Lung cancer screening CT took its most important step toward widespread implementation last week, when the U.S. Preventive Services Task Force (USPSTF) released a draft of its forthcoming recommendation that the 9 million U.S. people meeting entry criteria for the National Lung Screening Trial (age 55-79, with 30+ pack-years smoking history and quit < 15 years) should undergo yearly low-dose lung cancer screening CT. The recommendation earned a Grade B in the USPSTF’s ...

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Physicians who liberally prescribe empiric antibiotics are often maligned as irresponsible or unthinking by condescending colleagues and policy wonks. But are these doctors actually courageous and prudent, saving countless thousands of lives every year by refusing to bend to misguided pressure from antibiotic-conserving paper-pushers? As antibiotic resistance has emerged, many hospitals have begun requiring physicians to provide a rationale for every antibiotic dose prescribed. The Centers for Medicare and Medicaid (CMS) ...

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Full code is the universal default status for patients who haven’t chosen otherwise, but I suspect most physicians believe this policy is wrong. We know in our hearts we’re doing harm when we perform CPR on poor souls at the natural end of their lives, whose bodies can do nothing more than suffer. Appropriately timed end-of-life discussions are the supposed answer, but for doctors they are emotionally draining, interpersonally complex, and ...

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A heretic essay in JAMA by Vinay Prasad (Northwestern of Chicago), Adam Cifu (U. of Chicago) and John Ioannidis (Stanford) should be required reading for every medical student, resident, and to pass any board certification exam in any specialty ... in my humble opinion. John Ioannidis became one of my personal heroes with the publication of his great paper in PLoS Medicine, "Why Most Published Research Findings Are False," and ...

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I’m sure Ezekiel Emanuel hates being referred to as Rahm Emanuel’s brother, so I won’t describe him as such. After working as one of Obama’s main health care advisors, he’s now at U-Penn in a job spanning medicine, economics, and ethics. He’s also been writing engaging essays in JAMA about health care reform and economic change, that give us an augur into where health care reform might lead us. Here, ...

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