There were several news stories recently that reported that Pfizer had abandoned its efforts to have its Lipitor brand of atorvastatin made available over the counter (OTC), without a prescription. I was never a big fan of OTC statins, but I was struck by the reason that Pfizer put out:

The study did not meet its primary objectives of demonstrating patient compliance with the direction to check their low-density lipoprotein cholesterol ...

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shutterstock_228580378 I have written previously about some “aha moments” that I have had as a clinician, when something that I knew was coming seemed to arrive with a thud in my own practice. I had another one of those moments a couple of weeks ago. I was finishing up with a new patient, and had explained to him and his wife my assessment ...

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shutterstock_195635468 I was driving to work the other day, and there was a story on the radio about the Congressional reaction to the latest recommendations for breast cancer screening from the United States Preventive Services Task Force (USPSTF). Here’s the background. USPSTF published recommendations in late 2009 for the use of screening mammography in different age groups. For women between 40 and ...

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I had two experiences recently that reminded me that many doctors and nurses remain resistant to measuring and improving how patients experience the care we provide. One was a face-to-face discussion with a senior physician. The other was reading an article by a nurse. Both the doctor and the nurse denounced the growing focus on the patient experience by citing the threat to the quality of care, and I believe ...

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It has been known for a long time that “health care” -- all the stuff that we do, prescribe and provide -- is a minor determinant of how “healthy” any of us is. Overall health, or more technically, the variability in health outcomes, is much more dependent on the combination of genetics, personal behavior (think smoking and seat belts), environmental factors and socioeconomic status than it is on health care. I ...

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A recent piece in the New York Times profiled a young man with a remarkable medical history, and an equally remarkable approach to sharing it. I think it raises some profound issues regarding the self-monitoring movement and the “ownership” of patients’ health information, both of which have the potential to change our traditional practices in a big way. The guy -- Steven Keating -- is not your average Joe. He is a ...

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A few years ago, the United States Navy launched a new recruiting and marketing campaign using the slogan: “America’s Navy: A global force for good.” The line was apparently a flop, and the Navy threw it overboard for “protecting America the world over,” but I liked it. I thought it captured a deep truth about the Navy, which is that it is undoubtedly a global force and that the force exists for ...

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There are plenty of good reasons why thoughtful physicians are often unhappy with the current approach to measuring the quality of care they provide. Some, of course, object to the whole notion of quality measurement, but I believe they are in a shrinking minority clinging to an anachronistic mental model in which each physician defines for himself what constitutes high quality care. I have addressed this previously. But even those, ...

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I was listening to the news on my way to work recently, and heard a story about the review conducted after the well-publicized security breach at the White House. Like many people, I was shocked when the story of the fence-jumper first broke. How was it possible that some guy with a knife managed to get over the fence, cross the lawn, enter the White House and get deep into the ...

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In my administrative role, I have the great pleasure of signing thank you letters to patients and family members who have acknowledged the great care they have received by one of our physicians or other caregivers. It is a nice way to tell the patient “we got your note” and to simultaneously recognize the provider by copying her or him. The best part is that I get to read the ...

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