Gorillacillin and the Tragedy of the Commons
Was I right to prescribe an inferior medication to my patient?
(Read the rest and view comments at Critical Decisions)
Was I right to prescribe an inferior medication to my patient?
(Read the rest and view comments at Critical Decisions)

Carol Jefferson’s right lung x-ray looked the color of a February storm in Northern Minnesota—a blizzard of white making bone and lung invisible. Her lung was “whited out” because she was experiencing a dangerous combination of tumor and infection.
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A bunch of media outlets are beginning to report on a new study of mine (conducted with a couple of great colleagues) in which we found that docs choose different treatments for themselves than they recommend to their patients. Kinda scary stuff. This Marketplace report is worth listening to. Check out the ‘News and Press’ page for links to some of the other reports.
Elizabeth’s breast cancer had already spread to her bones and was now invading lymph nodes in her right armpit, causing painful swelling that kept her up at night. Today, however, as she walked into her oncologist’s office, Elizabeth felt like things were under control. “All right, so how is your arm?” the oncologist asked. “Actually,…
Facing advanced cancer, who among us wouldn’t look to our oncologist for expert advice on whether another round of chemotherapy makes sense? But do you know what your oncologist cares about, and can you be sure her recommendations map onto your own treatment preferences? … (Read the rest and view comments at Critical Decisions)
In my most recent post, I describe several psychologic and economic phenomena impeding our ability to rein in the cost of end-of-life care. In brief, people with nothing to lose, who don’t trust doctors recommending they receive hospice care, and who face few economic consequences for receiving expensive care – they aren’t likely to put the…
When it comes to healthcare spending, the U.S. is without peer. Consider the 20 countries making up the Organization for Economic Cooperation and Development (called the OECD by the cool kids). The organization includes countries like Australia, Austria, Belgium, Canada, Chile, and the Czech Republic. Oh also Finland, France, Germany…you get the idea. It also…