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Philly Health Insider

Philadelphia Inquirer - 7/10/2024

Jul. 10—Good morning. This week, we're looking back at some of The Inquirer's coverage on Philadelphia's yearslong gun violence crisis — after the nation's top doctor issued a warning declaring gun violence a national public health crisis. Plus, tips from a "size-inclusive" physician, news on a local health system souring on private equity, and a deep dive into overdose deaths occurring inside Philly's jails.

Got tips, questions, or suggestions? For a chance to be featured in this newsletter, email us back.

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Aubrey Whelan and Abraham Gutman, Inquirer health reporters, @abrahamgutman and @aubreywhelan.

The Big Read: Gun violence and public health

Gun violence is a public health crisis in America, U.S. Surgeon General Vivek H. Murthy declared this summer, showing the federal government considers the deaths and damage from firearms a significant health threat. This is the first time a surgeon general has done so. In the process, he validated a slew of physicians, medical schools, and professional societies who have spent decades studying firearm deaths through a public-health lens.

Murthy's advisory is devastating reading, noting the rising number of deaths nationwide between 2012 and 2022 and digging into disparities in the race and gender of victims. Black Americans are particularly at risk to die by homicide, while older white Americans and younger Native Americans and Alaska Natives face increased risk from suicide. Males are more likely to die from gunshots than females, except in cases of intimate partner violence.

In highlighting the "collective toll" of gun violence on communities, the surgeon general gave our city a grim nod. He cited a study of CHOP patients from 2021 that found that in the month after a shooting took place, kids from the nearby blocks were 50% more likely to visit the ED for mental health concerns.

Reporters at The Inquirer have covered gun violence in Philadelphia for years. Here's a roundup of stories, on and off the health desk, about this public health crisis:

1.

Deaths declining: Gun violence deaths dramatically decreased in Philadelphia this year after spiking during the pandemic (as they did nationwide). Chris Palmer, Ellie Rushing, and Dylan Purcell dug into why these numbers are dropping — and why that question is very hard to answer.

2.

Kids in crossfire: This May, 8-year-old Keilyn Natareno was shot in the head on her way home from school. Ellie spoke to the St. Chris doctors who saved her life about the rise in shootings involving children and the risks that come from exposure to violence.

3.

"Scoop and run" response: Hospitals have trained staff to extricate shooting victims from the back seats of cars — the most common mode of transportation to the ED. Police and community members also are using an ancient device, the tourniquet, to quell bleeding.

4.

Violence prevention: Free gun locks are provided to families at CHOP, among other programs. And some area hospitals have hired gun violence survivors to connect fellow victims with mental health support.

The latest news to pay attention to

1.

Inside city jails, people are overdosing and dying. Aubrey and investigative reporter Samantha Melamed found that city jails have seen at least 25 drug-related deaths in recent years, raising questions about the safety of Mayor Cherelle L. Parker's proposal to arrest more people for drug use.

2.

After contract negotiations between Trinity Health Mid-Atlantic and a private-equity radiology group soured, Trinity is now moving away from contracting with such firms — starting with radiology.

3.

What's a half-empty hospital to do with all that extra space? Our colleague Wendy Ruderman reports that some of the area's cash-strapped hospitals are renting whole floors to movie and TV productions.

Exclusive data dive

This week's number: $200,000.

That's the average debt for MD graduates from Philly-area schools.

We looked into the cost of medical school, and levels of debt for med students, after news broke Monday that former NYC Mayor Michael Bloomberg is donating $1 billion to Johns Hopkins to pay for the tuition of most students.

It's a newish trend: billionaires have made medical schools mostly free at the Albert Einstein College of Medicine in NYC, NYU, and the Cleveland Clinic.

So, how much would a gift like Bloomberg's have saved Philadelphia medical school graduates? The answer depends on the school.

Drexel's MD graduates reported the highest average debt: $257,732. Those graduating from Penn have the lowest average debt at $142,177.

And osteopathic schools, such as PCOM and Virtua-Rowan, graduate DOs with similar levels of debt.

Read more to see how tuition rates compare.

Hospital inspections

Each week, we highlight state inspections at the various hospitals in our region. Up this week: Center City'sPennsylvania Hospital, which is affiliated with Penn Medicine. Inspectors found no problems during site visits between November 2023 and April 2024.

Experts say

Weight shaming is entrenched in much of the health-care system — despite the fact that it can keep patients from forgoing care, writes Mara Gordon, an assistant professor of family medicine at Cooper Medical School of Rowan University.

Gordon, a primary care physician, wrote about how she runs a "size-inclusive" practice to help offset that stigma: "That means I don't pressure my patients into conversations about weight loss, and I don't bring up their weight unless it's something they ask to talk about."

Making moves

Eric Mankin has stepped down as the president of Main Line HealthCare, the suburban health system's primary-care network. The family medicine physician started at Main Line in 2013 and will continue to practice in Newtown Square.

His interim replacement is Donald Klingen, another family physician who is the system's chief medical information officer.

Other recent moves at Main Line include the retirement of general counsel Brian Corbett; he will be succeeded by his deputy Della Payne. In addition, Leigh Ehrlich this winter replaced the system's retiring CFO, Mike Buongiorno.

Bulletin board

We're keeping our eyes on another tense health system-insurer contract negotiation, this time between Temple Health and Keystone First, the largest Medicaid plan in Southeastern Pennsylvania.

Their contract expires July 31, and Temple Health posted an alert on its website that its doctors may no longer be in-network with Keystone as of Aug. 1 if the two health leaders can't make a deal. The sticking point seems to be the usual: how much the insurer will pay for health services.

Keystone made news in May, when its contract negotiations with Children's Hospital of Philadelphia dragged out and families began to panic. The two ultimately reached a new deal, with about a month to spare.

Temple's negotiations are also coming down to the wire, with just a few weeks left to broker a deal to keep its doctors in-network with Keystone. We'll keep you posted on any developments.

How has your hospital been affected by the gun violence crisis? For a chance to be featured in this newsletter, email us back.

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