More Coverage of Our Research on Out-Of-Pocket Cost Conversations

Here is a nice summary of our research, published by an excellent reporter at The American Journal of Managed Care: A new qualitative study of clinical meetings between physicians and patients pointed out certain behavioral concerns that stand in the way of helping patients navigate out-of-pocket spending. The study, published in Health Affairs and led…

Physicians Can't Stop Overtreating Diabetes And Hypertension

Aggressive control of blood pressure has saved millions of lives, and has prevented millions of people from experiencing heart attacks, strokes and kidney failure, among other things. Admittedly, controlling blood pressure is not the sexy part of medical care, but when primary care doctors like me help people get their blood pressure under control, we…

Is It Rational for Breast Cancer Patients to Have Bilateral Mastectomies?

Warning: I am not writing about Angelina Jolie. I am not asking whether women like Jolie, with a strong family histories of breast cancer and known genetic mutations, should consider having bilateral mastectomies. Women like Jolie face extremely high lifetime risks of breast cancer, and thus must make difficult decisions about whether to receive prophylactic…

Reducing Healthcare Waste: Don’t Expect Patients To Take The Lead

Lena Wright’s best friend was hunched over like a character from a French novel, with spinal bones so thin they would fracture with a fit of sneezing. Determined to avoid that fate, Wright (a pseudonym) asked her primary care doctor to test her for osteoporosis with a DEXA scan, also known as Dual Energy X-ray…

The Wrong Way To React When Terminally Ill Patients Cry

Just three weeks earlier, she had noticed something strange about one of her breasts. An irregular shape. Her daughter brought her to the doctor, and soon the patient, I’ll call her Amanda, was diagnosed with breast cancer, stage “to be determined.” In fact, she was now in an oncologist’s office, learning what tests she would…

How to Make People Think Robots and Corpses Have Feelings

The right to die has played a critical role in the development of the doctor/patient relationship. It was families clamoring for the right to allow their loved ones to die who forced the world to recognize that physicians’ medical decisions aren’t just medical decisions, but involve enormous value judgments. In 1975, Karen Ann Quinlan’s loving…

Talking To Your Doctor About Out-Of-Pocket Costs Can Save You Money

Healthcare is often really costly. And with increasing frequency, a significant chunk of those costs is being passed on to patients in the form of high deductibles, copays, or other out-of-pocket expenses. As a result, millions of Americans struggle to pay medical bills each year. What’s a poor patient to do? For starters–they can talk…