Daily Rounds: St. Vincent Strike Averted; Prostate Surgery; Budget-Busting Health Mandates; Sheep Safe At MGH

Strike Is Off The Board — Nurses Reach Tentative Pact — Worcester Telegram & Gazette
WORCESTER — St. Vincent Hospital nurses yesterday scuttled plans for a one-day strike that would have started tomorrow, saying they reached a tentative agreement with hospital management for a three-year contract that includes improved staffing provisions. A vote to ratify the agreement is planned next week. The proposed contract provides that no nurse would care for more than four to five patients during the day and evening, and no more than five patients at night. The nurses’ previous contract allowed nurses to care for up to six patients during the day and evening, and up to seven patients at night, according to a news release.

Swedish Study Finds Surgery For Prostate Cancer Better Than Waiting — NPR Shots Blog
For men diagnosed with prostate cancer, uncertainty about what to do remains a big problem, despite years of research on the options. Now, a Swedish study suggests that radical prostatectomy — complete removal of the prostate gland — is better than "watchful waiting" for the treatment of younger men with low-risk prostate cancer. On the surface, this seems to contradict a U.S. trend toward holding off on surgery and monitoring men who have low-risk cancers with what's called "active surveillance."

How Rich Health Care Mandates Could Bust The Budget — Fortune
If HHS gets the requirement wrong by stuffing those plans with such expensive mandates, it will bust future federal budgets and give small business owners a powerful incentive to cancel coverage. It will also push young people to go uninsured when they're healthy, then buy policies when they're sick — the reverse of the Obama administration's goal of getting as many workers as possible paying into a giant insurance pool. "HHS cannot both make the plans extremely generous, and also make them affordable so that they cover millions more Americans. Those goals contradict one another," says Jonathan Gruber, an MIT economist who helped design health care reform in Massachusetts, and a strong supporter of the original Obama bill. Why are these beams and trusses of health care reform being chosen only now, more than a year after President Obama signed the bill into law?

Mass. General stops use of sheep in training program — The Boston Globe's White Coat Notes
Students enrolling in the advanced trauma life support training course provided by Massachusetts General Hospital in October will be learning skills needed to evaluate, resuscitate, and transport trauma patients by practicing on simulators — not on live sheep as past students have done — a hospital spokesman said today.

A Better Medical School Admission Test — The New York Times
But the MCAT has had one major failing in its otherwise brilliant performance: It has been unable to consistently predict personal and professional characteristics. As early as 1946, medical educators were trying to design the MCAT in a way that might tease out such information, but they, and those who followed, were unable to succeed. Now the MCAT is about to undergo its fifth revision, the first in nearly 25 years. Last month, the Association of American Medical Colleges, the national organization that administers the MCAT, released the preliminary recommendations of a 22-member advisory committee that has been studying the issue for the last three years. They recommend, among other things, lengthening the four-and-a-half hour exam by 90 minutes and adding questions on disciplines like sociology and psychology. The new exam would also test analytical and reasoning skills in areas like ethics, philosophy and cross-cultural studies, which could include questions about how someone living in a particular demographic situation, for example, might perceive and interact with others.