Research
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Health Care in an Evolving Immigration Landscape — Providing Care while Upholding the Law
Many clinicians and healthcare provider organizations are struggling to figure out how to do their jobs with all the recent changes in immigration policies. I co-authored a commentary in the NEJM that provides guidance about how to uphold their duty to patients while staying compliant with emerging laws.
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Integrating Out-of-Pocket Costs Into Shared Decision-Making for Heart Failure With Reduced Ejection Fraction
Led by the amazing Neal Dickert, cardiologist at Emory, we conducted an RCT of an intervention designed to promote cost conversations. Read more here
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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…