Would This Picture Help You Shop for a Doctor?
Attention all you design and #nudge fans. Here is a graphic from ProPublica that attempts to help people choose a physician. Do you think it works? What would you do to improve it?
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Has Mammography Created an Epidemic of Pseudo-Survivorship?
Karen Vogt’s breast cancer journey began like many others, with her breasts painfully squeezed into a mammography machine. At age 52, it was far from her first mammogram, but this scan would be the most consequential by far. It revealed microcalcifications, little areas of breast tissue speckled with deposits of calcium that her radiologist worried…
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Your New Liver Is Only a Learjet Away: Part 3 of 3
As I have described in two earlier posts, here and here, the transplant system in the US suffers from terrible geographic disparities. People needing liver transplants in Northern California wait more than six years on average for an organ to become available, versus only three months in places like Memphis Tennessee. The solution to the…
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Your New Liver Is Only a Learjet Away: Part 1 of 3
The forty million dollar Gulfstream jet landed at Memphis International airport in the early morning hours, its schedule hastily arranged earlier that day from Northern California, where the flight originated. Waiting on the tarmac was Dr. James Eason, head of transplant surgery at Methodist University Hospital, who planned on whisking the passenger to the operating…
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An Eye for an Eye, a Cataract for…$4000?!
California is in the middle of an historic drought, with the government setting limits on how long people can sing in the shower. Farmers in the state may soon need to cut back on planting or production, as ground water dries up. But California is still fruitful ground for testing promising ways to improve how…
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The Question Isn't Whether We Are Overdiagnosing Cancer, But How Much
Medical experts now agree that as a result of aggressive screening programs, we have an epidemic of cancer overdiagnosis in the United States. With mammograms finding tiny cancers and PSA tests discovering unpalpable prostate cancers, we are now unearthing some cancers too early for our own good. What do experts mean by “overdiagnosis,” you ask?…
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If You Look for Cancer, You'll Find It
What would you like first: the good news or the bad news? Let me start with the bad. Life expectancy among patients in the U.S. with thyroid cancer lags behind that in Korea. In fact, the vast majority of patients diagnosed with thyroid cancer in Korea are cured of that illness, a statement I can’t…
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Millions To Be Made On…Generic Drugs?
It is well accepted among health economics wonks that the lion’s share of pharmaceutical company profits come when these companies hold exclusive rights to their products. Once their blockbuster pills go “generic,” competitors enter the marketplace and profits plummet. Consider captopril, a groundbreaking heart failure medication introduced in the early 80s by Bristol-Myers Squibb under…
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The Hidden Psychology of Antibiotic Prescribing
Experts in decision psychology and behavioral economics have conclusively shown that humans, those silly creatures, are not always rational decision makers. They let unconscious forces influence their thinking, and not always for the better. But of course, doctors aren’t human. Right? Well, here is some evidence of just how human we doctors are. The odds…
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The High Price of Affordable Medicine
In the old days, blockbuster drugs were moderately expensive pills taken by hundreds of thousands of patients. Think blood pressure, cholesterol and diabetes pills. But today, many blockbusters are designed to target much less common diseases, illnesses like multiple sclerosis and rheumatoid arthritis or even specific subcategories of cancer. These medications have become blockbusters not…