She didn’t talk like a stroke victim. “I…I…I…k…kkk…can…can…can’t…t…t…t…talk.” She struggled with her words, struggling on early syllables, only to then spurt out full and correct words. “N…N…N…No.” Recognizing this unusual speech pattern, the neurologist Allan Ropper, author of Reaching Down the Rabbit Hole, expertly queried the patient and her loved ones, and determined she had…
I joined two other, much smarter, colleagues in calling for the use of behavioral economics and decision psychology to improve the design of the websites people use to purchase health insurance in the U.S. That article came out today in the New England Journal of Medicine. Here is a taste: In October 2013, the Affordable…
In a recent Health Affairs article, David Asch and I wrote about how hard it can be to stop screening aggressively for things like breast and prostate cancer even when the evidence suggests we are doing more harm than good. Well, journalist Steven Petrow has a nice piece in the Washington Post looking at the…
The Atlantic recently reproduced a figure showing just how much people like things when they are free. Specifically, they looked at health interventions and show that people are more likely to take up these interventions, or products, when they don’t cost anything. And certainly, free is better than expensive, but free is also a whole…
Mammograms have long been touted as a life-saving preventive test. But recently, people have been re-examining the relative harms and benefits of mammography. This re-examination became quite earnest when the United States Preventive Services Task Force recommended against beginning routine mammography before age 50. Even at later ages, experts are beginning to more thoroughly recognize…
It is well known that Medicare expenditures threaten the financial solvency of the U.S. government. And it is pretty well agreed upon that some of our Medicare spending goes towards wasteful medical care. But which medical care is wasteful and how much is such care costing us? A study in JAMA Internal Medicine provides a…
Here is the opening of a recent media story, reporting on a noble attempt researchers made to promote colon cancer screening by telling people when their genetic risk of such cancer was elevated: People at average-risk for colorectal cancer (CRC) who underwent genetic and environmental risk assessment (GERA) to evaluate their risk for CRC were…
I have been writing a bit lately on the need for healthcare providers to talk with their patients about healthcare costs, if for no other reason than to enable patients to determine whether they can afford to pay for the healthcare that their doctors are recommending them to receive. I have been criticized for this position, on…
I spoke the other day to Melissa Dahl, a writer for New York Magazine. She wrote a really nice piece on what medical professionals call “contralateral prophylactic mastectomy” – when a woman with breast cancer chooses not only to remove the affected breast, but also the unaffected breast in order to reduce the chance of…
A very disturbing new study was just published, in which physicians viewed a video of a patient with back pain asking for OxyContin. Twenty percent of docs said they would prescribe that med under that circumstance: …Too often, doctors prescribe potentially dangerous medications to patients who shouldn’t be getting them, and what they prescribe is…