Well, a whole bunch of supporters of the rule are chiming in now to say that argument has no legal merit.

The dozen new suits, representing some 43 Catholic dioceses, universities and charities “have made a splash by virtue of their number, but when you take a moment to actually look at them, there’s nothing to see,” Sarah Lipton-Lubet, policy counsel for the American Civil Liberties Union, wrote in a blog post. “The rule is constitutional, it violates no federal law, and it’s incredibly important for women.”

Lipton-Lubet is talking about the rules issued in January (and amended in February to address the religious backlash) that require prescription contraception and sterilization services to be available without additional copays as part of most health insurance packages.

While those filing the lawsuits charge that offering the coverage (or even being forced to facilitate it) in violation of their religious belief runs afoul of the First Amendment’s guarantee of freedom of religion, Lipton-Lubet points out that the Supreme Court has already weighed in on the question.

“The Free Exercise Clause does not require any exemptions from a neutral law of general applicability. As the Supreme Court held two decades ago, in an opinion authored by Justice Antonin Scalia, to do otherwise would be to create a system “in which each conscience is a law unto itself.” Translation? If it applies equally and doesn’t target any faith, it’s not a First Amendment violation.”

(Backers of the church challenges, however, point to a more recent case, a unanimous ruling this past January, where the justices said religious organizations should have broader hiring and firing power than other businesses.)

But even setting the Supreme Court aside, pointed out Ian Milhiser of the Center for American Progress, more than half the states already require contraceptive coverage. And the issue has already been litigated at that level by the Catholic church — and the challengers lost.

In 1999, in California, Milhiser wrote, “five of the court’s six Republican justices held that, even if the law were examined under the strictest level of constitutional scrutiny, California’s contraceptive access law is constitutional.”

And even if the issues hadn’t been litigated before, the current cases are premature, says Nancy Northup of the Center for Reproductive Rights. That’s because the work on the regulations remains ongoing.

“This is the most cynical kind of political theater and nothing more,” she said in a statement. “Rather than working constructively with the Administration and allowing the rulemaking process to reach a resolution, these groups have chosen to grab headlines with a political stunt that will only burden the courts with untimely claims.”

But even though most religious-based organizations will have an additional year – until August 1, 2013 – to come into compliance with the new requirements, some are already taking action.

The 2,800 student Franciscan University of Steubenville in Ohio, for example, announced earlier this month that it would stop offering health insurance coverage for students this fall rather than comply with the mandate. [Copyright 2012 National Public Radio]

Take those small, brightly colored single-use packs of laundry detergent that are becoming popular. To a curious toddler or small child, they look like candy.

But once inside childrens’ mouths, the tempting packs can burst, releasing a concentrated blast of irriitating detergent. Already this year there have been at least 250 cases of illness from the packs reported to poison control centers across the country.

And the particulars of the illnesses are worrisome. Children vomit. More than you would expect, says Dr. Michael Beuhler, medical director of the Carolinas Poison Center in Charlotte, N.C. And the kids often get much sicker in a hurry. “Children grow excessively tired and lethargic,” he tells Shots. Some then develop so much trouble breathing they need help from a ventilator.

“We don’t have a good handle on exactly what’s going on,” he says. But the symptoms are worse than with other types of detergent that kids ingest. One hypothesis, he says, is that something in these detergent packs is acting like a strong, short-acting sedative.

Within a few hours those symptoms usually pass. The prognosis for kids is very good overall, he says, assuming they get prompt medical care. “It’s really just a matter of supporting their breathing for that short period of time,” he says.

There haven’t been any reports of deaths, but an analysis of the data from poison control centers continues. The specific hazards posed by the detergent packs were only recognized this month.

Buehler says parents need to treat the detergent packs with respect. “They can’t be left where a child can find them,” he says.

For its part, Procter & Gamble, maker of Tide Pods, said Friday it would add a double-latch to the containers of pods as a safeguard. Those will show up in stores starting in July.

For what it’s worth, injuries to kids from household cleaning products dropped by almost half to about 12,000 in 2006 from around 22,000 in 1990. Kids between 1 and 3 years old remain the most vulnerable, accounting for almost three-quarters of the cases. [Copyright 2012 National Public Radio]

But a device developed at MIT to squirt medicines quickly and pretty much painlessly through the skin suggests that the future of medicine could be needle-free.

The idea is to shoot an extremely thin, extremely fast jet of medicine straight through skin and into muscle. “It’s sort of like a laser beam,” project leader and mechanical engineering professor Ian Hunter tells Shots.

But because the jet is so thin — he compares it to a mosquito’s proboscis — it’s unlikely to produce much pain. Details of the prototype are published in the journal Medical Engineering and Physics.

Needles, as we all know, can be quite painful, and it’s estimated that at least 10 percent of the population has needle phobia. There’s also the risk of accidental jabs, which can spread disease. Jet injections could avoid these problems.

Jet injection technology has been around for quite a while. It’s been used in mechanical devices for more than a century (think of a car’s fuel injector), and was first used to deliver vaccines in the 1960s. The technology even showed up on Star Trek as “hypospray.” Nor is it the only needle-free alternative in the works for vaccines and other medicines.

But Hunter says this device has big advantages, thanks to some 21st-century technology.

Existing medical jet injectors use a spring or other mechanical method to force liquid out. All the medicine comes rushing out at once, at a fixed speed and pressure. It gets the job done, but it’s not very precise. The diameter of the jets also tends to be several times bigger than those from Hunter’s device, causing more pain and raising the risk of infection.

Hunter’s injector uses a piston made from a coil of wire wrapped around a magnet. A computer chip calls the shots for the injection, so to speak, allowing for millisecond-by-millisecond control over the speed and pressure of the jet.

Once the skin is penetrated with a quick burst, the injector can back off a bit to deliver a precise quantity of the drug, exactly where it’s needed.

“I think that’s the big difference between this device and other devices, is the degree of precision,” Hunter says. “We have a degree of control that hasn’t been possible before.”

The new injector has yet to be tested on people, but has been used on animals, like sheep, without apparent discomfort. “The sheep did not seem to even be aware that they were being injected,” Hunter says. But it will be a few years yet before the injector could be ready for use at home or in a hospital near you.

In the meantime, Hunter’s team will work on additional features that take advantage of the injector’s built-in computer. They want to combine it with a separate device that can sense the thickness and elasticity of the patient’s skin, so the injector could adjust its speed and pressure accordingly. It could also tell the difference between the patient’s skin and that of the health care worker, to prevent accidental self-injections. [Copyright 2012 National Public Radio]

Since nurses provide most of the patient care in hospitals, we were surprised at the findings. We wanted to find out more. We wanted to know what was going on from nurses themselves. So we put a call-out on Facebook.

We received hundreds of responses and read them all: piles of stories about nurses feeling overworked, getting no breaks, no lunches and barely enough time to go to the bathroom. Even worse, many nurses say breaks and lunchtimes are figured into their salaries and deducted, whether they take them not.

When we asked nurses who responded to our call-out if we could interview them for broadcast, most said no. They worried about their employers’ reaction. Many would be interviewed only anonymously.

“We’re always afraid that something will happen to our patients during the time we’re off the floor,” one nurse says, “and I personally don’t feel comfortable leaving them unless I know that a co-worker is actually looking after them during the time that I’m off the floor.”

This nurse says she rarely stops. Not for 12 hours. She’s an emergency room nurse in a busy urban hospital. The ideal, she says, would be one nurse for every three patients in her ER. But she typically cares for five patients or more — often eight, if she’s covering for a colleague taking a lunch break. She says there are times when she can’t leave patients’ bedsides.

“Maybe I was injecting medication that you have to push slowly over five-10 minutes so it doesn’t harm them,” she says, “and I can see call bell going off in the hallway, and there’s no way I could respond to that.”

The only option is to literally yell down the hallway and hope another nurse hears her and responds to the patient call bell. There have been shifts where she’s driven home at the end of her 12-hour shift, white-knuckling the steering wheel and wondering whether she’s “missed something.”

Another nurse likens her job to “spinning plates,” just “praying,” she says, that one doesn’t fall. “And these are human beings,” she says, “not products on conveyor belts.”

Stories like this suggest there’s a shortage of nurses. But Linda Aiken, a researcher and professor of nursing at the University of Pennsylvania School of Nursing says that’s not the case. There was a shortage about a decade ago, she says. Today, however, that’s changed. The number of RNs graduating has increased dramatically over the past decade, but many can’t find jobs.

“There’s no an actual nursing shortage,” Aiken says. “There’s a shortage of nursing care in hospitals and other health care facilities.”

Nancy Foster, a vice president with the American Hospital Association, says hospitals are facing big financial challenges.

“In part, it’s because our patients are sicker — coming to us with more intense diseases and disorders than they did 25 years,” she says. “In part, it’s because there’s so many more medications and devices and other interventions at our fingertips; we can help many more patients and restore them to health.”

Which is terrific, of course, but it’s not cheap. Any reductions in nurse staffing at a time of increasing patient demand, Aiken says, jeopardizes patient care.

“Nurses are the surveillance system in hospitals for early detection and intervention [to save patients lives],” she says.

According to one nurse, little clues from patients are critical.

“I mean, you might walk into a room, and they are breathing and answering your questions,” the nurse says, “but if you look at their neck and the jugular vein is slightly distended … taking the time to pick up on the small details like that are the early warning signs that somebody’s getting sicker fast.”

In our poll, 47 percent of Americans who were hospitalized overnight in the past year said they were “very” satisfied with their care. Another 39 percent said they were “somewhat satisfied.” Some things could have been better. Only 16 percent said they were dissatisfied.

It’s not all bad news, but with a rapidly aging population, the fear is the nursing staff will be stretched even more thinly. Plus, while our call-out to nurses on Facebook was not scientific, the NPR/RWJ/Harvard poll is, and it does point to significant problems when it comes to the availability of nurses at the hospital bedside. [Copyright 2012 National Public Radio]

“There’s some data to suggest that the average patient gets to speak for between 12 and 15 seconds before the physician interrupts them,” Shore says. “And that makes you feel like the person is not listening.”

A doctor’s impatience, though, is often driven more by economics than ego. Reimbursement rates for a primary care visit are notoriously low, and Shore laments the need to hustle patients in and out.

“When you have that pressure to see three, four, maybe five patients an hour, you can’t wait for the exposition of the patient’s story. Which is exactly what you should do. But you can’t,” he says.

A new poll by NPR, the Robert Wood Johnson Foundation and Harvard School of Public Health found about 3 out of 5 patients think their doctors are rushing through exams. That’s nearly the exact same number as three decades ago.

NPR’s survey asked people the same questions as another poll did back in 1983. We found doctors got better marks on some patient interactions. For example, 64 percent of people said doctors usually explained things well to them, versus 49 percent in 1983. They also are more likely to say doctors are trying to hold down medical costs.

But when it comes to time, there is a stubborn feeling that doctors are in too big of a hurry. That is troubling — and frustrating — to physicians like Shore who feel that they are already packing more into every workday and are stretched thin by paperwork.

“I think a lot of physicians in smaller practice realized they were becoming both the clerk and the HR and the accounts payable and the accounts receivable and the office manager — things which they may not have an interest in and certainly had no training for,” Shore says. But he says many doctors just didn’t have the cash flow to hire administrative staff.

Two months ago, Shore opened a new office in which he’s trying to break from the day-to-day grind. Appointments are now 20 minutes, instead of 15. And he’s hired several other doctors to spread the workload around. But there’s also been a shift in his thinking about the way he provides care to his patients: He’s trying to treat them more like customers, and focus on making them happy.

“Who are your customers? What do they want? Try to meet those needs,” Shore says.

And what his customers want, he believes, is access to him and his staff — how they want it, like over email, and when they want it, like after-hours. To do that, Shore has given up on the model of the doctor as a lonely superhero. Instead, everything is about the team.

Shore hunkers down each morning with his medical assistants for a “care huddle,” a rare, quiet moment to strategize about the patients coming in that day. Those assistants now play a bigger role in care, renewing prescriptions and briefing the doctor before he enters the exam room. A check-out assistant guides “customers” out the door.

Shore is trying to make up the financial difference of hiring these additional people by getting the office manager to badger insurance companies to pay more money per patient for better patient health.

That doesn’t include patients getting any test or treatment they demand. But Shore’s younger colleague Payal Bhandari sounds as much a marketer as family physician when she talks about her hopes for a better assembly line.

“It will actually produce a much better product, where you can actually listen to patients,” Bhandari says. “And the physician is a lot happier because they don’t feel like, ‘Ugh! Another person!’ They can actually do their job, but there are others helping them in the process.”

Will these improvements be enough to move the stubborn poll number? Shore is optimistic, a belief reflected in a fortune cookie message taped to his office window: It says: “Be not afraid of growing slowly. Be afraid only of standing still.”

Varney is a reporter with NPR member station KQED. [Copyright 2012 KQED Public Broadcasting]

But there are a few more things I thought you might want to know about the new guideline from the U.S. Preventive Services Task Force that says men of all ages should forgo routine blood tests to detect prostate cancer.

Research from Johns Hopkins suggests the chances that doctors will listen aren’t great.

In case you missed it, which I doubt is possible, the influential task force concluded that the harms from PSA testing outweigh the benefits when it comes to routine use. The recommendation left the door open for men and their doctors to talk things over and go ahead with the test if they agreed it would be worthwhile.

Urologists are hopping mad about the guideline. They’re the ones who treat prostate cancer once it’s found. But how do internists, family doctors and others who order the initial screening tests feel?

The Hopkins researchers surveyed some after a draft version of the task force guidelines was released last October. Among the more than 100 providers of primary care who were familiar with the draft guidelines, only 1.8 percent said they would no longer order PSA tests. And just 21.9 percent said they were much less likely to order the tests. The findings were published in the Archives of Internal Medicine.

Why? Nearly three-quarters of the respondents said patients expected regular PSA screening to continue. Two-thirds said, essentially, it would take too much time to explain. And about half cited malpractice concerns.

Other details on their findings about barriers to change in the use of PSA tests were published in Cancer.

The American Cancer Society’s Dr. Otis Brawley, who supports the task force’s recommendation, told NPR reporters Tuesday: “I’m going to predict that people will continue to be unscientific.” [Copyright 2012 National Public Radio]

Afghanistan, Nigeria and Pakistan are the only three countries left where poliovirus remains endemic. But work to put the paralyzing virus on the ropes there is in danger of failing. Cases in all three countries jumped last year.

Weak public health systems, armed conflicts and corruption have hurt vaccination efforts. Now leading public health officials have proposed an emergency plan of action to get things back on track..

“Polio eradication is at a tipping point,” says a report published by the World Health Organization today. “If immunity is not raised in the three remaining countries to levels necessary to stop poliovirus transmission, polio eradication will fail.”

The emergency plan calls for stepped-up vaccination campaigns in areas of all three counties where polio poses the biggest threat.

Another goal: raise more money for eradication. There’s about a $1 billion shortfall in funding for eradication.

Despite setbacks, there’s also been reason for hope. New cases are at an all-time low — 55 cases so far this year.

And in January, India marked a year without a new case of polio. That’s a milestone in the global effort to eliminate polio. It wasn’t that long ago that India reported as many as 100,000 cases a year. [Copyright 2012 National Public Radio]

But some hospitals around the nation are trying to make their patients’ stays a little less unpleasant.

They’re members of an organization called Planetree, which was founded by a patient named Angelica Thieriot, who had a not-so-good hospital experience back in the 1970s.

“She herself became very ill and was hospitalized,” says Planetree President Susan Frampton. “And while she felt she got good clinical quality care, she was really horrified by the human experience that she had. So she founded Planetree with a very lofty goal: to change the health care system to be more patient- and family-centered. And that has been our mission … for the last three and a half decades.”

Today Planetree has certified, or “designated,” 30 hospitals and nursing homes in the U.S. and four countries as meeting a specific list of criteria that qualify them as providing truly patient-centered care.

Among the 14 Planetree hospitals in the U.S. is Fauquier Hospital, a 97-bed facility in Warrenton, Va., on the outskirts of Washington, D.C.

CEO Rodger Baker says there was an element of business to his decision to transform his hospital into a more patient-centered place. “We felt it could differentiate us in a market with giants around us,” he says.

But mostly he wanted to make the change because he was convinced that something was wrong with the way hospitals were treating patients.

“We put patients in rooms with gowns that don’t have backs on them; we strip them of their dignity; we don’t explain things to them. And that’s really not what they want,” he says.

Baker says he first heard of Planetree in the early 1990s. But he had his epiphany while listening to the head of a Planetree hospital in Oregon, Mid-Columbia Medical Center, several years later.

“He talked about all the things they did in that hospital,” Baker remembers. “And for some reason it seemed to click with me in terms of it was the right thing to do … He talked about healing the whole person, dealing with individuals in terms of not just doing the science, but also healing the whole body, in terms of the spirit as well.”

Indeed, Fauquier, which achieved its Planetree designation in 2007, offers a wide array of services not usually found in your average hospital.

Not only is every one of its patient rooms a private one, it has food cooked and delivered to order, some from its own organic garden.

The walls are decorated with local art, which is sold monthly to raise funds for the hospital’s foundation. And the hallways are carpeted, to keep the noise level down.

“We have massage therapy; we do hand massages,” says Lisa Spitzer, the hospital’s concierge. “We bake cookies; every week we have volunteers come in once a week for this wonderful vanilla aromatherapy.”

Spitzer — whose job is essentially to make sure that patients, staff and families have whatever they need, whenever they need it — describes Fauquier as “having a different energy about it” since it adopted the Planetree model.

Doctors and patients seem to agree.

Interventional radiologist Adam Winick admits he was a skeptic at first.

Winick says he was particularly concerned about doing away with set visiting hours, which among other things gave patients’ families open access to the intensive care unit.

“My own little area that I was most worried about was in a code setting when the patient’s heart stops. And having the family members standing there watching I felt would traumatize the patients’ families, because they don’t understand what’s going on,” he says.

But that hasn’t turned out to be a problem after all: The hospital always makes sure a staff member is on hand to explain to the family what’s going on in those situations.

Winick also says that communication has improved between patients and staff, and between doctors and nurses as a result of the changes. Poor communication in the hospital was a key complaint in the poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health.

“It puts everybody in the mindset that I’m doing this for the patient,” he says. “A doctor doesn’t mistreat a nurse out of anger because he’s doing it or she’s doing it — asking a question for the patient’s benefit.”

Patients also seem to appreciate what they see as more personal care.

“It’s friendly, it’s more like home,” says Marianna Traczuk, who’s been in and out of Fauquier several times being treated for ovarian cancer. She says she prefers Fauquier to the hospital where she used to get care in Maryland. “It’s nice to have someone walk in and say, ‘Hi, how are you today?’ instead of walking by and acting as if you’re invisible.”

And how much more does all this pampering cost?

Actually, unlike many hospitals, Fauquier doesn’t charge extra for private rooms or fancy food.

And Planetree President Susan Frampton says that providing the kind of care that involves patients and their families, and that patients actually want, can cut costs. She says that one hospital system that has some hospitals in the Planetree system and some that aren’t compared its orthopedic patients.

“And they found that the length of stay was actually shorter” in the Planetree hospitals, she says. “People healed quicker, they were discharged more quickly, and so the cost of care came down. So [it was] interesting to counter that misbelief that care has to be more expensive if it’s done in a patient-centered context, or in a place that’s more pleasant to be in.”

But health quality experts like Don Berwick, the former head of Medicare, warn that the most important part of places that are designated by Planetree aren’t the fancy extras like alternative therapies or fancy food — it’s the actual involvement of patients and families in their own care.

“The amenities are nice, of course,” he says. “But what really counts in patient-centered care is that the more patients and families and their loved ones participate in their own care, really play an active role in the care itself, the better the care gets. Outcomes get better, costs fall, and satisfaction increases. So this isn’t about the amenities; this is about the core of health care.”

Berwick and other quality experts also warn that being a patient-centered facility doesn’t itself guarantee high-quality care. Patients still have to make sure the medical staff is following proper guidelines for care and getting those good outcomes. But they say that keeping the patient and family highly involved in their care is one important indicator of a good hospital. [Copyright 2012 National Public Radio]

The harms, such as false alarms and unnecessary surgeries that leave some men impotent and incontinent, outweigh the benefits of the PSA test, according to the U.S. Preventive Services Task Force.

So the influential group this week made an official recommendation against a regular PSA.

To be sure, if doctor and patient want to go ahead with a PSA test, that’s OK, as long as there’s been a frank discussion about the pros and cons. “The decision to start or continue screening should be an informed one that reflects an understanding of the possible benefits and harms and should respect an individual man’s preferences,” as a summary for patients puts it in the Annals of Internal Medicine.

Love or hate the recommendations, will they stick?

Probably not.

Previously, for instance, the task force had recommended against PSA testing of men over 75. And, as the case of 81-year-old financier Warren Buffett showed recently, that advice has not been universally heeded.

“I’m going to predict that people will continue to be unscientific,” Dr. Otis Brawley, chief medical officer of the American Cancer Society, told a group of reporters and editors at NPR in Washington Tuesday. And, among other things, that means doctors will “continue to practice faith-based medicine” instead of one rooted in the best evidence, he said.

The latest guideline shouldn’t be such a surprise. The American Cancer Society has been saying since 1997 that the evidence for benefits from PSA screening haven’t been proved.

And even the American Urological Association, which expressed outrage over the task force’s latest advice, has acknowledged in prior advice to doctors:

“Patients need to be informed of the risks and benefits of testing before it is undertaken. The risks of overdetection and overtreatment should be included in this discussion.”

But habits haven’t changed, Brawley said, adding, “Nobody is listening to us.”

Ultimately, Brawley says men and their doctors need a better test than PSA, one that can detect prostate cancers that both can be cured and need to be cured. Many men with slow-growing prostate cancers will die of other causes.

For more on the fallout from the recommendation, see this roundup of a chat on Twitter Wednesday featuring Brawley, Nancy Metcalf from Consumer Reports and urologist Deepak Kapoor. Liz Szabo, health reporter at USA Today, moderated the lively discussion. [Copyright 2012 National Public Radio]

Our NPR-Thomson Reuters Health Poll found that about 60 percent of Americans would support modest compensation in the form of credits toward future health care needs of people who made donations while alive of kidneys, bone marrow and portions of liver.

Bioethicist Dr. Stuart Youngner, from Case Western Reserve’s med school, and I joined Neal Conan on NPR’s Talk of the Nation Tuesday to chat about the findings and hear from people across the country.

The callers helped give voice to the core issue. There’s a persistent shortage of organs in this country, and it’s getting worse. The rate of organ donations has fallen 2 percent since 2005, and the waiting list of recipients has grown 25 percent, Youngner pointed out.

Federal law bans financial incentives for organ donations. But is it time to reconsider?

Andrew from New Orleans told us about his father’s search for kidney after a car accident 10 years:

“And I know we’re desperately searching and on the lists and have had no avail. But I know if we had the chance to actually buy one, you know, and get us off of that waiting period, we would jump all over the – jump all over it to get him the kidney.”

Taber (spelled phonetically by our transcript service) weighed in from Tuscon with his experience as both a donor and recipient. He’s got ligaments in one knee from a cadaver, and he’s given bone marrow. When he gave bone marrow, he was out of work. All his expenses were covered, but he said there can be “hidden expenses,” such as lost earnings or travel costs. So, he said:

“I think I personally would be against any kind of compensation for a deceased donor. But for living donors who actually have expenses and the like, I can definitely see some sort of limited compensation making a big difference.”

By email, Michael in Casper, Wyo., said he’s willing to donate his organs free of charge once he dies, but not before:

“I would not be willing to sell any of my organs. As soon as I’m clinically dead, then they can have what can be of use. But up until that point, I will keep what I have no matter what the monetary compensation might be.”

For more, listen to the show or read the transcipt. [Copyright 2012 National Public Radio]