — is surprisingly common in the general population. At least one in every six Americans suffers from tinnitus — around 50 million people. Of these, the condition is “burdensome” for 20 million, according to the American Tinnitus Foundation. Two million of them have severe, disabling tinnitus, often accompanied by depression.

The problem has no cure and no very effective treatment. But after decades of dead-end research, scientists are beginning to figure out what causes the constant ringing, whistling, whooshing or hissing that makes sufferers feel trapped inside their own heads.

New research is providing some surprising clues. Continue reading

Feds Seek Massachusetts Health Exchange Records

Federal authorities have subpoenaed records related to the Massachusetts Health Connector, including a period covering the breakdown of the health exchange’s website, The Associated Press has learned.

“The administration received a subpoena regarding the Health Connector’s difficulties dating back to 2010 and we are fully cooperating with the Department of Justice,” Elizabeth Guyton, a spokeswoman for Gov. Charlie Baker, said in a statement.

The administration said the subpoena came from the U.S. Attorney’s Office in Boston shortly after Baker took office in January. No details were immediately available, and it was not clear what information was being sought from the agency.

The U.S. Attorney’s office did not immediately return a request seeking comment.

Massachusetts’ first-in-the-nation universal health care program served as a model for President Barack Obama’s Affordable Care Act. But the state’s transition to the federal program in 2013-2014 proved disastrous, forcing the administration of former Gov. Deval Patrick to place hundreds of thousands of residents into temporary Medicaid coverage.

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Team Of MGH Doctors And Nurses Headed To Nepal To Treat Earthquake Victims

Members of the MGH medical team headed to Nepal to help care for the more than 10,000 people injured in last weekend's earthquake attend a last-minute briefing Thursday morning at MGH's Center for Global Health. (Courtesy MGH)

Members of the MGH medical team headed to Nepal to help care for the more than 10,000 people injured in last weekend’s earthquake attend a last-minute briefing Thursday morning at MGH’s Center for Global Health. (Courtesy MGH)

As the death toll following a massive earthquake last Saturday in Nepal continues to rise, and more than 10,000 injured men, women and children await treatment, a group of nurses and physicians from Massachusetts General Hospital will join those working to keep survivors alive.

They plan to arrive in Kathmandu on Saturday, with all the basic equipment. Each person will carry their own tent, sleeping bag, mosquito net and basic medical supplies, hopefully in a carry-on so they’ll have a place to sleep if luggage is lost in the chaos.

At a last-minute training Thursday morning, members of the team acknowledged that they can’t prepare for the emotional impact of arriving in a city where rain and a shortage of wood is making it difficult to dispose of the nearly 6,000 bodies recovered so far.

“We cremate our dead,” said Dr. Bijay Acharya, who is from Nepal, explaining that the country follows Hindu customs. “They’ve run out of wood, so bodies are piling up in hospitals.”

Most of the doctors and nurses on this trip have either been to Nepal or traveled to other medical disaster zones. But Dr. Hilarie Cranmer, director of disaster response for MGH’s Center for Global Health, says the devastation in Nepal may still be shocking.

Continue reading