Research
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Physician Gender and Patient Perceptions of Interpersonal and Technical Skills in Online Reviews
Do patients’ on-line physician reviews reveal gender bias? In a study led by the marvelous Dr. Farrah Madanay, we looked at that question, and found some disturbing results. Female physicians tend to be judged more on their ‘personality’ than male physicians.
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Out of Pocket Getting Out of Hand
In this NEJM Perspective, my (awesome) co-authors and I argue that we need to reduce costs, to patients and society, for drugs that receive ‘accelerated approval’ by the FDA. Drugs, in other words, that still haven’t proven to meaningfully benefit patients.
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Are Students Ready to Run Student-Run Clinics?
With an outstanding student from Baylor College of Medicine, I co-authored an essay on some of the clinical, administrative, and ethical problems raised by student-run clinics. We suggest ways to improve things going forward. Check it out here
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Talking About Suffering in the Intensive Care Unit
We were worried: that when ICU clinicians discuss patient “suffering” with patients’ family, they are using the emotionally powerful word as a way of persuading them to withhold or withdraw life support. Was our worry justified? In this study, led by Brent Kious, we analyze how clinicians and family members used the word when meeting…
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What Do Psychiatrists Think About Caring for Patients Who Have Extremely Treatment-Refractory Illness?
Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient…
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Shared Decision-Making Communication and Prognostic Misunderstanding in the ICU
Surrogates often make decisions on behalf of critically ill patients.1 Surrogate comprehension of patient survival prognosis can affect these decisions: surrogate prognostic estimates of survival that are overly optimistic compared with clinician estimates are associated with increased use of life-sustaining treatments and reduced quality of life for dying patients.2,3 … Different prognostic estimates by surrogates…
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Private Equity Acquisition of Physician Practices—Looking for Ethical Guidance From Professional Societies
In 2012, private equity firms purchased approximately 75 physician-owned practices; by 2021, that number had risen to almost 500. However, private equity acquisitions can also lead to ethically troubling consequences. For example, to maximize the return on their investments, private equity firms sometimes pressure clinicians to see more patients, perform more procedures on those patients,…
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Classification of Patients’ Judgments of Their Physicians in Web-Based Written Reviews Using Natural Language Processing
Patients increasingly rely on web-based physician reviews to choose a physician and share their experiences. However, the unstructured text of these written reviews presents a challenge for researchers seeking to make inferences about patients’ judgments. This study aims to train, test, and validate an advanced natural language processing algorithm for classifying the presence and valence of…
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Helping Patients Decide: Ten Steps to Better Risk Communication
With increasing frequency, patients are being asked to make complex decisions about cancer screening, prevention, and treatment. These decisions are fraught with emotion and cognitive difficulty simultaneously. In this commentary, we highlight 10 methods that have been empirically shown to improve patients’ understanding of risk and benefit information and/or their decision making. The methods range from…
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Professional Experiences and Career Trajectories of Mid- to Senior-Career Women Clinician-Scientists
How have women mid- to senior-career clinician-scientists experienced gender throughout their careers? In this qualitative interview study among 31 women clinician-scientists, participants experienced the institution of academic medicine as a male-centric system misaligned with the needs of women and people with family caregiving responsibilities. They felt that women’s needs were underrecognized and unaccommodated even in…