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…
I’m not sure why I didn’t notice this earlier, but I just came across a very gracious, even overly generous, review of my book, Critical Decisions in the leading journal of bioethics, The Hastings Center Report. I thought I would share it with you: When I finally got eyeglasses as a teenager, after denying the…
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…
For decades now, policymakers have been trying to slow down the growth of healthcare costs. For much of this time, a large part of that effort was directed at hospital spending. American hospitals are extremely expensive, and take care of patients with the most severe illnesses. So if we’re going to control costs, it seems…
An article in the New England Journal of Medicine in June (no one accused me of being a timely blogger!) shows that academic medical centers often provide poorly-reimbursed services that other healthcare institutions avoid. Where more general hospitals might avoid having psychiatric emergencies available, 90% of academic medical centers offer such services: Whereas only 4%…
Such a no-brainer: If patients who receive care at Hospital A are more likely to get readmitted to the hospital 10, 20 or 30 days after discharge than patients in Hospital B, then Hospital A must be doing something wrong. Perhaps clinicians at that hospital are less adept at diagnosing and managing patients’ problems. Perhaps…
Biologic drugs are a big deal for the pharmaceutical industry right now. Blockbuster chemicals for common conditions like diabetes and hypertension are largely things of the past. We’re getting pretty good at controlling those conditions, and few people expect a slew of major scientific breakthroughs that will lead to many more multibillion dollar treatments for…
High costs make it hard for many patients to afford their medications. That’s why some medical experts believe we should give important medications to patients for free, to see if that improves their health outcomes. One famous example of this approach is the MI FREEE Trial, which offered free cardiovascular medication to patients who would…