Kate Scannell, MD

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 01/06/2013

Last month, the country was shocked to learn that a gunman shot and killed 20 schoolchildren in Newtown, Conn. The tragedy sparked yet another so-called "national conversation" about gun control, igniting predictable passions on both sides of the heated debate. While National Rifle Association leadership recommended armed security guards in schools to enhance children's safety, gun-control advocates demanded stricter legislation to limit assault weapons and high-capacity magazines.

Locked in stark disagreement, still, both sides claimed to be aiming at the same objective: to keep children safe. How could that be?

"Keeping children safe" is always a great idea. But as an idea or abstraction, it can be easily shaped into a platitude, a moral imperative, or a political sound bite used to lure people toward wildly differing points of view. Want to keep children safe and healthy? Well, then -- do/do not have them vaccinated. Do/do not provide them with sex education. Do/do not allow contact sports. Do/do not pass legislation allowing confidential abortion counseling for teens. Do/do not tinker with school lunch menus.

A major problem with "keeping children safe" is, well ... that it is such a great "idea." It brilliantly shines as a shared concept, but is dimly seen as a collective reality. Why should that be? Read More 

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 12/23/2012

Connecticut shootings
On December 14, a 20-year-old gunman walked into Sandy Hook Elementary School on an otherwise unremarkable day in pastoral Newtown, CT. But when his gunfire ceased, we would learn that he had brutally shot and killed twenty young schoolchildren and six of their teachers before taking his own life as well.

At the time of this writing, children are still being buried in Newtown. We're hearing the usual media rhetoric -- about our country's appalling gun violence, our stunned witness of yet another mass domestic killing, the need for stricter gun control laws and greater access to mental health services. . .  Read More 

By Dr. Kate Scannell, Syndicted Columnist
First published in Print: 12/08/2012


Until recently, the law of the land firmly held that once the Food and Drug Administration (FDA) approved a drug, doctors could prescribe it as they saw fit -- but the drugmakers could market the drug only for the FDA-approved indications as specified on the drug's so-called "label." Indeed, it was illegal for drug sales reps to even mention, let alone promote, the use of a drug for conditions that were "off label."

But Monday, a federal appeals court wrote a new script that could pose far-reaching side effects on U.S. drug regulation and patient safety. In a 2-1 decision, the judges of the 2nd U.S. Circuit Court of Appeals ruled that a pharmaceutical salesman's First Amendment rights of free speech had been violated when he was convicted in 2009 for promoting off-label drug use. His conviction was overturned, and the pharmaceutical industry celebrated.

As a doctor and a patient, I think this ruling was a big mistake. It jeopardizes drug regulation in the public interest, and it allows drug companies to have an even louder say in how medicine is practiced. It upholds and defends the free speech of a commercially motivated drug salesperson as though it were an abstraction, without considering the real risk of real harm to actual patients.

But like yelling "fire" in a crowded theater, shouting out a drug's name in a busy clinic filled with harried physicians and vulnerable patients can cause mortal harm.  Read More 

By Dr. Kate Scannell, Syndicated Columnist
First published in print: 11/25/2012

They can haunt you for life. They can keep you awake at night They can change forever how you practice medicine. And for many doctors, they are the stuff of everyday experience.

"They" are the "ethical dilemmas" that so thoroughly permeate medical practice as to become inseparable from it. And because these dilemmas are so enmeshed, it is often difficult to tease them out from the daily fabric of health care. Still, they regularly thread through medical decision-making between doctors and patients in clinics, and through hospital policy-making in the executive offices.
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By Kate Scannell, MD
First Published in Print: 11/11/2012

President Barack Obama's health care reform law survived a couple of brutal battles this year. In the first major match of 2012, we watched 27 states try to kill the Affordable Care Act in the U.S. Supreme Court, claiming that it violated constitutional law. The punch line, however, was delivered in a 5-4 decision that left most of the act standing as the supreme law of the land.

Bruised but not broken, the health care act then began slouching toward November, through blistering bipartisan bickering, facing peril of extinction should Obama lose the election. Indeed, Republican candidate Mitt Romney had promised to begin repealing the act on his very first day in office.

But with Obama's re-election last week, the embattled health care act was again resuscitated and restored to health. And because the act was such an integral feature of Obama's campaign platform, American voters provided much of the saving life support for Obamacare.  Read More 

By Dr. Kate Scannell
First published in print: 10/28/2012

I'm going to ask my nephew to read the 202-page report issued last week by the United States Anti-Doping Agency that summarizes the doping allegations against cyclist Lance Armstrong by his own teammates and entourage. It's a powerful document that stimulates critical thinking about sportsmanship and athletic competition, and it raises important ethical issues about athletes' pervasive use of performance-enhancing drugs.

Because the report cobbles together stories from professional athletes who broke a code of silence that had tethered them to a troubling team secret, it also offers insights about these issues from the experiences of intimate insiders. No aunt or school health counselor can compete with that for the prized attention of a serious young man trying to imagine what life might be like as a professional athlete.

At times, the USADA report reads like William Golding's classic novel, "Lord of the Flies." On a literal level, we learn what happens when a group of (mostly) men are sequestered on an island (team) of their own making and self-governance, without effective supervision by oversight agencies that are supposed to enforce publicly agreed-upon rules of conduct.

In short order, leaders emerge within the team and regularly break those rules. A new regime supplants the old order and, ultimately, everyone comes to fear retaliation if they don't comply with the new norm. So they take the secret handshake -- or the blood doping, the growth hormone, the steroids.  Read More 

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 10/13/2012

How do 14,000 people in 23 states hobble into a doctor's office complaining of back or joint pain -- only to discover, days to months later, that they may have been injected with a potentially lethal infection?

That's the central question for public health authorities who are trying to contain the current multistate outbreak of fungal meningitis linked to contaminated steroid injections. As of last Thursday, the number of people known to have developed the meningitis had risen to 170, including 14 deaths. Regrettably, those tallies are expected to rise as doctors and patients become increasingly aware of this unusual fungal infection which can take weeks to months to diagnose.  Read More 

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 09/29/2012

I have a friend who is always preparing for "the worst." He owns every imaginable kind of insurance policy for himself and his beloved cat. I could live several years off the disaster provisions he has stored in his Chevy's trunk ... or his garden shed ... or his hallway closet ...

September is his favorite month because he gets to celebrate two favored occasions: "National Preparedness Month" and "International Talk Like a Pirate Day." He recently asked me (again) whether I had gotten my act together (finally) and prepared a "landlubber's survival kit for the next merciless squall." Yarrgh.
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By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 09/15/2012

Years ago while hurriedly shopping at my local Safeway, I turned my cart into the bread aisle and nearly ran over one of my patients. Relieved that I had not injured him, I immediately pulled back and tried to escape his notice. While I generally enjoyed running into patients (without injurious instruments) in public, I had an appointment to make within the hour and could not afford a lengthy conversation.

Still, I had noticed that my patient held within his hands the same coupon circular I held in mine. Like me, he was selecting food purchases by price and special discount. Weeks earlier, that same man had been in my medical office, strong-arming me for an expensive antibiotic -- all the while I explained that it would provide no benefit for his mild cold. But he had read about the drug in a magazine ad, and, by all accounts, the antibiotic possessed amazing supra-human powers. It was a sniffle-buster, a mucus-vaporizer, a death-avenger; ostensibly, it could bring about world peace and ... well, cure the common cold.

At no point during our office encounter was the subject of cost brought up. My patient's insurance company would pay the bill, so perhaps it did not concern him. To me, it was important to base my refusal to prescribe the drug on "cold" medical facts -- not on a price tag. On clinically sound, scientifically-based reasoning that acknowledged both the uselessness and the potential harms of using bacterial antibiotics for a common cold.

But should I have raised the topic of wasteful spending with my fellow coupon-clipper? Should I have asked him to consider the consequences of resource utilization on a useless treatment that would only profit the drugmaker? That would help abet the escalating costs of health care and insurance premiums?  Read More 

By Dr. Kate Scannell, Syndicated Columnist
First published in print: 09/02/2012

Delivering biting public viewpoints can sometimes sting -- always a risk when writing an opinion column. Still, I assume that risk and straightaway proclaim: I hate mosquitoes.

I know some readers will oppose my view. But I'll bet that, unlike me, they don't transmute into one huge welt, from head to toe, after a single stinging encounter with a mosquito. That they've never slapped themselves unconscious trying to kill a maniacally buzzing mosquito circling their ears. That perhaps they're behind in their reading, lacking updated news about West Nile virus in recent reports from the Centers for Disease Control and Prevention.

We currently face an outbreak of mosquito-borne WNV infection in the U.S.  Read More