For decades, the pharmaceutical industry has been highly profitable. The recipe for such profits has been pretty simple for most of the last half-century–discover a chemical or molecule that treats a common problem, like hypertension or diabetes or erectile dysfunction, and make billions of dollars while that product is still under patent protection. But of…
We have a vaccine crisis in the this country. Not just the one caused by anti-vaxxers like Jenny McCarthy, scaring Americans away from life-saving childhood vaccines with pseudo-scientific claims about autism. Instead I’m talking about a bigger crisis, one caused by a dangerously thin supply of vaccines. Wise parents who ignore the blatherings of people…
My father is 92 years old, and I am beginning to wonder whether the best thing for his health would be to stay away from doctors. That’s because well intentioned physicians often expose their elderly patients to harmful and unnecessary services out of habit. That’s certainly the message I absorbed after reading a recent issue…
It is notoriously difficult to change physician behavior. When it’s discovered that primary care physicians are, say, prescribing too few cholesterol pills or too many antibiotics, it will not be easy to change those behaviors. Physicians are strong-willed people, with lots of things competing for their attention and with many well ingrained habits. That’s why…
My student and colleague, Karen Scherr, recently published an excellent article showing that physicians don’t always describe robotic surgery in an unbiased manner. Here is a nice write up of that work: Author Peter Ubel referred to a study done at four Veterans Affairs medical centers of men making decisions on how best to treat…
For my entire life, a half century and counting, healthcare spending in the U.S. has almost always risen faster than inflation. Sometimes it’s relatively slow, sometimes it’s relatively fast, but no matter the time, healthcare spending is climbing. Getting healthcare spending under control is really important for us to do if we hope to have…
I know, I know: correlation does not mean causation. But it is still suspicious that when industry employees join as co-authors in medical journals, the randomized trials they are writing about are more likely to show positive results – results that make industry products look good. At least that was the finding from a study…
Here is a great graphic from the Center for Science in the Public Interest laying out how supermarkets lay out food to encourage impulse purchases: So much for “free” markets!
For much of the history of U.S. medical care, hospitals and physicians have existed as separate financial entities. Physicians in the U.S. have typically been self-employed, as solo or group practitioners and not as hospital employees. An internist like me might have admitting privileges to several local hospitals. When we admit patients to one of…
One reason our healthcare system in the United States is so messed up is that so few Americans understand much about it. For that reason, their attitudes towards various healthcare reform proposals veer left and right depending on how they are asked for their opinions. Here’s great evidence of that phenomenon, as reported by the…