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)
Healthcare markets are complex and confusing places. But one fact is simple and straightforward: all else equal, hospitals and emergency departments are a lot more expensive than outpatient clinics. Which makes it all the more bewildering that so many low income patients prefer hospitals over primary care clinics. Bewildering until now. Shreya Kangovi and colleagues…
In residency, we had a term for ER docs who always seemed to find an excuse to admit patients to the hospital. We called them sieves. Recent evidence suggests that sieves in the ER drive up costs, workloads, and hospital utilization; but they do not save lives.
The American Urological Association (the AUA) is outraged that the Unites State Preventative Services Task Force doesn’t support, has even “disparaged,” PSA screening. Dr. John Lynch, a member of its Board of Directors, even appealed to prostate cancer survivors to lobby against the Task Force’s recommendation, painting a dire picture of life without this controversial screening test:
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A cranky customer snaps at his barista, lodging an unjustifiable complaint about the service, the temperature of the drink…about anything and everything. He came into the store angry (and in pain from a chronic illness) and he needed something–or someone!–to take it out on. He is met by a well-trained smile, the barista doling out…
The urologist broke the news: “Out of 12 cores, three were positive for cancer, so you have a small amount of cancer.” He would soon explain the treatment choices—surgery, radiation, or active surveillance (watching the cancer closely with blood tests and biopsies). He described each option in elaborate detail, because he knew that the “right…
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Brian Zikmund-Fisher took the lead on a study published this week in which we found evidence that when people face tough decisions, it helps for them to break the decision into smaller pieces, and take it one step at a time. Here is a link to some media coverage in India.