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James M. Berklan
James M. Berklan

As many readers of this space know, part of the McKnight's extension for long-term care professionals includes free, educational webinars. Now hold on — this isn't a commercial for them.

Rather, it's an introduction to point out that at the end of each webinar, our moderators — yours truly included — thank the listeners for helping make it a great event.

Why? Because our webinar attendees always get to ask questions — and without fail they raise excellent points we all learn from.

Similarly, readers also help make McKnight's the outstanding professional news source it has become. So it is that we come to a recent email to the editor. (In olden days, they were simply letters to the editor. Sigh.)

In it, reader Bill Bogdanovich challenges our article about a JAMA report. The piece, “Sustainability of dramatic drop in SNF antipsychotic use in doubt” pertained to a brief report by esteemed researchers including Alice Bonner and Don Berwick, both of them old friends of McKnight's. The research was basically a status report on efforts to curb antipsychotics use.

As is often the case when referring to a broader study, we highlighted a few specific points. In this case, we chose to refer prominently to the top point researchers themselves enumerated.

In plain black and white, the JAMA report noted, “Despite the success of CMS and collaborating stakeholders, many questions remain: (1) Are recent declines in antipsychotic drug use in nursing homes sustainable, and how low can use go?” There were five more thought-provoking questions that followed, numbered 2 through 6. We printed each.

For the headline, however, we keyed on the question raised in, well, the No. 1 question researchers raised — about sustainability. Bogdanovich called us on our approach, including the headline use of “in doubt.” Better phrasing probably would have been to say the sustainability was “in question,” which is precisely what the researchers did at the start of their list.

It's nothing like surgeons have to do, but journalists also have to deal with some pretty thin slicing sometimes. Typically, “in doubt” means the same as “in question.” Typically, but not always.

That's what I liked so much about Bogdanovich's getting in contact with us. (If the name is familiar, by the way, that's because he's the board chairman of the Massachusetts Senior Care Association, and the president and CEO of Broad Reach Healthcare.) While praising McKnight's for being “an important source of information to our provider community,” he wanted to make sure other parts of the study were highlighted, as well.

The JAMA report suggests “a vision for the future,” and possibly a “blueprint” for addressing other care issues in nursing homes and other settings, he pointed out. A de-emphasis on confrontation and enforcement can be effective, a notion most providers can agree with.

“The questions they ask are there to challenge us to look beyond those initial victories to other potential impacts and even unintended consequences – both positive and negative,” Bogdanovich wrote.

The goal is to take the work to the next level, he added — a goal we heartily endorse.

With our readers repeatedly engaging — have you seen the typical stream of comments under articles at lately? — we know it's possible to continue to take the discussion to an even greater level. And for that, we thank you.

Follow James M. Berklan @JimBerklan. Email him at

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.