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…
A quick quiz before we start today’s lesson. What do we call a tree that grows from acorns? What do we call a funny story? What sound does a frog make? What is another word for a cape? What do we call the white part of an egg? On that last question, were you tempted…
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…
David Asch and I recently published an article in Health Affairs on the challenge of getting healthcare practitioners to stop doing things they are accustomed to doing, even when the evidence that those things are harmful becomes overwhelming. Here is a teaser from that article, and a link to the full piece: As hard as…
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…
My home state of North Carolina is one of a number of states that refused to expand Medicaid, even though the Affordable Care Act stipulates that the federal government will cover the majority of expenses associated with such expansion. Here is an excellent story in the Fayetteville Observer laying out the issues: Denise Johnson works…
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 an oft recited paradox that Americans like the men or women representing them in Congress, while hating Congress as a whole. In fact, respect for Congress is near all-time lows. In what has to be seen as a bad sign for the medical profession, people’s attitudes towards physicians are beginning to look downright…