In residency, we had a term for ER docs who always seemed to find an excuse to admit patients to the hospital. We called them sieves.
Recent evidence suggests that sieves in the ER drive up costs, workloads, and hospital utilization; but they do not save lives.
Put simply, shared decision making is the gold standard — the sine qua non* — for how medical decisions ought to be made. The pipe medical choice is rarely a function of medical facts alone. Tough decisions require value judgments, and it is the patient’s valuesthat often determine which choice is best. An operation cannot…
Not long ago, I spoke with a freelance journalist, Charlotte Huff, who put together a really nice article in Cancer Today, describing how cancer patients can get more engaged in their care. I thought I would share a bit of that piece with you today: Gloria Full wasn’t surprised that the recommended chemotherapy regimen was aggressive….
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…
If an antibiotic would cure your infection, your doctor would probably still warn you about the chance of sun sensitivity before prescribing the pill. But even when the costs of a medical intervention might force patients to choose between paying the bill or keeping up with their mortgages, American physicians rarely discuss that serious side effect with…
Yes, I’ve ranted about healthcare prices before. On more than one occasion. But I have a new rant for you. It’s not about the high price of new drugs It’s not about a couple pharmo-bro CEOs hiking prices of generic medications by 4 or 5,000% It’s about brand name drugs already on the market, that,…
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%…