Will we – you and me and our parents and neighbors – be a significant force in quelling the tide of over-testing for the early detection of disease? When you have had cancer as many times as I have, you become suspicious that there are more cancer cells inside you waiting for some obscure signal to make them leap into action and start multiplying out of control.  So you develop a ...

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The outsourcing of work by businesses to the cheapest available workers has received a lot of attention in recent years.  It has largely escaped notice, however, that the new labor force isn’t necessarily located in Southeast Asia, but is often found here at home and is virtually free.  It is us, using our laptops and smart phones to perform more and more functions once carried out by knowledgeable salespeople and ...

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Members of the  American public are frequently surveyed about their trust in various professionals.  Doctors and nurses usually wind up near the top of the list, especially when compared to lawyers, hairdressers and politicians.  Trust in professionals is important to us: they possess expertise we lack but need, to solve problems ranging from the serious (illness) to the relatively trivial (appearance). How much professionals trust us seems irrelevant: our ...

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"The most important thing I learned was that different doctors know different things: I need to ask my internist different questions than I do my oncologist." This was not some sweet ingénue recounting the early lessons she learned from a recent encounter with health care.  Nope.  It was a 62-year-old woman whose husband has been struggling with multiple myeloma for ...

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In the recent Coen brothers' remake of the 1969 movie True Grit, Mattie Ross, an intrepid 14-year-old, is determined to hunt down and kill the man who murdered her father. To accomplish this, she hires U.S. Marshal Rooster Cogburn, (played by a mumbling Jeff Bridges) a rough, one-eyed veteran of many such quests - then announces that she plans to come along.  She figures she is prepared. After all, she and her ...

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As far as my chemo nurse Olga (not her real name)  is concerned, I can do nothing right. She scolded me for sending an e-mail when she thought I should have called and vice versa.  She scolded me for going home before my next appointment was scheduled.  She scolded me for asking to speak to her personally instead of whichever nurse was available.  She scolded me for calling my oncologist directly. ...

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"How to Haggle With Your Doctor" was the title of a recent Business section column in the New York Times.  This is one of many similar directives to the public in magazines, TV and Websites urging us to lower the high price of our health care by going  mano a mano with our physicians about the price of tests they recommend and the drugs they prescribe.  Such articles provide simple, ...

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