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Could Pay-For-Performance Lead To Overuse Of Antibiotics?

Not long ago, the Joint Commission (a healthcare quality organization) established that patients with pneumonia should receive antibiotics within four hours of diagnosis. Timely diagnosis and treatment can be the difference between life and death in patients with this illness. In fact, some people believe this kind of quality measure should play a large role…

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Are Doctors Ready to Talk about Health Care Costs with Patients?

While I was on vacation, I spoke with reporter about a topic near and dear to my heart – importance of getting clinicians to talk about health care costs with their patients. The reporter put together a very nice piece on the topic, which I thought I would share with you: Doctors Aren’t Grasping For…

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How To Tell Someone That She Is Dying

Elizabeth’s breast cancer had already spread to her bones and was now invading lymph nodes in her right armpit, causing painful swelling that kept her up at night. Today, however, as she walked into her oncologist’s office, Elizabeth felt like things were under control. “All right, so how is your arm?” the oncologist asked. “Actually,…

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If Costs Are Unknown, Can Doctors Still Talk About Them?

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…

Unnecessary Mastectomies Following Breast Cancer Diagnoses?

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…

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Orthopedic Surgeons Get "F" Grade On Knowing Cost Of The Devices They Implant

A new study asks Orthopedic surgeons to guess the price of the devices they implant – “the amount your institution currently pays the vendor for the implant.” Despite a lenient grading system, in which the researchers counted as correct any guess within 20% of the actual price, surgeons estimated costs correctly only 1 in 5…

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A Simple Nudge That Will Improve Medical Care for People with Diabetes

When patients with diabetes come to the doctor’s office, it is important for their clinicians to take a look at their feet. Many, if not most, foot amputations among people with diabetes would be prevented with this simple exam, an exam that will identify problems early enough to prevent them from progressing. But us busy…