AssociatedNews.US

…news for the Media

Author: admin

Understanding Surprise Medical Bills Legislation

admin

There’s legislation in Congress to curb surprise medical billing. NPR’s Lulu Garcia-Navarro talks with Emmarie Huetteman of Kaiser Health News.



LULU GARCIA-NAVARRO, HOST:

Maybe this has happened to you or someone you love. You go to the hospital. You have a procedure done. Then comes a nasty surprise – a medical bill for thousands or tens of thousands of dollars not covered by insurance. Now legislation in the House and Senate is inching forward that would roll back that practice, but it’s faced a lot of resistance and millions of dollars in advertising and lobbying. Who’s responsible? Emmarie Huetteman of Kaiser Health News joins me now to explain.

Good morning.

EMMARIE HUETTEMAN: Good morning. Thanks for having me.

GARCIA-NAVARRO: So we’ve heard about these so-called surprise bills before, but briefly explain to us what is actually going on here. The official term is balance billing, right?

HUETTEMAN: That’s correct. So what’s happening is, in many parts across the country that haven’t banned this yet, patients get a bill that is the difference between what their doctor charged and what the insurance paid. And in many cases, that’s a huge amount of money, and it’s not what people expected to pay.

GARCIA-NAVARRO: How is this legislation we mentioned designed to help fix that problem?

HUETTEMAN: So the legislation that’s being considered right now looks at a practice called benchmarking to try and pay these surprise bills. Benchmarking means that an insurance company would pay a provider basically a fee based on the average of what other providers in the area had been paid for that service. There are a lot of groups that say this is not the right way to go – doctors in particular. They’re worried that they’re going to end up with depressed fees that make it hard for them to continue to cover their administrative and other costs.

And they favor a method called arbitration. Arbitration would basically look like, you know, the provider would offer their quote for what they think they should be paid for the procedure, and the insurance company would offer their quote for what they think they should pay for the procedure. And a third party would mediate, look at the options and say, OK, I select yours. And hey, loser, you get to pay the fees of arbitration. It’s an interesting process. People criticize it by saying this is not going to make things less complex, but it is the argument being put forward by doctors in particular.

GARCIA-NAVARRO: I was surprised to learn that private equity firms are behind some of this lobbying, too. Explain their role here.

HUETTEMAN: So private equity firms come into the picture because there are at least a few of them that own physician staffing companies. Now, a lot of people don’t really know what a physician staffing company is.

GARCIA-NAVARRO: I have to say I hadn’t heard of it.

HUETTEMAN: Not surprising. Basically, a company will hire a doctor, and then you get hired out to hospitals, and they help you with a lot of the administrative tasks that really, like, take up a lot of doctors’ time. These groups are owned by private equity in many cases. Some of the biggest ones are that provide a lot of the emergency room doctors in this country, for instance. And so you see those physician staffing groups really pushing back against this legislation in Congress right now. And you have to look at it and say, you’re owned by private equity, which, ultimately, you’re interested in profits…

GARCIA-NAVARRO: Profit.

HUETTEMAN: …For your investors. Yeah.

GARCIA-NAVARRO: And you cite, actually, something very interesting. Research from 2017 shows that when a physician staffing company owned by private equity entered a market, out-of-network billing rates went up between 81 and 90%. And when you see other groups working with a hospital, rates increased by 33 percentage points, which sort of suggests that these groups coming in are going to naturally raise costs. And maybe the pushback isn’t so much about how much these fees are, but more about, actually, these private equity firms.

HUETTEMAN: It’s possible. At the very least, they’re involved in this fight, and the fight has been a deep-pocketed fight, let’s say. There’s a lot of money being thrown around, and it makes sense that some of that money would be coming from these groups that have a lot to lose.

GARCIA-NAVARRO: It would seem like an easy win for legislators to say, people don’t want bills; people don’t want surprise bills. Why isn’t this getting more traction?

HUETTEMAN: You’re right to ask. And even though there are Democrats and Republicans who agree that surprise billing should be fixed, as I said, there was a lot of money that’s been thrown around recently into attack ads. There’s a lot of lobbyists wandering Capitol Hill and a lot of doctors wandering Capitol Hill. And even though it’s the year before the election, it’s close enough to Election Day that a lot of members of Congress are worried about taking a hard vote.

GARCIA-NAVARRO: That’s Emmarie Huetteman of Kaiser Health News. Thank you very much.

HUETTEMAN: Thank you.

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Let’s block ads! (Why?)

Protests Against Ban On Women At Men’s Soccer Games In Iran

admin

NPR’s Lulu Garcia-Navarro talks with former Iranian soccer coach Katayoun Khosrowyar about Sahar Khodayari, a young woman who died after trying to watch a stadium soccer game in Iran.



LULU GARCIA-NAVARRO, HOST:

Women in Iran are prohibited from attending men’s soccer games in the national stadium. To get around that, some women dress up as men to go. They risk arrest and worse. Last week, Sahar Khodayari was sentenced to six months in prison for attending a men’s game. At the court, she then set herself on fire in protest and she died. Her death has now sparked worldwide outrage, with calls on FIFA, the sport’s governing body, to intervene. Activists have used the hashtag #bluegirl on Twitter, the color of Khodayari’s favorite Iranian team. That includes Kat Khosrowyar, former coach to Iran’s national under-19 women’s team. She’s now head coach at Seattle’s Reign Academy and she joins us now on the line. Thank you so much.

KATAYOUN KHOSROWYAR: Thank you, Lulu. It’s an honor to be here today.

GARCIA-NAVARRO: Why do you think this prompted such a huge outcry and response?

KHOSROWYAR: This has never happened before. I mean, I’ve lived in Iran since 2005. It’s only been a few months that I’ve moved back to the U.S. And, you know, growing up there, there was no women’s soccer. So I helped, you know, pick up and create that platform for women. For me, this is like something that is, you know, completely outrageous – to hear that something so bad has happened to, you know, a fan – a woman who was a huge soccer fan. You know, because I was there for 15 years, and I’ve seen how soccer is ingrained in our DNA. So this has been a really unfortunate event and it’s very difficult to cope with.

GARCIA-NAVARRO: Kat, Iran isn’t a hyper-segregated society. Men and women work together. They socialize and mix in public life. So why do authorities separate men and women in stadiums?

KHOSROWYAR: This is a very good question. It’s a very, very tricky question, as well, because I still don’t know the answers to that. And I don’t know the answer because of this specific stadium – Azadi Stadium is in the capital of Tehran. It holds 100,000 people. It has a lot of security. And I think what is going through, you know, their head is that they don’t know how to, you know, protect the women that go in there with, you know, 100,000 men all over the place. But if you go to, like, the other big cities of Iran, if you go, like, with other sports, there is no problem with it.

GARCIA-NAVARRO: FIFA President Gianni Infantino has previously urged Iranian authorities to take “concrete steps” for women to attend games. Are authorities likely to respond to pressure from FIFA?

KHOSROWYAR: The authorities are responding. I think the government does want this to happen, it just takes time. There has been a lot of talk for the past few years, they just want to test it. For example, last year, with my national team, we were able to go twice, which was very historic. So we only thought that that was going to continue. But the government needs to facilitate opening the stadium for women and, you know, FIFA has demanded it. I do, you know, hope the situation gets resolved quickly for women to come watch their favorite team play and support them.

GARCIA-NAVARRO: You’ve seen the hashtag #bluegirl trending on Twitter. You asked in a tweet what sports fans could do to support female soccer fans in Iran. Do you think fans can actually change things?

KHOSROWYAR: Fans are the change-makers in the country. You know, soccer is the national sport. I think that this has to somehow evolve into getting more women involved and men have to, you know, support this cause because we do need, you know, their help. We do need the fact that they’ve been, you know, working in soccer for a much longer time than we have to get involved in helping us progress. So I think men need to either come together to, like, help us or, you know, it’s just going to continue the way it is. And men have a huge role – bigger role than us to help facilitate what what happens next.

GARCIA-NAVARRO: That’s Kat Khosrowyar, head coach at Seattle’s Reign Academy. Thank you so much.

KHOSROWYAR: Thank you, Lulu, for having me.

(SOUNDBITE OF HOMAYOUN SHAJARIAN’S “LIBERATION: TASNIF ON KHAYAM QUATRAIN”)

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Let’s block ads! (Why?)

Not My Job: We Quiz WNBA Star Tina Charles, A Former UConn Husky, On Huskies

admin
New York Liberty's Tina Charles plays in a WNBA basketball game on Aug. 12, 2018 in New York.

Gregory Payan/AP

Tina Charles has won two Olympic golds, the WNBA Rookie of the Year and MVP awards, and now is the starting center for the New York Liberty.

As a University of Connecticut alum, she’s a proud Husky, so we’ll ask her three questions about actual huskies — you know, the dogs that pull sleds through the snow.

Click the audio link above to find out how she does.

Let’s block ads! (Why?)

Saturday Sports: Horse Racing, Antonio Brown

admin

A juiced triple crown winner and an NFL player accused of sexual assault can still play: NPR’s Scott Simon talks with ESPN’s Michele Steele about this week in sports.



SCOTT SIMON, HOST:

And now to the mellow sounds of B.J. Lederman, who writes our theme music. It’s time for sports.

(SOUNDBITE OF MUSIC)

SIMON: Another scandal hits horse racing. Will a Triple Crown winner have to get back the roses? Also, Antonio Brown of the New England Patriots is accused of sexual assault but will still take the field. And an injury puts one of baseball’s great young talents on the bench just before the playoffs. We’re joined now by ESPN’s Michele Steele. Good morning, Michele. Good to have you back.

MICHELE STEELE: Great to be back, Scott.

SIMON: And let’s – you’re in Chicago. Right?

STEELE: Yes, right, I am.

SIMON: Even better then.

STEELE: (Laughter).

SIMON: So let’s start with the scandal. Justify failed a drug test in April 2018 before going on to win that year’s Kentucky Derby, ultimately the Triple Crown. According to the rules of racing, he should have been disqualified until an investigation was complete. Why wasn’t he?

STEELE: My goodness, Scott. What a bombshell of a story. You know only 13 horses in history have won the Triple Crown. Of course, that’s winning the Kentucky Derby, the Preakness, the Belmont Stakes. Justify was one of those horses in 2018. This is a big, big deal. The New York Times had the scoop. Justify tested positive for a banned substance called scopolamine. And this was right after the Santa Anita Derby. It’s sort of a performance-enhancing drug.

Then the California Horse Racing Board did three weird things. One, they slow-walked to confirm the test. It took them more than a month to let Justify’s trainer, Bob Baffert, know. He’s a little bit the Bill Belichick of racing. Two, they did not reveal the test publicly, which is something that they normally would have done. And then four months later, after Justify won all of these accolades, won the Triple Crown, they sort of quietly dropped the case altogether…

SIMON: Yeah.

STEELE: …Because they say that Justify maybe could have eaten some contaminated feed. And that was the reason for the flunked drug test. So real mystery.

SIMON: Will something like this make fans think this sport is fixed? And you mentioned Santa Anita. Of course, the deaths of Santa Anita have been a terrible scandal in the racing industry, not to mention a loss.

STEELE: You know, this Triple Crown winner, unfortunately, is going to have an asterisk by his name. Now, the way horse racing works – they don’t give back the roses so to speak. He’s not going to lose his title. In fact, he’s already out to stud in Australia. So Justify…

SIMON: Sixty million dollars, if I’m not mistaken.

STEELE: Sixty million dollars, yes. So there’s lots of powerful interests here in horse racing. And as we know, you know, it’s a very insular sport where the people who are on the California Regulating Board are the same people who would hire guys like Bob Baffert.

So a little bit – we’re seeing them closed the wagons so to speak with – where this case, you know, is concerned. And I don’t think much is really going to happen here except for people will be scratching their heads in the future, wondering if Justify really did it on his own.

SIMON: In the half-minute we have left – Patriots, you used to cover the team. Antonio Brown is going to be a New – when have the New England Patriots say – sorry, you’re not wearing our uniform until these charges of sexual assault are investigated.

STEELE: Well, you know what, Scott? It has – partly has to do with the words I’m about to say which is that Antonio Brown is one of the best wide receivers in football. He is just a tremendous player, and talent wins out. All week he has been preparing as if he’s going to play the Miami Dolphins tomorrow, on Sunday.

And on the team’s part, they have said that they do not condone any sexual violence. He’s been accused in a civil lawsuit, but they’re going to do – as Bill Belichick said – what’s, quote, “best for the team.” It appears that he’s going to play, and then the league is going to investigate this. We’ll see what happens.

SIMON: ESPN’s Michelle Steele. Thanks so much.

STEELE: Sure.

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Let’s block ads! (Why?)

Democratic Debate Exposes Deep Divides Among Candidates Over Health Care

admin

Democratic presidential candidates Sen. Bernie Sanders and former Vice President Joe Biden debate onstage during the Democratic presidential debate at Texas Southern University on Thursday in Houston.

Win McNamee/Getty Images


hide caption

toggle caption

Win McNamee/Getty Images

Once again, health care took up a large chunk of a Democratic primary debate. Once again, there were fights over costs, coverage and whether the party is growing too extreme.

But this time, all of the front-runners were onstage together, providing the first opportunity for all of them to take direct aim at each other and their vastly differing health care plans. It made for some heated exchanges, putting “Medicare for All” supporters on defense. But it also showed clearly that some candidates are cautious not to criticize others’ proposals too harshly.

Thursday night’s debate featured two stalwart supporters of the single-payer “Medicare for All” health care plan: Vermont Sen. Bernie Sanders, who introduced the bill, and Massachusetts Sen. Elizabeth Warren, one of the bill’s co-sponsors. And from the start, former Vice President Joe Biden came out swinging at them.

“How are we going to pay for it? I want to hear tonight how that’s happening,” he said, making the case that his public option proposal would cost less.

One of the main arguments against “Medicare for All” is that it would mean much higher government spending. Supporters counter that it would lead to overall less health care spending than the current system. (Studies have been mixed on this question of whether costs would be higher or lower.)

What would change, they argue, is that the spending would be done by the government, with taxpayer dollars, rather than via copays and premiums, for example.

Warren drove at this point when moderator George Stephanopoulos asked about the potential for higher taxes for everyday Americans. In her answer, she did not give a flat yes or no — and avoided giving an endlessly sound-bite-able answer about the potential for higher taxes for everyday Americans.

“Instead of paying premiums into insurance companies and then having insurance companies build their profits by saying no to coverage, we are going to do this by saying everyone is covered by ‘Medicare for All,’ every health care provider is covered,” she said. “And the only question here in terms of difference is where to send the bill.”

There are also many Democrats, such as Minnesota Sen. Amy Klobuchar, who stress that “Medicare for All” would virtually eliminate private insurance.

“While Bernie wrote the bill, I read the bill,” she said. “And on Page 8 of the bill, it says that we will no longer have private insurance as we know it. And that means that 149 million Americans will no longer be able to have their current insurance in four years.”

Polling has shown that many Americans don’t understand that private insurance would largely disappear under “Medicare for All”; polling has also shown that the idea of eliminating private insurance makes the plan much less popular.

Altogether, eight candidates on Thursday’s stage support either a public option or some other sort of overhaul that would still maintain a substantial role for private insurance.

Polling shows that a public option is far more popular than single-payer health care. A July NPR/PBS NewsHour/Marist poll found that 90% of Democrats, as well as 70% of all adults, support a public option. Meanwhile, 64% of Democrats (and 41% of all adults) support “Medicare for All.”

That’s less support, but still a majority of Democrats support Sanders’ single-payer plan, some of them passionately.

Perhaps with that in mind, even candidates who support other plans refrained from attacking the proposal — or its author — too hard.

For example, while Klobuchar slammed “Medicare for All,” she made sure to praise Sanders himself for working with her on trying to bring down prescription drug prices.

California Sen. Kamala Harris, who co-sponsored Sanders’ bill, sold her plan as a ” ‘Medicare for All’ plan,” though it is substantially different from what Sanders has proposed. (It would, for example, retain a significant role for private insurance.) She also took care to praise Sanders, even while she supports a different plan.

“I want to give credit to Bernie,” she said. “Take credit, Bernie. You know, you brought us this far in ‘Medicare for All.’ “

New Jersey Sen. Cory Booker, who also co-sponsored Sanders’ plan, said Thursday, “I believe in ‘Medicare for All,’ ” but he also proposed a more incremental approach. Indeed, in past debates, when asked, he did not indicate that he would be willing to get rid of private insurance, which Sanders’ bill would largely do.

In responding to Biden’s attacks, Warren made sure to praise former President Barack Obama, saying, “We all owe huge debt to President Obama” for the Affordable Care Act. Likewise, Biden hugged Obama tightly in promoting his own plan, saying that it would build on Obamacare.

Obamacare is popular among Democrats — 84% have a favorable view of it — and it has grown in popularity among all Americans since Donald Trump’s election. However, all Democrats in this field agree that it needs an overhaul. The balancing act that many are trying to do is pushing their own plans without slamming others’ too hard.

Let’s block ads! (Why?)

Should Black Athletes Go To Black Schools?

admin

An Alabama helmet on December 31, 2016, at the Georgia Dome in Atlanta, GA.

Scott Donaldson/Getty Images


hide caption

toggle caption

Scott Donaldson/Getty Images

Top-tier black college athletes should take their talents to historically black institutions. That’s the argument that Jemele Hill is making in a new piece for the Atlantic. She says that doing so could benefit both the colleges and the communities around them.

The piece, It’s Time for Black Athletes to Leave White Colleges, argues that when highly-ranked black athletes even look at HBCUs, it “threatens to crack the foundation on which the moneymaking edifice of college sports rests” — that foundation being black athletes drawing acclaim, attention, and money to primarily white institutions.

It’s an argument that has drawn some criticism — Hill says she’s been called a “segregationist” for even suggesting the idea. To that, she says, “those people don’t know very much about HBCUs.” (Of course, Hill is no stranger to that kind of critique. She famously drew the ire of President Trump and his supporters after referring to him as a white supremacist on Twitter.)

Hill spoke to All Things Considered about the piece.

Interview Highlights

On the history of student athletes at HBCUs

That was exclusively where [black students] could go, and as a result you had a lot of the top talent. At that point in time you had a college like Grambling State University, which was basically considered to be what would be today’s version of the University of Alabama, because they were that talented, putting so many players in the NFL over the course of their history. But obviously once there was desegregation, a lot of these black athletes began to go all over. HBCUs in the major revenue sports — talking about basketball and football — began to lose, or not have as much of a foothold.

If you look at the college landscape now, everybody pretty much knows [it] has become a billion dollar industry, given the television contracts, the money, the interest, the marketing, shoe deals, all of that. But black athletes in general are being exploited, because they’re not being paid, and they’re clearly the backbone of a lot of these universities, of which their labor has helped them become these huge powerhouses. You’re looking at schools like Texas and Alabama who have a 200 million dollar athletic budget — not a school budget, just the athletic budget. All that is built on the backs of black athletes.

HBCUs generally speaking do not have large endowments, nothing that could equal any of some of the universities like Harvard. Why not take your talent to these HBCUs that once were the only place that you could go, and help to reimagine those universities from a financial standpoint the communities around them and to some degree kind of rebuild these historic institutions.

On what it would take for this to work

You would need a group, frankly, a whole exodus of athletes who would think really really really big picture in order for this to happen.

It can’t be one or two, because one or two is not enough. There have been individual cases of a top-tier black talent going to these schools. But they need a wave of a conscientious effort on behalf of these athletes to do that, to help to rebuild these schools, the communities around them. And I think it will be a trickle down effect into strengthening essentially a huge base in the black community, which has always been kind of the black middle class. When you look at the number of lawyers, doctors, professionals that have come from HBCUs, I mean Kamala Harris is running for president. She went to Howard University. So when you look at the level of output that most black colleges have in general, to strengthen that even more with a very solvent, steady, stable financial base I think is just a huge benefit all around.

On the precedent for this kind of movement in athletics

We see this happen a lot in college football and college basketball, where you have athletes who have been playing together in high school, maybe on the same team. Because a lot of these guys play on the same AAU teams, two or three of them will go to one university, because they all want to play together.

One of the more famous examples is [University of Michigan’s] Fab Five: Jalen Rose and Chris Webber both are from Detroit, both had a relationship, and they got to know the other members — Juwan Howard, Ray Jackson and Jimmy King. And five freshmen went to the University of Michigan and changed college basketball.

I don’t see why that couldn’t happen for an HBCU. I mean look, we’ve seen a lot of these athletes. They have chosen to go to smaller schools or be walk ons sometimes at some of these bigger schools. My thing is like, why be a walk somewhere? Go to an HBCU.

I know I was speaking from a standpoint of utter utopia. It’s a little bit more more challenging than that. But I do think it’s possible. I think some of it has to be a concerted push, and some of this has to come from their own homes.

When I was making my college decision, no one talked to me about going to an HBCU. I’m from Detroit, and that’s a black city, right? I knew other people who had gone, but nobody said, “Hey, did you ever think about going here now?” Two HBCUs wound up being on my final list of colleges, and I owe that to the Cosby Show and A Different World.

On the exposure athletes get at larger schools

As we’ve seen always has been the case in sports, and really virtually anything entertainment based, is exposure goes where the talent is. So the exposure would be, to me, the least of the issues, because again, there are players in the NFL and NBA who went to black colleges and they were found. And I think that’s part of what I got at in this piece is the mentality that some of these young athletes have. They think the schools make them.

Now I’m not going to pretend that if you go to a black college there are things you have to prove that say, somebody who goes to Oregon or Florida State doesn’t have to prove. That being said, teams want to get better, and they want to go where the talent is, and it’s the same with television networks. They follow where the audience goes and where the talent is.

Let’s block ads! (Why?)

Patriots Taking Antonio Brown’s Status ‘One Day At A Time’ Following Rape Accusation

admin

Wide receiver Antonio Brown was sued in federal court by his former trainer who claims Brown sexually assaulted and raped her. As the NFL investigates, the Patriots say they are standing by Brown.

Jeff Chiu/AP


hide caption

toggle caption

Jeff Chiu/AP

Embattled Patriots wide receiver Antonio Brown is expected to practice with the team on Wednesday, a day after Brown’s former trainer accused him of rape in a federal lawsuit.

In a combative press conference, Patriots coach Bill Belichick said the accusations “are what they are” and that “I won’t be entering into a discussion about that right now,” adding that the team is taking the latest controversy involving Brown “one day at a time.”

Brown’s future was thrown further into question on Wednesday after news reports that the NFL is considering whether to place the star wide-receiver on leave in light of the lawsuit. The Washington Post first reported that the NFL is giving “serious condition” to making Brown ineligible to play.

Brown has not been charged with any crime.

His lawyer, Darren Heitner, released a statement denying the accusations against his client. “Mr. Brown denies each and every allegation in the lawsuit. He will pursue all legal remedies to not only clear his name, but to also protect other professional athletes against false accusations,” Heitner said.

On Tuesday, a former trainer accused Brown of sexual assault and rape in a federal lawsuit filed in the U.S. District Court for the Southern District of Florida, where Brown resides.

In the suit, Britney Taylor, 28, says she met Brown when they both attended Central Michigan University and were bible study partners. Brown transferred to Louisiana State University, but the two kept in communication.

According to the suit, Brown messaged Taylor, who runs a gymnastics training center in Memphis, on Facebook and asked her to assist him with “improving flexibility and strength in his ankles and fast twist muscles,” and that she agreed to help.

In June 2017, when the two were in one of Brown’s houses in the Pittsburgh area, Brown exposed himself to Taylor and then forcibly kissed her, according to the lawsuit. Taylor “willed herself to brush off the episode,” her lawyers say in the complaint.

The suit describes a subsequent episode when the two were streaming a church service at Brown’s home in Miami and the all-star wide receiver allegedly masturbated behind Taylor without her knowing. The suit contains degrading messages allegedly sent by Brown bragging about the incident.

The suit says Taylor ended contact with Brown but that he reached out months later, apologizing for his actions and asking her to train him again during off-season weekends. She agreed under the conditions that he not make advances on her and that he provide her with a private hotel room.

In May 2018, the lawsuit says, Brown invited her to a club in Miami with friends. Afterward, Taylor drove Brown and a friend back to Brown’s house and went to use the restroom. Brown allegedly then pulled her into his bedroom and raped her. The suit says Taylor pleaded with him to stop, saying “no” and “stop,” but that Brown refused.

Taylor talked about the alleged rape and the two other incidents with her mother, Brown’s chef and a member of her church, according to the lawsuit.

“Brown preyed on Ms. Taylor’s kindness and her religious devotion, casting himself as a person equally dedicated to his religious faith and someone she could trust. In reality, he used manipulation and false promises to lure her into his world, and once there, he sexually assaulted and raped her,” wrote Taylor’s lawyer, David Haas.

Brown said through his attorney that the relationship with Taylor was consensual.

“Mr. Brown, whose hard work and dedication to his craft has allowed him to rise to the top of his profession, refuses to be the victim of what he believes to be a money grab,” Heitner says.

Heitner says that prior to the alleged rape, Taylor reached out to Brown about a $1.6 million investment in a business project and that Brown turned it down.

A spokesman for the NFL declined to comment on the lawsuit. The Patriots said in a statement Wednesday that the team takes the allegations “very seriously,” saying the NFL has told them league officials will be investigating.

Brown is no stranger to controversy. He clashed with the NFL over regulations that would not allow him to use his preferred helmet.

Just last week, when he was with the Oakland Raiders, Brown recorded a conversation with coach Jon Gruden and posted it on YouTube. On Saturday, the Raiders voided a multimillion-dollar contract with the wide receiver and released him.

He was snapped up by the New England Patriots days later. He has yet to play a game with the Patriots.

Let’s block ads! (Why?)

How To Teach Future Doctors About Pain In The Midst Of The Opioid Crisis

admin
Students in medical schools are about to become doctors in the midst of an opioid crisis. That's why one top U.S. medical school is rethinking what to teach them about pain and pain management.

Tracy Lee for NPR

The next generation of doctors will start their careers at a time when physicians are feeling pressure to limit prescriptions for opioid painkillers.

Yet every day, they’ll face patients who are hurting from injuries, surgical procedures, or disease. Around 20% of adults in the U.S. live with chronic pain.

That’s why some medical students felt a little apprehensive as they gathered recently for a mandatory, four-day course at Johns Hopkins University in Baltimore — home to one of the top medical schools in the country.

The subject of the course? Pain.

“I initially was a bit scared and I guess a bit wary coming into this course because of the opioid crisis,” says medical student Annie Cho. “That seems like that’s the only thing that people have been talking about nowadays.”

She wasn’t the only one aware of how fraught pain can be right now. Student Jenny Franke says she’s been shadowing doctors in a clinic, and has already seen new patients come in with pain.

“And it seems that the therapy that they are on hasn’t been working, and a lot of the time their past primary care providers just keep prescribing the same thing over and over,” Franke says. “Sometimes those patients will ask for opioids, and then it turns into kind of an awkward conversation.”

Even though doctors see a lot of pain, medical schools traditionally haven’t dedicated much time to teaching future physicians about it, says Shravani Durbhakula, a pain management specialist at Johns Hopkins Hospital and director of the pain course this year.

“Most medical schools get about nine hours of formalized pain education,” says Durbhakula. “If I was to think back to my training, it probably is somewhere about that much time.”

While she remembers some classes on certain painkillers, she says, “I don’t remember a lot of formal pain education, certainly not any kind of course that was given to me. It was just something you kind of learned as you went along.”

“There are very few medical schools that have a course like ours,” agrees Jennifer Haythornthwaite, a professor in the Department of Psychiatry & Behavioral Sciences at Johns Hopkins University School of Medicine.

Most schools have integrated pain management throughout their curriculum, says Alison Whelan, chief medical education officer at the Association of American Medical Colleges, which represents hundreds of medical schools and teaching hospitals.

A couple of years ago, her group did a telephone survey of its members to see what they were teaching about pain. They asked about four important categories: what pain is, how you identify it and assess the severity, how you treat it, and how you deal with cultural and social issues related to pain management.

While 87% of medical schools reported teaching all of those pain-related subjects, there’s great interest in medical schools in coming up with new ways to bolster teaching about the management of pain.

And a recent review of a key medical licensing exam showed that most of the questions it asked about pain focused on assessment, rather than on safe and effective pain management.

Barbara Del Duke, a spokesperson for the National Board of Medical Examiners, says that every year, hundreds of volunteers gather to write new questions for this test. “The opioid epidemic is definitely on the minds of these volunteers,” she says. “We see evidence of this through the test items they write.”

All of this is a big change. About a decade ago, as the opioid crisis was taking off in the U.S., a Johns Hopkins neurologist and pain specialist named Beth Hogans looked to see what medical schools were teaching about these drugs.

“U.S. medical students were getting less than one hour, on average, of opioid- related instruction in medical school,” Hogans says. “That’s not enough.”

She helped create the four-day course at Hopkins, with the idea of giving all students a solid foundation for thinking about pain and pain management at the start of their medical education.

Here, the students learn that pain is a physical and an emotional experience, and that doctors tend to underestimate pain. They learn how it can be affected by people’s moods, cultural expectations or individual sensitivity. They discuss problems with the usual way of asking patients to rate their pain on a scale of 1 to 10, and learn to instead ask if and how pain limits people’s daily activities.

And, of course, they talk about opioids. A doctor named Ryan Graddy asks the students to pull out their cellphones. He says they should text him a few words in response to this question: “What comes to mind when I say ‘chronic opioid therapy?’ “

Their answers start to appear on a big screen behind him. The first word is BAD. Other words pop up, including ADDICTION and DRUG ABUSE. The lecture hall fills with nervous laughter.

“So, interesting, right, a lot of negative connotations that people have with chronic opioid therapy,” says Graddy, who goes on to describe some of the challenges his patients face and why some have been on opioid pain medications long-term.

Overall, students get taught that opioids are just one tool in the toolbox — though one they will have to learn to use thoughtfully and carefully.

“You wouldn’t really use a chainsaw to cut a piece of paper. But you also wouldn’t use a pair of scissors to cut down a tree,” Cho says.

Over and over, speakers stress the need to build a relationship with patients rather than just write a prescription.

“We can’t just focus on that single moment of writing a script,” says bioethicist Travis Rieder, who shared a harrowing account of how he was prescribed opioids by about a dozen different caregivers after having an accident and then surgery. When he became physically dependent and wanted to stop taking opioids, he couldn’t find a doctor willing to help him get through his agonizing withdrawal.

Rieder’s experiences surprised medical student David Botros. “I really didn’t expect that to even be … I don’t want to say possible, but even a factor in the health care world, I guess,” Botros says.

Botros and the other students heard about other possible medications, beyond opioids. And they learned that pain control goes way beyond just prescribing drugs. Patients could benefit from physical therapy, cognitive behavioral psychotherapy and all kinds of exercise, like yoga.

“You really need to address the whole person,” says Traci Speed, assistant professor of psychiatry and behavioral sciences at Johns Hopkins. She notes that co-occurring depression or substance use can increase the severity of pain. “It’s the chicken and the egg, which one do you treat first? And sometimes, you have to treat both to really get patients to improve.”

Graddy thinks the medical profession overall has been doing a disservice to patients when it comes to chronic pain. “I see that certainly in my own practice — a lot of patients who have bounced around from place to place and not been treated with the respect or dignity or empathy that they deserve,” he says.

That’s why this hospital invited patients and their families to this lecture hall, to movingly convey how pain impacts their entire lives. And these medical students definitely get the message.

“I felt like I learned a lot and it was very helpful,” Franke says. “One thing I learned was to really get into the patients’ perspectives and their values, and figuring out what their pain goals are. One important thing we learned is that it’s rare that you will get a chronic pain level to a zero.”

Tony Wang took this course two years ago and is just finishing his third year of medical school.

“The takeaway message that I distinctly remember leaving with was that pain management is extremely complicated,” Wang says. “It’s not just, give this medication and they’ll feel better.”

Let’s block ads! (Why?)