Regular readers of my blog know that I believe that the harms of prostate-specific antigen (PSA) screening for prostate cancer outweigh the benefits — if benefits exist at all. That isn't to say that I will not order the test in a man who understands the risks and expresses a clear preference to be screened. In a recent editorial in American Family Physician, I explained ...

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I recently attended a conference in Savannah, Georgia sponsored by the Association for Prevention Teaching and Research. Since I haven't spent much time in Georgia outside of Savannah and Atlanta, the welcoming plenary on improving health outcomes for the state's rural and underserved populations was eye-opening. According to Dr. Keisha Callins, Chair of the Department of Community Medicine at Mercer University, Georgia ranked 39th out of 50 states in primary care physician ...

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Dr. Tom Price may become the first medical doctor to lead the U.S. Department of Health and Human Services in 24 years. One might think that having completed medical school and practiced orthopedic surgery before entering politics might give him some extra insight into what works and what doesn't in medicine. But judging by a letter to then-HHS Secretary Kathleen Sebelius that he signed in 2011 objecting to the ...

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It's been a rough past couple of months not only for millions of Americans whose health care futures depend on decisions to be made by the new Congress and the Trump administration but for those of us who teach about the U.S. health system for a living. As one health policy expert I follow tweeted only half-facetiously, on election night: "Dear students: all that stuff I taught you about the ...

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On the election day that made Donald Trump the next president of the United States, I traveled to Lancaster, Pennsylvania to give a lecture. Long a conservative political stronghold, Lancaster County was dotted with "Make America Great Again" campaign signs, forecasting Trump's comfortable 47,000 vote margin there, which ended up being more than two-thirds of his 68,000 victory margin in Pennsylvania, one of the states that effectively decided ...

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It sounded too good to be true when I first heard about Theranos, a company that promised to revolutionize medical testing by making it possible to perform dozens of tests on a single drop of blood, rather than the several tubes that would typically be required. And that wasn't all. Theranos CEO Elizabeth Holmes, a Stanford dropout and media magnet whose wardrobe seems to consist solely of all-black outfits, promised ...

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I recognized a glitch in my electronic medical record's decision support software when it prompted me to consider prostate and colorectal cancer screening in a 93-year-old man, who, though remarkably vigorous for his age, was unlikely to live for the additional 10 years needed to benefit from either test. Although deciding not to screen this patient was easy, determining when to stop cancer screening in older patients is often more ...

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Over the past few months, the federal government has mobilized against what is being called "the opioid crisis": a national epidemic of fatal overdoses that in 2014 claimed more than 14,000 lives, the most ever recorded. Since most of these opioids were originally prescribed by physicians to treat pain, the Centers for Disease Control and Prevention recently finalized a guideline containing recommendations for appropriate opioid ...

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One of the most notable things so many of last year’s biggest health stories have in common is that they envision an increased role for shared decision-making in primary care. Some patients will want to receive few aggressive interventions at the end of life; others will want more. Some women will be fine with waiting until age 45 or 50 to get their first mammogram; others will still want to start at ...

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The American Medical Association (AMA) recently called for a ban on direct-to-consumer (DTC) advertising of prescription drugs and medical devices, arguing that this type of advertising drives the nation's escalating drug bill by creating demand for new, expensive medications that are often no more effective than older ones. Since the first televised prescription drug ad aired in the U.S. in 1983, pharmaceutical companies have spent billions ...

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