Why should you care? Gooz says this "increases the likelihood that more trials will go abroad and that more of them will not even be registered with the FDA, which makes them all but impossible to monitor."

Huge issue. And, as Gooz points out, one not reported by many news organizations.

"Ultrasound machines were once the size of washing machines and used solely by radiologists and sonographers working in radiology departments. But in the past 10 years they have become cheaper, smaller, and more portable—the latest models are even pocket sized.

As a result ultrasound machines are increasingly used by non-radiologists as part of the clinical examination or to assist in practical procedures such as insertion of a central line. The number of general practitioners buying their own ultrasound machines has also gradually increased. So is this good or bad news for patients?

Gill Markham, vice president of the Royal College of Radiologists, says: "The price of an ultrasound machine has come down enormously to £5000-£10 000 [{euro}6000-{euro}12 000; $10 000-$20 000] and as a result they are used much more widely. Ultrasound has a reputation as a simple, easy test. It is easy to do but interpreting the results is not so easy and there are things that could be missed."

Paul Allan, clinical director of radiology for Edinburgh, agrees: "There are people with very little training using ultrasound badly." He says he is aware of surgeons doing ultrasound investigations for acute abdominal pain and mistaking invasive cancers for ruptured spleen.

The key issue is adequate training. As Dr Allan says, "I have no problem with who does ultrasound investigations, but they must be trained. Ultrasound does require experience and expertise. There is no physical risk to the patient but there is a risk of false negatives or false positives."

The Rocky Mountain News’s coverage of John McCain’s campaign stop in Denver last week raises an important issue for reporters, especially those covering the election: Do you let a candidate’s remarks stand unchallenged even if they are wrong or misleading?

McCain had come to town to talk mostly about health care, the paper reported, noting that the topic took up a large part of his hour-long speech. The News offered all too typical coverage of such talks, however—bits and pieces on a lot of topics, with quotes here and there. We do learn that on health care, McCain urged states to take a leadership role in reform, and that he pumped his tax credit aimed at helping Americans buy health insurance. In the next graph, the paper said that McCain’s rationale for the tax credits “is that making major reforms and using government to work through the problem will affect the quality of coverage for Americans—which he called the best in the world.”

The best health care in the world? McCain has asserted that before and so have other politicians. No doubt we will hear it again. But the evidence says otherwise.

Read the whole piece and see some of her reminders about Clinton's and Obama's less-than-true campaign comments.

"The Uninsured: You're in your 20s. Why should you care?" is a website researched, designed and launched by four seniors.

Mind you, it's not perfect. But consider that this was an effort of 20-something undergrads. They proved that you can tackle a complex issue and make it come to life for your audience using various media formats.

There were three other noteworthy student projects in this class this semester but this is the only one I can make immediately publicly accessible.

There is hope for the future of health journalism.

Among the oddities reported by the Journal:

• people eat, walk, make phone calls or get behind the wheel while still asleep after taking the drugs;
• some people have cut themselves with knives, consumed inedibles like buttered cigarettes and woken up gasping for air with their mouths full of peanut butter, a particular sleep-eating favorite.

The piece begins:

"A few weeks ago, devoted listeners of National Public Radio were treated to an episode of the award-winning radio series The Infinite Mind called "Prozac Nation: Revisited." The segment featured four prestigious medical experts discussing the controversial link between antidepressants and suicide. In their considered opinions, all four said that worries about the drugs have been overblown.

The radio show, which was broadcast nationwide and paid for in part by the John D. and Catherine T. MacArthur Foundation, had the air of quiet, authoritative credibility. Host Dr. Fred Goodwin, a former director of the National Institute of Mental Health, interviewed three prominent guests, and any radio producer would be hard-pressed to find a more seemingly credible quartet. Credible, that is, except for a crucial detail that was never revealed to listeners: All four of the experts on the show, including Goodwin, have financial ties to the makers of antidepressants. Also unmentioned were the "unrestricted grants" that The Infinite Mind has received from drug makers, including Eli Lilly, the manufacturer of the antidepressant Prozac.

We don't know just how much funding or when the show last received it, since neither Goodwin nor the show's producers responded to repeated requests for interviews. But the larger point is that undisclosed financial conflicts of interest among media sources seem to be popping up all over the place these days. Some experts who appear independent are, in fact, serving as stealth marketers for the drug and biotech industries, and reporters either don't know about their sources' conflicts of interests, or they fail to disclose them to the public."

Disclosure: I am interviewed in the story. But don't let that stop you. The piece is worth reading.

"More than half the 28 new members of writers of the next edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) have ties to the drug industry. The conflicts of interests were posted online by the APA last week. They ranged from small to extensive. Leading the pack was William Carpenter, Jr., director of Maryland Psychiatric Research Center at the University of Maryland, who over the past last five years worked as a consultant for 13 drug companies, including Pfizer, Eli Lilly, Wyeth, Merck, Astra Zeneca, and Bristol-Myers Squibb. APA President Carolyn B. Robinowitz claimed that "we have made every effort to ensure that DSM-V will be based on the best and latest scientific research, and to eliminate conflicts of interest in its development." The fifth DSM, produced in conjunction with the National Institute of Mental Health, will be published in 2012. It is used by mental health professionals to classify mental illnesses."

The newspaper says that three of its reporters spent four months examining the JPS Health Network.

The series, which began last week, opened like this in part one:

"The waiting room reeked. Along a crowded hallway, patients lay in beds, with only a thin curtain for privacy. Nurses readying for a new case in surgery noticed blood, bone and globules of fat on the walls and floor and stuck to wheels of carts.

Chance brought to the hospital teenagers from car wrecks, fathers hurt on the job, police officers injured in the line of duty. Others -- the poor -- came because they believed they had nowhere else to go.

They were greeted last year at an overburdened emergency department where the staff could be robotic and hardened to patients. Sometimes, inexperienced nurses evaluated the sick and suffering.

Some patients were shuffled to a stifling back room to wait. Medical records, crucial lab results -- even patients -- got lost. Staff didn't notice when one Alzheimer's patient walked home in 100-degree heat. Another patient was dismissed because doctors didn't get lab results indicating a life-threatening disease.

The trauma center was described as a war zone. Operating rooms as chaotic. In too many places, instruments were broken, rooms dirty, linens threadbare.

Welcome to a hospital flush with cash and rife with problems. Welcome to John Peter Smith Hospital, hub of the Tarrant County Hospital District.

Boosted by tax funding other local hospitals don't get, JPS has been racking up fat surpluses -- nearly $97 million last year alone.

But the cash has not helped a dedicated core of doctors and nurses overcome the system's callousness, ineptitude and filth. JPS is a hospital that many of its own doctors wouldn't recommend."

The blog posting kicked off many interesting reader responses. One of my faves:

"I have been in the HSA and hi deduct insurance plans for 3 years. First 2 years were nice, saving on premiums and socking away some money. The third year, 2008, my wife spent the first 6 days in the hospital, so now I am on the losing side of the “savings”. Can I get on Stark and Waxman’s health plan?

As usual, the socialists (read Democrats) use analysis of “averages” to prove a point when there is not a point. Next year I will retire and take all of my money to another country. Hasta la vista, comrades, communism does not work and is not for me."

As Thurston Howell III once said on the show: "No one can pull the wool over my eyes. Cashmere maybe, but wool, never."

In the Los Angeles Times, *Workers' Health Insurance Costs Soar*:

Workers with job-based coverage for their families saw earnings rise 3% from 2001 to 2005, while their health insurance premium contribution increased 30%, according to the study by researchers at the State Health Access Data Assistance Center at the University of Minnesota. The average cost nationally of family coverage during the period increased nearly $2,500, to $10,728 from $8,281.

On a Chicago Tribune blog, " Ouch! Health Costs Rise as the Economy Falters":

Slightly more than 1 in 4 Americans (28 percent) report that the recent economic downturn has caused "serious problems" paying for medical care and insurance, according to a new survey by the Kaiser Family Foundation, a California policy group. It’s the third most frequent type of problem people are encountering, behind problems paying for gas (44 percent) and getting a raise or a good paying job (29 percent).

In a separate study, also released by the Kaiser Foundation, researchers at the Urban Institute are estimating that a 1 percent rise in the national unemployment rate would throw 1.1 million Americans into the ranks of the uninsured.

Current estimates put the number of people without health care coverage at around 47 million.

That’s what happens during a recession: People lose jobs and job growth stalls. Also, more people end up turning to state programs such as Medicaid or SCHIP (the State Children’s Health Insurance Plan) for health care coverage.

In turn, that puts states in a bind because state revenues drop when unemployment rises (and businesses, by definition, aren’t doing as well). Combine expanded need for public programs with reduced revenues and you have a difficult situation.

Layer on top of that expanding budget deficits in the states and you have a very, very difficult situation.

Look at how one observer analyzed recent news coverage of the stories behind some of these headlines:

The Independent: "Big breakfast is most important meal -- if you want a baby boy."

Reuters: "Skipping breakfast may mean your baby is a girl."

New Scientist: "Breakfast cereals boost chances of conceiving boys."

CNN.com: "Study shows bananas make baby boys."

New York Times: "Boy or Girl? The Answer May Depend on Mom's Eating Habits."

Competition and the market also today gives us the news that the new CEO of UnitedHealth Group, Inc. received total compensation of more than $5 million last year. (He's gotta go some to catch the compensation total of his predecessor, Bill McGuire.)

Ah, the American way, with 16% of the gross domestic product spent on health care, and, ironically, 16% of the population without health insurance.

You gotta love how that market works.

Disclosure: Robert is my friend and trusted colleague. I hired him at CNN longer ago than either of us wants to remember.

Just to give you a taste of his book, here are some of the chapter titles:

1. Says Who? How We Know What (We Think) We Know
2. The News Media: Eat This!
3. Diet Books: Don't Eat That!
4. Advertisements: Take a Supplement!
5. Government Campaigns: Watch Your Cholesterol!
6. Celebrities: Get Tested!
7. Health Groups: Wear Sunscreen!
8. Consumer Activists: Beware of Chemicals!
9. Anti-Aging Doctors: Don't Get Sick, Don't Get Old, Don't Die!
10. Guaranteed! Overpromising on Prevention

We need more journalists like him, and more informational/educational efforts like his book.

Congratulations, Robert. Hope you sell a bunch of them.

Shearlings Got Plowed is the name of a blog covering recent problems at drugmaker Schering-Plough

The site is now two years old and has reviewed more than 540 stories.